Search results for: complementing nursing support
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7372

Search results for: complementing nursing support

5902 Wettability of Superhydrophobic Polymer Layers Filled with Hydrophobized Silica on Glass

Authors: Diana Rymuszka, Konrad Terpiłowski, Lucyna Hołysz, Elena Goncharuk, Iryna Sulym

Abstract:

Superhydrophobic surfaces exhibit extremely high water repellency. The commonly accepted basic criterion for such surfaces is a water contact angle larger than 150°, low contact angle hysteresis and low sliding angle. These surfaces are of special interest, because properties such as anti-sticking, anti-contamination and self-cleaning are expected. These properties are attractive for many applications such as anti-sticking of snow for antennas and windows, anti-biofouling paints for boats, waterproof clothing, self-cleaning windshields for automobiles, dust-free coatings or metal refining. The various methods for the preparation of superhydrophobic surfaces since last two decades have been reported, such as phase separation, electrochemical deposition, template method, plasma method, chemical vapor deposition, wet chemical reaction, sol-gel processing, lithography and so on. The aim of the study was to investigate the influence of modified colloidal silica, used as a filler, on the hydrophobicity of the polymer film deposited on the glass support activated with plasma. On prepared surfaces water advancing (ӨA) and receding (ӨR) contact angles were measured and then their total apparent surface free energy was determined using the contact angle hysteresis approach (CAH). The structures of deposited films were observed with the help of an optical microscope. Topographies of selected films were also determined using an optical profilometer. It was found that plasma treatment influence glass surface wetting and energetic properties that is observed in higher adhesion between polymer/filler film and glass support. Using the colloidal silica particles as a filler for the polymer thin film deposited on the glass support, it is possible to produce strongly adhering layers of superhydrophobic properties. The best superhydrophobic properties were obtained for surfaces of the film glass/polimer + modified silica covered in 89 and 100%. The advancing contact angle measured on these surfaces amounts above 150° that leads to under 2 mJ/m2 value of the apparent surface free energy. Such films may have many practical applications, among others, as dust-free coatings or anticorrosion protection.

Keywords: contact angle, plasma, superhydrophobic, surface free energy

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5901 Selective Synthesis of Pyrrolic Nitrogen-Doped Carbon Nanotubes Its Physicochemical Properties and Application as Pd Nanoparticles Support

Authors: L. M. Ombaka, R. S. Oosthuizen, P. G. Ndungu, V. O. Nyamori

Abstract:

Understanding the role of nitrogen species on the catalytic properties of nitrogen-doped carbon nanotubes (N-CNTs) as catalysts supports is critical as nitrogen species influence the support’s properties. To evaluate the influence of pyrrolic nitrogen on the physicochemical properties and catalytic activity of N-CNTs supported Pd (Pd/N-CNTs); N-CNTs containing varying pyrrolic contents were synthesized. The catalysts were characterised by the use of transmission electron microscope (TEM), scanning electron microscope, X-ray photoelectron spectroscopy (XPS), X-ray diffraction, Fourier transform infrared spectroscopy, and temperature programmed reduction. TEM analysis showed that the Pd nanoparticles were mainly located along the defect sites on N-CNTs. XPS analysis revealed that the abundance of Pd0 decreased while that of Pd2+ increased as the quantity of pyrrolic nitrogen increased. The increase of Pd2+ species was accredited to the formation of stable Pd-N coordination complexes which prevented further reduction of Pd2+ to Pd0 during synthesis. The formed Pd-N complexes increased the stability and dispersion of Pd2+ nanoparticles. The selective hydrogenation of nitrobenzophenone to aminobenzophenone over Pd/N-CNTs was compared to that of Pd on carbon nanotubes (Pd/CNTs). Pd/N-CNTs showed a higher catalytic activity and selectivity compared with Pd/CNTs. Pyrrolic nitrogen functional groups significantly promoted the selectivity towards aminobenzophenone formation.

Keywords: pyrrolic N-CNTs, hydrogenation reactions, chemical vapour deposition technique

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5900 Optimization of Catalyst Parameters to Get Chlorine Free Bimetallic Catalysts

Authors: Noreen Sajjad Ghulam Hussain

Abstract:

Catalysts are prepared by simple physical mixing and thermal treatment of support and metal acetate precursors.The effect of metal ratio and metal loading to produce highly active catalyst for the oxidation of benzyl alcohol are studied.

