Search results for: emergency staff department

Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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Authors: Ian N. Robertson

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Alkali Silica Reaction (ASR) occurs in concrete when the alkali hydroxides (Na, K and OH) from the cement react with unstable silica, SiO2, in some types of aggregate. The gel that forms during this reaction will expand when it absorbs water, potentially leading to cracking and overall expansion of the concrete. ASR has resulted in accelerated deterioration of concrete highways, dams and other structures that are exposed to moisture during their service life. Concrete aggregates available in Hawaii have not demonstrated a history of ASR, however, accelerated laboratory tests using ASTM 1260 indicated a potential for ASR with some aggregates. Certain clients are now requiring import of aggregates from the US mainland at great expense. In order to assess the accuracy of the laboratory test results, a long-term field study of the potential for ASR in concretes made with Hawaiian aggregates was initiated in 2011 with funding from the US Federal Highway Administration and Hawaii Department of Transportation. Thirty concrete specimens were constructed of various concrete mixtures using aggregates from all Hawaiian aggregate sources, and some US mainland aggregates known to exhibit ASR expansion. The specimens are located in an open field site in Manoa valley on the Hawaiian Island of Oahu, exposed to relatively high humidity and frequent rainfall. A weather station at the site records the ambient conditions on a continual basis. After two years of monitoring, only one of the Hawaiian aggregates showed any sign of expansion. Ten additional specimens were fabricated with this aggregate to confirm the earlier observations. Admixtures known to mitigate ASR, such as fly ash and lithium, were included in some specimens to evaluate their effect on the concrete expansion. This paper describes the field evaluation program and presents the results for all forty specimens after four years of monitoring.

Keywords: aggregate, alkali silica reaction, concrete durability, field exposure

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Authors: Sushila Jaiswal, Awadhesh Kumar Jaiswal

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Background: Primary melanocytic tumors of the central nervous system (CNS) are uncommon lesions and arise from the melanocytes located within the leptomeninges. Aim and objective: The aim of the study was to evaluate the clinical details, histomorphology of the primary melanocytic tumor of CNS. Method: The study was performed by the retrospective review of the case records of the primary melanocytic tumors of CNS diagnosed in our department. The formalin-fixed, paraffin embedded tissue blocks and tissue sections were retrieved and reviewed. Results: Seven cases (6 males, 1 female; age range- 16-40 years; mean age- 27 years) of primary melanocytic tumors of CNS were retrieved over last seven years. The tumor was intracranial (n=5; frontal – 1 case, parietal – 1 case, cerebello-pontine angle- 1 case, occipital -1 case, foramen magnum-1 case) and intra spinal (n=2; cervical – 2 cases). All patients presented with the neurological deficits related to the location of the tumor. Four cases were malignant melanoma; two were melanocytoma of intermediate grade and remaining one was melanocytoma. On histopathology, melanocytoma and melanoma both displayed sheets of well-differentiated melanocytes having round to oval nuclei with finely dispersed chromatin, occasional single eosinophilic nucleoli and a moderate amount of cytoplasm with abundant granular melanin pigment. The absence of mitosis and macronucleoli was noticed in melanocytoma while melanoma showed frequent mitosis and macronucleoli. On immunohistochemistry, both showed diffuse strong HMB45 and S-100 immunopositivity. Conclusion: Primary melanocytic tumors of CNS are rare and predominantly seen in males. It is important to differentiate melanoma from melanocytoma as prognosis of later is good.

Keywords: melanocytoma, melanoma, brain tumor, melanin

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Authors: Biniam Bahiru Tufa, Hana Delil Tesfaye, Seife Demisse Legesse, Manaye Tamire

