Search results for: nutrition care process

Authors: Gabriel Jinga, Madalina Dumitru

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The objective of this paper is to present the process of change in management accounting in Romania, a former communist country from Eastern Europe. In order to explain this process, we used the contingency and institutional theories. We focused on the following directions: the presentation of the scientific context and motivation of this research and the case study. We presented the state of the art in the process of change in the management accounting from the international and national perspective. We also described the evolution of management accounting in Romania in the context of economic and political changes. An important moment was the fall of communism in 1989. This represents a starting point for a new economic environment and for new management accounting. Accordingly, we developed a case study which presented this evolution. The conclusion of our research was that the changes in the management accounting system of the company analysed occurred in the same time with the institutionalization of some elements (e.g. degree of competition, training and competencies in management accounting). The management accounting system was modeled by the contingencies specific to this company (e.g. environment, industry, strategy).

Keywords: management accounting, change, Romania, contingency, institutional theory

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Authors: Sarra Kitanou

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Membrane bioreactor (MBR) systems are one of the most widely used wastewater treatment processes for various municipal and industrial waste streams. It is based on complex interactions between biological processes, filtration process and rheological properties of the liquid to be treated. Its complexity makes understanding system operation and optimization more difficult, and traditional methods based on experimental analysis are costly and time consuming. The present study was based on an external membrane bioreactor pilot scale with ceramic membranes compared to conventional activated sludge process (ASP) plant. Both systems received their influent from a domestic wastewater. The membrane bioreactor (MBR) produced an effluent with much better quality than ASP in terms of total suspended solids (TSS), organic matter such as biological oxygen demand (BOD) and chemical oxygen demand (COD), total Phosphorus and total Nitrogen. Other effluent quality parameters also indicate substantial differences between ASP and MBR. This study leads to conclude that in the case domestic wastewater, MBR treatment has excellent effluent quality. Hence, the replacement of the ASP by the MBRs may be justified on the basis of their improved removal of solids, nutrients, and micropollutants. Furthermore, in terms of reuse the great quality of the treated water allows it to be reused for irrigation.

Keywords: aerobic wastewater treatment, conventional activated sludge process, membrane bioreactor, reuse for irrigation

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Authors: W. Jahouach-Rabai, J. Aribi, Z. Azzouz-Berriche, R. Lahsni, F. Hosni

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Gamma irradiation applied in removing pharmaceutical contaminants from wastewater is an effective advanced oxidation process (AOP), considered as an alternative to conventional water treatment technologies. In this purpose, the degradation efficiency of several detected contaminants under gamma irradiation was evaluated. In fact, radiolysis of organic pollutants in aqueous solutions produces powerful reactive species, essentially hydroxyl radical ( ·OH), able to destroy recalcitrant pollutants in water. Pharmaceuticals considered in this study are aqueous solutions of paracetamol, ibuprofen, and diclofenac at different concentrations 0.1-1 mmol/L, which were treated with irradiation doses from 3 to 15 kGy. The catalytic oxidation of these compounds by gamma irradiation was investigated using hydrogen peroxide (H₂O₂) as a convenient oxidant. Optimization of the main parameters influencing irradiation process, namely irradiation doses, initial concentration and oxidant volume (H₂O₂) were investigated, in the aim to release high degradation efficiency of considered pharmaceuticals. Significant modifications attributed to these parameters appeared in the variation of degradation efficiency, chemical oxygen demand removal (COD) and concentration of radio-induced radicals, confirming them synergistic effect to attempt total mineralization. Pseudo-first-order reaction kinetics could be used to depict the degradation process of these compounds. A sophisticated analytical study was released to quantify the detected radio-induced radicals (electron paramagnetic resonance spectroscopy (EPR) and high performance liquid chromatography (HPLC)). All results showed that this process is effective for the degradation of many pharmaceutical products in aqueous solutions due to strong oxidative properties of generated radicals mainly hydroxyl radical. Furthermore, the addition of an optimal amount of H₂O₂ was efficient to improve the oxidative degradation and contribute to the high performance of this process at very low doses (0.5 and 1 kGy).