Keywords: catalyst, acetates, benzyl alcohols

Procedia PDF Downloads 416
5899 Developing Pan-University Collaborative Initiatives in Support of Diversity and Inclusive Campuses

Authors: David Philpott, Karen Kennedy

Abstract:

In recognition of an increasingly diverse student population, a Teaching and Learning Framework was developed at Memorial University of Newfoundland. This framework emphasizes work that is engaging, supportive, inclusive, responsive, committed to discovery, and is outcomes-oriented for both educators and learners. The goal of the Teaching and Learning framework was to develop a number of initiatives that builds on existing knowledge, proven programs, and existing supports in order to respond to the specific needs of identified groups of diverse learners: 1) academically vulnerable first year students; 2) students with individual learning needs associated with disorders and/or mental health issues; 3) international students and those from non-western cultures. This session provides an overview of this process. The strategies employed to develop these initiatives were drawn primarily from research on student success and retention (literature review), information on pre-existing programs (environmental scan), an analysis of in-house data on students at our institution; consultations with key informants at all of Memorial’s campuses. The first initiative that emerged from this research was a pilot project proposal for a first-year success program in support of the first-year experience of academically vulnerable students. This program offers a university experience that is enhanced by smaller classes, supplemental instruction, learning communities, and advising sessions. The second initiative that arose under the mandate of the Teaching and Learning Framework was a collaborative effort between two institutions (Memorial University and the College of the North Atlantic). Both institutions participated in a shared conversation to examine programs and services that support an accessible and inclusive environment for students with disorders and/or mental health issues. A report was prepared based on these conversations and an extensive review of research and programs across the country. Efforts are now being made to explore possible initiatives that address culturally diverse and non-traditional learners. While an expanding literature has emerged on diversity in higher education, the process of developing institutional initiatives is usually excluded from such discussions, while the focus remains on effective practice. The proposals that were developed constitute a co-ordination and strengthening of existing services and programs; a weaving of supports to engage a diverse body of students in a sense of community. This presentation will act as a guide through the process of developing projects addressing learner diversity and engage attendees in a discussion of institutional practices that have been implemented in support of overcoming challenges, as well as provide feedback on institutional and student outcomes. The focus of this session will be on effective practice, and will be of particular interest to university administrators, educational developers, and educators wishing to implement similar initiatives on their campuses; possible adaptations for practice will be addressed. A presentation of findings from this research will be followed by an open discussion where the sharing of research, initiatives, and best practices for the enhancement of teaching and learning is welcomed. There is much insight and understanding to be gained through the sharing of ideas and collaborative practice as we move forward to further develop the program and prepare other initiatives in support of diversity and inclusion.

Keywords: eco-scale, green analysis, environmentally-friendly, pharmaceuticals analysis

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5898 Parkinson’s Disease Detection Analysis through Machine Learning Approaches

Authors: Muhtasim Shafi Kader, Fizar Ahmed, Annesha Acharjee

Abstract:

Machine learning and data mining are crucial in health care, as well as medical information and detection. Machine learning approaches are now being utilized to improve awareness of a variety of critical health issues, including diabetes detection, neuron cell tumor diagnosis, COVID 19 identification, and so on. Parkinson’s disease is basically a disease for our senior citizens in Bangladesh. Parkinson's Disease indications often seem progressive and get worst with time. People got affected trouble walking and communicating with the condition advances. Patients can also have psychological and social vagaries, nap problems, hopelessness, reminiscence loss, and weariness. Parkinson's disease can happen in both men and women. Though men are affected by the illness at a proportion that is around partial of them are women. In this research, we have to get out the accurate ML algorithm to find out the disease with a predictable dataset and the model of the following machine learning classifiers. Therefore, nine ML classifiers are secondhand to portion study to use machine learning approaches like as follows, Naive Bayes, Adaptive Boosting, Bagging Classifier, Decision Tree Classifier, Random Forest classifier, XBG Classifier, K Nearest Neighbor Classifier, Support Vector Machine Classifier, and Gradient Boosting Classifier are used.

Keywords: naive bayes, adaptive boosting, bagging classifier, decision tree classifier, random forest classifier, XBG classifier, k nearest neighbor classifier, support vector classifier, gradient boosting classifier

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5897 Empowering Volunteers at Tawanchai Centre for Patients with Cleft Lip and Palate

Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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5896 Motivation and Quality Teaching of Chinese Language: Analysis of Secondary School Studies

Authors: Robyn Moloney, HuiLing Xu

Abstract:

Many countries wish to produce Asia-literate citizens, through language education. International contexts of Chinese language education are seeking pedagogical innovation to meet local contextual factors frequently holding back learner success. In multicultural Australia, innovative pedagogy is urgently needed to support motivation in sustained study, with greater strategic integration of technology. This research took a qualitative approach to identify need and solutions. The paper analyses strategies that three secondary school teachers are adopting to meet specific challenges in the Australian context. The data include teacher interviews, classroom observations and student interviews. We highlight the use of task-based learning and differentiated teaching for multilevel classes, and the role which digital technologies play in facilitating both areas. The strategy examples are analysed in reference both to a research-based framework for describing quality teaching, and to current understandings of motivation in language learning. The analysis of data identifies learning featuring deep knowledge, higher-order thinking, engagement, social support, utilisation of background knowledge, and connectedness, all of which work towards the learners having a sense of autonomy and an imagination of becoming an adult Chinese language user.

