Search results for: management technology

Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

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Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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Authors: Thea Freese, Michael Gille, Andrew Hursthouse, John Struthers

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Ship operators on the North and Baltic Sea have been experiencing increased political interest in marine environmental protection and cleaner vessel operations. Stricter legislation on SO2 and NOx emissions, ballast water management and other measures of protection are currently being phased in or will come into force in the coming years. These measures benefit the health of the marine environment, while increasing company’s operational costs. In times of excess shipping capacity and linked consolidation in the industry non-compliance with environmental rules is one way companies might hope to stay competitive with both intra- and inter-modal trade. Around 5-15% of industry participants are believed to neglect laws on vessel-source pollution willingly or unwillingly. Exploratory in-depth interviews conducted with 12 experts from various stakeholder groups informed the researchers about variables influencing compliance levels, including awareness and apprehension, willingness to comply, ability to comply and effectiveness of controls. Semi-structured expert interviews were evaluated using qualitative content analysis. A model of determinants of compliance was developed and is presented here. While most vessel operators endeavour to achieve full compliance with environmental rules, a lack of availability of technical solutions, expediency of implementation and operation and economic feasibility might prove a hindrance. Ineffective control systems on the other hand foster willing non-compliance. With respect to motivations, lacking time, lacking financials and the absence of commercial advantages decrease compliance levels. These and other variables were inductively developed from qualitative data and integrated into a model on environmental compliance. The outcomes presented here form part of a wider research project on economic effects of maritime environmental legislation. Research on determinants of compliance might inform policy-makers about actual behavioural effects of shipping companies and might further the development of a comprehensive legal system for environmental protection.

Keywords: compliance, marine environmental protection, exploratory qualitative research study, clean vessel operations, North and Baltic Sea area

Procedia PDF Downloads 383

Authors: Alfonso Sepulveda, Brecht Put, Nouha Labyedh, Philippe M. Vereecken

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High energy and power density are the main requirements of today’s high demanding applications in consumer electronics. Lithium ion batteries (LIB) have the highest energy density of all known systems and are thus the best choice for rechargeable micro-batteries. Liquid electrolyte LIBs present limitations in safety, size and design, thus thin film all-solid state batteries are predominantly considered to overcome these restrictions in small devices. Although planar all-solid state thin film LIBs are at present commercially available they have low capacity (<1mAh/cm2) which limits their application scenario. By using micro-or nanostructured surfaces (i.e. 3D batteries) and appropriate conformal coating technology (i.e. electrochemical deposition, ALD) the capacity can be increased while still keeping a high rate performance. The main challenges in the introduction of solid-state LIBs are low ionic conductance and limited cycle life time due to mechanical stress and shearing interfaces. Novel materials and innovative nanostructures have to be explored in order to overcome these limitations. Thin film 3D compatible materials need to provide with the necessary requirements for functional and viable thin-film stacks. Thin film electrodes offer shorter Li-diffusion paths and high gravimetric and volumetric energy densities which allow them to be used at ultra-fast charging rates while keeping their complete capacities. Thin film electrolytes with intrinsically high ion conductivity (~10-3 S.cm) do exist, but are not electrochemically stable. On the other hand, electronically insulating electrolytes with a large electrochemical window and good chemical stability are known, but typically have intrinsically low ionic conductivities (<10-6 S cm). In addition, there is the need for conformal deposition techniques which can offer pinhole-free coverage over large surface areas with large aspect ratio features for electrode, electrolyte and buffer layers. To tackle the scaling of electrodes and the conformal deposition requirements on future 3D batteries we study LiMn2O4 (LMO) and Li4Ti5O12 (LTO). These materials are among the most interesting electrode candidates for thin film batteries offering low cost, low toxicity, high voltage and high capacity. LMO and LTO are considered 3D compatible materials since they can be prepared through conformal deposition techniques. Here, we show the scaling effects on rate performance and cycle stability of thin film cathode layers of LMO created by RF-sputtering. Planar LMO thin films below 100 nm have been electrochemically characterized. The thinnest films show the highest volumetric capacity and the best cycling stability. The increased stability of the films below 50 nm allows cycling in both the 4 and 3V potential region, resulting in a high volumetric capacity of 1.2Ah/cm3. Also, the creation of LTO anode layers through a post-lithiation process of TiO2 is demonstrated here. Planar LTO thin films below 100 nm have been electrochemically characterized. A 70 nm film retains 85% of its original capacity after 100 (dis)charging cycles at 10C. These layers can be implemented into a high aspect ratio structures. IMEC develops high aspect Si pillars arrays which is the base for the advance of 3D thin film all-solid state batteries of future technologies.

Keywords: Li-ion rechargeable batteries, thin film, nanostructures, rate performance, 3D batteries, all-solid state

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Authors: You-Kai Jhang, Yang-Cheng Lu

