Search results for: supply chain quality management

Authors: Bu Kyung Park

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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

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Authors: Kevin Potoczny, Katsuichiro Goda

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The St. Lawrence lowlands extend from Ottawa to Quebec City and are known for large deposits of sensitive Leda clay. Leda clay deposits are responsible for many large landslides, such as the 1993 Lemieux and 2010 St. Jude (4 fatalities) landslides. Due to the large extent and sensitivity of Leda clay, regional hazard analysis for landslides is an important tool in risk management. A 2018 regional study by Farzam et al. on the susceptibility of Leda clay slopes to landslide hazard uses 1 arc second topographical data. A qualitative method known as Hazus is used to estimate susceptibility by checking for various criteria in a location and determine a susceptibility rating on a scale of 0 (no susceptibility) to 10 (very high susceptibility). These criteria are slope angle, geological group, soil wetness, and distance from waterbodies. Given the flat nature of St. Lawrence lowlands, the current assessment fails to capture local slopes, such as the St. Jude site. Additionally, the data did not allow one to analyze failure planes accurately. This study majorly improves the analysis performed by Farzam et al. in two aspects. First, regional assessment with high resolution data allows for identification of local locations that may have been previously identified as low susceptibility. This then provides the opportunity to conduct a more refined analysis on the failure plane of the slope. Slopes derived from 1 arc second data are relatively gentle (0-10 degrees) across the region; however, the 1- and 2-meter resolution 2022 HRDEM provided by NRCAN shows that short, steep slopes are present. At a regional level, 1 arc second data can underestimate the susceptibility of short, steep slopes, which can be dangerous as Leda clay landslides behave retrogressively and travel upwards into flatter terrain. At the location of the St. Jude landslide, slope differences are significant. 1 arc second data shows a maximum slope of 12.80 degrees and a mean slope of 4.72 degrees, while the HRDEM data shows a maximum slope of 56.67 degrees and a mean slope of 10.72 degrees. This equates to a difference of three susceptibility levels when the soil is dry and one susceptibility level when wet. The use of GIS software is used to create a regional susceptibility map across the St. Lawrence lowlands at 1- and 2-meter resolutions. Failure planes are necessary to differentiate between small and large landslides, which have so far been ignored in regional analysis. Leda clay failures can only retrogress as far as their failure planes, so the regional analysis must be able to transition smoothly into a more robust local analysis. It is expected that slopes within the region, once previously assessed at low susceptibility scores, contain local areas of high susceptibility. The goal is to create opportunities for local failure plane analysis to be undertaken, which has not been possible before. Due to the low resolution of previous regional analyses, any slope near a waterbody could be considered hazardous. However, high-resolution regional analysis would allow for more precise determination of hazard sites.

Keywords: hazus, high-resolution DEM, leda clay, regional analysis, susceptibility

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Ananya Pal, Neelakshi Sarkar, Debraj Saha, Dipanwita Das, Subhashish Kamal Guha, Bibhuti Saha, Runu Chakravarty

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Presently, tenofovir disoproxil fumurate (TDF) is the most effective anti-viral agent for the treatment of hepatitis B virus (HBV) in individuals co-infected with HIV and HBV as TDF has activity to suppress both wild-type and lamivudine (3TC)-resistant HBV. However, suboptimal response to TDF was reported in HIV-HBV co-infected individuals with prior 3TC therapy from different countries recently. The incidence of 3TC-resistant HBV strains is quite high in HIV-HBV co-infected patients experiencing long-term anti-retroviral therapy (ART) in eastern India. In spite of this risk, most of the patients with long-term 3TC treatment are continued with the same anti-viral agent in this country. Only a few have received TDF in addition to 3TC in the ART regimen since TDF has been available in India for the treatment of HIV-infected patients in 2012. In this preliminary study, we investigated the virologic and biochemical parameters among HIV-HBV co-infected patients who are non-responders to 3TC treatment during the continuation of 3TC or TDF add-on to 3TC in their ART regimen. Fifteen HIV-HBV co-infected patients who experienced long-term 3TC (mean duration months 36.87 ± 24.08 months) were identified with high HBV viremia ( > 20,000 IU/ml) or harbouring 3TC-resistant HBV. These patients receiving ART from School of Tropical Medicine Kolkata, the main ART centre in eastern India were followed-up semi-annually for next three visits. Different virologic parameters including quantification of plasma HBV load by real-time PCR, detection of hepatitis B e antigen (HBeAg) by commercial ELISA and anti-viral resistant mutations by sequencing were studied. During three follow-up among study subjects, 86%, 47%, and 43% had 3TC-mono-therapy (mean treatment-duration 41.54±18.84, 49.67±11.67, 54.17±12.37 months respectively) whereas 14%, 53%, and 57% experienced TDF in addition to 3TC (mean treatment duration 4.5±2.12, 16.56±11.06, and 23±4.07 months respectively). Mean CD4 cell-count in patients receiving 3TC was tended to be lower during third follow-up as compared to the first and the second [520.67±380.30 (1st), 454.8±196.90 (2nd), and 397.5±189.24 (3rd) cells/mm3) and similar trend was seen in patients experiencing TDF in addition to 3TC [334.5±330.218 (1st), 476.5±194.25 (2nd), and 461.17±269.89 (3rd) cells/mm3]. Serum HBV load was increased during successive follow-up of patients with 3TC-mono-therapy. Initiation of TDF lowered serum HBV-load among 3TC-non-responders at the time of second visit ( < 2,000 IU/ml), interestingly during third follow-up, mean HBV viremia increased >1 log IU/ml (mean 3.56±2.84 log IU/ml). Persistence of 3TC-resistant double and triple mutations was also observed in both the treatment regimens. Mean serum alanine aminotransferase remained elevated in these patients during this follow-up study. Persistence of high HBV viraemia and 3TC-resistant mutation in HBV during the continuation of 3TC might lead to major public health threat in India. The inclusion of TDF in the ART regimen of 3TC non-responder HIV-HBV co-infected patients showed adverse treatment response in terms of virologic and biochemical parameters. Therefore, serious attention is necessary for proper management of long-term 3TC experienced HIV-HBV co-infected patients with high HBV viraemia or 3TC-resistant HBV mutants in India.