Keywords: Chinese pedagogy, digital technologies, motivation, secondary school

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5895 Knowledge, Attitude, and Practices of Nurses on the Pain Assessment and Management in Level 3 Hospitals in Manila

Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

Abstract:

Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

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5894 Identification of Hepatocellular Carcinoma Using Supervised Learning Algorithms

Authors: Sagri Sharma

Abstract:

Analysis of diseases integrating multi-factors increases the complexity of the problem and therefore, development of frameworks for the analysis of diseases is an issue that is currently a topic of intense research. Due to the inter-dependence of the various parameters, the use of traditional methodologies has not been very effective. Consequently, newer methodologies are being sought to deal with the problem. Supervised Learning Algorithms are commonly used for performing the prediction on previously unseen data. These algorithms are commonly used for applications in fields ranging from image analysis to protein structure and function prediction and they get trained using a known dataset to come up with a predictor model that generates reasonable predictions for the response to new data. Gene expression profiles generated by DNA analysis experiments can be quite complex since these experiments can involve hypotheses involving entire genomes. The application of well-known machine learning algorithm - Support Vector Machine - to analyze the expression levels of thousands of genes simultaneously in a timely, automated and cost effective way is thus used. The objectives to undertake the presented work are development of a methodology to identify genes relevant to Hepatocellular Carcinoma (HCC) from gene expression dataset utilizing supervised learning algorithms and statistical evaluations along with development of a predictive framework that can perform classification tasks on new, unseen data.

Keywords: artificial intelligence, biomarker, gene expression datasets, hepatocellular carcinoma, machine learning, supervised learning algorithms, support vector machine

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5893 Kinesio Taping in Treatment Patients with Intermittent Claudication

Authors: Izabela Zielinska

Abstract:

Kinesio Taping is classified as physiotherapy method supporting rehabilitation and modulating some physiological processes. It is commonly used in sports medicine and orthopedics. This sensory method has influence on muscle function, pain sensation, intensifies lymphatic system as well as improves microcirculation. The aim of this study was to assess the effect of Kinesio Taping in patients with ongoing treatment of peripheral artery disease (PAD). The study group comprised 60 patients (stadium II B at Fontain's scale). All patients were divided into two groups (30 person/each), where 12 weeks long treadmill training was administrated. In the second group, the Kinesio Taping was applied to support the function of the gastrocnemius muscle. The measurements of distance and time until claudication pain, blood flow of arteries in lower limbs and ankle brachial index were taken under evaluation. Examination performed after Kinesio Taping therapy showed statistically significant increase in gait parameters and muscle strength in patients with intermittent claudication. The Kinesio Taping method has clinically significant effects on enhancement of pain-free distance and time until claudication pain in patients with peripheral artery disease. Kinesio Taping application can be used to support non-invasive treatment in patients with intermittent claudication. Kinesio Taping can be employed as an alternative way of therapy for patients with orthopedic or cardiac contraindications to be treated with treadmill training.

Keywords: intermittent claudication, kinesiotaping, peripheral artery disease, treadmill training

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5892 Management Software for the Elaboration of an Electronic File in the Pharmaceutical Industry Following Mexican Regulations

Authors: M. Peña Aguilar Juan, Ríos Hernández Ezequiel, R. Valencia Luis

Abstract:

For certification, certain goods of public interest, such as medicines and food, it is required the preparation and delivery of a dossier. For its elaboration, legal and administrative knowledge must be taken, as well as organization of the documents of the process, and an order that allows the file verification. Therefore, a virtual platform was developed to support the process of management and elaboration of the dossier, providing accessibility to the information and interfaces that allow the user to know the status of projects. The development of dossier system on the cloud allows the inclusion of the technical requirements for the software management, including the validation and the manufacturing in the field industry. The platform guides and facilitates the dossier elaboration (report, file or history), considering Mexican legislation and regulations, it also has auxiliary tools for its management. This technological alternative provides organization support for documents and accessibility to the information required to specify the successful development of a dossier. The platform divides into the following modules: System control, catalog, dossier and enterprise management. The modules are designed per the structure required in a dossier in those areas. However, the structure allows for flexibility, as its goal is to become a tool that facilitates and does not obstruct processes. The architecture and development of the software allows flexibility for future work expansion to other fields, this would imply feeding the system with new regulations.

Keywords: electronic dossier, cloud management software, pharmaceutical industry, sanitary registration

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5891 Academic, Socio-Cultural and Psychological Satisfaction of International Higher Degree Research Students (IRHD) in Australia

Authors: Baohua Yu

Abstract:

In line with wider tends in the expansion of international student mobility, the number of international higher degree research students has grown at a significant rate in recent years. In particular, Australia has become a hub for attracting international higher degree research students from around the world. However, research has identified that international higher degree research students often encounter a wide range of academic and socio-cultural challenges in adapting to their new environment. Moreover, this can have a significant bearing on their levels of satisfaction with their studies. This paper outlines the findings of a mixed method study exploring the experiences and perceptions of international higher degree research students in Australia. Findings revealed that IRHD students’ overall and academic satisfaction in Australia were highly related to each other, and they were strongly influenced by their learning and research, moderately influenced by co-national support and intercultural contact ability. Socio-cultural satisfaction seemed to belong to a different domain from academic satisfaction because it was explained by a different set of variables such as living and adaptation and intercultural contact ability. In addition, the most important issues in terms of satisfaction were not directly related to academic studies. Instead, factors such as integration into the community, interacting with other students, relationships with supervisors, and the provision of adequate desk space were often given the greatest weight. Implications for how university policy can better support international doctoral students are discussed.

