Search results for: advance directives
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 688

Search results for: advance directives

688 Knowledge, Attitude and Practices Regarding Advance Directives among Resident Physicians in Vicente Sotto Memorial Medical Center

Authors: Marica Pidor-Quingco, Francis Cabatingan

Abstract:

Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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687 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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686 Let’s talk about it! Increasing Advance Directives and End-of-Life Planning Awareness & Acceptance in Multi-Cultural Population with Low Health Literacy in a Faith-Based Setting

Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

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685 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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684 Challenges and Practical Tips for Advance Care Planning and End-of-Life Communications With Cancer Patients in Global Pandemic

Authors: Poonam Goswami

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Background: The diagnosis of a serious illness like cancer can have an impact on a patient’s emotional well-being and may result in psychological symptoms, anxiety, depression, and loss of control. Advance care planning discussions ensure patients’ values and goals of care, including patients’ freedom to choose their place of death, are respected. Unfortunately, these discussions are often delayed and are not initiated early in patients’ cancer trajectory. As a result, patients’ wishes often remains unknown until the last phase of their life. Evidence suggests that many patients inappropriately receive aggressive treatment near the end of life, which does lead to higher resource utilization, decreased quality of life, and increased cost. Additionally, the novel coronavirus disease 2019 (COVID-19) pandemic challenged the health care systems worldwide and raised important ethical issues, especially regarding the potential need for rationing health care in the context of scarce resources and crisis capacity. The importance of goal concordant care is now even substantially important and is heightened in the context of this pandemic. Problem: Although there is growing evidence on the effects of the ACP on the completion of advanced directives, improved patient and family concordance for preferences for medical care, and receipt of care, there is still a lack of standardized ACP conversation strategies for patients with cancer. Methods: The Key concepts of ACP include (1) assessing patient and family readiness, (2) identifying a surrogate decision maker ( medical power of attorney), (3) exploring patient and family understanding of the disease and treatment options,(4) discussing the values and goals of care, and options for end-of-life care, (5) documenting patient preferences in the medical record, and (6) revisiting the discussions at every change in the treatment plan and /or change in clinical status, including at every hospitalization. Conclusion/Implication for practice: Advance Care Planning (ACP) and end-of-life (EOL) discussions are important for patients, families, and health care providers. Adopting the verbal and nonverbal communication strategies can help overcome the barriers to effective communication on these difficult discussions. ACP with goals of care discussions should not be delayed until the patient is hospitalized.

Keywords: advance care planning, end of life, cancer, global, pandemic

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683 Joint Optimal Pricing and Lot-Sizing Decisions for an Advance Sales System under Stochastic Conditions

Authors: Maryam Ghoreishi, Christian Larsen

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In this paper, we investigate the effect of stochastic inputs on problem of joint optimal pricing and lot-sizing decisions where the inventory cycle is divided into advance and spot sales periods. During the advance sales period, customer can make reservations while customer with reservations can cancel their order. However, during the spot sales period customers receive the order as soon as the order is placed, but they cannot make any reservation or cancellation during that period. We assume that the inter arrival times during the advance sales and spot sales period are exponentially distributed where the arrival rate is decreasing function of price. Moreover, we assume that the number of cancelled reservations is binomially distributed. In addition, we assume that deterioration process follows an exponential distribution. We investigate two cases. First, we consider two-state case where we find the optimal price during the spot sales period and the optimal price during the advance sales period. Next, we develop a generalized case where we extend two-state case also to allow dynamic prices during the spot sales period. We apply the Markov decision theory in order to find the optimal solutions. In addition, for the generalized case, we apply the policy iteration algorithm in order to find the optimal prices, the optimal lot-size and maximum advance sales amount.

