Search results for: polycentric water resource management

Authors: Richard Mababu Mukiur

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Leadership is an important drive that plays a key role in the success and development of organizations, particularly in the current context of digital transformation, highly competitivity and globalization. Leaders are persons that hold a dominant and privileged position within an organization, field, or sector of activities and are able to manage, motivate and exercise a high degree of influence over other in order to achieve the institutional goals. They achieve commitment and engagement of others to embrace change, and to make good decisions. Leadership studies in higher education institutions have examined how effective leaders hold their organizations, and also to find approaches which fit best in the organizations context for its better management, transformation and improvement. Moreover, recent studies have highlighted the impact of leadership styles on organizational performance and innovation capacities, since some styles give better results than others. Effective leadership is part of learning process that take place through day-to-day tasks, responsibilities, and experiences that influence the organizational performance, innovation and engagement of employees. The adoption of appropriate leadership styles can improve organization results and encourage learning process, team skills and performance, and employees' motivation and engagement. In the case of case of Information Technology sector, leadership styles are particularly crucial since this sector is leading relevant changes and transformations in the knowledge society. In this context, the main objective of this study is to analyze managers leadership styles with their relation to organizational performance and innovation that may be mediated by learning organization process and demographic variables. Therefore, it was hypothesized that the transformational and transactional leadership will be the main style adopted in Information Technology sector and will influence organizational performance and innovation capacity. A sample of 540 participants from Information technology sector has been determined in order to achieve the objective of this study. The Multifactor Leadership Questionnaire was administered as the principal instrument, Scale of innovation and Learning Organization Questionnaire. Correlations and multiple regression analysis have been used as the main techniques of data analysis. The findings indicate that leadership styles have a relevant impact on organizational performance and innovation capacity. The transformational and transactional leadership are predominant styles in Information technology sector. The effective leadership style tend to be characterized by the capacity of generating and sharing knowledge that improve organization performance and innovation capacity. Managers are adopting and adapting their leadership styles that respond to the new organizational, social and cultural challenges and realities of contemporary society. Managers who encourage innovation, foster learning process, share experience are useful to the organization since they contribute to its development and transformation. Learning process capacity and demographic variables (age, gender, and job tenure) mediate the relationship between leadership styles, innovation capacity and organizational performance. The transformational and transactional leadership tend to enhance the organizational performance due to their significant impact on team-building, employees' engagement and satisfaction. Some practical implications and future lines of research have been proposed.

Keywords: leadership styles, tranformational leadership, organisational performance, organisational innovation

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Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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Authors: Noura Al Akkari, Aurélie Foucquier, Sylvain Lespinats

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Load monitoring is a management process for energy consumption towards energy savings and energy efficiency. Non Intrusive Load Monitoring (NILM) is one method of load monitoring used for disaggregation purposes. NILM is a technique for identifying individual appliances based on the analysis of the whole residence data retrieved from the main power meter of the house. Our NILM framework starts with data acquisition, followed by data preprocessing, then event detection, feature extraction, then general appliance modeling and identification at the final stage. The event detection stage is a core component of NILM process since event detection techniques lead to the extraction of appliance features. Appliance features are required for the accurate identification of the household devices. In this research work, we aim at developing a new event detection methodology with accurate load disaggregation to extract appliance features. Time-domain features extracted are used for tuning general appliance models for appliance identification and classification steps. We use unsupervised algorithms such as Dynamic Time Warping (DTW). The proposed method relies on detecting areas of operation of each residential appliance based on the power demand. Then, detecting the time at which each selected appliance changes its states. In order to fit with practical existing smart meters capabilities, we work on low sampling data with a frequency of (1/60) Hz. The data is simulated on Load Profile Generator software (LPG), which was not previously taken into consideration for NILM purposes in the literature. LPG is a numerical software that uses behaviour simulation of people inside the house to generate residential energy consumption data. The proposed event detection method targets low consumption loads that are difficult to detect. Also, it facilitates the extraction of specific features used for general appliance modeling. In addition to this, the identification process includes unsupervised techniques such as DTW. To our best knowledge, there exist few unsupervised techniques employed with low sampling data in comparison to the many supervised techniques used for such cases. We extract a power interval at which falls the operation of the selected appliance along with a time vector for the values delimiting the state transitions of the appliance. After this, appliance signatures are formed from extracted power, geometrical and statistical features. Afterwards, those formed signatures are used to tune general model types for appliances identification using unsupervised algorithms. This method is evaluated using both simulated data on LPG and real-time Reference Energy Disaggregation Dataset (REDD). For that, we compute performance metrics using confusion matrix based metrics, considering accuracy, precision, recall and error-rate. The performance analysis of our methodology is then compared with other detection techniques previously used in the literature review, such as detection techniques based on statistical variations and abrupt changes (Variance Sliding Window and Cumulative Sum).

Keywords: general appliance model, non intrusive load monitoring, events detection, unsupervised techniques;

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Authors: Ani Wilson Uchenna, Ogbonna Chikodi

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This study examined the impact of artificial intelligence driven applications on banks’ performance in West Africa using Nigeria and Ghana as case studies. Specifically, the study examined the extent to which deployment of smart automated teller machine impacts the banks’ net worth within the reference period in Nigeria and Ghana. It ascertained the impact of point of sale on banks’ net worth within the reference period in Nigeria and Ghana. Thirdly, it verified the extent to which webpay services can influence banks’ performance in Nigeria and Ghana and finally, determined the impact of mobile pay services on banks’ performance in Nigeria and Ghana. The study used automated teller machine (ATM), Point of sale services (POS), Mobile pay services (MOP) and Web pay services (WBP) as proxies for explanatory variables while Bank net worth was used as explained variable for the study. The data for this study were sourced from central bank of Nigeria (CBN) Statistical Bulletin as well as Bank of Ghana (BoGH) Statistical Bulletin, Ghana payment systems oversight annual report and world development indicator (WDI). Furthermore, the mixed order of integration observed from the panel unit test result justified the use of autoregressive distributed lag (ARDL) approach to data analysis which the study adopted. While the cointegration test showed the existence of cointegration among the studied variables, bound test result justified the presence of long-run relationship among the series. Again, ARDL error correction estimate established satisfactory (13.92%) speed of adjustment from long run disequilibrium back to short run dynamic relationship. The study found that while Automated teller machine (ATM) had statistically significant impact on bank net worth (BNW) of Nigeria and Ghana, point of sale services application (POS) statistically and significantly impact on bank net worth within the study period, mobile pay services application was statistically significant in impacting the changes in the bank net worth of the countries of study while web pay services (WBP) had no statistically significant impact on bank net worth of the countries of reference. The study concluded that artificial intelligence driven application have significant an positive impact on bank performance with exception of web pay which had negative impact on bank net worth. The study recommended that management of banks both in Nigerian and Ghanaian should encourage more investments in AI-powered smart ATMs aimed towards delivering more secured banking services in order to increase revenue, discourage excessive queuing in the banking hall, reduced fraud and minimize error in processing transaction. Banks within the scope of this study should leverage on modern technologies to checkmate the excesses of the private operators POS in order to build more confidence on potential customers. Government should convert mobile pay services to a counter terrorism tool by ensuring that restrictions on over-the-counter withdrawals to a minimum amount is maintained and place sanctions on withdrawals above that limit.

