Search results for: risk management failure

Authors: Fariba Ebrahimi, Mehdi Ghorbani

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Achieving to integrated Water management fundamentally needs to effective relation, coordination, collaboration and synergy among various actors who have common but different responsibilities. In this sense, the foundation of comprehensive and integrated management is not compatible with centralization and top-down strategies. The aim of this paper is analysis institutional network of water relevant stakeholders and water policy monitoring in Shemiranat. In this study collaboration networks between informal and formal institutions co-management process have been investigated. Stakeholder network analysis as a quantitative method has been implicated in this research. The results of this study indicate that institutional cohesion is medium; sustainability of institutional network is about 40 percent (medium). Additionally the core-periphery index has measured in this study according to reciprocity index. Institutional capacities for integrated natural resource management in regional level are measured in this study. Furthermore, the necessity of centrality reduction and promote stakeholders relations and cohesion are emphasized to establish a collaborative natural resource governance.

Keywords: policy monitoring, water management, social network, stakeholder, shemiranat

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Authors: Mario Tauzene Afonso Matangue, Ivan Andres Sanchez Ortiz

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The Metropolitan area of Maputo (Mozambique Capital City) is located in semi-arid zone (800 mm annual rainfall) with 1101170 million inhabitants. On the west side, there are the flatlands of Infulene where the Mulauze River flows towards to the Indian Ocean, receiving at this site, the storm water contaminated with sanitary sewage from Maputo, transported through a concrete open channel. In Infulene, local communities grow salads crops such as tomato, onion, garlic, lettuce, and cabbage, which are then commercialized and consumed in several markets in Maputo City. Lettuce is the most daily consumed salad crop in different meals, generally in fast-foods, breakfasts, lunches, and dinners. However, the risk of infection by several pathogens due to the consumption of lettuce, using the Quantitative Microbial Risk Assessment (QMRA) tools, is still unknown since there are few studies or publications concerning to this matter in Mozambique. This work is aimed at determining the annual risk arising from the consumption of lettuce grown in Infulene valley, in Maputo, using QMRA tools. The exposure model was constructed upon the volume of contaminated water remaining in the lettuce leaves, the empirical relations between the number of pathogens and the indicator of microorganisms (E. coli), the consumption of lettuce (g) and reduction of pathogens (days). The reference pathogens were Vibrio cholerae, Cryptosporidium, norovirus, and Ascaris. The water quality samples (E. coli) were collected in the storm water channel from January 2016 to December 2018, comprising 65 samples, and the urban lettuce consumption data were collected through inquiry in Maputo Metropolis covering 350 persons. A non-parametric bootstrap was performed involving 10,000 iterations over the collected dataset, namely, water quality (E. coli) and lettuce consumption. The dose-response models were: Exponential for Cryptosporidium, Kummer Confluent hypergeomtric function (1F1) for Vibrio and Ascaris Gaussian hypergeometric function (2F1-(a,b;c;z) for norovirus. The annual infection risk estimates were performed using R 3.6.0 (CoreTeam) software by Monte Carlo (Latin hypercubes), a sampling technique involving 10,000 iterations. The annual infection risks values expressed by Median and the 95th percentile, per person per year (pppy) arising from the consumption of lettuce are as follows: Vibrio cholerae (1.00, 1.00), Cryptosporidium (3.91x10⁻³, 9.72x 10⁻³), nororvirus (5.22x10⁻¹, 9.99x10⁻¹) and Ascaris (2.59x10⁻¹, 9.65x10⁻¹). Thus, the consumption of the lettuce would result in greater risks than the tolerable levels ( < 10⁻³ pppy or 10⁻⁶ DALY) for all pathogens, and the Vibrio cholerae is the most virulent pathogens, according to the hit-single models followed by the Ascaris lumbricoides and norovirus. The sensitivity analysis carried out in this work pointed out that in the whole QMRA, the most important input variable was the reduction of pathogens (Spearman rank value was 0.69) between harvest and consumption followed by water quality (Spearman rank value was 0.69). The decision-makers (Mozambique Government) must strengthen the prevention measures related to pathogens reduction in lettuce (i.e., washing) and engage in wastewater treatment engineering.