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Major contributions of this study are threefold: designing a new model of planar-membrane humidifier for Proton Exchange Membrane Fuel Cell (PEMFC), an index to measure the Effectiveness (εT) of that humidifier, and an air compressor system to replicate related planar-membrane humidifier experiments. PEMFC as a kind of renewable energy has become more and more important in recent years due to its reliability and durability. To maintain the efficiency of the fuel cell, the membrane of PEMFC need to be controlled in a good hydration condition. How to maintain proper membrane humidity is one of the key issues to optimize PEMFC. We developed new humidifier to recycle water vapor from cathode air outlet so as to keep the moisture content of cathode air inlet in a PEMFC. By measuring parameters such as dry side air outlet dew point temperature, dry side air inlet temperature and humidity, wet side air inlet temperature and humidity, and differential pressure between dry side and wet side, we calculated indices obtained by dew point approach temperature (DPAT), water flux (J), water recovery ratio (WRR), effectiveness (εT), and differential pressure (ΔP). We discussed six topics including sealing effect, flow rate effect, flow direction effect, channel effect, temperature effect, and humidity effect by using these indices. Gas cylinders are used as sources of air supply in many studies of humidifiers. Gas cylinder depletes quickly during experiment at 1kW air flow rate, and it causes replication difficult. In order to ensure high stable air quality and better replication of experimental data, this study designs an air supply system to overcome this difficulty. The experimental result shows that the best rate of pressure loss of humidifier is 0.133×10³ Pa(g)/min at the torque of 25 (N.m). The best humidifier performance ranges from 30-40 (LPM) of air flow rates. The counter flow configured humidifies moisturizes the dry side inlet air more effectively than the parallel flow humidifier. From the performance measurements of the channel plates various rib widths studied in this study, it is found that the narrower the rib width is, the more the performance of humidifier improves. Raising channel width in same hydraulic diameter (Dh ) will obtain higher εT and lower ΔP. Moreover, increasing the dry side air inlet temperature or humidity will lead to lower εT. In addition, when the dry side air inlet temperature exceeds 50°C, the effect becomes even more obvious.

Keywords: PEM fuel cell, water management, membrane humidifier, heat and mass transfer, humidifier performance

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Authors: Pradip Kumar Das

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As the entire world continues its rapid move towards industrialization, it has seriously threatened mankind’s ability to maintain an ecological balance. Geographical and natural forces have a significant influence on the location of industries. Industrialization is the foundation stone of the development of any country, while the unplanned industrialization and discharge of waste by industries is the cause of environmental pollution. There is growing degree of awareness and concern globally among nations about environmental degradation or pollution. Environmental resources endowed by the gift of nature and not manmade are invaluable natural resources of a country like India. Any developmental activity is directly related to natural and environmental resources. Economic development without environmental considerations brings about environmental crises and damages the quality of life of present, as well as future generation. As corporate sectors in the global market, especially in India, are becoming anxious about environmental degradation, naturally more and more emphasis will be ascribed to how environment-friendly the outcomes are. Maintaining accounts of such environmental and natural resources in the country has become more urgent. Moreover, international awareness and acceptance of the importance of environmental issues has motivated the development of a branch of accounting called “Environmental Accounting”. Environmental accounting attempts to detect and focus the resources consumed and the costs rendered by an industrial unit to the environment. For the sustainable development of mankind, a healthy environment is indispensable. Gradually, therefore, in many countries including India, environment matters are being given top most priority. Accounting and disclosure of environmental matters have been increasingly manifesting as an important dimension of corporate accounting and reporting practices. But, as conventional accounting deals with mainly non-living things, the formulation of valuation, and measurement and accounting techniques for incorporating environment-related matters in the corporate financial statement sometimes creates problems for the accountant. In the light of this situation, the conceptual analysis of the study is concerned with the rationale of environmental accounting on the economy and society as a whole, and focuses the failures of the traditional accounting system. A modest attempt has been made to throw light on the environmental awareness in developing nations like India and discuss the problems associated with the implementation of environmental accounting. The conceptual study also reflects that despite different anomalies, environmental accounting is becoming an increasing important aspect of the accounting agenda within the corporate sector in India. Lastly, a conclusion, along with recommendations, has been given to overcome the situation.

Keywords: environmental accounting, environmental degradation, environmental management, environmental resources

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Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

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Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

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Authors: S. Albert, R. Cossu, A. Grinham, C. Heatherington, C. Wilson

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Shipping trends suggest increasing vessel size and draught visiting Australian ports highlighting potential challenges to port infrastructure and requiring optimization of shipping channels to ensure safe passage for vessels. The Port of Brisbane in Queensland, Australia has an 80 km long access shipping channel which vessels must transit 15 km of relatively shallow coffee rock (generic class of indurated sands where sand grains are bound within an organic clay matrix) outcrops towards the northern passage in Moreton Bay. This represents a risk to shipping channel deepening and maintenance programs as the dredgeability of this material is more challenging due to its high cohesive strength compared with the surrounding marine sands and potential higher acid sulfate risk. In situ assessment of acid sulfate sediment for dredge spoil control is an important tool in mitigating ecological harm. The coffee rock in an anoxic undisturbed state does not pose any acid sulfate risk, however when disturbed via dredging it’s vital to ensure that any present iron sulfides are either insignificant or neutralized. To better understand the potential risk we examined the reduction potential of coffee rock across the entire dredge cycle in order to accurately portray the true outcome of disturbed acid sulfate sediment in dredging operations in Moreton Bay. In December 2014 a dredge trial was undertaken with a trailing suction hopper dredger. In situ samples were collected prior to dredging revealed acid sulfate potential above threshold guidelines which could lead to expensive dredge spoil management. However, potential acid sulfate risk was then monitored in the hopper and subsequent discharge, both showing a significant reduction in acid sulfate potential had occurred. Additionally, the acid neutralizing capacity significantly increased due to the inclusion of shell fragments (calcium carbonate) from the dredge target areas. This clearly demonstrates the importance of assessing potential acid sulfate risk across the entire dredging cycle and highlights the need to carefully evaluate sources of acidity.

