Search results for: health supply chain system strengthening
26028 Prevalence and Mechanisms of Antibiotic Resistance in Escherichia coli Isolated from Mastitic Dairy Cattle in Canada
Authors: Satwik Majumder, Dongyun Jung, Jennifer Ronholm, Saji George
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Bovine mastitis is the most common infectious disease in dairy cattle, with major economic implications for the dairy industry worldwide. Continuous monitoring for the emergence of antimicrobial resistance (AMR) among bacterial isolates from dairy farms is vital not only for animal husbandry but also for public health. In this study, the prevalence of AMR in 113 Escherichia coli isolates from cases of bovine clinical mastitis in Canada was investigated. Kirby-Bauer disk diffusion test with 18 antibiotics and microdilution method with three heavy metals (copper, zinc, and silver) was performed to determine the antibiotic and heavy-metal susceptibility. Resistant strains were assessed for efflux and ß-lactamase activities besides assessing biofilm formation and hemolysis. Whole-genome sequences for each of the isolates were examined to detect the presence of genes corresponding to the observed AMR and virulence factors. Phenotypic analysis revealed that 32 isolates were resistant to one or more antibiotics, and 107 showed resistance against at least one heavy metal. Quinolones and silver were the most efficient against the tested isolates. Among the AMR isolates, AcrAB-TolC efflux activity and ß-lactamase enzyme activities were detected in 13 and 14 isolates, respectively. All isolates produced biofilm but with different capacities, and 33 isolates showed α-hemolysin activity. A positive correlation (Pearson r = +0.89) between efflux pump activity and quantity of biofilm was observed. Genes associated with aggregation, adhesion, cyclic di-GMP, quorum sensing were detected in the AMR isolates, corroborating phenotype observations. This investigation showed the prevalence of AMR in E. coli isolates from bovine clinical mastitis. The results also suggest the inadequacy of antimicrobials with a single mode of action to curtail AMR bacteria with multiple mechanisms of resistance and virulence factors. Therefore, it calls for combinatorial therapy for the effective management of AMR infections in dairy farms and combats its potential transmission to the food supply chain through milk and dairy products.Keywords: antimicrobial resistance, E. coli, bovine mastitis, antibiotics, heavy-metals, efflux pump, ß-lactamase enzyme, biofilm, whole-genome sequencing
Procedia PDF Downloads 21926027 Lessons Learned in Developing a Clinical Information System and Electronic Health Record (EHR) System That Meet the End User Needs and State of Qatar's Emerging Regulations
Authors: Darshani Premaratne, Afshin Kandampath Puthiyadath
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The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly, the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned. The Government of Qatar is taking active steps in improving quality of health care industry in the state of Qatar. In this initiative development and market introduction of Clinical Information System and Electronic Health Record (EHR) system are proved to be a highly challenging process. Along with an organization specialized on EHR system development and with the blessing of Health Ministry of Qatar the process of introduction of EHR system in Qatar healthcare industry was undertaken. Initially a market survey was carried out to understand the requirements. Secondly the available government regulations, needs and possible upcoming regulations were carefully studied before deployment of resources for software development. Sufficient flexibility was allowed to cater for both the changes in the market and the regulations. As the first initiative a system that enables integration of referral network where referral clinic and laboratory system for all single doctor (and small scale) clinics was developed. Setting of isolated single doctor clinics all over the state to bring in to an integrated referral network along with a referral hospital need a coherent steering force and a solid top down framework. This paper discusses about the lessons learned in developing, in obtaining approval of the health ministry and in introduction to the industry of the single doctor referral network along with an EHR system. It was concluded that development of this nature required continues balance between the market requirements and upcoming regulations. Further accelerating the development based on the emerging needs, implementation based on the end user needs while tallying with the regulations, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and proper utilization of findings were equally found paramount in successful development of end product. Development of full scale Clinical Information System and EHR system are underway based on the lessons learned.Keywords: clinical information system, electronic health record, state regulations, integrated referral network of clinics
Procedia PDF Downloads 36426026 Seismic Reinforcement of Existing Japanese Wooden Houses Using Folded Exterior Thin Steel Plates
Authors: Jiro Takagi
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Approximately 90 percent of the casualties in the near-fault-type Kobe earthquake in 1995 resulted from the collapse of wooden houses, although a limited number of collapses of this type of building were reported in the more recent off-shore-type Tohoku Earthquake in 2011 (excluding direct damage by the Tsunami). Kumamoto earthquake in 2016 also revealed the vulnerability of old wooden houses in Japan. There are approximately 24.5 million wooden houses in Japan and roughly 40 percent of them are considered to have the inadequate seismic-resisting capacity. Therefore, seismic strengthening of these wooden houses is an urgent task. However, it has not been quickly done for various reasons, including cost and inconvenience during the reinforcing work. Residents typically spend their money on improvements that more directly affect their daily housing environment (such as interior renovation, equipment renewal, and placement of thermal insulation) rather than on strengthening against extremely rare events such as large earthquakes. Considering this tendency of residents, a new approach to developing a seismic strengthening method for wooden houses is needed. The seismic reinforcement method developed in this research uses folded galvanized thin steel plates as both shear walls and the new exterior