Keywords: annual infections risk, lettuce, non-parametric bootstrapping, quantitative microbial risk assessment tools

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: R. Khoza, K. K. Govender

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The aim of the study was to review and critically evaluate the supply chain management (SCM) strategies and challenges in the private residential construction sector in South Africa. The study was grounded in three theories, namely, theory of constraints, principal-agency theory, and stakeholder theory. A quantitative approach was used to survey 320 private residential construction companies which registered with the National Homebuilders Registration Council (NHBRC) within the Gauteng province. The data from 250 questionnaires returned were analysed using SPSS (Versions 23) and Smart PLS. It became evident that the SCM challenges included lack of trust between the supplier and the organization; lack of adoption of SCM system; lack of a sufficiently skilled SCM workforce; and poor implementation of contract management. The findings also indicate that there is a significant positive relationship between the performance of the private residential construction sector in South Africa and SCM challenges, SCM strategies and SCM processes. A framework is proposed comprising SCM practices and strategies of private residential construction sector in South Africa, which will enable them to enhance performance.

Keywords: management challenges, residential housing, South Africa, supply chain management

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Authors: Chuen-arom Janthimachai-amorn, Chirawadee Harnrittha

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This study aims to identify the factors facilitating the knowledge management to develop the graduate study programs to achieve success and to identify the approaches in developing the graduate study programs in the Rajbhat Suansunantha University. The 10 respondents were the administrators, the faculty, and the personnel of its Graduate School. The research methodology was based on Pla-too Model of the Knowledge Management Institute (KMI) by allocating the knowledge indicators, the knowledge creation and search, knowledge systematization, knowledge processing and filtering, knowledge access, knowledge sharing and exchanges and learning. The results revealed that major success factors were knowledge indicators, evident knowledge management planning, knowledge exchange and strong solidarity of the team and systematic and tenacious access of knowledge. The approaches allowing the researchers to critically develop the graduate study programs were the environmental data analyses, the local needs and general situations, data analyses of the previous programs, cost analyses of the resources, and the identification of the structure and the purposes to develop the new programs.

Keywords: program development, knowledge management, graduate study programs, Rajbhat Suansunantha University

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Authors: A. B. M. Rezaul Islam, Ernur Karadogan

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Shape memory alloys (SMAs) are known for their shape memory effect and pseudoelasticity behavior. Their thermomechanical behaviors are modeled by numerous researchers using microscopic thermodynamic and macroscopic phenomenological point of view. Tanaka, Liang-Rogers and Ivshin-Pence models are some of the most popular SMA macroscopic phenomenological constitutive models. They describe SMA behavior in terms of stress, strain and temperature. These models involve material parameters and they have associated uncertainty present in them. At different operating temperatures, the uncertainty propagates to the output when the material is subjected to loading followed by unloading. The propagation of uncertainty while utilizing these models in real-life application can result in performance discrepancies or failure at extreme conditions. To resolve this, we used probabilistic approach to perform the sensitivity and uncertainty analysis of Tanaka, Liang-Rogers, and Ivshin-Pence models. Sobol and extended Fourier Amplitude Sensitivity Testing (eFAST) methods have been used to perform the sensitivity analysis for simulated isothermal loading/unloading at various operating temperatures. As per the results, it is evident that the models vary due to the change in operating temperature and loading condition. The average and stress-dependent sensitivity indices present the most significant parameters at several temperatures. This work highlights the sensitivity and uncertainty analysis results and shows comparison of them at different temperatures and loading conditions for all these models. The analysis presented will aid in designing engineering applications by eliminating the probability of model failure due to the uncertainty in the input parameters. Thus, it is recommended to have a proper understanding of sensitive parameters and the uncertainty propagation at several operating temperatures and loading conditions as per Tanaka, Liang-Rogers, and Ivshin-Pence model.

