Search results for: medical data visualization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 27591

Search results for: medical data visualization

5091 Identification of Clay Mineral for Determining Reservoir Maturity Levels Based on Petrographic Analysis, X-Ray Diffraction and Porosity Test on Penosogan Formation Karangsambung Sub-District Kebumen Regency Central Java

Authors: Ayu Dwi Hardiyanti, Bernardus Anggit Winahyu, I. Gusti Agung Ayu Sugita Sari, Lestari Sutra Simamora, I. Wayan Warmada

Abstract:

The Penosogan Formation sandstone, that has Middle Miosen age, has been deemed as a reservoir potential based on sample data from sandstone outcrop in Kebakalan and Kedawung villages, Karangsambung sub-district, Kebumen Regency, Central Java. This research employs the following analytical methods; petrography, X-ray diffraction (XRD), and porosity test. Based on the presence of micritic sandstone, muddy micrite, and muddy sandstone, the Penosogan Formation sandstone has a fine-coarse granular size and middle-to-fine sorting. The composition of the sandstone is mostly made up of plagioclase, skeletal grain, and traces of micrite. The percentage of clay minerals based on petrographic analysis is 10% and appears to envelop grain, resulting enveloping grain which reduces the porosity of rocks. The porosity types as follows: interparticle, vuggy, channel, and shelter, with an equant form of cement. Moreover, the diagenesis process involves compaction, cementation, authigenic mineral growth, and dissolving due to feldspar alteration. The maturity of the reservoir can be seen through the X-ray diffraction analysis results, using ethylene glycol solution for clay minerals fraction transformed from smectite–illite. Porosity test analysis showed that the Penosogan Formation sandstones has a porosity value of 22% based on the Koeseomadinata classification, 1980. That shows high maturity is very influential for the quality of reservoirs sandstone of the Penosogan Formation.

Keywords: sandstone reservoir, Penosogan Formation, smectite, XRD

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5090 Uncertainty and Volatility in Middle East and North Africa Stock Market during the Arab Spring

Authors: Ameen Alshugaa, Abul Mansur Masih

Abstract:

This paper sheds light on the economic impacts of political uncertainty caused by the civil uprisings that swept the Arab World and have been collectively known as the Arab Spring. Measuring documented effects of political uncertainty on regional stock market indices, we examine the impact of the Arab Spring on the volatility of stock markets in eight countries in the Middle East and North Africa (MENA) region: Egypt, Lebanon, Jordon, United Arab Emirate, Qatar, Bahrain, Oman and Kuwait. This analysis also permits testing the existence of financial contagion among equity markets in the MENA region during the Arab Spring. To capture the time-varying and multi-horizon nature of the evidence of volatility and contagion in the eight MENA stock markets, we apply two robust methodologies on consecutive data from November 2008 to March 2014: MGARCH-DCC, Continuous Wavelet Transforms (CWT). Our results indicate two key findings. First, the discrepancies between volatile stock markets of countries directly impacted by the Arab Spring and countries that were not directly impacted indicate that international investors may still enjoy portfolio diversification and investment in MENA markets. Second, the lack of financial contagion during the Arab Spring suggests that there is little evidence of cointegration among MENA markets. Providing a general analysis of the economic situation and the investment climate in the MENA region during and after the Arab Spring, this study bear significant importance for policy makers, local and international investors, and market regulators.

Keywords: Portfolio Diversification , MENA Region , Stock Market Indices, MGARCH-DCC, Wavelet Analysis, CWT

Procedia PDF Downloads 292
5089 Work System Design in Productivity for Small and Medium Enterprises: A Systematic Literature Review

Authors: Silipa Halofaki, Devi R. Seenivasagam, Prashant Bijay, Kritin Singh, Rajeshkannan Ananthanarayanan

Abstract:

This comprehensive literature review delves into the effects and applications of work system design on the performance of Small and Medium-sized Enterprises (SMEs). The review process involved three independent reviewers who screened 514 articles through a four-step procedure: removing duplicates, assessing keyword relevance, evaluating abstract content, and thoroughly reviewing full-text articles. Various criteria, such as relevance to the research topic, publication type, study type, language, publication date, and methodological quality, were employed to exclude certain publications. A portion of articles that met the predefined inclusion criteria were included as a result of this systematic literature review. These selected publications underwent data extraction and analysis to compile insights regarding the influence of work system design on SME performance. Additionally, the quality of the included studies was assessed, and the level of confidence in the body of evidence was established. The findings of this review shed light on how work system design impacts SME performance, emphasizing important implications and applications. Furthermore, the review offers suggestions for further research in this critical area and summarizes the current state of knowledge in the field. Understanding the intricate connections between work system design and SME success can enhance operational efficiency, employee engagement, and overall competitiveness for SMEs. This comprehensive examination of the literature contributes significantly to both academic research and practical decision-making for SMEs.

Keywords: literature review, productivity, small and medium sized enterprises-SMEs, work system design

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5088 Aggregate Supply Response of Some Livestock Commodities in Algeria: Cointegration- Vector Error Correction Model Approach

Authors: Amine M. Benmehaia, Amine Oulmane

Abstract:

The supply response of agricultural commodities to changes in price incentives is an important issue for the success of any policy reform in the agricultural sector. This study aims to quantify the responsiveness of producers of some livestock commodities to price incentives in Algerian context. Time series analysis is used on annual data for a period of 52 years (1966-2018). Both co-integration and vector error correction model (VECM) are used through the Nerlove model of partial adjustment. The study attempts to determine the long-run and short-run relationships along with the magnitudes of disequilibria in the selected commodities. Results show that the short-run price elasticities are low in cow and sheep meat sectors (8.7 and 8% respectively), while their respective long-run elasticities are 16.5 and 10.5, whereas eggs and milk have very high short-run price elasticities (82 and 90% respectively) with long-run elasticities of 40 and 46 respectively. The error correction coefficient, reflecting the speed of adjustment towards the long-run equilibrium, is statistically significant and have the expected negative sign. Its estimates are 12.7 for cow meat, 33.5 for sheep meat, 46.7 for eggs and 8.4 for milk. It seems that cow meat and milk producers have a weak feedback of about 12.7% and 8.4% respectively of the previous year's disequilibrium from the long-run price elasticity, whereas sheep meat and eggs producers adjust to correct long run disequilibrium with a high speed of adjustment (33.5% and 46.7 % respectively). The implication of this is that much more in-depth research is needed to identify those factors that affect agricultural supply and to describe the effect of factors that shift supply in response to price incentives. This could provide valuable information for government in the use of appropriate policy measures.

Keywords: Algeria, cointegration, livestock, supply response, vector error correction model

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5087 Investigating Elements of Identity of Traditional Neighborhoods in Isfahan and Using These Elements in the Design of Modern Neighborhoods

Authors: Saman Keshavarzi

Abstract:

The process of planning, designing and building neighborhoods is a complex and multidimensional part of urban planning. Understanding the elements that give a neighborhood a sense of identity can lead to successful city planning and result in a cohesive and functional community where people feel a sense of belonging. These factors are important in ensuring that the needs of the urban population are met to live in a safe, pleasant and healthy society. This research paper aims to identify the elements of the identity of traditional neighborhoods in Isfahan and analyzes ways of using these elements in the design of modern neighborhoods to increase social interaction between communities and cultural reunification of people. The neighborhood of Jolfa in Isfahan has a unique socio-cultural identity as it dates back to the Safavid Dynasty of the 16th century, and most of its inhabitants are Christian Armenians of a religious minority. The elements of the identity of Jolfa were analyzed through the following research methods: field observations, distribution of questionnaires and qualitative analysis. The basic methodology that was used to further understand the Jolfa neighborhood and deconstruct the identity image that residents associate with their respective neighborhoods was a qualitative research method. This was done through utilizing questionnaires that respondents had to fill out in response to a series of research questions. From collecting these qualitative data, the major finding was that traditional neighborhoods that have elements of identity embedded in them are seen to have closer-knit communities whose residents have strong societal ties. This area of study in urban planning is vital to ensuring that new neighborhoods are built with concepts of social cohesion, community and inclusion in mind as they are what lead to strong, connected, and prosperous societies.

Keywords: development, housing, identity, neighborhood, policy, urbanization

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5086 Reliability Qualification Test Plan Derivation Method for Weibull Distributed Products

Authors: Ping Jiang, Yunyan Xing, Dian Zhang, Bo Guo

Abstract:

The reliability qualification test (RQT) is widely used in product development to qualify whether the product meets predetermined reliability requirements, which are mainly described in terms of reliability indices, for example, MTBF (Mean Time Between Failures). It is widely exercised in product development. In engineering practices, RQT plans are mandatorily referred to standards, such as MIL-STD-781 or GJB899A-2009. But these conventional RQT plans in standards are not preferred, as the test plans often require long test times or have high risks for both producer and consumer due to the fact that the methods in the standards only use the test data of the product itself. And the standards usually assume that the product is exponentially distributed, which is not suitable for a complex product other than electronics. So it is desirable to develop an RQT plan derivation method that safely shortens test time while keeping the two risks under control. To meet this end, for the product whose lifetime follows Weibull distribution, an RQT plan derivation method is developed. The merit of the method is that expert judgment is taken into account. This is implemented by applying the Bayesian method, which translates the expert judgment into prior information on product reliability. Then producer’s risk and the consumer’s risk are calculated accordingly. The procedures to derive RQT plans are also proposed in this paper. As extra information and expert judgment are added to the derivation, the derived test plans have the potential to shorten the required test time and have satisfactory low risks for both producer and consumer, compared with conventional test plans. A case study is provided to prove that when using expert judgment in deriving product test plans, the proposed method is capable of finding ideal test plans that not only reduce the two risks but also shorten the required test time as well.

Keywords: expert judgment, reliability qualification test, test plan derivation, producer’s risk, consumer’s risk

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5085 Development and Validation Method for Quantitative Determination of Rifampicin in Human Plasma and Its Application in Bioequivalence Test

Authors: Endang Lukitaningsih, Fathul Jannah, Arief R. Hakim, Ratna D. Puspita, Zullies Ikawati

Abstract:

Rifampicin is a semisynthetic antibiotic derivative of rifamycin B produced by Streptomyces mediterranei. RIF has been used worldwide as first line drug-prescribed throughout tuberculosis therapy. This study aims to develop and to validate an HPLC method couple with a UV detection for determination of rifampicin in spiked human plasma and its application for bioequivalence study. The chromatographic separation was achieved on an RP-C18 column (LachromHitachi, 250 x 4.6 mm., 5μm), utilizing a mobile phase of phosphate buffer/acetonitrile (55:45, v/v, pH 6.8 ± 0.1) at a flow of 1.5 mL/min. Detection was carried out at 337 nm by using spectrophotometer. The developed method was statistically validated for the linearity, accuracy, limit of detection, limit of quantitation, precise and specifity. The specifity of the method was ascertained by comparing chromatograms of blank plasma and plasma containing rifampicin; the matrix and rifampicin were well separated. The limit of detection and limit of quantification were 0.7 µg/mL and 2.3 µg/mL, respectively. The regression curve of standard was linear (r > 0.999) over a range concentration of 20.0 – 100.0 µg/mL. The mean recovery of the method was 96.68 ± 8.06 %. Both intraday and interday precision data showed reproducibility (R.S.D. 2.98% and 1.13 %, respectively). Therefore, the method can be used for routine analysis of rifampicin in human plasma and in bioequivalence study. The validated method was successfully applied in pharmacokinetic and bioequivalence study of rifampicin tablet in a limited number of subjects (under an Ethical Clearance No. KE/FK/6201/EC/2015). The mean values of Cmax, Tmax, AUC(0-24) and AUC(o-∞) for the test formulation of rifampicin were 5.81 ± 0.88 µg/mL, 1.25 hour, 29.16 ± 4.05 µg/mL. h. and 29.41 ± 4.07 µg/mL. h., respectively. Meanwhile for the reference formulation, the values were 5.04 ± 0.54 µg/mL, 1.31 hour, 27.20 ± 3.98 µg/mL.h. and 27.49 ± 4.01 µg/mL.h. From bioequivalence study, the 90% CIs for the test formulation/reference formulation ratio for the logarithmic transformations of Cmax and AUC(0-24) were 97.96-129.48% and 99.13-120.02%, respectively. According to the bioequivamence test guidelines of the European Commission-European Medicines Agency, it can be concluded that the test formulation of rifampicin is bioequivalence with the reference formulation.

Keywords: validation, HPLC, plasma, bioequivalence

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5084 The Application of Enzymes on Pharmaceutical Products and Process Development

Authors: Reginald Anyanwu

Abstract:

Enzymes are biological molecules that significantly regulate the rate of almost all of the chemical reactions that take place within cells, and have been widely used for products’ innovations. They are vital for life and serve a wide range of important functions in the body, such as aiding in digestion and metabolism. The present study was aimed at finding out the extent to which biological molecules have been utilized by pharmaceutical, food and beverage, and biofuel industries in commercial and scale up applications. Taking into account the escalating business opportunities in this vertical, biotech firms have also been penetrating enzymes industry especially that of food. The aim of the study therefore was to find out how biocatalysis can be successfully deployed; how enzyme application can improve industrial processes. To achieve the purpose of the study, the researcher focused on the analytical tools that are critical for the scale up implementation of enzyme immobilization to ascertain the extent of increased product yield at minimum logistical burden and maximum market profitability on the environment and user. The researcher collected data from four pharmaceutical companies located at Anambra state and Imo state of Nigeria. Questionnaire items were distributed to these companies. The researcher equally made a personal observation on the applicability of these biological molecules on innovative Products since there is now shifting trends toward the consumption of healthy and quality food. In conclusion, it was discovered that enzymes have been widely used for products’ innovations but there are however variations on their applications. It was also found out that pivotal contenders of enzymes market have lately been making heavy investments in the development of innovative product solutions. It was recommended that the applications of enzymes on innovative products should be widely practiced.

Keywords: enzymes, pharmaceuticals, process development, quality food consumption, scale-up applications

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5083 Burden of Diet-related Colorectal Cancer in OECD Countries from 1990 to 2021 with Projections to 2050: Findings from Global Burden of Disease Study

Authors: Zegeye Abebe

Abstract:

Background: Unhealthy diet is a major risk factor for CRC. This study assessed diet-related CRC burden from 1990 to 2021 in Organization for Economic Co-operation and Development (OECD) nations and estimated the burden until 2050 Methods: Data for OECD countries on diet-related CRC disability-adjusted life years (DALYs) and deaths were obtained from the Global Burden of Disease (GBD), 2021. The estimated annual percent change (EAPC) was calculated to analyse the CRC burden attributable to dietary factors. A generalised additive model with negative binomial distribution was used to predict the future burden of CRC attributable to dietary factors from 2021 to 2050. Results: In 2021, the age-standardised percentage of diet-related CRC DALYs and deaths were 39.1% (95% uncertainty interval (UI): 9.3, 61.3) and 39.0% (95% UI: 9.7, 60.9), respectively, in the OECD countries. Between 1990 and 2021, the age-standardised DALYs decreased from 185 to 129 per 100,000, and deaths decreased from 8 to 6 per 100,000 population for OECD countries. Similarly, the EAPC of rates showed a downward trend (EAPCdeaths = -1.26, and EAPCDALYs = -1.20). The estimated diet-related CRC DALYs and deaths are projected to increase to 4.1 million DALYs and 0.2 million deaths by 2050. There has been a downward trend in CRC deaths (EAPC = 1.33 for both sexes) and in DALYs (-0.90 for males and -1.0 for females) from 1990 to 2050. Conclusion: Diet-related CRC burden remains significant. Implementation of nutrition intervention programmes is necessary to promote access to affordable and nutritious foods and to raise awareness about the importance of a healthy diet in reducing CRC risk.

Keywords: colorectal cancer, dietary factor, age-standardized DALYs rate, age-standardized death rate, global burden of diseases

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5082 Customers Preference towards Islamic Banking in Ethiopia and Its Determinants: A PLS-SEM Analysis

Authors: Anwar Adem

Abstract:

Purpose: This study aimed to examine the socioeconomic, religious, and institutional factors affecting customers towards Islamic Banking in Ethiopia. Design/methodology/approach: This study employed a partial Least Square -structural equation modelling (PLS-SEM) to analyse survey data collected from Customer of Islamic Banking in Ethiopia in the capital city Addis Ababa, using a structured questionnaire with a 5-point Likert scale. Convenience and snowball sampling were used to obtain a broad sample of respondents. The sample size was 310. Findings: The findings indicate that Zakat literacy, high religiosity level, Islamic Bank Service Quality, and Awareness about Islamic Banking operations significantly influence customers' preference towards Islamic banking in Ethiopia. However, competitive pricing was found to have an insignificant effect on customers' preference for Islamic banking in this context. Practical implications: These findings underscore the need for the Islamic banking industry should initiate comprehensive awareness campaigns to promote Islamic banking products and their alignment with human welfare and adherence to Shariah principles. These campaigns should be conducted collaboratively by Islamic banks in partnership with renowned religious scholars from the respective region or territory to ensure maximum effectiveness. Additionally, policymakers, regulatory bodies, and particularly higher education institutions should foster a robust understanding of Islamic finance principles and products among consumers. Originality/value: This study provides unique insights into the determinants that shape customers' preference towards Islamic Banking in Ethiopia. The findings provide a foundation for developing superior quality of service delivery by Islamic banks that aligns with Ethiopia’s sociocultural dynamics.

