Search results for: cross-border insolvency provisions in the 2016 code
Commenced in January 2007
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Edition: International
Paper Count: 3098

Search results for: cross-border insolvency provisions in the 2016 code

938 Using Large Databases and Interviews to Explore the Temporal Phases of Technology-Based Entrepreneurial Ecosystems

Authors: Elsie L. Echeverri-Carroll

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Entrepreneurial ecosystems have become an important concept to explain the birth and sustainability of technology-based entrepreneurship within regions. However, as a theoretical concept, the temporal evolution of entrepreneurship systems remain underdeveloped, making it difficult to understand their dynamic contributions to entrepreneurs. This paper argues that successful technology-based ecosystems go over three cumulative spawning stages: corporate spawning, entrepreneurial spawning, and community spawning. The importance of corporate incubation in vibrant entrepreneurial ecosystems is well documented in the entrepreneurial literature. Similarly, entrepreneurial spawning processes for venture capital-backed startups are well documented in the financial literature. In contrast, there is little understanding of both the third stage of entrepreneurial spawning (when a community of entrepreneurs become a source of firm spawning) and the temporal sequence in which spawning effects occur in a region. We test this three-stage model of entrepreneurial spawning using data from two large databases on firm births—the Secretary of State (160,000 observations) and the National Establishment Time Series (NEST with 150,000 observations)—and information collected from 60 1½-hour interviews with startup founders and representatives of key entrepreneurial organizations. This temporal model is illustrated with case study of Austin, Texas ranked by the Kauffman Foundation as the number one entrepreneurial city in the United States in 2015 and 2016. The 1½-year study founded by the Kauffman Foundation demonstrates the importance of taken into consideration the temporal contributions of both large and entrepreneurial firms in understanding the factors that contribute to the birth and growth of technology-based entrepreneurial regions. More important, these learnings could offer an important road map for regions that pursue to advance their entrepreneurial ecosystems.

Keywords: entrepreneurial ecosystems, entrepreneurial industrial clusters, high-technology, temporal changes

Procedia PDF Downloads 254
937 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity

Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji

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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.

Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy

Procedia PDF Downloads 58
936 Influence of Geologic and Geotechnical Dataset Resolution on Regional Liquefaction Assessment of the Lower Wairau Plains

Authors: Omer Altaf, Liam Wotherspoon, Rolando Orense

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The Wairau Plains are located in the northeast of the South Island of New Zealand, with alluvial deposits of fine-grained silts and sands combined with low-lying topography suggesting the presence of liquefiable deposits over significant portions of the region. Liquefaction manifestations were observed in past earthquakes, including the 1848 Marlborough and 1855 Wairarapa earthquakes, and more recently during the 2013 Lake Grassmere and 2016 Kaikōura earthquakes. Therefore, a good understanding of the deposits that may be susceptible to liquefaction is important for land use planning in the region and to allow developers and asset owners to appropriately address their risk. For this purpose, multiple approaches have been employed to develop regional-scale maps showing the liquefaction vulnerability categories for the region. After applying semi-qualitative criteria linked to geologic age and deposit type, the higher resolution surface mapping of geomorphologic characteristics encompassing the Wairau River and the Opaoa River was used for screening. A detailed basin geologic model developed for groundwater modelling was analysed to provide a higher level of resolution than the surface-geology based classification. This is used to identify the thickness of near-surface gravel deposits, providing an improved understanding of the presence or lack of potentially non-liquefiable crust deposits. This paper describes the methodology adopted for this project and focuses on the influence of geomorphic characteristics and analysis of the detailed geologic basin model on the liquefaction classification of the Lower Wairau Plains.

Keywords: liquefaction, earthquake, cone penetration test, mapping, liquefaction-induced damage

Procedia PDF Downloads 163
935 Machine Learning Techniques in Bank Credit Analysis

Authors: Fernanda M. Assef, Maria Teresinha A. Steiner

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The aim of this paper is to compare and discuss better classifier algorithm options for credit risk assessment by applying different Machine Learning techniques. Using records from a Brazilian financial institution, this study uses a database of 5,432 companies that are clients of the bank, where 2,600 clients are classified as non-defaulters, 1,551 are classified as defaulters and 1,281 are temporarily defaulters, meaning that the clients are overdue on their payments for up 180 days. For each case, a total of 15 attributes was considered for a one-against-all assessment using four different techniques: Artificial Neural Networks Multilayer Perceptron (ANN-MLP), Artificial Neural Networks Radial Basis Functions (ANN-RBF), Logistic Regression (LR) and finally Support Vector Machines (SVM). For each method, different parameters were analyzed in order to obtain different results when the best of each technique was compared. Initially the data were coded in thermometer code (numerical attributes) or dummy coding (for nominal attributes). The methods were then evaluated for each parameter and the best result of each technique was compared in terms of accuracy, false positives, false negatives, true positives and true negatives. This comparison showed that the best method, in terms of accuracy, was ANN-RBF (79.20% for non-defaulter classification, 97.74% for defaulters and 75.37% for the temporarily defaulter classification). However, the best accuracy does not always represent the best technique. For instance, on the classification of temporarily defaulters, this technique, in terms of false positives, was surpassed by SVM, which had the lowest rate (0.07%) of false positive classifications. All these intrinsic details are discussed considering the results found, and an overview of what was presented is shown in the conclusion of this study.