Keywords: AOP, COD, hydroxyl radical, EPR, gamma irradiation, HPLC, pharmaceuticals

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Sonia Anand Knowlton

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There are some cases where we as a society feel deeply uncomfortable with the use of Artificial Intelligence (AI) tools in the judicial decision-making process, and justifiably so. A perfect example is COMPAS, an algorithmic model that predicts recidivism rates of offenders to assist in the determination of their bail conditions. COMPAS turned out to be extremely racist: it massively overpredicted recidivism rates of Black offenders and underpredicted recidivism rates of white offenders. At the same time, there are certain uses of AI in the judicial decision-making process that many would feel more comfortable with and even support. Take, for example, a “super-breathalyzer,” an (albeit imaginary) tool that uses AI to deliver highly detailed information about the subject of the breathalyzer test to the legal decision-makers analyzing their drunk-driving case. This article evaluates the point at which a judge’s use of AI tools begins to undermine the public’s trust in the administration of justice. It argues that the answer to this question depends on whether the AI tool is in a role in which it must perform a moral evaluation of a human being.

Keywords: artificial intelligence, judicial reasoning, morality, technology, algorithm

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Authors: Justin D. Olmanson, Fitsum Abebe, Valerie Jones, Eric Kyle, Xianquan Liu, Katherine Robbins, Guieswende Rouamba

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The history of education technology--and designing, adapting, and adopting technologies for use in educational spaces--is nuanced, complex, and dynamic. Yet, despite a range of continually emerging technologies, the design and development process often yields results that appear quite similar in terms of affordances and interactions. Through this study we (1) verify the extent to which designs have been constrained, (2) consider what might account for it, and (3) offer a way forward in terms of how we might identify and strategically sidestep these influences--thereby increasing the diversity of our designs with a given technology or within a particular learning domain. We begin our inquiry from the perspective that a host of co-influencing elements, fields, and meta narratives converge on the education technology design process to exert a tangible, often homogenizing effect on the resultant designs. We identify several elements that influence design in often implicit or unquestioned ways (e.g. curriculum, learning theory, economics, learning context, pedagogy), we describe our methodology for identifying the elemental positionality embedded in a design, we direct our analysis to a particular subset of technologies in the field of literacy, and unpack our findings. Our early analysis suggests that the majority of education technologies designed for use/used in US public schools are heavily influenced by a handful of mainstream theories and meta narratives. These findings have implications for how we approach the education technology design process--which we use to suggest alternative methods for designing/ developing with emerging technologies. Our analytical process and re conceptualized design process hold the potential to diversify the ways emerging and established technologies get incorporated into our designs.

Keywords: curriculum, design, innovation, meta narratives

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Authors: Netanel Stern

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Artificial intelligence (AI) algorithms have emerged as powerful tools in the field of psychiatry, offering new possibilities for enhancing diagnosis and treatment outcomes. This article explores the utilization of AI algorithms in psychiatry, highlighting their potential to revolutionize patient care. Various AI algorithms, including machine learning, natural language processing (NLP), reinforcement learning, clustering, and Bayesian networks, are discussed in detail. Moreover, ethical considerations and future directions for research and implementation are addressed.

Keywords: AI, software engineering, psychiatry, neuroimaging

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Authors: Francisco A. Ribeiro Da Costa

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Who is responsible for teaching architecture; consider various ways to participate in learning, manipulating various pedagogical tools to streamline the creative process. The Architectural Design Studio (ADS) should become a holistic, systemic process responding to the complexity of our world. This essay corresponds to a deep reflection developed by the author on the teaching of architecture. The outcomes achieved are the corollary of experimentation; discussion and application of pedagogical methods that allowed consolidate the creativity applied by students. The purpose is to show the conjectures that have been considered effective in creating an intellectual environment that nurtures the subject of Architectural Design Studio (ADS), as an operational synthesis in the final stage of the degree. These assumptions, which are part of the proposed model, displaying theories and teaching methodologies that try to respect the learning process based on student learning styles Kolb, ensuring their latent specificities and formulating the structure of the ASD discipline. In addition, the assessing methods are proposed, which consider the architectural Design Studio as an operational synthesis in the teaching of architecture.

