Search results for: team climate inventory
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4808

Search results for: team climate inventory

2948 Cardiac Arrest after Cardiac Surgery

Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

Abstract:

Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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2947 The Making of a Community: Perception versus Reality of Neighborhood Resources

Authors: Kirstie Smith

Abstract:

This paper elucidates the value of neighborhood perception as it contributes to the advancement of well-being for individuals and families within a neighborhood. Through in-depth interviews with city residents, this paper examines the degree to which key stakeholders’ (residents) evaluate their neighborhood and perception of resources and identify, access, and utilize local assets existing in the community. Additionally, the research objective included conducting a community inventory that qualified the community assets and resources of lower-income neighborhoods of a medium-sized industrial city. Analysis of the community’s assets was compared with the interview results to allow for a better understanding of the community’s condition. Community mapping revealed the key informants’ reflections of assets were somewhat validated. In each neighborhood, there were more assets mapped than reported in the interviews. Another chief supposition drawn from this study was the identification of key development partners and social networks that offer the potential to facilitate locally-driven community development. Overall, the participants provided invaluable local knowledge of the perception of neighborhood assets, the well-being of residents, the condition of the community, and suggestions for responding to the challenges of the entire community in order to mobilize the present assets and networks.

Keywords: community mapping, family, resource allocation, social networks

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2946 Climate Change Impact on Slope Stability: A Study of Slope Drainage Design and Operation

Authors: Elena Mugarza, Stephanie Glendinning, Ross Stirling, Colin Davies

Abstract:

The effects of climate change and increased rainfall events on UK-based infrastructure are observable, with an increasing number being reported on in the national press. The fatal derailment at Stonehaven in 2020 prompted a wider review of Network Rail-owned earthworks assets. The event was indicated by the Rail Accident Investigation Branch (RAIB) to be caused by mis-installed drainage on the adjacent cutting. The slope failure on Snake Pass (public highway A57) was reportedly caused by significant water ingress following numerous storm events and resulted in the road’s closure for several months. This problem is only projected to continue with greater intensity and more prolonged rainfall events forecasted in the future. Subsequently, this project is designed to evaluate effective drainage trench design within infrastructure embankments, considering the capillary barrier phenomenon that may govern their deterioration and resultant failure. Theoretically, the differential between grain sizes of the embankment clays and gravels, customarily used in drainage trenches, would have a limiting effect on infiltration. As such, it is anticipated that the inclusion of an additional material with an intermediate grain size should improve the hydraulic conductivity across the drainage boundary. Multiple drainage designs will be studied using instrumentation within the drain and surrounding clays. Data from the real-world installation at the BIONICS embankment will be collected and compared with laboratory and Finite Element (FE) simulations. This research aims to reduce the risk of infrastructure slope failures by improving the resilience of earthwork drainage and lessening the consequential impact on transportation networks.

Keywords: earthworks, slope drainage, transportation slopes, deterioration, capillary barriers, field study

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2945 Bamboo as the Frontier for Economically Sustainable Solution to Flood Control and Human Wildlife Conflict

Authors: Nirman Kumar Ojha

Abstract:

Bamboo plantation can be integrated for natural embankment against flood and live fencing against wild animals, at the same time provide economic opportunity for the poor farmers as a sustainable solution and adaptation alternative. 2010 flood in the Rui River completely inundated fields of four VDCs in Madi, Chitwan National Park with extensive bank erosion. The main aim of this action research was to identify an economically sustainable natural embankment against flood and also providing wildlife friendly fencing to reduce human-wildlife conflict. Community people especially poor farmers were trained for soil testing, land identification, plantation, and the harvesting regime, nursery set up and intercropping along with bamboo plantation on the edge of the river bank in order to reduce or minimize soil erosion. Results show that farmers are able to establish cost efficient and economically sustainable river embankment with bamboo plantation also creating a fence for wildlife which has also promoted bamboo cultivation and conservation. This action research has amalgamated flood control and wildlife control with the livelihood of the farmers which otherwise would cost huge resource. Another major impact of the bamboo plantation is its role in climate change and its adaptation process reducing degradation and improving vegetation cover contributing to landscape management. Based on this study, we conclude that bamboo plantation in Madi, Chitwan promoted the livelihood of the poor farmers providing a sustainable economic solution to reduce bank erosion, human-wildlife conflict and contributes to landscape management.

Keywords: climate change and conservation, economic opportunity, flood control, national park

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2944 Holomorphic Prioritization of Sets within Decagram of Strategic Decision Making of POSM Using Operational Research (OR): Analytic Hierarchy Process (AHP) Analysis

Authors: Elias Ogutu Azariah Tembe, Hussain Abdullah Habib Al-Salamin

Abstract:

There is decagram of strategic decisions of operations and production/service management (POSM) within operational research (OR) which must collate, namely: design, inventory, quality, location, process and capacity, layout, scheduling, maintain ace, and supply chain. This paper presents an architectural configuration conceptual framework of a decagram of sets decisions in a form of mathematical complete graph and abelian graph. Mathematically, a complete graph is undirected (UDG), and directed (DG) a relationship where every pair of vertices are connected, collated, confluent, and holomorphic. There has not been any study conducted which, however, prioritizes the holomorphic sets which of POMS within OR field of study. The study utilizes OR structured technique known as The Analytic Hierarchy Process (AHP) analysis for organizing, sorting and prioritizing (ranking) the sets within the decagram of POMS according to their attribution (propensity), and provides an analysis how the prioritization has real-world application within the 21st century.

