Search results for: timing jitter

Authors: Abdullah Arafat, Ali Al-Farhan, Amir Omair

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Objectives: To review and assess the effectiveness of the implemented modified five-levels triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential city, Riyadh, Saudi Arabia. Method: The applied study design was an observational cross sectional design. A data collection sheet was designed and distributed to triage nurses; the data collection was done during triage process and was directly observed by the co-investigator. Triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP) and total length of stay (TLS) taking in consideration timing of presentation and level of triage. Results: During the study period, a total of 187 patients were included in our study. 118 visits were at weekdays and 68 visits at weekends. Overall, 173 patients (92.5%) were seen by the physician in timely manner according to triage guidelines while 14 patients (7.5%) were not seen at appropriate time.Overall, The mean time before seen the triage nurse (TBT) was 5.36 minutes, the mean time to be seen by physician (TBP) was 22.6 minutes and the mean length of stay (TLS) was 59 minutes. The data didn’t showed significant increase in TBT, TBP, and number of patients not seen at the proper time, referral rate and admission rate during weekend. Conclusion: The CTAS is adaptable to countries beyond Canada and worked properly. The applied CTAS triage system in Al-Yarmook UCC is considered to be effective and well applied. Overall, urgent cases have been seen by physician in timely manner according to triage system and there was no delay in the management of urgent cases.

Keywords: CTAS, emergency, Saudi Arabia, triage, urgent care

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Authors: Papitchaya Papangkorn

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Matching the expectations of teachers and learners is significant for successful language learning. Moreover, teachers should discover what their learners think and feel about what and how they want to learn. Therefore, this study investigates International College, Suan Sunandha Rajabhat University students’ preferences toward error corrections in order to help SSRUIC teachers match their expectations and their learners because it is important for successful language learning. This study examined the learners’ attitude and preference toward error correction through 50 first year SSRUIC students both male (25) and female (25) in Bangkok, Thailand. The data were collected from a questionnaire and interviews to investigate the necessity and frequency, timing, type of errors, method of corrective feedback, and person who gives error correction in order to answer the overall research question and sub-questions. The findings indicate five suggestions regarding the overall research question. Firstly, errors should be treated, and always be treated. Secondly, treating errors after finish speaking is the most appropriate time. Thirdly, “errors that may cause problems in an understanding of listener” and “frequent spoken errors” should be treated. Fourthly, repetition and explicit feedback were the most popular types of feedback among males, whereas metalinguistic feedback was the most favoured types amongst females. Finally, teachers were the most preferred person to deliver corrective feedback for the learners. Although the results of the study are difficult to generalize to a larger population, which are Thai EFL learners because of the small sample, the findings provide useful information that may contribute to understanding of SSRUIC learners’ preferences toward error corrections and it might reduce the gap between what teachers employ and what students expect when receiving corrective feedback. The reduction of this gap may be useful for the learning process and could enhance the efforts of both teachers and learners in a Thai context.

Keywords: attitude, corrective feedback, error, preference

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Authors: Saeed Poormoaied, Zumbul Atan

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Emergency shipments provide a powerful mechanism to alleviate the risk of imminent stock-outs and can result in substantial benefits in an inventory system. Customer satisfaction and high service level are immediate consequences of utilizing emergency shipments. In this paper, we consider a single-echelon periodic review inventory system consisting of a single local warehouse, being replenished from a central warehouse with ample capacity in an infinite horizon setting. Since the structure of the optimal policy appears to be complicated, we analyze this problem under an order-up-to-S inventory control policy framework, the (S, T) policy, with the emergency shipment consideration. In each period of the periodic review policy, there is a single opportunity at any point of time for the emergency shipment so that in case of stock-outs, an emergency shipment is requested. The goal is to determine the timing and amount of the emergency shipment during a period (emergency shipment policy) as well as the base stock periodic review policy parameters (replenishment policy). We show that how taking advantage of having an emergency shipment during periods improves the performance of the classical (S, T) policy, especially when fixed and unit emergency shipment costs are small. Investigating the structure of the objective function, we develop an exact algorithm for finding the optimal solution. We also provide a heuristic and an approximation algorithm for the periodic review inventory system problem. The experimental analyses indicate that the heuristic algorithm is computationally more efficient than the approximation algorithm, but in terms of the solution efficiency, the approximation algorithm performs very well. We achieve up to 13% cost savings in the (S, T) policy if we apply the proposed emergency shipment policy. Moreover, our computational results reveal that the approximated solution is often within 0.21% of the globally optimal solution.

Keywords: emergency shipment, inventory, periodic review policy, approximation algorithm.