Keywords: acid sulfate, coffee rock, indurated sand, dredging, maintenance dredging

Procedia PDF Downloads 368

Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

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Authors: Eleni Karantzola, Athanasios Karasimos, Vasiliki Makri, Ioanna Skouvara

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Historical linguistics unveils the historical depth of languages and traces variation and change by analyzing linguistic variables over time. This field of linguistics usually deals with a closed data set that can only be expanded by the (re)discovery of previously unknown manuscripts or editions. In some cases, it is possible to use (almost) the entire closed corpus of a language for research, as is the case with the Thesaurus Linguae Graecae digital library for Ancient Greek, which contains most of the extant ancient Greek literature. However, concerning ‘dynamic’ periods when the production and circulation of texts in printed as well as manuscript form have not been fully mapped, representative samples and corpora of texts are needed. Such material and tools are utterly lacking for Early Modern Greek (16th-18th c.). In this study, the principles of the creation of EMoGReC, a pilot representative corpus of Early Modern Greek (16th-18th c.) are presented. Its design follows the fundamental principles of historical corpora. The selection of texts aims to create a representative and balanced corpus that gives insight into diachronic, diatopic and diaphasic variation. The pilot sample includes data derived from fully machine-readable vernacular texts, which belong to 4-5 different textual genres and come from different geographical areas. We develop a hierarchical linguistic annotation scheme, further customized to fit the characteristics of our text corpus. Regarding variables and their variants, we use as a point of departure the bundle of twenty-four features (or categories of features) for prose demotic texts of the 16th c. Tags are introduced bearing the variants [+old/archaic] or [+novel/vernacular]. On the other hand, further phenomena that are underway (cf. The Cambridge Grammar of Medieval and Early Modern Greek) are selected for tagging. The annotated texts are enriched with metalinguistic and sociolinguistic metadata to provide a testbed for the development of the first comprehensive set of tools for the Greek language of that period. Based on a relational management system with interconnection of data, annotations, and their metadata, the EMoGReC database aspires to join a state-of-the-art technological ecosystem for the research of observed language variation and change using advanced computational approaches.

Keywords: early modern Greek, variation and change, representative corpus, diachronic variables.

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Authors: Mawong R., Bussracumpakorn C.

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Millions of young people around the world have been affected by COVID-19 to their psychological and social effects. Millennials’ stresses have been shaped by a few global issues, including climate change, political instability, and financial crisis. In particular, the spread of COVID-19 has become laying psychological and socioeconomic scars on them. When end-of-life planning turns into more widely discussed, the stigma and taboos around this issue are greatly lessened. End-of-life planning is defined as a future life plan, such as financial, legacy, funeral, and memorial planning. This plan would help millennials to discover the value and meaning of life. This study explores the attitudes of Thai Millennials toward end-of-life planning as a new normal awareness of life in order to initiate an innovative service concept to fit with their value and meaning. The study conducts an in-depth interview with 12 potential participants who have awareness or action on the plan. The framework of the customer journey map is used to analyze the responses to examine trigger points, barriers, beliefs, and expectations. The findings pointed to a service concept that is suggested for a new end-of-life planning service that is suited to Thai Millennials in 4 different groups, which are 1. Social -Conscious as a socially aware who to donate time and riches to make the world and society a better place, their end-of-life planning value is inspired by the social impact of giving something or some action that they will be able to do after life or during life which provides a variety of choice based on their preference to give to society, 2. Life Fulfillment who make a life goal for themselves and attempt to achieve it before the time comes to their value will be to inspire life value with a customized plan and provide guidance to suggest, 3. Prevention of the After-Death Effect who want to plan to avoid the effects of their death as patriarch, head of the family, and anchor of someone, so they want to have a plan that brings confidence and feel relief while they are still alive and they want to find some reliable service that they can leave the death will or asset, and 4. No Guilty Planning who plan for when they wish to be worry-free as a self-responsible they want to have the plan which is easy to understand and easy to access. The overall finding of the study is to understand the new service concept of end-of-life planning which to improve knowledge of significant life worth rather than death planning, encouraging people to reassess their lives in a positive way, leading to higher self-esteem and intrinsic motivation for this generation in this time of global crisis.

Keywords: design management, end-of-life planning, millennial generation, service design solution

Procedia PDF Downloads 187

Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

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Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Subramanyam Devarakonda Hanumantharao, Udayendu Prakash Sharma, Mahesh Garg

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Introduction: Gomabai Netralaya a reputed eye hospital is located in Neemuch a small city of Madhya Pradesh, India. The hospital is established in 1992 by Late. G.D Agrawal a renowned educationist, freedom fighter and philanthropist. The eye hospital was established to serve all sections of the society in affordable manner. To provide comprehensive eye care services to the rural poor the hospital started organizing outreach camps since 1994. Purpose: To study the cost effectiveness of outreach eye camps for addressing the sustainability issues of the outreach program. Methods: One year statistics of outreach eye camps were collected from Hospital Management Information System software to analyze the productivity of camps. Income and expenses report was collected from outreach department records to analyze per camp expenses and per patient expenses against the income generated. All current year records were analyzed to have accuracy of information and results. Information was collected in two ways: 1)Actual camp performance records and expenses from book of accounts. 2)Cross verification was done through one to one discussion with outreach staff. Results: Total 17534 outpatients were examined through 52 outreach eye camps. Total 6042 (34% of total outpatients) patients were advised with cataracts and 4651 (77% of advice) operations were performed. The average OPD per camp was 337 and per camp 116 patients was advised for cataract surgery and 89 surgeries were performed per camp. Total 18200 US$ incurred on organizing 52 outreach camps in the radius of 100 k.ms. Considering the total outpatients screened through camps the screening cost per patient was 1.00 US$ and considering the surgical output the per surgery expenses was 4.00 US$. The cost recovery of the total expenses was through Government grant of US$ 16.00 per surgery (that includes surgical grant). All logistics cost of camps and patients transportation cost was taken care by local donors. Conclusion: The present study demonstrates that with people’s participation, successful high volume outreach eye camps can be organized. The cost effectiveness of the outreach camps is totally depended on volume of outpatient’s turn-up at camp site and per camp surgical output. The only solution to sustainability of outreach eye camps is sharing of cost with local donors and increasing productivity.