Keywords: artificial intelligence (ai), bank performance, automated teller machines (atm), point of sale (pos)

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Authors: Sumedha Weerasekara, Morgan Miles, Mark Morrison, Branka Krivokapic-Skoko

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This paper is aimed at exploring the interrelationships among entrepreneurial ecosystem factors and entrepreneurial cognition in regional and metropolitan ecosystems. Entrepreneurial ecosystem factors examined include: culture, infrastructure, access to finance, informal networks, support services, access to universities, and the depth and breadth of the talent pool. Using a multivariate approach we explore the impact of these ecosystem factors or elements on entrepreneurial cognition. In doing so, the existing body of knowledge from the literature on entrepreneurial ecosystem and cognition have been blended to explore the relationship between entrepreneurial ecosystem factors and cognition in a way not hitherto investigated. The concept of the entrepreneurial ecosystem has received increased attention as governments, universities and communities have started to recognize the potential of integrated policies, structures, programs and processes that foster entrepreneurship activities by supporting innovation, productivity and employment growth. The notion of entrepreneurial ecosystems has evolved and grown with the advancement of theoretical research and empirical studies. Importance of incorporating external factors like culture, political environment, and the economic environment within a single framework will enhance the capacity of examining the whole systems functionality to better understand the interaction of the entrepreneurial actors and factors within a single framework. The literature on clusters underplays the role of entrepreneurs and entrepreneurial management in creating and co-creating organizations, markets, and supporting ecosystems. Entrepreneurs are only one actor following a limited set of roles and dependent upon many other factors to thrive. As a consequence, entrepreneurs and relevant authorities should be aware of the other actors and factors with which they engage and rely, and make strategic choices to achieve both self and also collective objectives. The study uses stratified random sampling method to collect survey data from 12 different regions in regional and metropolitan regions of NSW, Australia. A questionnaire was administered online among 512 Small and medium enterprise owners operating their business in selected 12 regions in NSW, Australia. Data were analyzed using descriptive analyzing techniques and partial least squares - structural equation modeling. The findings show that even though there is a significant relationship between each and every entrepreneurial ecosystem factors, there is a weak relationship between most entrepreneurial ecosystem factors and entrepreneurial cognition. In the metropolitan context, the availability of finance and informal networks have the largest impact on entrepreneurial cognition while culture, infrastructure, and support services having the smallest impact and the talent pool and universities having a moderate impact on entrepreneurial cognition. Interestingly, in a regional context, culture, availability of finance, and the talent pool have the highest impact on entrepreneurial cognition, while informal networks having the smallest impact and the remaining factors – infrastructure, universities, and support services have a moderate impact on entrepreneurial cognition. These findings suggest the need for a location-specific strategy for supporting the development of entrepreneurial cognition.

Keywords: academic achievement, colour response card, feedback

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Authors: Claudio Di Benedetto, Irene Bengo

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The objective of the paper is to study how large European companies develop social business (SB) at the base of the economic pyramid (BoP). BoP markets are defined as the four billions people living with an annual income below $3,260 in local purchasing power. Despite they are heterogeneous in terms of geographic range they present some common characteristics: the presence of significant unmet (social) needs, high level of informal economy and the so-called ‘poverty penalty’. As a result, most people living at BoP are excluded from the value created by the global market economy. But it is worth noting, that BoP population with an aggregate purchasing power of around $5 trillion a year, represent a huge opportunity for companies that want to enhance their long-term profitability perspective. We suggest that in this context, the development of SB is, for companies, an innovative and promising way to satisfy unmet social needs and to experience new forms of value creation. Indeed, SB can be considered a strategic model to develop CSR programs that fully integrate the social dimension into the business to create economic and social value simultaneously. Despite in literature many studies have been conducted on social business, only few have explicitly analyzed such phenomenon from a company perspective and their role in the development of such initiatives remains understudied with fragmented results. To fill this gap the paper analyzes the key characteristics of the social business initiatives developed by European companies at BoP. The study was performed analyzing 1475 European companies participating in the United Nation Global Compact, the world’s leading corporate social responsibility program. Through the analysis of the corporate websites the study identifies companies that actually do SB at BoP. For SB initiatives identified, information were collected according to a framework adapted from the SB model developed by preliminary results show that more than one hundred European companies have already implemented social businesses at BoP accounting for the 6,5% of the total. This percentage increases to 15% if the focus is on companies with more than 10.440 employees. In terms of geographic distribution 80% of companies doing SB at BoP are located in western and southern Europe. The companies more active in promoting SB belong to financial sector (20%), energy sector (17%) and food and beverage sector (12%). In terms of social needs addressed almost 30% of the companies develop SB to provide access to energy and WASH, 25% of companies develop SB to reduce local unemployment or to promote local entrepreneurship and 21% of companies develop SB to promote financial inclusion of poor. In developing SB companies implement different social business configurations ranging from forms of outsourcing to internal development models. The study identifies seven main configurations through which company develops social business and each configuration present distinguishing characteristics respect to the involvement of the company in the management, the resources provided and the benefits achieved. By performing different analysis on data collected the paper provides detailed insights on how European companies develop SB at BoP.

Keywords: base of the economic pyramid, corporate social responsibility, social business, social enterprise

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Authors: Maike Andresen, Georg Dochtmann

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Due to political, social, and societal changes in labor organization, top-sharing, defined as job-sharing in leading positions, becomes more important in HRM. German companies are looking for practical and economically meaningful solutions that allow to enduringly increase women’s ratio in management, not only because of a recently implemented quota. Furthermore, supporting employees in achieving work-life balance is perceived as an important goal for a sustainable HRM to gain competitive advantage. Top-sharing is seen as being suitable to reach both goals. To evaluate determinants leading to effective top-sharing, a case study of a newly implemented top-sharing tandem in a large German enterprise was conducted over a period of 15 months. In this company, a full leadership position was split into two 60%-part-time positions held by an experienced female leader in her late career and a female college who took over her first leadership position (mid-career). We assumed a person-person fit in terms of a match of the top sharing partners’ personality profiles (Big Five) and their leadership motivations to be important prerequisites for an effective collaboration between them. We evaluated the person-person fit variables once before the tandem started to work. Both leaders were expected to learn from each other (mentoring, competency development). On an operational level, they were supposed to lead together the same employees in an effective manner (leader-member exchange), presupposing an effective cooperation between both (handing over information). To see developments over time, these processes were evaluated three times over the span of the project. Top-Sharing and the underlined processes are expected to positively influence the tandem’s performance which has been evaluated twice, at the beginning and the end of the project, to assess its development over time as well. The evaluation of the personality and the basic motives suggests that both executives can be a successful top-sharing tandem. The competency evaluations (supervisor as well as self-assessment) increased over the time span. Although the top sharing tandem worked on equal terms, they implemented rather classical than peer-mentoring due to different career ambitions of the tandem partners. Thus, opportunities were not used completely. Team-member exchange scores proved the good cooperation between the top-sharers. Although the employees did not evaluate the leader-member-exchange between them and the two leaders of the tandem homogeneously, the top-sharing tandem itself did not have the impression that the employees’ task performance depended on whom of the tandem was responsible for the task. Furthermore, top-sharing did not negatively influence the performance of both leaders. During qualitative interviews with the top-sharers and their team, we found that the top-sharers could focus more easily on their tasks. The results suggest positive outcomes of top-sharing (e.g. competency improvement, learning from each other through mentoring). Top-Sharing does not hamper performance. Thus, further research and practical implementations are suggested. As part-time jobs are still more often a female solution to increase their work-life- and work-family-balance, top-sharing may be a suitable solution to increase the woman’s ratio in leadership positions as well as to sustainable increase work-life-balance of executives.