architectural finish. The existing finish is not removed. Because galvanized steel plates are aesthetic and durable, they are commonly used in modern Japanese buildings on roofs and walls. Residents could feel a physical change through the reinforcement, covering existing exterior walls with steel plates. Also, this exterior reinforcement can be installed with only outdoor work, thereby reducing inconvenience for residents since they would not be required to move out temporarily during construction. The Durability of the exterior is enhanced, and the reinforcing work can be done efficiently since perfect water protection is not required for the new finish. In this method, the entire exterior surface would function as shear walls and thus the pull-out force induced by seismic lateral load would be significantly reduced as compared with a typical reinforcement scheme of adding braces in selected frames. Consequently, reinforcing details of anchors to the foundations would be less difficult. In order to attach the exterior galvanized thin steel plates to the houses, new wooden beams are placed next to the existing beams. In this research, steel connections between the existing and new beams are developed, which contain a gap for the existing finish between the two beams. The thin steel plates are screwed to the new beams and the connecting vertical members. The seismic-resisting performance of the shear walls with thin steel plates is experimentally verified both for the frames and connections. It is confirmed that the performance is high enough for bracing general wooden houses.Keywords: experiment, seismic reinforcement, thin steel plates, wooden houses
Procedia PDF Downloads 22726025 Experimental Evaluation of Stand Alone Solar Driven Membrane Distillation System
Authors: Mejbri Sami, Zhani Khalifa, Zarzoum Kamel, Ben Bacha Habib, Koschikowski Joachim, Pfeifle Daniel
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Many places worldwide, especially arid and semi-arid remote regions, are suffering from the lack of drinkable water and the situation will be aggravated in the near future. Furthermore, remote areas are characterised by lack of conventional energy sources, skilled personnel and maintenance facilities. Therefore, the development of small to medium size, stand-alone and robust solar desalination systems is needed to provide independent fresh water supply in remote areas. This paper is focused on experimental studies on compact membrane distillation (MD) solar desalination prototype located at the Mechanical Engineering Department site, Kairouan University, Kairouan, Tunisia. The pilot system is designed and manufactured as a part of a research and development project funded by the MESRS/BMBF. The pilot system is totally autonomous. The electrical energy required to operate the unit is generated through a field of 4 m² of photovoltaic panels, and the heating of feed water is provided by a field of 6 m² of solar collectors. The Kairouan plant performance of the first few months of operation is presented. The highest freshwater production of 150 L/d is obtained on a sunny day in July of 633 W/m²d.Keywords: experimental, membrane distillation, solar desalination, Permeat gap
Procedia PDF Downloads 13826024 The Influence of E-Health Education on Professional Practice: A Qualitative Study
Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield
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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.Keywords: e-health, postgraduate education, clinical practice, curriculum
Procedia PDF Downloads 16426023 Energy Harvesting and Storage System for Marine Applications
Authors: Sayem Zafar, Mahmood Rahi
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Rigorous international maritime regulations are in place to limit boat and ship hydrocarbon emissions. The global sustainability goals are reducing the fuel consumption and minimizing the emissions from the ships and boats. These maritime sustainability goals have attracted a lot of research interest. Energy harvesting and storage system is designed in this study based on hybrid renewable and conventional energy systems. This energy harvesting and storage system is designed for marine applications, such as, boats and small ships. These systems can be utilized for mobile use or off-grid remote electrification. This study analyzed the use of micro power generation for boats and small ships. The energy harvesting and storage system has two distinct systems i.e. dockside shore-based system and on-board system. The shore-based system consists of a small wind turbine, photovoltaic (PV) panels, small gas turbine, hydrogen generator and high-pressure hydrogen storage tank. This dockside system is to provide easy access to the boats and small ships for supply of hydrogen. The on-board system consists of hydrogen storage tanks and fuel cells. The wind turbine and PV panels generate electricity to operate electrolyzer. A small gas turbine is used as a supplementary power system to contribute in case the hybrid renewable energy system does not provide the required energy. The electrolyzer performs the electrolysis on distilled water to produce hydrogen. The hydrogen is stored in high-pressure tanks. The hydrogen from the high-pressure tank is filled in the low-pressure tanks on-board seagoing vessels to operate the fuel cell. The boats and small ships use the hydrogen fuel cell to provide power to electric propulsion motors and for on-board auxiliary use. For shore-based system, a small wind turbine with the total length of 4.5 m and the disk diameter of 1.8 m is used. The small wind turbine dimensions make it big enough to be used to charge batteries yet small enough to be installed on the rooftops of dockside facility. The small dimensions also make the wind turbine easily transportable. In this paper, PV, sizing and solar flux are studied parametrically. System performance is evaluated under different operating and environmental conditions. The parametric study is conducted to evaluate the energy output and storage capacity of energy storage system. Results are generated for a wide range of conditions to analyze the usability of hybrid energy harvesting and storage system. This energy harvesting method significantly improves the usability and output of the renewable energy sources. It also shows that small hybrid energy systems have promising practical applications.Keywords: energy harvesting, fuel cell, hybrid energy system, hydrogen, wind turbine
Procedia PDF Downloads 14026022 Analysis of a Discrete-time Geo/G/1 Queue Integrated with (s, Q) Inventory Policy at a Service Facility