Keywords: camps, outreach, productivity, sustainable

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Authors: Habib Abida, Noura Dahri

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Flash floods are among the most serious natural hazards that have disastrous environmental and human impacts. They are associated with exceptional rain events, characterized by short durations, very high intensities, rapid flows and small spatial extent. Flash floods happen very suddenly and are difficult to forecast. They generally cause damage to agricultural crops and property, infrastructures, and may even result in the loss of human lives. The city of Gabes (South-eastern Tunisia) has been exposed to numerous damaging floods because of its mild topography, clay soil, high urbanization rate and erratic rainfall distribution. The risks associated with this situation are expected to increase further in the future because of climate change, deemed responsible for the increase of the frequency and the severity of this natural hazard. Recently, exceptional events hit Gabes City causing death and major property losses. A major flooding event hit the region on June 2nd, 2014, causing human deaths and major material losses. It resulted in the stagnation of storm water in the numerous low zones of the study area, endangering thereby human health and causing disastrous environmental impacts. The characterization of flood risk in Gabes Watershed (South-eastern Tunisia) is considered an important step for flood management. Analytical Hierarchy Process (AHP) method coupled with Monte Carlo simulation and geographic information system were applied to delineate and characterize flood areas. A spatial database was developed based on geological map, digital elevation model, land use, and rainfall data in order to evaluate the different factors susceptible to affect flood analysis. Results obtained were validated by remote sensing data for the zones that showed very high flood hazard during the extreme rainfall event of June 2014 that hit the study basin. Moreover, a survey was conducted from different areas of the city in order to understand and explore the different causes of this disaster, its extent and its consequences.

Keywords: analytical hierarchy process, flash floods, Gabes, remote sensing, Tunisia

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Authors: Zhang Tao, Si Tang, Zhang Yufeng, Jin Jiahua

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Work pressure is an emerging research of organizational behavior. Many factors associated with this study also attracted the interest of scholars. Macao is surrounding by open micro-capitalist economy which has a high internationalization level and Mature operation system. And there is no doubt that tourism and hotel service industry is the pillar of the Macao economy with the developing of the mainland individual tourist visa. More and more cities are willing to inclusive culture diversity which lead to the amount of inbound tourists present high-speed up trend cause the hotel industry has a strong customer base and development space. At the same time, the hotel staff is an important role in the service. However, affected by some adverse factors, the hotel staff face a variety of pressures. This study combs the concept and theory of pressures relevant influencing factors and puts forward the purpose of this research. The focus of this study will be organizational supported by work efficiency and work pressure, using qualitative and quantitative research methods. Through questionnaires and interviews, 10 hotels in Macao were selected and 500 questionnaires were distributed to the employees. Statistical analysis software SPSS was used for descriptive statistics. By exploratory factor analysis and confirmatory factor analysis, effect. And the relevant practitioners on behalf of the interview content analysis. The innovation of this research lies in the empirical study of the relationship between the working pressure, organizational support and working efficiency of Macau hotel practitioners, and constructs and validates the structural model of the relationship among them. This model will be helpful for people to use more research methods to study hotel practitioners pressure in the future. At the same time, we can draw the following conclusions: 1. There is a significant negative correlation between salary level and job stress; 2. There is a significant negative correlation between job stress and performance; 3. Different organizational support can interfere the relationship between job stress and performance; 4. Put forward the strategy of relevance adjustment, which provides a reference value for the hotel industry in human resource management. It would be helpful to improve their service standard by training their practitioners more scientifically and rationally.

Keywords: Macau, perceived organizational support, work stress, work efficiency

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Authors: Samuel Carpintero

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Public-private partnerships (PPP) arrangements have emerged all around the world as a response to infrastructure deficits and the need to refurbish existing infrastructure. The motivations of governments for embarking on PPPs for the delivery of public infrastructure are manifold, and include on-time and on-budget delivery as well as access to private project management expertise. The PPP formula has been used by some State governments in United States and Canada, where the participation of private companies in financing and managing infrastructure projects has increased significantly in the last decade, particularly in the transport sector. On the one hand, this paper examines the various ways used in these two countries in the implementation of PPP arrangements, with a particular focus on risk transfer. The examination of risk transfer in this paper is carried out with reference to the following key PPP risk categories: construction risk, revenue risk, operating risk and availability risk. The main difference between both countries is that in Canada the demand risk remains usually within the public sector whereas in the United States this risk is usually transferred to the private concessionaire. The aim is to explore which lessons can be learnt from both models than might be useful for other countries. On the other hand, the paper also analyzes why the Spanish companies have been so successful in winning PPP contracts in North America during the past decade. Contrary to the Latin American PPP market, the Spanish companies do not have any cultural advantage in the case of the United States and Canada. Arguably, some relevant reasons for the success of the Spanish groups are their extensive experience in PPP projects (that dates back to the late 1960s in some cases), their high technical level (that allows them to be aggressive in their bids), and their good position and track-record in the financial markets. The article’s empirical base consists of data provided by official sources of both countries as well as information collected through face-to-face interviews with public and private representatives of the stakeholders participating in some of the PPP schemes. Interviewees include private project managers of the concessionaires, representatives of banks involved as financiers in the projects, and experts in the PPP industry with close knowledge of the North American market. Unstructured in-depth interviews have been adopted as a means of investigation for this study because of its powers to achieve honest and robust responses and to ensure realism in the collection of an overall impression of stakeholders’ perspectives.