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The healthcare industry is witnessing a digital transformation, with artificial intelligence (AI) offering potential solutions for challenges in health supply chain management (HSCM). However, the adoption of AI in this field remains limited. This research aimed to assess the knowledge, attitude, and practice of AI among students and employees in the health supply chain sector in Ethiopia. Using an explanatory case study research design with a concurrent mixed approach, quantitative and qualitative data were collected simultaneously. The study included 153 participants comprising students and employed health supply chain professionals working in various sectors. The majority had a pharmacy background, and one-third of the participants were male. Most respondents were under 35 years old, and around 68.6% had less than 10 years of experience. The findings revealed that 94.1% of participants had prior knowledge of AI, but only 35.3% were aware of its application in the supply chain. Moreover, the majority indicated that their training curriculum did not cover AI in health supply chain management. Participants generally held positive attitudes toward the necessity of AI for improving efficiency, effectiveness, and cost savings in the supply chain. However, many expressed concerns about its impact on job security and satisfaction, considering it as a burden Graduate students demonstrated higher knowledge of AI compared to employed staff, while graduate students also exhibited a more positive attitude toward AI. The study indicated low previous utilization and potential future utilization of AI in the health supply chain, suggesting untapped opportunities for improvement. Overall, while supply chain experts and graduate students lacked sufficient understanding of AI and its significance, they expressed favorable views regarding its implementation in the sector. The study recommends that the Ethiopian government and international organizations consider introducing AI in the undergraduate pharmacy curriculum and promote its integration into the health supply chain field.

Keywords: knowledge, attitude, practice, supply chain, articifial intellegence

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Authors: Gulam Anwer Khan, A. Gautam

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Background: The arch of aorta is a large artery that arches over the root of the left lung and connects the ascending aorta and descending aorta. It is situated in the superior mediastinum behind the manubrium sterni. It gives off three major branches i.e. brachiocephalic trunk, left common carotid artery and left subclavian artery arising from the superior surface of arch of aorta from right to left. Material and Methods: This was a descriptive study. It was carried out in 44 cadavers, obtained during dissections for undergraduates of Department of Anatomy, Chitwan Medical College, Bharatpur, Chitwan, between March 2015 to October 2016. Cadavers of both sexes were included in the present study. The arch of aorta was dissected and exposed according to the methods described by Romanes in Cunningham’s manual of practical anatomy. Results: Out of 44 dissected cadavers, 35 (79.54%) were male and 9 (20.46%) were female cadavers. The normal branching pattern of the arch of aorta was encountered in 28 (63.64%) cadavers and the remaining 16 (36.36%) cadavers showed variations in the branching pattern of arch of aorta. Two different types of variations on the branching pattern of arch of aorta were noted in the present study, in which 12 (27.27%) cadavers had common trunk of the Arch of Aorta. In 3 (5.00%) male cadavers, we found the origin of the Thyroid ima artery. This variation was noted in 1(1.66%) female cadaver. Conclusion: The present study carried out on adult human cadavers’ revealed wide variations in the branching pattern of the arch of ao rta. These variations are of clinical significance and also very useful for the anatomists, radiologists, anesthesiologists, surgeons for practice during angiography, instrumentation, supra-aortic thoracic, head and neck surgery.

Keywords: arch of aorta, brachiocephalic trunk, left common carotid artery, left subclavian artery, Thyroidea ima artery

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Authors: Usman Tunde Saadu, Adedayo Adesokan, Raseed Adewale Hamsat

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This study examined the influence of procrastination on the academic achievement of students in tertiary institutions in Kwara State, Nigeria. Descriptive survey was adopted for this study and the total number of 300 respondents participated in the study. Stratified and simple random sampling techniques were used to select 3 institutions and 30 departments respectively. Systematic sampling technique was used to select 10 final year students in each department. Two instruments were used to obtain data from the respondents. Procrastination Assessment Scale adapted from Solomon and Rothblum (1984) and a proforma designed by researchers to obtain students CGPA in 2013/2014 academic session. The reliability score of 0.80 was obtained for the instrument using split half method. One research question and one hypothesis were postulated for this study. Percentage was employed to answer research question while research hypothesis was tested with t-test statistical analysis at 0.05 level of significant. The findings of this study revealed that most of final year students in tertiary institutions in Kwara State procrastinated because 82.3% engaged in procrastination while 17.7% did not procrastinate. Also, the study revealed that there was a significant difference between the academic achievement of tertiary institution students who procrastinate and those who did not procrastinate (cal. t-value =2.634 < critical t-value = 1.960). Students who did not engage in act of procrastinate achieved better academically than students who engage in procrastination. Based on the findings of this study, the following recommendations were made; procrastination as a concept, should be taught at the various institutions so that students will understand what the concept is all about. Guidance and counsellor and educational psychologists should be employed at various institutions to handle students who procrastinate so that appropriate methods will be recommended so solve the problem.