Keywords: mentoring, part-time leadership, top-sharing, work-life-balance

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Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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Authors: Margit Kastner

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To overcome the negative consequences associated with large class sizes and to support students in developing the necessary competences (e.g., critical thinking, problem-solving, or team-work skills) a marketing course has been redesigned by implementing project-based learning with peer assessment (PBL&PA). This means that students can voluntarily take advantage of this supplementary offer and explore -in addition to attending the lecture where clicker questions are asked- a real-world problem, find a solution, and assess the results of peers while working in small collaborative groups. In order to handle this with little further effort, the process is technically supported by the university’s e-learning system in such a way that students upload their solution in form of an assignment which is then automatically distributed to peer groups who have to assess the work of three other groups. Finally, students’ work is graded automatically considering both, students’ contribution to the project and the conformity of the peer assessment. The purpose of this study is to evaluate students’ perception of PBL&PA using an online-questionnaire to collect the data. More specifically, it aims to discover students’ motivations for (not) working on a project and the benefits and problems students encounter. In addition to the survey, students’ performance was analyzed by comparing the final grades of those who participated in PBL&PA with those who did not participate. Among the 260 students who filled out the questionnaire, 47% participated in PBL&PA. Besides extrinsic motivations (bonus credits), students’ participation was often motivated by learning and social benefits. Reasons for not working on a project were connected to students’ organization and management of their studies (e.g., time constraints, no/wrong information) and teamwork concerns (e.g., missing engagement of peers, prior negative experiences). In addition, high workload and insufficient extrinsic motivation (bonus credits) were mentioned. With regards to benefits and problems students encountered during the project, students provided more positive than negative comments. Positive aspects most often stated were learning and social benefits while negative ones were mainly attached to the technical implementation. Interestingly, bonus credits were hardly named as a positive aspect meaning that intrinsic motivations have become more important when working on the project. Team aspects generated mixed feelings. In addition, students who voluntarily participated in PBL&PA were, in general, more active and utilized further course offers such as clicker questions. Examining students’ performance at the final exam revealed that students without participating in any of the offered active learning tasks performed poorest in the exam while students who used all activities were best. In conclusion, the goals of the implementation were met in terms of students’ perceived benefits and the positive impact on students’ exam performance. Since the comparison of the automatic grading with faculty grading showed valid results, it is possible to rely only on automatic grading in the future. That way, the additional workload for faculty will be within limits. Thus, the implementation of project-based learning with peer assessment can be recommended for large classes.

Keywords: automated grading, large classes, peer assessment, project-based learning

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Authors: Probuddha Mukhopadhyay

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The infiltration of key elements to the civil structure is foraying its way to reclaim, what is its own. The reclamation of lives and spaces, once challenged, becomes a consistent process of ingress, disguised as parallels to the moving city, disperses into discourses often unheard of and conveniently forgotten. In this age of 'hyper'-urbanization, there are solutions suggested to a plethora of issues faced by citizens, in improving their standards of living. Problems are ancillary to proposals that emerge out of the underlying disorders of the townscape. These interventions result in the formulation of urban policies, to consolidate and optimize, to regularize and to streamline resources. Policy and practice are processes where the politics in policies define the way in which urban solutions are prescribed. Social constraints, that formulate the various cycles of order and disorders within the urban realm, are the stigmas for such interventions. There is often a direct relation of policy to place, no matter how people-centric it may seem to be projected. How we live our lives depends on where we live our lives - a relative statement for urban problems, varies from city to city. Communal compositions, welfare, crisis, socio-economic balance, need for management are the generic roots for urban policy formulation. However, in reality, the gentry administering its environmentalism is the criterion, that shapes and defines the values and expanse of such policies. In relation to the psycho-spatial characteristic of urban spheres with respect to the other side of this game, there have been instances, where the associational values have been reshaped by interests. The public domain reclaimed for exclusivity, thus creating fortified neighborhoods. Here, the citizen cumulative is often drifted by proposals that would over time deplete such landscapes of the city. It is the organized rebellion that in turn formulates further inward looking enclaves of latent aggression. In recent times, it has been observed that the unbalanced division of power and the implied processes of regulating the weak, stem the rebellion who respond in kits and parts. This is a phenomenon that mimics the guerilla warfare tactics, in order to have systems straightened out, either by manipulations or by force. This is the form of the city determined by the various forms insinuated by the state of city wide decisions. This study is an attempt at understanding the way in which development is interpreted by the state and the civil society and the role that community driven processes undertake to reinstate their claims to the city. This is a charter of consolidated patterns of negotiations that tend to counter policies. The research encompasses a study of various contested settlements in two cities of India- Mumbai and Kolkata, tackling dissent through spatial order. The study has been carried out to identify systems - formal and informal, catering to the most challenged interests of the people with respect to their habitat, a model to counter the top-down authoritative framework challenging the legitimacy of such settlements.

Keywords: urban design, insurgence, tactical urbanism, urban governance, civil society, state

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Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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Authors: Hanan Begali, Shahi Dost, Annett Ziegler, Markus Cornberg, Maria-Esther Vidal, Anke R. M. Kraft

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Chronic hepatitis B virus (HBV) infection can be treated with nucleot(s)ide analog (NA), for example, which inhibits HBV replication. However, they have hardly any influence on the functional cure of HBV, which is defined by hepatitis B surface antigen (HBsAg) loss. NA needs to be taken life-long, which is not available for all patients worldwide. Additionally, NA-treated patients are still at risk of developing cirrhosis, liver failure, or hepatocellular carcinoma (HCC). Although each patient has the same components of the immune system, immune responses vary between patients. Therefore, a deeper understanding of the immune response against HBV in different patients is necessary to understand the parameters leading to HBV cure and to use this knowledge to optimize HBV therapies. This requires seamless integration of an enormous amount of diverse and fine-grained data from viral markers, e.g., hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg). The data integration system relies on the assumption that profiling human immune systems requires the analysis of various variables (e.g., demographic data, treatments, pre-existing conditions, immune cell response, or HLA-typing) rather than only one. However, the values of these variables are collected independently. They are presented in a myriad of formats, e.g., excel files, textual descriptions, lab book notes, and images of flow cytometry dot plots. Additionally, patients can be identified differently in these analyses. This heterogeneity complicates the integration of variables, as data management techniques are needed to create a unified view in which individual formats and identifiers are transparent when profiling the human immune systems. The proposed study (HBsRE) aims at integrating heterogeneous data sets of 87 chronically HBV-infected patients, e.g., clinical data, immune cell response, and HLA-typing, with knowledge encoded in biomedical ontologies and open-source databases into a knowledge-driven framework. This new technique enables us to harmonize and standardize heterogeneous datasets in the defined modeling of the data integration system, which will be evaluated in the knowledge graph (KG). KGs are data structures that represent the knowledge and data as factual statements using a graph data model. Finally, the analytic data model will be applied on top of KG in order to develop a deeper understanding of the immune profiles among various patients and to evaluate factors playing a role in a holistic profile of patients with HBsAg level loss. Additionally, our objective is to utilize this unified approach to stratify patients for new effective treatments. This study is developed in the context of the project “Transforming big data into knowledge: for deep immune profiling in vaccination, infectious diseases, and transplantation (ImProVIT)”, which is a multidisciplinary team composed of computer scientists, infection biologists, and immunologists.

Keywords: chronic hepatitis B infection, immune response, knowledge graphs, ontology

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Authors: Yollande Sènan Djivoh, Dominique de Jaeger