Keywords: HBV, HIV, TDF, 3TC-resistant

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Authors: Ernest Nweke, Enkhtuya Bavuudorj

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The harsh realities of the scandalous failure of several notable corporations in the past two decades have inextricably resulted in a surge in corporate governance studies. Nevertheless, little or no attention has been paid to corporate governance studies in Mongolian firms and much less to the comprehension of the correlation among ownership structure, corporate governance mechanisms and trend of innovative activities. Innovation is the bed rock of enterprise success. However, the funding and support for innovative activities in many firms are to a great extent determined by the incentives provided by the firm’s internal and external governance mechanisms. Mongolia is an East Asian country currently undergoing a fast-paced transition from socialist to democratic system and it is a widely held view that private ownership as against public ownership fosters innovation. Hence, following the privatization policy of Mongolian Government which has led to the transfer of the ownership of hitherto state controlled and state directed firms to private individuals and organizations, expectations are high that sufficient motivation would be provided for firm managers to engage in innovative activities. This research focuses on the relationship between ownership structure, corporate governance on one hand and the level of innovation on the hand. The paper is empirical in nature and derives data from both reliable secondary and primary sources. Secondary data for the study was in respect of ownership structure of Mongolian listed firms and innovation trend in Mongolia generally. These were analyzed using tables, charts, bars and percentages. Personal interviews and surveys were held to collect primary data. Primary data was in respect of corporate governance practices in Mongolian firms and were collected using structured questionnaire. Out of a population of three hundred and twenty (320) companies listed on the Mongolian Stock Exchange (MSE), a sample size of thirty (30) randomly selected companies was utilized for the study. Five (5) management level employees were surveyed in each selected firm giving a total of one hundred and fifty (150) respondents. Data collected were analyzed and research hypotheses tested using Chi-Square test statistic. Research results showed that corporate governance mechanisms were better and have significantly improved overtime in privately held as opposed to publicly owned firms. Consequently, the levels of innovation in privately held firms were considerably higher. It was concluded that a significant and positive relationship exists between private ownership and good corporate governance on one hand and the level of funding provided for innovative activities in Mongolian firms on the other hand.

Keywords: corporate governance, innovation, ownership structure, stock exchange

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Authors: Revaz Gvelesiani

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The problem of compliance between the state economic policy and entrepreneurial policy of businesses is primarily manifested in the contradictions related to the congruence between entrepreneurship development and self-development strategies. Among various types (financial, monetary, social, etc.) of the state economic policy aiming at the development of entrepreneurship, economic order policy is of special importance. Its goal is to set the framework for both public and private economic activities and achieve coherence between the societal value system and the formation of the economic order framework. Economic order policy, in its turn, involves intrinsic contradiction between the social and the competitive order. Competitive order is oriented on the principle of success, while social order _ on the criteria of need satisfaction, which contradicts, at least partly, to the principles of success. Thus within the economic order policy, on the one hand, the state makes efforts to form social order and expand its frontiers, while, on the other hand, market is determined to establish functioning competitive order and ensure its realization. Locating the adequate spaces for and setting the rational border between the state (social order) and the private (competitive order) activities, represents the phenomenon of the decisive importance from the entrepreneurship development strategy standpoint. In the countries where the above mentioned spaces and borders are “set” correctly, entrepreneurship agents (small, medium-sized and large businesses) achieve great success by means of seizing the respective segments and maintaining the leading positions in the internal, the European and the world markets for a long time. As for the entrepreneurship self-development strategy, above all, it involves: •market identification; •interactions with consumers; •continuous innovations; •competition strategy; •relationships with partners; •new management philosophy, etc. The analysis of compliance between the entrepreneurship strategy and entrepreneurship culture should be the reference point for any kind of internationalization in order to avoid shocks of cultural nature and the economic backwardness. Stabilization can be achieved only when the employee actions reflect the existing culture and the new contents of culture (targeted culture) is turned into the implicit consciousness of the personnel. The future leaders should learn how to manage different cultures. Entrepreneurship can be managed successfully if its strategy and culture are coherent. However, not rarely enterprises (organizations) show various forms of violation of both personal and team actions. If personal and team non-observances appear as the form of influence upon the culture, it will lead to global destruction of the system and structure. This is the entrepreneurship culture pathology that complicates to achieve compliance between the entrepreneurship strategy and entrepreneurship culture. Thus, the intrinsic contradictions of entrepreneurship development and self-development strategies complicate the task of reaching compliance between the state economic policy and the company entrepreneurship policy: on the one hand, there is a contradiction between the social and the competitive order within economic order policy and on the other hand, the contradiction exists between entrepreneurship strategy and entrepreneurship culture within entrepreneurship policy.

Keywords: economic order policy, entrepreneurship, development contradictions, self-development contradictions

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Authors: Thomas S. Abia II

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Intel Chandler Site has internally developed its first-of-kind (FOK) facility-scale wastewater treatment system to achieve multi-metal ion exchange. The process was carried out using a serial process train of carbon filtration, pH / ORP adjustment, and cationic exchange purification to treat dilute metal wastewater (DMW) discharged from a substrate packaging factory. Spanning a trial period of 10 months, a total of 3,271 samples were collected and statistically analyzed (average baseline + standard deviation) to evaluate the performance of a 95-gpm, multi-reactor continuous copper ion exchange treatment system that was consequently retrofitted for manganese ion exchange to meet environmental regulations. The system is also equipped with an inline acid and hot caustic regeneration system to rejuvenate exhausted IX resins and occasionally remove surface crud. Data generated from lab-scale studies was transferred to system operating modifications following multiple trial-and-error experiments. Despite the DMW treatment system failing to meet internal performance specifications for manganese output, it was observed to remove the cation notwithstanding the prevalence of copper in the waste stream. Accordingly, the average manganese output declined from 6.5 + 5.6 mg¹L⁻¹ at pre-pilot to 1.1 + 1.2 mg¹L⁻¹ post-pilot (83% baseline reduction). This milestone was achieved regardless of the average influent manganese to DMW increasing from 1.0 + 13.7 mg¹L⁻¹ at pre-pilot to 2.1 + 0.2 mg¹L⁻¹ post-pilot (110% baseline uptick). Likewise, the pre-trial and post-trial average influent copper values to DMW were 22.4 + 10.2 mg¹L⁻¹ and 32.1 + 39.1 mg¹L⁻¹, respectively (43% baseline increase). As a result, the pre-trial and post-trial average copper output values were 0.1 + 0.5 mg¹L⁻¹ and 0.4 + 1.2 mg¹L⁻¹, respectively (300% baseline uptick). Conclusively, the operating pH range upstream of treatment (between 3.5 and 5) was shown to be the largest single point of influence for optimizing manganese uptake during multi-metal ion exchange. However, the high variability of the influent copper-to-manganese ratio was observed to adversely impact the system functionality. The journal herein intends to discuss the operating parameters such as pH and oxidation-reduction potential (ORP) that were shown to influence the functional versatility of the ion exchange system significantly. The literature also proposes to discuss limitations of the treatment system such as influent copper-to-manganese ratio variations, operational configuration, waste by-product management, and system recovery requirements to provide a balanced assessment of the multi-metal ion exchange process. The take-away from this literature is intended to analyze the overall feasibility of ion exchange for metals manufacturing facilities that lack the capability to expand hardware due to real estate restrictions, aggressive schedules, or budgetary constraints.

