Search results for: mobilization delays
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 470

Search results for: mobilization delays

440 Malnutrition Among Adult Hospitalized Orthopedic Patients: Nursing Role And Nutrition Screening

Authors: Ehsan Ahmed Yahia

Abstract:

Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

Procedia PDF Downloads 74
439 Identifying Project Delay Factors in the Australian Construction Industry

Authors: Syed Sohaib Bin Hasib, Hiyam Al-Kilidar

Abstract:

Meeting project deadlines is a major challenge for most construction projects. In this study, perceptions of contractors, clients, and consultants are compared relative to a list of factors derived from the review of the extant literature on project delay. 59 causes (categorized into 8 groups) of project delays were identified from the literature. A survey was devised to get insights and ranking of these factors from clients, consultants & contractors in the Australian construction industry. Findings showed that project delays in the Australian construction industry are mainly the result of skill shortages, interference in execution, and poor coordination and communication between the project stakeholders.

Keywords: construction, delay factors, time delay, australian construction industry

Procedia PDF Downloads 142
438 Delay-Independent Closed-Loop Stabilization of Neutral System with Infinite Delays

Authors: Iyai Davies, Olivier L. C. Haas

Abstract:

In this paper, the problem of stability and stabilization for neutral delay-differential systems with infinite delay is investigated. Using Lyapunov method, new delay-independent sufficient condition for the stability of neutral systems with infinite delay is obtained in terms of linear matrix inequality (LMI). Memory-less state feedback controllers are then designed for the stabilization of the system using the feasible solution of the resulting LMI, which are easily solved using any optimization algorithms. Numerical examples are given to illustrate the results of the proposed methods.

Keywords: infinite delays, Lyapunov method, linear matrix inequality, neutral systems, stability

Procedia PDF Downloads 405
437 Role of Additional Food Resources in an Ecosystem with Two Discrete Delays

Authors: Ankit Kumar, Balram Dubey

Abstract:

This study proposes a three dimensional prey-predator model with additional food, provided to predator individuals, including gestation delay in predators and delay in supplying the additional food to predators. It is assumed that the interaction between prey and predator is followed by Holling type-II functional response. We discussed the steady states and their local and global asymptotic behavior for the non-delayed system. Hopf-bifurcation phenomenon with respect to different parameters has also been studied. We obtained a range of predator’s tendency factor on provided additional food, in which the periodic solutions occur in the system. We have shown that oscillations can be controlled from the system by increasing the tendency factor. Moreover, the existence of periodic solutions via Hopf-bifurcation is shown with respect to both the delays. Our analysis shows that both delays play an important role in governing the dynamics of the system. It changes the stability behavior into instability behavior. The direction and stability of Hopf-bifurcation are also investigated through the normal form theory and the center manifold theorem. Lastly, some numerical simulations and graphical illustrations have been carried out to validate our analytical findings.

Keywords: additional food, gestation delay, Hopf-bifurcation, prey-predator

Procedia PDF Downloads 105
436 Youth Branches of the Ruling Political Party as an Intersection Point: An Examination in Context of Capital Type

Authors: Merve Ak Efe

Abstract:

Youth branches in Turkey are one of the sub-fields where political ideologies are intersected with daily life practices. When the youth branches are examined within the framework of daily life practices, a social area can be defined where many types of capital turn into gains. The relationship between politics and capital is not only financial but can also be observed in the form of social, cultural, or emotional capital. This paper examines the political mobilization of young people who are members of the Youth Branch of the Justice and Development Party. The reason why JDP (Adalet ve Kalkınma Partisi) was chosen is that they have been the ruling party for twenty years, and there is a considerable number of young members within the party. Since Bayrampaşa is a district where JDP is politically active, This study is based on Bayrampaşa youth branches. The study examines how young people who are members of the party are mobilized and the everyday life practices and emotions underlying this mobilization. The data was collected through in-depth interviews with 13 young people, and the participant observation method was applied at the weekly meetings of the Justice and Development Party Bayrampaşa Youth Branch. Youth Branches represent a political space in which emotions turn into action for the young people who are involved in the party. During the field study at the micro level, it has been observed that the Bayrampaşa JDP Youth Branch hosted a transformation that incorporates political and social practices into modern tactics. One of the other results shows that being a member of youth branches causes a significant rise in social capital for young people. On the other hand, for the members with low cultural capital, there is an increase in social capital; however, an increase in cultural capital is not prominent.