Keywords: international higher degree research students, academic adaptation, socio-cultural adaptation, student satisfaction

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5890 Dueling Burnout: The Dual Role Nurse

Authors: Melissa Dorsey

Abstract:

Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.

Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership

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5889 Empowerment Model: A Strategy for Supporting Creative Economy through Traditional Weaving in Anajiaka Village

Authors: Sita Yuliastuti Amijaya, Wiyatiningsih Wiyatiningsih, Paulus Bawole

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Weaving skills were not originally a way to earn money for the traditional people on Sumba Island. Weaving is a leisure activity carried out between farming and caring for families. It is quite understandable if the weavers are women. At this time, weaving crafts become a unique potential inherent in an area, so that the weaver women also have the potential to drive economic activity in regional tourism sector. This study aims to measure the sustainability of traditional weaving business activities in Anajiaka Village, Umbu Ratu Nggay Barat, Central Sumba Regency, which is able to support the creative economy. The analysis was performed using qualitative descriptive methods by comparing the criteria of smart living and smart economy in the study of smart city. This study found that business sustainability will be better maintained if it is bound in a joint commitment, for example by forming a group of craftsmen. Other challenges besides the commitment of the group members are aspects of local government support and related agencies, in the form of guidance, funding, and promotion. In addition, fabric order targets, maintaining family and community balance, are recognized as obstacles for craftsmen. The modern marketing model is not yet mastered by the craftsmen group, so it needs assistance for future development.

Keywords: agriculture, craftsmen, creativepreneur, smart economy, smart living

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5888 Shaping Students’ Futures: Evaluating Professors’ Effectiveness as Academic Advisors in Postsecondary Institutions

Authors: Mohamad Musa, Khaldoun Aldiabat, Chelsea McLellan

Abstract:

In higher education, academic advising and counseling are pivotal for guiding students towards successful academic and professional trajectories. Within this landscape, professors play a critical role as academic advisors, offering guidance and support to students navigating their educational journey. This study endeavors to delve into the effectiveness of professors in this capacity through a comprehensive quantitative survey. Amidst the research objectives lies a profound exploration of students' perceptions regarding professors' effectiveness as academic advisors. Additionally, the study aims to elucidate the nuanced strengths and limitations inherent in professors' advisory roles. Through meticulous examination, the research seeks to uncover the profound impact of professors' engagement on student academic accomplishments and contentment. Moreover, it will scrutinize the requisite qualifications, training, and support mechanisms necessary for professors to excel in advisory roles. Utilizing a quantitative survey methodology, this research will gather invaluable insights into students' perspectives on professors' advisory competencies. Rigorous statistical analysis of survey responses will illuminate the efficacy of professors as academic advisors. The survey instrument will intricately measure diverse dimensions such as students' satisfaction levels with advisory sessions, the perceived efficacy of advice rendered by professors, and the holistic influence of professors' involvement on academic triumphs. Anticipated outcomes encompass a meticulous quantitative evaluation of professors' efficacy in academic advisory roles. Moreover, the research endeavors to delineate areas of proficiency and areas necessitating refinement within professors' advisory practices. Through these efforts, the study aims to provide valuable insights that can inform strategies for enhancing professors' advisory practices and optimizing the support systems available to students in higher education institutions. The study seeks to go beyond surface-level evaluations by delving into the intricate relationship between professors' involvement in academic advising and student academic outcomes. By unraveling this complex interplay, the research endeavors to shed light on the mechanisms through which professors' guidance impacts students' academic success, satisfaction, and overall educational experience.

Keywords: academic advising, professors, effectiveness, quantitative survey, student outcomes

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5887 Generic Early Warning Signals for Program Student Withdrawals: A Complexity Perspective Based on Critical Transitions and Fractals

Authors: Sami Houry

Abstract:

Complex systems exhibit universal characteristics as they near a tipping point. Among them are common generic early warning signals which precede critical transitions. These signals include: critical slowing down in which the rate of recovery from perturbations decreases over time; an increase in the variance of the state variable; an increase in the skewness of the state variable; an increase in the autocorrelations of the state variable; flickering between different states; and an increase in spatial correlations over time. The presence of the signals has management implications, as the identification of the signals near the tipping point could allow management to identify intervention points. Despite the applications of the generic early warning signals in various scientific fields, such as fisheries, ecology and finance, a review of literature did not identify any applications that address the program student withdrawal problem at the undergraduate distance universities. This area could benefit from the application of generic early warning signals as the program withdrawal rate amongst distance students is higher than the program withdrawal rate at face-to-face conventional universities. This research specifically assessed the generic early warning signals through an intensive case study of undergraduate program student withdrawal at a Canadian distance university. The university is non-cohort based due to its system of continuous course enrollment where students can enroll in a course at the beginning of every month. The assessment of the signals was achieved through the comparison of the incidences of generic early warning signals among students who withdrew or simply became inactive in their undergraduate program of study, the true positives, to the incidences of the generic early warning signals among graduates, the false positives. This was achieved through significance testing. Research findings showed support for the signal pertaining to the rise in flickering which is represented in the increase in the student’s non-pass rates prior to withdrawing from a program; moderate support for the signals of critical slowing down as reflected in the increase in the time a student spends in a course; and moderate support for the signals on increase in autocorrelation and increase in variance in the grade variable. The findings did not support the signal on the increase in skewness of the grade variable. The research also proposes a new signal based on the fractal-like characteristic of student behavior. The research also sought to extend knowledge by investigating whether the emergence of a program withdrawal status is self-similar or fractal-like at multiple levels of observation, specifically the program level and the course level. In other words, whether the act of withdrawal at the program level is also present at the course level. The findings moderately supported self-similarity as a potential signal. Overall, the assessment of the signals suggests that the signals, with the exception with the increase of skewness, could be utilized as a predictive management tool and potentially add one more tool, the fractal-like characteristic of withdrawal, as an additional signal in addressing the student program withdrawal problem.

Keywords: critical transitions, fractals, generic early warning signals, program student withdrawal

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5886 Carbon Skimming: Towards an Application to Summarise and Compare Embodied Carbon to Aid Early-Stage Decision Making

Authors: Rivindu Nethmin Bandara Menik Hitihamy Mudiyanselage, Matthias Hank Haeusler, Ben Doherty

Abstract:

Investors and clients in the Architectural, Engineering and Construction industry find it difficult to understand complex datasets and reports with little to no graphic representation. The stakeholders examined in this paper include designers, design clients and end-users. Communicating embodied carbon information graphically and concisely can aid with decision support early in a building's life cycle. It is essential to create a common visualisation approach as the level of knowledge about embodied carbon varies between stakeholders. The tool, designed in conjunction with Bates Smart, condenses Tally Life Cycle Assessment data to a carbon hot-spotting visualisation, highlighting the sections with the highest amounts of embodied carbon. This allows stakeholders at every stage of a given project to have a better understanding of the carbon implications with minimal effort. It further allows stakeholders to differentiate building elements by their carbon values, which enables the evaluation of the cost-effectiveness of the selected materials at an early stage. To examine and build a decision-support tool, an action-design research methodology of cycles of iterations was used along with precedents of embodied carbon visualising tools. Accordingly, the importance of visualisation and Building Information Modelling are also explored to understand the best format for relaying these results.

Keywords: embodied carbon, visualisation, summarisation, data filtering, early-stage decision-making, materiality

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5885 Upgrades for Hydric Supply in Water System Distribution: Use of the Bayesian Network and Technical Expedients

Authors: Elena Carcano, James Ball

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This work details the strategies adopted by the Italian Water Utilities during the distribution of water in emergency conditions which glide from earthquakes and droughts to floods and fires. Several water bureaus located over the national territory have been interviewed, and the collected information has been used in a database of potential interventions to be taken. The work discusses the actions adopted by water utilities. These are generally prioritized in order to minimize the social, temporal, and economic burden that the damaged and nearby areas need to support. Actions are defined relying on the Bayesian Network Approach, which constitutes the hard core of any decision support system. The Bayesian Networks give answers to interventions to real and most likely risky cases. The added value of this research consists in supplying the National Bureau, namely Protezione Civile, in charge of managing havoc and catastrophic situations with a univocal plot outline so as to be able to handle actions uniformly at the expense of different local laws or contradictory customs which squander any recovery conditions, proper technical service, and economic aids. The paper is organized as follows: in section 1, the introduction is stated; section 2 provides a brief discussion of BNNs (Bayesian Networks), section 3 introduces the adopted methodology; and in the last sections, results are presented, and conclusions are drawn.

Keywords: hierarchical process, strategic plan, water emergency conditions, water supply

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5884 Improving the Employee Transfer Experience within an Organization

Authors: Drew Fockler

Abstract:

This research examines how to improve an employee’s experience when transferring between departments within an organization. This research includes a historical review of a Canadian retail organization. Based on this historical review, gaps are identified between current and future visions to show where problems with existing training and development practices need to be resolved to reduce front-line employee turnover within an organization. The strategies within this paper support leaders through the LEAD: Listen, Explore, Act and Develop, Change Management Model. The LEAD Change Management Model supports the change process. This research proposes three possible solutions to improve an employee who is transferring between departments. The best solution to resolve the problem of improving an employee moving between departments experience is creating a Training Manager position within the retail store. A Training Manager position could support both employees and leadership with training and development of staff who are moving between departments. Within this research, an implementation plan using the TransX Model was created. The TransX Model is a hybrid of Leader-Member Exchange Theory and Transformational Leadership Theory to facilitate this organizational change within an organization by creating a common vision. Finally, this research provides the next steps as well as future considerations to enhance the training manager role within an organization.