Keywords: academic, achievement, procrastination, institution

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Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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Authors: Archana Surendran, Kalpana C. A.

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Vitamin D insufficiency is highly prevalent in women. Vitamin D bioavailability could be reduced in obesity due to increased sequestration by white adipose tissue. Increased sun exposure due to more frequent outdoor physical activity as well as a diet rich in vitamin D could be the common cause of both higher levels of 25(OH)D and a more favorable lipid profile. The study was conducted with the aim to assess the obesity status among selected working women in Coimbatore, determine their lifestyle and physical activity pattern, study their dietary intake, estimate the vitamin D and lipid profile of selected women and associate the relationship between Vitamin D and obesity among the selected women. A total of 100 working women (non pregnant, non lactating) working in IT sector, hotels and teaching staff were selected for the study. Anthropometric measurements and dietary recall were conducted for all. The women were further categorized as obese and non-obese based on their BMI. Fifteen obese and 15 non-obese women were selected and their fasting blood glucose level, serum Vitamin D and lipid profile were measured. Association between serum vitamin D, lipid profile, anthropometric measurements, food intake and sun exposure was correlated. Fifty six percent of women in the age group between 25-39 years and 44 percent of women in the age group between 40-45 years were obese. Waist and hip circumference of women in the age group between 40-45 years (89.7 and 107.4 cm) were higher than that of obese women in the age group between 25-39 years (88.6 and 102.8 cm). There were no women with sufficient vitamin D levels. In the age group between 40-45 years (obese women), serum Vitamin D was inversely proportional to waist-hip ratio and LDL cholesterol. There was an inverse relationship between body fat percentage and Total cholesterol with serum vitamin D among the women of the age group between 25-39 years. Consumption of milk and milk products were low among women. Intake of calcium was deficit among the women in both the age groups and showed a negative correlation. Sun exposure was less for all the women. Findings from the study revealed that obese women with a higher consumption of fat and less intake of calcium-rich foods have low serum Vitamin D levels than the non-obese women. Thus, it can be concluded that there is an association between Vitamin D status and obesity among adult women.

Keywords: obesity, sun exposure, vitamin D, women

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Md Ruhul Amin

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This study was conducted in the experimental field of the Department of Entomology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh during November 2017 to May 2018 with a view to understanding the seasonal abundance of the major sucking pests namely thrips, aphid and red spider mite on rose. The findings showed that the thrips started to build up their population from the middle of January with abundance 1.0 leaf⁻¹, increased continuously, reached to the peak level (2.6 leaf⁻¹) in the middle of February and then declined. Aphid started to build up their population from the second week of November with abundance 6.0 leaf⁻¹, increased continuously, reached to the peak level (8.4 leaf⁻¹) in the last week of December and then declined. Mite started to build up their population from the first week of December with abundance 0.8 leaf⁻¹, increased continuously, reached to the peak level (8.2 leaf⁻¹) in the second week of March and then declined. Thrips and mite prevailed until the last week of April, and aphid showed their abundance till last week of May. The daily mean temperature, relative humidity, and rainfall had an insignificant negative correlation with thrips and significant negative correlation with aphid abundance. The daily mean temperature had significant positive, relative humidity had an insignificant positive, and rainfall had an insignificant negative correlation with mite abundance. The multiple linear regression analysis showed that the weather parameters together contributed 38.1, 41.0 and 8.9% abundance on thrips, aphid and mite on rose, respectively and the equations were insignificant.

Keywords: aphid, mite, thrips, weather factors

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Authors: Angeliki Vassila, Dimitrios Kalogeropoulos, Rania Rawashdeh, Nigel Hall, Najiha Rahman, Mark Fabian, Suresh Thulasidharan, Hossain Parwez

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Introduction: Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. Methods: This is a retrospective analysis that examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. Results: A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Conclusions: Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: scleritis, necrotizing scleritis, scleroderma, autoimmune disease

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Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

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Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

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Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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Authors: Clare Cunningham

