Search results for: patient management

Authors: Hyekyung Woo, Gwihyun Kim

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mHealth, which encompasses mobile health technologies and interventions, is rapidly evolving in various medical specialties, and its impact is evident in oncology. This review describes current trends in research addressing the integration of mHealth into the management of breast cancer by examining evaluations of mHealth and its contributions across the cancer care continuum. Mobile technologies are perceived as effective in prevention and as feasible for managing breast cancer, but the diagnostic accuracy of these tools remains in doubt. Not all phases of breast cancer treatment involve mHealth, and not all have been addressed by research. These drawbacks in the application of mHealth to breast cancer management call for intensified research to strengthen its role in breast cancer care.

Keywords: mobile application, breast cancer, content analysis, mHealth

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Authors: Mohsen Yaghmoor, Sima Radmanesh

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Rapid environmental changes have been threaten the life of many organizations .Enabling and productivity of human resource should be considered as the most important issue in order to increase performance and ensure survival of the organizations. In this research, the effectiveness of management factory in productivity & inability of human resource have been identified and reviewed at glance. Afterward there were two questions they are “what are the factors effecting productivity and enabling of human resource” . And ”what are the priority order based on effective management of human resource in Fars Poultry Complex". A specified questionnaire has been designed in order to priorities and effectiveness of the identified factors. Six factors specify to consist of: Individual characteristics, teaching, motivation, partnership management, authority or power submission and job development that have most effect on organization. Then specify a questionnaire for priority and effect measurement of specified factor that reach after collect information and using statistical tests of keronchbakh alpha coefficient r=0.792 that we can say the questionnaire has sufficient reliability. After information analysis of specified six factors by Friedman test categorize their effect. Measurement on organization respectively consists of individual characteristics, job development or enrichment, authority submission, partnership management, teaching and motivation. At last it has been indicated to approaches to increase making power full and productivity of manpower.

Keywords: productivity, empowerment, enrichment, authority submission, partnership management, teaching, motivation

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Authors: Wichai Srisud, Shunnawat Pungbangkradee, Sukanya Chaemchoy

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This research study aims to analyze and assess school management guidelines designed to enhance the level of Student School Engagement of students at Bangkok Christian College, according to three following primary objectives: 1) to evaluate the level of Student School Engagement among Bangkok Christian College students, 2) to examine the Priority Needs Index of school management for promoting an optimum level of Student School Engagement among Bangkok Christian College students, and 3) to develop additional guidelines for school management to further enhance the level of Student School Engagement of Bangkok Christian College students. The research was conducted using Explanatory Design research methodology, with data obtained from a sample comprised of 291 students and 6 administrative personnel. The research findings indicated that: 1) The overall level of Student School Engagement was high. Emotional engagement averaged at the highest level, followed by Behavioral Engagement and Cognitive Engagement, respectively. 2) The Priority Needs Index of school management for promoting Student School Engagement of Bangkok Christian College students was examined, revealing that Evaluation averaged at the highest PNI level, followed by Planning and Implementation, respectively. 3) Guidelines for school management to enhance Student School Engagement of Bangkok Christian College students should consist of four approaches: 3.1) A Cognitive Engagement Enhancing Approach, which must include (1) fostering students’ problem-solving flexibility, and their ability to devise solutions for overcoming potential challenges, and (2) encouraging students to deal effectively with academic setbacks, rather than becoming overwhelmed by what they may perceive as failures, 3.2) An Emotional Engagement Enhancing Approach, cultivating students’ interests, aspirations and goals in learning to maximize emotional investment in their academic pursuits, and 3.3) A Behavioral Engagement Enhancing Approach, for elevating students’ focus and attentiveness during learning, and improving their ability to avoid distractions during study time.