Keywords: employee transfers, employee engagement, human resources, employee induction, TransX model, lead change management model

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5883 Detection of Powdery Mildew Disease in Strawberry Using Image Texture and Supervised Classifiers

Authors: Sultan Mahmud, Qamar Zaman, Travis Esau, Young Chang

Abstract:

Strawberry powdery mildew (PM) is a serious disease that has a significant impact on strawberry production. Field scouting is still a major way to find PM disease, which is not only labor intensive but also almost impossible to monitor disease severity. To reduce the loss caused by PM disease and achieve faster automatic detection of the disease, this paper proposes an approach for detection of the disease, based on image texture and classified with support vector machines (SVMs) and k-nearest neighbors (kNNs). The methodology of the proposed study is based on image processing which is composed of five main steps including image acquisition, pre-processing, segmentation, features extraction and classification. Two strawberry fields were used in this study. Images of healthy leaves and leaves infected with PM (Sphaerotheca macularis) disease under artificial cloud lighting condition. Colour thresholding was utilized to segment all images before textural analysis. Colour co-occurrence matrix (CCM) was introduced for extraction of textural features. Forty textural features, related to a physiological parameter of leaves were extracted from CCM of National television system committee (NTSC) luminance, hue, saturation and intensity (HSI) images. The normalized feature data were utilized for training and validation, respectively, using developed classifiers. The classifiers have experimented with internal, external and cross-validations. The best classifier was selected based on their performance and accuracy. Experimental results suggested that SVMs classifier showed 98.33%, 85.33%, 87.33%, 93.33% and 95.0% of accuracy on internal, external-I, external-II, 4-fold cross and 5-fold cross-validation, respectively. Whereas, kNNs results represented 90.0%, 72.00%, 74.66%, 89.33% and 90.3% of classification accuracy, respectively. The outcome of this study demonstrated that SVMs classified PM disease with a highest overall accuracy of 91.86% and 1.1211 seconds of processing time. Therefore, overall results concluded that the proposed study can significantly support an accurate and automatic identification and recognition of strawberry PM disease with SVMs classifier.

Keywords: powdery mildew, image processing, textural analysis, color co-occurrence matrix, support vector machines, k-nearest neighbors

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5882 Return to Work after a Mental Health Problem: Analysis of Two Different Management Models

Authors: Lucie Cote, Sonia McFadden

Abstract:

Mental health problems in the workplace are currently one of the main causes of absences. Research work has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process and has established the best management practices to ensure a successful return-to-work. However, very few studies have specifically explored the combination of various management models and determined whether they could satisfy the needs of the stakeholders. The objective of this study is to analyze two models for managing the return to work: the ‘medical-administrative’ and the ‘support of the worker’ in order to understand the actions and actors involved in these models. The study also aims to explore whether these models meet the needs of the actors involved in the management of the return to work. A qualitative case study was conducted in a Canadian federal organization. An abundant internal documentation and semi-directed interviews with six managers, six workers and four human resources professionals involved in the management of records of employees returning to work after a mental health problem resulted in a complete picture of the return to work management practices used in this organization. The triangulation of this data facilitated the examination of the benefits and limitations of each approach. The results suggest that the actions of management for employee return to work from both models of management ‘support of the worker’ and ‘medical-administrative’ are compatible and can meet the needs of the actors involved in the return to work. More research is needed to develop a structured model integrating best practices of the two approaches to ensure the success of the return to work.

Keywords: return to work, mental health, management models, organizations

Procedia PDF Downloads 199
5881 Using Human-Centred Service Design and Partnerships as a Model to Promote Cross-Sector Social Responsibility in Disaster Resilience: An Australian Case Study

Authors: Keith Diamond, Tracy Collier, Ciara Sterling, Ben Kraal

Abstract:

The increased frequency and intensity of disaster events in the Asia-Pacific region is likely to require organisations to better understand how their initiatives, and the support they provide to their customers, intersect with other organisations aiming to support communities in achieving disaster resilience. While there is a growing awareness that disaster response and recovery rebuild programmes need to adapt to more integrated, community-led approaches, there is often a discrepancy between how programmes intend to work and how they are collectively experienced in the community, creating undesired effects on community resilience. Following Australia’s North Queensland Monsoon Disaster of 2019, this research set out to understand and evaluate how the service and support ecosystem impacted on the local community’s experience and influenced their ability to respond and recover. The purpose of this initiative was to identify actionable, cross-sector, people-centered improvements that support communities to recover and thrive when faced with disaster. The challenge arose as a group of organisations, including utility providers, banks, insurers, and community organisations, acknowledged that improving their own services would have limited impact on community wellbeing unless the other services people need are also improved and aligned. The research applied human-centred service design methods, typically applied to single products or services, to design a new way to understand a whole-of-community journey. Phase 1 of the research conducted deep contextual interviews with residents and small business owners impacted by the North Queensland Monsoon and qualitative data was analysed to produce community journey maps that detailed how individuals navigated essential services, such as accommodation, finance, health, and community. Phase 2 conducted interviews and focus groups with frontline workers who represented industries that provided essential services to assist the community. Data from Phase 1 and Phase 2 of the research was analysed and combined to generate a systems map that visualised the positive and negative impacts that occurred across the disaster response and recovery service ecosystem. Insights gained from the research has catalysed collective action to address future Australian disaster events. The case study outlines a transformative way for sectors and industries to rethink their corporate social responsibility activities towards a cross-sector partnership model that shares responsibility and approaches disaster response and recovery as a single service that can be designed to meet the needs of communities.