Keywords: constitutive models, FAST sensitivity analysis, sensitivity analysis, sobol, shape memory alloy, uncertainty analysis

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Authors: Riaz A. Agha, Alexander J. Fowler, Seon-Young Lee, Buket Gundogan, Katharine Whitehurst, Harkiran K. Sagoo, Kyung Jin Lee Jeong, Douglas G. Altman, Dennis P. Orgill

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Introduction: Case Series are an important and common study type. Currently, no guideline exists for reporting case series and there is evidence of key data being missed from such reports. We propose to develop a reporting guideline for case series using a methodologically robust technique. The first step in this process is a systematic review of literature relevant to the reporting deficiencies of case series. Methods: A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, EMBASE, Cochrane Methods Register, Science Citation index and Conference Proceedings Citation index, from the start of indexing until 5th November 2014. Independent screening, eligibility assessments and data extraction was performed. Included articles were analyzed for five areas of deficiency: failure to use standardized definitions missing or selective data transparency or incomplete reporting whether alternate study designs were considered. Results: The database searching identified 2,205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequency of methodological and reporting issues identified was a failure to use standardized definitions (57%), missing or selective data (66%), transparency, or incomplete reporting (70%), whether alternate study designs were considered (11%) and other issues (52%). Conclusion: The methodological and reporting quality of surgical case series needs improvement. Our data shows that clear evidence-based guidelines for the conduct and reporting of a case series may be useful to those planning or conducting them.

Keywords: case series, reporting quality, surgery, systematic review

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Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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Authors: Abbos Utkirov

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Total Quality Management (TQM) in the context of educational institutions requires careful planning and the implementation of an annual quality program to achieve its vision effectively. By applying TQM concepts, the higher education system can experience significant improvements. This study aims to examine TQM in higher education, focusing on Critical Success Factors (CSF) and their implementation across all areas. The study ultimately concludes that CSF and their execution play a crucial role in higher education institutions. Some institutions have already benefited from TQM methods by dedicating themselves to the system and using it to achieve their objectives. Through this review, recent studies shed light on how the TQM system can employ various strategies and hypotheses to empower employees, foster a positive and supportive environment, and emphasize the importance of enabling students to unleash their full potential.

Keywords: total quality management (TQM), critical success factor (CSF), organizational performance, quality management practices

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Authors: Ali Kassem

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Background: In the last few years, factors such as insulin resistance (IR) and hepatic steatosis have been linked to progression of hepatic fibrosis.Patients with chronic liver disease, and cirrhosis in particular, are known to be prone to IR. However, chronic HCV (hepatitis C) infection may induce IR, regardless of the presence of liver cirrhosis. Our aims are to study insulin resistance (IR) assessed by HOMA-IR (Homeostatic Model Assessment Insulin Resistance) as a possible risk factor in disease progression in cirrhotic patients and to evaluate the role of IR in hepatic fibrosis progression. The correlations of HOMA-IR values to laboratory, virological and histopathological parameters of chronic HCV are also examined. Methods: The study included 50 people divided into 30 adult chronic hepatitis C patients diagnosed by PCR (polymerase chain reaction) within previous 6 months and 20 healthy controls. The functional and morphological status of the liver were evaluated by ultrasonography and laboratory investigations including liver function tests and by liver biopsy. Fasting blood glucose and fasting insulin levels were measured and body mass index and insulin resistance were calculated. Patients having HOMA-IR >2.5 were labeled as insulin resistant. Results: Chronic hepatitis C patients with IR showed significantly higher mean values of BMI (body mass index) and fasting insulin than those without IR (P < 0.000). Patients with IR were more likely to have steatosis (p = 0.006), higher necroinflammatory activity (p = 0.05). No significant differences were found between the two groups regarding hepatic fibrosis. Conclusion: HOMA-IR measurement could represent a novel marker to identify the cirrhotic patients at greater risk for the progression of liver disease. As IR is a potentially modifiable risk factor, these findings may have important prognostic and therapeutic implications. Assessment of IR by HOMA-IR and improving insulin sensitivity are recommended in patients with HCV and related chronic liver disease.

Keywords: hepatic fibrosis, hepatitis C virus infection, hepatic steatosis, insulin resistance