Keywords: copper, industrial wastewater treatment, multi-metal ion exchange, manganese

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Authors: Shivayogi Charantimath

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Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1^st and 2^nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1^st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1^st and 2^nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1^st week and 53.6% for 2^nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1^st week and 33.3% in 2^nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1^st week follow up and 0.000 for 2^nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: curcumin, chemotheraphy, mucositis, radiotheraphy

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Authors: Kristina Amaleviciute, Ieva Jokubauskaite, Alvyra Slepetiene, Jonas Volungevicius, Inga Liaudanskiene

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The main task of this research was to investigate the chemical composition of the differently used soil in profiles. To identify the differences in the soil were investigated organic carbon (SOC) and its fractional composition: dissolved organic carbon (DOC), mobile humic acids (MHA) and C to N ratio of natural and anthropogenically affected Luvisols. Research object: natural and anthropogenically affected Luvisol, Akademija, Kedainiai, distr. Lithuania. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LAMMC. Soil samples for chemical analyses were taken from the genetics soil horizons. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) in 590 nm wavelength using glucose standards. For mobile humic acids (MHA) determination the extraction procedure was carried out using 0.1 M NaOH solution. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR. pH was measured in 1M H2O. N total was determined by Kjeldahl method. Results: Based on the obtained results, it can be stated that transformation of chemical composition is going through the genetic soil horizons. Morphology of the upper layers of soil profile which is formed under natural conditions was changed by anthropomorphic (agrogenic, urbogenic, technogenic and others) structure. Anthropogenic activities, mechanical and biochemical disturbances destroy the natural characteristics of soil formation and complicates the interpretation of soil development. Due to the intensive cultivation, the pH values of the curve equals (disappears acidification characteristic for E horizon) with natural Luvisol. Luvisols affected by agricultural activities was characterized by a decrease in the absolute amount of humic substances in separate horizons. But there was observed more sustainable, higher carbon sequestration and thicker storage of humic horizon compared with forest Luvisol. However, the average content of humic substances in the soil profile was lower. Soil organic carbon content in anthropogenic Luvisols was lower compared with the natural forest soil, but there was more evenly spread over in the wider thickness of accumulative horizon. These data suggest that the organization of geo-ecological declines and agroecological increases in Luvisols. Acknowledgement: This work was supported by the 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: agrogenization, dissolved organic carbon, luvisol, mobile humic acids, soil organic carbon

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Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

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Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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The global financial crisis that erupted in 2008 is associated mainly with the debt crisis. It quickly spread globally through financial markets, international banks and trade links, and affected many economic sectors. Measured by the index of the year-on-year change in GDP and industrial production, the consequences of the global financial crisis manifested themselves with some delay also in the Czech economy. This can be considered a result of the overwhelming export orientation of Czech industrial enterprises. These events offer an important opportunity to study how financial and macroeconomic instability affects corporate performance. Corporate performance factors have long been given considerable attention. It is therefore reasonable to ask whether the findings published in the past are also valid in the times of economic instability and subsequent recession. The decisive factor in effective corporate performance measurement is the existence of an appropriate system of indicators that are able to assess progress in achieving corporate goals. Performance measures may be based on non-financial as well as on financial information. In this paper, financial indicators are used in combination with other characteristics, such as the firm size and ownership structure. Financial performance is evaluated based on traditional performance indicators, namely, return on equity and return on assets, supplemented with indebtedness and current liquidity indices. As investments are a very important factor in corporate performance, their trends and importance were also investigated by looking at the ratio of investments to previous year’s sales and the rate of reinvested earnings. In addition to traditional financial performance indicators, the Economic Value Added was also used. Data used in the research were obtained from a questionnaire survey administered in industrial enterprises in the Czech Republic and from AMADEUS (Analyse Major Database from European Sources), from which accounting data of companies were obtained. Respondents were members of the companies’ senior management. Research results unequivocally confirmed that corporate performance dropped significantly in the 2010-2012 period, which can be considered a result of the global financial crisis and a subsequent economic recession. It was reflected mainly in the decreasing values of profitability indicators and the Economic Value Added. Although the total year-on-year indebtedness declined, intercompany indebtedness increased. This can be considered a result of impeded access of companies to bank loans due to the credit crunch. Comparison of the results obtained with the conclusions of previous research on a similar topic showed that the assumption that firms under foreign control achieved higher performance during the period investigated was not confirmed.

Keywords: corporate performance, foreign control, intercompany indebtedness, ratio of investment

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Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie

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Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.

Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin

Procedia PDF Downloads 275

Authors: Wageeh A. Nafei

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This paper explores the role of Paradoxical Leadership (PL) in enhancing Organizational Success (OS) at private hospitals in Egypt. Based on the collected data from employees in private hospitals (doctors, nursing staff, and administrative staff). The researcher has adopted a sampling method to collect data for the study. The appropriate statistical methods, such as Alpha Correlation Coefficient (ACC), Confirmatory Factor Analysis (CFA), and Multiple Regression Analysis (MRA), are used to analyze the data and test the hypotheses. The research has reached a number of results, the most important of which are (1) there is a statistical relationship between the independent variable represented by PL and the dependent variable represented by Organizational Success (OS). The paradoxical leader encourages employees to express their opinions and builds a work environment characterized by flexibility and independence. Also, the paradoxical leader works to support specialized work teams, which leads to the creation of new ideas, on the one hand, and contributes to the achievement of outstanding performance on the other hand. (2) the mentality of the paradoxical leader is flexible and capable of absorbing all suggestions from all employees. Also, the paradoxical leader is interested in enhancing cooperation among them and provides an opportunity to transfer experience and increase knowledge-sharing. Also, the sharing of knowledge creates the necessary diversity that helps the organization to obtain rich external information and enables the organization to deal with a rapidly changing environment. (3) The PL approach helps in facing the paradoxical demands of employees. A paradoxical leader plays an important role in reducing the feeling of instability in the work environment and lack of job security, reducing negative feelings for employees, restoring balance in the work environment, improving the well-being of employees, and increasing the degree of job satisfaction of employees in the organization. The study referred to a number of recommendations, the most important of which are (1) the leaders of the organizations must listen to the views of employees and their needs and move away from the official method of control. The leader should give sufficient freedom to employees to participate in decision-making and maintain enough space among them. The treatment between the leaders and employees must be based on friendliness, (2) the need for organizational leaders to pay attention to sharing knowledge among employees through training courses. The leader should make sure that every information provided by the employee is valuable and useful, which can be used to solve a problem that may face his/her colleagues at work, (3) the need for organizational leaders to pay attention to sharing knowledge among employees through brainstorming sessions. The leader should ensure that employees obtain knowledge from their colleagues and share ideas and information among them. This is in addition to motivating employees to complete their work in a new creative way, which leads to employees’ not feeling bored of repeating the same routine procedures in the organization.

Keywords: paradoxical leadership, organizational success, human resourece, management

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Authors: Mairo H. Ipadeola, Catherine James Atteng

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The term social inclusion refers to a process by which those disadvantaged in society can have access to fully participate in education like others. Student with special needs are expected to learn along with their peers within the some educational institutions which provide adequate access for all. There for, the study sort to understand the typical ways in which students with disabilities (SWD) were denied from fully participating as students in Kaduna Polytechnic. In doing this, two (2) objectives and research questions were raised. Firstly, to explore the attitudes of others towards students with disabilities in the institutions and secondly, to ascertain the extent of social participation and physical accessibility for students with disabilities (SWD) while in the institutions. Based on the objectives the paper postulated the research questions: what are the attitudes of management, teachers, and students towards students with special need in Kaduna Polytechnic and to what extent did the students with disabilities experience social participation and physical accessibility within Kaduna Polytechnic school environment? The study area was Kaduna Polytechnic. The study engaged the interview for the data collected which were transcribed and analyzed by thematic coding. The findings were categorized under themes, sub-themes, and codes. The findings revealed that the perception, behavior, and association experiences of students with disabilities within Kaduna Polytechnic were not encouraging. Their experiences were characterized by negative attitudes, feelings of rejection, neglect, and bullying. Data generated on social participation indicated that 71% of the respondents believed that learning, school activities, recreations, and student politics between SWD and the other student were in the direction of low / very low. All the respondents, particularly students with blindness and physical challenges faced difficulty with environmental and physical access above all within the school environment, classroom, walkways and ramps, Also, directions were none existent in most departments with physical access to classrooms, toilets, cafeterias, and school shops absent or very low (71% and 29% of the respondents). The conclusion was that the physical barriers limited the possibilities of social participation of SWD.The paper made some recommendations such as mass public enlightenment on radio and television to change the perception of society about people with disability. Also, the federal, state, and local governments enact building acts for fresh builders and adopted measures and time frames for existing public buildings to be made accessible for people with disabilities. All stakeholders should ensure that the five (5) percent budget set aside by State Universal Basic Education Board (SUBEB) and/or Tertiary Education Trust Fund (TETFUND) for the provision of specialized equipment and facilities for the student with special needs should be used prudently spent and monitored by the board.cm.

Keywords: social inclusion, students with disability, social participation, environmental/physical access

Procedia PDF Downloads 36

Authors: Ibrahim Rassoul, A. Serir, E-K. Si Ahmed, J. Legrand

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The acronym PEM refers to Proton Exchange Membrane or alternatively Polymer Electrolyte Membrane. Due to its high efficiency, low operating temperature (30–80 °C), and rapid evolution over the past decade, PEMFCs are increasingly emerging as a viable alternative clean power source for automobile and stationary applications. Before PEMFCs can be employed to power automobiles and homes, several key technical challenges must be properly addressed. One technical challenge is elucidating the mechanisms underlying water transport in and removal from PEMFCs. On one hand, sufficient water is needed in the polymer electrolyte membrane or PEM to maintain sufficiently high proton conductivity. On the other hand, too much liquid water present in the cathode can cause “flooding” (that is, pore space is filled with excessive liquid water) and hinder the transport of the oxygen reactant from the gas flow channel (GFC) to the three-phase reaction sites. The experimental transparent fuel cell used in this work was designed to represent actual full scale of fuel cell geometry. According to the operating conditions, a number of flow regimes may appear in the microchannel: droplet flow, blockage water liquid bridge /plug (concave and convex forms), slug/plug flow and film flow. Some of flow patterns are new, while others have been already observed in PEMFC microchannels. An algorithm in MATLAB was developed to automatically determine the flow structure (e.g. slug, droplet, plug, and film) of detected liquid water in the test microchannels and yield information pertaining to the distribution of water among the different flow structures. A video processing algorithm was developed to automatically detect dynamic and static liquid water present in the gas channels and generate relevant quantitative information. The potential benefit of this software allows the user to obtain a more precise and systematic way to obtain measurements from images of small objects. The void fractions are also determined based on images analysis. The aim of this work is to provide a comprehensive characterization of two-phase flow in an operating fuel cell which can be used towards the optimization of water management and informs design guidelines for gas delivery microchannels for fuel cells and its essential in the design and control of diverse applications. The approach will combine numerical modeling with experimental visualization and measurements.