Keywords: artificial neural networks (ANNs), classifier algorithms, credit risk assessment, logistic regression, machine Learning, support vector machines

Procedia PDF Downloads 89
934 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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933 Standards of Toxicity and Food Security in Brazil

Authors: Ana Luiza Da Gama E Souza

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This article aims to discuss the problem of food insecurity in Brazil in what it refers to contamination of food by chemical substances such as herbicides, pesticides, and other contaminants. The issue will be faced by analyzing, on the one hand, the standards that guide the food system in the world and, on the other hand, human rights indicators whose purpose is to provide an effective monitoring of the State's obligations to guarantee food security, analyzing the implications of the former for the success of the latter. The methodology adopted in this article was bibliographic-documentary and consists of three moments of analysis. The first moment consists in the analysis of the reports of the Commission on Human Rights of the Organization of American States to identify the set of progress indicators developed by the Commission. This analysis will involve the new methodology used to evaluate the efficiency in monitoring food security in Brazil the case of using pesticides in the production of food at levels of toxicity not admitted by the inspection bodies. The second moment consists in evaluating the mechanism for monitoring food security in Brazil, which was initially established by the National Food Security Plan (PLANSAN) for 2012-2015 and improved by the II National Food Security Plan for 2016-2019. Those mechanisms were prepared by the Chamber (CAISAN), and have the function to compare the monitoring proposals with the results presented by CAISAN on the Indicators and Results Report of the National Plan for Food and Nutrition Security 2012-2015. The third moment was intended to understand, analyze and evaluate the standardization process of the agri-food system, especially regarding the level of toxicity standards, that is related to food safety monitoring as a guarantee of pesticide-free food. The results show the dependence between private standards of toxicity and the indicators of food safety that leads to inefficiency on monitoring that mechanism in Brazil.

Keywords: standards, indicators, human rights, food security

Procedia PDF Downloads 318
932 Estimation of Greenhouse Gas (GHG) Reductions from Solar Cell Technology Using Bottom-up Approach and Scenario Analysis in South Korea

Authors: Jaehyung Jung, Kiman Kim, Heesang Eum

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Solar cell is one of the main technologies to reduce greenhouse gas (GHG). Thereby, accurate estimation of greenhouse gas reduction by solar cell technology is crucial to consider strategic applications of the solar cell. The bottom-up approach using operating data such as operation time and efficiency is one of the methodologies to improve the accuracy of the estimation. In this study, alternative GHG reductions from solar cell technology were estimated by a bottom-up approach to indirect emission source (scope 2) in Korea, 2015. In addition, the scenario-based analysis was conducted to assess the effect of technological change with respect to efficiency improvement and rate of operation. In order to estimate GHG reductions from solar cell activities in operating condition levels, methodologies were derived from 2006 IPCC guidelines for national greenhouse gas inventories and guidelines for local government greenhouse inventories published in Korea, 2016. Indirect emission factors for electricity were obtained from Korea Power Exchange (KPX) in 2011. As a result, the annual alternative GHG reductions were estimated as 21,504 tonCO2eq, and the annual average value was 1,536 tonCO2eq per each solar cell technology. Those results of estimation showed to be 91% levels versus design of capacity. Estimation of individual greenhouse gases (GHGs) showed that the largest gas was carbon dioxide (CO2), of which up to 99% of the total individual greenhouse gases. The annual average GHG reductions from solar cell per year and unit installed capacity (MW) were estimated as 556 tonCO2eq/yr•MW. Scenario analysis of efficiency improvement by 5%, 10%, 15% increased as much as approximately 30, 61, 91%, respectively, and rate of operation as 100% increased 4% of the annual GHG reductions.

Keywords: bottom-up approach, greenhouse gas (GHG), reduction, scenario, solar cell

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931 The Opportunities and Challenges of Adopting International Financial Reporting Standards in Saudi Capital Market

Authors: Abdullah Almulhim

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The International Accounting Standards Board (IASB) was established in 2001 to develop International Financial Reporting Standards (IFRS) that bring transparency, accountability, and efficiency to financial markets around the world. In addition, the IFRS provide a unified accounting language, which is especially important in the era of globalization. However, the establishment of a single set of high-quality international accounting standards is a matter of growing importance, as participants in the increasingly integrated world capital market demand comparability and transparency of financial reporting worldwide. Saudi Arabia became the 149th member of the World Trade Organization (WTO) on 11 December 2005, which has increased the need to convert to IFRS. Currently, the Saudi Arabian Monetary Authority (SAMA) requires banks and insurance companies in Saudi Arabia to report under IFRS Standards. However, until the end of 2016, SOCPA standards were applied to all other companies, listed and unlisted. From 2017, listed Saudi companies would be required to report under IFRS Standards as adopted by SOCPA effective 2017. This paper is to investigate the expected benefits gained and highlight the challenges faced by adopting IFRS by the listed companies in the Saudi Stock Exchange. Questionnaires were used as the main method of data collection. They were distributed to listed companies in the Saudi Capital Market. Data obtained through the questionnaires have been imported into SPSS statistical software for analysis. The expected results of this study will show the benefits of adopting IFRS by Saudi Listed Companies. However, this study will investigate the challenges faced by adopting IFRS by the listed companies in the Saudi Arabian Stock Market. Findings will be discussed later upon completion of initial analysis.

