Search results for: expert review
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5247

Search results for: expert review

3777 Quick off the Mark with Achilles Tendon Rupture

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

Abstract:

Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

Procedia PDF Downloads 121
3776 Design an Assessment Model of Research and Development Capabilities with the New Product Development Approach: A Case Study of Iran Khodro Company

Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

Abstract:

In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

Procedia PDF Downloads 337
3775 A Review on Valorisation of Chicken Feathers: Current Status and Future Prospects

Authors: Tamrat Tesfaye, Bruce Sithole, Deresh Ramjugernath

Abstract:

Worldwide, the poultry–processing industry generates large quantities of feather by-products that amount to 40 billion kilograms annually. The feathers are considered wastes although small amounts are often processed into valuable products such as feather meal and fertilizers. The remaining waste is disposed of by incineration or by burial in controlled landfills. Improper disposal of these biological wastes contributes to environmental damage and transmission of diseases. Economic pressures, environmental pressures, increasing interest in using renewable and sustainable raw materials, and the need to decrease reliance on non-renewable petroleum resources behove the industry to find better ways of dealing with waste feathers. A closer look at the structure and composition of feathers shows that the whole part of a chicken feather (rachis and barb) can be used as a source of a pure structural protein called keratin which can be exploited for conversion into a number of high-value bio products. Additionally, a number of technologies can be used to convert other biological components of feathers into high value added products. Thus, conversion of the waste into valuable products can make feathers an attractive raw material for the production of bio products. In this review, possible applications of chicken feathers in a variety of technologies and products are discussed. Thus, using waste feathers as a valuable resource can help the poultry industry to dispose of the waste feathers in an environmentally sustainable manner that also generates extra income for the industry. Their valorisation can result in their sustainable conversion into high-value materials and products on the proviso of existence or development of cost-effective technologies for converting this waste into the useful products.

Keywords: biodegradable product, keratin, poultry waste, feathers, valorisation

Procedia PDF Downloads 294
3774 Circular Economy Maturity Models: A Systematic Literature Review

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

Abstract:

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

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

Procedia PDF Downloads 112
3773 Advances in Genome Editing and Future Prospects for Sorghum Improvement: A Review

Authors: Micheale Yifter Weldemichael, Hailay Mehari Gebremedhn, Teklehaimanot Hailesslasie Teklu

Abstract:

Recent developments in targeted genome editing accelerated genetic research and opened new potentials to improve crops for better yields and quality. Given the significance of cereal crops as a primary source of food for the global population, the utilization of contemporary genome editing techniques like CRISPR/Cas9 is timely and crucial. CRISPR/Cas technology has enabled targeted genomic modifications, revolutionizing genetic research and exploration. Application of gene editing through CRISPR/Cas9 in enhancing sorghum is particularly vital given the current ecological, environmental, and agricultural challenges exacerbated by climate change. As sorghum is one of the main staple foods of our region and is known to be a resilient crop with a high potential to overcome the above challenges, the application of genome editing technology will enhance the investigation of gene functionality. CRISPR/Cas9 enables the improvement of desirable sorghum traits, including nutritional value, yield, resistance to pests and diseases, and tolerance to various abiotic stresses. Furthermore, CRISPR/Cas9 has the potential to perform intricate editing and reshape the existing elite sorghum varieties, and introduce new genetic variations. However, current research primarily focuses on improving the efficacy of the CRISPR/Cas9 system in successfully editing endogenous sorghum genes, making it a feasible and successful undertaking in sorghum improvement. Recent advancements and developments in CRISPR/Cas9 techniques have further empowered researchers to modify additional genes in sorghum with greater efficiency. Successful application and advancement of CRISPR techniques in sorghum will aid not only in gene discovery and the creation of novel traits that regulate gene expression and functional genomics but also in facilitating site-specific integration events. The purpose of this review is, therefore, to elucidate the current advances in sorghum genome editing and highlight its potential in addressing food security issues. It also assesses the efficiency of CRISPR-mediated improvement and its long-term effects on crop improvement and host resistance against parasites, including tissue-specific activity and the ability to induce resistance. This review ends by emphasizing the challenges and opportunities of CRISPR technology in combating parasitic plants and proposing directions for future research to safeguard global agricultural productivity.

