Search results for: hospital industry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7446

Search results for: hospital industry

5316 Development of Generally Applicable Intravenous to Oral Antibiotic Switch Therapy Criteria

Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

Abstract:

Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

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5315 Nursing System Development in Patients Undergoing Operation in 3C Ward

Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

Abstract:

Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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5314 Eco-Nanofiltration Membranes: Nanofiltration Membrane Technology Utilization-Based Fiber Pineapple Leaves Waste as Solutions for Industrial Rubber Liquid Waste Processing and Fertilizer Crisis in Indonesia

Authors: Andi Setiawan, Annisa Ulfah Pristya

Abstract:

Indonesian rubber plant area reached 2.9 million hectares with productivity reached 1.38 million. High rubber productivity is directly proportional to the amount of waste produced rubber processing industry. Rubber industry would produce a negative impact on the rubber industry in the form of environmental pollution caused by waste that has not been treated optimally. Rubber industrial wastewater containing high-nitrogen compounds (nitrate and ammonia) and phosphate compounds which cause water pollution and odor problems due to the high ammonia content. On the other hand, demand for NPK fertilizers in Indonesia continues to increase from year to year and in need of ammonia and phosphate as raw material. Based on domestic demand, it takes a year to 400,000 tons of ammonia and Indonesia imports 200,000 tons of ammonia per year valued at IDR 4.2 trillion. As well, the lack of phosphoric acid to be imported from Jordan, Morocco, South Africa, the Philippines, and India as many as 225 thousand tons per year. During this time, the process of wastewater treatment is generally done with a rubber on the tank to contain the waste and then precipitated, filtered and the rest released into the environment. However, this method is inefficient and thus require high energy costs because through many stages before producing clean water that can be discharged into the river. On the other hand, Indonesia has the potential of pineapple fruit can be harvested throughout the year in all of Indonesia. In 2010, production reached 1,406,445 tons of pineapple in Indonesia or about 9.36 percent of the total fruit production in Indonesia. Increased productivity is directly proportional to the amount of pineapple waste pineapple leaves are kept continuous and usually just dumped in the ground or disposed of with other waste at the final disposal. Through Eco-Nanofiltration Membrane-Based Fiber Pineapple leaves Waste so that environmental problems can be solved efficiently. Nanofiltration is a process that uses pressure as a driving force that can be either convection or diffusion of each molecule. Nanofiltration membranes that can split water to nano size so as to separate the waste processed residual economic value that N and P were higher as a raw material for the manufacture of NPK fertilizer to overcome the crisis in Indonesia. The raw materials were used to manufacture Eco-Nanofiltration Membrane is cellulose from pineapple fiber which processed into cellulose acetate which is biodegradable and only requires a change of the membrane every 6 months. Expected output target is Green eco-technology so with nanofiltration membranes not only treat waste rubber industry in an effective, efficient and environmentally friendly but also lowers the cost of waste treatment compared to conventional methods.

Keywords: biodegradable, cellulose diacetate, fertilizers, pineapple, rubber

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5313 Congenital Malformations in Neonate Dogs in the Sao Paulo State University Veterinary Hospital, Botucatu, Sao Paulo, Brazil

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Congenital malformations are organ defects due to genetic or teratogenic causes, which can lead to high mortality in dog litters. This study assessed and described the congenital malformations in newborn dogs. The study included litters attend in the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil. One hundred seventy-eight litters and 803 newborns were evaluated. The occurrence of litters with malformations was 24.7%, and of newborns was 6.7%. Twenty-seven different malformations were registered: anasarca, anal atresia, cleft lip, cleft palate, duplicated right ribcage, equinovarus, exencephaly, gastroschisis, hydrocephaly, lissencephaly, macroglossia, microphthalmia, mitral valve dysplasia, omphalocele, eyelid agenesis, persistent urachus, polydactyly, pulmonary hypoplasia, pulmonary valve stenosis, rectovaginal fistula, agenesis of abdominal muscles, rib hypoplasia, scoliosis, segmental aplasia of the intestines, tricuspid valve dysplasia, unilateral kidney agenesis, and vaginal atresia. 68.7% of newborns died as a result of malformations. The pure breeds with the highest chances of manifesting malformations in contrast with mixed breeds were French Bulldog, Pug, English Bulldog, Rottweiler, German Spitz, Pinscher, Pitbull, Yorkshire Terrier, and Shih-Tzu. Significant values (P<0.05) occurred in races French Bulldogs and Pugs. The causes of congenital disabilities are possibly related to hereditary genetic factors considering that the highest incidence of malformations was observed among purebreds. There as one case of exposure to a teratogenic agent, but no other mothers were exposed to such agents during pregnancy. Two cases of consanguineal breeding between siblings were reported. The mortality rate was high. Genetic breeding programs for reproduction, avoiding consanguineous mating, care in choosing parents, and avoiding maternal exposure to teratogenic agents are of utmost importance in reducing dog malformations and consequent mortality.