Keywords: school engagement, guidelines for school management

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Authors: Janet Wing-Chong Wai, Alex Chiu-Wing Lee, Hailey Hoi-Ching Tsang, Jeffrey Chiu, Kwok-Wing Tang

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Background: Mammography has limited sensitivity and specificity though it is the primary imaging technique for detection of early breast cancer. Ultrasound imaging and contrast-enhanced MRI are useful adjunct tools to mammography. The advantage of breast MRI is high sensitivity for invasive breast cancer. Therefore, indications for and use of breast magnetic resonance imaging have increased over the past decade. Objectives: 1. Cases demonstration on different indications for breast MR imaging. 2. To review of the common artifacts and pitfalls in breast MR imaging. Materials and Methods: This is a retrospective study including all patients underwent dynamic contrast-enhanced breast MRI examination in our centre, performed from Jan 2011 to Dec 2017. The clinical data and radiological images were retrieved from the EPR (electronic patient record), RIS (Radiology Information System) and PACS (Picture Archiving and Communication System). Results and Discussion: Cases including (1) Screening of the contralateral breast in patient with a new breast malignancy (2) Breast augmentation with free injection of unknown foreign materials (3) Finding of axillary adenopathy with an unknown site of primary malignancy (4) Neo-adjuvant chemotherapy: before, during, and after chemotherapy to evaluate treatment response and extent of residual disease prior to operation. Relevant images will be included and illustrated in the presentation. As with other types of MR imaging, there are different artifacts and pitfalls that can potentially limit interpretation of the images. Because of the coils and software specific to breast MR imaging, there are some other technical considerations that are unique to MR imaging of breast regions. Case demonstration images will be available in presentation. Conclusion: Breast MR imaging is a highly sensitive and reasonably specific method for the detection of breast cancer. Adherent to appropriate clinical indications and technical optimization are crucial for achieving satisfactory images for interpretation.

Keywords: MRI, breast, clinical, cancer

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Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

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Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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Authors: Kwok Tak Kit

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Construction and demolition (C&D) waste generated in the process of urbanization which only contribute to approx. 25–35 per cent of municipal solid waste (MSW), and the action to reduce the generation of other MSW is considered more critical. Developed and cities produce a higher percentage of inorganic waste rather than organic waste. Most of the MSW was disposed in landfill, and a large number of the landfills are not effectively and efficiently operated to receive the untreated incoming waste. It is also a global problem that the demands for enhancement of basic infrastructure for waste collection, treatment, and disposal, including rehabilitation of the dump sites, is the urgent priority. This paper is to review the factors taken into consideration of waste management development in relation to circular economy development on development countries and green recovery in the post-pandemic era for further researches use.

Keywords: waste management, waste reduction, circular economy, developed countries, sustainable design goals

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Authors: Chanthima Phromket, Jakret Mettathamrong, Parnisara Prajudtasri

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The purpose of this paper is to investigate the relationship between effects of service quality management capability and business alliance effectiveness on the performance of tourist agency business in Thailand: The moderating role of organizational climate. A survey was used as a research instrument and was given to the owner/managers of tourist agency business in Thailand. The model is tested using the data collected from 400 tourist agency business in Thailand. The results indicate that service quality management capability have the positive influence on business alliance effectiveness and performance. Trust, commitment, and cooperation are the antecedents that have a positive effect on the performance, and the results show non-significant when it is moderated by Organizational climate. Thus, contributions and suggestions are also provided for further research.

Keywords: service quality management capability, business alliance effectiveness, organizational climate, tourist agency

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Authors: Qiaoyun Yang

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Organizational scholars have paid enormous attention on how local governments manage their knowledge during the past two decades. Government knowledge management (KM) research recognizes that the management of knowledge flows and networks is critical to reforms on government service efficiency and the effect of administration. When dealing with complex affairs, all the limitations resulting from a lack of KM concept, processes and technologies among all the involved organizations begin to be exposed and further compound the processing difficulty of the affair. As a result, the challenges for individual or group knowledge sharing, knowledge digging and organizations’ collaboration in government's activities are diverse and immense. This analysis presents recent situation of government KM in China drawing from a total of more than 300 questionnaires and highlights important challenges that remain. The causes of the lapses in KM processes within and across the government agencies are discussed.