Keywords: CRISPR/Cas9, genome editing, quality, sorghum, stress, yield

Procedia PDF Downloads 36
3772 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

Procedia PDF Downloads 257
3771 Retrospective Demographic Analysis of Patients Lost to Follow-Up from Antiretroviral Therapy in Mulanje Mission Hospital, Malawi

Authors: Silas Webb, Joseph Hartland

Abstract:

Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

Procedia PDF Downloads 186
3770 Interval Type-2 Fuzzy Vibration Control of an ERF Embedded Smart Structure

Authors: Chih-Jer Lin, Chun-Ying Lee, Ying Liu, Chiang-Ho Cheng

Abstract:

The main objective of this article is to present the semi-active vibration control using an electro-rheological fluid embedded sandwich structure for a cantilever beam. ER fluid is a smart material, which cause the suspended particles polarize and connect each other to form chain. The stiffness and damping coefficients of the ER fluid can be changed in 10 micro seconds; therefore, ERF is suitable to become the material embedded in the tunable vibration absorber to become a smart absorber. For the ERF smart material embedded structure, the fuzzy control law depends on the experimental expert database and the proposed self-tuning strategy. The electric field is controlled by a CRIO embedded system to implement the real application. This study investigates the different performances using the Type-1 fuzzy and interval Type-2 fuzzy controllers. The Interval type-2 fuzzy control is used to improve the modeling uncertainties for this ERF embedded shock absorber. The self-tuning vibration controllers using Type-1 and Interval Type-2 fuzzy law are implemented to the shock absorber system. Based on the resulting performance, Internal Type-2 fuzzy is better than the traditional Type-1 fuzzy control for this vibration control system.

Keywords: electro-rheological fluid, semi-active vibration control, shock absorber, type 2 fuzzy control

Procedia PDF Downloads 446
3769 A Systematic Review Regarding Caregiving Relationships of Adolescents Orphaned by Aids and Primary Caregivers

Authors: M. Petunia Tsweleng

Abstract:

Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

Procedia PDF Downloads 179
3768 Teacher-Scaffolding vs. Peer-Scaffolding in Task-Based ILP Instruction: Effects on EFL Learners’ Metapragmatic Awareness

Authors: Amir Zand-Moghadam, Mahnaz Alizadeh

Abstract:

The aim of the present study was to investigate the effect of teacher-scaffolding versus peer-scaffolding on EFL learners’ metapragmatic awareness in the paradigm of task-based language teaching (TBLT). To this end, a number of dialogic information-gap tasks requiring two-way interactant relationship were designed for the five speech acts of request, refusal, apology, suggestion, and compliment following Ellis’s (2003) model. Then, 48 intermediate EFL learners were randomly selected, homogenized, and assigned to two groups: 26 participants in the teacher-scaffolding group (Group One) and 22 in the peer-scaffolding group (Group Two). While going through the three phases of pre-task, while-task, and post-task, the participants in the first group completed the designed tasks by the teacher’s interaction, scaffolding, and feedback. On the other hand, the participants in the second group were required to complete the tasks in expert-novice pairs through peer scaffolding in all the three phases of a task-based syllabus. The findings revealed that the participants in the teacher-scaffolding group developed their L2 metapragmatic awareness more than the peer-scaffolding group. Thus, it can be concluded that teacher-scaffolding is more effective than peer scaffolding in developing metapragmatic awareness among EFL learners. It can also be claimed that the use of tasks can be more influential when they are accompanied by teacher-scaffolding. The findings of the present study have implications for language teachers and researchers.