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Authors: Zhongmin Wang, Wudong Fan, Hengshan Zhang, Yimin Zhou

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In data-driven prognostic methods, the prediction accuracy of the estimation for remaining useful life of bearings mainly depends on the performance of health indicators, which are usually fused some statistical features extracted from vibrating signals. However, the existing health indicators have the following two drawbacks: (1) The differnet ranges of the statistical features have the different contributions to construct the health indicators, the expert knowledge is required to extract the features. (2) When convolutional neural networks are utilized to tackle time-frequency features of signals, the time-series of signals are not considered. To overcome these drawbacks, in this study, the method combining convolutional neural network with gated recurrent unit is proposed to extract the time-frequency image features. The extracted features are utilized to construct health indicator and predict remaining useful life of bearings. First, original signals are converted into time-frequency images by using continuous wavelet transform so as to form the original feature sets. Second, with convolutional and pooling layers of convolutional neural networks, the most sensitive features of time-frequency images are selected from the original feature sets. Finally, these selected features are fed into the gated recurrent unit to construct the health indicator. The results state that the proposed method shows the enhance performance than the related studies which have used the same bearing dataset provided by PRONOSTIA.

Keywords: continuous wavelet transform, convolution neural net-work, gated recurrent unit, health indicators, remaining useful life

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Authors: Rajkumar Ghosh

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The Out-of-Sequence Thrust (OOST) is a common phenomenon in collisional tectonic settings like the Himalayas. These OOSTs are activated in different locations at different time frames. These OOST are linked with the multiple Himalayan Thrusts. Apart from minimal documentation in geological mapping for OOST, there exists a lack of field data to establish OOST in the field. This work has considered three thrusts from NW Himalaya in Himachal Pradesh with published data from other sources, allowing a re-examination for correlation of OOST. For the Sutlej section, the approach has been to do fieldwork and microstructural studies. The information related to the cross-cut signature of S/C- and relative time relation could help to predict the nature of OOST. The activation timing, along with the basis of identification of OOST in Higher Himalayan, was documented in various literature. Compilation of the Grain Boundary Migration (GBM) associated temperature range (400–750 °C) was documented from microstructural studies along the Jhakri-Chaura section. No such significant temperature variation across thrusts was observed. Strain variation paths using S Ʌ C angle measurement were carried out along the Jeori-Wangtu transect to distinguish overprinting structures for OOSTs. Near the Chaura Thrust (CT), angular variation of S Ʌ C was documented, and it varies within a range of 15° - 28 °. Along the NH22 (National Highway, 22), all tectonic units of the orogen are exposed in NW Himalaya, INDIA. But there are inherent difficulties in finding field evidence of OOST, largely due to the lack of adequate surface morphology, including topography and drainage pattern.

Keywords: out-of-sequence thrust (OOST), main central thrust (MCT), south tibetan detachment system (STDS), jhakri thrust (JT), sarahan thrust (ST), chaura thrust (CT), higher himalaya (HH), greater himalayan crystalline (GHC)

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Authors: Suprehatin Suprehatin

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Improving the participation of smallholder farmers in horticultural value chains to benefit from the rapidly growing demand for high-value agricultural products is one strategy for raising farm income. However, smallholder farmer participation in Indonesian horticultural value chains is under-researched. To address this knowledge gap, this study aims to describe the current status of horticultural crop adoption in Indonesia and analyze the motivations and dynamics of smallholder farmer participation in horticultural value chains: why some small farmers join these new and potentially profitable chains and continue their participation. This study also examines the characteristics of farmers who adopted and those who did not adopt a new horticultural crop with respect to the household (farmer), farm and institutional characteristics. The analysis was conducted using unique data from a 2013 survey of 960 Indonesian farmers on Java Island that produce a variety of agricultural products. Basic statistical analysis showed relatively low adoption rates (10%) of new horticultural crops amongst 960 selected Indonesian farmers with different decisions made in terms of number and timing of new horticultural crop adoption. Adopters were motivated mainly by higher profit, higher yield, and more cash opportunities. The result also showed that current low rates of horticultural crop adoption are associated with a variety of factors, such as lower levels of education among farmers, resource constraints, lack of information on horticultural crop production and low participation in farmer groups. These findings will be helpful for policymakers when designing policies and programs to promote greater participation of Indonesian smallholder farmers in horticultural value chains. In other words, a revitalisation of agricultural policy beyond staple food is important to seize potential benefits from the ongoing agricultural food market transformation.