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Background: Abdominal exercises are commonly practised nowadays. Specific techniques of abdominal muscles strengthening like hypopressive exercises have recently emerged and their practice is encouraged against the practice of Curl-up especially in postpartum. The acute and the training effects of these exercises did not allow to advise one exercise to the detriment of another. However, physiotherapists remain reluctant to perform Curl-up with postpartum women because of its potential harmful effect on the pelvic floor. Design: This study was a randomized control trial registered under the number PACTR202110679363984. Objective: to observe the training effect of two experimental protocols (Curl-up versus Drawing-in+Diaphragmatic aspiration) on the abdominal wall (interrecti distance, rectus and transversus abdominis thickness, abdominal strength) in Beninese postpartum women. Pelvic floor function (tone, endurance, urinary incontinence) will be assessed to evaluate potential side effects of exercises on the pelvic floor. Method: Postpartum women diagnosed with diastasis recti were randomly assigned to one of three groups (Curl-up, Drawingin+Diaphragmatic aspiration and control). Abdominal and pelvic floor parameters were assessed before and at the end of the 6-week protocol. The interrecti distance and the abdominal muscles thickness were assessed by ultrasound and abdominal strength by dynamometer. Pelvic floor tone and strength were assessed with Biofeedback and urinary incontinence was quantified by pad test. To compare the results between the three groups and the two measurements, a two-way Anova test with repeated measures was used (p<0.05). When interaction was significant, a posthoc using Student t test, with Bonferroni correction, was used to compare the three groups regarding the difference (end value minus initial value). To complete these results, a paired Student t test was used to compare in each group the initial and end values. Results: Fifty-eight women participated in this study, divided in three groups with similar characteristics regarding their age (29±5 years), parity (2±1 children), BMI (26±4 kg/m2 ), time since the last birth (10±2 weeks), weight of their baby at birth (330±50 grams). Time effect and interaction were significant (p<0.001) for all abdominal parameters. Experimental groups improved more than control group. Curl-up group improved more (p=0.001) than Drawing-in+Diaphragmatic aspiration group regarding the interrecti distance (9.3±4.2 mm versus 6.6±4.6 mm) and abdominal strength (20.4±16.4 Newton versus 11.4±12.8 Newton). Drawingin+Diaphragmatic aspiration group improved (0.8±0.7 mm) more than Curl-up group (0.5±0.7 mm) regarding the transversus abdominis thickness (p=0.001). Only Curl-up group improved (p<0.001) the rectus abdominis thickness (1.5±1.2 mm). For pelvic floor parameters, both experimental groups improved (p=0.01) except for tone which improved (p=0.03) only in Drawing-in+Diaphragmatic aspiration group from 19.9±4.1 cmH2O to 22.2±4.5 cmH2O. Conclusion: Curl-up was more efficient to improve abdominal function than Drawingin+Diaphragmatic aspiration. However, these exercises are complementary. None of them degraded the pelvic floor, but Drawing-in+Diaphragmatic aspiration improved further the pelvic floor function. Clinical implications: Curl-up, Drawing-in and Diaphragmatic aspiration can be used for the management of abdominal function in postpartum women. Exercises must be chosen considering the specific needs of each woman’s abdominal and pelvic floor function.

Keywords: curl-up, drawing-in, diaphragmatic aspiration, hypopressive exercise, postpartum women

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Authors: Kitti Supchukun, Kris Angkanaporn, Teerapong Yata

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The product innovation using a nutraceutical delivery system on improving the growth performance of broilers is the product planning and development to solve the antibiotics banning policy incurred in the local and global livestock production system. Restricting the use of antibiotics can reduce the quality of chicken meat and increase pathogenic bacterial contamination. Although other alternatives were used to replace antibiotics, the efficacy was inconsistent, reflecting on low chicken growth performance and contaminated products. The product innovation aims to effectively deliver the selected active ingredients into the body. This product is tested on the pharmaceutical lab scale and on the farm-scale for market feasibility in order to create product innovation using the nutraceutical delivery system model. The model establishes the product standardization and traceable quality control process for farmers. The study is performed using mixed methods. Starting with a qualitative method to find the farmers' (consumers) demands and the product standard, then the researcher used the quantitative research method to develop and conclude the findings regarding the acceptance of the technology and product performance. The survey has been sent to different organizations by random sampling among the entrepreneur’s population including integrated broiler farm, broiler farm, and other related organizations. The mixed-method results, both qualitative and quantitative, verify the user and lead users' demands since they provide information about the industry standard, technology preference, developing the right product according to the market, and solutions for the industry problems. The product innovation selected nutraceutical ingredients that can solve the following problems in livestock; bactericidal, anti-inflammation, gut health, antioxidant. The combinations of the selected nutraceutical and nanostructured lipid carriers (NLC) technology aim to improve chemical and pharmaceutical components by changing the structure of active ingredients into nanoparticle, which will be released in the targeted location with accurate concentration. The active ingredients in nanoparticle form are more stable, elicit antibacterial activity against pathogenic Salmonella spp and E.coli, balance gut health, have antioxidant and anti-inflammation activity. The experiment results have proven that the nutraceuticals have an antioxidant and antibacterial activity which also increases the average daily gain (ADG), reduces feed conversion ratio (FCR). The results also show a significant impact on the higher European Performance Index that can increase the farmers' profit when exporting. The product innovation will be tested in technology acceptance management methods from farmers and industry. The production of broiler and commercialization analyses are useful to reduce the importation of animal supplements. Most importantly, product innovation is protected by intellectual property.

Keywords: nutraceutical, nano structure lipid carrier, anti-microbial drug resistance, broiler, Salmonella

Procedia PDF Downloads 178

Authors: Guenther Schuh, Michael Riesener, Jan Kantelberg

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Due to the fugacity of markets and the reduction of product lifecycles, manufacturing companies from high-wage countries are nowadays faced with the challenge to place more innovative products within even shorter development time on the market. At the same time, volatile customer requirements have to be satisfied in order to successfully differentiate from market competitors. One potential approach to address the explained challenges is provided by agile values and principles. These agile values and principles already proofed their success within software development projects in the form of management frameworks like Scrum or concrete procedure models such as Extreme Programming or Crystal Clear. Those models lead to significant improvements regarding quality, costs and development time and are therefore used within most software development projects. Motivated by the success within the software industry, manufacturing companies have tried to transfer agile mechanisms of action to the development of hardware products ever since. Though first empirical studies show similar effects in the agile development of hardware products, no comprehensive procedure model for the design of development iterations has been developed for hardware development yet due to different constraints of the domains. For this reason, this paper focusses on the design of agile product development processes by transferring mechanisms of action used in agile software development towards product development. This is conducted by decomposing the individual systems 'product development' and 'agile software development' into relevant elements and symbiotically composing the elements of both systems in respect of the design of agile product development processes afterwards. In a first step, existing product development processes are described following existing approaches of the system theory. By analyzing existing case studies from industrial companies as well as academic approaches, characteristic objectives, activities and artefacts are identified within a target-, action- and object-system. In partial model two, mechanisms of action are derived from existing procedure models of agile software development. These mechanisms of action are classified in a superior strategy level, in a system level comprising characteristic, domain-independent activities and their cause-effect relationships as well as in an activity-based element level. Within partial model three, the influence of the identified agile mechanism of action towards the characteristic system elements of product development processes is analyzed. For this reason, target-, action- and object-system of the product development are compared with the strategy-, system- and element-level of agile mechanism of action by using the graph theory. Furthermore, the necessity of existence of activities within iteration can be determined by defining activity-specific degrees of freedom. Based on this analysis, agile product development processes are designed in form of different types of iterations within a last step. By defining iteration-differentiating characteristics and their interdependencies, a logic for the configuration of activities, their form of execution as well as relevant artefacts for the specific iteration is developed. Furthermore, characteristic types of iteration for the agile product development are identified.