Keywords: congenital defects, teratogenesis, canine neonatology, newborn puppy

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5312 A Critical Re-Evaluation of Knowledge Management Definitions and Terminologies

Authors: Raymond Olayinka

Abstract:

The last three decades have witnessed myriads of definitions of knowledge management proposed by researchers and industry practitioners. Despite the magnitude of research and available literature on knowledge management, there is yet to be a consensus on what constitutes a good definition. There exists an in-exhaustive list of definitions which can appear confusing, conflicting and overlapping. What is even more daunting is the lack of common terminology in describing knowledge management processes and the inconsistency in the sequence in which the processes take. Whilst newbies to knowledge management research would struggle to make sense of knowledge management definitions, industry practitioners would struggle with their applicability. Against this backdrop, this study aimed to re-evaluate knowledge management definitions and terminologies. The objectives were threefold: (1) to conduct a critical review of an existing body of work around knowledge management concepts and definitions (2) to analyse and synthesise findings (3) to present conclusions and recommendations. The methodology for this study centres around the review of the literature and secondary data sources. A total of 48 knowledge management processes were found and extracted from various definitions (e.g. ‘identify’, ‘capture’, ‘codify’, ‘store’…). A taxonomy of the processes was created based on the commonality of the entities. The 48 processes were classified under 8 headings which were further converged into 3 main headings namely ‘acquire’, ‘exploit’ and ‘evaluate’, of which all definitions therefore hinge. The study concludes that in the multitude of knowledge management definitions, there is a consistent pattern to which the processes are organised and should be utilised. The contribution of this study is in the synthesis of previous work by various authors and the presentation of a more holistic approach to knowledge management definitions and terminologies.

Keywords: knowledge management definitions, knowledge management terminologies, knowledge management processes, literature review

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5311 Effects of Using a Recurrent Adverse Drug Reaction Prevention Program on Safe Use of Medicine among Patients Receiving Services at the Accident and Emergency Department of Songkhla Hospital Thailand

Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

Abstract:

Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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5310 Transformation of the Business Model in an Occupational Health Care Company Embedded in an Emerging Personal Data Ecosystem: A Case Study in Finland

Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

Abstract:

Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: ecosystem, business model, personal data, preventive healthcare

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5309 Determinants of Aggregate Electricity Consumption in Ghana: A Multivariate Time Series Analysis

Authors: Renata Konadu

Abstract:

In Ghana, electricity has become the main form of energy which all sectors of the economy rely on for their businesses. Therefore, as the economy grows, the demand and consumption of electricity also grow alongside due to the heavy dependence on it. However, since the supply of electricity has not increased to match the demand, there has been frequent power outages and load shedding affecting business performances. To solve this problem and advance policies to secure electricity in Ghana, it is imperative that those factors that cause consumption to increase be analysed by considering the three classes of consumers; residential, industrial and non-residential. The main argument, however, is that, export of electricity to other neighbouring countries should be included in the electricity consumption model and considered as one of the significant factors which can decrease or increase consumption. The author made use of multivariate time series data from 1980-2010 and econometric models such as Ordinary Least Squares (OLS) and Vector Error Correction Model. Findings show that GDP growth, urban population growth, electricity exports and industry value added to GDP were cointegrated. The results also showed that there is unidirectional causality from electricity export and GDP growth and Industry value added to GDP to electricity consumption in the long run. However, in the short run, there was found to be a directional causality among all the variables and electricity consumption. The results have useful implication for energy policy makers especially with regards to electricity consumption, demand, and supply.

Keywords: electricity consumption, energy policy, GDP growth, vector error correction model

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5308 Knowledge Capital and Manufacturing Firms’ Innovation Management: Exploring the Impact of Transboundary Investment and Assimilative Capacity.

Authors: Suleman Bawa, Ayiku Emmanuel Lartey

Abstract:

Purpose - This paper aims to examine the association between knowledge capital and multinational firms’ innovation management. We again explored the impact of transboundary investment and assimilative capacity between knowledge capital and multinational firms’ innovation management. The vital position of knowledge capital and multinational firms’ innovation management in today’s increasingly volatile environment coupled with fierce competition has been extensively acknowledged by academics and industry investment capitals. Design/methodology/approach - The theoretical association model and an empirical correlation analysis were constructed based on relevant research using data collected from 19 multinational firms in Ghana as the subject, and path analysis was constructed using SPSS 22.0 and AMOS 24.0 to test the formulated hypotheses. Findings - Varied conclusions are drawn consequential from theoretical inferences and empirical tests. For multinational firms, knowledge capital relics positively significant to multinational firms’ innovation management. Multinational firms with advanced knowledge capital likely spawn greater corporations’ innovation management. Second, transboundary investment efficiently intermediates the association between knowledge physical capital, knowledge interactive capital, and corporations’ innovation management. At the same time, this impact is insignificant between knowledge of empirical capital and corporations’ innovation management. Lastly, the impact of transboundary investment and assimilative capacity on the association between knowledge capital and corporations’ innovation management is established. We summarized the implications for managers based on our outcomes. Research limitations/implications - Multinational firms must dynamically build knowledge capital to augment corporations’ innovation management. Conversely, knowledge capital motivates multinational firms to implement transboundary investment and cultivate assimilative capacity. Accordingly, multinational firms can efficiently exploit diverse information to augment their corporate innovation management. Practical implications – This paper presents a comprehensive justification of knowledge capital and manufacturing firms’ innovation management by exploring the impact of transboundary investment and assimilative capacity within the manufacturing industry, its sequential progress, and its associated challenges. Originality/value – This paper is amongst the first to find empirical results to back knowledge capital and manufacturing firms’ innovation management by exploring the impact of transboundary investment and assimilative capacity within the manufacturing industry. Additionally, aligning knowledge as a coordinative instrument is a significant input to our discernment in this area.