Authors: Akash Verma, Sujit Kumar Samanta
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This study examines a discrete-time Geo/G/1 queueing-inventory system attached with (s, Q) inventory policy. Assume that the customers follow the Bernoulli process on arrival. Each customer demands a single item with arbitrarily distributed service time. The inventory is replenished by an outside supplier, and the lead time for the replenishment is determined by a geometric distribution. There is a single server and infinite waiting space in this facility. Demands must wait in the specified waiting area during a stock-out period. The customers are served on a first-come-first-served basis. With the help of the embedded Markov chain technique, we determine the joint probability distributions of the number of customers in the system and the number of items in stock at the post-departure epoch using the Matrix Analytic approach. We relate the system length distribution at post-departure and outside observer's epochs to determine the joint probability distribution at the outside observer's epoch. We use probability distributions at random epochs to determine the waiting time distribution. We obtain the performance measures to construct the cost function. The optimum values of the order quantity and reordering point are found numerically for the variety of model parameters.Keywords: discrete-time queueing inventory model, matrix analytic method, waiting-time analysis, cost optimization
Procedia PDF Downloads 4626021 A Cellular-Based Structural Health Monitoring Device (HMD) Based on Cost-Effective 1-Axis Accelerometers
Authors: Chih-Hsing Lin, Wen-Ching Chen, Chih-Ting Kuo, Gang-Neng Sung, Chih-Chyau Yang, Chien-Ming Wu, Chun-Ming Huang
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This paper proposes a cellular-based structure health monitoring device (HMD) for temporary bridge monitoring without the requirement of power line and internet service. The proposed HMD includes sensor node, power module, cellular gateway, and rechargeable batteries. The purpose of HMD focuses on short-term collection of civil infrastructure information. It achieves the features of low cost by using three 1-axis accelerometers with data synchronization problem being solved. Furthermore, instead of using data acquisition system (DAQ) sensed data is transmitted to Host through cellular gateway. Compared with 3-axis accelerometer, our proposed 1-axis accelerometers based device achieves 50.5% cost saving with high sensitivity 2000mv/g. In addition to fit different monitoring environments, the proposed system can be easily replaced and/or extended with different PCB boards, such as communication interfaces and sensors, to adapt to various applications. Therefore, with using the proposed device, the real-time diagnosis system for civil infrastructure damage monitoring can be conducted effectively.Keywords: cellular-based structural health monitoring, cost-effective 1-axis accelerometers, short-term monitoring, structural engineering
Procedia PDF Downloads 51826020 3D Modelling and Numerical Analysis of Human Inner Ear by Means of Finite Elements Method
Authors: C. Castro-Egler, A. Durán-Escalante, A. García-González
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This paper presents a method to generate a finite element model of the human auditory inner ear system. The geometric model has been realized using 2D images from a virtual model of temporal bones. A point cloud has been gotten manually from those images to construct a whole mesh with hexahedral elements. The main difference with the predecessor models is the spiral shape of the cochlea with its three scales completely defined: scala tympani, scala media and scala vestibuli; which are separate by basilar membrane and Reissner membrane. To validate this model, numerical simulations have been realised with two models: an isolated inner ear and a whole model of human auditory system. Ideal conditions of displacement are applied over the oval window in the isolated Inner Ear model. The whole model is made up of the outer auditory channel, the tympani, the ossicular chain, and the inner ear. The boundary condition for the whole model is 1Pa over the auditory channel entrance. The numerical simulations by FEM have been done using a harmonic analysis with a frequency range between 100-10.000 Hz with an interval of 100Hz. The following results have been carried out: basilar membrane displacement; the scala media pressure according to the cochlea length and the transfer function of the middle ear normalized with the pressure in the tympanic membrane. The basilar membrane displacements and the pressure in the scala media make it possible to validate the response in frequency of the basilar membrane.Keywords: finite elements method, human auditory system model, numerical analysis, 3D modelling cochlea
Procedia PDF Downloads 36526019 Determinants of the Income of Household Level Coir Yarn Labourers in Sri Lanka
Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu
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Sri Lanka is one of the prominent countries for the coir production. The coir is one of the by-products of the coconut and the coir industry is considered to be one of the traditional industries in Sri Lanka. Because of the inherent nature of the coir industry, labourers play a significant role in the coir production process. The study has analyzed the determinants of the income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division. Simple random sampling was used to generate a sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews, and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were performed for mean comparison. The findings revealed that the household level coir yarn industry is dominated by the female workers and it was identified that fewer numbers of workers have engaged in this industry as the main occupation. In addition to that, elderly participation in the industry is higher than the younger participation and most of them have engaged in the industry as a source of extra income. Level of education, the methods of engagement, satisfaction, engagement in the industry by the next generation, support from the government, method of government support, working hours per day, employed as a main job, number of completed units per day, suffering from job related diseases and type of the diseases were related with income level of household level coir yarn laboures. The recommendations as to flourish in future includes, technological transformation for coir yarn production, strengthening the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programmes, the establishment of the labourers’ association, the initiation of micro credit schemes and better consideration about the job oriented diseases.Keywords: coir yarn, determinants, income, Sri Lanka