Keywords: inventory control, pricing, Markov decision theory, advance sales system

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682 Effect of Ausubel's Advance Organizer Model to Enhancing Meta-Cognition of Students at Secondary Level

Authors: Qaisara Parveen, M. Imran Yousuf

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The purpose of this study was to find the effectiveness of the use of advance organizer model for enhancing meta-cognition of students in the subject of science. It was hypothesized that the students of experimental group taught through advance organizer model would show the better cognition than the students of control group taught through traditional teaching. The population of the study consisted of all secondary school students studying in government high school located in Rawalpindi. The sample of the study consisted of 50 students of 9th class of humanities group. The sample was selected on the basis of their pretest scores through matching, and the groups were randomly assigned for the treatment. The experimental group was taught through advance organizer model while the control group was taught through traditional teaching. The self-developed achievement test was used for the purpose of pretest and posttest. After collecting the pre-test score and post-test score, the data was analyzed and interpreted by use of descriptive statistics as mean and standard deviation and inferential statistics t-test. The findings indicate that students taught using advance organizers had a higher level of meta-cognition as compared to control group. Further, meta cognition level of boys was found higher than that of girls students. This study also revealed the fact that though the students at different meta-cognition level approached learning situations in a different manner, Advance organizer model is far superior to Traditional method of teaching.

Keywords: descriptive, experimental, humanities, meta-cognition, statistics, science

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681 Individual Cylinder Ignition Advance Control Algorithms of the Aircraft Piston Engine

Authors: G. Barański, P. Kacejko, M. Wendeker

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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

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680 Maximising the Therapeutic Value of the Mental Capacity Act of Singapore for People Who Lack Legal Capacity

Authors: Kenji Gwee

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The Mental Capacity Act is a new legislation that allows for lasting powers of attorney and court-appointed deputies, in respect of people who lack legal capacity. While the UK Act, after which the Singapore Act is modeled, has been shown to be therapeutic to donors, the Singapore Act differs from its UK counterpart and it is unclear if the Singapore Act can be beneficial to donors as purported. The purpose of this study was to determine what the perceptions of three groups of stakeholders (patients, caregivers and psychiatrists) are about the aspects of the Mental Capacity Act that are therapeutic to donors. In addition, ways to increase the therapeutic value of the Act to donors are sought. A qualitative methodology was used and the research was guided by two theoretical frameworks: therapeutic jurisprudence and an interpretive constructive framework. Interviews with 12 psychiatrists, and focus groups with twenty three patients and seven caregivers showed agreement that, allowing donors to nominate more than one decision- maker, and whistle-blowing mechanisms for recourse for abuse, were therapeutic to donors. To further increase the therapeutic value of the Act, 2 suggestions were made: the Act should provide for (i) advanced healthcare directives- allowing donors to make advance decisions to refuse treatment, or cease existing treatment, and (ii) independent advocacy services- to have a case worker to represent people who have no family or friends and are thus unable to find suitable donees.

Keywords: Mental Capacity Act, therapeutic jurisprudence, qualitative methodology, the UK Act

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679 The Passive Recipient – How the Pupil Comes across in Local Swedish Health Policy Documents

Authors: Zofia Hammerin, Goran Basic, Disa Bergnehr

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Ever since the Ottawa charter in 1986, health promotion through schools has been stressed across the globe. Both in the global and national discourse, schools are made responsible not only for providing education but also for working with pupil health and well-being. In Sweden, where the study is set, it is emphasized in national directives that promoting pupil health should be part of the school practice. Since the Swedish school system is decentralized, these directives need to be interpreted and recontextualized locally. This study aims to explore how the student comes across in Swedish local health policy documents. The data consists of 37 such documents called student health plans collected from different high schools throughout Sweden. The analysis was inspired by critical discourse analysis, and tentative results are divided into two main themes; the invisible actor and the passive recipient. The pupil is largely invisible in the documents, and the discourse instead focuses on school health service staff and, to some extent, the teachers. When the pupils are visible, they mainly come across as passive recipients of health promoting actions. Since participation, taking action, and feeling empowered are key aspects of health promotion, the findings could impact the pupils’ possibilities for health and well-being.

Keywords: health promotion, high school, student, sweden

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678 Advocating for and Implementing the Use of Advance Top Bar (ATB) for a More Than 100% Increase in Honey Yield in Top Bar Hives Owing to Honey Harvesting Without Comb Destruction