Keywords: political mobilization, everyday practices, emotional capital, social capital, cultural capital

Procedia PDF Downloads 94
435 Step Method for Solving Nonlinear Two Delays Differential Equation in Parkinson’s Disease

Authors: H. N. Agiza, M. A. Sohaly, M. A. Elfouly

Abstract:

Parkinson's disease (PD) is a heterogeneous disorder with common age of onset, symptoms, and progression levels. In this paper we will solve analytically the PD model as a non-linear delay differential equation using the steps method. The step method transforms a system of delay differential equations (DDEs) into systems of ordinary differential equations (ODEs). On some numerical examples, the analytical solution will be difficult. So we will approximate the analytical solution using Picard method and Taylor method to ODEs.

Keywords: Parkinson's disease, step method, delay differential equation, two delays

Procedia PDF Downloads 177
434 The Kidney-Spine Traffic System: Future Cities, Ensuring World Class Civic Amenities in Urban India

Authors: Abhishek Srivastava, Jeevesh Nandan, Manish Kumar

Abstract:

The study was taken to analyse the alternative source of traffic system for effective and more convenient traffic flow by reducing points of conflicts as well as angle of conflict and keeping in view to minimize the problem of unnecessarily long waiting time, delays, congestion, traffic jam and geometric delays due to intersection between circular and straight lanes. It is a twin kidney-spine type structure system with special allowance for Highway users for quicker passes. Thus reduction in number and intensity of accidents, significance reduction in traffic jam, conservation of valuable time.

Keywords: traffic system, collision reduction of vehicles, smooth flow of vehicles, traffic jam

Procedia PDF Downloads 394
433 Pedestrian Behavior at Signalized Intersections in Izmir, Turkey

Authors: Pelin Onelcin, Yalcin Alver

Abstract:

This paper investigates the walking speed and delays of pedestrians at two signalized intersections where the vehicle speed limits are different. Data was collected during afternoon and evening peak hours on November 15, 2013 and on December 6, 2013. Observational surveys were conducted by video recording technique. Pedestrians were categorized according to their gender, group size, stuff carrying condition and age. Results showed that individuals walked fastest when the group size is taken into consideration. The smallest 15th percentile walking speed was seen in the oldest age group (over 60 years old). Pedestrians experienced high delays both at roadsides and at medians. Factors affecting the pedestrian walking speed were analyzed by ANOVA.

Keywords: pedestrian delay, pedestrian walking speed, signalized crosswalk, ANOVA

Procedia PDF Downloads 370
432 Nephroblastoma at Universitas Academic Hospital Complex in the Last 20 Years

Authors: I. Iroka, L. Mgidlana, J. Willoughby, S. Dhlamini, P. Nxumalo, S. Sefadi, A. Mthembu, E. Gerber, E. Brits

Abstract:

Introduction: Nephroblastoma is a common paediatric tumor with good survival rates when diagnosed and treated early. Method: This retrospective study aimed to describe the patients with nephroblastoma seen at Universitas Academic Hospital Complex between the years 2000 and 2020. Results: In the study period, there were 207 patients identified. The patient profile had slightly more male than female patients; the median age was under four years of age. The study found a median delay of one month between symptom onset and diagnosis; a common cause was a delay in seeking care. Patients diagnosed and treated more than a month after symptoms started had poorer survival rates. There was a higher rate of Stage IV disease compared to similar studies in South Africa. Good preoperative histology and no relapse had good survival rates.. Patients from Lesotho had longer delays and presented with more severe diseases than the South African cohort. Conclusion: Early identification and treatment lead to better outcomes. Health-seeking behaviour, misdiagnosis, and referral delays might contribute to the long delays. A targeted study for patients from Lesotho is recommended.