Procedia PDF Downloads 31326018 HelpMeBreathe: A Web-Based System for Asthma Management
Authors: Alia Al Rayssi, Mahra Al Marar, Alyazia Alkhaili, Reem Al Dhaheri, Shayma Alkobaisi, Hoda Amer
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We present in this paper a web-based system called “HelpMeBreathe” for managing asthma. The proposed system provides analytical tools, which allow better understanding of environmental triggers of asthma, hence better support of data-driven decision making. The developed system provides warning messages to a specific asthma patient if the weather in his/her area might cause any difficulty in breathing or could trigger an asthma attack. HelpMeBreathe collects, stores, and analyzes individuals’ moving trajectories and health conditions as well as environmental data. It then processes and displays the patients’ data through an analytical tool that leads to an effective decision making by physicians and other decision makers.Keywords: asthma, environmental triggers, map interface, web-based systems
Procedia PDF Downloads 29526017 Tower Crane Selection and Positioning on Construction Sites
Authors: Dirk Briskorn, Michael Dienstknecht
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Cranes are a key element in construction projects as they are the primary lifting equipment and among the most expensive construction equipment. Thus, selecting cranes and locating them on-site is an important factor for a project's profitability. We focus on a site with supply and demand areas that have to be connected by tower cranes. There are several types of tower cranes differing in certain specifications such as costs or operating radius. The objective is to select cranes and determine their locations such that each demand area is connected to its supply area at minimum cost. We detail the problem setting and show how to obtain a discrete set of candidate locations for each crane type without losing optimality. This discretization allows us to reduce our problem to the classic set cover problem. Despite its NP-hardness, we achieve good results employing a standard solver and a greedy heuristic, respectively.Keywords: positioning, selection, standard solver, tower cranes
Procedia PDF Downloads 37526016 Antimicrobial Activity of 2-Nitro-1-Propanol and Lauric Acid against Gram-Positive Bacteria
Authors: Robin Anderson, Elizabeth Latham, David Nisbet
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Propagation and dissemination of antimicrobial resistant and pathogenic microbes from spoiled silages and composts represents a serious public health threat to humans and animals. In the present study, the antimicrobial activity of the short chain nitro-compound, 2-nitro-1-propanol (9 mM) as well as the medium chain fatty acid, lauric acid, and its glycerol monoester, monolaurin, (each at 25 and 17 µmol/mL, respectfully) were investigated against select pathogenic and multi-drug resistant antimicrobial resistant Gram-positive bacteria common to spoiled silages and composts. In an initial study, we found that growth rates of a multi-resistant Enterococcus faecalis (expressing resistance against erythromycin, quinupristin/dalfopristin and tetracycline) and Staphylococcus aureus strain 12600 (expressing resistance against erythromycin, linezolid, penicillin, quinupristin/dalfopristin and vancomycin) were more than 78% slower (P < 0.05) by 2-nitro-1-propanol treatment during culture (n = 3/treatment) in anaerobically prepared ½ strength Brain Heart Infusion broth at 37oC when compared to untreated controls (0.332 ± 0.04 and 0.108 ± 0.03 h-1, respectively). The growth rate of 2-nitro-1-propanol-treated Listeria monocytogenes was also decreased by 96% (P < 0.05) when compared to untreated controls cultured similarly (0.171 ± 0.01 h-1). Maximum optical densities measured at 600 nm were lower (P < 0.05) in 2-nitro-1-propanol-treated cultures (0.053 ± 0.01, 0.205 ± 0.02 and 0.041 ± 0.01, respectively) than in untreated controls (0.483 ± 0.02, 0.523 ± 0.01 and 0.427 ± 0.01, respectively) for E. faecalis, S. aureus and L. monocytogenes, respectively. When tested against mixed microbial populations during anaerobic 24 h incubation of spoiled silage, significant effects of treatment with 1 mg 2-nitro-1-propanol (approximately 9.5 µmol/g) or 5 mg lauric acid/g (approximately 25 µmol/g) on populations of wildtype Enterococcus and Listeria were not observed. Mixed populations treated with 5 mg monolaurin/g (approximately 17 µmol/g) had lower (P < 0.05) viable cell counts of wildtype enterococci than untreated controls after 6 h incubation (2.87 ± 1.03 versus 5.20 ± 0.25 log10 colony forming units/g, respectively) but otherwise significant effects of monolaurin were not observed. These results reveal differential susceptibility of multi-drug resistant enterococci and staphylococci as well as L. monocytogenes to the inhibitory activity of 2-nitro-1-propanol and the medium chain fatty acid, lauric acid and its glycerol monoester, monolaurin. Ultimately, these results may lead to improved treatment technologies to preserve the microbiological safety of silages and composts.Keywords: 2-nitro-1-propanol, lauric acid, monolaurin, gram positive bacteria
Procedia PDF Downloads 11026015 IOT Based Process Model for Heart Monitoring Process
Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed
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Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.Keywords: IoT, process model, remote patient monitoring system, smart watch
Procedia PDF Downloads 33426014 Building a Framework for Digital Emergency Response System for Aged, Long Term Care and Chronic Disease Patients in Asia Pacific Region
Authors: Nadeem Yousuf Khan
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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology
Procedia PDF Downloads 12326013 Connecting the Dots: Bridging Academia and National Community Partnerships When Delivering Healthy Relationships Programming
Authors: Nicole Vlasman, Karamjeet Dhillon