Authors: Perry Ayi Mankattah

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Introduction: Africa, which should lead the world in honey production, is importing three times the honey it produces even though it has a healthy, industrious and large population of bees. This is due to the mechanism of honey harvesting that destroys the combs and thereby reducing honey production and rate of harvesting. For Africa to take its place in the world of honey production, Africa should adopt a method that enables a higher rate of honey harvesting. The Advance Top Bar is, therefore, a simplified framework that provides that answer. It can be made of wood, plastic and metal that can be fabricated by tin/metal smiths, wielders and carpenters at the village level without any very sophisticated machines. Material and Methods: ATB is a top bar-like hollow framework of dimension 3.2*48 cm that can be made of wood, plastic and metal. It is made up of three parts of a constant hollow top bar, a variable grooved bottom bar with both bars being joined through synchronized holes (that align both the top and bottom bars ) by either metal or plastic rods of length 22cm and diameter of 5 mm with rounded balls at both ends It could be used with foundation combs or without and also other accessories to have about ten (10) function which includes commercial propolis harvesting queen rearing etc. The variable bottom bar length depends on the width of the hive, as most African beehives are somehow not standardized. Results: Foundation combs are placed within the Advance Top Bar for the bees to form their combs over its mesh to prevent comb breakage during honey harvesting. Similarly, honeycombs on top bars will produce natural foundation combs when also placed in the Advance top bar system just as they are re-used in the Langstroth Frames. Discussions and Conclusions: Any modification that will promote non-comb destruction during honey harvesting in Top bars shall cause Africa to increase honey production by over 100% as beekeepers adopt the mechanism. Honey-laden combs from the current normal top bars could be placed in the Advance Top Bar to harvest without comb destruction; hence the same system could be used as a transition to the adoption of the Advance Top Bar with less cost.

Keywords: honey, harvest, increase, production

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677 Development and Performance Analysis of Multifunctional City Smart Card System

Authors: Vedat Coskun, Fahri Soylemezgiller, Busra Ozdenizci, Kerem Ok

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In recent years, several smart card solutions for transportation services of cities with different technical infrastructures and business models has emerged considerably, which triggers new business and technical opportunities. In order to create a unique system, we present a novel, promising system called Multifunctional City Smart Card System to be used in all cities that provides transportation and loyalty services based on the MasterCard M/Chip Advance standards. The proposed system provides a unique solution for transportation services of large cities over the world, aiming to answer all transportation needs of citizens. In this paper, development of the Multifunctional City Smart Card System and system requirements are briefly described. Moreover, performance analysis results of M/Chip Advance Compatible Validators which is the system's most important component are presented.

Keywords: smart card, m/chip advance standard, city transportation, performance analysis

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676 Knowledge about Dementia: Why Should Family Caregivers Know that Dementia is a Terminal Disease?

Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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675 Addressing Head Transplantation and Its Legal, Social and Neuroethical Implications

Authors: Joseph P. Mandala

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This paper examines the legal and medical ethics concerns, which proponents of human head transplantation continue to defy since the procedure was first attempted on dogs in 1908. Despite recent bioethical objections, proponents have proceeded with radical experimentation, claiming transplantation would treat incurable diseases and improve patients’ quality of life. In 2018, Italian neurosurgeon, Sergio Canavero, and Dr. Xiaoping Ren claimed to have performed a head transplant on a corpse in China. Content analysis of literature shows that the procedure failed to satisfy scientific, legal, and bioethical elements because, unlike humans, corpses cannot coordinate function. Putting a severed head onto a body that has been dead for several days is not equivalent to a transplant which would require successfully reconnecting and restoring function to a spinal cord. While reconnection without restoration of bodily function is not transplantation, the publicized procedure on animals and corpses could leapfrog to humans, sparking excitement in society likely to affect organ donors and recipients from territorial jurisdictions with varying legal and ethical regimes. As neurodiscoveries generate further excitement, the need to preemptively address the legal and medical ethics impact of head transplantation in our society cannot be overstated. A preemptive development of methods to address the impact of head transplantation will help harmonizing national and international laws on organ donations, advance directives, and laws affecting end of life.