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Authors: Malkit Singh

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This paper presents an in-depth analysis of the problem of migration from Punjab to the West while analyzing the history and patterns of generations of migration of Punjabis to the West. A special emphasis is given to link the present socio-economic and political crisis with the historical pattern of Punjabis’ migration to the West from colonial India to Independent Bharat, along with the stories of the success and failures of Western aspirants’ youth from Punjab. The roots of the migration from Punjab to the West have been traced from the invasion of the British in Punjab, resulting in the socio-economic and political dismantling of the Punjabi society, which resulted in the migration of the Punjabis to the other colonies of the British Empire. The grim position at home despite of all the efforts and hard work by the majority of the Punjabis, particularly from the farmer community and the shining lifestyle of some families of the village or vicinity who have some relatives in the West have encouraged the large number of Punjabis to change their fortune by working in West. However, the Visa and Work Permit regime has closed the doors of the West for those who are unskilled, semi-skilled and not qualified for the visa and work permit norms, but their inspiration to change their fortune by working abroad at any cost has resulted into the development of big business fraud of immigration agent and firms in Punjab that resulted into the loss of the thousands lives, imprisonment in the foreign and selling of the properties of the Punjabis. The greed for the greener pastures in the West and, the plight of the deserted wives of NRIs and the illegal routes adopted by the Punjabi youth due to the non-availability of visas and work permits are dealt in a comprehensive method. The rise and fall of Punjab as a land of the breadbasket of Bharat and the marginalization of the farmers with middle and small holdings due to the capital-intensive techniques are linked with the forced migration of the Punjabis. The failure of the government to address and respond to the rampant corruption, agriculture failure and the resulting problems of law and order before and after the troubled period of militancy in Punjab and the resulting migration to the West are comprehensively covered. The new trend of the Student Visa and Study abroad, particularly in Canada, Australia, and New Zealand, despite of the availability of quality education at very low cost in India. The early success of some students in getting study visas from Australia, Canada, New Zealand etc. and getting permanent immigration to these countries have encouraged the majority of Punjabi youth to leave their motherland for better opportunities in the prosperous lands, that is, again, failed as these countries are flooded with the Punjabi students. Moreover, the total failure of the political leadership of Punjab to address the basic needs of society, like law and order and stop the drug menace issues in the post-militancy Punjab is also done to understand the problem.

Keywords: Punjab, migration, West, agriculture

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Authors: Ronald Mraz, Gary C. Kessler, Ethan Gold, John G. Cline

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The International Ice Patrol (IIP) continually monitors iceberg activity in the North Atlantic by direct observation using ships, aircraft, and satellite imagery. Daily reports detailing navigational boundaries of icebergs have significantly reduced the risk of iceberg contact. What is currently lacking is formatting this data for automatic transmission and display of iceberg navigational boundaries in commercial navigation equipment. This paper describes the methodology and implementation of a system to format iceberg limit information for dissemination through existing radio network communications. This information will then automatically display on commercial navigation equipment. Additionally, this information is reformatted for Google Earth rendering of iceberg track line limits. Having iceberg limit information automatically available in standard navigation equipment will help support full autonomous operation of sailing vessels.

Keywords: iceberg, iceberg risk, iceberg track lines, AIS messaging, international ice patrol, North American ice service, google earth, autonomous surface vessels

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Authors: A. A. Abdullah, K. A. Lindsay

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The management of a salt-gradient is investigated with respect to the interaction between the solar pond and its associated evaporation pond. Issues considered are the impact of precipitation and the operation of the flushing system with particular reference to the case in which the flushing fluid is pure water. Results suggest that a management strategy based on a flushing system that simply replaces evaporation losses of water from the solar pond and evaporation pond will be optimally efficient. Such a management strategy will maintain the operational viability of a salt-gradient solar pond as a reservoir of cheap heat while simultaneously ensuring that the associated evaporation pond can feed the storage zone of the solar pond with sufficient saturated brine to balance the effect of salt diffusion. Other findings are, first, that once near saturation is achieved in the evaporation pond, the efficacy of the proposed management strategy is relatively insensitive to both the size of the evaporation pond or its depth, and second, small changes in the extraction of heat from the storage zone of a salt-gradient solar pond have an amplified effect on the temperature of that zone. The possibility of boiling of the storage zone cannot be ignored in a well-configured salt-gradient solar pond.

Keywords: aqueous sodium chloride, constitutive expression, solar pond, salt-gradient

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Authors: Desmond Chinedu Oparaku, Pearl C. Akanwa, Oyemike Victor Benson

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This paper examines the challenges facing library and information centers (LICs) in managing indigenous knowledge in academic libraries in developing countries. The need for managing an indigenous knowledge in library and information centers in developing nations is becoming more critical. There is an ever increasing output of indigenous knowledge; effective management of indigenous knowledge becomes necessary to enable the next generation benefit from them. This paper thus explores the concept of indigenous knowledge (IK), nature of indigenous knowledge (IK), the various forms of indigenous knowledge (IK), sources of indigenous knowledge (IK), and relevance of indigenous knowledge (IK). The expectations of library and information professionals towards effective management of indigenous knowledge and the challenges to effective management of indigenous knowledge were highlighted. Recommendations were made based on the identified challenges.