Keywords: KM processes, KM technologies, government, KM situation

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Authors: P. Nafisi Poor, P. Javid

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Over the past few years, the idea of adaptive buildings and specifically, adaptive building energy management systems (ABEMS) has become popular. Well-performed management in terms of energy is to create a balance between energy consumption and user comfort; therefore, in new energy management models, efficient energy consumption is not the sole factor and the user's comfortability is also considered in the calculations. One of the main ways of measuring this factor is by analyzing user feedback on the conditions to understand whether they are satisfied with conditions or not. This paper provides a comprehensive review of recent approaches towards energy management systems based on users' feedbacks and subsequently performs a comparison between them premised upon their efficiency and accuracy to understand which approaches were more accurate and which ones resulted in a more efficient way of minimizing energy consumption while maintaining users' comfortability. It was concluded that the highest accuracy rate among the presented works was 95% accuracy in determining satisfaction and up to 51.08% energy savings can be achieved without disturbing user’s comfort. Considering the growing interest in designing and developing adaptive buildings, these studies can support diverse inquiries about this subject and can be used as a resource to support studies and researches towards efficient energy consumption while maintaining the comfortability of users.

Keywords: adaptive buildings, energy efficiency, intelligent buildings, user comfortability

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Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal

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Authors: Wan Noorul Hafilah Binti Wan Ariffin

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Dam safety management is the crucial infrastructure as dam failure has a catastrophic effect on the community. Dam safety management is the effective framework of key actions and activities for the dam owner to manage the safety of the dam for its entire life cycle. However, maintaining dam safety is a challenging task as there are changes in current dam states. These changes introduce new risks to the dam's safety, which had not been considered when the dam was designed. A new framework has to be developed to adapt to the changes in the dam risk and make the dams resilient. This study proposes a risk-based decision-making adaptation framework for dam safety management. The research focuses on climate change's impact on hydrological situations as it causes floods and damages the dam structure. The risk analysis framework is adopted to improve the dam management strategies. The proposed study encompasses four phases. To start with, measuring the effect by assessing the impact of climate change on embankment dam, the second phase is to analyze the potential embankment dam failures. The third is analyzing the different components of risks related to the dam and, finally, developing a robust decision-making framework.

Keywords: climate change, embankment dam, failure, risk-informed decision making

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Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Benhenni Abdellaziz

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Irrigation is a limiting factor for agricultural production and socioeconomic development of many countries in the arid and semi-arid world. However, the sustainability of irrigation systems requires rational management of the water resource, which is becoming increasingly rare in these regions. The objective of this work is to apply a geographic information system (GIS) coupled with a model for calculating crop water requirements (CROPWATER) for the management of irrigation water in irrigated areas and offer managers an effective tool to better manage water resources in these areas. The application area of GIS is the irrigated perimeter of Western Middle Cheliff, which is located in a semi-arid region (Middle Cheliff). The scope in question is considerable agrarian dynamics and an increased need for irrigation of most crops.

Keywords: GIS, CROPWAT, irrigation, water management, middle cheliff

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Authors: Kudu Dangana

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The occurrences of disaster often call for the support of both government and non-government organization. Consequently, disaster relief remains extremely important in disaster management. However, this approach alone does not proactively address the need to adduce the human and environment impacts of future disasters. Recent thinking in the area of disaster management is indicative of the need for a new paradigm that focuses on reducing the risk of disasters with the involvement and participation of communities. This paper reviews the need for communities to place more emphasis on a holistic approach to disaster risk reduction. This approach involves risk assessment, risk reduction, early warning and disaster preparedness in order to effectively address the reduction of social, economic, and environmental costs of disasters nationally and at the global level.

Keywords: disaster, early, management, warning, relief, risk vulnerability

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Authors: Gadisa Alemayehu, Muralidhar Avvari, Atkilt Mulu G.

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Since 1962 EC, the Faffa Food Share Company has been producing and supplying flour (famix) and value-added flour (baby food) in Ethiopia. It meets nearly all of the country's total flour demand, both for relief and commercial markets. However, it is incompetent in the international market due to a poor maintenance management system. The results of recorded documents and stopwatches revealed that frequent failure machines, as well as a poor maintenance management system, cause increased production downtimes, resulting in a 29.19 percent decrease in production from the planned production. As a result, the current study's goal is to recommend newly developed software for use in and as a Computerized Maintenance Management System (CMMS). As a result, the system increases machine reliability and decreases the frequency of equipment failure, reducing breakdown time and maintenance costs. The company's overall manufacturing performance improved by 4.45 percent, particularly after the implementation of the CMMS.