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Whilst there is a strong global research base on the benefits of structured writing retreats and similar provisions, such as Shut Up and Write events, for academic staff and postgraduate researchers, very little has been published about the worth of such events for undergraduate students. This is despite the fact that, internationally, undergraduate student researchers experience similar pressures, distractions and feelings towards writing as those who are at more senior levels within the academy. This paper reports on a mixed-methods study with cohorts of third-year undergraduate students over the course of four academic years. This involved a range of research instruments adopted over the four years of the study. They include the administration of four questionnaires across three academic years, a collection of ethnographic recordings in the second year, and the collation of reflective journal entries and evaluations from all four years. The final two years of data collection took place during the period of Covid-19 restrictions when writing retreats moved to the virtual space which adds an additional dimension of interest to the analysis. The analysis involved the collation of quantitative questionnaire data to observe patterns in expressions of attitudes towards writing. Qualitative data were analysed thematically and used to corroborate and support the quantitative data when appropriate. The resulting data confirmed that one of the biggest challenges for undergraduate students mirrors those reported in the findings of studies focused on more experienced researchers. This is not surprising, especially given the number of undergraduate students who now work alongside their studies, as well as the increasing number who have caring responsibilities, but it has, as yet, been under-reported. The data showed that the groups of writing retreat participants all had very positive experiences, with accountability, a sense of community and procrastination avoidance some of the key aspects. The analysis revealed the sometimes transformative power of these events for a number of these students in terms of changing the way they viewed writing and themselves as writers. The data presented in this talk will support the proposal that retreats should much more widely be offered to undergraduate students across the world.

Keywords: academic writing, students, undergraduates, writing retreat

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Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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Authors: Meltem Koray, Arda Ozgon, Duygu Ofluoglu, Mehmet Yaltirik

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Oral ulcerations can be seen as a side effect of different drugs. These ulcers usually appear within a few weeks following drug treatment. In most of cases, these ulcers resist to conventional treatments, such as anesthetics, antiseptics, anti-inflammatory agents, cauterization, topical tetracycline and corticosteroid treatment. The diagnosis is usually difficult, especially in patients receiving multiple drug therapies. Hyaluronan or hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing and also used for oral ulcer treatment. The aim of this report is to present the treatment of drug-induced oral ulceration on maxillary mucosa with HA gel. 60-year-old male patient was referred to Department of Oral and Maxillofacial Surgery complaining of oral ulcerations during few weeks. He had received chemotherapy and radiotherapy in 2014 with the diagnosis of nasopharyngeal carcinoma, and he has accompanying systemic diseases such as; cardiological, neurological diseases and gout. He is medicated with Escitalopram (Cipralex® 20mg), Quetiapine (Seroquel® 100mg), Mirtazapine (Zestat® 15mg), Acetylsalicylic acid (Coraspin® 100mg), Ramipril-hydrochlorothiazide (Delix® 2.5mg), Theophylline anhydrous (Teokap Sr® 200mg), Colchicine (Colchicum Dispert® 0.5mg), Spironolactone (Aldactone® 100mg), Levothyroxine sodium (Levotiron® 50mg). He had painful oral ulceration on the right side of maxillary mucosa. The diagnosis was 'drug-induced oral ulceration' and HA oral gel (Aftamed® Oral gel) was prescribed 3 times a day for 2 weeks. Complete healing was achieved within 3 weeks without any side effect and discomfort. We suggest that HA oral gel is a potentially useful local drug which can be an alternative for management of drug-induced oral ulcerations.

Keywords: drug-induced, hyaluronic acid, oral ulceration, maxillary mucosa

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Authors: E. Kempen, M. J. Labuschagne, M. P. Jama

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There is evidence that any learning experience should happen in a safe learning environment as students then will interact, experiment, and construct new knowledge. However, little is known about the specific elements required to create a safe learning environment for the millennial generation, especially in optometry education. This study aimed to identify the specific elements that will contribute to a safe learning environment for the millennial generation of optometry students. Methods: An intrinsic qualitative case study was undertaken with undergraduate students from the Department of Optometry at the University of the Free State, South Africa. An open-ended questionnaire survey was completed after the application of nine different teaching-learning methods based on the experiential learning cycle. A total number of 307 questionnaires were analyzed. Two focus group interviews were also conducted to provide additional data to supplement the data and ensure the triangulation of data. Results: Important elements based on the opinions, feelings, and perceptions of student respondents were analyzed. Students feel safe in an environment with which they are familiar, and when they are familiar with each other, the educators, and the surroundings. Small-group learning also creates a safe and familiar environment. Both these elements create an environment where they feel safe to ask questions. Students value an environment where they are able to learn without influencing their marks or disadvantaging the patients. They enjoy learning from their peers, but also need personal contact with educators. Elements such as consistency and an achievable objective also were also analyzed. Conclusion: The findings suggest that to respond to the real need of this generation of students, insight must be gained in students’ perceptions to identify their needs and the learning environment to optimize learning pedagogies. With the implementation of these personalized elements, optometry students will be able to take responsibility and accountability for their learning.