Keywords: library, indigenous knowledge, information centres, information professionals

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Authors: Xin Jie Li

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Due to population agglomeration, huge scale, and complex activities, megacities have become risk centers. To resist the risks brought by development uncertainty, the construction of resilient cities has become a common strategic choice for megacities. As a key link in promoting the modernization of the national governance system and governance capacity, optimizing the layout of national land space that focuses on ecology, production, and life and improving the rationality of spatial resource allocation are conducive to fundamentally promoting the resilience construction of megacities. Therefore, based on the perspective of territorial space governance, this article explores the potential risks faced by the territorial space of megacities and proposes possible paths for the resilience construction of megacities from four aspects: promoting the construction of a resilience system throughout the entire life cycle, constructing a disaster prevention and control system with ecological resilience, creating an industrial spatial pattern with production resilience, and enhancing community resilience to anchor the front line of risk response in megacities.

Keywords: mega cities, potential risks, resilient city construction, territorial and spatial governance

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Authors: Majid Yazdandoust

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This study, tries to suggest a design method based on displacement using finite difference numerical modeling in reinforcing soil retaining wall with steel strip. In this case, dynamic loading characteristics such as duration, frequency, peak ground acceleration, geometrical characteristics of reinforced soil structure and type of the site are considered to correct the pseudo static method and finally introduce the pseudo static coefficient as a function of seismic performance level and peak ground acceleration. For this purpose, the influence of dynamic loading characteristics, reinforcement length, height of reinforced system and type of the site are investigated on seismic behavior of reinforcing soil retaining wall with steel strip. Numerical results illustrate that the seismic response of this type of wall is highly dependent to cumulative absolute velocity, maximum acceleration, and height and reinforcement length so that the reinforcement length can be introduced as the main factor in shape of failure. Considering the loading parameters, mechanically stabilized earth wall parameters and type of the site showed that the used method in this study leads to most efficient designs in comparison with other methods which are generally suggested in cods that are usually based on limit-equilibrium concept. The outputs show the over-estimation of equilibrium design methods in comparison with proposed displacement based methods here.

Keywords: pseudo static coefficient, seismic performance design, numerical modeling, steel strip reinforcement, retaining walls, cumulative absolute velocity, failure shape

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Authors: Lattari Samir

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The performance of a production process is the result of proper operation where the management tools appear as the key to success through process management which consists of managing and implementing a quality policy, organizing and planning the manufacturing, and thus defining an efficient logic as the main areas covered by production management. To carry out this delicate mission, which requires reconciling often contradictory objectives, the auditor is called upon, who must be able to express an opinion on the effectiveness of the operation of the "production" function. To do this, the auditor must structure his mission in three phases, namely, the preparation phase to assimilate the particularities of this function, the implementation phase and the conclusion phase. The audit is a systematic and independent examination of all the stages of a manufacturing process intended to determine whether the pre-established arrangements for the combination of production factors are respected, whether their implementation is effective and whether they are relevant in relation to the goals.

Keywords: audit, performance of process, independent examination, management tools, audit of accounts

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Authors: Tanvir A. Uddin, Blake Goud