Keywords: PPP, concession, infrastructure, construction

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Authors: D. Bjelica, T. Slavinski, V. Vukimrovic, D. Pavlovic, D. Bodroza, V. Dabetic

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Traditional methods and techniques used in higher education may be significantly persuasive on the university students' perception about quality of the teaching process. Students’ satisfaction with the university experience may be affected by chosen educational approaches. Contemporary project management trends recognize agile approaches' beneficial, so modern practice highlights their usage, especially in the IT industry. A key research question concerns the possibility of applying agile methods in youth education. As agile methodology pinpoint iteratively-incremental delivery of results, its employment could be remarkably fruitful in education. This paper demonstrates the agile concept's application in the university students’ education through the continuous delivery of student solutions. Therefore, based on the fundamental values and principles of the agile manifest, paper will analyze students' performance and learned lessons in their encounter with the agile environment. The research is based on qualitative and quantitative analysis that includes sprints, as preparation and realization of student tasks in shorter iterations. Consequently, the performance of student teams will be monitored through iterations, as well as the process of adaptive planning and realization. Grounded theory methodology has been used in this research, as so as descriptive statistics and Man Whitney and Kruskal Wallis test for group comparison. Developed constructs of the model will be showcase through qualitative research, then validated through a pilot survey, and eventually tested as a concept in the final survey. The paper highlights the variability of educational curricula based on university students' feedbacks, which will be collected at the end of every sprint and indicates to university students' satisfaction inconsistency according to approaches applied in education. Values delivered by the lecturers will also be continuously monitored; thus, it will be prioritizing in order to students' requests. Minimal viable product, as the early delivery of results, will be particularly emphasized in the implementation process. The paper offers both theoretical and practical implications. This research contains exceptional lessons that may be applicable by educational institutions in curriculum creation processes, or by lecturers in curriculum design and teaching. On the other hand, they can be beneficial regarding university students' satisfaction increscent in respect of teaching styles, gained knowledge, or even educational content.

Keywords: academic performances, agile, high education, university students' satisfaction

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Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

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Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P＜0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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Authors: Jonathan Nii Laryea Ashong, Samuel Opare

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Current sustainable cities debate focuses on the formidable problems for the Ghana’s largest urban and rural agglomerations, the majority of all urban dwellers continue to reside in far smaller urban settlements. It is estimated that by year 2030, almost all the Ghana’s population growth will likely be intense in urban areas including Nkawkaw in the Kwahu West Municipality of Ghana. Nkawkaw is situated on the road and former railway between Accra and Kumasi, and lies about halfway between these cities. It is also connected by road to Koforidua and Konongo. According to the 2013 census, Nkawkaw has a settlement population of 61,785. Many international agencies, government and private architectures’ are been asked to adequately recognize the naming of streets and property addressing system among the 170 districts across Ghana. The naming of streets and numbering of properties is to assist Metropolitan, Municipal and District Assemblies to manage the processes for establishing coherent address system nationally. Street addressing in the Nkawkaw in the Kwahu West Municipality which makes it possible to identify the location of a parcel of land, public places or dwellings on the ground based on system of names and numbers, yet agreement on how to progress towards it remains elusive. Therefore, reliable and effective development control for proper street naming and property addressing systems are required. The Intelligent Addressing (IA) technology from the UK is being used to name streets and properties in Ghana. The intelligent addressing employs the technique of unique property Reference Number and the unique street reference number which would transform national security and other service providers’ ability to respond rapidly to distress calls. Where name change is warranted following the review of existing streets names, the Physical Planning Department (PPDs) shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the provisions of the policy and the processes outlined for street name change for new development. In the case of existing streets with no names, the respective PPDs shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the requirements set out in municipality. Naming of access ways proposed for new developments shall be done at the time of developing sector layouts (subdivision maps) for the designated areas. In the case of private gated developments, the developer shall submit the names of the access ways as part of the plan and other documentation forwarded to the Municipal District Assembly for approval. The names shall be reviewed first by the PPD to avoid duplication and to ensure conformity to the required standards before submission to the Assembly’s Statutory Planning Committee for approval. The Kwahu West Municipality is supposed to be self-sustaining, providing basic services to inhabitants as a result of proper planning layouts, street naming and property addressing system that prevail in the area. The implications of these future projections are discussed.