Keywords: knowledge capital, transboundary investment, innovation management, assimilative capacity

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5307 The Causes and Effects of Housing Project Abandonment in Malaysia

Authors: Abdul Aziz Abdullah, Anuar Alias, Khor Hooi Ting, Guan Ngah Mei

Abstract:

One of the major sectors which contribute significant growth to socio-economic development is the construction and development industry. This industry is most badly hurt during the 1997 and 2008 economic crisis thus causing many government and private projects to be deferred and abandoned. The purpose of this study is to examine the causes and effects of housing project abandonment in Malaysia. This objective is achieved through rigorous review of literatures and documents related to housing and abandoned housing project. The finding revealed there are several causes of housing project abandonment. The significant causes are: economic recession, inadequacy of finance, poor marketing and sales strategies, technical problems faced during construction, problems caused by compensations demanded by squatters for resettlement, insolvency of contractor, cost overrun and currency fluctuation amongst others. However the alarming effect of housing project is: house buyers of abandoned project have the monthly payment although the house is delivered to house buy. In other case house buyers have to entangle in many legal action with the financial institution. This finding provides the various ministries in the Government some insights on real causes and effects of abandoned project. Perhaps this finding can enhance the current solution the Ministry of Housing Local Government on addressing the prevailing issue of reviving existing abandoned project in the country.

Keywords: abandoned project, abandonment, housing project, ministry of housing and local government, causes and effect

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5306 Absorptive Capabilities in the Development of Biopharmaceutical Industry: The Case of Bioprocess Development and Research Unit, National Polytechnic Institute

Authors: Ana L. Sánchez Regla, Igor A. Rivera González, María del Pilar Monserrat Pérez Hernández

Abstract:

The ability of an organization to identify and get useful information from external sources, assimilate it, transform and apply to generate products or services with added value is called absorptive capacity. Absorptive capabilities contribute to have market opportunities to firms and get a leader position with respect to others competitors. The Bioprocess Development and Research Unit (UDIBI) is a Research and Development (R&D) laboratory that belongs to the National Polytechnic Institute (IPN), which is a higher education institute in Mexico. The UDIBI was created with the purpose of carrying out R and D activities for the Transferon®, a biopharmaceutical product developed and patented by IPN. The evolution of competence and scientific and technological platform made UDIBI expand its scope by providing technological services (preclínical studies and bio-compatibility evaluation) to the national pharmaceutical industry and biopharmaceutical industry. The relevance of this study is that those industries are classified as high scientific and technological intensity, and yet, after a review of the state of the art, there is only one study of absorption capabilities in biopharmaceutical industry with a similar scope to this research; in the case of Mexico, there is none. In addition to this, UDIBI belongs to a public university and its operation does not depend on the federal budget, but on the income generated by its external technological services. This fact represents a highly remarkable case in Mexico's public higher education context. This current doctoral research (2015-2019) is contextualized within a case study, its main objective is to identify and analyze the absorptive capabilities that characterise the UDIBI that allows it had become in a one of two third authorized laboratory by the sanitary authority in Mexico for developed bio-comparability studies to bio-pharmaceutical products. The development of this work in the field is divided into two phases. In a first phase, 15 interviews were conducted with the UDIBI personnel, covering management levels, heads of services, project leaders and laboratory personnel. These interviews were structured under a questionnaire, which was designed to integrate open questions and to a lesser extent, others, whose answers would be answered on a Likert-type rating scale. From the information obtained in this phase, a scientific article was made (in review and a proposal of presentation was submitted in different academic forums. A second stage will be made from the conduct of an ethnographic study within this organization under study that will last about 3 months. On the other hand, it is intended to carry out interviews with external actors around the UDIBI (suppliers, advisors, IPN officials, including contact with an academic specialized in absorption capacities to express their comments on this thesis. The inicial findings had shown two lines: i) exist institutional, technological and organizational management elements that encourage and/or limit the creation of absorption capacities in this scientific and technological laboratory and, ii) UDIBI has had created a set of multiple transfer technology of knowledge mechanisms which have had permitted to build a huge base of prior knowledge.