Keywords: farmer adoption, high value, horticultural crops, Indonesia

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Authors: Peaceman Sopazi, Mabila Mathebula, John Smallwood

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Recent health and safety (H&S) concerns and their resultant impact on railway operations, namely, the severe acute respiratory syndrome (SARS) or collectively known as SARS-CoV-2 (Covid-19) pandemic and the Fourth Industrial Revolution (4IR), which have dominated public discourse, brought into question as to whether, or not, some aspects of how we have so far managed safety oversight as railway regulatory bodies and operators will remain relevant in a changing railway environment. Railway practitioners have generally found themselves between a proverbial rock and a hard place by being confronted by emerging challenges which have brought along great opportunities for sustainability. As witnesses and participants to the progressively introduced railway safety management, and transformation regimes, this paper attempts to share gathered field experience on adaptable regulatory oversight and safety awareness. The discourse is approached from a South African context but also with an informed perspective of what seems to work and what usually does not. The authors share their own multi and transdisciplinary experience coupled with insights they have gained as researchers of global trends in general safety management and specific aspects of railway safety management, for sustainability. In addition to sharing a largely experience-based methodology for survival, suggestions are offered for consideration as a way of keeping the railway safety management discourse alive as practitioners navigate a new path which is shrouded in a cloud of untold uncertainty. The authors further believe that the right timing for the implementation of the proposed suggestions in this paper will produce beneficial outcomes. Finally, the paper will identify areas that are still open for further investigation for and by researchers and practitioners alike.

Keywords: health & safety management, safety awareness, railway safety management, railway systems sustainability

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Authors: Lauren M. Cook, Tove A. Larsen

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Due to their potential to provide numerous ecosystem services, green roofs have been proposed as a solution to mitigate a growing list of environmental challenges, like urban flooding and urban heat island effect. Because of their cooling effect, green roofs placed below rooftop photovoltaic (PV) panels also have the potential to increase PV panel efficiency. Sedums, a type of succulent plant, are commonly used on green roofs because they are drought and heat tolerant. However, other plant species, such as grasses or plants with reflective properties, have been shown to reduce more runoff and cool the rooftop more than succulent species due to high evapotranspiration (ET) and reflectivity, respectively. The goal of this study is to evaluate whether vegetation with high ET or reflectivity can influence multiple co-benefits of the green roof. Four small scale green roofs in Zurich are used as an experiment to evaluate differences in (1) the timing and amount of runoff discharged from the roof, (2) the air temperature above the green roof, and (3) the temperature and efficiency of solar panels placed above the green roof. One grass species, Silene vulgaris, and one silvery species, Stachys byzantia, are compared to a baseline of Sedum album and black roof. Initial results from August to November 2019 show that the grass species has retained more cumulative runoff and led to a lower canopy temperature than the other species. Although the results are not yet statistically significant, they may suggest that plants with higher ET will have a greater effect on canopy temperature than plants with high reflectivity. Future work will confirm this hypothesis and evaluate whether it holds true for solar panel temperature and efficiency.

Keywords: co-benefit estimation, green cities, green roofs, solar panels

Procedia PDF Downloads 78

Authors: Jenny Radeva, Anke-Gundula Roth, Christian Goebbert, Robert Niestroj-Pahl, Lars Daehne, Axel Wolfram, Juergen Wiese

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Ceramic membranes for water purification combine excellent stability with long-life characteristics and high chemical resistance. Layer-by-Layer coating is a well-known technique for customization and optimization of filtration properties of membranes but is mostly used on polymeric membranes. Ceramic membranes comprising a metal oxide filtration layer of Al2O3 or TiO2 are charged and therefore highly suitable for polyelectrolyte adsorption. The high stability of the membrane support allows efficient backwash and chemical cleaning of the membrane. The presented study reports metal oxide/organic composite membrane with an increased rejection of bivalent salts like MgSO4 and the organic micropollutant Diclofenac. A self-build apparatus was used for applying the polyelectrolyte multilayers on the ceramic membrane. The device controls the flow and timing of the polyelectrolytes and washing solutions. As support for the Layer-by-Layer coat, ceramic mono-channel membranes were used with an inner capillary of 8 mm diameter, which is connected to the coating device. The inner wall of the capillary is coated subsequently with polycat- and anions. The filtration experiments were performed with a feed solution of MgSO4 and Diclofenac. The salt content of the permeate was detected conductometrically and Diclofenac was measured with UV-Adsorption. The concluded results show retention values of magnesium sulfate of 70% and diclofenac retention of 60%. Further experimental research studied various parameters of the composite membrane-like Molecular Weight Cut Off and pore size, Zeta potential and its mechanical and chemical robustness.