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Over the past four years, the Healthy Relationships Program has been delivered in community organizations and schools across Canada. More than 240 groups have been facilitated in collaboration with 33 organizations. As a result, 2157 youth have been engaged in the programming. The purpose and scope of the Healthy Relationships Program are to offer sustainable, evidence-based skills through small group implementation to prevent violence and promote positive, healthy relationships in youth. The program development has included extensive networking at regional and national levels. The Healthy Relationships Program is currently being implemented, adapted, and researched within the Resilience and Inclusion through Strengthening and Enhancing Relationships (RISE-R) project. Alongside the project’s research objectives, the RISE-R team has worked to virtually share the ongoing findings of the project through a slow ontology approach. Slow ontology is a practice integrated into project systems and structures whereby slowing the pace and volume of outputs offers creative opportunities. Creative production reveals different layers of success and complements the project, the building blocks for sustainability. As a result of integrating a slow ontology approach, the RISE-R team has developed a Geographic Information System (GIS) that documents local landscapes through a Story Map feature, and more specifically, video installations. Video installations capture the cartography of space and place within the context of singular diverse community spaces (case studies). By documenting spaces via human connections, the project captures narratives, which further enhance the voices and faces of the community within the larger project scope. This GIS project aims to create a visual and interactive flow of information that complements the project's mixed-method research approach. Conclusively, creative project development in the form of a geographic information system can provide learning and engagement opportunities at many levels (i.e., within community organizations and educational spaces or with the general public). In each of these disconnected spaces, fragmented stories are connected through a visual display of project outputs. A slow ontology practice within the context of the RISE-R project documents activities on the fringes and within internal structures; primarily through documenting project successes as further contributions to the Centre for School Mental Health framework (philosophy, recruitment techniques, allocation of resources and time, and a shared commitment to evidence-based products).Keywords: community programming, geographic information system, project development, project management, qualitative, slow ontology
Procedia PDF Downloads 15626012 Reducing Hazardous Materials Releases from Railroad Freights through Dynamic Trip Plan Policy
Authors: Omar A. Abuobidalla, Mingyuan Chen, Satyaveer S. Chauhan
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Railroad transportation of hazardous materials freights is important to the North America economics that supports the national’s supply chain. This paper introduces various extensions of the dynamic hazardous materials trip plan problems. The problem captures most of the operational features of a real-world railroad transportations systems that dynamically initiates a set of blocks and assigns each shipment to a single block path or multiple block paths. The dynamic hazardous materials trip plan policies have distinguishing features that are integrating the blocking plan, and the block activation decisions. We also present a non-linear mixed integer programming formulation for each variant and present managerial insights based on a hypothetical railroad network. The computation results reveal that the dynamic car scheduling policies are not only able to take advantage of the capacity of the network but also capable of diminishing the population, and environment risks by rerouting the active blocks along the least risky train services without sacrificing the cost advantage of the railroad. The empirical results of this research illustrate that the issue of integrating the blocking plan, and the train makeup of the hazardous materials freights must receive closer attentions.Keywords: dynamic car scheduling, planning and scheduling hazardous materials freights, airborne hazardous materials, gaussian plume model, integrated blocking and routing plans, box model
Procedia PDF Downloads 20726011 Teaching a Senior Design Course in Industrial Engineering
Authors: Mehmet Savsar
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Industrial Engineering is one of the engineering disciplines that deal with analysis, design, and improvement of systems, which include manufacturing, supply chain, healthcare, communication, and general service systems. Industrial engineers involve with comprehensive study of a given system, analysis of its interacting units, determination of problem areas, application of various optimization and operations research tools, and recommendation of solutions resulting in significant improvements. The Senior Design course in Industrial Engineering is the culmination of the Industrial Engineering Curriculum in a Capstone Design course, which fundamentally deals with systems analysis and design. The course at Kuwait University has been carefully designed with various course objectives and course outcomes in mind to achieve several program outcomes by practices and learning experiences, which are explicitly gained by systems analysis and design. The Senior Design Course is carried out in a selected industrial or service organization, with support from its engineering personnel, during a full semester by a team of students, who are usually in the last semester of their academic programs. A senior faculty member constantly administers the course to ensure that the students accomplish the prescribed objectives. Students work in groups to formulate issues and propose solutions and communicate, results in formal written and oral presentations. When the course is completed, they emerge as engineers that can be clearly identified as more mature, able to communicate better, able to participate in team work, able to see systems perspective in analysis and design, and more importantly, able to assume responsibility at entry level as engineers. The accomplishments are mainly due to real life experiences gained during the course of their design study. This paper presents methods, procedures, and experiences in teaching a Senior Design Course in Industrial Engineering Curriculum. A detailed description of the course, its role, its objectives, outcomes, learning practices, and assessments are explained in relation to other courses in Industrial Engineering Curriculum. The administration of the course, selected organizations where the course project is carried out, problems and solution tools utilized, student accomplishments and obstacles faced are presented. Issues discussed in this paper could help instructors in teaching the course as well as in clarifying the contribution of a design course to the industrial engineering education in general. In addition, the methods and teaching procedures presented could facilitate future improvements in industrial engineering curriculum.Keywords: senior design course, industrial engineering, capstone design, education
