Search results for: international medical corps (IMC)

Authors: A. Sainvil, J. Mallela, L. M. Pereira

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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.

Keywords: adolescents, cancer, resilience, health management

Procedia PDF Downloads 94

Authors: Katie Wood

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Cyber criminals are constantly on the lookout for new opportunities to exploit organisation and cause destruction. This could lead to significant cause of economic loss for organisations in the form of destruction in finances, reputation and even the overall survival of the organization. Additionally, this leads to serious consequences on national security. The threat of possible cyber attacks places further pressure on organisations to ensure they are secure, at a time where international scale cyber attacks have occurred in a range of sectors. Stakeholders are wanting confidence that their data is protected. This is only achievable if a business fosters a resilient supply chain strategy which is implemented throughout its supply chain by having a strong cyber leadership culture. This paper will discuss the essential role and need for organisations to adopt a cyber leadership culture and direction to learn about own internal processes to ensure mitigating systemic vulnerability of its supply chains. This paper outlines that to protect national security there is an urgent need for cyber awareness culture change. This is required in all organisations, regardless of their sector or size, to implementation throughout the whole supplier chain to support and protect economic prosperity to make the UK more resilient to cyber-attacks. Through businesses understanding the supply chain and risk management cycle of their own operates has to be the starting point to ensure effective cyber migration strategies.

Keywords: cyber leadership, cyber migration strategies, resilient supply chain strategy, cybersecurity

Procedia PDF Downloads 244

Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

Procedia PDF Downloads 191

Authors: Olivia Martina Dalla Torre

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The aim of this paper is to describe and analyse some urban writings that emerge in politically disputed areas, namely the Occupied Palestinian Territories, and more specifically in Deheishe refugee camp. These graffiti are visible on the walls of houses, all around the camp, and they convey messages of protest but also of hope or claim about the complex political situation in the occupied territories. These graffiti can be then interpreted as political and politicized semiotic resources. In this paper, after having introduced the political situation of the Palestinian Territories in a historical perspective, we will question a specific dimension of these writings, i.e., their multilingual and ideological aspect. To do this, we will focus on ethnographic fieldwork on Deheishe refugee camp and we will draw on the theoretical framework of the critical communication studies which assert that language practices are not neutral and that they need to be understood through the lens of the historical context of production, crossing space and time. By analysing the relationship between the discursive constructions of the messages and the languages used, we will point out some of the possible reasons and functions of the presence of these multilingual discursive productions. We will show that if, on the one hand, these graffiti confirm the huge presence of Western actors in the region, on the other hand, they attest the presence of an international movement against the Israeli occupation and against other struggles as well. Concluding, we will argue that multilingualism certainly represents a diversification of the linguistic landscape and that it gives a transnational and political dimension to the graffiti.

Keywords: communication, graffiti, multilingualism, Palestine, transnationalism

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Tareq M. Aziz Elven

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The issue of Human Rights enforcement in Southeast Asia has become the serious problem and attract the attention of international community. Principally, Association of Southeast Asian Nations (ASEAN) has mentioned the Human Rights as one of the focus and be a part of the ASEAN Charter in 2008. It was followed by the establishment of ASEAN Inter-Governmental Commission on Human Rights (AICHR). AICHR is the commission of Human Rights enforcement in Southeast Asia which has a duty, function, and an authority to conduct dissemination and protection of Human Rights. In the end of 2016, however, the function of protection mandated to AICHR have not achieved yet. It can be proved by several cases of Human Rights violation which still exist and have not settled yet. One of case which attracts the public attention recently is human rights violation towards Rohingya in Myanmar. Using the juridical-normative method, the research aims to examine the urgency of Human Rights court establishment in Southeast Asia region which able to issue the decision that binds the ASEAN members or the violating parties. The data shows that ASEAN needs to establish a regional court which intended to settle the Human Rights violations in ASEAN region. Furthermore, the research also highlights three strong factors should be settled by ASEAN for establishing human rights court i.e. the significant distinction of democracy and human rights development among the members, the strong implementation of non-intervention principle, and the financial matter to sustain the court.