Keywords: water purification, polyelectrolytes, membrane modification, layer-by-layer coating, ceramic membranes

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Authors: Claire Norman-Maillet

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Insider fraud is a major financial crime threat whereby an employee defrauds (or attempts to defraud) their current, prospective, or past employer. ‘Employee’ covers anyone employed by the company, including Board members and part-time staff. Insider fraud can take many forms, including an employee working alone or in collusion with others. Insider fraud has been on the rise since the Coronavirus pandemic and shows no signs of slowing. The objective of the research is to better understand how FinTechs are impacted by insider fraud and, therefore, how to stop it. This research will make an original contribution to the financial crime field, given the timing of this research being intertwined with the cost-of-living crisis in the UK and the global Coronavirus pandemic. This research focuses on insider fraud within FinTechs specifically, as they are arguably a modern phenomenon in the financial institutions space and have cutting-edge technology at their disposal. To achieve the research objective, the researcher held semi-structured interviews with over 20 individuals who deal with insider fraud perpetration in a practitioner, recruitment, or advisory capacity. The interviews were subsequently transcribed and analysed thematically. Main findings in the research suggest that FinTechs are arguably in the best position to combat insider fraud, given their focus on using recent technologies, as this can be used to combat the threat. However, insider fraud has been ignored owing to the denial of accepting the possibility that colleagues would defraud their employer, as well as the idea that external fraud is the most important threat. The research concludes that, whilst the technology is understandably prioritised by FinTechs for providing an agreeable customer experience, insider fraud needs to be given a platform upon which to be recognised as a significant threat to any company. Moreover, insider fraud needs to be given the same level of weighting and attention by Executive Committees and Boards as the customer experience.

Keywords: insider fraud, occupational fraud, COVID-19, COVID, Coronavirus, pandemic, internal fraud, financial crime, economic crime

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

Procedia PDF Downloads 213

Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

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Authors: B. S. Premalatha, Kausalya Sahani

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Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.

Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing

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Authors: K. Nikovics, D. Riccobono, M. Oger, H. Morin, L. Barbier, T. Poyot, X. Holy, A. Bendahmane, M. Drouet, A. L. Favier

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Muscle regeneration after injury (as irradiation) is of great importance. However, the molecular and cellular mechanisms are still unclear. Cytokines are believed to play fundamental role in the different stages of muscle regeneration. They are secreted by many cell populations, but the predominant producers are macrophages and helper T cells. On the other hand, it has been shown that adipose tissue derived stromal/stem cell (ASC) injection could improve muscle regeneration. Stem cells probably induce the coordinated modulations of gene expression in different macrophage cells. Therefore, we investigated the patterns and timing of changes in gene expression of different cytokines occurring upon stem cells loading. Muscle regeneration was studied in an irradiated muscle of minipig animal model in presence or absence of ASC treatment (irradiated and treated with ASCs, IRR+ASC; irradiated not-treated with ASCs, IRR; and non-irradiated no-IRR). We characterized macrophage populations by immunolabeling in the different conditions. In our study, we found mostly M2 and a few M1 macrophages in the IRR+ASC samples. However, only few M2b macrophages were noticed in the IRR muscles. In addition, we found intensive fibrosis in the IRR samples. With in situ hybridization and immunolabeling, we analyzed the cytokine expression of the different macrophages and we showed that M2d macrophage are the most abundant in the IRR+ASC samples. By in situ hybridization, strong expression of the transforming growth factor β (TGF-β) was observed in the IRR+ASC but very week in the IRR samples. But when we analyzed TGF-β level with immunolabeling the expression was very different: many M2 macrophages showed week expression in IRR+ASC and few cells expressing stronger level in IRR muscles. Therefore, we investigated the MMP expressions in the different muscles. Our data showed that the M2 macrophages of the IRR+ASC muscle expressed MMP2 proteins. Our working hypothesis is that MMP2 expression of the M2 macrophages can decrease fibrosis in the IRR+ASC muscle by capturing TGF-β.