Keywords: ILP, metapragmatic awareness, scaffolding, task-based instruction

Procedia PDF Downloads 582
3767 Assessing Perinatal Mental Illness during the COVID-19 Pandemic: A Review of Measurement Tools

Authors: Mya Achike

Abstract:

Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

Procedia PDF Downloads 134
3766 Perspectives on Sustainable Bioeconomy in the Baltic Sea Region

Authors: Susanna Vanhamäki, Gabor Schneider, Kati Manskinen

Abstract:

‘Bioeconomy’ is a complex concept that cuts across many sectors and covers several policy areas. To achieve an overall understanding and support a successful bioeconomy, a cross-sectorial approach is necessary. In practice, due to the concept’s wide scope and varying international approaches, fully understanding bioeconomy is challenging on policy level. This paper provides a background of the topic through an analysis of bioeconomy strategies in the Baltic Sea region. Expert interviews and a small survey were conducted to discover the current and intended focuses of these countries’ bioeconomy sectors. The research shows that supporting sustainability is one of the keys in developing the future bioeconomy. The results highlighted that the bioeconomy has to be sustainable and based on circular economy principles. Currently, traditional bioeconomy sectors like food, wood, fish & waters as well as fuel & energy, which are in the core of national bioeconomy strategies, are best known and are considered more relevant than other bioeconomy industries. However, there is increasing potential for novel sectors, such as textiles and pharmaceuticals. The present research indicates that the opportunities presented by these bioeconomy sectors should be recognised and promoted. Education, research and innovation can play key roles in developing transformative and sustainable improvements in primary production and renewable resources. Furthermore, cooperation between businesses and educators is important.

Keywords: bioeconomy, circular economy, policy, strategy

Procedia PDF Downloads 175
3765 Exploring the Mechanisms of Quality Assurance in the Chinese Translation Industry

Authors: Youru Zhou

Abstract:

This paper seeks to unveil the quality assurance practices in the Chinese translation industry. Since China’s reform and opening up, the Chinese language service industry has enjoyed impressively rapid growth. However, while still in its early stage of professionalization, the Chinese translation industry is also facing many challenges, such as the lack of clear admission requirements, a powerful regulation authority and a great number of qualified professionals. ‘How quality is assured’ means a great deal to translation in China at this stage. In order to examine the mechanisms in which quality is assured, this paper studied four international and national standards that have gained widespread adoption by Chinese translation companies and examined the content that is relevant to translation quality assurance. Case studies with six selected Chinese translation companies of different sizes were conducted to confirm and exemplify the descriptions on the standards. It has been found that quality in the industry is a relative concept which is mainly determined by the demand of clients. Furthermore, the procedures of translation can vary from task to task dependent on the agreement made between the service provider and clients. Finally, there are companies relying on expert-oriented mechanisms to assure the quality of translation, while other companies and standards insist on process-oriented ones.

Keywords: case study, Chinese translation industry, professional practice, translation quality assurance, translation standards

Procedia PDF Downloads 143
3764 A Systematic Review of Efficacy and Safety of Radiofrequency Ablation in Patients with Spinal Metastases

Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

Abstract:

Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

Procedia PDF Downloads 172
3763 Maternal and Neonatal Outcomes in Women Undergoing Bariatric Surgery: A Systematic Review and Meta-Analysis

Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

Abstract:

Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

Procedia PDF Downloads 406
3762 Decision-Making Strategies on Smart Dairy Farms: A Review

Authors: L. Krpalkova, N. O' Mahony, A. Carvalho, S. Campbell, G. Corkery, E. Broderick, J. Walsh

Abstract:

Farm management and operations will drastically change due to access to real-time data, real-time forecasting, and tracking of physical items in combination with Internet of Things developments to further automate farm operations. Dairy farms have embraced technological innovations and procured vast amounts of permanent data streams during the past decade; however, the integration of this information to improve the whole farm-based management and decision-making does not exist. It is now imperative to develop a system that can collect, integrate, manage, and analyse on-farm and off-farm data in real-time for practical and relevant environmental and economic actions. The developed systems, based on machine learning and artificial intelligence, need to be connected for useful output, a better understanding of the whole farming issue, and environmental impact. Evolutionary computing can be very effective in finding the optimal combination of sets of some objects and, finally, in strategy determination. The system of the future should be able to manage the dairy farm as well as an experienced dairy farm manager with a team of the best agricultural advisors. All these changes should bring resilience and sustainability to dairy farming as well as improving and maintaining good animal welfare and the quality of dairy products. This review aims to provide an insight into the state-of-the-art of big data applications and evolutionary computing in relation to smart dairy farming and identify the most important research and development challenges to be addressed in the future. Smart dairy farming influences every area of management, and its uptake has become a continuing trend.