Keywords: AICHR, ASEAN, human rights, human rights court

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Authors: Ayman M. Mansour, Bilal Hawashin, Hesham Alsalem

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Faster delivery of laboratory test results is one of the most noticeable signs of good laboratory service and is often used as a key performance indicator of laboratory performance. Despite the availability of technology, the delivery time of clinical laboratory test results continues to be a cause of customer dissatisfaction which makes patients feel frustrated and they became careless to get their laboratory test results. The Medical Clinical Laboratory test results are highly sensitive and could harm patients especially with the severe case if they deliver in wrong time. Such results affect the treatment done by physicians if arrived at correct time efforts should, therefore, be made to ensure faster delivery of lab test results by utilizing new trusted, Robust and fast system. In this paper, we proposed a distributed Multi-Agent System to enhance and faster the process of laboratory test results delivery using SMS. The developed system relies on SMS messages because of the wide availability of GSM network comparing to the other network. The software provides the capability of knowledge sharing between different units and different laboratory medical centers. The system was built using java programming. To implement the proposed system we had many possible techniques. One of these is to use the peer-to-peer (P2P) model, where all the peers are treated equally and the service is distributed among all the peers of the network. However, for the pure P2P model, it is difficult to maintain the coherence of the network, discover new peers and ensure security. Also, security is a quite important issue since each node is allowed to join the network without any control mechanism. We thus take the hybrid P2P model, a model between the Client/Server model and the pure P2P model using GSM technology through SMS messages. This model satisfies our need. A GUI has been developed to provide the laboratory staff with the simple and easy way to interact with the system. This system provides quick response rate and the decision is faster than the manual methods. This will save patients life.

Keywords: multi-agent system, delivery process, GSM technology, clinical laboratory results

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Authors: Amjed Rasheed

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Rebellions are driven by several incentives. They do not often occur because of historical grievances or political exclusion. They can be driven by the desire to control over natural resources, or by both. In the case of the Islamic State (ISIL), greed and grievance are both drive this radical group to operate in Iraq and Syria. This article aims to show that grievance was the trigger to the emergence of ISIL. It also aims to demonstrate that ISIL is using oil as a tool, to implements its political ends, than a purpose per se. In other words, the emergence of ISIL is based on socio-political conditions, which are domestically driven, and oil is not ISIL’s aim but a source of revenue to finance its activities. This paper applies conflict analysis methodology to analyse the conflict in Iraq and Syria, with a specific highlight to ISIL. By doing so, it gives ahistorical background on emergence of ISIL. It also provides an insightful explanation on the main dynamics and the tactics this organisation applies. It also delivers a sufficient explanation on how it recruits its members, both local and international. It concludes that tackling ISIL needs a more sophisticated approach than the one Obama administration has adopted. It is more a political issue to be tackled by political means, than a military one to be tackled by military means. The current war is an Intra-Sunni war, and therefore, Sunni states have to be on board to crackdown ISIL. Besides, the article finishes with the argument that democratisation is not necessarily the key answer to bring stability to the region, but a sort of governance that provides security and material needs to individuals.

Keywords: ISIL, Iraq, domestic politics, Islamic radicalisation

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Authors: Maryam Beiranvand, Sajad Yaghoubi

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Background: Some microbes can colonize plants’ inner tissues without causing obvious damage and can even produce useful bioactive substances. In the present study, the diversity of the endophytic bacteria associated with medicinal plants from Iran was investigated by culturing techniques, molecular gene identification, as well as measuring them for antibacterial activity. Results: In the spring season from 2013 to 2014, 35 herb pharmacology samples were collected, sterilized, meshed, and then cultured on selective media culture. A total of 199 endophytic bacteria were successfully isolated from 35 tissue cultures of medical plants, and sixty-seven out of 199 bacterial isolates were subjected to identification by the 16S rRNA gene sequence analysis method. Based on the sequence similarity gene and phylogenetic analyses, these isolates were grouped into five classes, fourteen orders, seventeen families, twenty-one genera, and forty strains. The most abundant group of endophytic bacteria was actinobacterial, consisting of thirty-two (47%) out of 67 bacterial isolates. Ten (22.3%) out of 67 bacterial isolates remained unidentified and classified at the genus level. The signature of the 16S rRNA gene formed a distinct line in a phylogenetic tree showing that they might be new species of bacteria. One (5.2%) out of 67 bacterial isolates was still not well categorized. Forty-two out of 67 strains were candidates for antimicrobial activity tests. Nineteen (45%) out of 42 strains showed antimicrobial activity multidrug-resistance (MDR); thirteen (68%) out of 19 strains were allocated to classes actinobacteria. Four (21%) out of 19 strains belonged to the Bacillaceae family, one (5.2%) out of 19 strains was the Paenibacillaceae family, and one (5.2%) out of 19 strains belonged to the Pseudomonadaceae family. The other twenty-three strains did not show inhibitory activities. Conclusions: Our research showed a high-level phylogenetic diversity and the intoxicating antibiotic activity of endophytic bacteria in the herb pharmacology of Iran.