Keywords: CMMS, manufacturing performance, delivery, availability, flexibility, Faffa Food Share Company

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Authors: Wei Yao

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A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

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Authors: K. H. Yang, T. C. Yeh, P. S. Lu, F. C. Yang, T. Y. Wu, W. J. Sung

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In this study, a series of full-scale hot smoke tests has been conducted to validate the performances of the smoke management system in the WWY center for arts before grand opening. Totaled 19 scenarios has been established and experimented with fire sizes ranging from 2 MW to 10 MW. The measured ASET data provided by the smoke management system experimentation were compared with the computer-simulated RSET values for egress during the design phase. The experimental result indicated that this system could successfully provide a safety margin of 200% and ensure a safe evacuation in case of fire in the WWY project, including worst-cases and fail-safe scenarios. The methodology developed and results obtained in this project can provide a useful reference for future applications, such as for the large-scale indoor sports dome and arena, stadium, shopping malls, airport terminals, and stations or tunnels for railway and subway systems.

Keywords: building hot smoke tests, performance-based smoke management system designs, full-scale experimental validation, tenable condition criteria

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Authors: Briohny H. Spencer, Russ Chess-Williams, Catherine McDermott, Shailendra Anoopkumar-Dukie, David Christie

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Background: Prostate cancer is the second most common cancer diagnosed in men worldwide and the most prevalent in Australian men. In 2015, it was estimated that approximately 18,000 new cases of prostate cancer were diagnosed in Australia. Currently, for localised disease, androgen depravation therapy (ADT) and radiotherapy are a major part of the curative management of prostate cancer. ADT acts to reduce the levels of circulating androgens, primarily testosterone and the locally produced androgen, dihydrotestosterone (DHT), or by preventing the subsequent activation of the androgen receptor. Thus, the growth of the cancerous cells can be reduced or ceased. Radiation techniques such as brachytherapy (radiation delivered directly to the prostate by transperineal implant) or external beam radiation therapy (exposure to a sufficient dose of radiation aimed at eradicating malignant cells) are also common techniques used in the treatment of this condition. Radiotherapy (RT) has significant limitations, including reduced effectiveness in treating malignant cells present in hypoxic microenvironments leading to radio-resistance and poor clinical outcomes and also the significant side effects for the patients. Alpha1-adrenoceptor antagonists are used for many prostate cancer patients to control lower urinary tract symptoms, due to the progression of the disease itself or may arise as an adverse effect of the radiotherapy treatment. In Australia, a significant number (not a majority) of patients receive a α1-ADR antagonist and four drugs are available including prazosin, terazosin, alfuzosin and tamsulosin. There is currently limited published data on the effects of α1-ADR antagonists during radiotherapy, but it suggests these medications may improve patient outcomes by enhancing the effect of radiotherapy. Aim: To determine the impact of α1-ADR antagonists treatments on time to biochemical relapse following radiotherapy. Methods: A retrospective study of male patients receiving radiotherapy for biopsy-proven localised prostate cancer was undertaken to compare cancer outcomes for drug-naïve patients and those receiving α1-ADR antagonist treatments. Ethical approval for the collection of data at Genesis CancerCare QLD was obtained and biochemical relapse (defined by a PSA rise of >2ng/mL above the nadir) was recorded in months. Rates of biochemical relapse, prostate specific antigen doubling time (PSADT) and Kaplan-Meier survival curves were also compared. Treatment groups were those receiving α1-ADR antagonists treatment before or concurrent with their radiotherapy. Data was statistically analysed using One-way ANOVA and results expressed as mean ± standard deviation. Major findings: The mean time to biochemical relapse for tamsulosin, prazosin, alfuzosin and controls were 45.3±17.4 (n=36), 41.5±19.6 (n=11), 29.3±6.02 (n=6) and 36.5±17.6 (n=16) months respectively. Tamsulosin, prazosin but not alfuzosin delayed time to biochemical relapse although the differences were not statistically significant. Conclusion: Preliminary data for the prior and/or concurrent use of tamsulosin and prazosin showed a positive trend in delaying time to biochemical relapse although no statistical significance was shown. Larger clinical studies are indicated and with thousands of patient records yet to be analysed, it may determine if there is a significant effect of these drugs on control of prostate cancer.