Keywords: absorptive capabilities, biopharmaceutical industry, high research and development intensity industries, knowledge management, transfer of knowledge

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5305 Assessing the Lifestyle Factors, Nutritional and Socioeconomic Status Associated with Peptic Ulcer Disease: A Cross-Sectional Study among Patients at the Tema General Hospital of Ghana

Authors: Marina Aferiba Tandoh, Elsie Odei

Abstract:

Peptic Ulcer Disease (PUD) is amongst the commonest gastrointestinal problems that require emergency treatment in order to preserve life. The prevalence of PUD is increasing within the Ghanaian population, deepening the need to identify factors that are associated with its occurrence. This cross-sectional study assessed the nutritional status, socioeconomic and lifestyle factors associated with PUD among patients attending the Out-Patient Department of the Tema General Hospital of Ghana. A food frequency questionnaire and a three-day, 24-hour recall were used to assess the dietary intakes of study participants. A standardized questionnaire was used to obtain information on the participants’ socio-demographic characteristics, lifestyle as well as medical history. The data was analyzed using SPSS version 22. The mean age of study participants was 32.8±15.41years. Females were significantly higher (61.4%) than males (38.6%) (p < 0.001). All participants had received some form of education, with tertiary education being the highest (52.6%). The majority of them managed their condition with medications only (86%), while 10.5% managed it with a combination of medications and diet. The rest were either by dietary counseling only (1.8%), or surgery only (1.8%). or herbal medicines (29.3%), which were made from home (7.2%) or bought from a medical store (10.8%). Most of the participants experienced a recurrence of the disease (42.1%). For those who had ever experienced recurrences of the disease, it happened when they ate acidic foods (1.8%), ate bigger portions (1.8%), starved themselves (1.8%), or were stressed (1.8%). Others also had triggers when they took certain medications (1.8%) or ate too much pepper (1.8%). About 49% of the participants were either overweight or obese with a recurrence of PUD (p>0.05). Obese patients had the highest rate of PUD recurrences (41%). Drinking alcohol was significantly associated with the recurrence of PUD (χ2= 5.243, p=0.026). Other lifestyles, such as weed smoking, fasting, and use of herbal medicine and NSAIDs did not have any significant association with the disease recurrence. There was no significant correlation between the various dietary patterns and anthropometric parameters except dietary pattern one (salty snacks, regular soft drinks, milk, sweetened yogurt, ice cream, and cooked vegetables), which had a positive correlation with weight (p=0.002) and BMI (p=0.038). PUD patients should target weight reduction actions and reduce alcohol intake as measures to control the recurrence of the disease. Nutrition Education among this population must be promoted to minimize the recurrence of PUD.

Keywords: Dietary patterns, lifestyle factors, nutritional status, peptic ulcer disease

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5304 The Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Patients with Local and Diffuse Coronary Artery Disease

Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

Abstract:

De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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5303 Factors Affecting Customer Loyalty in the Independent Surveyor Service Industry in Indonesia

Authors: Sufrin Hannan, Budi Suharjo, Rita Nurmalina, Kirbrandoko

Abstract:

The challenge for independent surveyor service companies now is growing with increasing uncertainty in business. Protection from the government for domestic independent surveyor industry from competitor attack, such as entering the global surveyors to Indonesia also no longer exists. Therefore, building customer loyalty becomes very important to create a long-term relationship between an independent surveyor with its customers. This study aims to develop a model that can be used to build customer loyalty by looking at various factors that determine customer loyalty, especially on independent surveyors for coal inspection in Indonesia. The development of this model uses the relationship marketing approach. Testing of the hypothesis is done by testing the variables that determine customer loyalty, either directly or indirectly, which amounted to 10 variables. The data were collected from 200 questionnaires filled by independent surveyor company decision makers from 51 exporting companies and coal trading companies in Indonesia and analyzed using Structural Equation Model (SEM). The results show that customer loyalty of independent surveyors is influenced by customer satisfaction, trust, switching-barrier, and relationship-bond. Research on customer satisfaction shows that customer satisfaction is influenced by the perceived quality and perceived value, while perceived quality is influenced by reliability, assurance, responsiveness, and empathy.

Keywords: relationship marketing, customer loyalty, customer satisfaction, switching barriers, relationship bonds

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5302 Multi-Stage Multi-Period Production Planning in Wire and Cable Industry

Authors: Mahnaz Hosseinzadeh, Shaghayegh Rezaee Amiri

Abstract:

This paper presents a methodology for serial production planning problem in wire and cable manufacturing process that addresses the problem of input-output imbalance in different consecutive stations, hoping to minimize the halt of machines in each stage. To this end, a linear Goal Programming (GP) model is developed, in which four main categories of constraints as per the number of runs per machine, machines’ sequences, acceptable inventories of machines at the end of each period, and the necessity of fulfillment of the customers’ orders are considered. The model is formulated based upon on the real data obtained from IKO TAK Company, an important supplier of wire and cable for oil and gas and automotive industries in Iran. By solving the model in GAMS software the optimal number of runs, end-of-period inventories, and the possible minimum idle time for each machine are calculated. The application of the numerical results in the target company has shown the efficiency of the proposed model and the solution in decreasing the lead time of the end product delivery to the customers by 20%. Accordingly, the developed model could be easily applied in wire and cable companies for the aim of optimal production planning to reduce the halt of machines in manufacturing stages.