Keywords: medical plant, endophytic bacteria, antimicrobial activity, whole genome sequencing analysis

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Authors: Yooseo Pang, Jongwoong Choi, Yong Cho, Yongchae Jeong

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Climate crisis, such as environmental problems related to energy supply, is getting emerged issues, so the use of renewable energy is essentially required to solve these problems, which are mainly managed by the Paris Agreement, the international treaty on climate change. The government of the Republic of Korea announced that the key long-term goal for a low-carbon strategy is “Carbon neutrality by 2050”. It is focused on the role of the internet data centers (IDC) in which large amounts of data, such as artificial intelligence (AI) and big data as an impact of the 4th industrial revolution, are managed. The demand for the cooling system market for IDC was about 9 billion US dollars in 2020, and 15.6% growth a year is expected in Korea. It is important to control the temperature in IDC with an efficient air conditioning system, so hydrothermal energy is one of the best options for saving energy in the cooling system. In order to save energy and optimize the operating conditions, it has been considered to apply ‘the dam deep water air conditioning system. Deep water at a specific level from the dam can supply constant water temperature year-round. It will be tested & analyzed the amount of energy saving with a pilot plant that has 100RT cooling capacity. Also, a target of this project is 1.2 PUE (Power Usage Effectiveness) which is the key parameter to check the efficiency of the cooling system.

Keywords: hydrothermal energy, HVAC, internet data center, free-cooling

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Authors: Golyasamin Khanehzaei, Mohd. Bakri Ishak, Ahmad Makmom Hj Abdullah, Latifah Abd Manaf

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Abstract—Management of clinical waste is a critical problem worldwide. Immediate attention is required to manage the clinical waste in an appropriate way in newly developing economy country such as Malaysia. The increasing amount of clinical waste generated is resulted from rapid urbanization and growing number of private health care facilities in developing countries such as Malaysia. In order to develop a sensible clinical waste management system and improvement of the management, information on factors affecting clinical waste generation has the crucial role. This paper is the study of management characteristics of clinical waste and the level of efficiency of clinical waste management systems operating in private clinics located in Selangor, Malaysia. Are they following the proper international standards? By taking all of this in consideration the aim of this paper is to identify and discuss the current trend, current challenges and also the present opportunities among the challenges of clinical waste management in private clinics of Selangor, Malaysia. The SWOT analysis was characterized for the evaluation of strengths, weaknesses, opportunities and threats. The methodology for this study was constituted of direct observation, Informal interviews, Conducting SWOT analysis, conduction of one sustainability dimensions analysis and application. The results show that clinical waste management in private clinics is far from an ideal model.

Keywords: clinical waste, SWOT analysis, Selangor, Malaysia

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Authors: Shilpa Balan

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Radio Frequency Identification, also popularly known as RFID is used to automatically identify and track tags attached to items. This study focuses on the application of RFID in healthcare. The adoption of RFID in healthcare is a crucial technology to patient safety and inventory management. Data from RFID tags are used to identify the locations of patients and inventory in real time. Medical errors are thought to be a prominent cause of loss of life and injury. The major advantage of RFID application in healthcare industry is the reduction of medical errors. The healthcare industry has generated huge amounts of data. By discovering patterns and trends within the data, big data analytics can help improve patient care and lower healthcare costs. The number of increasing research publications leading to innovations in RFID applications shows the importance of this technology. This study explores the current state of research of RFID in healthcare using a text mining approach. No study has been performed yet on examining the current state of RFID research in healthcare using a data mining approach. In this study, related articles were collected on RFID from healthcare journal and news articles. Articles collected were from the year 2000 to 2015. Significant keywords on the topic of focus are identified and analyzed using open source data analytics software such as Rapid Miner. These analytical tools help extract pertinent information from massive volumes of data. It is seen that the main benefits of adopting RFID technology in healthcare include tracking medicines and equipment, upholding patient safety, and security improvement. The real-time tracking features of RFID allows for enhanced supply chain management. By productively using big data, healthcare organizations can gain significant benefits. Big data analytics in healthcare enables improved decisions by extracting insights from large volumes of data.