Procedia PDF Downloads 13526010 Performance Analysis of High Temperature Heat Pump Cycle for Industrial Process
Authors: Seon Tae Kim, Robert Hegner, Goksel Ozuylasi, Panagiotis Stathopoulos, Eberhard Nicke
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High-temperature heat pumps (HTHP) that can supply heat at temperatures above 200°C can enhance the energy efficiency of industrial processes and reduce the CO₂ emissions connected with the heat supply of these processes. In the current work, the thermodynamic performance of 3 different vapor compression cycles, which use R-718 (water) as a working medium, have been evaluated by using a commercial process simulation tool (EBSILON Professional). All considered cycles use two-stage vapor compression with intercooling between stages. The main aim of the study is to compare different intercooling strategies and study possible heat recovery scenarios within the intercooling process. This comparison has been carried out by computing the coefficient of performance (COP), the heat supply temperature level, and the respective mass flow rate of water for all cycle architectures. With increasing temperature difference between the heat source and heat sink, ∆T, the COP values decreased as expected, and the highest COP value was found for the cycle configurations where both compressors have the same pressure ratio (PR). The investigation on the HTHP capacities with optimized PR and exergy analysis has also been carried out. The internal heat exchanger cycle with the inward direction of secondary flow (IHX-in) showed a higher temperature level and exergy efficiency compared to other cycles. Moreover, the available operating range was estimated by considering mechanical limitations.Keywords: high temperature heat pump, industrial process, vapor compression cycle, R-718 (water), thermodynamic analysis
Procedia PDF Downloads 15026009 Transforming Water-Energy-Gas Industry through Smart Metering and Blockchain Technology
Authors: Khoi A. Nguyen, Rodney A. Stewart, Hong Zhang
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Advanced metering technologies coupled with informatics creates an opportunity to form digital multi-utility service providers. These providers will be able to concurrently collect a customers’ medium-high resolution water, electricity and gas demand data and provide user-friendly platforms to feed this information back to customers and supply/distribution utility organisations. With the emergence of blockchain technology, a new research area has been explored which helps bring this multi-utility service provider concept to a much higher level. This study aims at introducing a breakthrough system architecture where smart metering technology in water, energy, and gas (WEG) are combined with blockchain technology to provide customer a novel real-time consumption report and decentralized resource trading platform. A pilot study on 4 properties in Australia has been undertaken to demonstrate this system, where benefits for customers and utilities are undeniable.Keywords: blockchain, digital multi-utility, end use, demand forecasting
Procedia PDF Downloads 17326008 Engaging Women Entrepreneurs in School Adolescent Health Program to Ensure Menstrual Hygiene Management in Rural Bangladesh
Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed
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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management
Procedia PDF Downloads 20126007 Addressing Microbial Contamination in East Hararghe, Oromia, Ethiopia: Improving Water Sanitation Infrastructure and Promoting Safe Water Practices for Enhanced Food Safety
Authors: Tuji Jemal Ahmed, Hussen Beker Yusuf
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Food safety is a major concern worldwide, with microbial contamination being one of the leading causes of foodborne illnesses. In Ethiopia, drinking water and untreated groundwater are a primary source of microbial contamination, leading to significant health risks. East Hararghe, Oromia, is one of the regions in Ethiopia that has been affected by this problem. This paper provides an overview of the impact of untreated groundwater on human health in Haramaya Rural District, East Hararghe and highlights the urgent need for sustained efforts to address the water sanitation supply problem. The use of untreated groundwater for drinking and household purposes in Haramaya Rural District, East Hararghe is prevalent, leading to high rates of waterborne illnesses such as diarrhea, typhoid fever, and cholera. The impact of these illnesses on human health is significant, resulting in significant morbidity and mortality, especially among vulnerable populations such as children and the elderly. In addition to the direct health impacts, waterborne illnesses also have indirect impacts on human health, such as reduced productivity and increased healthcare costs. Groundwater sources are susceptible to microbial contamination due to the infiltration of surface water, human and animal waste, and agricultural runoff. In Haramaya Rural District, East Hararghe, poor water management practices, inadequate sanitation facilities, and limited access to clean water sources contribute to the prevalence of untreated groundwater as a primary source of drinking water. These underlying causes of microbial contamination highlight the need for improved water sanitation infrastructure, including better access to safe drinking water sources and the implementation of effective treatment methods. The paper emphasizes the need for regular water quality monitoring, especially for untreated groundwater sources, to ensure safe drinking water for the population. The implementation of effective preventive measures, such as the use of effective disinfectants, proper waste disposal methods, and regular water quality monitoring, is crucial to reducing the risk of contamination and improving public health outcomes in the region. Community