Keywords: experiences and perceptions, safe learning environment, millennial generation, recommendation for optometry education

Procedia PDF Downloads 137

Authors: Patrick C. H. Morel, Ian W. Barugh, Kirsty L. Chidgey

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The aim of this study was to quantify the level of piglet deaths in outdoor farrowing systems in New Zealand. A total of 14 farms were visited, the farmers interviewed, and data collected. A total of 10,154 sows were kept on those farms representing an estimated 33% of the NZ sow herd or 80% of the outdoor sow herd in 2016. Data from 25,911 litters was available for the different analyses. The characteristics and reproductive performance for the years 2015-2016 from the 14 farms surveyed in this study were analysed, and the following results were obtained. The average percentage of stillbirths was 7.1% ranging between 3.5 and 10.7%, and the average pre-weaning live-born mortality was 16.7% ranging between 3.7% and 23.6%. The majority of piglet deaths (89%) occurred during the first week after birth, with 81% of deaths occurring up to day three. The number of piglets born alive was 12.3 (8.0 to 14.0), and average number of piglets weaned per sow per year was 22.4, range 10.5-27.3. The average stocking rate per ha (number of sows and mated gilts) was 15.3 and ranged from 2.8 to 28.6. The sow to boar ratio average was 20.9:1 and the range was 7.1: 1 to 63:1. The sow replacement rate ranged between 37% and 78%. There was a large variation in the piglet live-born mortality both between months within a farm and between farms within a given month. The monthly recorded piglet mortality ranged between 7.7% and 31.5%, and there was no statistically significant difference between months on the number of piglets born, born alive, weaned or on pre-weaning piglet mortality. Twelve different types of hut/farrowing systems were used on the 14 farms. No difference in piglet mortality was observed between A-Frame, A-Frame Modified and for Box-shape huts. There was a positive relationship between the average number of piglets born per litter and the number of piglets born alive (r=0.975) or the number weaned per litter (r=0.845). Moreover, as the average number of piglets born-alive increases, both pre-weaning live-born mortality rate and the number of piglets weaned increased. An increase of 1 piglet in the number born alive corresponds to an increase of 2.9% in live-born mortality and an increase of 0.56 piglets weaned. Farmers reported that staff are the key to success with the key attributes being: good and reliable with attention to detail and skills with the stock.

Keywords: mortality, piglets, outdoor, pig farm

Procedia PDF Downloads 114

Authors: Rowane May A. Fesalbon, Greyland C. Agno, Jodel L. Cuasay, Dindo A. Malonzo, Ma. Rosario Concepcion O. Ang

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The Department of Energy of the Republic of the Philippines estimates that the country’s energy reserves for 2015 are dwindling– observed in the rotating power outages in several localities. To aid in the energy crisis, a national hydropower resource assessment scheme is developed. Hydropower is a resource that is derived from flowing water and difference in elevation. It is a renewable energy resource that is deemed abundant in the Philippines – being an archipelagic country that is rich in bodies of water and water resources. The objectives of this study is to develop a methodology for a national hydropower resource assessment using hydrologic modeling and geospatial techniques in order to generate resource maps for future reference and use of the government and other stakeholders. The methodology developed for this purpose is focused on two models – the implementation of the Soil and Water Assessment Tool (SWAT) for the river discharge and the use of geospatial techniques to analyze the topography and obtain the head, and generate the theoretical hydropower potential sites. The methodology is highly coupled with Geographic Information Systems to maximize the use of geodatabases and the spatial significance of the determined sites. The hydrologic model used in this workflow is SWAT integrated in the GIS software ArcGIS. The head is determined by a developed algorithm that utilizes a Synthetic Aperture Radar (SAR)-derived digital elevation model (DEM) which has a resolution of 10-meters. The initial results of the developed workflow indicate hydropower potential in the river reaches ranging from pico (less than 5 kW) to mini (1-3 MW) theoretical potential.