Keywords: RFID, data mining, data analysis, healthcare

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Authors: Abdsalam Alahwal, Suren Pillay

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Libya saw the occurrence of violations of human rights on a large scale as well as the deterioration of the rule of law in large parts of the country after the February 17 revolution that removed the Colonel Muammar Gaddafi from power in what is known upheaval of the Arab Spring. Although Libya, a country with a modern democracy, but he has declared unconstitutional temporarily allowed to exercise all the rights of political, civil and judicial, but the presence of weapons in the hands of militias list on the basis of regional, tribal and ideology was the main reason for the deterioration of the humanitarian situation as well as the foreign intervention in Libya. Where reports stressed that violations are serious committed by the conflicting parties from power after the fall of Gaddafi of assassinations and kidnapping of identity and practices related to human trafficking Some of these reports indicate that some ethnic ingredients such as Tawergha and Epiphyseal where was deliberately targeted by some militias were displacement around the city because of their allegiance to the former regime after the war ended in 2012. It is noteworthy that many of these violations and abuses committed by these militias that participated overthrow Gaddafi may rise to war crimes and crimes against humanity. That the intervention in Libya, although it had a human purpose and under the pretext of reducing the political system of human rights violations, but that the main objective, which was behind the international intervention was to overthrow the existing political system and the elimination of Muammar Gaddafi.

Keywords: Arab Spring, democracy, revolution , Libya

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Authors: Cinthia C. Costa, Heloisa L. Burnquist, Joaquim J. M. Guilhoto

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This study identified the impact of special agricultural safeguards (SSG) for the global market of meat and for the Brazilian economy. The tariff lines subject to SSG were selected and the period of analysis was 1995 (when the rules about the SSGs were established) to 2015 (more recent period for which there are notifications). The value of additional tariff was calculated for each of the most important tariff lines. The import volume and the price elasticities for imports were used to estimate the impacts of each additional tariff estimated on imports. Finally, the effect of Brazilian exports of meat without SSG taxes was calculated as well as its impact in the country’s economy by using an input-output matrix. The most important markets that applied SSGs were the U.S. for beef and European Union for poultry. However, the additional tariffs could be estimated in only two of the sixteen years that the U.S. applied SSGs on beef imports, suggesting that its use has been enforced when the average annual price has been higher than the trigger price level. The results indicated that the value of the bovine and poultry meat that could not be exported by Brazil due to SSGs to both markets (EU and the U.S.) was equivalent to BRL 804 million. The impact of this loss in trade was about: BRL 3.7 billion of the economy’s production value (at 2015 prices) and almost BRL 2 billion of the Brazilian Gross Domestic Product (GDP).

Keywords: beef, poultry meat, SSG tariff, input-output matrix, Brazil

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Authors: Mira Ezora Zainal Abidin, Siti Fauzuna Othman, Zalina Harun, M. Hafiz M. Pikri

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In a fire incident involving a Nitrogen storage tank that over-pressured and exploded, resulting in a fire in one of the units in a refinery, lack of data and evidence hampered the investigation to determine the root cause. Instrumentation and fittings were destroyed in the fire. To make it worst, this incident occurred during the COVID-19 pandemic, making collecting and testing evidence delayed. In addition to that, the storage tank belonged to a third-party company which requires legal agreement prior to the refinery getting approval to test the remains. Despite all that, the investigation had to be carried out with stakeholders demanding answers. The investigation team had to devise alternative means to support whatever little evidence came out as the most probable root cause. International standards, practices, and previous incidents on similar tanks were referred. To narrow down to just one root cause from 8 possible causes, transient simulations were conducted to simulate the overpressure scenarios to prove and eliminate the other causes, leaving one root cause. This paper shares the methodology used and details how transient simulations were applied to help solve this. The experience and lessons learned gained from the event investigation and from numerous case studies via transient analysis in finding the root cause of the accident leads to the formulation of future mitigations and design modifications aiming at preventing such incidents or at least minimize the consequences from the fire incident.