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Emerging trends in FinTech-enabled alternative finance, which includes channels and instruments emerging outside the traditional financial system, heralds unprecedented opportunities to improve financial intermediation and increase access to finance. With widespread criticism of the mainstream Islamic banking and finance sector as either mimicking the conventional system, failing to achieve inclusive growth or both, industry stakeholders are turning to technology to show that finance can be done differently. This paper will outline the critical elements for successful deployment of technology to maximize benefit and minimize potential for harm from introduction of Islamic FinTech and propose recommendations for Islamic financial institutions, FinTech companies, regulators and other stakeholders who are integrating or who are considering introducing FinTech solutions. The paper will present an overview of literature, present relevant case studies and summarize the lessons from interviews conducted with Islamic FinTech founders from around the world. With growing central bank concerns about leveraged loans and ballooning private credit markets globally (estimated at $1.4 trillion), current and future Islamic FinTech operators are at risk of contributing to the problems they aim to solve by operating in a 'shadow banking' system. The paper will show that by systematising a robust theory of change linked to positive outcomes, utilising objective impact frameworks (e.g., the Impact Measurement Project) and instilling a risk management culture that is proactive about potential social harm (e.g., irresponsible lending), FinTech can enable the Islamic finance industry to support positive social impact and minimize harm in support of the maqasid. The adoption of FinTech within the Islamic finance context is still at a nascent stage and the recommendations we provide based on the limited experience to date will help address some of the major cross-cutting issues related to FinTech. Further research will be needed to elucidate in more detail issues relating to individual sectors and countries within the broader global Islamic finance industry.

Keywords: alternative finance, FinTech, Islamic finance, maqasid, theory of change

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: Ljiljana Stojković, Manja Zec, Maja Zivkovic, Maja Bundalo, Marija Glibetić, Dragan Alavantić, Aleksandra Stankovic

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Cardiovascular disease (CVD) is associated with alterations in DNA methylation, the latter modulated by dietary polyphenols. The present pilot study (part of the original clinical study registered as NCT02800967 at www.clinicaltrials.gov) aimed to investigate the impact of 4-week daily consumption of polyphenol-rich Aronia melanocarpa juice on Long Interspersed Nucleotide Element-1 (LINE-1) methylation in peripheral blood leukocytes, in subjects (n=34, age of 41.1±6.6 years) at moderate CVD risk, including an increased body mass index, central obesity, high normal blood pressure and/or dyslipidemia. The goal was also to examine whether factors known to affect DNA methylation, such as folate intake levels, MTHFR C677T gene variant, as well as the anthropometric and metabolic parameters, modulated the LINE-1 methylation levels upon consumption of polyphenol-rich Aronia juice. The experimental analysis of LINE-1 methylation was done by the MethyLight method. MTHFR C677T genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Folate intake was assessed by processing the data from the food frequency questionnaire and repeated 24-hour dietary recalls. Serum lipid profile was determined by using Roche Diagnostics kits. The statistical analyses were performed using the Statistica software package. In women, after vs. before the treatment period, a significant decrease in LINE-1 methylation levels was observed (97.54±1.50% vs. 98.39±0.86%, respectively; P=0.01). The change (after vs. before treatment) in LINE-1 methylation correlated directly with MTHFR 677T allele presence, average daily folate intake and the change in serum low-density lipoprotein cholesterol, while inversely with the change in serum triacylglycerols (R=0.72, R2=0.52, adjusted R2=0.36, P=0.03). The current results imply potential cardioprotective effects of habitual polyphenol-rich Aronia juice consumption achieved through the modifications of DNA methylation pattern in subjects at CVD risk, which should be further confirmed. Hence, the precision nutrition-driven modulations of DNA methylation may become targets for new approaches in the prevention and treatment of CVD.

Keywords: Aronia melanocarpa, cardiovascular risk, LINE-1, methylation, peripheral blood leukocytes, polyphenol

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Authors: Robyn White, Juan Bornman, Ensa Johnson

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People with disabilities are at a high risk of becoming victims of crime. Individuals with little or no functional speech (LNFS) face an even higher risk. One way of reducing the risk of remaining a victim of crime is to face the alleged perpetrator in court as a witness – therefore it is important for a person with LNFS who has been a victim of crime to have the required vocabulary to testify in court. The aim of this study was to identify and describe the core and fringe legal vocabulary required by illiterate victims of crime, who have little or no functional speech, to testify in court as witnesses. A mixed-method, the exploratory sequential design consisting of two distinct phases was used to address the aim of the research. The first phase was of a qualitative nature and included two different data sources, namely in-depth semi-structured interviews and focus group discussions. The overall aim of this phase was to identify and describe core and fringe legal vocabulary and to develop a measurement instrument based on these results. Results from Phase 1 were used in Phase 2, the quantitative phase, during which the measurement instrument (a custom-designed questionnaire) was socially validated. The results produced six distinct vocabulary categories that represent the legal core vocabulary and 99 words that represent the legal fringe vocabulary. The findings suggested that communication boards should be individualised to the individual and the specific crime. It is believed that the vocabulary lists developed in this study act as a valid and reliable springboard from which communication boards can be developed. Recommendations were therefore made to develop an Alternative and Augmentative Communication Resource Tool Kit to assist the legal justice system.