Keywords: polymer electrolyte fuel cell, air-water two phase flow, gas diffusion layer, microchannels, advancing contact angle, receding contact angle, void fraction, surface tension, image processing

Procedia PDF Downloads 285

Authors: Olufunke Olufunmilayo Ilemobayo, Barakat. O Abdulazeez

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Profit making among poultry egg farmers has been a challenge to efficient distribution of scarce farm resources over the years, due majorly to low capital base, inefficient management, technical inefficiency, economic inefficiency, thus poultry egg production has moved into an underperformed situation, characterised by low profit margin. Though previous studies focus mainly on broiler production and efficiency of its production, however, paucity of information exist in the areas of profit efficiency in the study area. Hence, determinants of profit efficiency among poultry egg farmers in Ondo State, Nigeria were investigated. A purposive sampling technique was used to obtain primary data from poultry egg farmers in Owo and Akure local government area of Ondo State, through a well-structured questionnaire. socio-economic characteristics such as age, gender, educational level, marital status, household size, access to credit, extension contact, other variables were input and output data like flock size, cost of feeder and drinker, cost of feed, cost of labour, cost of drugs and medications, cost of energy, price of crate of table egg, price of spent layers were variables used in the study. Data were analysed using descriptive statistics, budgeting analysis, and stochastic profit function/inefficiency model. Result of the descriptive statistics shows that 52 per cent of the poultry farmers were between 31-40 years, 62 per cent were male, 90 per cent had tertiary education, 66 per cent were primarily poultry farmers, 78 per cent were original poultry farm owners and 55 per cent had more than 5 years’ work experience. Descriptive statistics on cost and returns indicated that 64 per cent of the return were from sales of egg, while the remaining 36 per cent was from sales of spent layers. The cost of feeding take the highest proportion of 69 per cent of cost of production and cost of medication the lowest (7 per cent). A positive gross margin of N5, 518,869.76, net farm income of ₦ 5, 500.446.82 and net return on investment of 0.28 indicated poultry egg production is profitable. Equipment’s cost (22.757), feeding cost (18.3437), labour cost (136.698), flock size (16.209), drug and medication cost (4.509) were factors that affecting profit efficiency, while education (-2.3143), household size (-18.4291), access to credit (-16.027), and experience (-7.277) were determinant of profit efficiency. Education, household size, access to credit and experience in poultry production were the main determinants of profit efficiency of poultry egg production in Ondo State. Other factors that affect profit efficiency were cost of feeding, cost of labour, flock size, cost of drug and medication, they positively and significantly influenced profit efficiency in Ondo State, Nigeria.

Keywords: cost and returns, economic inefficiency, profit margin, technical inefficiency

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Authors: Gunjan Srivastava, Shamila Kalia

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Dalbergia sissoo Roxb., (Family- Leguminosae; Subfamily- Papilionoideae), is an economically and ecologically important tree species having medicinal value. Of the rich complex of insect fauna, ten have been recognized as potential pests of nurseries and plantations. Present study was conducted to explore an effective ecofriendly control of Dichomeris eridantis Meyrick, an important defoliator pest of D. sissoo. Health and environmental concerns demanded devising a bio-intensive pest management strategy and employing ecofriendly measures. In the present laboratory bioassay two entomopathogenic fungi Acremonium perscinum and Beauveria bassiana were tested and compared for evaluating the efficacy of their seven different concentrations (besides control) against the 3rd, 4th and 5th instar larvae of D. eridantis, on the basis of mean percent mortality data recorded and tabulated for seven days after treatment application. Analysis showed that both treatments vary significantly among themselves. Also, variations amongst instars and duration with respect to their mortality were highly significant (p < .001). All their interactions were found to vary significantly. B. bassiana at 0.25x107 spores / ml spore concentration caused maximum mean percent mortality (62.38%) followed by mean percent mortality at its 0.25x106 spores / ml concentration (56.67%). Mean percent mortality at maximum spore concentration (0.054x107 spores / ml) and next highest spore concentration (0.054 x106 spores / ml) due to A. perscinum treatment were far less effective (mean percent mortality of 45.40% and 31.29%, respectively). At 168 hours mean percent mortality of larval instars due to both fungal treatment applications reached its maximum (52.99%) whereas, at 24 hours mean percent mortality remained least (5.70%). In both cases, treatments were most effective against 3rd instar larvae and least effective against 5th instar larvae. A comparative acccount of efficacy of B. bassiana and A. perscinum on the 3rd, 4th and 5th instar larvae of D. eridantis on 5th, 6th and 7th post treatment observation days after their application, on the basis of their median lethal concentrations (LC50) proved B. bassiana to be more potential microbial pathogen of the two fungal microbes, for all the three instars (3rd, 4th and 5th) of D. eridantis, on all the three days (5th, 6th and 7th post observation days after application of both treatments). Percent mortality of D. eridantis increased in a dose dependent manner. Koch’s Postulates tested positive, thus confirming the pathogenicity of B. bassiana against the larval instars of D. eridantis. LC90 values of 0.280x1011 spores/ml, 0.301x108 spores/ml and 0.262x108 spores/ml concentrations of B. bassiana were standardized which can effectively cause mortality of all the larval instars of D. eridantis in the field after 5th, 6th and 7th day of their application, respectively. Therefore, these concentrations can be safely used in nurseries as well as plantations of D. sissoo for effective control of D. eridantis larvae.

Keywords: Acremonium perscinum, Beauveria bassiana, Dalbergia sissoo, Dichomeris eridantis

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Authors: Y. A. Sani., A. A. Yakubu., A. A. Jamilu., J. Omeke, I. J. Sambo

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With the rising global threat of food security, cancer, and related diseases (carcinogenic) because of increased usage of inorganic substances in agricultural food production, the Ministry of Food Agriculture and Livestock of the Republic of Turkey organized an International Workshop on Organic Agriculture between 8–12th December 2014 at the International Agricultural Research and Training Center, Izmir. About 21 countries, including Nigeria, were invited to attend the training workshop. Several topics on organic agriculture were presented by renowned scholars, ranging from regulation, certification, crop, animal, seed production, pest and disease management, soil composting, and marketing of organic agricultural products, among others. This paper purposely selected two countries (Macedonia and Iran) out of the 21 countries to assess their level of development in terms of organic agriculture as compared to Nigeria. Macedonia, with a population of only 2.1 million people as of 2014, started organic agriculture in 2005 with only 266ha of land and has grown significantly to over 5,000ha in 2010, covering such crops as cereals (62%), forage (20%) fruit orchard (7%), vineyards (5%), vegetables (4%), oil seed and industrial crops (1%) each. Others are organic beekeeping from 110 hives to over 15,000 certified colonies. As part of government commitment, the level of government subsidy for organic products was 30% compared to the direct support for conventional agricultural products. About 19 by-laws were introduced on organic agricultural production that was fully consistent with European Union regulations. The republic of Iran, on the other hand, embarked on organic agriculture for the fact, that the country recorded the highest rate of cancer disease in the world, with over 30,000 people dying every year and 297 people diagnosed every day. However, the host country, Turkey, is well advanced in organic agricultural production and now being the largest exporter of organic products to Europe and other parts of the globe. A technical trip to one of the villages that are under the government scheme on organic agriculture reveals that organic agriculture was based on market-demand-driven and the support of the government was very visible, linking the farmers with private companies that provide inputs to them while the companies purchase the products at harvest with a high premium price. However, in Nigeria, research on organic agriculture was very recent, and there was very scanty information on organic agriculture due to poor documentation and very low awareness, even among the elites. The paper, therefore, recommends that the government should provide funds to NARIs to conduct research on organic agriculture and to establish clear government policy and good pre-conditions for sustainable organic agricultural production in the country.