Keywords: goal programming approach, GP, production planning, serial manufacturing process, wire and cable industry

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5301 Renewable Energy Industry Trends and Its Contributions to the Development of Energy Resilience in an Era of Accelerating Climate Change

Authors: A. T. Asutosh, J. Woo, M. Kouhirostami, M. Sam, A. Khantawang, C. Cuales, W. Ryor, C. Kibert

Abstract:

Climate change and global warming vortex have grown to alarming proportions. Therefore, the need for a shift in the conceptualization of energy production is paramount. Energy practices have been created in the current situation. Fossil fuels continue their prominence, at the expense of renewable sources. Despite this abundance, a large percentage of the world population still has no access to electricity but there have been encouraging signs in global movement from nonrenewable to renewable energy but means to reverse climate change have been elusive. Worldwide, organizations have put tremendous effort into innovation. Conferences and exhibitions act as a platform that allows a broad exchange of information regarding trends in the renewable energy field. The Solar Power International (SPI) conference and exhibition is a gathering of concerned activists, and probably the largest convention of its kind. This study investigates current development in the renewable energy field, analyzing means by which industry is being applied to the issue. In reviewing the 2019 SPI conference, it was found innovations in recycling and assessing the environmental impacts of the solar products that need critical attention. There is a huge movement in the electrical storage but there exists a large gap in the development of security systems. This research will focus on solar energy, but impacts will be relevant to the entire renewable energy market.

Keywords: climate change, renewable energy, solar, trends, research, solar power international, SPI

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5300 The Impact of Economic Growth on Carbon Footprints of High-Income and Non-High-Income Countries: A Comparative Analysis

Authors: Ghunchq Khan

Abstract:

The increase in greenhouse gas (GHGs) emissions is a main environmental problem. Diverse human activities and inappropriate economic growth have stimulated a trade-off between economic growth and environmental deterioration all over the world. The impact of economic growth on the environment has received attention as global warming and environmental problems have become more serious. The focus of this study is on carbon footprints (production and consumption) and analyses the impact of GDP per capita on carbon footprints. A balanced panel of 99 countries from 2000 to 2016 is estimated by employing autoregressive distributed lags (ARDL) model – mean group (MG) and pooled mean group (PMG) estimators. The empirical results indicate that GDP per capita has a significant and positive impact in the short run but a negative effect in the long run on the carbon footprint of production in high-income countries by controlling trade openness, industry share, biological capacity, and population density. At the same time, GDP per capita has a significant and positive impact in both the short and long run on the carbon footprint of the production of non-high-income countries. The results also indicate that GDP per capita negatively impacts the carbon footprint of consumption for high-income countries; on the other hand, the carbon footprint of consumption increases as GDP per capita grows in non-high-income countries.

Keywords: ARDL, carbon footprint, economic growth, industry share, trade openness

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5299 Tuberculosis : Still a Nightmare for Third World Countries

Authors: Muhammad Younas, Zimal Naveed

Abstract:

Introduction : TB is caused by the bacillus Mycobacterium tuberculosis, which is spread when people who are sick with TB expel bacteria into the air (e.g. by coughing). The 30 high TB burden countries accounted for 87% of all estimated incident cases worldwide, and eight of these countries accounted for more than two thirds of the global total: India (27%), Indonesia (10%), China (7.1%), the Philippines (7.0%), Pakistan (5.7%), Nigeria (4.5%), Bangladesh (3.6%) and the Democratic Republic of the Congo (3.0%). Objective : To analyze prevalence of tuberculosis among the people who presented at THQ hospital Bhalwal between April 2024 to June 2024. Method : Total of 9200 patients presented in the OPD of THQ hospital Bhalwal were included in the study. These presumed cases underwent diagnostic testing by sputum for AFB, Gene expert and chest x rays. The data was then classified based Pulmonary and Extra-pulmonary TB disease and further classified on the basis of bacteriology positive and clinically diagnosed TB. The registered TB cases were then classified in 8 age groups in years and according to the gender. All the registered TB cases were then tested for HIV to observe the relation between Tuberculosis and HIV. Results : The total of 9200 patients presented to OPD during the period of 3 months between April 2024 to June 2024. Total registered cases of Tuberculosis were 161 (comprising 153 new cases and 8 cases after treatment failure). Out of the new cases 83 were males and 70 female cases were identified. The majority of males that were identified lies between age 55-64 and 65 and above while the majority of females that were diagnosed lies in the age group of 5-14 and 15-24. All the registered cases were then tested for HIV but none of them were found to be positive. Conclusion : According to World Health Organisation Global Tuberculosis Report, the incidence of Tubeculosis per 100000 people was 258, equivalent to 0.258 %. However, the study reveals an exceptionally high frequency of TB cases. The prevalence of Tuberculosis per 100000 people was found to be 1750 which is equivalent to 1.75 %. The study revealed that larger proportion of the population is currently affected by TB compared to the global average incidence reported by the WHO. The findings of the study indicates that the prevalence of tuberculosis (TB) among females is most common in the younger population, specifically between the ages of 5 to 24, and particularly within the peak fertility age group of 15 to 24 years. The health of women in their peak fertility years is crucial for maternal and child health outcomes. This highlights the need for targeted public health interventions in this area to manage and reduce the burden of TB.