Keywords: nephroblastoma, South Africa, Lesotho, developing country

Procedia PDF Downloads 73
431 Temporal Delays along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

Procedia PDF Downloads 316
430 Conflict of the Thai-Malaysian Gas Pipeline Project

Authors: Nopadol Burananuth

Abstract:

This research was aimed to investigate (1) the relationship among local social movements, non-governmental Organization activities and state measures deployment; and (2) the effects of local social movements, non-governmental Organization activities, and state measures deployment on conflict of local people towards the Thai-Malaysian gas pipeline project. These people included 1,000 residents of the four districts in Songkhla province. The methods of data analysis consist of multiple regression analysis. The results of the analysis showed that: (1) local social movements depended on information, and mass communication; deployment of state measures depended on compromise, coordination, and mass communication; and (2) the conflict of local people depended on mobilization, negotiation, and campaigning for participation of people in the project. Thus, it is recommended that to successfully implement any government policy, consideration must be paid to the conflict of local people, mobilization, negotiation, and campaigning for people’s participation in the project.

Keywords: conflict, NGO activities, social movements, state measures

Procedia PDF Downloads 296
429 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

Procedia PDF Downloads 188
428 The Analysis Fleet Operational Performance as an Indicator of Load and Haul Productivity

Authors: Linet Melisa Daubanes, Nhleko Monique Chiloane

Abstract:

The shovel-truck system is the most prevalent material handling system used in surface mining operations. Material handling entails the loading and hauling of material from production areas to dumping areas. The material handling process has operational delays that have a negative impact on the productivity of the load and haul fleet. Factors that may contribute to operational delays include shovel-truck mismatch, haul routes, machine breakdowns, extreme weather conditions, etc. The aim of this paper is to investigate factors that contribute to operational delays affecting the productivity of the load and haul fleet at the mine. Productivity is the measure of the effectiveness of producing products from a given quantity of units, the ratio of output to inputs. Productivity can be improved by producing more outputs with the same or fewer units and/or introducing better working methods etc. Several key performance indicators (KPI) for the evaluation of productivity will be discussed in this study. These KPIs include but are not limited to hauling conditions, bucket fill factor, cycle time, and utilization. The research methodology of this study is a combination of on-site time studies and observations. Productivity can be optimized by managing the factors that affect the operational performance of the haulage fleet.

Keywords: cycle time, fleet performance, load and haul, surface mining

Procedia PDF Downloads 161
427 Delays for Emergency Cesarean Sections and Neonatal Outcomes in Three Rural District Hospitals in Rwanda: A Retrospective Cross-Sectional Study

Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

Abstract:

In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

Procedia PDF Downloads 199
426 Case Study on the Effects of Early Mobilization in the Post-Surgical Recovery of Athletes with Open Triangular Fibrocartilage Complex Repair

Authors: Blair Arthur Agero Jr., Lucia Garcia Heras

Abstract:

The triangular fibrocartilage complex (TFCC) is one of the crucial stabilizing ligaments of the wrist. The TFCC is also subject to excessive stress amongst performance athletes and enthusiasts. The excessive loading of the TFCC may lead to a partial or complete rupture that requires surgery. The recovery from an open TFCC surgical repair may take several months. Immobilization of the repaired wrist for a given period is part of all the current protocols in the post-surgical treatment. The immobilization to prevent the rotation of the forearm can last from six weeks to eight weeks with the wrist held in a neutral position. In all protocols reviewed, the pronosupination is only initiated between the 6th week and 8th week or even later after the cast is removed. The prolonged immobilization can cause stiffness of the wrist and hand. Furthermore, the entire period of post-surgical hand therapy has its economic impact, especially for performing athletes. However, delayed mobilization, specifically rotation of the wrist, is necessary to allow ligament healing. This study aims to report the effects of early mobilization of the wrist in athletes who had an open surgical repair of the TFCC. The surgery was done by the co-author, and the hand therapy was implemented by the main author. The cases documented spans from 2014 to 2019 and were all performed in Dubai, United Arab Emirates. All selected participants in this case study were provided with a follow-up questionnaire to ascertain their current condition since their surgery. The respondents reported high satisfaction in the results of their treatment and have verified zero re-rupture of their TFCC despite mobilizing and rotating the wrist at the third-week post-surgery during their hand therapy. There is also a negligible number of respondents who reported a limitation in their ranges of pronosupination. This case study suggests that early mobilization of the wrist after an open TFCC surgical repair can be more beneficial to the patient as opposed to the traditional treatment of prolonged immobilization. However, it should be considered that the patients selected in this case study are professional performance athletes and advanced fitness enthusiasts. Athletes are known to withstand vigorous physical stress in their training that may correlate to their ability to better cope with the progressive stress that was implemented during their hand therapy. Nevertheless, this approach has its merits, and application of it may be adjusted for patients with a similar injury and surgical procedure.