Keywords: organic agriculture, food security, food safety, food nutrition

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Authors: R. Kenova, K. Anguelov, R. Nikolova

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The human factor plays a major role in boosting the competitive capacity of logistic enterprises. This is of particular importance when it comes to logistic companies. On the one hand they should be strictly compliant with legislation; on the other hand, they should be competitive in terms of pricing and of delivery timelines. Moreover, their policies should allow them to be as flexible as possible. All these circumstances are reason for very serious challenges for the qualification, motivation and experience of the human resources, working in logistic companies or in logistic departments of trade and industrial enterprises. The geographic place of Bulgaria puts it in position of a country with some specific competitive advantages in the goods transport from Europe to Asia and back. Along with it, there is a number of logistic companies, that operate in this sphere in Bulgaria. In the current paper, the authors aim to establish the condition of the administrative capacity and human resources in the logistic companies and logistic departments of trade and industrial companies in Bulgaria in order to propose some guidelines for improving of their effectiveness. Due to independent empirical research, conducted in Bulgarian logistic, trade and industrial enterprises, the authors investigate both the impact degree and the interdependence of various factors that characterize the administrative capacity. The study is conducted with a prepared questionnaire, in format of direct interview with the respondents. The volume of the poll is 50 respondents, representatives of: general managers of industrial or trade enterprises; logistic managers of industrial or trade enterprises; general managers of forwarding companies – either with own or with hired transport; experts from Bulgarian association of logistics; logistic lobbyist and scientists of the relevant area. The data are gathered for 3 months, then arranged by a specialized software program and analyzed by preset criteria. Based on the results of this methodological toolbox, it can be claimed that there is a correlation between the individual criteria. Also, a commitment between the administrative capacity and other factors that determine the competitiveness of the studied companies is established. In this paper, the authors present results of the empirical research that concerns the number and the workload in the logistic departments of the enterprises. Also, what is commented is the experience, related to logistic processes management and human resources competence. Moreover, the overload level of the logistic specialists is analyzed as one of the main threats for making mistakes and losing clients. The paper stands behind the thesis that there is indispensability of forming an effective and efficient administrative capacity, based on the number, qualification, experience and motivation of the staff in the logistic companies. The paper ends with recommendations about the qualification and experience of the specialists in logistic departments; providing effective and efficient administrative capacity in the logistic departments; interdependence of the human factor and the other factors that influence the enterprise competitiveness.

Keywords: administrative capacity, human resources, logistic competitiveness, staff qualification

Procedia PDF Downloads 126

Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

Procedia PDF Downloads 56

Authors: Anshu Gupta, Charu Gupta

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Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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Authors: Adam Gushgari

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The SARS-CoV-2 pandemic has catalyzed the rapid adoption of wastewater-based epidemiology (WBE) methodologies both domestically and internationally. To support the rapid scale-up of pandemic-response wastewater surveillance systems, multiple federal agencies (i.e. US CDC), non-government organizations (i.e. Water Environment Federation), and private charities (i.e. Bill and Melinda Gates Foundation) have funded over $220 million USD supporting development and expanding equitable access of surveillance methods. Funds were primarily distributed directly to municipalities under the CARES Act (90.6%), followed by academic projects (7.6%), and initiatives developed by private companies (1.8%). In addition to federal funding for wastewater monitoring primarily conducted at wastewater treatment plants, state/local governments and private companies have leveraged wastewater sampling to obtain health and lifestyle data on student, prison inmate, and employee populations. We explore the viable paths for expansion of the WBE m1ethodology across a variety of analytical methods; the development of WBE-specific samplers and real-time wastewater sensors; and their application to various governments and private sector industries. Considerable investment in, and public acceptance of WBE suggests the methodology will be applied to other future notifiable diseases and health risks. Early research suggests that WBE methods can be applied to a host of additional “biological insults” including communicable diseases and pathogens, such as influenza, Cryptosporidium, Giardia, mycotoxin exposure, hepatitis, dengue, West Nile, Zika, and yellow fever. Interest in chemical insults is also likely, providing community health and lifestyle data on narcotics consumption, use of pharmaceutical and personal care products (PPCP), PFAS and hazardous chemical exposure, and microplastic exposure. Successful application of WBE to monitor analytes correlated with carcinogen exposure, community stress prevalence, and dietary indicators has also been shown. Additionally, technology developments of in situ wastewater sensors, WBE-specific wastewater samplers, and integration of artificial intelligence will drastically change the landscape of WBE through the development of “smart sewer” networks. The rapid expansion of the WBE field is creating significant business opportunities for professionals across the scientific, engineering, and technology industries ultimately focused on community health improvement.

Keywords: wastewater surveillance, wastewater-based epidemiology, smart cities, public health, pandemic management, substance abuse

Procedia PDF Downloads 81

Authors: Ivo Zution Goncalves, Christopher M. U. Neale, Hiran Medeiros, Everardo Mantovani, Natalia Souza