Keywords: adipose tissue derived stromal/stem cell, cytokine, macrophage, muscle regeneration

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Authors: Alonggot Limcharoen, Jintana Wannarat, Vorawat Panich

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This study aims to investigate the balancing of the number of operators (Line Balancing technique) in the production line of hard disk drive components in order to increase efficiency. At present, the trend of using hard disk drives has continuously declined leading to limits in a company’s revenue potential. It is important to improve and develop the production process to create market share and to have the ability to compete with competitors with a higher value and quality. Therefore, an effective tool is needed to support such matters. In this research, the Arena program was applied to analyze the results both before and after the improvement. Finally, the precedent was used before proceeding with the real process. There were 14 work stations with 35 operators altogether in the RA production process where this study was conducted. In the actual process, the average production time was 84.03 seconds per product piece (by timing 30 times in each work station) along with a rating assessment by implementing the Westinghouse principles. This process showed that the rating was 123% underlying an assumption of 5% allowance time. Consequently, the standard time was 108.53 seconds per piece. The Takt time was calculated from customer needs divided by working duration in one day; 3.66 seconds per piece. Of these, the proper number of operators was 30 people. That meant five operators should be eliminated in order to increase the production process. After that, a production model was created from the actual process by using the Arena program to confirm model reliability; the outputs from imitation were compared with the original (actual process) and this comparison indicated that the same output meaning was reliable. Then, worker numbers and their job responsibilities were remodeled into the Arena program. Lastly, the efficiency of production process enhanced from 70.82% to 82.63% according to the target.

Keywords: hard disk drive, line balancing, ECRS, simulation, arena program

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Authors: Yenesew Mengiste Yihun, Abraham Mehari Haile, Teklu Erkossa, Bart Schultz

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Teff (Eragrostic tef) is a staple food in Ethiopia. The local and international demand for the crop is ever increasing pushing the current price five times compared with that in 2006. To meet this escalating demand increasing production including using irrigation is imperative. Optimum application of irrigation water, especially in semi-arid areas is profoundly important. AquaCrop model application in irrigation water scheduling and simulation of water productivity helps both irrigation planners and agricultural water managers. This paper presents simulation and evaluation of AquaCrop model in optimizing the yield and biomass response to variation in timing and rate of irrigation water application. Canopy expansion, canopy senescence and harvest index are the key physiological processes sensitive to water stress. For full irrigation water application treatment there was a strong relationship between the measured and simulated canopy and biomass with r2 and d values of 0.87 and 0.96 for canopy and 0.97 and 0.74 for biomass, respectively. However, the model under estimated the simulated yield and biomass for higher water stress level. For treatment receiving full irrigation the harvest index value obtained were 29%. The harvest index value shows generally a decreasing trend under water stress condition. AquaCrop model calibration and validation using the dry season field experiments of 2010/2011 and 2011/2012 shows that AquaCrop adequately simulated the yield response to different irrigation water scenarios. We conclude that the AquaCrop model can be used in irrigation water scheduling and optimizing water productivity of Teff grown under water scarce semi-arid conditions.

Keywords: AquaCrop, climate smart agriculture, simulation, teff, water security, water stress regions

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Authors: Pontus Backstrom

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In the educational literature on peer effects, attention has been brought to the fact that the mechanisms creating peer effects are still to a large extent hidden in obscurity. The hypothesis in this study is that the Frame Factor Theory can be used to explain these mechanisms. At heart of the theory is the concept of “time needed” for students to learn a certain curricula unit. The relations between class-aggregated time needed and the actual time available, steers and hinders the actions possible for the teacher. Further, the theory predicts that the timing and pacing of the teachers’ instruction is governed by a “criterion steering group” (CSG), namely the pupils in the 10th-25th percentile of the aptitude distribution in class. The class composition hereby set the possibilities and limitations for instruction, creating peer effects on individual outcomes. To test if the theory can be applied to the issue of peer effects, the study employs multilevel structural equation modelling (M-SEM) on Swedish TIMSS 2015-data (Trends in International Mathematics and Science Study; students N=4090, teachers N=200). Using confirmatory factor analysis (CFA) in the SEM-framework in MPLUS, latent variables are specified according to the theory, such as “limitations of instruction” from TIMSS survey items. The results indicate a good model fit to data of the measurement model. Research is still in progress, but preliminary results from initial M-SEM-models verify a strong relation between the mean level of the CSG and the latent variable of limitations on instruction, a variable which in turn have a great impact on individual students’ test results. Further analysis is required, but so far the analysis indicates a confirmation of the predictions derived from the frame factor theory and reveals that one of the important mechanisms creating peer effects in student outcomes is the effect the class composition has upon the teachers’ instruction in class.