Keywords: teaching-learning, architectural design studio, architecture, education

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Chung-Yang Chuang, Hui-Min Wang, Min-Yan Dong, Chang-Jung Chang

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PET fiber is the most widely used fiber worldwide. This man-made fiber is prepared from petroleum chemicals, which may cause environmental pollution and resource exhausting issues, such as the use of non-renewable sources, greenhouse gas emission and discharge of wastewater. Therefore, the textile made by recycle-PET is the trend in the future. Recycle-PET fiber, compared with petroleum-made PET, shows lower carbon emissions and resource exhaustion. However, “fabric decoloring” is the key barrier to textile recycling. The dyes existing in the fabrics may cause PET chain degradation and appearance drawbacks during the textile recycling process. In this research, the water-based decoloring agent was used to remove the dispersed dye in the PET fabrics in order to obtain the colorless PET fabrics after the decoloring process. The decoloring rate of PET fabrics after the decoloring process was up to 99.0%. This research provides a better solution to resolve the issues of appearance and physical properties degradation of fabrics-recycle PET materials due to the residual dye. It may be possible to convert waste PET textiles into new high-quality PET fiber and build up the loop of PET textile recycling.

Keywords: PET, decoloring, disperse dye, textile recycle

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Authors: Yiqi Wu, Simon Tait, Andrew Nichols

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Management of UK railway drainage assets is challenging due to the large amounts of historical assets with long asset life cycles. A major concern for asset managers is to maintain the required performance economically and efficiently while complying with the relevant regulation and legislation. As the majority of the drainage assets are buried underground and are often difficult or costly to examine, it is important for asset managers to understand and model the degradation process in order to foresee the upcoming reduction in asset performance and conduct proactive maintenance accordingly. In this research, a Markov chain approach is used to model the deterioration process of rail drainage assets. The study is based on historical condition scores and characteristics of drainage assets across the whole railway network in England, Scotland, and Wales. The model is used to examine the effect of various characteristics on the probabilities of degradation, for example, the regional difference in probabilities of degradation, and how material and shape can influence the deterioration process for chambers, channels, and pipes.

Keywords: deterioration, degradation, markov models, probability, railway drainage

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Authors: Peter Balco, Miriam Filipova

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The university education is generally concentrated on acquiring theoretical as well as professional knowledge. The right mix of these knowledges is key in creating innovative as well as inventive solutions. Despite the understanding of their importance by the professional community, these are promoted with problems and misunderstanding. The reason for the failure of many non-traditional, innovative approaches is the ignorance of Leadership in the process of their implementation, ie decision-making. In our paper, we focused on the role of Leadership in the educational process and how this knowledge can support decision-making, the selection of a suitable, optimal solution for practice.

Keywords: leadership, soft skills, innovation, invention, knowledge

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Authors: Thorsten Prante, Robert Schöch, Ruth Fleisch, Vaheh Khachatouri, Alexander Walch

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The development of industrial plant control software is a complex and often very expensive task. One of the core problems is that a lot of the implementation and adaptation work can only be done after the plant hardware has been installed. In this paper, we present our approach to virtually developing and validating plant-level control software of production plants. This way, plant control software can be virtually commissioned before actual ramp-up of a plant, reducing actual commissioning costs and time. Technically, this is achieved by linking the actual plant-wide process control software (often called plant server) and an elaborate virtual plant model together to form an emulation system. Method-wise, we are suggesting a four-step iterative process with well-defined increments and time frame. Our work is based on practical experiences from planning to commissioning and start-up of several cut-to-size plants.