Keywords: Zakat literacy, religiosity, customer preference, awareness

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5081 Moving from Computer Assisted Learning Language to Mobile Assisted Learning Language Edutainment: A Trend for Teaching and Learning

Authors: Ahmad Almohana

Abstract:

Technology has led to rapid changes in the world, and most importantly to education, particularly in the 21st century. Technology has enhanced teachers’ potential and has resulted in the provision of greater interaction and choices for learners. In addition, technology is helping to improve individuals’ learning experiences and building their capacity to read, listen, speak, search, analyse, memorise and encode languages, as well as bringing learners together and creating a sense of greater involvement. This paper has been organised in the following way: the first section provides a review of the literature related to the implementation of CALL (computer assisted learning language), and it explains CALL and its phases, as well as attempting to highlight and analyse Warschauer’s article. The second section is an attempt to describe the move from CALL to mobilised systems of edutainment, which challenge existing forms of teaching and learning. It also addresses the role of the teacher and the curriculum content, and how this is affected by the computerisation of learning that is taking place. Finally, an empirical study has been conducted to collect data from teachers in Saudi Arabia using quantitive and qualitative method tools. Connections are made between the area of study and the personal experience of the researcher carrying out the study with a methodological reflection on the challenges faced by the teachers of this same system. The major findings were that it is worth spelling out here that despite the circumstances in which students and lecturers are currently working, the participants revealed themselves to be highly intelligent and articulate individuals who were constrained from revealing this criticality and creativity by the system of learning and teaching operant in most schools.

Keywords: CALL, computer assisted learning language, EFL, English as a foreign language, ELT, English language teaching, ETL, enhanced technology learning, MALL, mobile assisted learning language

Procedia PDF Downloads 172
5080 Analysis, Evaluation and Optimization of Food Management: Minimization of Food Losses and Food Wastage along the Food Value Chain

Authors: G. Hafner

Abstract:

A method developed at the University of Stuttgart will be presented: ‘Analysis, Evaluation and Optimization of Food Management’. A major focus is represented by quantification of food losses and food waste as well as their classification and evaluation regarding a system optimization through waste prevention. For quantification and accounting of food, food losses and food waste along the food chain, a clear definition of core terms is required at the beginning. This includes their methodological classification and demarcation within sectors of the food value chain. The food chain is divided into agriculture, industry and crafts, trade and consumption (at home and out of home). For adjustment of core terms, the authors have cooperated with relevant stakeholders in Germany for achieving the goal of holistic and agreed definitions for the whole food chain. This includes modeling of sub systems within the food value chain, definition of terms, differentiation between food losses and food wastage as well as methodological approaches. ‘Food Losses’ and ‘Food Wastes’ are assigned to individual sectors of the food chain including a description of the respective methods. The method for analyzing, evaluation and optimization of food management systems consist of the following parts: Part I: Terms and Definitions. Part II: System Modeling. Part III: Procedure for Data Collection and Accounting Part. IV: Methodological Approaches for Classification and Evaluation of Results. Part V: Evaluation Parameters and Benchmarks. Part VI: Measures for Optimization. Part VII: Monitoring of Success The method will be demonstrated at the example of an invesigation of food losses and food wastage in the Federal State of Bavaria including an extrapolation of respective results to quantify food wastage in Germany.

Keywords: food losses, food waste, resource management, waste management, system analysis, waste minimization, resource efficiency

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5079 Rrelationship Between Intrauterine Growth Retardation and TORCH Infections in Neonates

Authors: Seyed Saeid Nabavi

Abstract:

Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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5078 Metrology in Egyptian Architecture, Interrelation with Archaeology

Authors: Monica M. Marcos

Abstract:

In the framework of Archaeological Research, Heritage Conservation and Restoration, the object of study is metrology applied in composition of religious architecture in ancient Egypt, and usefulness in Archaology. The objective is the determination of the geometric and metrological relations in architectural models and the module used in the initial project of the buildings. The study and data collection of religious buildings, tombs and temples of the ancient Egypt, is completed with plans. The measurements systematization and buildings modulation makes possible to establish common compositional parameters, with a module determined by the measurement unit used. The measurement system corresponding to the main period of egyptian history, was the Egyptian royal cubit. The analysis of units measurements, used in architectural design, provides exact numbers on buildable spaces dimensions. It allows establishing proportional relationships between them, and finding a geometric composition module, on which the original project was based. This responds to a philosophical and functional concept of projected spaces. In the heritage rehabilitation and restoration field, knowledge of metrology helps in excavation, reconstruction and restoration of construction elements. The correct use of metrology contributes to the identification of possible work areas, helping to locate where the damaged or missing areas are. Also in restoration projects, metrology is useful for reordering and locating decontextualized parts of buildings. The conversion of measurements taken in the current International System to the ancient egyptian measurements, allows understand its conceptual purpose and its functionality, which makes easier to carry out archaeological intervention. In the work carried out in archaeological excavations, metrology is an essential tool for locating sites and establishing work zones.