Keywords: ArcSWAT, renewable energy, hydrologic model, hydropower, GIS

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Thakur Pushpawati, Singh Vinita, Agrawal Sarita, Mohapatra Eli

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Polycystic ovary syndrome (PCOS) is a disease of endocrine and frequently encountered in women in their reproductive period, and it is characterized by clinical features of anovulation, clinical and biochemical features of hyperandrogenism, and PCOS morphology on ultrasonographic examination. In Indian scenario, only a few studies are available on the correlation of serum 25-dihydroxy vitamin D3 level and insulin level. The present study is a prospective case-control study and aims to estimate the concentration of serum 25-dihydroxy vitamin D3 and insulin resistance and determine the association of serum 25-dihydroxy vitamin D3 with insulin resistance in PCOS women of 18-40 years age group. In this study, the primary objective is to estimate the concentration of 25-dihydroxy vitamin D3, insulin, glycaemic status, calcium and phosphorus levels in 18-40 year age women with polycystic ovary syndrome and to compare these parameters with age and BMI matched healthy control of same age group women. The secondary objective is to determine the association between 25-dihydroxy vitamin D3 concentration and insulin resistance among PCOS cases in 18-40 years age group women. This study was carried on at outpatient Department of Obstetrics & Gynaecology, Aiims Raipur. It took one year from the date of approval. In case, 32 women were diagnosed (Diagnosed PCOS cases as per Rotterdoms criteria among women of 18-40 years of age), as control group 32 women of 18-40 years of age were diagnosed As a result, serum insulin level was elevated among PCOS women along with 25-dihydroxy vitamin D3 deficiency.Conclude up, PCOS is more common in the age group of 20-40 years. There is a strong correlation between vitamin D deficiency and insulin resistance among PCOS patients.

Keywords: vitamin D, insulin resistance, PCOS, reproductive age group

Procedia PDF Downloads 135

Authors: Rasha Ahmadi

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In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

Procedia PDF Downloads 142

Authors: Yessenia Parrado, Ana Barbosa, Daniela Mahe, Sebastian Toro, Jhon Garcia

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The purpose of this work is to present the identification and characterization of the barriers and enablers to public innovation in the Central Region of Colombia from a mixed methodology in a research carried out in 2020 by the Laboratory of Innovation, Creativity and New Technologies of the National University of Colombia in alliance with the National Planning Department. Based on the research, the index of barriers to regional and departmental public innovation was built, which reflects the level of difficulty of the territorial entities to overcome the barriers present around three dimensions: organizational structure of the entity, generation of public value, and governance processes. The index was built from the item response methodology and the multiple correspondence analysis from the application of an institutional information form for public entities and a perception form for public servants. This investigation had the participation of 36 entities and 1038 servers and servants from the departments of Huila, Meta, Boyacá, Cundinamarca, Tolima, and the Capital District. In this exercise, it was identified that the departmental indices range between 13 and 44 and that the regional index was 30 out of 100. From the analysis of the information, it was possible to establish that the main barriers are the lack of specialized agencies for public innovation exercises, lack of qualified personnel and work methodologies for public innovation, inadequate information management, lack of feedback between the learning from governmental and non-governmental entities, the inability of the initiatives to generate binding participation mechanisms and the lack of qualification of citizens to participate in these processes.

Keywords: item response, public innovation, quantitative analysis, compared analysis

Procedia PDF Downloads 125

Authors: Emilie Zimet

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During our department meetings for teachers of children with learning disabilities and difficulties, we often discuss the best practices for supporting students who come to school with literacy difficulties. After completing Sounds Write and Writing Revolution courses, it seems there is a possibility to link approaches and still maintain fidelity to a program and provide individualised instruction to support students with such difficulties and disabilities. In this case study, the researcher has been focussing on how best to use the knowledge acquired to provide quality intervention that targets the varied areas of challenge that students require support in. Students present to school with a variety of co-occurring reading and writing deficits and with complementary approaches, such as The Writing Revolution and Sounds Write, it is possible to support students to improve their fundamental skills in these key areas. Over the next twelve weeks, the researcher will collect data on current students with whom this approach will be trialled and then compare growth with students from last year who received support using Sounds-Write only. Maintaining fidelity may be a potential challenge as each approach has been tested in a specific format for best results. The aim of this study is to determine if approaches can be combined, so the implementation will need to incorporate elements of both reading (from Sounds Write) and writing (from The Writing Revolution). A further challenge is the time length of each session (25 minutes), so the researcher will need to be creative in the use of time to ensure both writing and reading are targeted while ensuring the programs are implemented. The implementation will be documented using student work samples and planning documents. This work will include a display of findings using student learning samples to demonstrate the importance of co-targeting the reading and writing challenges students come to school with.