Keywords: compositional effects, frame factor theory, peer effects, structural equation modelling

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Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

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Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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Authors: Ali Kadivar, Kaveh Niayesh

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The integration of green energy resources is a major focus, and the role of Medium Voltage Direct Current (MVDC) systems is exponentially expanding. However, the protection of MVDC systems against DC faults is a challenge that can have consequences on reliable and safe grid operation. This challenge reveals the need for MVDC circuit breakers (MVDC CB), which are in infancies of their improvement. Therefore will be a lack of MVDC CBs standards, including thresholds for acceptable power losses and operation speed. To establish a baseline for comparison purposes, a benchmark system for testing future MVDC CBs is vital. The literatures just give the timing sequence of each switch and the emphasis is on the topology, without in-depth study on the control algorithm of DCCB, as the circuit breaker control system is not yet systematic. A digital testing benchmark is designed for the Proof-of-concept of simulation studies using software models. It can validate studies based on real-time digital simulators and Transient Network Analyzer (TNA) models. The proposed experimental setup utilizes data accusation from the accurate sensors installed on the tested MVDC CB and through general purpose input/outputs (GPIO) from the microcontroller and PC Prototype studies in the laboratory-based models utilizing Hardware-in-the-Loop (HIL) equipment connected to real-time digital simulators is achieved. The improved control algorithm of the circuit breaker can reduce the peak fault current and avoid arc resignation, helping the coordination of DCCB in relay protection. Moreover, several research gaps are identified regarding case studies and evaluation approaches.

Keywords: DC circuit breaker, hardware-in-the-loop, real time digital simulation, testing benchmark

Procedia PDF Downloads 46

Authors: Naveen Kumar Perumalla, Devadas Kuna, Mohammed Akhter Ali

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Satellite Navigation System such as the United States Global Positioning System (GPS) plays a significant role in determining the user position. Similar to that of GPS, Indian Regional Navigation Satellite System (IRNSS) is a Satellite Navigation System indigenously developed by Indian Space Research Organization (ISRO), India, to meet the country’s navigation applications. This system is also known as Navigation with Indian Constellation (NavIC). The NavIC system’s main objective, is to offer Positioning, Navigation and Timing (PNT) services to users in its two service areas i.e., covering the Indian landmass and the Indian Ocean. Six NavIC satellites are already deployed in the space and their receivers are in the performance evaluation stage. Four NavIC dual frequency receivers are installed in the ‘Advanced GNSS Research Laboratory’ (AGRL) in the Department of Electronics and Communication Engineering, University College of Engineering, Osmania University, India. The NavIC receivers can be operated in two positioning modes: Stand-alone IRNSS and Hybrid (IRNSS+GPS) modes. In this paper, analysis of various parameters such as Dilution of Precision (DoP), three Dimension (3D) Root Mean Square (RMS) Position Error and Horizontal Position Error with respect to Visibility of Satellites is being carried out using the real-time IRNSS data, obtained by operating the receiver in both positioning modes. Two typical days (6th July 2017 and 7th July 2017) are considered for Hyderabad (Latitude-17°24'28.07’N, Longitude-78°31'4.26’E) station are analyzed. It is found that with respect to the considered parameters, the Hybrid mode operation of NavIC receiver is giving better results than that of the standalone positioning mode. This work finds application in development of NavIC receivers for civilian navigation applications.

Keywords: DoP, GPS, IRNSS, GNSS, position error, satellite visibility

Procedia PDF Downloads 178

Authors: Anthony J. Kondracki, Bonzo Reddick, Jennifer L. Barkin

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Background: Many pregnancies in the United States are affected each year with the most common sexually transmitted infections (STIs), including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP, syphilis), and the rate of congenital syphilis has reached a 20-year high. We sought to estimate the prevalence of CT, NG, and TP in pregnancy and the risk of preterm birth (PTB) (<37 weeks gestation) and low birthweight (LBW) (<2500g) deliveries according to utilization of prenatal care (PNC) during the COVID-19 pandemic. Methods: This study was based on the 2020 National Center for Health Statistics (NCHS) Natality File restricted to singleton births (N=3,512,858). We estimated the prevalence of CT, NG, TP, PTBand LBW across timing and the number of prenatal care (PNC) visits attended. In multivariable logistic regression models, adjusted odds ratios of PTB and LBW were assessed according to STIs and PNC status. E-values, based on effect size estimates and the lower bound of the 95% confidence intervals (CIs) of the association, examined the potential impact of unmeasured confounding. Results: CT (1.8%) was most prevalent in pregnancy, followed by NG (0.3%) and TP (0.1%). The strongest predictors of PTB and LBW were maternal NG (12.2% and 12.1%, respectively), late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-fold greater for each STI in women who received ≤10 compared to >10 prenatal visits. E-values demonstrated the minimum strength of potential unmeasured confounding necessary to explain away observed associations. Conclusions: Timely initiation and receipt of recommended number of prenatal visits benefits screening and treatment of all women for STIs, including NG to substantially reduce infant morbidity and mortality related to PTB and LBW among infants born during the COVID-19 pandemic.