Keywords: iterative system design, virtual plant engineering, plant control software, simulation and emulation, virtual commissioning

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Authors: Wen-Wen Wang, Qian Ye, Yi-Feng Lin

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Carbon dioxide emissions are expected to increase continuously, resulting in climate change and global warming. As a result, CO₂ capture has attracted a large amount of research attention. Among the various CO₂ capture methods, membrane technology has proven to be highly efficient in capturing CO₂, because it can be scaled up, low energy consumptions and small area requirements for use by the gas separation. Various nanofibrous membranes were successfully prepared by a simple electrospinning process. The membrane contactor combined with chemical absorption and membrane process in the post-combustion CO₂ capture is used in this study. In a membrane contactor system, the highly porous and water-repellent nanofibrous membranes were used as a gas-liquid interface in a membrane contactor system for CO₂ absorption. In this work, we successfully prepared the polyvinylidene fluoride (PVDF) porous membranes with an electrospinning process. Afterwards, the as-prepared water-repellent PVDF porous membranes were used for the CO₂ capture application. However, the pristine PVDF nanofibrous membranes were wetted by the amine absorbents, resulting in the decrease in the CO₂ absorption flux, the hydrophobic polydimethylsiloxane (PDMS) materials were added into the PVDF nanofibrous membranes to improve the solvent resistance of the membranes. To increase the hydrophobic properties and CO₂ absorption flux, more hydrophobic surfaces of the PDMS/PVDF nanofibrous membranes are obtained by the grafting of fluoroalkylsilane (FAS) on the membranes surface. Furthermore, the highest CO₂ absorption flux of the PDMS/PVDF nanofibrous membranes is reached after the FAS modification with four times. The PDMS/PVDF nanofibrous membranes with 60 wt% PDMS addition can be a long and continuous operation of the CO₂ absorption and regeneration experiments. It demonstrates the as-prepared PDMS/PVDF nanofibrous membranes could potentially be used for large-scale CO₂ absorption during the post-combustion process in power plants.

Keywords: CO₂ capture, electrospinning process, membrane contactor, nanofibrous membranes, PDMS/PVDF

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Authors: Adejoke Yemisi Ige

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This study presents a conceptual analysis and investigation into the development of a systematic framework required for better understanding of the social process of Alternative Dispute Resolution (ADR) and collective conciliation. The critical examination presented in this study is significant because; it draws on insight from ADR, negotiation and collective bargaining literature and applies it in our advancement of a methodical outline which gives an insight into the influence of the key actors and other stakeholder strategies and behaviours during dispute resolution in relation to the outcomes which is novel. This study is qualitative and essentially inductive in nature. One of the findings of the study confirms the need to consider ADR and collective conciliation within the context of the characteristic conditions; which focus on the need for some agreement to be reached. Another finding of the study shows the extent which information-sharing, willingness of the parties to negotiate and make concession assist both parties to attain resolution. This paper recommends that in order to overcome deadlock and attain acceptable outcomes at the end of ADR and collective conciliation, the importance of information exchange and sustenance of trade union and management relationship cannot be understated. The need for trade unions and management, the representatives to achieve their expectations in order to build the confidence and assurance of their respective constituents is essential. In conclusion, the analysis presented in this study points towards a set of factors that together can be called the social process of collective conciliation nevertheless; it acknowledges that its application to collective conciliation is new.

Keywords: alternative dispute resolution, collective conciliation, social process, theoretical framework, unveiling

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Authors: Mahasa Zahirnia

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The purpose of this paper is to explore new and effective ways of optimizing satellite images using artificial intelligence, and the process of implementing reinforcement learning to enhance the quality of data captured within the image. In our implementation of Bellman's Reinforcement Learning equations, associated state diagrams, and multi-stage image processing, we were able to enhance image quality, detect and define objects. Reinforcement learning is the differentiator in the area of artificial intelligence, and Q-Learning relies on trial and error to achieve its goals. The reward system that is embedded in Q-Learning allows the agent to self-evaluate its performance and decide on the best possible course of action based on the current and future environment. Results show that within a simulated environment, built on the images that are commercially available, the rate of detection was 40-90%. Reinforcement learning through Q-Learning algorithm is not just desired but required design criteria for image optimization and enhancements. The proposed methods presented are a cost effective method of resolving uncertainty of the data because reinforcement learning finds ideal policies to manage the process using a smaller sample of images.