Keywords: hand therapy, performance athlete, TFCC repair, wrist ligament

Procedia PDF Downloads 122
425 Airport Check-In Optimization by IP and Simulation in Combination

Authors: Ahmed Al-Sultan

Abstract:

The check-in area of airport terminal is one of the busiest sections at airports at certain periods. The passengers are subjected to queues and delays during the check-in process. These delays and queues are due to constraints in the capacity of service facilities. In this project, the airport terminal is decomposed into several check-in areas. The airport check-in scheduling problem requires both a deterministic (integer programming) and stochastic (simulation) approach. Integer programming formulations are provided to minimize the total number of counters in each check-in area under the realistic constraint that counters for one and the same flight should be adjacent and the desired number of counters remaining in each area should be fixed during check-in operations. By using simulation, the airport system can be modeled to study the effects of various parameters such as number of passengers on a flight and check-in counter opening and closing time.

Keywords: airport terminal, integer programming, scheduling, simulation

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424 Prevention of the Post – Intensive Care Syndrome (PICS) by Implementation of an ICU Delirium Prevention Strategy (DPB)

Authors: Paul M. H. J. Roekaerts

Abstract:

In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

Procedia PDF Downloads 282
423 Analysis and Improvement of Efficiency for Food Processing Assembly Lines

Authors: Mehmet Savsar

Abstract:

Several factors affect productivity of Food Processing Assembly Lines (FPAL). Engineers and line managers usually do not recognize some of these factors and underutilize their production/assembly lines. In this paper, a special food processing assembly line is studied in detail, and procedures are presented to illustrate how productivity and efficiency of such lines can be increased. The assembly line considered produces ten different types of freshly prepared salads on the same line, which is called mixed model assembly line. Problems causing delays and inefficiencies on the line are identified. Line balancing and related tools are used to increase line efficiency and minimize balance delays. The procedure and the approach utilized in this paper can be useful for the operation managers and industrial engineers dealing with similar assembly lines in food processing industry.

Keywords: assembly lines, line balancing, production efficiency, bottleneck

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422 Controlling Youths Participation in Politics in Sokoto State: A Constructive Inclusiveness for Good Governance in Nigeria

Authors: Umar Ubandawaki

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Political participation involves voluntary and deliberate efforts by the members of a political system to determine the kinds of political institution and individuals that will govern them and equally influence the mobilization and allocation of the available societal resources. Over the years, youths in Nigeria participated actively in political party rallies and voting to elect their leaders and representatives in governance. This paper examines categories and nature of participation in politics as well as factors that derived youths into politics in Sokoto State. Through the use of qualitative and quantitative data generated from focus group discussions, interviews and questionnaire, the paper find out that youth, in Sokoto State, have been induced in participatory activities that encourage political thuggery and manipulation of electoral outcomes. Moreover, they are neglected in the mobilization and allocation of the available resources of the society i.e they are denied dividends of good governance. The paper recommends that youths should be engaged into positive participatory activities for ensuring inclusiveness and promotion of good governance in Nigeria. It is hoped that this will enlighten youth and policy implementers on the constructive strategies in controlling youth’s participation in politics in Nigeria.