Keywords: COVID-19 pandemic, sexually transmitted infections, preterm birth, low birthweight, prenatal care

Procedia PDF Downloads 123

Authors: Richard Ren

Abstract:

Air pollution is a serious danger to international well-being and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.Air pollution is a serious danger to international wellbeing and economies - it will kill an estimated 7 million people every year, costing world economies $2.6 trillion by 2060 due to sick days, healthcare costs, and reduced productivity. In the United States alone, 60,000 premature deaths are caused by poor air quality. For this reason, there is a crucial need to develop effective methods to forecast air quality, which can mitigate air pollution’s detrimental public health effects and associated costs by helping people plan ahead and avoid exposure. The goal of this study is to propose an artificial intelligence framework for predicting future air quality based on timing variables (i.e. season, weekday/weekend), future weather forecasts, as well as past pollutant and air quality measurements. The proposed framework utilizes multiple machine learning algorithms (logistic regression, random forest, neural network) with different specifications and averages the results of the three top-performing models to eliminate inaccuracies, weaknesses, and biases from any one individual model. Over time, the proposed framework uses new data to self-adjust model parameters and increase prediction accuracy. To demonstrate its applicability, a prototype of this framework was created to forecast air quality in Los Angeles, California using datasets from the RP4 weather data repository and EPA pollutant measurement data. The results showed good agreement between the framework’s predictions and real-life observations, with an overall 92% model accuracy. The combined model is able to predict more accurately than any of the individual models, and it is able to reliably forecast season-based variations in air quality levels. Top air quality predictor variables were identified through the measurement of mean decrease in accuracy. This study proposed and demonstrated the efficacy of a comprehensive air quality prediction framework leveraging multiple machine learning algorithms to overcome individual algorithm shortcomings. Future enhancements should focus on expanding and testing a greater variety of modeling techniques within the proposed framework, testing the framework in different locations, and developing a platform to automatically publish future predictions in the form of a web or mobile application. Accurate predictions from this artificial intelligence framework can in turn be used to save and improve lives by allowing individuals to protect their health and allowing governments to implement effective pollution control measures.

Keywords: air quality prediction, air pollution, artificial intelligence, machine learning algorithms

Procedia PDF Downloads 92

Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

Abstract:

Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

Procedia PDF Downloads 294

Authors: Itsuo Yokoyama, Rikako Kikuti, Naoko Watabe, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Chronic kidney disease presents significant changes in mineral and bone metabolism, referred to as CKD-MBD. These changes lead to decreased bone mass, heightened bone fragility, fractures, and increased vascular and valvular calcification, ultimately impacting cardiovascular outcomes. Key contributors to these complications in dialysis patients include calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and the vitamin D hormonal system. Methods: In our outpatient dialysis clinic, we monitor the long-term effects of vascular calcifications by calculating the volume of calcified areas in the abdominal aorta based on CT scan data. The results revealed a progressive nature of vascular calcification. To extend our study, we measured the volume of calcification in bones (vertebrae and femur) corresponding to Hounsfield units of 200 and 300. The study aims to investigate changes in osteoporosis during a 5-year follow-up period and its relationship with extraosseous calcification. Results and Considerations: While extraosseous calcification demonstrated a generally progressive nature, often resistant to medical treatment, the degree of osteoporotic change varied among patients. The majority exhibited continuous osteoporotic changes, while some showed improvement or minimal changes in bone calcification. Variations in the distribution and magnitude of osteoporotic changes were observed between groups based on the timing of hemodialysis initiation during the study. The former group tended to display more osteoporotic changes, possibly attributed to differences in medication between the groups. Other contributing factors may include the patient's age, duration of dialysis, or causes of renal disease. In conclusion, we emphasize the importance of carefully monitoring calcium and phosphate levels and maintaining adequate dialysis therapy to prevent osteoporosis in dialysis patients.