Keywords: challenges, IAS, IFRS, opportunities, Saudi, SOCPA

Procedia PDF Downloads 233
930 The Untold Story of the Importance of ‘Insignia Imprinted’ for the Heritage Clay Roof Tiles in Malaysia

Authors: M. S. Sulaiman, N. Hassan, M. A. Aziz, M. S. A. Haron, J. H. A. Halim

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The classic profile of heritage clay roof tiles gives unique characteristics and timeless style to the almost historical building. It is not only designed to meet basic construction needs, offering great performance and durability but also highlights unnoticed stamp impressions, known as ‘insignia imprinted.’ It seems that the insignia imprinted is not significant to all stakeholders, especially in preserving heritage clay roof tiles in Malaysia. They are not even realized the existence and importance of that element, where it represents the cognitive and social character of that particular era. It creates a sense of belongings for the manufacturers regarding their most elementary features, such as a fortress, crown, fauna and etc. This research aims to identify and analyze the late stamp marks on heritage interlocking clay roof tiles in a government heritage building in Malaysia. The methodology used is literature reviews (desktop study), observation on sites, and interviews. Initial findings from the preliminary observation on-site in Peninsular Malaysia show some evidence that the stamp marks appear on the front and back sides of the tile that indicates the year, manufacturer, code numbers, and logos. Almost more than 30 samples of different types of stamp marks were found and collected. Some of which had been described Guichard & Carvin Cie Marsielle St Andre France, Pierre Sacoman St Henry Marsielle, Tuileries Aixoises Les Milles B.D.R France, The Calicut Tile Co Feroke, And B. Pinto & Co Mangalore dated 1865, 1919 and 1936. In view of this abundance of materials, it will lead to the establishment of a comprehensive database consisting of detailed specifications and material performance for future conservation works and maintenance purposes that will sustain for future references.

Keywords: clay roof tiles, insignia imprinted, interlocking, stamp mark

Procedia PDF Downloads 64
929 Expert System: Debugging Using MD5 Process Firewall

Authors: C. U. Om Kumar, S. Kishore, A. Geetha

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An Operating system (OS) is software that manages computer hardware and software resources by providing services to computer programs. One of the important user expectations of the operating system is to provide the practice of defending information from unauthorized access, disclosure, modification, inspection, recording or destruction. Operating system is always vulnerable to the attacks of malwares such as computer virus, worm, Trojan horse, backdoors, ransomware, spyware, adware, scareware and more. And so the anti-virus software were created for ensuring security against the prominent computer viruses by applying a dictionary based approach. The anti-virus programs are not always guaranteed to provide security against the new viruses proliferating every day. To clarify this issue and to secure the computer system, our proposed expert system concentrates on authorizing the processes as wanted and unwanted by the administrator for execution. The Expert system maintains a database which consists of hash code of the processes which are to be allowed. These hash codes are generated using MD5 message-digest algorithm which is a widely used cryptographic hash function. The administrator approves the wanted processes that are to be executed in the client in a Local Area Network by implementing Client-Server architecture and only the processes that match with the processes in the database table will be executed by which many malicious processes are restricted from infecting the operating system. The add-on advantage of this proposed Expert system is that it limits CPU usage and minimizes resource utilization. Thus data and information security is ensured by our system along with increased performance of the operating system.

Keywords: virus, worm, Trojan horse, back doors, Ransomware, Spyware, Adware, Scareware, sticky software, process table, MD5, CPU usage and resource utilization

Procedia PDF Downloads 406
928 A Review of Blog Assisted Language Learning Research: Based on Bibliometric Analysis

Authors: Bo Ning Lyu

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Blog assisted language learning (BALL) has been trialed by educators in language teaching with the development of Web 2.0 technology. Understanding the development trend of related research helps grasp the whole picture of the use of blog in language education. This paper reviews current research related to blogs enhanced language learning based on bibliometric analysis, aiming at (1) identifying the most frequently used keywords and their co-occurrence, (2) clustering research topics based on co-citation analysis, (3) finding the most frequently cited studies and authors and (4) constructing the co-authorship network. 330 articles were searched out in Web of Science, 225 peer-viewed journal papers were finally collected according to selection criteria. Bibexcel and VOSviewer were used to visualize the results. Studies reviewed were published between 2005 to 2016, most in the year of 2014 and 2015 (35 papers respectively). The top 10 most frequently appeared keywords are learning, language, blog, teaching, writing, social, web 2.0, technology, English, communication. 8 research themes could be clustered by co-citation analysis: blogging for collaborative learning, blogging for writing skills, blogging in higher education, feedback via blogs, blogging for self-regulated learning, implementation of using blogs in classroom, comparative studies and audio/video blogs. Early studies focused on the introduction of the classroom implementation while recent studies moved to the audio/video blogs from their traditional usage. By reviewing the research related to BALL quantitatively and objectively, this paper reveals the evolution and development trends as well as identifies influential research, helping researchers and educators quickly grasp this field overall and conducting further studies.