Keywords: egyptology, metrology, archaeology, measurements, Egyptian cubit

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5077 Entrepreneurial Orientation and Innovation Outcomes in Ghanaian Social Enterprises: Interaction Effect of Organizational Unlearning

Authors: Stephen Oduro

Abstract:

With a quantitative research design, this study seeks to analyze how, an intangible resource, Organisational Unlearning shapes the relationship between Entrepreneurial Orientation (EO) and Innovation Outcomes among social entrepreneurship organizations in Ghana. The Resource-Based View (RBV) of the firm and EO-Performance Contingency framework was adopted as the underpinning theories of the study. Entrepreneurial Orientation dimensions, namely Innovativeness, Autonomy, Risk-Taking, Proactiveness, and Competitive aggressiveness were examined to determine its significant, direct influence on the Innovation Outcomes of the social enterprises in Ghana. Organizational Unlearning dimensions, specifically examination of lens fitting, the consolidation of emergent understandings, and framework for changing individual habits were explored to determine whether they strengthen or weaken the direct nexus between Entrepreneurial Orientation dimensions and Innovation Outcomes. A self-administered questionnaire was administered to 556 targeted social enterprises across Africa through online questionnaire platform and the data generated and proposed hypotheses were analyzed and tested using Structural Equation Model-Partial Least Square (SEM-PLS 3) statistical tool. The findings revealed that EO dimensions, specifically proactiveness, autonomy, innovativeness, and risk-taking are positively related to IO, but we found no significant support for competitive aggressiveness. The findings, moreover, divulged that the positive, direct relationship between EO and IO is highly strengthened by OU. It is concluded that OU fully moderates the direct link between EO and IO. The present study contributes to the our understanding of the interrelationship among Entrepreneurial Orientation, Organizational Unlearning, and Innovation Outcomes in the social entrepreneurship context.

Keywords: entrepreneurial orientation, innovation outcomes, organizational unlearning, RBV, SEM-PLS, social enterprise, Africa

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5076 Psychological Distress Screening in Patients with Esophageal Cancer after Esophagectomy: A Scoping Review

Authors: Erietta-Christina Arnaoutaki, Stelios-Elion Bousi, Marinos Zachiotis, Simoni Zarkada, Alexandra Chrysagi, Mamdouh Fahad Alenazi, Dimitri Aristotle Raptis

Abstract:

Objective: This review aimed to evaluate the mental health status of patients with esophageal cancer following surgical treatment, as well as the role of psychological distress screening tests in this patient population. Methods: Studies reporting psychometric screening tools used in esophageal cancer patients after esophagectomy, published before January 2024 on PubMed, Scopus, and CENTRAL databases, were searched and analyzed. Results: Six non-randomized control trials were selected for inclusion in this scoping review, which involved 1059 patients undergoing esophagectomy for esophageal cancer. Among the included studies, five employed the Hospital Anxiety and Depression Scale (HADS) for anxiety and/or depression screening, while one used the MD Anderson Symptom Inventory for gastrointestinal cancer (MDASI-GI) for sadness screening. A range of time points was used to evaluate these patients: 102 patients were evaluated at 1 month, 230 patients at 3 months, 218 patients at 6 months, 653 patients at 12 months, and 154 patients at 24 months postoperatively. Analysis of data pooled from three studies employing the HADS revealed a prevalence of 19.45% for anxiety and 17.92% for depression at the 12-month follow-up and mean scores of 3.91 (3.12) and 3.56 (3.12) for the HADS anxiety (HADS-A) and depression (HADS-D) subscales respectively, at any time postoperatively. Conclusion: The findings show a neglected concern regarding the mental health of esophageal cancer survivors following surgical treatment. The use of psychometric screening tools is essential to address psychological distress and improve the quality of life of these patients.

Keywords: esophageal cancer, esophagectomy, psychological distress, anxiety, depression, psychometric tests, HADS, MDASI-GI

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5075 Agroecology and Seasonal Disparity Nexus with Nutritional Status of Children in Ethiopia

Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

Abstract:

Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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5074 Dietary Supplementation with Coula edulis B. Walnuts Prevents Diet-Induced Obesity and Insulin Resistance in Rats

Authors: Eric Beyegue, Boris Azantza, Judith Laure Ngondi, Julius E. Oben

Abstract:

Background: Dietary supplement may potentially help to fight obesity and other metabolic disorders such as adipogenesis, insulin resistance, and inflammation. The present study aimed to test whether supplementation with African walnuts (Aw) could have an effect on adipogenesis and others dysfunctions associated with obesity in rats. Methods: Wistar rats were fed with standard diet (SD) or high-fat high-sucrose diet (HFS) and HFS with supplemented (HFS-Aw) for eight weeks. Results: HFS diet-induced body weight gain and increased fat mass compared to SD. In addition HFS-fed rats developed fasting hyperglycaemia and insulinaemia as well as insulin resistance. Aw supplementation in HFS rats had a protective effect against adipose tissues weigh gain but slightly against body weight gain and major study related disorders. This could be mainly due to decreased food intake dependently of effect in food intake in central nervous system, which decreased in HFS rats supplemented with African walnut compared to the HFS-diet group. Interestingly, African walnut supplementation induced a slight decrease of fasting glycaemia, insulinaemia and Nitric Oxide which could partially explain its minor protective effect against diet-induced insulin resistance. Additionally a decrease in hepatic TG and transaminases levels suggesting a protective effect against liver injury. Conclusion: Taken together these data suggested that supplementation of African walnut could be used to prevent adipose weight gain and related disorders on the other hand, minimally reduced insulin resistance.