Keywords: CKD-MBD, dialysis, calcification, kidney

Procedia PDF Downloads 22

Authors: Mikael Soini, Kari Björn

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Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: engineering education, integrated curriculum, learning and teaching methods, learning experience

Procedia PDF Downloads 293

Authors: Yinsheng Zhang

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Changes in the extent and amount of snow cover in Eurasia are of great interest because of their vital impacts on the global climate system and regional water resource management. This study investigated the spatial and temporal variability of the snow cover extent (SCE) and snow water equivalent (SWE) of continental Eurasia using the Northern Hemisphere Equal-Area Scalable Earth Grid (EASE-Grid) Weekly SCE data for 1972–2006 and the Global Monthly EASE-Grid SWE data for 1979–2004. The results indicated that, in general, the spatial extent of snow cover significantly decreased during spring and summer, but varied little during autumn and winter over Eurasia in the study period. The date at which snow cover began to disappear in spring has significantly advanced, whereas the timing of snow cover onset in autumn did not vary significantly during 1972–2006. The snow cover persistence period declined significantly in the western Tibetan Plateau as well as the partial area of Central Asia and northwestern Russia but varied little in other parts of Eurasia. ‘Snow-free breaks’ (SFBs) with intermittent snow cover in the cold season were mainly observed in the Tibetan Plateau and Central Asia, causing a low sensitivity of snow cover persistence period to the timings of snow cover onset and disappearance over the areas with shallow snow. The averaged SFBs were 1–14 weeks in the Tibetan Plateau during 1972–2006 and the maximum intermittence could reach 25 weeks in some extreme years. At a seasonal scale, the SWE usually peaked in February or March but fell gradually since April across Eurasia. Both annual mean and annual maximum SWE decreased significantly during 1979–2004 in most parts of Eurasia except for eastern Siberia as well as northwestern and northeastern China.

Keywords: Eurasia, snow cover extent, snow cover persistence period, snow-free breaks, onset and disappearance timings, snow water equivalent

Procedia PDF Downloads 121

Authors: Jane N. O'Sullivan

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In most studies relating change in fertility to potentially causal factors (such as girls’ educational attainment, infant mortality or urbanization), the presence or nature of family planning efforts are not examined, potentially misattributing their contributions. Modest impacts of voluntary family planning programs on fertility change have been claimed, citing the near-term effects of historical quasi-experimental projects – notably in Bangladesh and in Ghana – where recipients and non-recipients could be contrasted. By their nature, such experiments lacked the wider cultural impacts of national programs. Concurrently, analyses relating population growth with economic advancement have been equivocal, discrediting previous widespread concern which prevailed before the 1980s. This neutral view has been revised more recently with demographic dividend theory crediting higher working-age proportion with some economic stimulus if supported by sufficient institutional and human capacity. In this study of country-level data, cross-country comparisons spanning six decades relate fertility decline with family planning effort, GDP per capita and female education, finding that the timing of rapid fertility decline aligns with commencement of voluntary family planning programs, while economic betterment came after substantial fertility fall. The relationship between fertility and primary education completion was inconsistent, with potential channels of causation operating in both directions. GDP per capita was unrelated to rate of fertility decline, but total fertility rates above three children per woman strongly impeded enrichment. By synchronizing countries with respect to their fertility transition, strong relationships are revealed which suggest lower fertility enables economic betterment, rather than the other way around. These results argue in favour of elevating voluntary family planning as a development priority.

Keywords: economic advance, family planning effort, fertility decline, population growth rate

Procedia PDF Downloads 108

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

Procedia PDF Downloads 64

Authors: Patsy Tan, Dana Baltutis

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This presentation demonstrates the effectiveness of music therapy in co-treatment with speech pathology and occupational therapy as an innovative way when working with children and adolescents with complex individual differences to facilitate communication, emotional, motor and social skills development. Each child with special needs and their carer has an individual profile which encompasses their visual-spatial, auditory, language, learning, mental health, family dynamic, sensory-motor, motor planning and sequencing profiles. The most common issues among children with special needs, especially those diagnosed with Autism Spectrum Disorder, are in the areas of regulation, communication, and social-emotional development. The ability of children living with challenges to communicate and use language and understand verbal and non-verbal information, as well as move their bodies to explore and interact with their environments in social situations, depends on the children being regulated both internally and externally and trusting their communication partners and understanding what is happening in the moment. For carers, it is about understanding the tempo, rhythm, pacing, and timing of their own individual profile, as well as the profile of the child they are interacting with, and how these can sync together. In this study, music therapy is used in co-treatment sessions with a speech pathologist and/or an occupational therapist using the DIRFloortime approach to facilitate the regulation, attention, engagement, reciprocity and social-emotional capacities of children presenting with complex individual differences. Documented changes in 10 domains of children’s development over a 12-month period using the Individual Music Therapy Assessment Profile (IMTAP) were observed. Children were assessed biannually, and results show significant improvements in the social-emotional, musicality and receptive language domains indicating that co-treatment with a music therapist using the DIRFloortime framework is highly effective. This presentation will highlight strategies that facilitate regulation, social-emotional and communication development for children and adolescents with complex individual profiles.

Keywords: communication, shared attention, regulation, social emotional

Procedia PDF Downloads 224