education and awareness-raising campaigns can also play a critical role in promoting safe water practices and reducing the risk of contamination. These campaigns can include educating the population on the importance of boiling water before drinking, the use of water filters, and proper sanitation practices. In conclusion, the use of untreated groundwater as a primary source of drinking water in East Hararghe, Oromia, Ethiopia, has significant impacts on human health, leading to widespread waterborne illnesses and posing a significant threat to public health. Sustained efforts are urgently needed to address the root causes of contamination, such as poor sanitation and hygiene practices, improper waste management, and the water sanitation supply problem, including the implementation of effective preventive measures and community-based education programs, ultimately improving public health outcomes in the region. A comprehensive approach that involves community-based water management systems, point-of-use water treatment methods, and awareness-raising campaigns can contribute to reducing the incidence of microbial contamination in the region.Keywords: food safety, health risks, microbial contamination, untreated groundwater
Procedia PDF Downloads 11526006 Sources and Content of Sexual Information among School Going Adolescents in Uganda
Authors: Jonathan Magala
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Context: Adolescents in Uganda face significant challenges related to sexual health due to inadequate sexual information. This lack of information puts young people at risk of early pregnancies, sexually transmitted infections, and poverty. Therefore, it is essential to understand the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Uganda. Research Aim: The aim of this study was to establish the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Luwero Town Council, Uganda. Methodology: This study used a cross-sectional approach with both qualitative and quantitative methods. Questionnaires and in-depth interviews were conducted with 384 school-going adolescents aged between 13-19 years in Luwero Town Council, Uganda. Findings: The results of the study revealed that adolescents receive sexual information from various sources, with schools being the most common source, followed by parents and religious institutions being the least utilized. Adolescents received information on various topics related to sexuality, including puberty and sexual changes, pregnancy and reproduction, STD information, abstinence, and family planning. However, the content of sexual information was inadequate in addressing the challenges facing adolescents, and there were generation gaps, lack of role models, peer influence, and government policies. The male character from all the sources was the least in offering sexual information to adolescents. Theoretical Importance: The study's findings highlight the need for policy implementation to strengthen sexual education in school curriculum, as the sources of sexual information and the content are inadequate. The various topics should be addressed in schools to provide comprehensive education on sexual health for adolescents. Data Collection and Analysis Procedures: Data collection involved questionnaires and in-depth interviews with school-going adolescents. The data gathered were analyzed using descriptive statistics and thematic analysis. Questions Addressed: The study aimed to answer questions about the sources of sexual information among school-going adolescents, the content of sexual information provided, the challenges faced in accessing the information, and the importance of sex education policy implementation. Conclusion: The study concludes that schools are a popular source of sexual information among school-going adolescents in Uganda. However, the content of the information provided is inadequate in addressing the challenges that adolescents face regarding their sexual health. Therefore, policy implementation is essential in strengthening sexual education in the school curriculum and addressing various topics related to sexual health.Keywords: adolescents, sexual information, schools, reproductive health
Procedia PDF Downloads 7726005 The Adverse Effects of Air Pollution on Mental Health in Metropolitans
Authors: Farrin Nayebzadeh, Mohammadreza Eslami Amirabadi
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According to technological progress and urban development, the cities of the world are growing to become metropolitans, living in which can be enthusiastic, entertaining and accessibility to the facilities like education, economic factors, hygiene and welfare is high. On the other hand, there are some problems that have been ignored in planning for such high quality of life, most important of which, is human health. Two aspects of human health are physical health and mental health, that are closely associated. Human mental health depends on two important factors: Biological factor and environmental factor. Air pollution is one of the most important environmental risk factors that affects mental health. Psychological and toxic effects of air pollution can lead to psychiatric symptoms, including anxiety and changes in mood, cognition, and behavior, depression and also children's mental disorders like hyperactivity, aggression and agitation. Increased levels of some air pollutants are accompanied by an increase in psychiatric admissions and emergency calls and, in some studies, by changes in behavior and a reduction in psychological well-being. Numerous toxic pollutants interfere with the development and adult functioning of the nervous system. Psychosocial stress can cause symptoms similar to those of organic mental disorders. These factors can cause resonance of psychiatric disorders. So, in cities of developing countries, people challenge with mental health problems due to environmental factors especially air pollution that have not been forecasted in urban planning.Keywords: air pollution, environmental factors, mental health, psychiatric disorder
Procedia PDF Downloads 50626004 A CMOS D-Band Power Amplifier in 22FDSOI Technology for 6G Applications
Authors: Karandeep Kaur
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This paper presents the design of power amplifier (PA) for mmWave communication systems. The designed amplifier uses GlobalFoundries 22 FDX technology and works at an operational frequency of 140 GHz in the D-Band. With a supply voltage of 0.8V for the super low threshold voltage transistors, the amplifier is biased in class AB and has a total current consumption of 50 mA. The measured saturated output power from the power amplifier is 5.6 dBm with an output-referred 1dB-compression point of 1.6dBm. The measured gain of PA is 19 dB with 3 dB-bandwidth ranging from 120 GHz to 140 GHz. The chip occupies an area of 795µm × 410µm.Keywords: mmWave communication system, power amplifiers, 22FDX, D-Band, cross-coupled capacitive neutralization