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Multispectral and thermal infrared imagery from satellite sensors coupled with climate and soil datasets were used to estimate evapotranspiration and biomass in center pivots planted to maize in Brazil during the 2016 season. The hybrid remote sensing based model named Spatial EvapoTranspiration Modelling Interface (SETMI) was applied using multispectral and thermal infrared imagery from the Landsat Thematic Mapper instrument. Field data collected by the IRRIGER center pivot management company included daily weather information such as maximum and minimum temperature, precipitation, relative humidity for estimating reference evapotranspiration. In addition, soil water content data were obtained every 0.20 m in the soil profile down to 0.60 m depth throughout the season. Early season soil samples were used to obtain water-holding capacity, wilting point, saturated hydraulic conductivity, initial volumetric soil water content, layer thickness, and saturated volumetric water content. Crop canopy development parameters and irrigation application depths were also inputs of the model. The modeling approach is based on the reflectance-based crop coefficient approach contained within the SETMI hybrid ET model using relationships developed in Nebraska. The model was applied to several fields located in Minas Gerais State in Brazil with approximate latitude: -16.630434 and longitude: -47.192876. The model provides estimates of real crop evapotranspiration (ET), crop irrigation requirements and all soil water balance outputs, including biomass estimation using multi-temporal satellite image inputs. An interpolation scheme based on the growing degree-day concept was used to model the periods between satellite inputs, filling the gaps between image dates and obtaining daily data. Actual and accumulated ET, accumulated cold temperature and water stress and crop water requirements estimated by the model were compared with data measured at the experimental fields. Results indicate that the SETMI modeling approach using data assimilation, showed reliable daily ET and crop water requirements for maize, interpolated between remote sensing observations, confirming the applicability of the SETMI model using new relationships developed in Nebraska for estimating mainly ET and water requirements in Brazil under tropical conditions.

Keywords: basal crop coefficient, irrigation, remote sensing, SETMI

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Authors: Neyzielle Ronnicque Cadiz

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The Philippine is a hotbed of disasters and is a locus of natural hazards. With an average of 20 typhoons entering the Philippine Area of Responsibility (PAR) each year, seven to eight (7-8) of which makes landfall. The country rather inevitably suffers from climate-related calamities. With this vulnerability to natural hazards, the relevant hazard-related issues that come along with the potential threat and occurrence of a disaster oftentimes garners lesser media attention than when a disaster actually occurred. Post-disaster news and events flood the content of news networks primarily focusing on, but not limited to, the efforts of the national government in resolving post-disaster displacement, and all the more on the community leaders’ incompetence in disaster mitigation-- even though the University of the Philippines’ NOAH Center work hand in hand with different stakeholders for disaster mitigation communication efforts. Disaster risk communication is actually a perennial dilemma. There are so many efforts to reach the grassroots level but emergency and disaster preparedness messages inevitably fall short.. The Philippines is very vulnerable to hazards risk and disasters but social media posts and communication efforts mostly go unnoticed, if not argued upon. This study illustrates the outcomes of a research focusing on the print, broadcast, and social media’s role on disaster communication involving the natural catastrophic events that took place in the Philippines from 2009 to present. Considering the country’s state of development, this study looks on the rapid and reliable communication between the government, and the relief/rescue workers in the affected regions; and how the media portrays these efforts effectively. Learning from the disasters that have occurred in the Philippines over the past decade, effective communication can ensure that any efforts to prepare and respond to disasters can make a significant difference. It can potentially either break or save lives. Recognizing the role of communications is not only in improving the coordination of vital services for post disaster; organizations gave priority in reexamining disaster preparedness mechanisms through the Communication with Communities (CwC) programs. This study, however, looks at the CwC efforts of the Philippine media platforms. CwC, if properly utilized by the media, is an essential tool in ensuring accountability and transparency which require effective exchange of information between disasters and survivors and responders. However, in this study, it shows that the perennial dilemma of the Philippine media is that the Disaster Risk Reduction and Management (DRRM) efforts of the country lie in the clouded judgment of political aims. This kind of habit is a multiplier of the country’s risk and insecurity. Sometimes the efforts in urging the public to take action seem useless because the challenge lies on how to achieve social, economic, and political unity using the tri-media platform.

Keywords: Philippines at risk, pre/post disaster communication, tri-media platform, UP NOAH

Procedia PDF Downloads 151

Authors: Sofia Maria Poulimenou, Ioannis Deliyannis, Elisavet Filippidou, Stamatella Laboura

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Smart technologies are being actively used to improve the experience of travel and promote or demote a destination’s reputation via a wide variety of social media applications and platforms. This paper conceptualises the design and deployment of smart management apps to promote culture, sustainability and accessibility within two destinations in Greece that represent the extremes of visiting scale. One is the densely visited Corfu, which is a UNESCO’s heritage site. The problems caused by the lack of organisation of the visiting experience and infrastructures affect all parties interacting within the site: visitors, citizens, public and private sector. Second is Kilkis, a low tourism destination with high seasonality and mostly inbound tourism. Here the issue faced is that traditional approaches to inform and motivate locals and visitors to explore and taste of the culture have not flourished. The problem is apprehended via the design and development of two systems named “Hologrammatic Corfu” for Corfu old town and “BRENDA” for the area of Kilkis. Although each system is designed independently, featuring different solutions to the problems, both approaches have been designed by the same team and a novel gaming and gamification methodology. The “Hologramatic Corfu” application has been designed, for the exploration of the site covering user requirments before, during and after the trip, with the use of transmedia content such as photos, 360-degree videos, augmented reality and hologrammatic videos. Also, a statistical analysis of travellers’ visits to specific points of interest is actively utilized enabling visitors to dynamically re-rooted during their visit, safeguarding sustainability and accessibility and inclusivity along the entire tourism cycle. “BRENDA” is designed specifically to promote gastronomic and historical tourism. This serious game implements and combines gaming and gamification elements in order to connect local businesses with cultural points of interest. As the environment of the project has a strong touristic orientation, “BRENDA” supports food-related gamified processes and historical games involving active participation of both local communities (content providers) and visitors (players) which are more likely to be successfully performed in the informal environment of travelling and promote sustainable tourism experiences. Finally, the paper presents the ability to re-use existing gaming components within new areas of interest via minimal adaptation and the use of transmedia aspects that enables destinations to be rebranded into smart destinations.