Keywords: corporate social responsibility, cross sector partnerships, disaster resilience, human-centred design, service design, systems change

Procedia PDF Downloads 138
5880 A Decision-Support Tool for Humanitarian Distribution Planners in the Face of Congestion at Security Checkpoints: A Real-World Case Study

Authors: Mohanad Rezeq, Tarik Aouam, Frederik Gailly

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In times of armed conflicts, various security checkpoints are placed by authorities to control the flow of merchandise into and within areas of conflict. The flow of humanitarian trucks that is added to the regular flow of commercial trucks, together with the complex security procedures, creates congestion and long waiting times at the security checkpoints. This causes distribution costs to increase and shortages of relief aid to the affected people to occur. Our research proposes a decision-support tool to assist planners and policymakers in building efficient plans for the distribution of relief aid, taking into account congestion at security checkpoints. The proposed tool is built around a multi-item humanitarian distribution planning model based on multi-phase design science methodology that has as its objective to minimize distribution and back ordering costs subject to capacity constraints that reflect congestion effects using nonlinear clearing functions. Using the 2014 Gaza War as a case study, we illustrate the application of the proposed tool, model the underlying relief-aid humanitarian supply chain, estimate clearing functions at different security checkpoints, and conduct computational experiments. The decision support tool generated a shipment plan that was compared to two benchmarks in terms of total distribution cost, average lead time and work in progress (WIP) at security checkpoints, and average inventory and backorders at distribution centers. The first benchmark is the shipment plan generated by the fixed capacity model, and the second is the actual shipment plan implemented by the planners during the armed conflict. According to our findings, modeling and optimizing supply chain flows reduce total distribution costs, average truck wait times at security checkpoints, and average backorders when compared to the executed plan and the fixed-capacity model. Finally, scenario analysis concludes that increasing capacity at security checkpoints can lower total operations costs by reducing the average lead time.

Keywords: humanitarian distribution planning, relief-aid distribution, congestion, clearing functions

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5879 Prevalence, Associated Factors, and Help-Seeking Behavior of Psychological Distress among International Students at the National University of Malaysia

Authors: Khadiga Kahwa, Aniza Ismail

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Depression, anxiety, and stress are associated with decreased role functioning, productivity, and quality of life. International students are more prone to psychological distress as they face many stressors while studying abroad. The objectives of the study were to determine the prevalence and associated factors of depression, anxiety, and stress among international students, their help-seeking behavior, and their awareness of the available on-campus mental support services. A cross-sectional study with a purposive sampling method was performed on 280 international students at Universiti Kebangsaan Malaysia (UKM) between the age of 18 and 35 years. The Depression Anxiety Stress Scale-21 (DASS-21) questionnaire was used anonymously to assess the mental health of students. Socio-demographic, help-seeking behavior, and awareness data were obtained. Independent sample t-test, one-way ANOVA test, and multiple linear regression were used to explore associated factors. The overall prevalence of depression, anxiety, and stress among international students were 58.9%, 71.8%, and 53.9%, respectively. Age was significantly associated with depression and anxiety. Ethnicity showed a significant association with depression and stress. No other factors were found to be significantly associated with psychological distress. Only 9.6% of the international students had sought help from on-campus mental support services. Students who were aware of the presence of such services were only 21.4% of the participants. In conclusion, this study addressed the gap in the literature on the mental health of international students and provided data that could be used in intervention programs to improve the mental health of the increasing number of international students in Malaysia.