Keywords: activity-based process model, agile mechanisms of action, agile product development, degrees of freedom

Procedia PDF Downloads 207

Authors: Luisa Müting, Wisnu Harto Adiwijoyo

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Agroforestry systems transform the agricultural landscapes in the Sahel region of Africa, providing food and farming products consumed for subsistence or sold for income. In the incrementally dry climate of the Sahel region, the spreading of agroforestry practices is integral for policymaker efforts to counteract land degradation and provide soil restoration in the region. Several measures on agroforestry practices have been implemented in the region by governmental and non-governmental institutions in recent years. However, despite the efforts, past research shows that awareness of how policies and interventions are being consumed and perceived by the public remains low. Therefore, interpreting public policy dilemmas by analyzing the public perception regarding agroforestry concepts and practices is necessary. Public perceptions and discourses can be an essential driver or constraint for the adoption of agroforestry practices in the region. Thus, understanding the public discourse behavior of crucial stakeholders could assist policymakers in developing inclusive and contextual policies that are relevant to the context of agroforestry adoption in Sahel region. To answer how information about agroforestry spreads and is perceived by the public. As internet usage increased drastically over the past decade, reaching a share of 33 percent of the population being connected to the internet, this research is based on online conversation data. Social media data from Facebook are gathered daily between April 2021 and April 2022 in Djibouti, Senegal, Mali, and Nigeria based on their share of active internet users compared to other countries in the Sahel region. A systematic methodology was applied to the extracted social media using discourse network analysis (DNA). This study then clustered the data by the types of agroforestry practices, sentiments, and country. Additionally, this research extracted the text data from online news media during the same period to pinpoint events related to the topic of agroforestry. The preliminary result indicates that tree management, crops, and livestock integration, diversifying species and genetic resources, and focusing on interactions and productivity across the agricultural system; are the most notable keywords in agroforestry-related conversations within the four countries in the Sahel region. Additionally, approximately 84 percent of the discussions were still dominated by big actors, such as NGO or government actors. Furthermore, as a subject of communication within agroforestry discourse, the Great Green Wall initiative generates almost 60 percent positive sentiment within the captured social media data, effectively having a more significant outreach than general agroforestry topics. This study provides an understanding for scholars and policymakers with a springboard for further research or policy design on agroforestry in the four countries of the Sahel region with systematically uncaptured novel data from the internet.

Keywords: sahel, djibouti, senegal, mali, nigeria, social networks analysis, public discourse analysis, sentiment analysis, content analysis, social media, online news, agroforestry, land restoration

Procedia PDF Downloads 101

Authors: M. Soubadra Devy, Savitha Swamy, Chethana V. Casiker

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Sustainable smart cities are emerging as an important concept in response to the exponential rise in the world’s urbanizing population. While earlier, only technical, economic and governance based solutions were considered, more and more layers are being added in recent times. With the prefix of 'sustainability', solutions which help in judicious use of resources without negatively impacting the environment have become critical. We present a case study of Bangalore city which has transformed from being a garden city and pensioners' paradise to being an IT city with a huge, young population from different regions and diverse cultural backgrounds. This has had a big impact on the green spaces in the city and the biodiversity that they support, as well as on farming/gardening practices. Edible landscapes comprising farms lands, home gardens and neighbourhood parks (NPs henceforth) were examined. The land prices of areas having NPs were higher than those that did not indicate an appreciation of their aesthetic value. NPs were part of old and new residential areas largely managed by the municipality. They comprised manicured gardens which were similar in vegetation structure and composition. Results showed that NPs that occurred in higher density supported reasonable levels of biodiversity. In situations where NPs occurred in lower density, the presence of a larger green space such as a heritage park or botanical garden enhanced the biodiversity of these parks. In contrast, farm lands and home gardens which were common within the city are being lost at an unprecedented scale to developmental projects. However, there is also the emergence of a 'neo-culture' of home-gardening that promotes 'locovory' or consumption of locally grown food as a means to a sustainable living and reduced carbon footprint. This movement overcomes the space constraint by using vertical and terrace gardening techniques. Food that is grown within cities comprises of vegetables and fruits which are largely pollinator dependent. This goes hand in hand with our landscape-level study that has shown that cities support pollinator diversity. Maintaining and improving these man-made ecosystems requires analysing the functioning and characteristics of the existing structures of governance. Social network analysis tool was applied to NPs to examine relationships, between actors and ties. The management structures around NPs, gaps, and means to strengthen the networks from the current state to a near-ideal state were identified for enhanced services. Learnings from NPs were used to build a hypothetical governance structure and functioning of integrated governance of NPs and edible landscapes to enhance ecosystem services such as biodiversity support, food production, and aesthetic value. They also contribute to the sustainability axis of smart cities.

Keywords: biodiversity support, ecosystem services, edible green spaces, neighbourhood parks, sustainable smart city

Procedia PDF Downloads 138

Authors: Gautam, Gurcharan Singh, Mandeep Kaur, Yogesh Aggarwal, Sanjeev Naval

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The present ground reality scenario of suffering of humanity shows the evidence of failure to take wrong decisions to shape the civilization with Irresponsibilities in the history. A strong positive will of right responsibilities make the right civilization structure which affects itself and the whole world. Present suffering of humanity shows and reflect the failure of past decisions taken to shape the true culture with right social structure of society, due to unplanned system of Indian civilization and its rapid disaster of population make the failure to face all kind of problems which make the society sufferer. Our India is still suffering from disaster like earthquake, floods, droughts, tsunamis etc. and we face the uncountable disaster of deaths from the beginning of humanity at the present time. In this research paper our focus is to make a Disaster Resistance Structure having the solution of dense populated urban cities area by high vertical expansion HYBRID STRUCTURE. Our efforts are to analyse the Reinforced Concrete Hybrid Structure at different seismic zones, these concrete frames were analyzed using the response spectrum method to calculate and compare the different seismic displacement and drift. Seismic analysis by this method generally is based on dynamic analysis of building. Analysis results shows that the Reinforced Concrete Building at seismic Zone V having maximum peak story shear, base shear, drift and node displacement as compare to the analytical results of Reinforced Concrete Building at seismic Zone III and Zone IV. This analysis results indicating to focus on structural drawings strictly at construction site to make a HYBRID STRUCTURE. The study case is deal with the 10 story height of a vertical expansion Hybrid frame structure at different zones i.e. zone III, zone IV and zone V having the column 0.45x0.36mt and beam 0.6x0.36mt. with total height of 30mt, to make the structure more stable bracing techniques shell be applied like mage bracing and V shape bracing. If this kind of efforts or structure drawings are followed by the builders and contractors then we save the lives during earthquake disaster at Bhuj (Gujarat State, India) on 26th January, 2001 which resulted in more than 19,000 deaths. This kind of Disaster Resistance Structure having the capabilities to solve the problems of densely populated area of cities by the utilization of area in vertical expansion hybrid structure. We request to Government of India to make new plans and implementing it to save the lives from future disasters instead of unnecessary wants of development plans like Bullet Trains.

Keywords: history, irresponsibilities, unplanned social structure, humanity, hybrid structure, response spectrum analysis, DRIFT, and NODE displacement

Procedia PDF Downloads 211

Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

Procedia PDF Downloads 134

Authors: Manasi Mahanty

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In the current phase of globalization, the mobility of capital facilitates outsourcing and subcontracting of production processes to the developing economies for cheap and flexible labour force. In such process, the globalization of production networks operates at multi-locational points within the nation. Under the new quota regime in the globalization period, the Indian manufacturing exporters came under the influence of corporate buyers and large retailers from the importing countries. As part of such process, the garment manufacturing sector is expected to create huge employment opportunities and to expand the export market in the country. While following these, expectations, the apparel and garment industries mostly target to hire female migrant workers with a purpose of establishing more flexible industrial relations through the casual nature of employment contract. It leads to an increasing women’s participation in the labour market as well as the rise in precarious forms of female paid employment. In the context, the main objective of the paper is to understand the wider dynamics of globalization of production and its link with informalization, feminization of labour force and internal migration process of the country. For this purpose, the study examines the changing labour relations in the KINFRA Apparel Park at Kerala’s Special Economic Zone which operates under the scheme ‘Apparel Parks for Export’ (APE) of the Government of India. The present study was based on both quantitative and qualitative analysis. In the first, the secondary sources of data were collected from the source location (SEAM centre) and destination (KINFRA Park). The official figures and data were discussed and analyzed in order to find out the various dimensions of labour relations under globalization of production. In the second, the primary survey was conducted to make a comparative analysis of local and migrant female workers. The study is executed by taking 100 workers in total. The local workers comprised of 53% of the sample whereas the outside state workers were 47%. Even personal interviews with management staff, and workers were also made for collecting the information regarding the organisational structure, nature, and mode of recruitment, work environment, etc. The study shows the enormous presence of rural women migrant workers in KINFRA Apparel Park. A Public Private Partnership (PPP) arranged migration system is found as Skills for Employment in Apparel Manufacturing (SEAM) from where young women and girls are being sent to work in garment factories of Kerala’s KINFRA International Apparel Park under the guise of an apprenticeship based recruitment. The study concludes that such arrangements try to avoid standard employment relationships and strengthen informalization, casualization and contractualization of work. In this process, the recruitment of women migrant workers is to be considered as best option for the employers of private industries which could be more easily hired and fired.