Keywords: holomorphic, decagram, decagon, confluent, complete graph, AHP analysis, SCM, HRM, OR, OM, abelian graph

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2943 Solid State Drive End to End Reliability Prediction, Characterization and Control

Authors: Mohd Azman Abdul Latif, Erwan Basiron

Abstract:

A flaw or drift from expected operational performance in one component (NAND, PMIC, controller, DRAM, etc.) may affect the reliability of the entire Solid State Drive (SSD) system. Therefore, it is important to ensure the required quality of each individual component through qualification testing specified using standards or user requirements. Qualification testing is time-consuming and comes at a substantial cost for product manufacturers. A highly technical team, from all the eminent stakeholders is embarking on reliability prediction from beginning of new product development, identify critical to reliability parameters, perform full-blown characterization to embed margin into product reliability and establish control to ensure the product reliability is sustainable in the mass production. The paper will discuss a comprehensive development framework, comprehending SSD end to end from design to assembly, in-line inspection, in-line testing and will be able to predict and to validate the product reliability at the early stage of new product development. During the design stage, the SSD will go through intense reliability margin investigation with focus on assembly process attributes, process equipment control, in-process metrology and also comprehending forward looking product roadmap. Once these pillars are completed, the next step is to perform process characterization and build up reliability prediction modeling. Next, for the design validation process, the reliability prediction specifically solder joint simulator will be established. The SSD will be stratified into Non-Operating and Operating tests with focus on solder joint reliability and connectivity/component latent failures by prevention through design intervention and containment through Temperature Cycle Test (TCT). Some of the SSDs will be subjected to the physical solder joint analysis called Dye and Pry (DP) and Cross Section analysis. The result will be feedbacked to the simulation team for any corrective actions required to further improve the design. Once the SSD is validated and is proven working, it will be subjected to implementation of the monitor phase whereby Design for Assembly (DFA) rules will be updated. At this stage, the design change, process and equipment parameters are in control. Predictable product reliability at early product development will enable on-time sample qualification delivery to customer and will optimize product development validation, effective development resource and will avoid forced late investment to bandage the end-of-life product failures. Understanding the critical to reliability parameters earlier will allow focus on increasing the product margin that will increase customer confidence to product reliability.

Keywords: e2e reliability prediction, SSD, TCT, solder joint reliability, NUDD, connectivity issues, qualifications, characterization and control

Procedia PDF Downloads 174
2942 Assessing Sustainability of Bike Sharing Projects Using Envision™ Rating System

Authors: Tamar Trop

Abstract:

Bike sharing systems can be important elements of smart cities as they have the potential for impact on multiple levels. These systems can add a significant alternative to other modes of mass transit in cities that are continuously looking for measures to become more livable and maintain their attractiveness for citizens, businesses and tourism. Bike-sharing began in Europe in 1965, and a viable format emerged in the mid-2000s thanks to the introduction of information technology. The rate of growth in bike-sharing schemes and fleets has been very rapid since 2008 and has probably outstripped growth in every other form of urban transport. Today, public bike-sharing systems are available on five continents, including over 700 cities, operating more than 800,000 bicycles at approximately 40,000 docking stations. Since modern bike sharing systems have become prevalent only in the last decade, the existing literature analyzing these systems and their sustainability is relatively new. The purpose of the presented study is to assess the sustainability of these newly emerging transportation systems, by using the Envision™ rating system as a methodological framework and the Israeli 'Tel -O-Fun' – bike sharing project as a case study. The assessment was conducted by project team members. Envision™ is a new guidance and rating system used to assess and improve the sustainability of all types and sizes of infrastructure projects. This tool provides a holistic framework for evaluating and rating the community, environmental, and economic benefits of infrastructure projects over the course of their life cycle. This evaluation method has 60 sustainability criteria divided into five categories: Quality of life, leadership, resource allocation, natural world, and climate and risk. 'Tel -O-Fun' project was launched in Tel Aviv-Yafo on 2011 and today provides about 1,800 bikes for rent, at 180 rental stations across the city. The system is based on a complex computer terminal that is located in the docking stations. The highest-rated sustainable features that the project scored include: (a) Improving quality of life by: offering a low cost and efficient form of public transit, improving community mobility and access, enabling the flexibility of travel within a multimodal transportation system, saving commuters time and money, enhancing public health and reducing air and noise pollution; (b) improving resource allocation by: offering inexpensive and flexible last-mile connectivity, reducing space, materials and energy consumption, reducing wear and tear on public roads, and maximizing the utility of existing infrastructure, and (c) reducing of greenhouse gas emissions from transportation. Overall, 'Tel -O-Fun' project was highly scored as an environmentally sustainable and socially equitable infrastructure. The use of this practical framework for evaluation also yielded various interesting insights on the shortcoming of the system and the characteristics of good solutions. This can contribute to the improvement of the project and may assist planners and operators of bike sharing systems to develop a sustainable, efficient and reliable transportation infrastructure within smart cities.