Keywords: anxiety, depression, stress, help-seeking behavior, students

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5878 Development and Validation of the University of Mindanao Needs Assessment Scale (UMNAS) for College Students

Authors: Ryan Dale B. Elnar

Abstract:

This study developed a multidimensional need assessment scale for college students called The University of Mindanao Needs Assessment Scale (UMNAS). Although there are context-specific instruments measuring the needs of clinical and non-clinical samples, literature reveals no standardized scales to measure the needs of the college students thus a four-phase item development process was initiated to support its content validity. Comprising seven broad facets namely spiritual-moral, intrapersonal, socio-personal, psycho-emotional, cognitive, physical and sexual, a pyramid model of college needs was deconstructed through FGD sample to support the literature review. Using various construct validity procedures, the model was further tested using a total of 881 Filipino college samples. The result of the study revealed evidences of the reliability and validity of the UMNAS. The reliability indices range from .929-.933. Exploratory and confirmatory factor analyses revealed a one-factor-six-dimensional instrument to measure the needs of the college students. Using multivariate regression analysis, year level and course are found predictors of students’ needs. Content analysis attested the usefulness of the instrument to diagnose students’ personal and academic issues and concerns in conjunction with other measures. The norming process includes 1728 students from the different colleges of the University of Mindanao. Further validation is recommended to establish a national norm for the instrument.

Keywords: needs assessment scale, validity, factor analysis, college students

Procedia PDF Downloads 431
5877 Integrating Data Mining within a Strategic Knowledge Management Framework: A Platform for Sustainable Competitive Advantage within the Australian Minerals and Metals Mining Sector

Authors: Sanaz Moayer, Fang Huang, Scott Gardner

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In the highly leveraged business world of today, an organisation’s success depends on how it can manage and organize its traditional and intangible assets. In the knowledge-based economy, knowledge as a valuable asset gives enduring capability to firms competing in rapidly shifting global markets. It can be argued that ability to create unique knowledge assets by configuring ICT and human capabilities, will be a defining factor for international competitive advantage in the mid-21st century. The concept of KM is recognized in the strategy literature, and increasingly by senior decision-makers (particularly in large firms which can achieve scalable benefits), as an important vehicle for stimulating innovation and organisational performance in the knowledge economy. This thinking has been evident in professional services and other knowledge intensive industries for over a decade. It highlights the importance of social capital and the value of the intellectual capital embedded in social and professional networks, complementing the traditional focus on creation of intellectual property assets. Despite the growing interest in KM within professional services there has been limited discussion in relation to multinational resource based industries such as mining and petroleum where the focus has been principally on global portfolio optimization with economies of scale, process efficiencies and cost reduction. The Australian minerals and metals mining industry, although traditionally viewed as capital intensive, employs a significant number of knowledge workers notably- engineers, geologists, highly skilled technicians, legal, finance, accounting, ICT and contracts specialists working in projects or functions, representing potential knowledge silos within the organisation. This silo effect arguably inhibits knowledge sharing and retention by disaggregating corporate memory, with increased operational and project continuity risk. It also may limit the potential for process, product, and service innovation. In this paper the strategic application of knowledge management incorporating contemporary ICT platforms and data mining practices is explored as an important enabler for knowledge discovery, reduction of risk, and retention of corporate knowledge in resource based industries. With reference to the relevant strategy, management, and information systems literature, this paper highlights possible connections (currently undergoing empirical testing), between an Strategic Knowledge Management (SKM) framework incorporating supportive Data Mining (DM) practices and competitive advantage for multinational firms operating within the Australian resource sector. We also propose based on a review of the relevant literature that more effective management of soft and hard systems knowledge is crucial for major Australian firms in all sectors seeking to improve organisational performance through the human and technological capability captured in organisational networks.

Keywords: competitive advantage, data mining, mining organisation, strategic knowledge management

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5876 Motherhood Constrained: The Minotaur Legend Reimagined Through the Perspective of Marginalized Mothers

Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

Procedia PDF Downloads 41
5875 Using Authentic and Instructional Materials to Support Intercultural Communicative Competence in ELT

Authors: Jana Beresova

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The paper presents a study carried out in 2015-2016 within the national scheme of research - VEGA 1/0106/15 based on theoretical research and empirical verification of the concept of intercultural communicative competence. It focuses on the current conception concerning target languages teaching compatible with the Common European Framework of Reference for Languages: Learning, teaching, assessment. Our research had revealed how the concept of intercultural communicative competence had been perceived by secondary-school teachers of English in Slovakia before they were intensively trained. Intensive workshops were based on the use of both authentic and instructional materials with the goal to support interculturally oriented language teaching aimed at challenging thinking. The former concept that supported the development of the students´ linguistic knowledge and the use of a target language to obtain information about the culture of the country whose language learners were learning was expanded by the meaning-making framework which views language as a typical means by which culture is mediated. The goal of the workshop was to influence English teachers to better understand the concept of intercultural communicative competence, combining theory and practice optimally. The results of the study will be presented and analysed, providing particular recommendations for language teachers and suggesting some changes in the National Educational Programme from which English learners should benefit in their future studies or professional careers.

Keywords: authentic materials, English language teaching, instructional materials, intercultural communicative competence

Procedia PDF Downloads 252
5874 A Qualitative Meta-Synthesis of the Caregiving Experiences of Family Caregivers for Elderly Cancer Patients in China: Implications for Health Social Work

Authors: Longtao He, Han Wu

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Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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5873 Adequate Nutritional Support and Monitoring in Post-Traumatic High Output Duodenal Fistula

Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

Abstract:

Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

Procedia PDF Downloads 247