Keywords: AGE, AFB, female, male

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5298 Presenting a Model Of Empowering New Knowledge-based Companies In Iran Insurance Industry

Authors: Pedram Saadati, Zahra Nazari

Abstract:

In the last decade, the role and importance of knowledge-based technological businesses in the insurance industry has greatly increased, and due to the weakness of previous studies in Iran, the current research deals with the design of the InsurTech empowerment model. In order to obtain the conceptual model of the research, a hybrid framework has been used. The statistical population of the research in the qualitative part were experts, and in the quantitative part, the InsurTech activists. The tools of data collection in the qualitative part were in-depth and semi-structured interviews and structured self-interaction matrix, and in the quantitative part, a researcher-made questionnaire. In the qualitative part, 55 indicators, 20 components and 8 concepts (dimensions) were obtained by the content analysis method, then the relationships of the concepts with each other and the levels of the components were investigated. In the quantitative part, the information was analyzed using the descriptive analytical method in the way of path analysis and confirmatory factor analysis. The proposed model consists of eight dimensions of supporter capability, supervisor of insurance innovation ecosystem, managerial, financial, technological, marketing, opportunity identification, innovative InsurTech capabilities. The results of statistical tests in identifying the relationships of the concepts with each other have been examined in detail and suggestions have been presented in the conclusion section.

Keywords: insurTech, knowledge-base, empowerment model, factor analysis, insurance

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5297 Procedure Model for Data-Driven Decision Support Regarding the Integration of Renewable Energies into Industrial Energy Management

Authors: M. Graus, K. Westhoff, X. Xu

Abstract:

The climate change causes a change in all aspects of society. While the expansion of renewable energies proceeds, industry could not be convinced based on general studies about the potential of demand side management to reinforce smart grid considerations in their operational business. In this article, a procedure model for a case-specific data-driven decision support for industrial energy management based on a holistic data analytics approach is presented. The model is executed on the example of the strategic decision problem, to integrate the aspect of renewable energies into industrial energy management. This question is induced due to considerations of changing the electricity contract model from a standard rate to volatile energy prices corresponding to the energy spot market which is increasingly more affected by renewable energies. The procedure model corresponds to a data analytics process consisting on a data model, analysis, simulation and optimization step. This procedure will help to quantify the potentials of sustainable production concepts based on the data from a factory. The model is validated with data from a printer in analogy to a simple production machine. The overall goal is to establish smart grid principles for industry via the transformation from knowledge-driven to data-driven decisions within manufacturing companies.

Keywords: data analytics, green production, industrial energy management, optimization, renewable energies, simulation

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5296 Sustainable Development of Medium Strength Concrete Using Polypropylene as Aggregate Replacement

Authors: Reza Keihani, Ali Bahadori-Jahromi, Timothy James Clacy

Abstract:

Plastic as an environmental burden is a well-rehearsed topic in the research area. This is due to its global demand and destructive impacts on the environment, which has been a significant concern to the governments. Typically, the use of plastic in the construction industry is seen across low-density, non-structural applications due to its diverse range of benefits including high strength-to-weight ratios, manipulability and durability. It can be said that with the level of plastic consumption experienced in the construction industry, an ongoing responsibility is shown for this sector to continually innovate alternatives for application of recycled plastic waste such as using plastic made replacement from polyethylene, polystyrene, polyvinyl and polypropylene in the concrete mix design. In this study, the impact of partially replaced fine aggregate with polypropylene in the concrete mix design was investigated to evaluate the concrete’s compressive strength by conducting an experimental work which comprises of six concrete mix batches with polypropylene replacements ranging from 0.5 to 3.0%. The results demonstrated a typical decline in the compressive strength with the addition of plastic aggregate, despite this reduction generally mitigated as the level of plastic in the concrete mix increased. Furthermore, two of the six plastic-containing concrete mixes tested in the current study exceeded the ST5 standardised prescribed concrete mix compressive strength requirement at 28-days containing 1.50% and 2.50% plastic aggregates, which demonstrated the potential for use of recycled polypropylene in structural applications, as a partial by mass, fine aggregate replacement in the concrete mix.