Keywords: bike sharing, Envision™, sustainability rating system, sustainable infrastructure

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2941 Physico-Chemical Parameters and Economic Evaluation of Bio-Ethanol Produced from Waste of Starting Dates in South Algeria

Authors: Insaf Mehani, Bachir Bouchekima

Abstract:

The fight against climate change and the replacement of fossil energies nearing exhaustion gradually emerge as major societal and economic challenges. It is possible to develop common dates of low commercial value, and put on the local and international market a new generation of products with high added values such as bio ethanol. Besides its use in chemical synthesis, bio ethanol can be blended with gasoline to produce a clean fuel while improving the octane.

Keywords: bio-energy, waste dates, bio ethanol, Algeria

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2940 Seasonal Assessment of Snow Cover Dynamics Based on Aerospace Multispectral Data on Livingston Island, South Shetland Islands in Antarctica and on Svalbard in Arctic

Authors: Temenuzhka Spasova, Nadya Yanakieva

Abstract:

Snow modulates the hydrological cycle and influences the functioning of ecosystems and is a significant resource for many populations whose water is harvested from cold regions. Snow observations are important for validating climate models. The accumulation and rapid melt of snow are two of the most dynamical seasonal environmental changes on the Earth’s surface. The actuality of this research is related to the modern tendencies of the remote sensing application in the solution of problems of different nature in the ecological monitoring of the environment. The subject of the study is the dynamic during the different seasons on Livingstone Island, South Shetland Islands in Antarctica and on Svalbard in Arctic. The objects were analyzed and mapped according to the Еuropean Space Agency data (ESA), acquired by sensors Sentinel-1 SAR (Synthetic Aperture Radar), Sentinel 2 MSI and GIS. Results have been obtained for changes in snow coverage during the summer-winter transition and its dynamics in the two hemispheres. The data used is of high time-spatial resolution, which is an advantage when looking at the snow cover. The MSI images are with different spatial resolution at the Earth surface range. The changes of the environmental objects are shown with the SAR images and different processing approaches. The results clearly show that snow and snow melting can be best registered by using SAR data via hh- horizontal polarization. The effect of the researcher on aerospace data and technology enables us to obtain different digital models, structuring and analyzing results excluding the subjective factor. Because of the large extent of terrestrial snow coverage and the difficulties in obtaining ground measurements over cold regions, remote sensing and GIS represent an important tool for studying snow areas and properties from regional to global scales.

Keywords: climate changes, GIS, remote sensing, SAR images, snow coverage

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2939 Management of Therapeutic Anticancer at Oran Teaching Hospital, Algeria

Authors: S. Boulenouar, M. Sefir, M. Benahmed

Abstract:

All facilities need medication and other pharmaceuticals for their operation. Management and supply is therefore to provide the different services of the facility goods and services in required quantity and quality. The permanent availability of drugs in the facilities is very difficult because most face many difficulties at the inventory management and drug supplies. Therefore, it is necessary for each health facility to know the causes for the malfunction of its management system to cope with them. It is in this context that we have undertaken to conduct this study to know the causes which should be taken into consideration by the concerned authorities to carry out their mission, which is to provide quality health care for the population. In terms of financial resources, the budget for medicines represents a significant part of the budget of the pharmacy. Our study shows that the share of the hospital budget reserved for the drugs procurement represent on average 70% of the budget of the pharmacy. The results show a state of lack of anticancer drugs at Oran teaching hospital. The analysis of the management process allowed us to know the level that the problem of stock-outs of anti-cancer drugs is at. Suggestions were made to that effect to improve the availability for these products and to respond better to the needs of patients.

Keywords: anticancer drugs, health care facility, budget, hospital pharmacist, hospital service

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2938 Restoring Total Form and Function in Patients with Lower Limb Bony Defects Utilizing Patient-Specific Fused Deposition Modelling- A Neoteric Multidisciplinary Reconstructive Approach

Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew

Abstract:

Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.

Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering

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2937 Fodder Production and Livestock Rearing in Relation to Climate Change and Possible Adaptation Measures in Manaslu Conservation Area, Nepal

Authors: Bhojan Dhakal, Naba Raj Devkota, Chet Raj Upreti, Maheshwar Sapkota

Abstract:

A study was conducted to find out the production potential, nutrient composition, and the variability of the most commonly available fodder trees along with the varying altitude to help optimize the dry matter requirement during winter lean period. The study was carried out from March to June, 2012 in Lho and Prok Village Development Committee of Manaslu Conservation Area (MCA), located in Gorkha district of Nepal. The other objective of the research was to learn the impact of climate change on livestock production linking it with feed availability. The study was conducted in two parts: social and biological. Accordingly, a households (HHs) survey was conducted to collect primary data from 70 HHs, focusing on the perception of respondents on impacts of climatic variability on the feeding management. The next part consisted of understanding yield potential and nutrient composition of the four most commonly available fodder trees (M. azedirach, M. alba, F. roxburghii, F. nemoralis), within two altitudes range: (1500-2000 masl and 2000-2500 masl) by using a RCB design in 2*4 factorial combination of treatments, each replicated four times. Results revealed that majority of the farmers perceived the change in climatic phenomenon more severely within the past five years. Farmers were using different adaptation technologies such as collection of forage from jungle, reducing unproductive animals, fodder trees utilization, and crop by product feeding at feed scarcity period. Ranking of the different fodder trees on the basis of indigenous knowledge and experiences revealed that F. roxburghii was the best-preferred fodder tree species (index value 0.72) in terms overall preferability whereas M. azedirach had highest growth and productivity (index value 0.77), F. roxburghii had highest adoptability (index value 0.69) and palatability (index value 0.69) as well. Similarly, fresh yield and dry matter yield of the each fodder trees was significant (P < 0.01) between the altitude and within species. Fodder trees yield analysis revealed that the highest dry matter (DM) yield (28 kg/tree) was obtained for F. roxburghii but that remained statistically similar (P > 0.05) to the other treatment. On the other hand, most of the parameters: ether extract (EE), acid detergent lignin (ADL), acid detergent fibre (ADF), cell wall digestibility (CWD), relative digestibility (RD), digestible nutrient (TDN), and Calcium (Ca) among the treatments were highly significant (P < 0.01). This indicates the scope of introducing productive and nutritive fodder trees species even at the high altitude to help reduce fodder scarcity problem during winter. The finding also revealed the scope of promoting all available local fodder trees species as crude protein content of these species were similar.

Keywords: fodder trees, yield potential, climate change, nutrient composition

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2936 An Evaluation of the Implementation of Training and Development in a South African Municipality

Authors: Granny K. Lobega, Ntsako Idrs Makamu

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The envisaged paper was to evaluate the implementation of training and development in a South African Municipality. The paper adopted a qualitative research approach. Primary data were collected from 20 participants which were sampled from the municipality, and data were collected by using semi-structured interviews. The main objective of the study was to assess the reason for the implementation of training and development program by the municipality. The study revealed that workers are helped to focus, and priority is placed on empowering employees, productivity is increased and contributing to better team morale. The study recommended that the municipality must establish proper procedures to be followed when selecting qualifying employees to attend the training and further use the training audit to establish the necessary training to be offered to qualifying employees.

Keywords: training, development, municipality, evaluation, human resource management

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2935 Mental Health of Caregivers in Public Hospital Intensive Care Department: A Multicentric Cross-Sectional Study

Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

Abstract:

Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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2934 The Food Security and Nutritional Diversity Impacts of Coupling Rural Infrastructure and Value Chain Development: Evidence from a Generalized Propensity Score Analysis

Authors: Latif Apaassongo Ibrahim, Owusu-Addo Ebenezer, Isaac Bonuedo

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Structural barriers - including inadequate infrastructure, poor market linkages, and limited access to financial and extension services - have been the major constraints to improved welfare in the semi-arid regions of Ghana; food insecurity and malnutrition are persistent. The effects of infrastructural improvements as countermeasures are often misdirected by confounding effects of other economic, social, and environmental variables. This study applies Directed Acyclic Graphs (DAGs) to map the causal pathways between infrastructure development and household welfare, identifying key mediators and confounders for one such initiative in Ghana. Then, using Generalized Propensity Score (GPS) and Doubly Robust Estimation (IPWRA), this study evaluates the differential roles of government-supported infrastructure improvements in access and intensity of commercial relative to public infrastructure, on household food security and women’s nutritional diversity given three major value-chain improvements. The main findings suggest that these infrastructure improvements positively impact food security and nutrition, with women’s empowerment and nutritional education acting as key mediators. Market access emerged as a stronger causal mechanism relative to productivity gains in linking infrastructure to improved welfare. Membership in Farmer-Based Organizations (FBOs) and participation in agribusiness linkages further amplified these impacts. However, the effects of infrastructure improvements were less clear when combined with the adoption of climate resilience practices, suggesting potential trade-offs.

Keywords: food security, nutrition, infrastructure, market access, women's empowerment, farmer-based organizations, climate resilience, Ghana

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2933 Shovadan; A Historical Heritage in the Architecture of the South West of Iran (Case Study: Dezfoul City)

Authors: Farnaz Nazem

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Iranian architects had creative ways for constructing the buildings in each climate. Some of these architectural elements were made under the ground. Shovadan is one of these underground spaces in hot- humid regions in Dezfoul and Shoushtar city that had special functions and characteristics. In this paper some subjects such as the history of Shovadan, its elements and effective factors in the formation of Shovadan in Dezfool city are discussed.