Keywords: blog, bibliometric analysis, language learning, literature review

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927 The Influence of Different Technologies on the Infiltration Properties and Soil Surface Crusting Processing in the North Bohemia Region

Authors: Miroslav Dumbrovsky, Lucie Larisova

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The infiltration characteristic of the soil surface is one of the major factors that determines the potential soil degradation risk. The physical, chemical and biological characteristic of soil is changed by the processing of soil. The infiltration soil ability has an important role in soil and water conservation. The subject of the contribution is the evaluation of the influence of the conventional tillage and reduced tillage technology on soil surface crusting processing and infiltration properties of the soil in the North Bohemia region. Field experimental work at the area was carried out in the years 2013-2016 on Cambisol district medium-heavy clayey soil. The research was conducted on sloping erosion-endangered blocks of compacted arable land. The areas were chosen each year in the way that one of the experimental areas was handled by conventional tillage technologies and the other by reduced tillage technologies. Intact soil samples were taken into Kopecký´s cylinders in the three landscape positions, at a depth of 10 cm (representing topsoil) and 30 cm (representing subsoil). The cumulative infiltration was measured using a mini-disc infiltrometer near the consumption points. The Zhang method (1997), which provides an estimate of the unsaturated hydraulic conductivity K(h), was used for the evaluation of the infiltration tests of the mini-disc infiltrometer. The soil profile processed by conventional tillage showed a higher degree of compaction and soil crusting processing. The bulk density was between 1.10–1.67 g.cm⁻³, compared to the land processed by the reduced tillage technology, where the values were between 0.80–1.29 g.cm⁻³. Unsaturated hydraulic conductivity values were about one-third higher within the reduced tillage technology soil processing.

Keywords: soil crusting processing, unsaturated hydraulic conductivity, cumulative infiltration, bulk density, porosity

Procedia PDF Downloads 225
926 Effect of Palm Bunch Ash and Neem (Azardirachta indica A. Juss) Leaf Powder on Termite Infestation in Groundnut Field

Authors: K. O. Ogbedeh, C. P. Ekwe, G. O. Ihejirika, S. A. Dialoke, O. P. Onyewuchi, C. P. Anyanwu, I. E. Kalu

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As one of the major pests of field crops, termites attack groundnut at all stages of its development, especially during prolonged dry spell. Effect of palm bunch ash and neem(Azardirachta indica A. Juss) leaf powder on termite infestation in groundnut field in Owerri, Nigeria was investigated in this study. The field trial was carried out in 2016 at the Teaching and Research Farm of the Federal University of Technology, Owerri, Nigeria. The experiment was laid out in a 3x3 Factorial fitted into a Randomized Complete Block Design (RCBD) with three replications. The treatments include three rates of palm bunch ash at 0.0 (control), 1.0 and 2.0tons/ha and three rates of neem leaf powder at 0.0(control), 1.0, 2.0 tons/ha respectively. Data were collected on percentage emergence, termite incidence and termite severity. These were subjected to analysis of variance (ANOVA), and means were separated using least significant difference at 5% level of probability. The result shows that there were no significant (P= 0.05) differences in percentage emergence amongst treatment means due to palm bunch ash and neem leaf powder applications. Contrarily, palm bunch ash at 2.0 tons/ha recorded the least termite incidence especially at twelve weeks after planting (12WAP) with a value of 22.20% while control plot maintained highest values at 6WAP (48.70%) and 12WAP (48.30%) respectively. Also palm bunch ash at 2.0tons/ha depressed termite severity more than other treatments especially at 2 and 4 WAP (0.56) respectively. Control plots on the other hand consistently maintained highest termite severity throughout the trial with the highest value at 2 and 12WAP (1.56). Conclusively, palm bunch ash exhibited highest depressive action against termite on groundnut especially at higher application value (2.0tons/ha).

Keywords: groundnut, incidence, neem, palm, severity, termites

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925 The American Theater: Latinos Performing as American Citizens by Supporting Trump's Ideals

Authors: Mariana Anaya Villafana

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The sudden change of a significant percentage of the Latino community in the United States elections towards a Republican political orientation was reflected during the 2016 presidential election. This moment represented a radical change that is happening inside the Latino community in the United States, the support they have given to Trump's campaign only demonstrates their support for new anti-immigration regulations and conservative values, which are causing a division of ideologies inside the Latino community. One of the main goals of the following research is to understand the whole phenomenon 'Why would people join their own oppressor?' Align themselves with the politics that prevent many of their relatives to come to the United States and made the assimilation process difficult for their parents. It is important to prove that a change in the identity has happened, through the use of power relations and the attachment to the desired object. A group of Hispanics/Latinos have decided to vote for Trump in order to belong to a society that hasn’t been able to fully include them within it, an action that can result on the non-intentional harm of the values and aims of the rest of the Latino/Hispanic community. In order to understand their new political beliefs, it is necessary to use the method of discourse analysis to comprehend those comments and interviews that are published on web sites such as: 'Latinos for Trump' and 'GOP Hispanic Division'. Among the results that the research has shown, the notion of the 'American Dream' can be considered as a determinant object for the construction of a new identity that is rooted in hard work and legality. One that is proud of the Latino heritage but still wants to maintain the boundaries between legality and illegality in relation to the immigrants. This discourse results on a contradiction to most of the cases because they mention that their families came to the U.S. as immigrants; the only difference is that they work hard to obtain legal citizenship.

Keywords: populism, identity, Latino Community, migration

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924 A Systematic Review on Measuring the Physical Activity Level and Pattern in Persons with Chronic Fatigue Syndrome

Authors: Kuni Vergauwen, Ivan P. J. Huijnen, Astrid Depuydt, Jasmine Van Regenmortel, Mira Meeus

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A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME) due to debilitating fatigue and post-exertional malaise (PEM). Identification of measurement instruments to evaluate the activity level and pattern is therefore important. The objective is to identify measurement instruments suited to evaluate the activity level and/or pattern in patients with CFS/ME and review their psychometric properties. A systematic literature search was performed in the electronic databases PubMed and Web of Science until 12 October 2016. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 49 articles and 15 unique measurement instruments were found, but only three instruments were evaluated in patients with CFS/ME: the Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), three self-report instruments measuring the physical activity level. The IPAQ-SF, CFS-AQ and API are all equally capable of evaluating the physical activity level, but none of the three measurement instruments are optimal to use. No studies about the psychometric properties of activity monitors in patients with CFS/ME were found, although they are often used as the gold standard to measure the physical activity pattern. More research is needed to evaluate the psychometric properties of existing instruments, including the use of activity monitors.