Keywords: Q-learning, image optimization, reinforcement learning, Markov decision process

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Authors: W. J. Strydom, K. Puren

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Place-making is viewed here as an empowering process in which people represent, improve and maintain their spatial (natural or built) environment. With the above-mentioned in mind, place-making is multi-dimensional and include a spatial dimension (including visual properties or the end product/plan), a procedural dimension during which (negotiation/discussion of ideas with all relevant stakeholders in terms of end product/plan) and a psychological dimension (inclusion of intrinsic values and meanings related to a place in the end product/plan). These three represent dimensions of place-making. The purpose of this paper is to explore these dimensions of place-making in a case study of a local community in Ikageng, Potchefstroom, North-West Province, South Africa. This case study represents an inclusive process that strives to empower a local community (forcefully relocated due to Apartheid legislation in South Africa). This case study focussed on the inclusion of participants in the decision-making process regarding their daily environment. By means of focus group discussions and a collaborative design workshop, data is generated and ultimately creates a linkage with the theoretical dimensions of place-making. This paper contributes to the field of spatial planning due to the exploration of the dimensions of place-making and the relevancy of this process on spatial planning (especially in a South African setting).

Keywords: community engagement, place-making, planning theory, spatial planning

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Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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Authors: Mahmoudi Noureddine, Kaou Abdellah

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Energy absorption is a major requirement for automotive structures. Although crashworthy structures of composite based glass fiber have exhibited energy absorption greater than similar at other composites structures, the crush process in many cases is accompanied by fracture, rather than by plastic deformation. The crash experiments show that the tubes are crushed in progressive manner start from one end of the tubes and delamination takes place between the layers. To better understand details of the crash process, ABAQUS finite element code is used.

Keywords: Energy absorption, crash, PEHD

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Chinwe Okpoko, Vivian Atasie

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One of the leading causes of death amongst women of child-bearing age in southeast Nigeria is pregnancy. Women in the reproductive age group die at a higher rate than men of the same age bracket. Furthermore, most maternal deaths occur among poor women who live in rural communities, and who generally fall within the low socio-economic group in society. Failure of policy makers and the media to create the strategic awareness and communication that conform with the sensibilities of this group account, in part, for the persistence of this malaise. Family planning (FP) is an essential component of safe motherhood, which is designed to ensure that women receive high-quality care to achieve an optimum level of health of mother and infant. The aim is to control the number of children a woman can give birth to and prevent maternal and child mortality and morbidity. This is what sustainable development goal (SDG) health target of World Health Organization (WHO) also strives to achieve. FP programmes reduce exposure to the risks of child-bearing. Indeed, most maternal deaths in the developing world can be prevented by fully investing simultaneously in FP and maternal and new-born care. Given the intrinsic value of communication in health care delivery, it is vital to adopt the most efficacious means of awareness creation and communication amongst rural women in FP. In a country where over 50% of her population resides in rural areas with attendant low-level profile standard of living, the need to communicate health information like FP through indigenous channels becomes pertinent. Interpersonal communication amongst family, friends, religious groups and other associations, is an efficacious means of communicating social issues in rural Africa. Communication in informal settings identifies with the values and social context of the recipients. This study therefore sought to determine the place of interpersonal communication on the knowledge of rural women on FP and how it influences uptake of FP. Descriptive survey design was used in the study, with interviewer administered questionnaire constituting the instrument for data collection. The questionnaire was administered on 385 women from rural communities in southeast Nigeria. The results show that majority (58.5%) of the respondents agreed that interpersonal communication helps women understand how to plan their family size. Many rural women (82%) prefer the short term natural method to the more effective modern contraceptive methods (38.1%). Husbands’ approval of FP, as indicated in the Mean response of 2.56, is a major factor that accounts for the adoption of FP messages among rural women. Socio-demographic data also reveal that educational attainment and/or exposure influenced women’s acceptance or otherwise of FP messages. The study, therefore, recommends amongst others, the targeting of husbands in subsequent FP communication interventions, since they play major role on contraceptive usage.