Keywords:

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674 Solution of Singularly Perturbed Differential Difference Equations Using Liouville Green Transformation

Authors: Y. N. Reddy

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The class of differential-difference equations which have characteristics of both classes, i.e., delay/advance and singularly perturbed behaviour is known as singularly perturbed differential-difference equations. The expression ‘positive shift’ and ‘negative shift’ are also used for ‘advance’ and ‘delay’ respectively. In general, an ordinary differential equation in which the highest order derivative is multiplied by a small positive parameter and containing at least one delay/advance is known as singularly perturbed differential-difference equation. Singularly perturbed differential-difference equations arise in the modelling of various practical phenomena in bioscience, engineering, control theory, specifically in variational problems, in describing the human pupil-light reflex, in a variety of models for physiological processes or diseases and first exit time problems in the modelling of the determination of expected time for the generation of action potential in nerve cells by random synaptic inputs in dendrites. In this paper, we envisage the use of Liouville Green Transformation to find the solution of singularly perturbed differential difference equations. First, using Taylor series, the given singularly perturbed differential difference equation is approximated by an asymptotically equivalent singularly perturbation problem. Then the Liouville Green Transformation is applied to get the solution. Several model examples are solved, and the results are compared with other methods. It is observed that the present method gives better approximate solutions.

Keywords: difference equations, differential equations, singular perturbations, boundary layer

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673 Applied Mathematical Approach on “Baut” Special High Performance Metal Aggregate by Formulation and Equations

Authors: J. R. Bhalla, Gautam, Gurcharan Singh, Sanjeev Naval

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Mathematics is everywhere behind the every things on the earth as well as in the universe. Predynastic Egyptians of the 5th millennium BC pictorially represented geometric designs. Now a day’s we can made and apply an equation on a complex geometry through applied mathematics. Here we work and focus on to create a formula which apply in the field of civil engineering in new concrete technology. In this paper our target is to make a formula which is applied on “BAUT” Metal Aggregate. In this paper our approach is to make formulation and equation on special “BAUT” Metal Aggregate by Applied Mathematical Study Case 1. BASIC PHYSICAL FORMULATION 2. ADVANCE EQUATION which shows the mechanical performance of special metal aggregates for concrete technology. In case 1. Basic physical formulation shows the surface area and volume manually and in case 2. Advance equation shows the mechanical performance has been discussed, the metal aggregates which had outstandingly qualities to resist shear, tension and compression forces. In this paper coarse metal aggregates is 20 mm which used for making high performance concrete (H.P.C).

Keywords: applied mathematical study case, special metal aggregates, concrete technology, basic physical formulation, advance equation

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672 Release Response of Black Spruce and White Spruce Following Overstory Lodgepole Pine Mortality Due to Mountain Pine Beetle Attack

Authors: F. O. Oboite, P. G. Comeau

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Advance regeneration is present in many lodgepole pine stands in Alberta. When the overstory pine canopy is killed by Mountain Pine Beetle (MPB) the growth of this advance is likely to increase. Understanding the growth response of these understory tree species is needed to improve mid-term timber supply projections and management decisions. To quantify the growth (diameter, height, height/diameter ratio) responses of black spruce and white spruce to lodgepole pine mortality, sample trees of black and white spruce advance regeneration were selected from 7 lodgepole pine dominated stands (5 attacked; 2 control) in the Foothills Region of western Alberta. Measurements were collected 7-8 years after MPB attack across a wide range of spruce height and stand densities. Analysis was done using mixed model linear regression. Result indicates that there was an increase in both diameter and height growth after MPB attack; however, this increase in growth was delayed for about four years. Both spruce species had similar height response and their height/diameter ratio decreased after release, partly as a result of increased understory light associated with loss of needles in the pine canopy. In addition, the diameter and height growth responses of both spruce species were strongly related to density, prerelease growth and initial size.

Keywords: mountain pine beetle, forest regeneration, lodgepole pine, growth response

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671 Efficient Relay Selection Scheme Utilizing OVSF Code in Cooperative Communication System

Authors: Yeong-Seop Ahn, Myoung-Jin Kim, Young-Min Ko, Hyoung-Kyu Song

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This paper proposes a relay selection scheme utilizing an orthogonal variable spreading factor (OVSF) code in a cooperative communication. The relay selection scheme influences on the communication performance in the cooperative communication. Conventional relay selection schemes such as the best harmonic mean relay selection scheme or the threshold-based relay selection scheme should know information such as channel state information (CSI) in advance. The proposed relay selection scheme does not require information in advance by using a reference signal utilizing the OVSF code. The simulation result shows that bit error rate (BER) performance of proposed relay selection scheme is similar to the best harmonic mean relay selection scheme that is known as one of the optimal relay selection schemes.