Keywords: literacy difficulties, intervention, individual differences, methods of provision

Procedia PDF Downloads 54

Authors: B. Ashraf, A. M. Malik

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The study was accomplished at the Department of Economics and Agriculture Economics, Pir Mahar Ali Shah ARID Agriculture University, Punjab, Pakistan during 2013-16 with a purpose to discover the effect of Islamic finance/banking on employment in Punjab, Pakistan. Islamic banking system is sub-component of conventional banking system in various countries of the world; however, in Pakistan, it has been established as a separate Islamic banking system. The Islamic banking operates under the doctrine of Shariah. It is claimed that the referred banking is free of interest (Riba) and addresses the philosophy and basic values of Islam in finance that reduces the factors of uncertainty, risk and others speculative activities. Two Islamic bank’s; Meezan Bank Limited (Pakistan) and Al-Baraka Bank Limited (Pakistan) from North Punjab (Bahawalnagar) and central Punjab (Lahore) west Punjab (Gujrat), Pakistan were randomly selected for the conduct of research. A total of 206 samples were collected from the define areas and banks through questionnaire. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) version 21.0. Multiple linear regressions were applied to prove the hypothesis. The results revealed that the assets formation had significant positive; whereas, the technology, length of business (experience) and bossiness size had significant negative impact with employment generation in Islamic finance/banking in Punjab, Pakistan. This concludes that the employment opportunities may be created in the country by extending the finance to business/firms to start new business and increase the Public awareness by the Islamic banks through intensive publicity. However; Islamic financial institutions may be encouraged by Government as it enhances the employment in the country.

Keywords: assets formation, borrowers, employment generation, Islamic banks, Islamic finance

Procedia PDF Downloads 324

Authors: I. Nyoman Mahayasa Adiputra

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Data in the field of health can be useful for the purposes of data analysis, one example of health data is disease data. Disease data is usually in a geographical plot in accordance with the area. Where the data was collected, in the city of Denpasar, Bali. Disease data report is still published in tabular form, disease information has not been mapped in GIS form. In this research, disease information in Denpasar city will be digitized in the form of a geographic information system with the smallest administrative area in the form of district. Denpasar City consists of 4 districts of North Denpasar, East Denpasar, West Denpasar and South Denpasar. In this research, we use Google fusion table technology for map digitization process, where this technology can facilitate from the administrator and from the recipient information. From the administrator side of the input disease, data can be done easily and quickly. From the receiving end of the information, the resulting GIS application can be published in a website-based application so that it can be accessed anywhere and anytime. In general, the results obtained in this study, divided into two, namely: (1) Geolocation of Denpasar and all of Denpasar districts, the process of digitizing the map of Denpasar city produces a polygon geolocation of each - district of Denpasar city. These results can be utilized in subsequent GIS studies if you want to use the same administrative area. (2) Dengue fever mapping in 2014 and 2015. Disease data used in this study is dengue fever case data taken in 2014 and 2015. Data taken from the profile report Denpasar Health Department 2015 and 2016. This mapping can be useful for the analysis of the spread of dengue hemorrhagic fever in the city of Denpasar.

Keywords: geographic information system, Google fusion table technology, delivery of disease data information, Denpasar city