Keywords: democracy, governance, inclusivenes, participation and politic

Procedia PDF Downloads 317
421 Stability of Hybrid Stochastic Systems

Authors: Manlika Ratchagit

Abstract:

This paper is concerned with robust mean square stability of uncertain stochastic switched discrete time-delay systems. The system to be considered is subject to interval time-varying delays, which allows the delay to be a fast time-varying function and the lower bound is not restricted to zero. Based on the discrete Lyapunov functional, a switching rule for the robust mean square stability for the uncertain stochastic discrete time-delay system is designed via linear matrix inequalities. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: robust mean square stability, discrete-time stochastic systems, hybrid systems, interval time-varying delays, Lyapunov functional, linear matrix inequalities

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420 New Results on Stability of Hybrid Stochastic Systems

Authors: Manlika Rajchakit

Abstract:

This paper is concerned with robust mean square stability of uncertain stochastic switched discrete time-delay systems. The system to be considered is subject to interval time-varying delays, which allows the delay to be a fast time-varying function and the lower bound is not restricted to zero. Based on the discrete Lyapunov functional, a switching rule for the robust mean square stability for the uncertain stochastic discrete time-delay system is designed via linear matrix inequalities. Finally, some examples are exploited to illustrate the effectiveness of the proposed schemes.

Keywords: robust mean square stability, discrete-time stochastic systems, hybrid systems, interval time-varying delays, lyapunov functional, linear matrix inequalities

Procedia PDF Downloads 407
419 A Construction Management Tool: Determining a Project Schedule Typical Behaviors Using Cluster Analysis

Authors: Natalia Rudeli, Elisabeth Viles, Adrian Santilli

Abstract:

Delays in the construction industry are a global phenomenon. Many construction projects experience extensive delays exceeding the initially estimated completion time. The main purpose of this study is to identify construction projects typical behaviors in order to develop a prognosis and management tool. Being able to know a construction projects schedule tendency will enable evidence-based decision-making to allow resolutions to be made before delays occur. This study presents an innovative approach that uses Cluster Analysis Method to support predictions during Earned Value Analyses. A clustering analysis was used to predict future scheduling, Earned Value Management (EVM), and Earned Schedule (ES) principal Indexes behaviors in construction projects. The analysis was made using a database with 90 different construction projects. It was validated with additional data extracted from literature and with another 15 contrasting projects. For all projects, planned and executed schedules were collected and the EVM and ES principal indexes were calculated. A complete linkage classification method was used. In this way, the cluster analysis made considers that the distance (or similarity) between two clusters must be measured by its most disparate elements, i.e. that the distance is given by the maximum span among its components. Finally, through the use of EVM and ES Indexes and Tukey and Fisher Pairwise Comparisons, the statistical dissimilarity was verified and four clusters were obtained. It can be said that construction projects show an average delay of 35% of its planned completion time. Furthermore, four typical behaviors were found and for each of the obtained clusters, the interim milestones and the necessary rhythms of construction were identified. In general, detected typical behaviors are: (1) Projects that perform a 5% of work advance in the first two tenths and maintain a constant rhythm until completion (greater than 10% for each remaining tenth), being able to finish on the initially estimated time. (2) Projects that start with an adequate construction rate but suffer minor delays culminating with a total delay of almost 27% of the planned time. (3) Projects which start with a performance below the planned rate and end up with an average delay of 64%, and (4) projects that begin with a poor performance, suffer great delays and end up with an average delay of a 120% of the planned completion time. The obtained clusters compose a tool to identify the behavior of new construction projects by comparing their current work performance to the validated database, thus allowing the correction of initial estimations towards more accurate completion schedules.

Keywords: cluster analysis, construction management, earned value, schedule

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418 Short Term Effects of Mobilization with Movement in a Patient with Fibromyalgia: A Case Report

Authors: S. F. Kanaan, Fatima Al-Kadi, H. Khrais

Abstract:

Background: Fibromyalgia is a chronic condition that is characterized by chronic pain that limits physical and functional activities. To our best knowledge, there is currently no key physiotherapy approach recommended to reduce pain and improve function. In addition, there are scarce studies that investigated the effect of manual therapy in the management of Fibromyalgia, and no study investigated the efficacy of Mulligan´s mobilization with movement (MWM) in particular. Methods: A 51-year-old female diagnosed with Fibromyalgia for more than a year. The patient was complaining of generalized pain including neck, lower back, shoulders, elbows, hips, and knees. In addition, the patient reported severe limitation in activities and inability to complete her work as a lawyer. The Intervention provided for the patient consisted of 4 sessions (in two weeks) of MWM for neck, lower back, shoulders, elbows, sacroiliac joint, hips, and knees. The Visual Analogue Scale of pain (VAS), Range of Motion (ROM), 10-minute walk test, Roland Morris Low Back Pain and Disability Questionnaire (RMQ), Disability of the Arm, Shoulder and Hand Score (DASH) were collected at the baseline and at the end of treatment. Results: Average improvement of ROM in the neck, lower back, shoulder, elbows, hips, and knees was 45%. VAS scale changed from pre-treatment to post-treatment as the following: neck pain (9 to 0), lower back pain (8 to 1), shoulders pain (8 to 2), elbows pain (7 to 1), and knees pain (9 to 0). The patient demonstrated improvement in all functional scale from pre-intervention to post-intervention: 10-meter walk test (9.8 to 4.5 seconds), RMQ (21 to 11/24), and DASH (88.7% to 40.5%). The patient did not report any side effect of using this approach. Conclusion: Fibromyalgia can cause joint 'faulty position' leading to pain and dysfunction, which can be reversed by using MWM. MWM showed to have clinically significant improvement in ROM, pain, and ability to walk and a clinically significant reduction in disability in only 4 sessions. This work can be expanded in a larger sample.

Keywords: mobilization, fibromyalgia, dysfunction, manual therapy

Procedia PDF Downloads 144
417 Further Analysis of Global Robust Stability of Neural Networks with Multiple Time Delays

Authors: Sabri Arik

Abstract:

In this paper, we study the global asymptotic robust stability of delayed neural networks with norm-bounded uncertainties. By employing the Lyapunov stability theory and Homeomorphic mapping theorem, we derive some new types of sufficient conditions ensuring the existence, uniqueness and global asymptotic stability of the equilibrium point for the class of neural networks with discrete time delays under parameter uncertainties and with respect to continuous and slopebounded activation functions. An important aspect of our results is their low computational complexity as the reported results can be verified by checking some properties symmetric matrices associated with the uncertainty sets of network parameters. The obtained results are shown to be generalization of some of the previously published corresponding results. Some comparative numerical examples are also constructed to compare our results with some closely related existing literature results.

Keywords: neural networks, delayed systems, lyapunov functionals, stability analysis

Procedia PDF Downloads 499
416 Water Problems, Social Mobilization and Migration: A Case Study of Lake Urmia

Authors: Fatemeh Dehghan Khangahi, Hakan Gunes

Abstract:

Transforming a public necessity into a commercial commodity becomes more and more evident as time goes on, and it is one of the issues of water shortage. Development projects of countries, consume the water and waterbeds in various forms, ignoring the concepts such as sustainability and the negative effects they place on the environment, pollute and change the ways of waterways. Throughout these processes, the water basins and all the vital environments sometimes can suffer damage to the irreparable level. In this context, the issue of Lake Urmia that is located in the North West of Iran left alone by drought, has been researched. The lake, which is on the list of UNESCO's biosphere reserves, is now exposed to the danger of desiccation. If the desiccation is fully realized, more than 5.000.000 people that they are living around the lake, will have to migrate as a result of negative living conditions. As a matter of fact, along with the recent years of increasing drought level, regional migrations have begun. In addition to migration issues, it is also necessary to specify the negative effects on human and all-round’s life that depend on the formation of salt storms, mixing of salt into the air and soil, which threaten human health seriously because the lake is salty. The main aim of this work is to raise national and international awareness of this problem, which is an environment and a human tragedy at the same time. This research has two basic questions: 1) In the case of Lake Urmia, what are environmental problems and how they have emerged and what is the role of governments? 2) What is the social consequence of this problem in relation to the first question? In response, after the literature search, having a comparative view of the situation of the Aral Sea and the Great Salt Lake (Utah, USA), which involved the two major international examples. The first, one is related to the terms of population and migration, the second is about biological properties. Then, data and status information that provided after 3 years area research has been evaluated. Towards the end, with the support of qualitative and quantitative methods, the study of social mobilization in the region has been carried out. An example of it is using the public space of TRAXTOR matches like a protests area.