Keywords: cooperative communication, relay selection, OFDM, OVSF code

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670 Some Yield Parameters of Wheat Genotypes

Authors: Shatha A. Yousif, Hatem Jasim, Ali R. Abas, Dheya P. Yousef

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To study the effect of the cross direction in bead wheat, three hybrid combinations (Babyle 113 , Iratome), (Sawa , Tamose2) and (Al Hashymya Al Iraq) were tested for plant height, number of tillers/m, number of grains per spike, weight of grains per spike, 1000-grain weight and grain yield. The results revealed that the direction of the cross had significant effect the number of grain/spike, tillers/m and grain yields. Grain yield was positively and significantly correlated with 1000-grain weight, number of grains per spike and tillers. Depend on the result of heritability and genetic advance it was suggested that 1000-grain weight number of grains per spike and tillers should be given emphasis for future wheat yield improvement programs.

Keywords: correlation, genetic advance, heritability, wheat, yield traits

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669 Genetic Trait Analysis of RIL Barley Genotypes to Sort-out the Top Ranked Elites for Advanced Yield Breeding Across Multi Environments of Tigray, Ethiopia

Authors: Hailekiros Tadesse Tekle, Yemane Tsehaye, Fetien Abay

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Barley (Hordeum vulgare L.) is one of the most important cereal crops in the world, grown for the poor farmers in Tigray with low yield production. The purpose of this research was to estimate the performance of 166 barley genotypes against the quantitative traits with detailed analysis of the variance component, heritability, genetic advance, and genetic usefulness parameters. The finding of ANOVA was highly significant variation (p ≤ 0:01) for all the genotypes. We found significant differences in coefficient of variance (CV of 15%) for 5 traits out of the 12 quantitative traits. The topmost broad sense heritability (H2) was recorded for seeds per spike (98.8%), followed by thousand seed weight (96.5%) with 79.16% and 56.25%, respectively, of GAM. The traits with H2 ≥ 60% and GA/GAM ≥ 20% suggested the least influenced by the environment, governed by the additive genes and direct selection for improvement of such beneficial traits for the studied genotypes. Hence, the 20 outstanding recombinant inbred lines (RIL) barley genotypes performing early maturity, high yield, and 1000 seed weight traits simultaneously were the top ranked group barley genotypes out of the 166 genotypes. These are; G5, G25, G33, G118, G36, G123, G28, G34, G14, G10, G3, G13, G11, G32, G8, G39, G23, G30, G37, and G26. They were early in maturity, high TSW and GYP (TSW ≥ 55 g, GYP ≥ 15.22 g/plant, and DTM below 106 days). In general, the 166 genotypes were classified as high (group 1), medium (group 2), and low yield production (group 3) genotypes in terms of yield and yield component trait analysis by clustering; and genotype parameter analysis such as the heritability, genetic advance, and genetic usefulness traits in this investigation.

Keywords: barley, clustering, genetic advance, heritability, usefulness, variability, yield

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668 Treatment of Cutting Oily-Wastewater by Sono-Fenton Process: Experimental Approach and Combined Process

Authors: Pisut Painmanakul, Thawatchai Chintateerachai, Supanid Lertlapwasin, Nusara Rojvilavan, Tanun Chalermsinsuwan, Nattawin Chawaloesphonsiya, Onanong Larpparisudthi

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Conventional coagulation, advance oxidation process (AOPs), and the combined process were evaluated and compared for its suitability to treat the stabilized cutting-oil wastewater. The 90% efficiency was obtained from the coagulation at Al2(SO4)3 dosage of 150 mg/L and pH 7. On the other hands, efficiencies of AOPs for 30 minutes oxidation time were 10% for acoustic oxidation, 12% for acoustic oxidation with hydrogen peroxide, 76% for Fenton, and 92% sono-Fenton processes. The highest efficiency for effective oil removal of AOPs required large amount of chemical. Therefore, AOPs were studied as a post-treatment after conventional separation process. The efficiency was considerable as the effluent COD can pass the standard required for industrial wastewater discharge with less chemical and energy consumption.