Keywords: Nkawkaw, Kwahu west municipality, street naming, property, addressing system

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Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

Procedia PDF Downloads 252

Authors: M. M. Essa, S. Subash, M. Akbar, S. Al-Adawi, A. Al-Asmi, G. J. Guillemein

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Objective: Transgenic (tg) mice which contain an amyloid precursor protein (APP) gene mutation, develop extracellular amyloid beta (Aβ) deposition in the brain, and severe memory and behavioural deficits with age. These mice serve as an important animal model for testing the efficacy of novel drug candidates for the treatment and management of symptoms of Alzheimer's disease (AD). Several reports have suggested that oxidative stress is the underlying cause of Aβ neurotoxicity in AD. Pomegranates contain very high levels of antioxidants and several medicinal properties that may be useful for improving the quality of life in AD patients. In this study, we investigated the effect of dietary supplementation of Omani pomegranate extract on the memory, anxiety and learning skills along with inflammation in an AD mouse model containing the double Swedish APP mutation (APPsw/Tg2576). Methods: The experimental groups of APP-transgenic mice from the age of 4 months were fed custom-mix diets (pellets) containing 4% pomegranate. We assessed spatial memory and learning ability, psychomotor coordination, and anxiety-related behavior in Tg and wild-type mice at the age of 4-5 months and 18-19 months using the Morris water maze test, rota rod test, elevated plus maze test, and open field test. Further, inflammatory parameters also analysed. Results: APPsw/Tg2576 mice that were fed a standard chow diet without pomegranates showed significant memory deficits, increased anxiety-related behavior, and severe impairment in spatial learning ability, position discrimination learning ability and motor coordination along with increased inflammation compared to the wild type mice on the same diet, at the age of 18-19 months In contrast, APPsw/Tg2576 mice that were fed a diet containing 4% pomegranates showed a significant improvements in memory, learning, locomotor function, and anxiety with reduced inflammatory markers compared to APPsw/Tg2576 mice fed the standard chow diet. Conclusion: Our results suggest that dietary supplementation with pomegranates may slow the progression of cognitive and behavioural impairments in AD. The exact mechanism is still unclear and further extensive research needed.

Keywords: Alzheimer's disease, pomegranates, oman, cognitive decline, memory loss, anxiety, inflammation

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Authors: Himali Gunasekara, Baddika Jayaratne

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Haematological abnormalities are known to cause Ischemic Stroke or Transient Ischemic Attack (TIA). The identification of haematological correlates plays an important role in a management and secondary prevention. The objective of this study was to describe haematological correlates of stroke and their association between stroke profile. The haematological correlates screened were Lupus Anticoagulant, Dysfibroginemia, Paroxysmal nocturnal haemoglobinurea (PNH), Sickle cell disease, Systemic Lupus Erythematosis (SLE) and Myeloploriferative Neoplasms (MPN). A cross sectional descriptive study was conducted in a sample of 152 stroke patients referred to haematology department of National Hospital of Sri Lanka for thrombophilia screening. Different tests were performed to assess each hematological correlate. Diluted Russels Viper Venom Test and Kaolin clotting time were done to assess Lupus anticoagulant. Full blood count (FBC), blood picture, Sickling test and High Performance Liquid Chromatography were the tests used for detection of Sickle cell disease. Paroxysmal nocturnal haemoglobinurea was assessed by FBC, blood picture, Ham test and Flowcytometry. FBC, blood picture, Janus Kinase 2 (V617F) mutation analysis, erythropoietin level and bone marrow examination were done to look for the Myeloproliferative neoplasms. Dysfibrinogenaemia was assessed by TT, fibrinogen antigen test, clot observation and clauss test. Anti nuclear antibody test was done to look for systemic lupus erythematosis. Among study sample, 134 patients had strokes and only 18 had TIA. The recurrence of stroke/TIA was observed in 13.2% of patients. The majority of patients (94.7%) have had radiological evidence of thrombotic event. One fourth of patients had past thrombotic events while 12.5% had family history of thrombosis. Out of haematological correlates screened, Lupus anticoagulant was the commonest haematological correlate (n=16 ) and dysfibrigonaemia(n=11 ) had the next high prevalence. One patient was diagnosed with Essential thrombocythaemia and one with SLE. None of the patients were positive for screening tests done for sickle cell disease and PNH. The Haematological correlates were identified in 19% of our study sample. Among stroke profile only presence of past thrombotic history was statistically significantly associated with haematological disorders (P= 0.04). Therefore, hematological disorders appear to be an important factor in etiological work-up of stroke patients particularly in patients with past thrombotic events.

Keywords: stroke, transient ischemic attack, hematological correlates, hematological disorders

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Authors: Liz Carmem Silva-Pereira, Raffael Alencar Mesquita Rodrigues, Francisco Helton Mendes Barbosa, Emerson de Freitas Ferreira