Keywords: big data, evolutionary computing, cloud, precision technologies

Procedia PDF Downloads 189
3761 Optimal Evaluation of Weather Risk Insurance for Wheat

Authors: Slim Amami

Abstract:

A model is developed to prevent the risks related to climate conditions in the agricultural sector. It will determine the yearly optimum premium to be paid by a farmer in order to reach his required turnover. The model is mainly based on both climatic stability and 'soft' responses of usually grown species to average climate variations at the same place and inside a safety ball which can be determined from past meteorological data. This allows the use of linear regression expression for dependence of production result in terms of driving meteorological parameters, main ones of which are daily average sunlight, rainfall and temperature. By a simple best parameter fit from the expert table drawn with professionals, optimal representation of yearly production is deduced from records of previous years, and yearly payback is evaluated from minimum yearly produced turnover. Optimal premium is then deduced, and gives the producer a useful bound for negotiating an offer by insurance companies to effectively protect their harvest. The application to wheat production in the French Oise department illustrates the reliability of the present model with as low as 6% difference between predicted and real data. The model can be adapted to almost every agricultural field by changing state parameters and calibrating their associated coefficients.

Keywords: agriculture, database, meteorological factors, production model, optimal price

Procedia PDF Downloads 221
3760 Impact of Human Resources Accounting on Employees' Performance in Organization

Authors: Hamid Saremi, Shida Hanafi

Abstract:

In an age of technology and economics, human capital has important and axial role in the organization and human resource accounting has a wide perception to key resources of organization i.e. human resources. Human resources accounting is new branch of accounting that has Short-lived and generally deals to a range of policies and measures that are related to various aspects of human resources and It gives importance to an organization's most important asset is its human resources and human resource management is the key to success in an organization and to achieve this important matter must review and evaluation of human resources data be with knowledge of accounting based on empirical studies and methods of measurement and reporting of human resources accounting information. Undoubtedly human resource management without information cannot be done and take decision and human resources accounting is practical way to inform the decision makers who are committed to harnessing human resources,, human resources accounting with applying accounting principles in the organization and is with conducting basic research on the extent of the of human resources accounting information" effect of employees' personal performance. In human resource accounting analysis and criteria and valuation of cost and manpower valuating is as the main resource in each Institute. Protection of human resources is a process that according to human resources accounting is for organization profitability. In fact, this type of accounting can be called as a major source in measurement and trends of costs and human resources valuation in each institution. What is the economic value of such assets? What is the amount of expenditures for education and training of professional individuals to value in asset account? What amount of funds spent should be considered as lost opportunity cost? In this paper, according to the literature of human resource accounting we have studied the human resources matter and its objectives and topic of the importance of human resource valuation on employee performance review and method of reporting of human resources according to different models.

Keywords: human resources, human resources, accounting, human capital, human resource management, valuation and cost of human resources, employees, performance, organization

Procedia PDF Downloads 547
3759 A Morphological Analysis of Swardspeak in the Philippines

Authors: Carlo Gadingan

Abstract:

Swardspeak, as a language, highlights the exclusive identity of the Filipino gay men and the oppression they are confronted in the society. This paper presents a morphological analysis of swardspeak in the Philippines. Specifically, it aims to find out the common morphological processes involved in the construction of codes that may unmask the nature of swardspeak as a language. 30 purposively selected expert users of swardspeak from Luzon, Visayas, and Mindanao were asked to codify 30 natural words through the Facebook Messenger application. The results of the structural analysis affirm that swardspeak follows no specific rules revealing complicated combinations of clipping/stylized clipping, borrowing, connotation through images, connotation through actions, connotation through sounds, affixation, repetition, substitution, and simple reversal. Moreover, it was also found out that most of these word formation processes occur in all word classes which indicate that swardspeak is very unpredictable. Although different codes are used for the same words, there are still codes that are really common to all homosexuals and these are Chaka (ugly), Crayola (cry), and Aida (referring to a person with AIDS). Hence, the prevailing word formation processes explored may be termed as observed time-specific patterns because the codes documented in this study may turn obsolete and may be replaced with novel ones in a matter of weeks to month, knowing the creativity of homosexuals and the multiplicity of societal resources which can be used to make the codes more opaque and more confusing for non-homosexuals.