Keywords: cutting oily-wastewater, advance oxidation process, sono-fenton, combined process

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667 The Verification Study of Computational Fluid Dynamics Model of the Aircraft Piston Engine

Authors: Lukasz Grabowski, Konrad Pietrykowski, Michal Bialy

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This paper presents the results of the research to verify the combustion in aircraft piston engine Asz62-IR. This engine was modernized and a type of ignition system was developed. Due to the high costs of experiments of a nine-cylinder 1,000 hp aircraft engine, a simulation technique should be applied. Therefore, computational fluid dynamics to simulate the combustion process is a reasonable solution. Accordingly, the tests for varied ignition advance angles were carried out and the optimal value to be tested on a real engine was specified. The CFD model was created with the AVL Fire software. The engine in the research had two spark plugs for each cylinder and ignition advance angles had to be set up separately for each spark. The results of the simulation were verified by comparing the pressure in the cylinder. The courses of the indicated pressure of the engine mounted on a test stand were compared. The real course of pressure was measured with an optical sensor, mounted in a specially drilled hole between the valves. It was the OPTRAND pressure sensor, which was designed especially to engine combustion process research. The indicated pressure was measured in cylinder no 3. The engine was running at take-off power. The engine was loaded by a propeller at a special test bench. The verification of the CFD simulation results was based on the results of the test bench studies. The course of the simulated pressure obtained is within the measurement error of the optical sensor. This error is 1% and reflects the hysteresis and nonlinearity of the sensor. The real indicated pressure measured in the cylinder and the pressure taken from the simulation were compared. It can be claimed that the verification of CFD simulations based on the pressure is a success. The next step was to research on the impact of changing the ignition advance timing of spark plugs 1 and 2 on a combustion process. Moving ignition timing between 1 and 2 spark plug results in a longer and uneven firing of a mixture. The most optimal point in terms of indicated power occurs when ignition is simultaneous for both spark plugs, but so severely separated ignitions are assured that ignition will occur at all speeds and loads of engine. It should be confirmed by a bench experiment of the engine. However, this simulation research enabled us to determine the optimal ignition advance angle to be implemented into the ignition control system. This knowledge allows us to set up the ignition point with two spark plugs to achieve as large power as possible.

Keywords: CFD model, combustion, engine, simulation

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666 Aqua Logo Design 2013 Decomposition and Meanings

Authors: Peni Rizki

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This article presents decomposition on Aqua logo design 2013 as well as exploration on the meanings denoting marketing resolution. In the analysis, it is described decomposition details on Aqua logo design 2013, a semiotics implementation on marketing enterprise. 2013’s design is different in parts from its first establishment in 1973. Upon that, design elements such as pictures and colors are examined in semiotic theories of sign utilized as directives to the meaning constructed. Each part of the design is analyzed based on its significations that generate denotation and connotation as well as myth. At the end will be concluded the converses of Aqua logo design 2013 in reflection to its initiated marketing creativity; what pictures and colors do in it.

Keywords: design, aqua, semiotics, signification

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665 Prediction of Rotating Machines with Rolling Element Bearings and Its Components Deterioration

Authors: Marimuthu Gurusamy

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In vibration analysis (with accelerometers) of rotating machines with rolling element bearing, the customers are interested to know the failure of the machine well in advance to plan the spare inventory and maintenance. But in real world most of the machines fails before the prediction of vibration analyst or Expert analysis software. Presently the prediction of failure is based on ISO 10816 vibration limits only. But this is not enough to monitor the failure of machines well in advance. Because more than 50% of the machines will fail even the vibration readings are within acceptable zone as per ISO 10816.Hence it requires further detail analysis and different techniques to predict the failure well in advance. In vibration Analysis, the velocity spectrum is used to analyse the root cause of the mechanical problems like unbalance, misalignment and looseness etc. The envelope spectrum are used to analyse the bearing frequency components, hence the failure in inner race, outer race and rolling elements are identified. But so far there is no correlation made between these two concepts. The author used both velocity spectrum and Envelope spectrum to analyse the machine behaviour and bearing condition to correlated the changes in dynamic load (by unbalance, misalignment and looseness etc.) and effect of impact on the bearing. Hence we could able to predict the expected life of the machine and bearings in the rotating equipment (with rolling element bearings). Also we used process parameters like temperature, flow and pressure to correlate with flow induced vibration and load variations, when abnormal vibration occurs due to changes in process parameters. Hence by correlation of velocity spectrum, envelope spectrum and process data with 20 years of experience in vibration analysis, the author could able to predict the rotating Equipment and its component’s deterioration and expected duration for maintenance.