Keywords: alpha1-adrenoceptor antagonists, biochemical relapse, prostate cancer, radiotherapy

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Authors: Hyeon-Kyo Lim, Tong-il Jang, Yong-Hee Lee

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As for any nuclear power plant, human error is one of the most dreaded factors that may result in unexpected accidents. Thus, for accident prevention, it is quite indispensable to analyze and to manage the influence of any factor which may raise the possibility of human errors. Among lots factors, stress has been reported to have significant influence on human performance. Stress level of a person may fluctuate over time. To handle the possibility over time, robust stress management program is required, especially in nuclear power plants. Therefore, to overcome the possibility of human errors, this study aimed to develop a stress management program as a part of Fitness-for-Duty (FFD) Program for the workers in nuclear power plants. The meaning of FFD might be somewhat different by research objectives, appropriate definition of FFD was accomplished in this study with special reference to human error prevention, and diverse stress factors were elicited for management of human error susceptibility. In addition, with consideration of conventional FFD management programs, appropriate tests and interventions were introduced over the whole employment cycle including selection and screening of workers, job allocation, job rotation, and disemployment as well as Employee-Assistance-Program (EAP). The results showed that most tools mainly concentrated their weights on common organizational factors such as Demands, Supports, and Relationships in sequence, which were referred as major stress factors.

Keywords: human error, accident prevention, work performance, stress, fatigue

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Authors: Maggie Hui

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Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Risk managers are responsible for managing risk, i.e. adopting strategies with the intention to minimize loss and maximize gains in spite of uncertainty. Which risk strategy to use often depends on the frequency of an event (i.e. probability) and the severity of its outcomes (i.e. impact). This is basically the way translation/localization project managers handle risk management. Although risk management could involve both positive and negative impacts, impact seems to be always negative in professional translators’ management models, e.g. how many days of project time are lost or how many clients are lost. However, for analysis of translation performance, the impact should be possibly positive (e.g. increased readability of the translation) or negative (e.g. loss of source-text information). In other words, the straight business model of risk management is not directly applicable to the study of risk management in the rendition process. This research aims to explore trainee translators’ risk managing while translating in a simulated setting that involves translator-client relations. A two-cycle experiment involving two roles, the translator and the simulated client, was carried out with a class of translation students to test the effects of the main variable of peer-group interaction. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) there is a wide gap between the translator’s internal risk management and their external presentation of risk; and (c) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence.

Keywords: risk management, role-playing simulation, translation pedagogy, translator-client relations

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Authors: S. U. Kunya, S. A. Mohammad

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Construction projects in Nigeria are characterized with risks emanating from delays and accompanying cost-overruns. The aim of the study was to identify and assess factors constraining the utilization of risk management strategies in the execution of public construction project in North-East Nigeria. Data was collected with the aid of a well-structured questionnaire administered to three identified projects in the North-east. Data collected were analysed using the severity index. Findings revealed political involvement, selection of inexperienced contractors and lack of coordinated public sector strategy as the most severe factors constraining the utilization of risk management strategies. The study recommended that: formulation of laws to prevent negative political meddling in construction projects; selection of experienced, risk-informed contractors; and comprehensive risk assessment and planning on all public construction projects.

Keywords: factors, Nigeria, north-east, public projects, risk management, strategies, utilization

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: Pimploi Tirastittam, Sawanath Treesathon, Amornrath Ongkawat

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Learning Management System (LMS) is the system which uses to manage the learning in order to grouping the content and learning activity between the lecturer and learner including online examination and evaluation. Nowadays, it is the borderless learning era so the learning activities can be accessed from everywhere in the world and also anytime via the information technology and media. The learner can easily access to the knowledge so the different in time and distance is not a constraint for learning anymore. The learning pattern which was used in this research is the integration of the in-class learning and online learning via internet and will be able to monitor the progress by the Learning management system which will create the fast response and accessible learning process via the social media. In order to increase the capability and freedom of the learner, the system can show the current and history of the learning document, video conference and also has the chat room for the learner and lecturer to interact to each other. So the objectives of the “The Design and Applied of Learning Management System via Social Media on Internet: Case Study of Operating System for Business Subject” are to expand the opportunity of learning and to increase the efficiency of learning as well as increase the communication channel between lecturer and student. The data of this research was collect from 30 users of the system which are students who enroll in the subject. And the result of the research is in the “Very Good” which is conformed to the hypothesis.