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Due to the Covid-19 pandemic declared in March 2020 by the World Health Organization, the way of social coexistence across the planet was affected, especially in educational processes, from the implementation of the remote modality as a teaching strategy. This teaching-learning modality caused a change in the routine and learning of basic education students, which resulted in serious consequences for the return to face-to-face teaching in 2021. 2022, at the Federal Institute of Education, Science and Technology of Pará (IFPA) – Campus Paragominas had their training process severely affected, having studied the initial half of their training in the remote modality, which compromised the carrying out of practical classes, technical visits and field classes, essential for the student formation on the environmental technician. With the objective of promoting the recomposition of these students' learning after returning to the face-to-face modality, an educational strategy was developed in the last period of the course. As teaching methodologies were used for research as an educational principle, the integrative project and the parallel recovery action applied jointly, aiming at recomposing the basic knowledge of the natural sciences, together with the technical knowledge of the environmental area applied to the course. The project assisted 58 finalist students of the environmental technical course. A research instrument was elaborated with parameters of evaluation of the environmental quality for study in 19 collection points, in the Uraim River urban hydrographic basin, in the Paragominas City – Pará – Brazilian Amazon. Students were separated into groups under the professors' and laboratory assistants’ orientation, and in the field, they observed and evaluated the places' environmental conditions and collected physical data and water samples, which were taken to the chemistry and biology laboratories at Campus Paragominas for further analysis. With the results obtained, each group prepared a technical report on the environmental conditions of each evaluated point. This work methodology enabled the practical application of theoretical knowledge received in various disciplines during the remote teaching modality, contemplating the integration of knowledge, people, skills, and abilities for the best technical training of finalist students. At the activity end, the satisfaction of the involved students in the project was evaluated, through a form, with the signing of the informed consent term, using the Likert scale as an evaluation parameter. The results obtained in the satisfaction survey were: on the use of research projects within the disciplines attended, 82% of satisfaction was obtained; regarding the revision of contents in the execution of the project, 84% of satisfaction was obtained; regarding the acquired field experience, 76.9% of satisfaction was obtained, regarding the laboratory experience, 86.2% of satisfaction was obtained, and regarding the use of this methodology as parallel recovery, 71.8% was obtained of satisfaction. In addition to the excellent performance of students in acquiring knowledge, it was possible to remedy the deficiencies caused by the absence of practical classes, technical visits, and field classes, which occurred during the execution of the remote teaching modality, fulfilling the desired educational recomposition.

Keywords: integrative project, parallel recovery, research as an educational principle, teaching-learning

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Authors: Rute Martins, Margarida Mascarenhas, Elsa Pereira

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The importance between sport and the natural environment was researched through a systematic literature in order to analyse the available scientific articles on the association of sport -angling also the physical activity, active leisure and recreation- and environmental behaviour. The collected data were gathered within the last five years (from 2013 to April 2018) in the Scopus, Web of Science, ScienceDirect, Sage, Green Leaf Online Library, GreenFile (EBSCO) and Wiley online Library databases. The content analysis based on the qualitative methods employed in this study was made with Nvivo software. Regarding only the inclusion of scientific articles, more than half of the collected papers highlighted tourism as the main area where sports is being researched with regard to the environmental theme. Thus, it is possible to extract a perspective of the orientations of the ecological concerns in the sports tourism industry. As such, in the winter sports, the climate change is already an identified issue, wondering about the impact of the environment on the sports practice. In this context, there is a focus on the possible adaptative strategies, researching the characteristics of the sports tourist and the winter sports industry. Regarding the natural parks and protected areas (such as reefs), most of the research is on the environmental impact of the sports tourism, choosing the conservation and the protection of nature as the core topics. The research of the sports tourist profile is addressed by many articles, where the motives for practice and the environmental values are being scanned, and relations to the recreation specialization, environmental responsibility, environmental education, and place-attachment concepts are being made. Regarding the sustainable management, the sports tourism study area is approaching the research in a more holistic way; exploring the stakeholder’s interconnection, focusing on landscape planning and environmentally sustainable practices of sport tourism organizations. The natural parks, protected areas, coral reefs, and snow areas serve as the preferred case-studies for investigating the environmental impact and the ecotourism, in particular, studied through hiking and diving in the great majority. The results of the study are a valuable resource to understand the importance of the sports tourism in the environmental and sustainable action along with the need of embracing all stakeholders within the relationship between the sport and the natural environment.

Keywords: ecotourism, environmental behaviour, outdoor recreation, sport tourism

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Authors: K. C. Apil, Keshab Sharma, Bigul Pokharel

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Kathmandu Valley, capital city of Nepal houses numerous historical monuments as well as religious structures which are as old as from the 4th century A.D. The city alone is home to seven UNESCO’s world heritage sites including various public squares and religious sanctums which are often regarded as living heritages by various historians and archeological explorers. Recently on April 25, 2015, the capital city including other nearby locations was struck with Gorkha earthquake of moment magnitude (Mw) 7.8, followed by the strongest aftershock of moment magnitude (Mw) 7.3 on May 12. This study reports structural failures and collapse of heritage structures in Kathmandu Valley during the earthquake and presents preliminary findings as to the causes of failures and collapses. Field reconnaissance was carried immediately after the main shock and the aftershock, in major heritage sites: UNESCO world heritage sites, a number of temples and historic buildings in Kathmandu Durbar Square, Patan Durbar Square, and Bhaktapur Durbar Square. Despite such catastrophe, a significant number of heritage structures stood high, performing very well during the earthquake. Preliminary reports from archeological department suggest that 721 of such structures were severely affected, whereas numbers within the valley only were 444 including 76 structures which were completely collapsed. This study presents recorded accelerograms and geology of Kathmandu Valley. Structural typology and architecture of the heritage structures in Kathmandu Valley are briefly described. Case histories of damaged heritage structures, the patterns, and the failure mechanisms are also discussed in this paper. It was observed that performance of heritage structures was influenced by the multiple factors such as structural and architecture typology, configuration, and structural deficiency, local ground site effects and ground motion characteristics, age and maintenance level, material quality etc. Most of such heritage structures are of masonry type using bricks and earth-mortar as a bonding agent. The walls' resistance is mainly compressive, thus capable of withstanding vertical static gravitational load but not horizontal dynamic seismic load. There was no definitive pattern of damage to heritage structures as most of them behaved as a composite structure. Some structures were extensively damaged in some locations, while structures with similar configuration at nearby location had little or no damage. Out of major heritage structures, Dome, Pagoda (2, 3 or 5 tiered temples) and Shikhara structures were studied with similar variables. Studying varying degrees of damages in such structures, it was found that Shikhara structures were most vulnerable one where Dome structures were found to be the most stable one, followed by Pagoda structures. The seismic performance of the masonry-timber and stone masonry structures were slightly better than that of the masonry structures. Regular maintenance and periodic seismic retrofitting seems to have played pivotal role in strengthening seismic performance of the structure. The study also recommends some key functions to strengthen the seismic performance of such structures through study based on structural analysis, building material behavior and retrofitting details. The result also recognises the importance of documentation of traditional knowledge and its revised transformation in modern technology.