Keywords: vibration analysis, velocity spectrum, envelope spectrum, prediction of deterioration

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664 Sustainable Lessons learnt from the attitudes of Language Instructors towards Computer Assisted Language Teaching (CALT)

Authors: Theophilus Adedokun, Sylvia Zulu, Felix Awung, Sam Usadolo

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The proliferation of technology into teaching process has brought about transformation into the field of education. Language teaching is not left behind from this tremendous transformation which has drastically altered the teaching of language. It is, however, appalling that some language instructors seem to possess negative attitudes toward the use of technology in language teaching, which in this study is referred to as Computer Assisted Language Teaching (CALT). The purpose of this study, therefore, is to explore sustainable lesson that can be learnt from the attitudes of language instructors towards language teaching in some public universities. The knowledge gained from this study could inform and advance the use of Computer Assisted Language Teaching. This study considers the historical progression of CALT and recommends that a fundamental approach is required for institutions to develop and advance the use of CALT for teaching. A review of sustainable lessons learnt from the attitudes of language instructors towards CALT are provided, and the CALT experience of 3 institutions are described. Drawing from this succinct description, this study makes recommendations on how operative CALT could be executed on a personal and institutional basis.

Keywords: attitudes, language instructors, sustainable lessons, computer assisted language teaching

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663 Assistive Technologies and the 'Myth' of Independent Living: A Sociological Understanding of Assistive Technologies for Locomotor Disabled in India

Authors: Pavani K. Sree, Ragahava Reddy Chandri

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Independent living and living with dignity have been the hallmarks of the movement of the persons with disabilities across the globe against the oppression perpetuated by society in the form of social and physical structural barriers. Advancements in assistive technologies have been providing a new lease of life to persons with disabilities. However, access to these technologies is marred by the issues of affordability and availability. Poor from the developing countries find it difficult to make independent living or live with dignity because of lack of access and inability to afford the advance technologies. Class and gender appear to be key factors influencing the access to modern assistive technologies. The present paper attempts to understand the dynamics of class and gender in accessing advanced technologies in the Indian context. Based on an empirical study in which data were collected from persons with locomotor disabilities and service providers, the paper finds that the advance technologies are expensive and inaccessible to all persons with disabilities. The paper also finds that men with disabilities are prioritized by the members of the family for the use of advance technologies while women with disabilities are forced to live with not so advanced technologies. The paper finds that the state institutions working in the field of prosthetics and assistive technologies fail to deliver to the requirements of the poor. It was found that because of lack of facilities at the state institutions the cost of prosthetics, in the case of orthopedically challenged, is expensive and unaffordable for the poor. It was found that while rich male access the private services the poor women depend on the state institutions. It may be said that the social, cultural stereotypes extend not only to the state organizations but also to the use of prosthetics. Thus the notions of independent living and living with dignity in third world countries context are still elusive.

Keywords: accessibility, assistive technology, class, gender, state

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662 The Speech Act Responses of Students on the Teacher’s Request in the EFL Classroom

Authors: Agis Andriani

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To create an effective teaching condition, the teacher requests the students as the instruction to guide the them interactively in the learning activities in the classroom. This study involves 160 Indonesian students who study English in the university, as participants in the discourse completion test, and ten of them are interviewed. The result shows that when the students response the teacher’s request, it realizes assertives, directives, commisives, expressives, and declaratives. These indicate that the students are active, motivated, and responsive in the learning process, although in the certain condition these responses are to prevent their faces from the shyness of their silence in interaction. Therefore, it needs the teacher’s creativity to give the conducive atmosphere in order to support the students’ participation in learning English.