Keywords: architecture, dezfoul city, Shovadan, south west of Iran

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2932 Adoption of Proactive and Reactive Supply Chain Resilience Strategies: A Comparison between Apparel and Construction Industries in Sri Lanka

Authors: Anuradha Ranawakage, Chathurani Silva

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With the growing expansion of global businesses, supply chains are increasingly exposed to numerous disruptions. Organizations adopt various strategies to mitigate the impact of these disruptions. Depending on the variations in the conditions and characteristics of supply chains, the adoption of resilience strategies may vary across industries. However, these differences are largely unexplored in the existing literature. Hence, this study aims to evaluate the adoption of three proactive strategies: proactive collaboration, digital connectivity, integrated SC risk management, and three reactive strategies: reactive collaboration, inventory and reserve capacity, and lifeline maintenance in the apparel and construction industries in Sri Lanka. An online questionnaire was used to collect data on the implementation of resilience strategies from a sample of 162 apparel and 185 construction companies operating in Sri Lanka. This research makes a significant contribution to the field of supply chain management by assessing the extent to which different resilience strategies are functioned within the apparel and construction industries in Sri Lanka, particularly in an era after a global pandemic that significantly disrupted supply chains all around the world.

Keywords: apparel, construction, proactive strategies, reactive strategies, supply chain resilience

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2931 Dragonflies (Odonata) Reflect Climate Warming Driven Changes in High Mountain Invertebrates Populations

Authors: Nikola Góral, Piotr Mikołajczuk, Paweł Buczyński

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Much scientific research in the last 20 years has focused on the influence of global warming on the distribution and phenology of living organisms. Three potential responses to climate change are predicted: individual species may become extinct, adapt to new conditions in their existing range or change their range by migrating to places where climatic conditions are more favourable. It means not only migration to areas in other latitudes, but also different altitudes. In the case of dragonflies (Odonata), monitoring in Western Europe has shown that in response to global warming, dragonflies tend to change their range to a more northern one. The strongest response to global warming is observed in arctic and alpine species, as well as in species capable of migrating over long distances. The aim of the research was to assess whether the fauna of aquatic insects in high-mountain habitats has changed as a result of climate change and, if so, how big and what type these changes are. Dragonflies were chosen as a model organism because of their fast reaction to changes in the environment: they have high migration abilities and short life cycle. The state of the populations of boreal-mountain species and the extent to which lowland species entered high altitudes was assessed. The research was carried out on 20 sites in Western Sudetes, Southern Poland. They were located at an altitude of between 850 and 1250 m. The selected sites were representative of many types of valuable alpine habitats (subalpine raised bog, transitional spring bog, habitats associated with rivers and mountain streams). Several sites of anthropogenic origin were also selected. Thanks to this selection, a wide characterization of the fauna of the Karkonosze was made and it was compared whether the studied processes proceeded differently, depending on whether the habitat is primary or secondary. Both imagines and larvae were examined (by taking hydrobiological samples with a kick-net), and exuviae were also collected. Individual species dragonflies were characterized in terms of their reproductive, territorial and foraging behaviour. During each inspection, the basic physicochemical parameters of the water were measured. The population of the high-mountain dragonfly Somatochlora alpestris turned out to be in a good condition. This species was noted at several sites. Some of those sites were situated relatively low (995 m AMSL), which proves that the thermal conditions at the lower altitudes might be still optimal for this species. The protected by polish law species Somatochlora arctica, Aeshna subarctica and Leucorrhinia albifrons, as well as strongly associated with bogs Leucorrhinia dubia and Aeshna juncea bogs were observed. However, they were more frequent and more numerous in habitats of anthropogenic origin, which may suggest minor changes in the habitat preferences of dragonflies. The subject requires further research and observations over a longer time scale.

Keywords: alpine species, bioindication, global warming, habitat preferences, population dynamics

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2930 Correction of Skeletal Deformity by Surgical Approach – A Case Report

Authors: Davender Kumar, Virender Singh, Rekha Sharma

Abstract:

Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetic, functional, and stable results Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion.

Keywords: camouflage, skeletal, orthognathic, dental

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2929 Educational Knowledge Transfer in Indigenous Mexican Areas Using Cloud Computing

Authors: L. R. Valencia Pérez, J. M. Peña Aguilar, A. Lamadrid Álvarez, A. Pastrana Palma, H. F. Valencia Pérez, M. Vivanco Vargas

Abstract:

This work proposes a Cooperation-Competitive (Coopetitive) approach that allows coordinated work among the Secretary of Public Education (SEP), the Autonomous University of Querétaro (UAQ) and government funds from National Council for Science and Technology (CONACYT) or some other international organizations. To work on an overall knowledge transfer strategy with e-learning over the Cloud, where experts in junior high and high school education, working in multidisciplinary teams, perform analysis, evaluation, design, production, validation and knowledge transfer at large scale using a Cloud Computing platform. Allowing teachers and students to have all the information required to ensure a homologated nationally knowledge of topics such as mathematics, statistics, chemistry, history, ethics, civism, etc. This work will start with a pilot test in Spanish and initially in two regional dialects Otomí and Náhuatl. Otomí has more than 285,000 speaking indigenes in Queretaro and Mexico´s central region. Náhuatl is number one indigenous dialect spoken in Mexico with more than 1,550,000 indigenes. The phase one of the project takes into account negotiations with indigenous tribes from different regions, and the Information and Communication technologies to deliver the knowledge to the indigenous schools in their native dialect. The methodology includes the following main milestones: Identification of the indigenous areas where Otomí and Náhuatl are the spoken dialects, research with the SEP the location of actual indigenous schools, analysis and inventory or current schools conditions, negotiation with tribe chiefs, analysis of the technological communication requirements to reach the indigenous communities, identification and inventory of local teachers technology knowledge, selection of a pilot topic, analysis of actual student competence with traditional education system, identification of local translators, design of the e-learning platform, design of the multimedia resources and storage strategy for “Cloud Computing”, translation of the topic to both dialects, Indigenous teachers training, pilot test, course release, project follow up, analysis of student requirements for the new technological platform, definition of a new and improved proposal with greater reach in topics and regions. Importance of phase one of the project is multiple, it includes the proposal of a working technological scheme, focusing in the cultural impact in Mexico so that indigenous tribes can improve their knowledge about new forms of crop improvement, home storage technologies, proven home remedies for common diseases, ways of preparing foods containing major nutrients, disclose strengths and weaknesses of each region, communicating through cloud computing platforms offering regional products and opening communication spaces for inter-indigenous cultural exchange.

Keywords: Mexicans indigenous tribes, education, knowledge transfer, cloud computing, otomi, Náhuatl, language

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2928 Modalmetric Fiber Sensor and Its Applications

Authors: M. Zyczkowski, P. Markowski, M. Karol

Abstract:

The team from IOE MUT is developing fiber optic sensors for the security systems for 15 years. The conclusions of the work indicate that these sensors are complicated. Moreover, these sensors are expensive to produce and require sophisticated signal processing methods.We present the results of the investigations of three different applications of the modalmetric sensor: • Protection of museum collections and heritage buildings, • Protection of fiber optic transmission lines, • Protection of objects of critical infrastructure. Each of the presented applications involves different requirements for the system. The results indicate that it is possible to developed a fiber optic sensor based on a single fiber. Modification of optoelectronic parts with a change of the length of the sensor and the method of reflections of propagating light at the end of the sensor allows to adjust the system to the specific application.

Keywords: modalmetric fiber optic sensor, security sensor, optoelectronic parts, signal processing

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2927 Aquatic and Marshy Flora from Fresh Water Wetlands on Quartz Sands in Pinar Del Río, Cuba

Authors: Vidal Pérez Hernández, Enrique González Pendás

Abstract:

The most of the aquatic and marshy flora in Cuba, is located on quartzitic sands ecosystems and they are represented by a wide variety of freshwater wetlands, which are spread in the whole south and south-western plain of Pinar del Río. The survey carried out in these ecosystems offers an updated inventory of these species, showing up their biological type, habit, distribution, and the threat grade to which are subjected, taking into account categories granted by UICN. A remarkable decrease is evidenced, in the total of these species respect to this area; due to deposit processes and deforestation, which are taken place by the human activity and the climatic change. It is linked to others threats like, limitless use of their water reserves for irrigating groves, the cattle raising and intensive fishing. Added to it, its sand with 99% pure crystal quartz, are used for the mining. The combination of all factors has a negative influence on a flora that stores more than 250 species, most of them herbaceous and hydrophytes. In these particular ecosystems were found a 40% endemism from total flora, and more than 80%, are evaluated inside the most sensitive threat categories, and already some of them have been declared as extinct.

Keywords: aquatic flora, marshy flora, quartzitic sands, wetlands

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2926 Intrusiveness, Appraisal and Thought Control Strategies in Patients with Obsessive Compulsive Disorder

Authors: T. Arshad

Abstract:

A correlation study was done to explore the relationship of intrusiveness, appraisal and thought control strategies in patients with Obsessive Compulsive Disorder. Theoretical frame work for the present study was Salkovskis (1985) cognitive model of obsessive compulsive disorder. Sample of 100 patients (men=48, women=52) of age 14-62 years (M=32.13, SD=10.37) was recruited from hospitals of Lahore, Pakistan. Revised Obsessional Intrusion Inventory, Stress Appraisal Measure, Thought Control Questionnaire and Symptoms Checklist-R were self-administered. Findings revealed that intrusiveness is correlated with appraisals (controllable by self, controllable by others, uncontrollable, stressfulness) and thought control strategy (punishment). Furthermore, appraisals (uncontrollable, stressfulness, controllable by others) were emerged as strong predictors for different through control strategies (distraction, punishment and social control). Moreover, men have higher frequency of intrusion, whereas women were frequently using social control as thought control strategy. Results implied that intrusiveness, appraisals (controllable by others, uncontrollable, stressfulness) and thought control strategy (punishment) are related which maintains the disorder.