Keywords: African walnut, dietary fiber, insulin resistance, oxidative stress

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5073 Advantages and Disadvantages of Socioscientific Issue Based Instruction in Science Classrooms: Pre-Service Science Teachers' Views

Authors: Aysegul Evren Yapicioglu

Abstract:

The social roles and responsibilities expected from citizens are increasing due to changing global living conditions. Science education is expected to prepare conscious and sensitive students. Because today’s students are the adults of future. Precondition of this task is Teacher Education. In the past decade, one of the most important research field is socioscientific issues. This study deals with advantages and disadvantages of socioscientific issue based instruction in science classroom according to pre-service science teachers’ views. A case study approach that is one of the qualitative research design was used to explore their views. Fourteen pre-service science teachers participated to instruction process. Dolphinariums, Kyoto Protocol, genetically modified organisms, recyclable black bags’ benefits and damages, genetic tests, alternative energy sources and organ donation are examples of socioscientific issues, which were taught through activities in a special teaching course. Diaries and focus group interview were used as data collection tools. As a result of the study, the advantages of socioscientific issue based instruction in science classroom comprise of six sub-categories which are multi-skilling, social awareness development of thinking, meaningful learning, character and professional development, contribution of scientific literacy whereas disadvantages of this instruction process are challenges teachers and students, limitations of teaching and learning process in pre-service science teachers’ perspectives. Finally, this study contributes to science teachers and researchers to overcome disadvantages and benefit from the advantage of socioscientific issue based instruction in science classroom.

Keywords: science education, socioscientific issues, socioscientific issue based instruction, pre-service science teacher

Procedia PDF Downloads 181
5072 Remaining Useful Life Estimation of Bearings Based on Nonlinear Dimensional Reduction Combined with Timing Signals

Authors: Zhongmin Wang, Wudong Fan, Hengshan Zhang, Yimin Zhou

Abstract:

In data-driven prognostic methods, the prediction accuracy of the estimation for remaining useful life of bearings mainly depends on the performance of health indicators, which are usually fused some statistical features extracted from vibrating signals. However, the existing health indicators have the following two drawbacks: (1) The differnet ranges of the statistical features have the different contributions to construct the health indicators, the expert knowledge is required to extract the features. (2) When convolutional neural networks are utilized to tackle time-frequency features of signals, the time-series of signals are not considered. To overcome these drawbacks, in this study, the method combining convolutional neural network with gated recurrent unit is proposed to extract the time-frequency image features. The extracted features are utilized to construct health indicator and predict remaining useful life of bearings. First, original signals are converted into time-frequency images by using continuous wavelet transform so as to form the original feature sets. Second, with convolutional and pooling layers of convolutional neural networks, the most sensitive features of time-frequency images are selected from the original feature sets. Finally, these selected features are fed into the gated recurrent unit to construct the health indicator. The results state that the proposed method shows the enhance performance than the related studies which have used the same bearing dataset provided by PRONOSTIA.

Keywords: continuous wavelet transform, convolution neural net-work, gated recurrent unit, health indicators, remaining useful life

Procedia PDF Downloads 137
5071 Determination of Heavy Metal Levels in Carissa spinarum and Toddalia asiatica Used as Herbal Medicines in Kisii and Nyamira Counties Region, Kenya

Authors: Moses A. Guto Maobe, Leonard Gitu, Erastus Gatebe

Abstract:

The plants Carissa spinarum and Toddalia asiatica have historically been used as herbal medicines in Kisii and Nyamira Counties region, Kenya. But, there is limited study about heavy metal contents in their different plant parts. Such information is necessary for proper use of the two plant species as herbal medicines. So, precise determination of heavy metal contents in different part of these herbs is required for quality, efficacy and safety use in the treatment of ailments. The main aim of this study was to standardize the two herbs of interest. The objective of this study was to evaluate the levels of heavy metal contents in the root of Carissa spinarum and Toddalia asiatica. A wet digestion method with concentrated nitric-hydrochloric acid was used for the dissolution of each herb part prior to elemental analysis. Standard solutions of various concentrations of each pure metal of analytical grade arsenic (As), cadmium (Cd) and mercury (Hg) were prepared and used. The analysis of As, Cd and Hg in each of two herbs was conducted by atomic absorption spectroscopy (AAS) Shimadzu model No. 6200. Data obtained from root of Carissa spinarum indicated concentration (mgkg⁻¹) of Arsenic (As), Cadmium (Cd) and Mercury (Hg) were 0.87 x 10⁻³, 7.02 x 10⁻⁶ and 0.66 x 10⁻³ respectively. Results obtained from root of Toddalia asiatica showed concentration (mgkg⁻¹) of Arsenic (As), Cadmium (Cd) and Mercury (Hg) were 1.33 x 10⁻³, 7.32 x 10⁻⁶ and 1.13 x 10⁻³, respectively. The permissible limits set by WHO for As, Cd and Hg in herbs are (mgkg⁻¹) < 1 - 5, < 0.3 – 1 and < 0.1- 0.5 respectively. The concentrations of As, Cd, and Hg determined were relatively higher in the root of Toddalia asiatica than the root of Carissa spinarum. It was concluded that levels of heavy metal contents of As, Cd, and Hg in the root of Carissa spinarum and Toddalia asiatica were within permissible limits set by WHO/FAO.