Keywords: discourse completion test, effective teaching, request, teacher’s creativity

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661 Variability Parameters for Growth and Yield Characters in Fenugreek, Trigonella spp. Genotypes

Authors: Anita Singh, Richa Naula, Manoj Raghav

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India is a leading producer and consumer of fenugreek for its culinary uses and medicinal application. In India, most of the people are of vegetarian class. In such a situation, a leafy vegetable, such as fenugreek is of chief concern due to its high nutritional property, medicinal values and industrial uses. One of the most important factors restricting their large scale production and development of superior varieties is that very scanty knowledge about their genetic diversity, inter and intraspecific variability and genetic relationship among the species. Improvement of the crop depends upon the magnitude of genetic variability for economic characters. Therefore, the present research work was carried out to analyse the variability parameters for growth and yield character in twenty-eight fenugreek genotypes along with two standard checks Pant Ragini and Pusa Early Bunching. The experiment was laid out in Randomized Block Design with three replication during rabi season 2015-2016 at Pantnagar Centre for Plant Genetic Resources, G.B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand. The analysis of variance revealed highly significant differences among all the genotypes for all traits. High genotypic and phenotypic coefficient variation were observed for characters, namely the number of primary branches per plant, number of leaves at 30, 45 and 60 DAS, green leaf yield per plant, green leaf yield q/ha . The genetic advance recorded highest in green leaf yield q/ha (33.93) followed by green leaf yield per plant (21.20g). Highest percent of heritability were shown by 1000 seed weight (99.12%) followed by the number of primary branches per plant (97.18%). Green leaf yield q/ha showed high heritability and high genetic advance. These superior genotypes can be further used in crop improvement programs of fenugreek.

Keywords: genetic advance, genotypic coefficient variation, heritability, phenotypic coefficient variation

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660 Competitive Advantage Challenges in the Apparel Manufacturing Industries of South Africa: Application of Porter’s Factor Conditions

Authors: Sipho Mbatha, Anne Mastament-Mason

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South African manufacturing global competitiveness was ranked 22nd (out of 38 countries), dropped to 24th in 2013 and is expected to drop further to 25th by 2018. These impacts negatively on the industrialisation project of South Africa. For industrialization to be achieved through labour intensive industries like the Apparel Manufacturing Industries of South Africa (AMISA), South Africa needs to identify and respond to factors negatively impacting on the development of competitive advantage This paper applied factor conditions from Porter’s Diamond Model (1990) to understand the various challenges facing the AMISA. Factor conditions highlighted in Porter’s model are grouped into two groups namely, basic and advance factors. Two AMISA associations representing over 10 000 employees were interviewed. The largest Clothing, Textiles and Leather (CTL) apparel retail group was also interviewed with a government department implementing the industrialisation policy were interviewed The paper points out that while AMISA have basic factor conditions necessary for competitive advantage in the clothing and textiles industries, Advance factor coordination has proven to be a challenging task for the AMISA, Higher Education Institutions (HEIs) and government. Poor infrastructural maintenance has contributed to high manufacturing costs and poor quick response as a result of lack of advanced technologies. The use of Porter’s Factor Conditions as a tool to analyse the sector’s competitive advantage challenges and opportunities has increased knowledge regarding factors that limit the AMISA’s competitiveness. It is therefore argued that other studies on Porter’s Diamond model factors like Demand conditions, Firm strategy, structure and rivalry and Related and supporting industries can be used to analyse the situation of the AMISA for the purposes of improving competitive advantage.

Keywords: compliance rule, apparel manufacturing industry, factor conditions, advance skills and South African industrial policy

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659 Green Innovation and Artificial Intelligence in Service

Authors: Fatemeh Khalili Varnamkhasti

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Numerous nations have recognized the critical ought to address natural issues, such as discuss contamination, squander transfer, worldwide warming, and common asset consumption, through the application of green innovation. The rise of cleverly advances has driven mechanical basic changes that will offer assistance accomplish carbon decrease. Manufactured insights (AI) innovation is an imperative portion of digitalization, giving unused mechanical apparatuses and bearings for the moo carbon advancement of endeavors. Quickening the brilliantly change of fabricating industry is an critical vital choice to realize the green advancement change. The reason why fabricating insights can advance the advancement of green advancement execution is that fabricating insights is conducive to the generation of "innovation advancement impact" and "fetched decrease impact" so as to advance green innovation advancement, at that point viably increment the alluring yields and essentially diminish the undesirable yields. AI improvement will boost GTI as it were when the escalated of natural direction and organization environment is over a certain edge esteem. In any case, the AI improvement spoken to by mechanical robot applications still has no self-evident impact on GTI, indeed, when the R&D venture surpasses a certain edge.

Keywords: greenhouse gas emissions, green infrastructure, artificial intelligence, environmental protection

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