Procedia PDF Downloads 16626003 Formal Development of Electronic Identity Card System Using Event-B
Authors: Tomokazu Nagata, Jawid Ahmad Baktash
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The goal of this paper is to explore the use of formal methods for Electronic Identity Card System. Nowadays, one of the core research directions in a constantly growing distributed environment is the improvement of the communication process. The responsibility for proper verification becomes crucial. Formal methods can play an essential role in the development and testing of systems. The thesis presents two different methodologies for assessing correctness. Our first approach employs abstract interpretation techniques for creating a trace based model for Electronic Identity Card System. The model was used for building a semi decidable procedure for verifying the system model. We also developed the code for the eID System and can cover three parts login to system sending of Acknowledgment from user side, receiving of all information from server side and log out from system. The new concepts of impasse and spawned sessions that we introduced led our research to original statements about the intruder’s knowledge and eID system coding with respect to secrecy. Furthermore, we demonstrated that there is a bound on the number of sessions needed for the analysis of System.Electronic identity (eID) cards promise to supply a universal, nation-wide mechanism for user authentication. Most European countries have started to deploy eID for government and private sector applications. Are government-issued electronic ID cards the proper way to authenticate users of online services? We use the eID project as a showcase to discuss eID from an application perspective. The new eID card has interesting design features, it is contact-less, it aims to protect people’s privacy to the extent possible, and it supports cryptographically strong mutual authentication between users and services. Privacy features include support for pseudonymous authentication and per service controlled access to individual data items. The article discusses key concepts, the eID infrastructure, observed and expected problems, and open questions. The core technology seems ready for prime time and government projects deploy it to the masses. But application issues may hamper eID adoption for online applications.Keywords: eID, event-B, Pro-B, formal method, message passing
Procedia PDF Downloads 23726002 How Social Support, Interaction with Clients and Work-Family Conflict Contribute to Mental Well-Being for Employees in the Human Service System
Authors: Uwe C. Fischer
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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.Keywords: client interaction, human service system, mental health, social support, work-family conflict
Procedia PDF Downloads 44126001 Building Information Modeling and Its Application in the State of Kuwait
Authors: Michael Gerges, Ograbe Ahiakwo, Martin Jaeger, Ahmad Asaad
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Recent advances of Building Information Modeling (BIM) especially in the Middle East have increased remarkably. Dubai has been taking a lead on this by making it mandatory for BIM to be adopted for all projects that involve complex architecture designs. This is because BIM is a dynamic process that assists all stakeholders in monitoring the project status throughout different project phases with great transparency. It focuses on utilizing information technology to improve collaboration among project participants during the entire life cycle of the project from the initial design, to the supply chain, resource allocation, construction and all productivity requirements. In view of this trend, the paper examines the extent of applying BIM in the State of Kuwait, by exploring practitioners’ perspectives on BIM, especially their perspectives on main barriers and main advantages. To this end structured interviews were carried out based on questionnaires and with a range of different construction professionals. The results revealed that practitioners perceive improved communication and mitigated project risks by encouraged collaboration between project participants. However, it was also observed that the full implementation of BIM in the State of Kuwait requires concerted efforts to make clients demanding BIM, counteract resistance to change among construction professionals and offer more training for design team members. This paper forms part of an on-going research effort on BIM and its application in the State of Kuwait and it is on this basis that further research on the topic is proposed.Keywords: building information modeling, BIM, construction industry, Kuwait
Procedia PDF Downloads 37926000 Bayesian Prospective Detection of Small Area Health Anomalies Using Kullback Leibler Divergence
Authors: Chawarat Rotejanaprasert, Andrew Lawson
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Early detection of unusual health events depends on the ability to detect rapidly any substantial changes in disease, thus facilitating timely public health interventions. To assist public health practitioners to make decisions, statistical methods are adopted to assess unusual events in real time. We introduce a surveillance Kullback-Leibler (SKL) measure for timely detection of disease outbreaks for small area health data. The detection methods are compared with the surveillance conditional predictive ordinate (SCPO) within the framework of Bayesian hierarchical Poisson modeling and applied to a case study of a group of respiratory system diseases observed weekly in South Carolina counties. Properties of the proposed surveillance techniques including timeliness and detection precision are investigated using a simulation study.Keywords: Bayesian, spatial, temporal, surveillance, prospective
Procedia PDF Downloads 31425999 An Analysis of Present Supplier Selection Criteria of State Pharmaceutical Corporation (SPC) Sri Lanka: A Case Study
Authors: Gamalath M. B. P. Abeysekara
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Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria
Procedia PDF Downloads 454