Keywords: chronic fatigue syndrome, data collection, physical activity, psychometrics

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923 Direct Approach in Modeling Particle Breakage Using Discrete Element Method

Authors: Ebrahim Ghasemi Ardi, Ai Bing Yu, Run Yu Yang

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Current study is aimed to develop an available in-house discrete element method (DEM) code and link it with direct breakage event. So, it became possible to determine the particle breakage and then its fragments size distribution, simultaneous with DEM simulation. It directly applies the particle breakage inside the DEM computation algorithm and if any breakage happens the original particle is replaced with daughters. In this way, the calculation will be followed based on a new updated particles list which is very similar to the real grinding environment. To validate developed model, a grinding ball impacting an unconfined particle bed was simulated. Since considering an entire ball mill would be too computationally demanding, this method provided a simplified environment to test the model. Accordingly, a representative volume of the ball mill was simulated inside a box, which could emulate media (ball)–powder bed impacts in a ball mill and during particle bed impact tests. Mono, binary and ternary particle beds were simulated to determine the effects of granular composition on breakage kinetics. The results obtained from the DEM simulations showed a reduction in the specific breakage rate for coarse particles in binary mixtures. The origin of this phenomenon, commonly known as cushioning or decelerated breakage in dry milling processes, was explained by the DEM simulations. Fine particles in a particle bed increase mechanical energy loss, and reduce and distribute interparticle forces thereby inhibiting the breakage of the coarse component. On the other hand, the specific breakage rate of fine particles increased due to contacts associated with coarse particles. Such phenomenon, known as acceleration, was shown to be less significant, but should be considered in future attempts to accurately quantify non-linear breakage kinetics in the modeling of dry milling processes.

Keywords: particle bed, breakage models, breakage kinetic, discrete element method

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922 Recent Developments and Expectations in the Legal Expenses Insurance in Turkey

Authors: İbrahim Arslan, Mücahit Ünal

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An important issue to ensure justice is to simplify the right to seek justice. But there is a cost of seeking justice in civil law. It costs at least, attorneys' fees and judicial expenses during the beginning and in case of losing a trial. Indeed, most of the people refrain from seeking justice because of these expenses. Therefore, it is not inappropriate to say that the removal of obstacles staying on the way of seeking justice will increase the belief in justice. Legal expenses insurance is a private law contract of insurance in which the insurer is obliged to pay premiums of the insured, to provide the necessary services for the protection of legal interests of the insured person within the agreed scope. This type of insurance is being practiced in the Western world for a long time. The special rights, duties and obligations of the parties to a legal expenses insurance contract shall be governed by the Turkish Commercial Code (TCC) and the contractual agreements which are regularly closed in the form of general terms and conditions. If the number of the legal expenses insurance contracts concluded increase this will definitely improve the percentage of seeking justice before the courts. The general terms and conditions applicable in Turkey generally include litigation costs, referee fees, guarantee fund , enforcement costs , appeal costs borne decision corrections costs. In addition, besides the insured, other family members or the people specified in the policy are protected in the scope of personal/family legal expenses insurance. The commercial law disputes fall outside the scope of coverage in this insurance branch. The insured person chooses his own lawyer and the insurer is not allowed to give advice during the selection of a lawyer. In April 2015, the Prime Minister announced of a new era in the field of legal expenses insurance in Turkey and this announcement excited the insurance industry and legal community.

Keywords: insurance, in the Turkish law on legal protection insurance, legal protection insurance, legal protection

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921 Effect of Distance to Health Facilities on Maternal Service Use and Neonatal Mortality in Ethiopia

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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920 Comparison of Allowable Stress Method and Time History Response Analysis for Seismic Design of Buildings

Authors: Sayuri Inoue, Naohiro Nakamura, Tsubasa Hamada

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The seismic design method of buildings is classified into two types: static design and dynamic design. The static design is a design method that exerts static force as seismic force and is a relatively simple design method created based on the experience of seismic motion in the past 100 years. At present, static design is used for most of the Japanese buildings. Dynamic design mainly refers to the time history response analysis. It is a comparatively difficult design method that input the earthquake motion assumed in the building model and examine the response. Currently, it is only used for skyscrapers and specific buildings. In the present design standard in Japan, it is good to use either the design method of the static design and the dynamic design in the medium and high-rise buildings. However, when actually designing middle and high-rise buildings by two kinds of design methods, the relatively simple static design method satisfies the criteria, but in the case of a little difficult dynamic design method, the criterion isn't often satisfied. This is because the dynamic design method was built with the intention of designing super high-rise buildings. In short, higher safety is required as compared with general buildings, and criteria become stricter. The authors consider applying the dynamic design method to general buildings designed by the static design method so far. The reason is that application of the dynamic design method is reasonable for buildings that are out of the conventional standard structural form such as emphasizing design. For the purpose, it is important to compare the design results when the criteria of both design methods are arranged side by side. In this study, we performed time history response analysis to medium-rise buildings that were actually designed with allowable stress method. Quantitative comparison between static design and dynamic design was conducted, and characteristics of both design methods were examined.