Keywords: environment problems, water, social mobilization, Lake Urmia, migration

Procedia PDF Downloads 107
415 Level of Gross Motor Development and Age Equivalents of Children 9 Years

Authors: Masri Baharom

Abstract:

The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

Procedia PDF Downloads 416
414 Techniques of Construction Management in Civil Engineering

Authors: Mamoon M. Atout

Abstract:

The Middle East Gulf region has witnessed rapid growth and development in many areas over the last two decades. The development of the real-estate sector, construction industry and infrastructure projects are a major share of the development that has participated in the civilization of the countries of the Gulf. Construction industry projects were planned and managed by different types of experts, who came from all over the world having different types of experiences in construction management and industry. Some of these projects were completed on time, while many were not, due to many accumulating factors. Many accumulated factors are considered as the principle reason for the problem experienced at the project construction stage, which reflected negatively on the project success. Specific causes of delay have been identified by construction managers to avoid any unexpected delays through proper analysis and considerations to some implications such as risk assessment and analysis for many potential problems to ensure that projects will be delivered on time. Construction management implications were adopted and considered by project managers who have experience and knowledge in applying the techniques of the system of engineering construction management. The aim of this research is to determine the benefits of the implications of construction management by the construction team and level of considerations of the techniques and processes during the project development and construction phases to avoid any delay in the projects. It also aims to determine the factors that participate to project completion delays in case project managers are not well committed to their roles and responsibilities. The results of the analysis will determine the necessity of the applications required by the project team to avoid the causes of delays that help them deliver projects on time, e.g. verifying tender documents, quantities and preparing the construction method of the project.

Keywords: construction management, control process, cost control, planning and scheduling

Procedia PDF Downloads 216
413 Multi-Sender MAC Protocol Based on Temporal Reuse in Underwater Acoustic Networks

Authors: Dongwon Lee, Sunmyeng Kim

Abstract:

Underwater acoustic networks (UANs) have become a very active research area in recent years. Compared with wireless networks, UANs are characterized by the limited bandwidth, long propagation delay and high channel dynamic in acoustic modems, which pose challenges to the design of medium access control (MAC) protocol. The characteristics severely affect network performance. In this paper, we study a MS-MAC (Multi-Sender MAC) protocol in order to improve network performance. The proposed protocol exploits temporal reuse by learning the propagation delays to neighboring nodes. A source node locally calculates the transmission schedules of its neighboring nodes and itself based on the propagation delays to avoid collisions. Performance evaluation is conducted using simulation, and confirms that the proposed protocol significantly outperforms the previous protocol in terms of throughput.

Keywords: acoustic channel, MAC, temporal reuse, UAN

Procedia PDF Downloads 320
412 Causes and Effects of Delays in Construction Projects in Akure, Ondo State, South-West Nigeria

Authors: K.T Alade, A.F Lawal, A.A Omonori

Abstract:

Construction is an everlasting activity across the globe. Likewise, the problem of delay in the construction industry is a global phenomenon. Although there are several reasons that may be responsible for delay during construction, this may vary from place to place and can be reduced to the minimum when identified. This study considered the major causes and effects of delay in the execution of construction projects in Akure, Ondo State, Nigeria. Using literatures, a total number of 30 causes of construction delays were identified. The convenient sampling technique was used to select sixty respondents for a survey. The respondents comprise twenty-two (22) clients, eighteen consultants (18) and twenty (20) contractors. The analyses of the primary data revealed that the three most important causes of delay in construction projects in Akure, Ondo State Nigeria are poor site management and supervision, inadequate contractors experience and client’s financial difficulties. Based on the findings of this study, recommendations were given on how the causes and effects of delay in construction can be mitigated.

Keywords: Akure, causes, construction projects, delay, effects

Procedia PDF Downloads 477
411 Level Of Gross Motor Development And Age Equivalents Of 9-Year-Old Children

Authors: Ahmad Hashim, Masri Baharom

Abstract:

The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

Procedia PDF Downloads 384