Keywords: female migration, globalization, informalization, KINFRA apparel park

Procedia PDF Downloads 339

Authors: Sonia P. Marrero Duran, Lilian Noya Dominguez, Lisandra Quintana Alvarez, Evert Martinez Perez, Ana Julia Acevedo Urquiaga

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Cuban business and economic policy are in the constant update as well as facing a client ever more knowledgeable and demanding. For that reason become fundamental for companies competitiveness through the optimization of its processes and services. One of the Cuban’s pillars, which has been sustained since the triumph of the Cuban Revolution back in 1959, is the free health service to all those who need it. This service is offered without any charge under the concept of preserving human life, but it implied costly management processes and logistics services to be able to supply the necessary medicines to all the units who provide health services. One of the key actors on the medicine supply chain is the Havana Distribution Center (HDC), which is responsible for the delivery of medicines in the province; as well as the acquisition of medicines from national and international producers and its subsequent transport to health care units and pharmacies in time, and with the required quality. This HDC also carries for all distribution centers in the country. Given the eminent need to create an actor in the supply chain that specializes in the medicines supply, the possibility of centralizing this operation in a logistics service provider is analyzed. Based on this decision, pharmacies operate as clients of the logistic service center whose main function is to centralize all logistics operations associated with the medicine supply chain. The HDC is precisely the logistic service provider in Havana and it is the center of this research. In 2017 the pharmacies had affectations in the availability of medicine due to deficiencies in the distribution routes. This is caused by the fact that they are not based on routing studies, besides the long distribution cycle. The distribution routs are fixed, attend only one type of customer and there respond to a territorial location by the municipality. Taking into consideration the above-mentioned problem, the objective of this research is to optimize the routes system in the Havana Distribution Center. To accomplish this objective, the techniques applied were document analysis, random sampling, statistical inference and tools such as Ishikawa diagram and the computerized software’s: ArcGis, Osmand y MapIfnfo. As a result, were analyzed four distribution alternatives; the actual rout, by customer type, by the municipality and the combination of the two last. It was demonstrated that the territorial location alternative does not take full advantage of the transportation capacities or the distance of the trips, which leads to elevated costs breaking whit the current ways of distribution and the currents characteristics of the clients. The principal finding of the investigation was the optimum option distribution rout is the 4th one that is formed by hospitals and the join of pharmacies, stomatology clinics, polyclinics and maternal and elderly homes. This solution breaks the territorial location by the municipality and permits different distribution cycles in dependence of medicine consumption and transport availability.

Keywords: computerized geographic software, distribution, distribution routs, vehicle problem routing (VPR)

Procedia PDF Downloads 160

Authors: Dalia Ambrazaitienė, Monika Vilkienė, Danute Karcauskienė, Gintaras Siaudinis

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The soil is a complex ecosystem that is part of our biosphere. The ability of soil to provide ecosystem services is dependent on microbial diversity. T Tillage is one of the major factors that affect soil properties. The no-till systems or shallow ploughless tillage are opposite of traditional deep ploughing, no-tillage systems, for instance, increase soil organic matter by reducing mineralization rates and stimulating litter concentrations of the top soil layer, whereas deep ploughing increases the biological activity of arable soil layer and reduces the incidence of weeds. The role of soil organisms is central to soil processes. Although the number of microbial species in soil is still being debated, the metagenomic approach to estimate microbial diversity predicted about 2000 – 18 000 bacterial genomes in 1 g of soil. Despite the key role of bacteria in soil processes, there is still lack of information about the bacterial diversity of soils as affected by tillage practices. This study focused on metagenomic analysis of bacterial diversity in long-term experimental plots of Dystric Epihypogleyic Albeluvisols in western part of Lithuania. The experiment was set up in 2013 and had a split-plot design where the whole-plot treatments were laid out in a randomized design with three replicates. The whole-plot treatments consisted of two tillage methods - deep ploughing (22-25 cm) (DP), ploughless tillage (7-10 cm) (PT). Three subsamples (0-20 cm) were collected on October 22, 2015 for each of the three replicates. Subsamples from the DP and PT systems were pooled together wise to make two composition samples, one representing deep ploughing (DP) and the other ploughless tillage (PT). Genomic DNA from soil sample was extracted from approximately 200 mg field-moist soil by using the D6005 Fungal/Bacterial Miniprep set (Zymo Research®) following the manufacturer’s instructions. To determine bacterial diversity and community composition, we employed a culture – independent approach of high-throughput pyrosequencing of the 16S rRNA gene. Metagenomic sequencing was made with Illumina MiSeq platform in Base Clear Company. The microbial component of soil plays a crucial role in cycling of nutrients in biosphere. Our study was a preliminary attempt at observing bacterial diversity in soil under two common but contrasting tillage practices. The number of sequenced reads obtained for PT (161 917) was higher than DP (131 194). The 10 most abundant genus in soil sample were the same (Arthrobacter, Candidatus Saccharibacteria, Actinobacteria, Acidobacterium, Mycobacterium, Bacillus, Alphaproteobacteria, Longilinea, Gemmatimonas, Solirubrobacter), just the percent of community part was different. In DP the Arthrobacter and Acidobacterium consist respectively 8.4 % and 2.5%, meanwhile in PT just 5.8% and 2.1% of all community. The Nocardioides and Terrabacter were observed just in PT. This work was supported by the project VP1-3.1-ŠMM-01-V-03-001 NKPDOKT and National Science Program: The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems [grant number SIT-9/2015] funded by the Research Council of Lithuania.

Keywords: deep ploughing, metagenomics, ploughless tillage, soil community analysis

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Authors: Nanteza Rachel

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Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

Procedia PDF Downloads 97

Authors: Rebeca P Ramos-Bueno, Maria Jose Gonzalez-Fernandez, Rosa M. Moreno-Zamora, Antonia Barros Heras, Yolanda Serrano Alonso, Carolina Sanchez Barranco

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Insects are a new source of fatty acids (FA), so they are considered a sustainable and environmentally friendly alternative for both animal feed and the human diet, and furthermore, their harvesting/rearing require a low-tech and low capital investment. For that reason, lipids obtained by insect breeding open interesting possibilities with alimentary and industrial purposes, i.e., the production of biodiesel. Particularly, certain insect species, especially during the larval stage, contain high proportions of fat which is highly dependent on their feed and stage of development. Among them, Hermetia illucens larvae can be bred on food wastes to produce fat- and protein-rich raw materials for food by-product management. So, insects can act as excellent bioconverters of organic waste to nutrient-rich materials. In this regard, the aim of the study was to evaluate the effects of fruit byproducts on the FA compositions of Tenebrio molitor, Zophoba morio, and H. illucens larvae. Firstly, oil was extracted with the green solvent ethyl acetate, and FA methyl ester was obtained and analyzed by GC to show the FA profile. In addition, the triacylglycerol (TAG) profile was obtained by HPLC. Dehydrated watermelon, tomato, and papaya by-products, as well as wheat-based control feed, were assayed. High FA content was reached by Z. morio larvae fed with all fruits; however, no differences were shown in lipid profile with any change. It is worth highlighting that both Z. morio and H. illucens could be selected as the best candidates for biodiesel production due to their high content of saturated FA. On the other hand, T. molitor larvae showed a higher content of monounsaturated FA than control larvae, whereas the n-6 polyunsaturated FA content decreased in larvae fed with fruits. This result indicates that the improvement of the FA profile of Tenebrio can depend on both the type of feeding and the intended use. The lipid profile of H. illucens larvae fed with papaya and tomato showed a slight increase in the content of α-linoleic acid (ALA, 18:3n3). This FA is the precursor of docosahexaenoic acid (DHA, 22:6n3), which plays an important role as a component of structural lipids in cell membranes as well as in the synthesis of eicosanoids, protecting and resolving. Also, it was evaluated the TAG profile of Z. morio larvae due to their highest oil content. The results showed a high oleic acid (OA, 18:1n9) content, which displays modulatory effects in a wide range of physiological functions, having anti-inflammatory and anti-atherogenic properties. In conclusion, this study clearly shows that Z. morio and H. illucens larvae constitute an alternative source of OA- and ALA-rich oils, respectively, which can be devoted for food use, as well as for using in the food and pharmaceutical industries, with agronomic implications. Finally, although the profile of Z. morio was not improved with fruit feeding, this kind of feeding could be used due to its low environmental impact.