Keywords: heavy metals, Carissa spinarum, Toddalia asiatica, wet digestion, pollutants, AAS

Procedia PDF Downloads 170
5070 Collaborative Online International Learning with Different Learning Goals: A Second Language Curriculum Perspective

Authors: Andrew Nowlan

Abstract:

During the Coronavirus pandemic, collaborative online international learning (COIL) emerged as an alternative to overseas sojourns. However, now that face-to-face classes have resumed and students are studying abroad, the rationale for doing COIL is not always clear amongst educators and students. Also, the logistics of COIL become increasingly complicated when participants involved in a potential collaboration have different second language (L2) learning goals. In this paper, the researcher will report on a study involving two bilingual, cross-cultural COIL courses between students at a university in Japan and those studying in North America, from April to December, 2022. The students in Japan were enrolled in an intercultural communication class in their L2 of English, while the students in Canada and the United States were studying intermediate Japanese as their L2. Based on a qualitative survey and journaling data received from 31 students in Japan, and employing a transcendental phenomenological research design, the researcher will highlight the students’ essence of experience during COIL. Essentially, students benefited from the experience through improved communicative competences and increased knowledge of the target culture, even when the L2 learning goals between institutions differed. Students also reported that the COIL experience was effective in preparation for actual study abroad, as opposed to a replacement for it, which challenges the existing literature. Both educators and administrators will be exposed to the perceptions of Japanese university students towards COIL, which could be generalized to other higher education contexts, including those in Southeast Asia. Readers will also be exposed to ideas for developing more effective pre-departure study abroad programs and domestic intercultural curriculum through COIL, even when L2 learning goals may differ between participants.

Keywords: collaborative online international learning, study abroad, phenomenology, EdTech, intercultural communication

Procedia PDF Downloads 83
5069 Predicting Ecological Impacts of Sea-Level Change on Coastal Conservation Areas in India

Authors: Mohammad Zafar-ul Islam, Shaily Menon, Xingong Li, A. Townsend Peterson

Abstract:

In addition to the mounting empirical data on direct implications of climate change for natural and human systems, evidence is increasing for other, indirect climate change phenomena such as sea-level rise. Rising sea levels and associated marine intrusion into terrestrial environments are predicted to be among the most serious eventual consequences of climate change. The many complex and interacting factors affecting sea levels create considerable uncertainty in sea-level rise projections: conservative estimates are on the order of 0.5-1.0 m globally, while other estimates are much higher, approaching 6 m. Marine intrusion associated with 1– 6 m sea-level rise will impact species and habitats in coastal ecosystems severely. Examining areas most vulnerable to such impacts may allow design of appropriate adaptation and mitigation strategies. We present an overview of potential effects of 1 and 6 m sea level rise for coastal conservation areas in the Indian Subcontinent. In particular, we examine the projected magnitude of areal losses in relevant biogeographic zones, ecoregions, protected areas (PAs), and Important Bird Areas (IBAs). In addition, we provide a more detailed and quantitative analysis of likely effects of marine intrusion on 22 coastal PAs and IBAs that provide critical habitat for birds in the form of breeding areas, migratory stopover sites, and overwintering habitats. Several coastal PAs and IBAs are predicted to experience higher than 50% losses to marine intrusion. We explore consequences of such inundation levels on species and habitat in these areas.

Keywords: sea-level change, coastal inundation, marine intrusion, biogeographic zones, ecoregions, protected areas, important bird areas, adaptation, mitigation

Procedia PDF Downloads 258
5068 Homogeneity and Trend Analyses of Temperature Indices: The Case Study of Umbria Region (Italy) in the Mediterranean Area

Authors: R. Morbidelli, C. Saltalippi, A. Flammini, A. Garcia-Marin, J. L. Ayuso-Munoz

Abstract:

The climate change, mainly due to greenhouse gas emissions associated to human activities, has been modifying hydrologic processes with a direct effect on air surface temperature that has significantly increased in the last century at global scale. In this context the Mediterranean area is considered to be particularly sensitive to the climate change impacts on temperature indices. An analysis finalized to study the evolution of temperature indices and to check the existence of significant trends in the Umbria Region (Italy) is presented. Temperature data were obtained by seven meteorological stations uniformly distributed in the study area and characterized by very long series of temperature observations (at least 60 years) spanning the 1924-2015 period. A set of 39 temperature indices represented by monthly and annual mean, average maximum and average minimum temperatures, has been derived. The trend analysis was realized by applying the non-parametric Mann-Kendall test, while the non-parametric Pettit test and the parametric Standard Normal Homogeneity test (SNHT) were used to check the presence of breakpoints or in-homogeneities due to environmental changes/anthropic activity or climate change effects. The Umbria region, in agreement with other recent studies exploring the temperature behavior in Italy, shows a general increase in all temperature indices, with the only exception of Gubbio site that exhibits very light negative trends or absence of trend. The presence of break points and in-homogeneity was widely explored through the selected tests and the results were checked on the basis of the well-known metadata of the meteorological stations.

Keywords: reception theory, reading, literary translation, horizons of expectation, reader

Procedia PDF Downloads 164
5067 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

Abstract:

Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

Procedia PDF Downloads 165
5066 Competitors’ Influence Analysis of a Retailer by Using Customer Value and Huff’s Gravity Model

Authors: Yepeng Cheng, Yasuhiko Morimoto

Abstract:

Customer relationship analysis is vital for retail stores, especially for supermarkets. The point of sale (POS) systems make it possible to record the daily purchasing behaviors of customers as an identification point of sale (ID-POS) database, which can be used to analyze customer behaviors of a supermarket. The customer value is an indicator based on ID-POS database for detecting the customer loyalty of a store. In general, there are many supermarkets in a city, and other nearby competitor supermarkets significantly affect the customer value of customers of a supermarket. However, it is impossible to get detailed ID-POS databases of competitor supermarkets. This study firstly focused on the customer value and distance between a customer's home and supermarkets in a city, and then constructed the models based on logistic regression analysis to analyze correlations between distance and purchasing behaviors only from a POS database of a supermarket chain. During the modeling process, there are three primary problems existed, including the incomparable problem of customer values, the multicollinearity problem among customer value and distance data, and the number of valid partial regression coefficients. The improved customer value, Huff’s gravity model, and inverse attractiveness frequency are considered to solve these problems. This paper presents three types of models based on these three methods for loyal customer classification and competitors’ influence analysis. In numerical experiments, all types of models are useful for loyal customer classification. The type of model, including all three methods, is the most superior one for evaluating the influence of the other nearby supermarkets on customers' purchasing of a supermarket chain from the viewpoint of valid partial regression coefficients and accuracy.