Keywords: codes, homosexuals, morphological processes, swardspeak

Procedia PDF Downloads 178
3758 A Guideline of Development of Suansunandha Rajabhat University in Order to Promote the Cultural Tourism

Authors: Weera Weerasophon

Abstract:

This research aims to study and survey a potential in the areas affecting development and study of management factors affecting cultural tourism for Suansunandha Rajabhat University in a model of a qualitative research as a survey research. The sample population includes executives, faculty members, and persons related to university management of Suansunandha Rajabhat University, the total number is 5 persons. The researcher distributed in-depth interview form for tools used in the research. The obtained data was brought to conduct content analysis by brainstorming from expert academician to persons related to university management of Suansunandha Rajabhat University in order to consider readiness in cultural tourism management for Suansunandha Rajabhat University, to analyze and develop to be a guideline for the development of Suansunandha Rajabhat University for promoting cultural tourism. From the study results, it is found that the factors of readiness in management, planning, organizing, personnel management, leadership and guiding, coordination, controlling, budgeting and marketing could influence to be a guideline for development of Suansunandha Rajabhat Universiy in order to promote cultural tourism; therefore, the university should prepare more plans concerning related matters, as well as development, determining form and policy of Suansunandha Rajabhat University.

Keywords: cultural tourism, Suansunandha Rajabhat University, tourism management, guideline of development

Procedia PDF Downloads 337
3757 Basic Research on Applying Temporary Work Engineering at the Design Phase

Authors: Jin Woong Lee, Kyuman Cho, Taehoon Kim

Abstract:

The application of constructability is increasingly required not only in the construction phase but also in the whole project stage. In particular, the proper application of construction experience and knowledge during the design phase enables the minimization of inefficiencies such as design changes and improvements in constructability during the construction phase. In order to apply knowledge effectively, engineering technology efforts should be implemented with design progress. Among many engineering technologies, engineering for temporary works, including facilities, equipment, and other related construction methods, is important to improve constructability. Therefore, as basic research, this study investigates the applicability of temporary work engineering during the design phase in the building construction industry. As a result, application of temporary work engineering has a greater impact on construction cost reduction and constructability improvement. In contrast to the existing design-bid-build method, the turn-key and CM (construct management) procurement methods currently being implemented in Korea are expected to have a significant impact on the direction of temporary work engineering. To introduce temporary work engineering, expert/professional organization training is first required, and a lack of client awareness should be preferentially improved. The results of this study are expected to be useful as reference material for the development of more effective temporary work engineering tasks and work processes in the future.

Keywords: Temporary Work Engineering, Design Phase, Constructability, Building Construction

Procedia PDF Downloads 384
3756 A Systematic Analysis of Knowledge Development Trends in Industrial Maintenance Projects

Authors: Lilian Ogechi Iheukwumere-Esotu, Akilu Yunusa-Kaltungo, Paul Chan

Abstract:

Industrial assets are prone to degradation and eventual failures due to repetitive loads and harsh environments in which they operate. These failures often lead to costly downtimes, which may involve loss of critical assets and/or human lives. The rising pressures from stakeholders for optimized systems’ outputs have further placed strains on business organizations. Traditional means of combating such failures are by adopting strategies capable of predicting, controlling, and/or reducing the likelihood of systems’ failures. Turnarounds, shutdowns, and outages (TSOs) projects are popular maintenance management activities conducted over a certain period of time. However, despite the critical and significant cost implications of TSOs, the management of the interface of knowledge between academia and industry to our best knowledge has not been fully explored in comparison to other aspects of industrial operations. This is perhaps one of the reasons for the limited knowledge transfer between academia and industry, which has affected the outcomes of most TSOs. Prior to now, the study of knowledge development trends as a failure analysis tool in the management of TSOs projects have not gained the required level of attention. Hence, this review provides useful references and their implications for future studies in this field. This study aims to harmonize the existing research trends of TSOs through a systematic review of more than 3,000 research articles published over 7 decades (1940- till date) which were extracted using very specific research criteria and later streamlined using nominated inclusion and exclusion parameters. The information obtained from the analysis were then synthesized and coded into 8 parameters, thereby allowing for a transformation into actionable outputs. The study revealed a variety of information, but the most critical findings can be classified into 4 folds: (1) Empirical validation of available conceptual frameworks and models is still a far cry in practice, (2) traditional project management views for managing uncertainties are still dominant, (3) Inconsistent approaches towards the adoption and promotion of knowledge management systems which supports creation, transfer and application of knowledge within and outside the project organization and, (4) exploration of social practices in industrial maintenance project environments are under-represented within the existing body of knowledge. Thus, the intention of this study is to depict the usefulness of a framework which incorporates fact findings emanating from careful analysis and illustrations of evidence based results as a suitable approach which can tackle reoccurring failures in industrial maintenance projects.

Keywords: industrial maintenance, knowledge management, maintenance projects, systematic review, TSOs

Procedia PDF Downloads 115
3755 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis

Authors: Maatouk Mohamed, Nouira Mariem

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

Procedia PDF Downloads 81
3754 A Literature Review on the Effect of Financial Knowledge toward Corporate Growth: The Important Role of Financial Risk Attitude

Authors: Risna Wijayanti, Sumiati, Hanif Iswari

Abstract:

This study aims to analyze the role of financial risk attitude as a mediation between financial knowledge and business growth. The ability of human resources in managing capital (financial literacy) can be a major milestone for a company's business to grow and build its competitive advantage. This study analyzed the important role of financial risk attitude in bringing about financial knowledge on corporate growth. There have been many discussions arguing that financial knowledge is one of the main abilities of corporate managers in determining the success of managing a company. However, a contrary argument of other scholars also enlightened that financial knowledge did not have a significant influence on corporate growth. This study used literatures' review to analyze whether there is another variable that can mediate the effect of financial knowledge toward corporate growth. Research mapping was conducted to analyze the concept of risk tolerance. This concept was related to people's risk aversion effects when making a decision under risk and the role of financial knowledge on changes in financial income. Understanding and managing risks and investments are complicated, in particular for corporate managers, who are always demanded to maintain their corporate growth. Substantial financial knowledge is extremely needed to identify and take accurate information for corporate financial decision-making. By reviewing several literature, this study hypothesized that financial knowledge of corporate managers would be meaningless without manager's courage to bear risks for taking favorable business opportunities. Therefore, the level of risk aversion from corporate managers will determine corporate action, which is a reflection of corporate-level investment behavior leading to attain corporate success or failure for achieving the company's expected growth rate.

Keywords: financial knowledge, financial risk attitude, corporate growth, risk tolerance

Procedia PDF Downloads 128
3753 A Review on the Hydrologic and Hydraulic Performances in Low Impact Development-Best Management Practices Treatment Train

Authors: Fatin Khalida Abdul Khadir, Husna Takaijudin

Abstract:

Bioretention system is one of the alternatives to approach the conventional stormwater management, low impact development (LID) strategy for best management practices (BMPs). Incorporating both filtration and infiltration, initial research on bioretention systems has shown that this practice extensively decreases runoff volumes and peak flows. The LID-BMP treatment train is one of the latest LID-BMPs for stormwater treatments in urbanized watersheds. The treatment train is developed to overcome the drawbacks that arise from conventional LID-BMPs and aims to enhance the performance of the existing practices. In addition, it is also used to improve treatments in both water quality and water quantity controls as well as maintaining the natural hydrology of an area despite the current massive developments. The objective of this paper is to review the effectiveness of the conventional LID-BMPS on hydrologic and hydraulic performances through column studies in different configurations. The previous studies on the applications of LID-BMP treatment train that were developed to overcome the drawbacks of conventional LID-BMPs are reviewed and use as the guidelines for implementing this system in Universiti Teknologi Petronas (UTP) and elsewhere. The reviews on the analysis conducted for hydrologic and hydraulic performances using the artificial neural network (ANN) model are done in order to be utilized in this study. In this study, the role of the LID-BMP treatment train is tested by arranging bioretention cells in series in order to be implemented for controlling floods that occurred currently and in the future when the construction of the new buildings in UTP completed. A summary of the research findings on the performances of the system is provided which includes the proposed modifications on the designs.

Keywords: bioretention system, LID-BMP treatment train, hydrological and hydraulic performance, ANN analysis

Procedia PDF Downloads 117
3752 A Review of the Potential Impact of Employer Branding on Employee

Authors: K. V. N. K. C. Sharma

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, organisation personnel, internal branding, leadership

Procedia PDF Downloads 239
3751 Systematic Review of Digital Interventions to Reduce the Carbon Footprint of Primary Care

Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

Abstract:

Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

Procedia PDF Downloads 60
3750 Developing a Risk Rating Tool for Shopping Centres

Authors: Prandesha Govender, Chris Cloete

Abstract:

Purpose: The objective of the paper is to develop a tool for the evaluation of the financial risk of a shopping center. Methodology: Important factors that indicate the success of a shopping center were identified from the available literature. Weights were allocated to these factors and a risk rating was calculated for 505 shopping centers in the largest province in South Africa by taking the factor scores, factor weights, and category weights into account. The ratings for ten randomly selected shopping centers were correlated with consumer feedback and standardized against the ECAI (External Credit Assessment Institutions) data for the same centers. The ratings were also mapped to corporates with the same risk rating to provide a better intuitive assessment of the meaning of the inherent risk of each center. Results: The proposed risk tool shows a strong linear correlation with consumer views and can be compared to expert opinions, such as that of fund managers and REITs. Interpretation of the tool was also illustrated by correlating the risk rating of selected shopping centers to the risk rating of reputable and established entities. Conclusions: The proposed Shopping Centre Risk Tool, used in conjunction with financial inputs from the relevant center, should prove useful to an investor when the desirability of investment in or expansion, renovation, or purchase of a shopping center is being considered.

Keywords: risk, shopping centres, risk modelling, investment, rating tool, rating scale

Procedia PDF Downloads 115
3749 Barrier Membrane Influence Histology of Guided Bone Regenerations: A Systematic Review and Meta-Analysis

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

Abstract:

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

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

Procedia PDF Downloads 150
3748 The Relationship between Spanish Economic Variables: Evidence from the Wavelet Techniques

Authors: Concepcion Gonzalez-Concepcion, Maria Candelaria Gil-Fariña, Celina Pestano-Gabino

Abstract:

We analyze six relevant economic and financial variables for the period 2000M1-2015M3 in the context of the Spanish economy: a financial index (IBEX35), a commodity (Crude Oil Price in euros), a foreign exchange index (EUR/USD), a bond (Spanish 10-Year Bond), the Spanish National Debt and the Consumer Price Index. The goal of this paper is to analyze the main relations between them by computing the Wavelet Power Spectrum and the Cross Wavelet Coherency associated with Morlet wavelets. By using a special toolbox in MATLAB, we focus our interest on the period variable. We decompose the time-frequency effects and improve the interpretation of the results by non-expert users in the theory of wavelets. The empirical evidence shows certain instability periods and reveals various changes and breaks in the causality relationships for sample data. These variables were individually analyzed with Daubechies Wavelets to visualize high-frequency variance, seasonality, and trend. The results are included in Proceeding 20th International Academic Conference, 2015, International Institute of Social and Economic Sciences (IISES), Madrid.

Keywords: economic and financial variables, Spain, time-frequency domain, wavelet coherency

Procedia PDF Downloads 240