Keywords: augmentative and alternative communication, person with little or no functional speech, sexual crimes, testifying in court, victim of crime, witness competency

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel

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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.

Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite

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Authors: Waleerak Sittisom

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The objectives of this research were to analyze transportation route management, to identify potential cost reductions in logistic operation. In-depth interview techniques and small group discussions were utilized with 25 participants from various backgrounds in the areas of logistics. The findings of this research revealed that there were four areas that companies are able to effectively manage a logistic cost reduction: managing the space within the transportation vehicles, managing transportation personnel, managing transportation cost, and managing control of transportation. On the other hand, there were four areas that companies were unable to effectively manage a logistic cost reduction: the working process of transportation, the route planning of transportation, the service point management, and technology management. There are five areas that cost reduction is feasible: personnel management, process of working, map planning, service point planning, and technology implementation. To be able to reduce costs, the transportation companies should suggest that customers use a file system to save truck space. Also, the transportation companies need to adopt new technology to manage their information system so that packages can be reached easy, safe, and fast. Staff needs to be trained regularly to increase knowledge and skills. Teamwork is required to effectively reduce the costs.

Keywords: cost reduction, management, logistics, transportation

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Authors: Chanpen Meenakorn

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This research aimed to examine the relationships between customer expectations and service quality management of Banpaew Hospital Samutsakorn in Thailand. The study sample consisted of 360 customers in patient unit. Data were collected using self-administered questionnaire. Descriptive statistics used were percentage, mean, and standard deviation. The analytical statistics comprised Pearson’s product moment correlation coefficient analysis. The result showed that service quality of nurses was very good with sustainable development trend. Physical evidence was at a high level, and the process and personal were rated at a high level. Additional, the study suggested that head nurse should be encouraged to improve service quality management, management training. Nurse administrators should create an appropriate nursing department climate, and provide necessary resources in the department. In addition, the nurse administrators should continuously follow up the results of customer expectations and focus on patients/customers, process management, information and knowledge management, and evaluation of service quality also.

Keywords: Banpaew Hospital, Customer Expectations, Service Provided, Samutsakorn

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Authors: Mahmoud Reza Tahamtan, Mohammad Saleh Bahreini

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Background and Purpose: Cystic echinococcosis, caused by the larval stage of Echinococcus granulosus, is a common parasitic infection of humans and is endemic in many parts of the world, including Iran. So that, one percent of those admitted to surgery departments are hydatid cyst patients, and using the ELISA method, the infection rate has been reported in different regions of Iran from 1.2% to 21.4%. Therefore, the aim of this study was to investigate the seroepidemiology of human hydatid cysts in Fars province, southern Iran, by ELISA method. Methods: In this cross-sectional study, 600 serum samples of persons who were referred to the laboratory of Nemazi Hospital in Shiraz for normal tests were examined for the presence of specific Anti-IgG antibodies to hydatid cysts by ELISA method. During the sampling, a structured questionnaire was used to obtain social data of individuals with determinants of risk factors for Cystic echinococcosis. Finally, the results of the ELISA test, along with demographic information completed by individuals, were analyzed using SPSS software. Results: The average age of the subjects in this study was 40.01 ± 9.166. The prevalence of hydatidosis was reported as 5.66% (34/600). The disease was more in the age group of 21-30, people living in villages, working in rural areas, and people with a history of other parasitic diseases. Statistically, a significant difference was observed between the prevalence of the disease and two risk factors, contact with dogs (OR= 0.042; 95%CI: 0.014-0.12; P= 0.001) and washing vegetables with water (OR= 0.08; 95%CI: 0.011-0.56; P= 0.012). Conclusion: The present study showed that hydatid cyst disease has a significant prevalence in this area. Also, based on the results, contact with dogs and not properly washing vegetables are two important factors of disease transmission.