Keywords: buildings, seismic design, allowable stress design, time history response analysis, Japanese seismic code

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919 Comparison of Health Related Quality of Life in End Stage Renal Diseases Undergoing Twice and Thrice Hemodialysis

Authors: Anamika A. Sharma, Arezou Ahmadi R. A., Narendra B. Parihar, Manjusha Sajith

Abstract:

Introduction: Hemodialysis is the most effective therapeutic technique for patient with ESRD second to renal transplantation. However it is a lifelong therapy which requires frequent hospital, or dialysis centers visits mainly twice and thrice weekly, thus considerably changes the normal way of patient’s living. So this study aimed to Assess Health-Related Quality of life in End-Stage Renal Disease (ESRD) Undergoing Twice and Thrice weekly Hemodialysis. Method: A prospective observational, cross-sectional study was carried out from September 2016 to April 2017 in end-stage renal disease patients undergoing hemodialysis. Socio-demographic and clinical details of patients were obtained from the medical records. WHOQOL-BREF questionnaire was used to Access Health-Related Quality Of Life. Quality of Life scores of Twice weekly and Thrice weekly hemodialysis was analyzed by Kruskal Wallis Test. Results: Majority of respondents were male (72.55%), married (89.31%), employed (58.02%), belong to middle class (71.00%) and resides in rural area (58.78%). The mean ages in the patient undergoing twice weekly and thrice weekly hemodialysis were 51.89 ± 15.64 years and 51.33 ± 15.70 years respectively. Average Quality of Life scores observed in twice weekly and thrice weekly hemodialysis was 52.07 ± 13.30 (p=0.0037) and 52.87 ± 13.47 (p=0.0004) respectively. The hemoglobin of thrice weekly dialysis patients (10.28 gm/dL) was high as compared to twice weekly dialysis (9.23 gm/dL). Patients undergoing thrice weekly dialysis had improved serum urea, serum creatinine values (95.85 mg/dL, 8.32 mg/dL) as compared to twice weekly hemodialysis ( 104.94 mg/dL, 8.68 mg/dL). Conclusion: Our study concluded that there was no significant difference between overall Health-Related Quality Of Life in twice weekly and thrice weekly hemodialysis. Frequent hemodialysis was associated with improved control of hypertension, serum urea, serum creatinine levels.

Keywords: end stage renal disease, health related quality of life, twice weekly hemodialysis, thrice weekly hemodialysis

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918 Vulnerability Assessment of Vertically Irregular Structures during Earthquake

Authors: Pranab Kumar Das

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Vulnerability assessment of buildings with irregularity in the vertical direction has been carried out in this study. The constructions of vertically irregular buildings are increasing in the context of fast urbanization in the developing countries including India. During two reconnaissance based survey performed after Nepal earthquake 2015 and Imphal (India) earthquake 2016, it has been observed that so many structures are damaged due to the vertically irregular configuration. These irregular buildings are necessary to perform safely during seismic excitation. Therefore, it is very urgent demand to point out the actual vulnerability of the irregular structure. So that remedial measures can be taken for protecting those structures during natural hazard as like earthquake. This assessment will be very helpful for India and as well as for the other developing countries. A sufficient number of research has been contributed to the vulnerability of plan asymmetric buildings. In the field of vertically irregular buildings, the effort has not been forwarded much to find out their vulnerability during an earthquake. Irregularity in vertical direction may be caused due to irregular distribution of mass, stiffness and geometrically irregular configuration. Detailed analysis of such structures, particularly non-linear/ push over analysis for performance based design seems to be challenging one. The present paper considered a number of models of irregular structures. Building models made of both reinforced concrete and brick masonry are considered for the sake of generality. The analyses are performed with both help of finite element method and computational method.The study, as a whole, may help to arrive at a reasonably good estimate, insight for fundamental and other natural periods of such vertically irregular structures. The ductility demand, storey drift, and seismic response study help to identify the location of critical stress concentration. Summarily, this paper is a humble step for understanding the vulnerability and framing up the guidelines for vertically irregular structures.

Keywords: ductility, stress concentration, vertically irregular structure, vulnerability

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917 Comparison of Statins Dose Intensity on HbA1c Control in Outpatients with Type 2 Diabetes: A Prospective Cohort Study

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Ahmed A. Khamis, Abeer Kharshid, Nor Azizah Aziz

Abstract:

The effect of statins dose intensity (SDI) on glycemic control in patients with existing diabetes is unclear. Also, there are many contradictory findings were reported in the literature; thus, it is limiting the possibility to draw conclusions. This project was designed to compare the effect of SDI on glycated hemoglobin (HbA1c%) control in outpatients with Type 2 diabetes in the endocrine clinic at Hospital Pulau Pinang, Malaysia, between July 2015 and August 2016. A prospective cohort study was conducted, where records of 345 patients with Type 2 diabetes (Moderate-SDI group 289 patients and high-SDI cohort 56 patients) were reviewed to identify demographics and laboratory tests. The target of glycemic control (HbA1c < 7% for patient < 65 years, and < 8% for patient ≥ 65 years) was estimated, and the results were presented as descriptive statistics. From 289 moderate-SDI cohorts with a mean age of 57.3 ± 12.4 years, only 86 (29.8%) cases were shown to have controlled glycemia, while there were 203 (70.2%) cases with uncontrolled glycemia with confidence interval (CI) of 95% (6.2–10.8). On the other hand, the high-SDI group of 56 patients with Type 2 diabetes with a mean age 57.7±12.4 years is distributed among 11 (19.6%) patients with controlled diabetes, and 45 (80.4%) of them had uncontrolled glycemia, CI: 95% (7.1–11.9). The study has demonstrated that the relative risk (RR) of uncontrolled glycemia in patients with Type 2 diabetes that used high-SDI is 1.15, and the excessive relative risk (ERR) is 15%. The absolute risk (AR) is 10.2%, and the number needed to harm (NNH) is 10. Outpatients with Type 2 diabetes who use high-SDI of statin have a higher risk of uncontrolled glycemia than outpatients who had been treated with a moderate-SDI.