Keywords: appraisal, intrusiveness, obsessive compulsive disorder, thought control strategies

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2925 Using Geographic Information Systems to Trace Conditions for Young Women's Experiences of Public Spaces in Disadvantaged Neighborhoods

Authors: Alazar G. Ejigu

Abstract:

Cities have traditionally been designed for and by men. Despite positive changes in this regard, contemporary cities appear to offer limited options and experiences to women in their everyday life. There are differences regarding the quality of space. Distressed or disadvantaged areas often have less access to urban qualities, such as services, parks, and public places, than more privileged ones. The most attractive meeting-places are located centrally, whereas many suburban areas lack these elements. By focusing on young women living in multi-ethnic working-class suburban areas in Stockholm - a group generally ignored and disadvantaged; the study aims to examine various forms of inequality or equality in three selected neighborhoods. Spatial data was collected through walk-along with the young girls, inventory of the places, and geodata made available by Statistics Sweden (SCB). The combined data was analyzed with the help of Geographic Information Systems (GIS). In line with Crenshaw - one of the forerunners of intersectional thinking – the project departs from the idea that if we address the needs of those who are disadvantaged and restructure urban space accordingly, then others will benefit too. Thus, working our way towards a more equal city.

Keywords: GIS, segregation, gender equality, urban planning

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2924 Teaching Environment and Instructional Materials on Students’ Performance in English Language: Implications for Counselling

Authors: Rosemary Saidu, Taiyelolu Martins Ogunjirin

Abstract:

The study examines the teaching environment and instructional materials on the performance of students in the English Language in selected secondary schools in Ogun State and its implication for counselling. Two research questions guided the study were developed. The study adopted a descriptive survey design. A multi-stage sampling technique was employed for the study. Samples of 100 students of Senior Secondary School Two (SSS11) were drawn. Purposive sampling technique was to select the five schools. Additionally, the instruments known as Teaching Environment and Instructional Materials on Students Performance in English Inventory (TEIMEI) and Student Achievement Scores (SAS) were used to elicit information. Thereafter, inferential statistics and the non-parametric chi-square statistics at 0.05 alpha levels and 3 degree of freedom were adopted as analytical tools. From the study, it was discovered among others that teaching environment and instructional materials significantly contributed to the performance of students in the English language. From the findings, it was recommended that among others functional language laboratory in the schools, counselors to regularly give guidance talk on the importance of the subject.

Keywords: performance, English language, teaching environment, instructional materials

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2923 Temperament and Character Dimensions as Personality Predictors of Relationship Quality: An Actor-Partner Interdependence Model

Authors: Dora Vajda, Somayyeh Mohammadi, Sandor Rozsa

Abstract:

Predicting the relationship satisfaction based on the personality characteristics of both partners has a long history. The association between relationship quality and personality traits has been previously demonstrated. Personality traits are most commonly assessed using the Five-Factor Model. The present study has focused on Cloninger's psychobiological model of personality that accounts for dimensions of both temperament and character. The goal of this study was to examine the actor and partner effect of couple's personality on relationship outcomes. In total, 184 heterosexual couples completed the Temperament and Character Inventory (TCI) and the Dyadic Adjustment Scale. The analysis was based on Actor-Partner Interdependence Model (APIM) using multilevel modeling (MLwiN). Results showed that character dimensions Self-Directedness and Cooperativeness had a statistically meaningful actor and partner effect on both partner's relationship quality. However, male's personality temperament dimension Reward Dependence had an only actor effect on his relationship quality. The findings contribute to the literature by highlighting the role of character dimensions of personality in romantic relationships.

Keywords: APIM (actor-partner interdependence model), MLwiN, personality, relationship quality

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2922 Modeling and Mapping of Soil Erosion Risk Using Geographic Information Systems, Remote Sensing, and Deep Learning Algorithms: Case of the Oued Mikkes Watershed, Morocco

Authors: My Hachem Aouragh, Hind Ragragui, Abdellah El-Hmaidi, Ali Essahlaoui, Abdelhadi El Ouali

Abstract:

This study investigates soil erosion susceptibility in the Oued Mikkes watershed, located in the Meknes-Fez region of northern Morocco, utilizing advanced techniques such as deep learning algorithms and remote sensing integrated within Geographic Information Systems (GIS). Spanning approximately 1,920 km², the watershed is characterized by a semi-arid Mediterranean climate with irregular rainfall and limited water resources. The waterways within the watershed, especially the Oued Mikkes, are vital for agricultural irrigation and potable water supply. The research assesses the extent of erosion risk upstream of the Sidi Chahed dam while developing a spatial model of soil loss. Several important factors, including topography, land use/land cover, and climate, were analyzed, with data on slope, NDVI, and rainfall erosivity processed using deep learning models (DLNN, CNN, RNN). The results demonstrated excellent predictive performance, with AUC values of 0.92, 0.90, and 0.88 for DLNN, CNN, and RNN, respectively. The resulting susceptibility maps provide critical insights for soil management and conservation strategies, identifying regions at high risk for erosion across 24% of the study area. The most high-risk areas are concentrated on steep slopes, particularly near the Ifrane district and the surrounding mountains, while low-risk areas are located in flatter regions with less rugged topography. The combined use of remote sensing and deep learning offers a powerful tool for accurate erosion risk assessment and resource management in the Mikkes watershed, highlighting the implications of soil erosion on dam siltation and operational efficiency.