Keywords: customer value, Huff's Gravity Model, POS, Retailer

Procedia PDF Downloads 124
5065 Navigating a Changing Landscape: Opportunities for Research Managers

Authors: Samba Lamine Cisse, Cheick Oumar Tangara, Seynabou Sissoko, Mahamadou Diakite, Seydou Doumbia

Abstract:

Introduction: Over the past two decades, the world has been constantly changing, with new trends in project management. These trends are transforming the methods and priorities of research project management. They include the rise of digital technologies, multidisciplinary, open science, and the pressure for high-impact results. Managers, therefore, find themselves at a crossroads between the challenges and opportunities offered by these new trends. This paper aims to identify the challenges and opportunities they face while proposing strategies for effectively navigating this dynamic context. Methodology: This is a qualitative study based on an analysis of the challenges and opportunities facing the University Clinical Research Center in terms of new technologies and project management methods. This blended approach provides an overview of emerging trends and practices. Results: This article shows how research managers can turn new research trends in their favor and how they can adapt to the changes they face to optimize the productivity of research teams while ensuring the quality and ethics of the work. It also explores the importance of developing skills in data management, international collaboration, and innovation management. Finally, it proposes strategies for responding effectively to the challenges posed by these new trends while strengthening the position of research managers as essential facilitators of scientific progress. Conclusion: Navigating this changing landscape requires research managers to be highly flexible and able to anticipate the realities of their institution. By adopting modern project management methodologies and cultivating a culture of innovation, they can turn challenges into opportunities and propel research toward new horizons. This paper provides a strategic framework for overcoming current obstacles and capitalizing on future developments in research.

Keywords: new trends, research management, opportunities, challenges

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5064 Intercultural Sensitivity in Iran: A Case Study of Intercultural Relations between Turks and Lors

Authors: Sepideh Mohammadi

Abstract:

Iran is a country that boasts of ethnic diversity, comprising various groups such as Turks, Lors, Arabs, Baluchs, Persians, Kurds, Gliks, Azaris, and Tabaris. The majority of people in Iran are Persians and as such, the Persian language is the official language of the country. However, it is also a common language among different ethnic groups. It is worth noting that there is a longstanding history of coexistence and cultural relations between the Turkic and Lor ethnic groups. The purpose of this article is to study the range of intercultural sensitivities of Turks and Lor peoples to identify the state of intercultural competence and reduce conflicts in the direction of cultural policy. It is important to gain insight into the mutual perceptions of Lor and Turkic people towards each other. Understanding these perceptions can greatly aid in fostering stronger relationships and promoting effective communication between the two ethnic groups. The study employed a qualitative content analysis approach to gather data using a semi-structured interview tool. The participants consisted of ten individuals from the Lor ethnic and ten individuals from the Turk ethnic. According to Milton Bennett's six-stage model, our findings reveal that the Turkish and Lor ethnic groups tend to exhibit higher intercultural sensitivity in the second stage, which consists of defense against differences. Both groups tend to emphasize the differences between them, and the notion of "us and the other" holds significant importance for them. It is important to acknowledge that both the Turk and Lor ethnicities consist of various clans, which significantly shape intercultural relations between them. A common stereotype in this regard is that the Turks of Tabriz province often do not recognize the Turks of other provinces of the country as their own. Moreover, our study indicates that an increase in interaction and communication between the Lor and Turk ethnic groups may lead to a reduction in cultural sensitivities between them.

Keywords: intercultural communication, intercultural sensitivity, Iran, Lor, Turk

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5063 Estimation of the Nutritive Value of Local Forage Cowpea Cultivars in Different Environments

Authors: Salem Alghamdi

Abstract:

Genotypes collected from farmers at a different region of Saudi Arabia as well as from Egyptian cultivar and a new line from Yamen. Seeds of these genotypes were grown in Dirab Agriculture Research Station, (Middle Region) and Al-Ahsa Palms and Dates Research Center (East region), during summer of 2015. Field experiments were laid out in randomized complete block design on the first week of June with three replications. Each experiment plot contained 6 rows 3m in length. Inter- and intra-row spacing was 60 and 25cm, respectively. Seed yield and its components were estimated in addition to qualitative characters on cowpea plants grown only in Dirab using cowpea descriptor from IPGRI, 1982. Seeds for chemical composite and antioxidant contents were analyzed. Highly significant differences were detected between genotypes in both locations and the combined of two locations for seed yield and its components. Mean data clearly show exceeded determine genotypes in seed yield while indeterminate genotypes had higher biological yield that divided cowpea genotypes to two main groups 1- forage genotypes (KSU-CO98, KSU-CO99, KSU-CO100, and KSU-CO104) that were taller and produce higher branches, biological yield and these are suitable to feed on haulm 2- food genotypes (KSU-CO101, KSU-CO102, and KSU-CO103) that produce higher seed yield with lower haulm and also these genotypes characters by high seed index and light seed color. Highly significant differences were recorded for locations in all studied characters except the number of branches, seed index, and biological yield, however, the interaction of genotype x location was significant only for plant height, the number of pods and seed yield per plant.

Keywords: Cowpea, genotypes, antioxidant contents, yield

Procedia PDF Downloads 257
5062 Reducing Ambulance Offload Delay: A Quality Improvement Project at Princess Royal University Hospital

Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

Abstract:

Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

Procedia PDF Downloads 107