Keywords: family planning, interpersonal communication, interpersonal interaction, traditional communication

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: H. Erbiyik, A. Bal, M. Sirakaya, Ö. Yesildal, E. Yolcu

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The emergence of many environmental issues began with the Industrial Revolution. The depletion of natural resources and emerging environmental challenges over time requires enterprises and managers to take into consideration environmental factors while managing business. If we take notice of these causes; the design and implementation of environmentally friendly green purchasing, production and waste management systems become very important at green logistics systems. Companies can adopt green supply chain with the awareness of these facts. The concept of green supply chain constitutes from green purchasing, green production, green logistics, waste management and reverse logistics. In this study, we wanted to identify the concept of green supply chain and why green supply chain should be applied. In the practice part of the study an analytic hierarchy process (AHP) study is conducted on an aluminum production company to evaluate suppliers.

Keywords: aluminum sector, analytic hierarchy process, decision making, green logistics

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Authors: Lydia Chan, Islam Shyha, Dale Dreyer, John Hamilton, Phil Hackney

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Nickel-based superalloys are generally known to be difficult to cut due to their strength, low thermal conductivity, and high work hardening tendency. Superalloy such as alloy 625 is often used in the oil and gas industry as a surfacing material to provide wear and corrosion resistance to components. The material is typically applied onto a metallic substrate through weld overlay cladding, an arc welding technique. Cladded surfaces are always rugged and carry a tough skin; this creates further difficulties to the machining process. The present work utilised design of experiment to optimise the internal cylindrical rough turning for weld overlay surfaces. An L27 orthogonal array was used to assess effects of the four selected key process variables: cutting insert, depth of cut, feed rate, and cutting speed. The optimal cutting conditions were determined based on productivity and the level of tool wear.

Keywords: cylindrical turning, nickel superalloy, turning of overlay, weld overlay

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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: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: F. Longo, G. Granello, G. Tecchio, F. Da Porto

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Unreinforced masonry (URM) infill walls are widely used throughout the world, also in seismic prone regions, as partitions in reinforced concrete building frames. Even if they do not represent structural elements, they can dramatically affect both strength and stiffness of RC structures by acting as a diagonal strut, modifying shear and displacements distribution along the building height, with uncertain consequences on structural safety. In the last decades, many refined models have been developed to describe infill walls effect on frame structural behaviour, but generally restricted to in-plane actions. Only very recently some new approaches were implemented to consider in-plane/out-of-plane interaction of URM infill walls in progressive collapse simulations. In the present work, a particularly promising macro-model was adopted for the progressive collapse analysis of infilled RC frames. The model allows to consider the bi-directional interaction in terms of displacement and strength capacity for URM infills, and to remove the infill contribution when the URM wall is supposed to fail during the analysis process. The model was calibrated on experimental data regarding two different URM panels thickness, modelling with particular care the post-critic softening branch. A frame specimen set representing the most common Italian structures was built considering two main normative approaches: a traditional design philosophy, corresponding to structures erected between 50’s-80’s basically designed to support vertical loads, and a seismic design philosophy, corresponding to current criteria that take into account horizontal actions. Non-Linear Static analyses were carried out on the specimen set and some preliminary evaluations were drawn in terms of different performance exhibited by the RC frame when the contemporary effect of the out-of-plane damage is considered for the URM infill.