Keywords: Learning Management System, social media, Operating System, information technology

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Charles Amoatey, Ebenezer Kumah

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Purpose: The purpose of this paper is to assess the effects of implementation of Distributor Management Solution (DMS) on supply chain performance in the Fast Moving Consumer Goods (FMCG) industry in Ghana. Methodology: A purposive sampling approach was used in selecting the respondents for the study. Data was collected from senior management and field supervisors from sales, distribution and customer service units of the case study firm and its channel members. This study made use of systematic literature review and results of survey data analysis to assess how information system has been used to improve supply chain performance. Findings: Results from the study showed that the critical effect factors from implementation of a DMS include (1) Obtain prompt and reliable feedback from the market; (2) Building the capacity and skills levels of employees as well as 3rd Party Agents; (3) Motivated top management to invest in MIS; and (4) Performance improvement in sales route management. The most critical challenges to an effective and sustainable MIS implementation are lack of enough trained IT employees and high barriers to cultural change especially with distributors. The paper recommends consistent investment in IS infrastructure and development of IT skills. Research limitations/implications: This study contributes to the literature by exploring the effects of distribution management solution implementation and supply chain performance in a developing country context. Considering the fact that this study is based on data from only one case study firm and its channel members, generalization of the results should be treated with caution. Practical implications: The findings have confirmed the benefits of implementing a Management Information System. The result should encourage channel members to allocate adequate resources for building MIS capacity to enhance their supply chain performance. Originality/Value: In this paper, the relationship between DMS/MIS implementation and improvement in supply chain performance, in the Ghanaian context, has been established.

Keywords: distributor management solution, fast-moving consumer goods, supply chain management, information systems, Ghana

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Authors: Ma. Manna Farrel B. Pinto

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As global industrialization progresses, the environment remains to be at risk of disturbances brought by developments of cities and communities. Impacts of flourishing industries such as tourism require rapid growth of establishments and may threaten ecosystems and natural resources. Puerto Galera as a biosphere reserve and declared as the Center of the World’s Center of Marine Shorefish Biodiversity is on the brink of ecological deterioration as tourism further develops in its coastal areas. Apparently, attempts were initiated to establish a baseline for designation of protection in the economic and coastal marine zones of Puerto Galera but continuity of its implementation and coordination of concerned units remains deficient. Indications of eutrophication have been observed based on water quality analysis although parameter values still comply with the national standards for coastal waters. Water quality data, biodiversity and hydrodynamic information, gathered from studies, and local government units were analysed to assess the condition of the coast as well as acting policies implemented by the local authorities. Sources of contaminants were also located in its three main communities, and their shores wherein in recommendations for installing wastewater treatment facilities and further improvement of policies of waste discharge must be addressed. With a conceptual framework proposed in the study, a comprehensive data analysis and coordinated management are necessary to form an integrated coastal management for further protection and preservation of the sustainable coastal marine ecosystem of Puerto Galera.

Keywords: coastal management, environmental management, integrated resource management, Puerto Galera

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Authors: Ebrahim Fataei, Seyed Ali Hosseini, Zahra Arabi, Habib farhadi, Mehdi Aalipour Erdi, Seiied Taghi Seiied Safavian

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Solid waste production is an integral part of human life and management of waste require full scientific approach and essential planning. The allocation of most management cost to collection and transportation and also the necessity of operational efficiency in this system, by limiting time consumption, and on the other hand optimum collection system and transportation is the base of waste design and management. This study was done to optimize the exits collection and transportation system of solid waste in Meshkinshahr city. So based on the analyzed data of municipal solid waste components in seven zones of Meshkinshahr city, and GIS software, applied to design storage place based on origin recycling and a route to collect and transport. It was attempted to represent an appropriate model to store, collect and transport municipal solid waste. The result shows that GIS can be applied to locate the waste container and determine a waste collection direction in an appropriate way.

Keywords: municipal solid waste management, transportation, optimizing, GIS, Iran

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Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

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Authors: Parul Garg

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Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

Procedia PDF Downloads 112