Keywords: cohort study, diabetes control, dose intensity, HbA1c, Malaysia, statin, type 2 diabetes mellitus, uncontrolled glycemia

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916 Investigation of the Ductility Improvement of Replaceable Hinge Member on Different Types of Precast Concrete Frames

Authors: Ali Berk Bozan, Reşat Atalay Oyguç

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The demand for precast reinforced concrete (RC) structures is growing, considering their certain benefits, including faster assembly, homogeneous materials, and high-quality labor. The structural integrity of precast reinforced concrete (RC) constructions is influenced by the effectiveness of the joints and connections. This paper contains an analytical study about four types of precast reinforced concrete frames, which vary according to the number of storeys and the number of bays with two different types of moment-resisting beam-to-column connection is investigated under cyclic displacement loading up to 5.6% drift rate by using ABAQUS software. The first connection type is the widely used moment-resisting connection that is defined as a wet connection in Turkish Seismic Code (TBDY). The second connection type is known as Artificial Controllable Plastic Hinge. The goal of this connection is to defend reinforced concrete components from earthquake-related plastic deformations by keeping them in a specialized connecting section. It will be possible to repair the broken connections after the earthquake. The cyclic behavior of the four types of frames with the mechanical plastic hinge and wet connection was analytically investigated, and then comparisons and suggestions were made on period, ductility, and structural system behavior coefficient. The analytical study shows that the replaceable plastic hinge element provides a significant period increase. Especially in the case of two storeys and two bays, the change in the period was felt the most compared to other frames. The results for ductility show a significant change in the ductility of the frames with replaceable plastic hinges. For the structural system behavior coefficient, a recommendation between 3.90 and 4.52 values was made.

Keywords: precast structures, replaceable plastic hinge, beam to column connections, ductility

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915 Simulation of Bird Strike on Airplane Wings by Using SPH Methodology

Authors: Tuğçe Kiper Elibol, İbrahim Uslan, Mehmet Ali Guler, Murat Buyuk, Uğur Yolum

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According to the FAA report, 142603 bird strikes were reported for a period of 24 years, between 1990 – 2013. Bird strike with aerospace structures not only threaten the flight security but also cause financial loss and puts life in danger. The statistics show that most of the bird strikes are happening with the nose and the leading edge of the wings. Also, a substantial amount of bird strikes is absorbed by the jet engines and causes damage on blades and engine body. Crash proof designs are required to overcome the possibility of catastrophic failure of the airplane. Using computational methods for bird strike analysis during the product development phase has considerable importance in terms of cost saving. Clearly, using simulation techniques to reduce the number of reference tests can dramatically affect the total cost of an aircraft, where for bird strike often full-scale tests are considered. Therefore, development of validated numerical models is required that can replace preliminary tests and accelerate the design cycle. In this study, to verify the simulation parameters for a bird strike analysis, several different numerical options are studied for an impact case against a primitive structure. Then, a representative bird mode is generated with the verified parameters and collided against the leading edge of a training aircraft wing, where each structural member of the wing was explicitly modeled. A nonlinear explicit dynamics finite element code, LS-DYNA was used for the bird impact simulations. SPH methodology was used to model the behavior of the bird. Dynamic behavior of the wing superstructure was observed and will be used for further design optimization purposes.

Keywords: bird impact, bird strike, finite element modeling, smoothed particle hydrodynamics

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914 Heliport Remote Safeguard System Based on Real-Time Stereovision 3D Reconstruction Algorithm

Authors: Ł. Morawiński, C. Jasiński, M. Jurkiewicz, S. Bou Habib, M. Bondyra

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With the development of optics, electronics, and computers, vision systems are increasingly used in various areas of life, science, and industry. Vision systems have a huge number of applications. They can be used in quality control, object detection, data reading, e.g., QR-code, etc. A large part of them is used for measurement purposes. Some of them make it possible to obtain a 3D reconstruction of the tested objects or measurement areas. 3D reconstruction algorithms are mostly based on creating depth maps from data that can be acquired from active or passive methods. Due to the specific appliance in airfield technology, only passive methods are applicable because of other existing systems working on the site, which can be blinded on most spectral levels. Furthermore, reconstruction is required to work long distances ranging from hundreds of meters to tens of kilometers with low loss of accuracy even with harsh conditions such as fog, rain, or snow. In response to those requirements, HRESS (Heliport REmote Safeguard System) was developed; which main part is a rotational head with a two-camera stereovision rig gathering images around the head in 360 degrees along with stereovision 3D reconstruction and point cloud combination. The sub-pixel analysis introduced in the HRESS system makes it possible to obtain an increased distance measurement resolution and accuracy of about 3% for distances over one kilometer. Ultimately, this leads to more accurate and reliable measurement data in the form of a point cloud. Moreover, the program algorithm introduces operations enabling the filtering of erroneously collected data in the point cloud. All activities from the programming, mechanical and optical side are aimed at obtaining the most accurate 3D reconstruction of the environment in the measurement area.