Keywords: compressive strength, concrete, polypropylene, sustainability

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5295 Preparation and Characterization of Iron/Titanium-Pillared Clays

Authors: Rezala Houria, Valverde Jose Luis, Romero Amaya, Molinari Alessandra, Maldotti Andrea

Abstract:

The escalation of oil prices in 1973 confronted the oil industry with the problem of how to maximize the processing of crude oil, especially the heavy fractions, to give gasoline components. Strong impetus was thus given to the development of catalysts with relatively large pore sizes, which were able to deal with larger molecules than the existing molecular sieves, and with good thermal and hydrothermal stability. The oil embargo in 1973 therefore acted as a stimulus for the investigation and development of pillared clays. Iron doped titania-pillared montmorillonite clays was prepared using bentonite from deposits of Maghnia in western-Algeria. The preparation method consists of differents steps (purification of the raw bentonite, preparation of a pillaring agent solution and exchange of the cations located between the clay layers with the previously formed iron/titanium solution). The characterization of this material was carried out by X-ray fluorescence spectrometry, X-ray diffraction, textural measures by BET method, inductively coupled plasma atomic emission spectroscopy, diffuse reflectance UV visible spectroscopy, temperature- programmed desorption of ammonia and atomic absorption.This new material was investigated as photocatalyst for selective oxygenation of the liquid alkylaromatics such as: toluene, paraxylene and orthoxylene and the photocatalytic properties of it were compared with those of the titanium-pillared clays.

Keywords: iron doping, montmorillonite clays, pillared clays, oil industry

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5294 Risk Factors Associated to Low Back Pain among Active Adults: Cross-Sectional Study among Workers in Tunisian Public Hospital

Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

Abstract:

Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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5293 Enabling Integrated Production of Electric Vehicles in Automotive Final Assembly: Realization of an Expert Study

Authors: Achim Kampker, Heiner Hans Heimes, Mathias Ordung, Jan-Philip Ganser

Abstract:

In the past years, the automotive industry has changed significantly. Innovative mobility concepts have become more important, and electric vehicles see a chance of replacing vehicles with combustion engines in the long term. However, the coming years will be characterized by coexistence. In this context, there are two possible production scenarios: One the one hand, electric vehicles could be manufactured in bespoke assembly lines. Concerning the uncertainty regarding sales figures development, this alternative boasts a high investment risk. Therefore, an integrated assembly building upon existing structures also seems a feasible solution. This empirical study aims at validating hypotheses concerning theoretical and practical challenges of the integrated production in the final assembly. In order to take a test of approaches of the research by analyzing censored feedback of professionals, these hypotheses are validated in the framework of an expert study. For this purpose, hypotheses have been generated on the basis of a requirements analysis and a concept specification. Thereupon, a list of question has been implemented and deduced from the hypotheses to execute an online- and written-survey and interviews with professionals. The interpretation and evaluation of the findings includes an inter-component comparison for the electric drivetrain. Furthermore, key drivers for a sufficient integrated product and process design are presented.

Keywords: automotive industry, final assembly, integrated manufacturing, product and process development

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5292 Selective Laser Melting (SLM) Process and Its Influence on the Machinability of TA6V Alloy

Authors: Rafał Kamiński, Joel Rech, Philippe Bertrand, Christophe Desrayaud

Abstract:

Titanium alloys are among the most important material in the aircraft industry, due to its low density, high strength, and corrosion resistance. However, these alloys are considered as difficult to machine because they have poor thermal properties and high reactivity with cutting tools. The Selective Laser Melting (SLM) process becomes even more popular through industry since it enables the design of new complex components, that cannot be manufactured by standard processes. However, the high temperature reached during the melting phase as well as the several rapid heating and cooling phases, due to the movement of the laser, induce complex microstructures. These microstructures differ from conventional equiaxed ones obtained by casting+forging. Parts obtained by SLM have to be machined in order calibrate the dimensions and the surface roughness of functional surfaces. The ball milling technique is widely applied to finish complex shapes. However, the machinability of titanium is strongly influenced by the microstructure. So the objective of this work is to investigate the influence of the SLM process, i.e. microstructure, on the machinability of titanium, compared to conventional forming processes. The machinability is analyzed by measuring surface roughness, cutting forces, cutting tool wear for a range of cutting conditions (depth of cut ap, feed per tooth fz, spindle speed N) in accordance with industrial practices.

Keywords: ball milling, microstructure, surface roughness, titanium

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5291 High Efficiency Solar Thermal Collectors Utilization in Process Heat: A Case Study of Textile Finishing Industry

Authors: Gökçen A. Çiftçioğlu, M. A. Neşet Kadırgan, Figen Kadırgan

Abstract:

Solar energy, since it is available every day, is seen as one of the most valuable renewable energy resources. Thus, the energy of sun should be efficiently used in various applications. The most known applications that use solar energy are heating water and spaces. High efficiency solar collectors need appropriate selective surfaces to absorb the heat. Selective surfaces (Selektif-Sera) used in this study are applied to flat collectors, which are produced by a roll to roll cost effective coating of nano nickel layers, developed in Selektif Teknoloji Co. Inc. Efficiency of flat collectors using Selektif-Sera absorbers are calculated in collaboration with Institute for Solar Technik Rapperswil, Switzerland. The main cause of high energy consumption in industry is mostly caused from low temperature level processes. There is considerable effort in research to minimize the energy use by renewable energy sources such as solar energy. A feasibility study will be presented to obtain the potential of solar thermal energy utilization in the textile industry using these solar collectors. For the feasibility calculations presented in this study, textile dyeing and finishing factory located at Kahramanmaras is selected since the geographic location was an important factor. Kahramanmaras is located in the south east part of Turkey thus has a great potential to have solar illumination much longer. It was observed that, the collector area is limited by the available area in the factory, thus a hybrid heating generating system (lignite/solar thermal) was preferred in the calculations of this study to be more realistic. During the feasibility work, the calculations took into account the preheating process, where well waters heated from 15 °C to 30-40 °C by using the hot waters in heat exchangers. Then the preheated water was heated again by high efficiency solar collectors. Economic comparison between the lignite use and solar thermal collector use was provided to determine the optimal system that can be used efficiently. The optimum design of solar thermal systems was studied depending on the optimum collector area. It was found that the solar thermal system is more economic and efficient than the merely lignite use. Return on investment time is calculated as 5.15 years.

Keywords: energy, renewable energy, selective surface, solar collector

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5290 A Case Study on Management of Coal Seam Gas by-Product Water

Authors: Mojibul Sajjad, Mohammad G. Rasul, Md. Sharif Imam Ibne Amir

Abstract:

The rate of natural gas dissociation from the Coal Matrix depends on depressurization of reservoir through removing of the cleat water from the coal seam. These waters are similar to brine and aged of long years. For improving the connectivity through fracking /fracturing, high pressure liquids are pumped off inside the coal body. A significant quantity of accumulated water, a combined mixture of cleat water and fracking fluids (back flow water) is pumped out through gas well. In Queensland Coal Seam Gas industry is in booming state and estimated of 30,000 wells would be active for CSG production forecasting life span of 30 years. Integrated water management along with water softening programs is practiced for subsequent treatment and later on discharge to nearby surface water catchment. Water treatment is an important part of the CSG industry. A case study on a CSG site and review on the test results are discussed for assessing the Standards & Practices for management of CSG by-product water and their subsequent disposal activities. This study was directed toward (i) water management and softening process in Spring Gully Mine field, (ii) Comparative analysis on experimental study and standards and (iii) Disposal of the treated water. This study also aimed for alternative usages and their impact on vegetation, living species as well as long term effects.

Keywords: coal seam gas (CSG), cleat water, hydro-fracking, product water

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5289 Coexisting Pathology of Unruptured Ectopic Pregnancy With Concurrent Ipsilateral Dermoid Cyst: A Rare Occurrence

Authors: Anne Nicole Fuentes

Abstract:

A 29 year old Gravida 1 Para 0 who presented at the hospital with a 5-week history of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound revealed 3 pathologic findings : Tuboovarian complex on the right adnexa, a complex mass indicative of an unruptured ectopic pregnancy and right ovarian new growth probably endometrioma. Pelvic laparotomy was done and histopathologic finding revealed tubal pregnancy, right and mature cystic teratoma of the right ovary. This case report demonstrates the importance of considering the coexistence of different gynecologic pathologies in the same patient and clinical importance of an accurate diagnostic evaluation.

Keywords: mature cystic teratoma, ectopic pregnancy, Tuboovarian abscess, bHCG

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5288 Investigations into Transition from Traditional Construction to Industrial Construction in Afghanistan

Authors: A. Latif Karimi

Abstract:

Since 2001, construction works, especially the construction of new homes and residential buildings, witnessed a dramatic boom across Afghanistan. More so, the construction industry and house builders are relied upon as important players in the country’s job market, economy and infrastructural development schemes. However, a lack of innovation, quality assurance mechanism, substandard construction and market dominance by traditional methods push all the parties in house building sector to shift for more advanced construction techniques and mass production technologies to meet the rising demands for proper accommodation. Meanwhile, rapid population growth and urbanization are widening the gap between the demand and supply of new and modern houses in urban areas like Kabul, Herat, etc. This paper investigates about current condition of construction practices in house building projects, the associated challenges, and the outcomes of transition to more reasonable and sustainable building methods. It is obvious, the introduction and use of Modern Methods of Construction (MMC) can help construction industry and house builders in Afghanistan to tackle the challenges and meet the desired standards for modern houses. This paper focuses on prefabrication, a popular MMC that is becoming more common, improving in quality and available in a variety of budgets. It is revealed that this method is the way forward to improving house building practices as it has been proven to reduce construction time, minimize waste and improve environmental performance of construction developments.

Keywords: modern houses, traditional construction, modern methods of construction, prefabrication, sustainable building

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5287 The Role of the Renal Specialist Podiatrist

Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

Abstract:

Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

Procedia PDF Downloads 78