Keywords: fatty acids, fruit byproducts, Hermetia illucens, Zophoba morio, Tenebrio molitor, insect rearing

Procedia PDF Downloads 147

Authors: Mina Naeini, Thomas A. Adams II

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Solid Oxide Fuel Cells (SOFCs) feature high electrical efficiency and generate substantial amounts of waste heat that make them suitable for integrated community energy systems (ICEs). By harvesting and distributing the waste heat through hot water pipelines, SOFCs can meet thermal demand of the communities. Therefore, they can replace traditional gas boilers and reduce greenhouse gas (GHG) emissions. Despite these advantages of SOFCs over competing power generation units, this technology has not been successfully commercialized in large-scale to replace traditional generators in ICEs. One reason is that SOFC performance deteriorates over long-term operation, which makes it difficult to find the proper sizing of the cells for a particular ICE system. In order to find the optimal sizing and operating conditions of SOFCs in a community, a proper knowledge of degradation mechanisms and effects of operating conditions on SOFCs long-time performance is required. The simplified SOFC models that exist in the current literature usually do not provide realistic results since they usually underestimate rate of performance drop by making too many assumptions or generalizations. In addition, some of these models have been obtained from experimental data by curve-fitting methods. Although these models are valid for the range of operating conditions in which experiments were conducted, they cannot be generalized to other conditions and so have limited use for most ICEs. In the present study, a general, detailed degradation-based model is proposed that predicts the performance of conventional SOFCs over a long period of time at different operating conditions. Conventional SOFCs are composed of Yttria Stabilized Zirconia (YSZ) as electrolyte, Ni-cermet anodes, and LaSr₁₋ₓMnₓO₃ (LSM) cathodes. The following degradation processes are considered in this model: oxidation and coarsening of nickel particles in the Ni-cermet anodes, changes in the pore radius in anode, electrolyte, and anode electrical conductivity degradation, and sulfur poisoning of the anode compartment. This model helps decision makers discover the optimal sizing and operation of the cells for a stable, efficient performance with the fewest assumptions. It is suitable for a wide variety of applications. Sulfur contamination of the anode compartment is an important cause of performance drop in cells supplied with hydrocarbon-based fuel sources. H₂S, which is often added to hydrocarbon fuels as an odorant, can diminish catalytic behavior of Ni-based anodes by lowering their electrochemical activity and hydrocarbon conversion properties. Therefore, the existing models in the literature for H₂-supplied SOFCs cannot be applied to hydrocarbon-fueled SOFCs as they only account for the electrochemical activity reduction. A regression model is developed in the current work for sulfur contamination of the SOFCs fed with hydrocarbon fuel sources. The model is developed as a function of current density and H₂S concentration in the fuel. To the best of authors' knowledge, it is the first model that accounts for impact of current density on sulfur poisoning of cells supplied with hydrocarbon-based fuels. Proposed model has wide validity over a range of parameters and is consistent across multiple studies by different independent groups. Simulations using the degradation-based model illustrated that SOFCs voltage drops significantly in the first 1500 hours of operation. After that, cells exhibit a slower degradation rate. The present analysis allowed us to discover the reason for various degradation rate values reported in literature for conventional SOFCs. In fact, the reason why literature reports very different degradation rates, is that literature is inconsistent in definition of how degradation rate is calculated. In the literature, the degradation rate has been calculated as the slope of voltage versus time plot with the unit of voltage drop percentage per 1000 hours operation. Due to the nonlinear profile of voltage over time, degradation rate magnitude depends on the magnitude of time steps selected to calculate the curve's slope. To avoid this issue, instantaneous rate of performance drop is used in the present work. According to a sensitivity analysis, the current density has the highest impact on degradation rate compared to other operating factors, while temperature and hydrogen partial pressure affect SOFCs performance less. The findings demonstrated that a cell running at lower current density performs better in long-term in terms of total average energy delivered per year, even though initially it generates less power than if it had a higher current density. This is because of the dominant and devastating impact of large current densities on the long-term performance of SOFCs, as explained by the model.

Keywords: degradation rate, long-term performance, optimal operation, solid oxide fuel cells, SOFCs

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Authors: Joao Ferreira Do Rosario, Maria De Lurdes Calisto, Ana Teresa Machado, Nuno Gustavo, Rui Gonçalves

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The tourism sector is increasingly important to the economic performance of countries and a relevant theme to academic research, increasing the importance of understanding how and why tourists evaluate tourism locations. The city of Lisbon is currently a tourist destination of excellence in the European and world-wide panorama, registering a significant growth of the economic weight of its tourist activities in the Gross Added Value of the region. Although there is research on the feedback of those who visit tourist sites and different methodologies for studying tourist sites have been applied, this research seeks to be innovative in the objective of obtaining insights on the competitiveness in terms of attractiveness of the city of Lisbon as a tourist destination, based the feedback of tourists in the Facebook pages of the most visited museums and monuments of Lisbon, an interpretation that is relevant in the development of strategies of tourist attraction. The intangible dimension of the tourism offer, due to its unique condition of simultaneous production and consumption, makes eWOM particularly relevant. The testimony of consumers is thus a decisive factor in the decision-making and buying process in tourism. Online social networks are one of the most used platforms for tourists to evaluate the attractiveness's points of a tourism destination (e.g. cultural and historical heritage), with this user-generated feedback enabling relevant information about the customer-tourists. This information is related to the tourist experience representing the true voice of the customer. Furthermore, this voice perceived by others as genuine, opposite to marketing messages, may have a powerful word-of-mouth influence on other potential tourists. The relevance of online reviews sharing, however, becomes particularly complex, considering social media users’ different profiles or the possible and different sources of information available, as well as their associated reputation associated with each source. In the light of these trends, our research focuses on the tourists’ feedback on Facebook pages of the most visited museums and monuments of Lisbon that contribute to its attractiveness as a tourism destination. Sentiment Analysis is the methodology selected for this research, using public available information in the online context, which was deemed as an appropriate non-participatory observation method. Data will be collected from two museums (Museu dos Coches and Museu de Arte Antiga) and three monuments ((Mosteiro dos Jerónimos, Torre de Belém and Panteão Nacional) Facebook pages during a period of one year. The research results will help in the evaluation of the considered places by the tourists, their contribution to the city attractiveness and present insights helpful for the management decisions regarding this museums and monuments. The results of this study will also contribute to a better knowledge of the tourism sector, namely the identification of attributes in the evaluation and choice of the city of Lisbon as a tourist destination. Further research will evaluate the Lisbon attraction points for tourists in different categories beyond museums and monuments, will also evaluate the tourist feedback from other sources like TripAdvisor and apply the same methodology in other cities and country regions.