Keywords: Gorkha earthquake, field observation, heritage structure, seismic performance, masonry building

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Authors: Alaa Osman, Sara Elgazzar, Breksal Elmiligy

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The Supply Chain Operation Reference (SCOR) model is considered one of the most widely implemented supply chain performance measurement systems (SCPMSs). Several studies have been proposed on the SCOR model adaptation in developed countries context; while there is a limited availability of previous work on the SCPMSs application generally and the SCOR model specifically in developing nations. This paper presents a research agenda on the SCOR model adaptation in the developing countries. It aims at investigating the challenges of adapting the SCOR model to manage and measure supply chain performance in developing countries. The research will exemplify the system in the Egyptian automotive sector to gain a comprehensive understanding of how the application of the SCOR model can affect the performance of automotive companies in Egypt, with a necessary understanding of challenges and obstacles faced the adaptation of the model in the Egyptian supply chain context. An empirical study was conducted on the Egyptian automotive sector in three companies considering three different classes: BMW, Hyundai and Brilliance. First, in-depth interviews were carried out to gain an insight into the implementation and the relevance of the concepts of supply chain management and performance measurement in the Egyptian automotive industry. Then, a formal survey was designed based on the SCOR model five main processes (plan, source, make, deliver and return) and best practices to investigate the challenges and obstacles faced the adaptation of the SCOR model in the Egyptian automotive supply chain. Finally, based on the survey results, the appropriate best practices for each process were identified in order to overcome the SCOR model adaptation challenges. The results showed that the implementation of the SCOR model faced different challenges and unavailability of the required enablers. The survey highlighted the low integration of end-to-end supply chain, lacks commitment for the innovative ideas and technologies, financial constraints and lack of practical training and support as the main challenges faced the adaptation of the SCOR model in the Egyptian automotive supply chain. The research provides an original contribution to knowledge by proposing a procedure to identify challenges encountered during the process of SCOR model adoption which can pave a way for further research in the area of SCPMSs adaptation, particularly in the developing countries. The research can help managers and organizations to identify obstacles and difficulties of the SCOR model adaptation, subsequently this can facilitate measuring the improved performance or changes in the organizational performance.

Keywords: automotive sector, developing countries, SCOR model, supply chain performance

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Authors: Biva Samadder, Samita Manna

Abstract:

India is a melting pot of races, tribes, castes and communities. The population of India can be roughly branched into the huge majority of “Civilized” Indians of the Plains and the minority of Tribal population of the hill area and the forest who constituting almost 16 percent of total population of India. The Kirat community composed of four ethnic tribes: Limbu, Lepcha, Dhimal, and Rai. These Kirat people were found to be rich in indigenous knowledge, skill and practices especially for the use on medicinal plants and livelihood purposes. The “Mundhum" is the oral scripture or the “Bible of the Limbus” which serves as the canon of the codes of the Limbu socialization, their moral values and the very orientation of their lifestyle. From birth till death the Limbus are disciplined in the life with full of religious rituals, traditions and culture governed by community norms with a rich legacy of indigenous knowledge and traditional practices. The present study has been conducted using both secondary as well as primary data by applying social methodology consisting of the social survey, questionnaire, interviews and observations in the Kalimpong Block-I of Darjeeling District of west Bengal of India, which is a heterogeneous zone in terms of its ethnic composition and where the Limbus are pre-dominantly concentrated. Due to their close contact with other caste and communities Limbus are now adjusted with the changing situation by borrowing some cultural traits from the other communities and changes that have taken place in their cultural practices, religious beliefs, economic aspects, languages and in social roles and relationships which is bringing the change in their material culture. Limbu language is placed in the Tibeto- Burman Language category. But due to the political and cultural domination of educationally sound and numerically dominant Bengali race, the different communities in this area forced to come under the one umbrella of the Nepali or Gorkhali nation (nation-people). Their respective identities had to be submerged in order to constitute as a strong force to resist Nepali domination and ensure their common survival. As Nepali is a lingua-franca of the area knowing and speaking Nepali language helps them in procuring economic and occupational facilities. Ironically, present day younger generation does not feel comfortable speaking in their own Limbu tongue. The traditional knowledge about medicinal plants, healing, and health culture is found to be wear away due to the lack of interest of young generation. Not only poverty, along with exclusion due to policies they are in the phase of extinction, but their capabilities are ignored and not documented and preserved especially in the case of Limbus who having a great cultural heritage of an oral tradition. Attempts have been made to discuss the persistence and changes in socioeconomic pattern of life in relation to the social structure, material culture, cultural practices, social relationships, indigenous technology, ethos and their values and belief system.

Keywords: changing social relationship, cultural transition, identity, indigenous knowledge, language

Procedia PDF Downloads 172

Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

Abstract:

Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

Procedia PDF Downloads 343