Keywords: airfield monitoring, artificial intelligence, stereovision, 3D reconstruction

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913 [Keynote Talk]: Study of Cooperative Career Education between Universities and Companies

Authors: Azusa Katsumata

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Where there is collaboration between universities and companies in the educational context, companies seek ‘knowledge’ from universities and provide a ‘place of practice’ to them. Several universities have introduced activities aimed at the mutual enlightenment of a diversity of people in career education. However, several programs emphasize on delivering results, and on practicing the prepared materials as planned. Few programs focus on unexpected failures and setbacks. This way of learning is important in career education so that classmates can help each other, overcome difficulties, draw out each other’s strengths, and learn from them. Seijo University in Tokyo offered Tokyo Tourism, a Project-Based Learning course, as a first-year career education course until 2016. In cooperation with a travel agency, students participate in planning actual tourism products for foreigners visiting Japan, undertake tours serving as guides. This paper aims to study the 'learning platform' created by a series of processes such as the fieldwork, planning tours, the presentation, selling the tourism products, and guiding the tourists. We conducted a questionnaire to measure the development of work-related skills in class. From the results of the questionnaire, we can see, in the example of this class, that students demonstrated an increased desire to be pro-active and an improved motivation to learn. Students have not, however, acquired policy or business skills. This is appropriate for first-year careers education, but we need to consider how this can be incorporated into future courses. In the questionnaire filled out by the students after the class, the following results were found. Planning and implementing travel products while learning from each other, and helping the teams has led to improvements in the student workforce. This course is a collaborative project between Japanese universities and the 2020 Tokyo Olympics and Paralympic Games committee.

Keywords: university career education, platform of learning, project-based learning, collaboration between university and company

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912 Micro-Scale Digital Image Correlation-Driven Finite Element Simulations of Deformation and Damage Initiation in Advanced High Strength Steels

Authors: Asim Alsharif, Christophe Pinna, Hassan Ghadbeigi

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The development of next-generation advanced high strength steels (AHSS) used in the automotive industry requires a better understanding of local deformation and damage development at the scale of their microstructures. This work is focused on dual-phase DP1000 steels and involves micro-mechanical tensile testing inside a scanning electron microscope (SEM) combined with digital image correlation (DIC) to quantify the heterogeneity of deformation in both ferrite and martensite and its evolution up to fracture. Natural features of the microstructure are used for the correlation carried out using Davis LaVision software. Strain localization is observed in both phases with tensile strain values up to 130% and 110% recorded in ferrite and martensite respectively just before final fracture. Damage initiation sites have been observed during deformation in martensite but could not be correlated to local strain values. A finite element (FE) model of the microstructure has then been developed using Abaqus to map stress distributions over representative areas of the microstructure by forcing the model to deform as in the experiment using DIC-measured displacement maps as boundary conditions. A MATLAB code has been developed to automatically mesh the microstructure from SEM images and to map displacement vectors from DIC onto the FE mesh. Results show a correlation of damage initiation at the interface between ferrite and martensite with local principal stress values of about 1700MPa in the martensite phase. Damage in ferrite is now being investigated, and results are expected to bring new insight into damage development in DP steels.

Keywords: advanced high strength steels, digital image correlation, finite element modelling, micro-mechanical testing

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911 Adding Business Value in Enterprise Applications through Quality Matrices Using Agile

Authors: Afshan Saad, Muhammad Saad, Shah Muhammad Emaduddin

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Nowadays the business condition is so quick paced that enhancing ourselves consistently has turned into a huge factor for the presence of an undertaking. We can check this for structural building and significantly more so in the quick-paced universe of data innovation and programming designing. The lithe philosophies, similar to Scrum, have a devoted advance in the process that objectives the enhancement of the improvement procedure and programming items. Pivotal to process enhancement is to pick up data that grants you to assess the condition of the procedure and its items. From the status data, you can design activities for the upgrade and furthermore assess the accomplishment of those activities. This investigation builds a model that measures the product nature of the improvement procedure. The product quality is dependent on the useful and auxiliary nature of the product items, besides the nature of the advancement procedure is likewise vital to enhance programming quality. Utilitarian quality covers the adherence to client prerequisites, while the auxiliary quality tends to the structure of the product item's source code with reference to its practicality. The procedure quality is identified with the consistency and expectedness of the improvement procedure. The product quality model is connected in a business setting by social occasion the information for the product measurements in the model. To assess the product quality model, we investigate the information and present it to the general population engaged with the light-footed programming improvement process. The outcomes from the application and the client input recommend that the model empowers a reasonable evaluation of the product quality and that it very well may be utilized to help the persistent enhancement of the advancement procedure and programming items.

Keywords: Agile SDLC Tools, Agile Software development, business value, enterprise applications, IBM, IBM Rational Team Concert, RTC, software quality, software metrics

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910 Applying an Automatic Speech Intelligent System to the Health Care of Patients Undergoing Long-Term Hemodialysis

Authors: Kuo-Kai Lin, Po-Lun Chang

Abstract:

Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

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909 Achieving Appropriate Use of Antibiotics through Pharmacists’ Intervention at Practice Point: An Indian Study Report

Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

Procedia PDF Downloads 169