Keywords: infill Panels macromodels, in plane-out of plane interaction, RC frames, URM infills

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Authors: Nizamuddin Zainuddin, Adam Mohd Saifudin, Ahmad Yusni Bahaudin, Mohd Hanizan Zalazilah, Roslan Jamaluddin

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Students’ enhanced experience through simulation is a crucial factor that brings reality to the classroom. The enhanced experience is all about developing, enriching and applications of a generic process flow in the field of logistics and transportations. As educational technology has improved, the effective use of simulations has greatly increased to the point where simulations should be considered a valuable, mainstream pedagogical tool. Additionally, in this era of ongoing (some say never-ending) assessment, simulations offer a rich resource for objective measurement and comparisons. Simulation is not just another in the long line of passing fads (or short-term opportunities) in educational technology. It is rather a real key to helping our students understand the world. It is a way for students to acquire experience about how things and systems in the world behave and react, without actually touching them. In short, it is about interactive pretending. Simulation is all about representing the real world which includes grasping the complex issues and solving intricate problems. Therefore, it is crucial before stimulate the real process of inbound and outbound logistics and transportation a generic process flow shall be developed. The paper will be focusing on the validization of the process flow by looking at the inputs gains from the sample. The sampling of the study focuses on multi-national and local manufacturing companies, third party companies (3PL) and government agency, which are selected in Peninsular Malaysia. A simulation flow chart was proposed in the study that will be the generic flow in logistics and transportation. A qualitative approach was mainly conducted to gather data in the study. It was found out from the study that the systems used in the process of outbound and inbound are System Application Products (SAP) and Material Requirement Planning (MRP). Furthermore there were some companies using Enterprises Resources Planning (ERP) and Electronic Data Interchange (EDI) as part of the Suppliers Own Inventories (SOI) networking as a result of globalized business between one countries to another. Computerized documentations and transactions were all mandatory requirement by the Royal Custom and Excise Department. The generic process flow will be the basis of developing a simulation program that shall be used in the classroom with the objective of further enhanced the students’ learning experience. Thus it will contributes to the body of knowledge on the enrichment of the student’s employability and also shall be one of the way to train new workers in the logistics and transportation filed.

Keywords: enhancement, simulation, process flow, logistics, transportation

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Authors: Gabriel Jinga, Madalina Dumitru

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The objective of this paper is to present the process of change in management accounting in Romania, a former communist country from Eastern Europe. In order to explain this process, we used the contingency and institutional theories. We focused on the following directions: the presentation of the scientific context and motivation of this research and the case study. We presented the state of the art in the process of change in the management accounting from the international and national perspective. We also described the evolution of management accounting in Romania in the context of economic and political changes. An important moment was the fall of communism in 1989. This represents a starting point for a new economic environment and for new management accounting. Accordingly, we developed a case study which presented this evolution. The conclusion of our research was that the changes in the management accounting system of the company analysed occurred in the same time with the institutionalisation of some elements (e.g. degree of competition, training and competencies in management accounting). The management accounting system was modelled by the contingencies specific to this company (e.g. environment, industry, strategy).

Keywords: management accounting, change, Romania, contingency and institutional theory

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Authors: Hyun-Woo Cho

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The monitoring of industrial production quality has to be implemented to alarm early warning for unusual operating conditions. Furthermore, identification of their assignable causes is necessary for a quality control purpose. For such tasks many multivariate statistical techniques have been applied and shown to be quite effective tools. This work presents a process data-based monitoring scheme for production processes. For more reliable results some additional steps of noise filtering and preprocessing are considered. It may lead to enhanced performance by eliminating unwanted variation of the data. The performance evaluation is executed using data sets from test processes. The proposed method is shown to provide reliable quality control results, and thus is more effective in quality monitoring in the example. For practical implementation of the method, an on-line data system must be available to gather historical and on-line data. Recently large amounts of data are collected on-line in most processes and implementation of the current scheme is feasible and does not give additional burdens to users.

Keywords: detection, filtering, monitoring, process data

Procedia PDF Downloads 562