Keywords: Lisbon tourism, opinion mining, sentiment analysis, tourism location attractiveness evaluation

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Authors: Charlotte K. Lee, Henrique R. N. Aguiar, Ralph Smith, James Baldock, Sam Botchey

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Background: Femoral neck stress fractures (FNSF) are uncommon, making up 1 to 7.2% of stress fractures in healthy subjects. FNSFs are prevalent in young women, military recruits, endurance athletes, and individuals with energy deficiency syndrome or female athlete triad. Presentation is often non-specific and is often misdiagnosed following the initial examination. There is limited research addressing the return–to–activity time after FNSF. Previous studies have demonstrated prognostic time predictions based on various imaging techniques. Here, (1) OxSport clinic FNSF practice standards are retrospectively reviewed, (2) FNSF cohort demographics are examined, (3) Regression models were used to predict return–to–activity prognosis and consequently determine bone stress risk factors. Methods: Patients with a diagnosis of FNSF attending Oxsport clinic between 01/06/2020 and 01/01/2020 were selected from the Rheumatology Assessment Database Innovation in Oxford (RhADiOn) and OxSport Stress Fracture Database (n = 14). (1) Clinical practice was audited against five criteria based on local and National Institute for Health Care Excellence guidance, with a 100% standard. (2) Demographics of the FNSF cohort were examined with Student’s T-Test. (3) Lastly, linear regression and Random Forest regression models were used on this patient cohort to predict return–to–activity time. Consequently, an analysis of feature importance was conducted after fitting each model. Results: OxSport clinical practice met standard (100%) in 3/5 criteria. The criteria not met were patient waiting times and documentation of all bone stress risk factors. Importantly, analysis of patient demographics showed that of the population with complete bone stress risk factor assessments, 53% were positive for modifiable bone stress risk factors. Lastly, linear regression analysis was utilized to identify demographic factors that predicted return–to–activity time [R2 = 79.172%; average error 0.226]. This analysis identified four key variables that predicted return-to-activity time: vitamin D level, total hip DEXA T value, femoral neck DEXA T value, and history of an eating disorder/disordered eating. Furthermore, random forest regression models were employed for this task [R2 = 97.805%; average error 0.024]. Analysis of the importance of each feature again identified a set of 4 variables, 3 of which matched with the linear regression analysis (vitamin D level, total hip DEXA T value, and femoral neck DEXA T value) and the fourth: age. Conclusion: OxSport clinical practice could be improved by more comprehensively evaluating bone stress risk factors. The importance of this evaluation is demonstrated by the population found positive for these risk factors. Using this cohort, potential bone stress risk factors that significantly impacted return-to-activity prognosis were predicted using regression models.

Keywords: eating disorder, bone stress risk factor, femoral neck stress fracture, vitamin D

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Authors: Seungsik Yu, Minho Kang

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As the threat of terrorism to nuclear facilities is increasing globally after the attacks of September 11, we are striving to recognize the physical protection system and strengthen the emergency response system. Since 2015, Korea has implemented physical protection security exercise for nuclear facilities. The exercise should be carried out with full cooperation between the operator and response forces. Performance testing of the physical protection system should include appropriate exercises, for example, force-on-force exercises, to determine if the response forces can provide an effective and timely response to prevent sabotage. Significant deficiencies and actions taken should be reported as stipulated by the competent authority. The IAEA(International Atomic Energy Agency) is also preparing force-on-force exercise program documents to support exercise of member states. Currently, ROK(Republic of Korea) is implementing exercise on the force-on-force exercise evaluation system which is developed by itself for the nuclear power plant, and it is necessary to establish the exercise procedure considering the use of the force-on-force exercise evaluation system. The purpose of this study is to establish the work procedures of the three major organizations related to the force-on-force exercise of nuclear power plants in ROK, which conduct exercise using force-on-force exercise evaluation system. The three major organizations are composed of licensee, KINAC (Korea Institute of Nuclear Nonproliferation and Control), and the NSSC(Nuclear Safety and Security Commission). Major activities are as follows. First, the licensee establishes and conducts an exercise plan, and when recommendations are derived from the result of the exercise, it prepares and carries out a force-on-force result report including a plan for implementation of the recommendations. Other detailed tasks include consultation with surrounding units for adversary, interviews with exercise participants, support for document evaluation, and self-training to improve the familiarity of the MILES (Multiple Integrated Laser Engagement System). Second, KINAC establishes a force-on-force exercise plan review report and reviews the force-on-force exercise plan report established by licensee. KINAC evaluate force-on-force exercise using exercise evaluation system and prepare training evaluation report. Other detailed tasks include MILES training, adversary consultation, management of exercise evaluation systems, and analysis of exercise evaluation results. Finally, the NSSC decides whether or not to approve the force-on-force exercise and makes a correction request to the nuclear facility based on the exercise results. The most important part of ROK's force-on-force exercise system is the analysis through the exercise evaluation system implemented by KINAC after the exercise. The analytical method proceeds in the order of collecting data from the exercise evaluation system and analyzing the collected data. The exercise application process of the exercise evaluation system introduced in ROK in 2016 will be concretely set up, and a system will be established to provide objective and consistent conclusions between exercise sessions. Based on the conclusions drawn up, the ultimate goal is to complement the physical protection system of licensee so that the system makes licensee respond effectively and timely against sabotage or unauthorized removal of nuclear materials.

Keywords: Force-on-Force exercise, nuclear power plant, physical protection, sabotage, unauthorized removal

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Authors: Cynthia Adlerstein

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Physical learning environment (PLE) has been considered, after family and educators, as the third teacher. There have been conflicting and converging viewpoints on the role of the physical dimensions of places to learn, in facilitating educational innovation and quality. Despite the different approaches, PLE has been widely recognized as a key factor in the quality of the learning experience , and in the levels of learning achievement in ECE . The conceptual frameworks of the field assume that PLE consists of a complex web of factors that shape the overall conditions for learning, and that much more interdisciplinary and complementary methodologies of research and development are required. Although the relevance of PLE attracts a broad international consensus, in Chile it remains under-researched and weakly regulated by public policy. Gaining deeper contextual understanding and more thoughtfully-designed recommendations require the use of innovative assessment tools that cross cultural and disciplinary boundaries to produce new hybrid approaches and improvements. When considering a PLE-based change process for ECE improvement, a central question is what dimensions, variables and indicators could allow a comprehensive assessment of PLE in Chilean kindergartens? Based on a grounded theory social justice inquiry, we adopted a mixed method design, that enabled a multivocal and interdisciplinary construction of data. By using in-depth interviews, discussion groups, questionnaires, and documental analysis, we elicited the PLE discourses of politicians, early childhood practitioners, experts in architectural design and ergonomics, ECE stakeholders, and 3 to 5 year olds. A constant comparison method enabled the construction of the dimensions, variables and indicators through which PLE assessment is possible. Subsequently, the instrument was applied in a sample of 125 early childhood classrooms, to test reliability (internal consistency) and validity (content and construct). As a result, an interdisciplinary and multivocal tool for assessing physical learning environments was constructed and validated, for Chilean kindergartens. The tool is structured upon 7 dimensions (wellbeing, flexible, empowerment, inclusiveness, symbolically meaningful, pedagogically intentioned, institutional management) 19 variables and 105 indicators that are assessed through observation and registration on a mobile app. The overall reliability of the instrument is .938 while the consistency of each dimension varies between .773 (inclusive) and .946 (symbolically meaningful). The validation process through expert opinion and factorial analysis (chi-square test) has shown that the dimensions of the assessment tool reflect the factors of physical learning environments. The constructed assessment tool for kindergartens highlights the significance of the physical environment in early childhood educational settings. The relevance of the instrument relies in its interdisciplinary approach to PLE and in its capability to guide innovative learning environments, based on educational habitability. Though further analysis are required for concurrent validation and standardization, the tool has been considered by practitioners and ECE stakeholders as an intuitive, accessible and remarkable instrument to arise awareness on PLE and on equitable distribution of learning opportunities.

Keywords: Chilean kindergartens, early childhood education, physical learning environment, third teacher

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Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

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