Keywords: smart tourism, gamification, user experience, transmedia content

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Abdallah Touaibia, Nachida Kasbadji Merzouk, Mustapha Merzouk, Ryma Belarbi

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accuracy assessment and a better understand of the wind resource distribution are the most important tasks for decision making before installing wind energy operating systems in a given region, there where our interest come to the Algerian coastline and its Mediterranean sea area. Despite its large coastline overlooking the border of Mediterranean Sea, there is still no strategy encouraging the development of offshore wind farms in Algerian waters. The present work aims to estimate the offshore wind fields for the Algerian Mediterranean Sea based on wind data measurements ranging from 1995 to 2018 provided of 24 years of measurement by seven observation stations focusing on three coastline cities in Algeria under a different measurement time step recorded from 30 min, 60 min, and 180 min variate from one to each other, two stations in Spain, two other ones in Italy and three in the coast of Algeria from the east Annaba, at the center Algiers, and to Oran taken place at the west of it. The idea behind consists to have multiple measurement points that helping to characterize this area in terms of wind potential by the use of interpolation method of their average wind speed values between these available data to achieve the approximate values of others locations where aren’t any available measurement because of the difficulties against the implementation of masts within the deep depth water. This study is organized as follow: first, a brief description of the studied area and its climatic characteristics were done. After that, the statistical properties of the recorded data were checked by evaluating wind histograms, direction roses, and average speeds using MatLab programs. Finally, ArcGIS and MapInfo soft-wares were used to establish offshore wind maps for better understanding the wind resource distribution, as well as to identify windy sites for wind farm installation and power management. The study pointed out that Cap Carbonara is the windiest site with an average wind speed of 7.26 m/s at 10 m, inducing a power density of 902 W/m², then the site of Cap Caccia with 4.88 m/s inducing a power density of 282 W/m². The average wind speed of 4.83 m/s is occurred for the site of Oran, inducing a power density of 230 W/m². The results indicated also that the dominant wind direction where the frequencies are highest for the site of Cap Carbonara is the West with 34%, an average wind speed of 9.49 m/s, and a power density of 1722 W/m². Then comes the site of Cap Caccia, where the prevailing wind direction is the North-west, about 20% and 5.82 m/s occurring a power density of 452 W/m². The site of Oran comes in third place with the North dominant direction with 32% inducing an average wind speed of 4.59 m/s and power density of 189 W/m². It also shown that the proposed method is either crucial in understanding wind resource distribution for revealing windy sites over a large area and more effective for wind turbines micro-siting.

Keywords: wind ressources, mediterranean sea, offshore, arcGIS, mapInfo, wind maps, wind farms

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Authors: Noor Ashikin Omar

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The rapid growth and advancement in information and communication technology (ICT) at a global scene has greatly influenced and revolutionised interaction amongst society. The use of ICT has become second nature in managing everyday lives, particularly in the education environment. Traditional learning methods of using blackboards and chalks have been largely improved by the use of ICT devices such as interactive whiteboards and computers in school. This paper aims to explore the impacts of virtual learning environments (VLE) on teacher’s pedagogy and student’s learning in primary school settings. The research was conducted in two phases. Phase one of this study comprised a short interview with the school’s senior assistants to examine issues and challenges faced during planning and implementation of FrogVLE in their respective schools. Phase two involved a survey of a number of questionnaires directed to three major stakeholders; the teachers, students and parents. The survey intended to explore teacher’s and student’s perspective and attitude towards the use of VLE as a teaching and learning medium and as a learning experience as a whole. In addition, the survey from parents provided insights on how they feel towards the use of VLE for their child’s learning. Collectively, the two phases enable improved understanding and provided observations on factors that had affected the implementation of the VLE into primary schools. This study offers the voices of the students which were frequently omitted when addressing innovations as well as teachers who may not always be heard. It is also significant in addressing the importance of teacher’s pedagogy on students’ learning and its effects to enable more effective ICT integration with a student-centred approach. Finally, parental perceptions in the implementation of VLE in supporting their children’s learning have been implicated as having a bearing on educational achievement. The results indicate that the all three stakeholders were positive and highly supportive towards the use of VLE in schools. They were able to understand the benefits of moving towards the modern method of teaching using ICT and accept the change in the education system. However, factors such as condition of ICT facilities at schools and homes as well as inadequate professional development for the teachers in both ICT skills and management skills hindered exploitation of the VLE system in order to fully utilise its benefits. Social influences within different communities and cultures and costs of using the technology also has a significant impact. The findings of this study are important to the Malaysian Ministry of Education because it informs policy makers on the impact of the Virtual Learning Environment (VLE) on teacher’s pedagogy and learning of Malaysian primary school children. The information provided to policy makers allows them to make a sound judgement and enables an informed decision making.

Keywords: attitudes towards virtual learning environment (VLE), parental perception, student's learning, teacher's pedagogy

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Authors: Rosilyn Sanders

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This qualitative study examined the impact of hiring people with intellectual disabilities (ID). The research questions were: What defines a disability? What accommodations are needed to ensure the success of a person with a disability? As a leader, what benefits do people with intellectual disabilities bring to the organization? What are the benefits of hiring people with intellectual disabilities in retail organizations? Moreover, how might people with intellectual disabilities contribute to the organizational culture of retail organizations? A narrative strength approach was used as a theoretical framework to guide the discussion and uncover the benefits of hiring individuals with intellectual disabilities in various retail organizations. Using qualitative interviews, the following themes emerged: diversity and inclusion, accommodations, organizational culture, motivation, and customer service. These findings put to rest some negative stereotypes and perceptions of persons with ID as being unemployable or unable to perform tasks when employed, showing instead that persons with ID can work efficiently when given necessary work accommodations and support in an enabling organizational culture. All participants were recruited and selected through various forms of electronic communication via social media, email invitations, and phone; this was conducted through the methodology of snowball sampling with the following demographics: age, ethnicity, gender, number of years in retail, number of years in management, and number of direct reports. The sample population was employed in several retail organizations throughout Arkansas and Texas. The small sample size for qualitative research in this study helped the researcher develop, build, and maintain close relationships that encouraged participants to be forthcoming and honest with information (Clow & James, 2014 ). Participants were screened to ensure they met the researcher's study; and screened to ensure that they were over 18 years of age. Participants were asked if they recruit, interview, hire, and supervise individuals with intellectual disabilities. Individuals were given consent forms via email to indicate their interest in participating in this study. Due to COVID-19, all interviews were conducted via teleconferencing (Zoom or Microsoft Teams) that lasted approximately 1 hour, which were transcribed, coded for themes, and grouped based on similar responses. Further, the participants were not privy to the interview questions beforehand, and demographic questions were asked at the end, including questions concerning age, education level, and job status. Each participant was assigned random numbers using an app called ‘The Random Number Generator ‘to ensure that all personal or identifying information of participants were removed. Regarding data storage, all documentation was stored on a password-protected external drive, inclusive of consent forms, recordings, transcripts, and researcher notes.

Keywords: diversity, positive psychology, organizational development, leadership

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