Keywords: soil erosion, GIS, remote sensing, deep learning, Mikkes Watershed, Morocco

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2921 Need for Elucidation of Palaeoclimatic Variability in the High Himalayan Mountains: A Multiproxy Approach

Authors: Sheikh Nawaz Ali, Pratima Pandey, P. Morthekai, Jyotsna Dubey, Md. Firoze Quamar

Abstract:

The high mountain glaciers are one of the most sensitive recorders of climate changes, because they have the tendency to respond to the combined effect of snow fall and temperature. The Himalayan glaciers have been studied with a good pace during the last decade. However, owing to its large ecological diversity and geographical vividness, major part of the Indian Himalaya is uninvestigated, and hence the palaeoclimatic patterns as well as the chronology of past glaciations in particular remain controversial for the entire Indian Himalayan transect. Although the Himalayan glaciers are nourished by two important climatic systems viz. the southwest summer monsoon and the mid-latitude westerlies, however, the influence of these systems is yet to be understood. Nevertheless, existing chronology (mostly exposure ages) indicate that irrespective of the geographical position, glaciers seem to grow during enhanced Indian summer monsoon (ISM). The Himalayan mountain glaciers are referred to the third pole or water tower of Asia as they form a huge reservoir of the fresh water supplies for the Asian countries. Mountain glaciers are sensitive probes of the local climate, and, thus, they present an opportunity and a challenge to interpret climates of the past as well as to predict future changes. The principle object of all the palaeoclimatic studies is to develop a futuristic models/scenario. However, it has been found that the glacial chronologies bracket the major phases of climatic events only, and other climatic proxies are sparse in Himalaya. This is the reason that compilation of data for rapid climatic change during the Holocene shows major gaps in this region. The sedimentation in proglacial lakes, conversely, is more continuous and, hence, can be used to reconstruct a more complete record of past climatic variability that is modulated by changing ice volume of the valley glacier. The Himalayan region has numerous proglacial lacustrine deposits formed during the late Quaternary period. However, there are only few such deposits which have been studied so far. Therefore, this is the high time when efforts have to be made to systematically map the moraines located in different climatic zones, reconstruct the local and regional moraine stratigraphy and use multiple dating techniques to bracket the events of glaciation. Besides this, emphasis must be given on carrying multiproxy studies on the lacustrine sediments that will provide a high resolution palaeoclimatic data from the alpine region of the Himalaya. Although the Himalayan glaciers fluctuated in accordance with the changing climatic conditions (natural forcing), however, it is too early to arrive at any conclusion. It is very crucial to generate multiproxy data sets covering wider geographical and ecological domains taking into consideration multiple parameters that directly or indirectly influence the glacier mass balance as well as the local climate of a region.

Keywords: glacial chronology, palaeoclimate, multiproxy, Himalaya

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2920 The Use of Political Savviness in Dealing with Workplace Ostracism: A Social Information Processing Perspective

Authors: Amy Y. Wang, Eko L. Yi

Abstract:

Can vicarious experiences of workplace ostracism affect employees’ willingness to voice? Given the increasingly interdependent nature of the modern workplace in which employees rely on social interactions to fulfill organizational goals, workplace ostracism –the extent to which an individual perceives that he or she is ignored or excluded by others in the workplace– has garnered significant interest from scholars and practitioners alike. Extending beyond conventional studies that largely focus on the perspectives and outcomes of ostracized targets, we address the indirect effects of workplace ostracism on third-party employees embedded in the same social context. Using a social information processing approach, we propose that the ostracism of coworkers acts as political information that influences third-party employees in their decisions to engage in risky and discretionary behaviors such as employee voice. To make sense of and to navigate through experiences of workplace ostracism, we posit that both political understanding and political skill allow third party employees to minimize the risks and uncertainty of voicing. This conceptual model was tested by a study involving 154 supervisor-subordinate dyads of a publicly listed bio-technology firm located in Mainland China. Each supervisor and their direct subordinates composed of a work team; each team had a minimum of two subordinates and a maximum of four subordinates. Human resources used the master list to distribute the ID coded questionnaires to the matching names. All studied constructs were measured using existing scales proved effective in previous literature. Hypotheses were tested using Confirmatory Factor Analysis and Hierarchal Multiple Regression. All three hypotheses were supported which showed that employees were less likely to engage in voice behaviors when their coworkers reported having experienced ostracism in the workplace. Results also showed a significant three-way interaction between political understanding and political skill on the relationship between coworkers’ ostracism and employee voice, indicating that political savviness is a valuable resource in mitigating ostracism’s negative and indirect effects. Our results illustrated that an employee’s coworkers being ostracized indeed adversely impacted his or her own voice behavior. However, not all individuals reacted passively to the social context; rather, we found that politically savvy individuals – possessing both political understanding and political skill – and their voice behaviors were less impacted by ostracism in their work environment. At the same time, we found that having only political understanding or only political skill was significantly less effective in mitigating ostracism’s negative effects, suggesting a necessary duality of political knowledge and political skill in combatting ostracism. Organizational implications, recommendations, and future research ideas are also discussed.

Keywords: employee voice, organizational politics, social information processing, workplace ostracism

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2919 Recognising and Managing Haematoma Following Thyroid Surgery: Simulation Teaching is Effective

Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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