Procedia PDF Downloads 129

Authors: P. Selyshchev

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Construction materials for nuclear facilities are operated under extreme thermal and radiation conditions. First of all, they are nuclear fuel, fuel assemblies, and reactor vessel. It places high demands on the control of their state, stability of their state, and their operating conditions. An irradiated material is a typical example of an open non-equilibrium system with nonlinear feedbacks between its elements. Fluxes of energy, matter and entropy maintain states which are far away from thermal equilibrium. The links that arise under irradiation are inherently nonlinear. They form the mechanisms of feed-backs that can lead to instability. Due to this instability the temperature of the sample, heat transfer, and the defect density can exceed the steady-state value in several times. This can lead to change of typical operation and an accident. Therefore, it is necessary to take into account the thermal instability to avoid the emergency situation. The point is that non-thermal energy can be accumulated in materials because irradiation produces defects (first of all these are vacancies and interstitial atoms), which are metastable. The stored energy is about energy of defect formation. Thus, an annealing of the defects is accompanied by releasing of non-thermal stored energy into thermal one. Temperature of the material grows. Increase of temperature results in acceleration of defect annealing. Density of the defects drops and temperature grows more and more quickly. The positive feed-back is formed and self-reinforcing annealing of radiation defects develops. To describe these phenomena a theoretical approach to thermal instability is developed via formalism of complex systems. We consider system of nonlinear differential equations for different components of microstructure and temperature. The qualitative analysis of this non-linear dynamical system is carried out. Conditions for development of instability have been obtained. Points of bifurcation have been found. Convenient way to represent obtained results is a set of phase portraits. It has been shown that different regimes of material state under irradiation can develop. Thus degradation of irradiated material can be limited by means of choice appropriate kind of evolution of materials under irradiation.

Keywords: irradiation, material, non-equilibrium state, nonlinear feed-back, thermal instability

Procedia PDF Downloads 268

Authors: Aliyu Damri

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In every educational institution, students of mass communication receive training to report events and issues accurately and objectively in accordance with official controls. However, the complex nature of society today made it possible to use WhatsApp platform that revolutionizes the means of sharing information, ideas, and experiences. This paper examined how students in the Department of Mass Communication, Abdu Gusau Polytechnic, Talata Mafara used WhatsApp platform in spreading fake news. It used in depth interview techniques and focus group discussion with students as well as the use of published materials to gather related and relevant data. Also, the paper used procedures involved to analyze long interview content. This procedure includes observation of a useful utterance, development of expanded observation, examination of interconnection of observed comments, collective scrutiny of observation for patterns and themes, and review and analysis of the themes across all interviews for development of thesis. The result indicated that inadequate and absent of official controls guiding the conduct of online information sharing, inaccuracies and poor source verification, lack of gate keeping procedures to ensure ethical and legal provisions, bringing users into the process, sharing all information, availability of misinformation, disinformation and rumor and problem of conversation strongly encouraged the emergence of fake news. Surprisingly, the idea of information as a commodity has increased, and transparency of a source as new ethics emerged.

Keywords: disinformation, fake news, group, mass communication, misinformation, WhatsApp

Procedia PDF Downloads 143

Authors: Diana Flores Galindo, Richard Gil Herrera

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Nowadays, Lean Manufacturing and Industry 4.0 are very important in every country. One of the main benefits is continued market presence. It has been identified that there is a need to change existing educational programs, as well as update the knowledge and skills of existing employees. It should be borne in mind that behind each technological improvement, there is a human being. Human talent cannot be neglected. The main objectives of this article are to review the link between Lean Manufacturing, the incorporation of Industry 4.0 and the steps to follow to implement it; analyze the current situation and study the implications and benefits of this new trend, with a particular focus on Mexico. Lean Manufacturing and Industry 4.0 implementation waves must always take care of the most important capital – intellectual capital. The methodology used in this article comprised the following steps: reviewing the reality of the fourth industrial revolution, reviewing employees’ skills on the journey to become world-class, and analyzing the situation in Mexico. Lean Manufacturing and Industry 4.0 were studied not as exclusive concepts, but as complementary ones. The methodological framework used is focused on motivating companies’ collaborators to guarantee common results, innovate, and remain in the market in the face of new requirements from company stakeholders. The key findings were that both trends emphasize the need to improve communication across the entire company and incorporate new technologies into everyday work, from the shop floor to administrative staff, to help improve processes. Taking care of people, activities and processes will bring a company success. In the specific case of Mexico, companies in all sectors need to be aware of and implement technological improvements according to their specific needs. Low-cost labor represents one of the most typical barriers. In conclusion, companies must build a roadmap according to their strategy and needs to achieve their short, medium- and long-term goals.

Keywords: lean management, lean manufacturing, industry 4.0, motivation, SWOT analysis, Hoshin Kanri

Procedia PDF Downloads 144