Keywords: Echinococcus granulosus, Cystic echinococcosis, hydatid cyst, Fars province

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Authors: Ali Azeem, Seung-Cheol Hong

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This study focuses on the epidemiological association between childhood leukaemia & adult brain cancer to offer strong evidence that extremely low-frequency magnetic field (ELF-MF) produced from power lines caused cancer. It also gives a comprehensive literature review on epidemiological studies of ELF-MF risk associated with HVTL and childhood leukaemia & adult brain cancer. From the literature review, it is concluded that there is a weak association present between ELF-MF and childhood leukaemia. No consistent association was present between brain cancer and ELF-MF. This study is done on Scielo data and PubMed using the terms extremely low-frequency magnetic field (ELF-MF+cancer), adult brain cancer, high power transmission lines, etc., for the past 10 years.

Keywords: childhood leukaemia, high voltage transmission lines, acute lymphoblastic leukaemia, power lines

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Authors: Doaa Abbas Zaher

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For the past two decades demand for knowledge has been increasing. Management of society’s knowledge has far reaching effects to economic growth through increased capacity to complete viable activities. Organizations use information technology to effect organizational change. This is a challenge for the less developed nations whose capacity to integrate knowledge in core functions is limited. This creates organizational problems as there is global competition amongst organizations. Cross-cultural perceptions influence difference knowledge Management. This study provides a cross-cultural analysis on the influence in knowledge culture in Japan and Saudi Arabia to effect change in organizations. Since different countries adopt different knowledge management strategies, this dictates the state of organizational development through enriched organizational culture. The research uses a mixed approach design to collect data from primary and secondary sources. Primary source will use the questionnaires while secondary sources uses case analysis from books, articles, reports, and journals. The study will take a period of three years to come up with a complete paper.

Keywords: knowledge management, organizational culture, information, society knowledge

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Authors: Kari M. Solomon

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Companies with a culture accepting of change management and performance excellence are better suited to determine their sustainability performance and impacts. A mature corporate culture supportive of performance excellence is better positioned to integrate sustainability management tools into their standard business strategy. Companies use various sustainability management tools and reporting standards to communicate levels of sustainability performance to their stakeholders, more often focusing on shareholders and investors. A research gap remains in understanding how companies adapt business excellence models to define corporate sustainability performance. A content analysis of medium-sized enterprises using corporate sustainability reports and business excellence models reveals the challenges and opportunities of reporting sustainability performance in the context of organizational excellence. The outcomes of this content analysis contribute knowledge on the resources needed for companies to build sustainability performance management systems integral to existing management systems. The findings of this research inform academic research areas of corporate sustainability performance, the business community contributing to sustainable development initiatives, and integrating sustainable development issues into business excellence models. There are potential research links between sustainability performance management and the alignment of the United Nations Sustainable Development Goals (UN SDGs) when organizations promote a culture of performance or business excellence.

Keywords: business excellence, corporate sustainability, performance excellence, sustainability performance

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Authors: Mohammad Reza Bagherzadeh, Mohammad Hossein Taheri

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Knowledge management serves as one of the great breakthroughs in information and knowledge era and given its outstanding features, successful organizations tends to adopt it. Therefore, to deal with knowledge management establishment in universities is of special importance. In this regard, the present research aims to shed lights on factors background knowledge management establishment at Islamic Azad University, Behshahr Branch (Northern Iran). Considering three factors information technology system, knowledge process system and organizational culture as a fundamental of knowledge management infrastructure, foregoing factors were evaluated individually. The present research was conducted in descriptive-survey manner and participants included all staffs and faculty members, so that according to Krejcie & Morgan table a sample size proportional to the population size was considered. The measurement tools included survey questionnaire whose reliability was calculated to 0.83 according to Cronbachs alpha. To data analysis, descriptive statistics such as frequency and its percentage tables, column charts, mean, standard deviation and as for inferential statistics Kolomogrov- Smirnov test and single T-test were used. The findings show that despite the good corporate culture as one of the three factors background the establishment of the knowledge management at Islamic Azad University Behshahr Branch, other two ones, including IT systems, and knowledge processes systems are characterized with adverse status. As a result, these factors have caused no necessary conditions for the establishment of Knowledge Management in the university provided.

Keywords: knowledge management, information technology, knowledge processes, organizational culture, educational institutions

Procedia PDF Downloads 504