Keywords: fire, transient, simulation, relief

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Authors: Aparajita Bhattacharya, Mousumi Dutta, Zakir Husain, Dionne Sequeira, Asima Mukhopadhyay

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Background: Tata Medical Centre (TMC), Kolkata is a major cancer referral centre in Eastern India and neighbouring countries providing state of the art facilities; however, it is a non-profit organisation with patients requiring to pay at subsidised rates. Although a system for social assessment and applying for governmental/ non-governmental (NGO) funds is in place, access is challenging. Amongst gynaecological cancers (GC), ovarian cancer (OC) is associated with the highest treatment cost; majority of which is required at the beginning when complex surgery is performed and funding arrangements cannot be made in time. We therefore appointed a dedicated Medical Social Worker (MSW) in 2016, supported by NGO for GC patients in order to assist patients/family members to access/avail these funds more readily and assist in economic evaluation for both direct and opportunity costs. Objectives: To reflect on our experience and challenges in collecting data on economic evaluation of cancer patients and compare success rates in achieving fund mobilization after introduction of MSW. Methods: A Retrospective survey. Patients with OC and their relatives were seen by the MSW during the initial outpatients department visit and followed though till discharge from the hospital and during follow-up visits. Assistance was provided in preparing the essential documents/paperwork/contacts for the funding agencies including both governmental (Chief-Minister/Prime-Minister/President) and NGO sources. In addition, a detailed questionnaire was filled up for economic assessment of direct/opportunity costs during the entire treatment and 12 months follow up period which forms a part of the study called HEPTROC (Health economic evaluation of primary treatment for ovarian cancer) developed in collaboration with economics departments of Universities. Results: In 2015, 102 patients were operated for OC; only 16 patients (15.68 %) had availed funding of a total sum of INR 1640000 through the hospital system for social assessment. Following challenges were faced by majority of the relatives: 1. Gathering important documents/proper contact details for governmental funding bodies and difficulty in following up the current status 3. Late arrival of funds. In contrast in 2016, 104 OC patients underwent surgery; the direct cost of treatment was significantly higher (median, INR 300000- 400000) compared to other GCs (n=274). 98/104 (94.23%) OC patients could be helped to apply for funds and 90/104(86.56%) patients received funding amounting to a total of INR 10897000. There has been a tenfold increase in funds mobilized in 2016 after the introduction of dedicated MSW in GC. So far, in 2017 (till June), 46/54(85.18%) OC patients applied for funds and 37/54(68.51%) patients have received funding. In a qualitative survey, all patients appreciated the role of the MSW who subsequently became the key worker for patient follow up and the chief portal for patient reported outcome monitoring. Data collection quality for the HEPTROC study was improved when questionnaires were administered by the MSW compared to researchers. Conclusion: Introduction of cancer specific MSW can expedite the availability of funds required for cancer patients and it can positively impact on patient satisfaction and outcome reporting. The economic assessment will influence fund allocation and decision for policymaking in ovarian cancer. Acknowledgement: Jivdaya Foundation Dallas, Texas.

Keywords: economic evaluation, funding, medical social worker, ovarian cancer

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Authors: Seyed Vahid Kamal Alavi

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Italy has experienced a notable quantity and impact of disasters due to natural hazards and technological accidents caused by diverse risk sources on its physical, technological, and human/sociological infrastructures during past decade. This study discusses the frequency and impacts of the most three physical devastating natural hazards in Italy for the period 2000–2013. The approach examines the reliability of a range of open source WebGIS techniques versus a proposed multi-hazard risk management methodology. Spatial and attribute data which include USGS publically available hazard data and thirteen years Munich RE recorded data for Italy with different severities have been processed, visualized in a GIS (Geographic Information System) framework. Comparison of results from the study showed that the multi-hazard risk maps generated using open source techniques do not provide a reliable system to analyze the infrastructures losses in respect to national risk sources while they can be adopted for general international risk management purposes. Additionally, this study establishes the possibility to critically examine and calibrate different integrated techniques in evaluating what better protection measures can be taken in an area.

Keywords: multi-hazard risk mapping, risk management, GIS, Italy

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Authors: May Ziade

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Postgraduate studies in English language and literature at the University of Sydney provided opportunity for research into one of the most significant singer/songwriters of our time, Bob Dylan, and his masterpiece from the mid-1960s, ‘Desolation Row’. With a title alluding to Jack Kerouac’s Desolation Angels as well as John Steinbeck’s Cannery Row, ‘Desolation Row’ is Bob Dylan’s magnum opus. Recorded on August 4 1965, it takes pride of place as the last track on the revolutionary 1965 album of rock poetics, Highway 61 Revisited. From its inception, its epic proportions (ten long verses) and rich and baffling imagery got our attention - it amused, fascinated and beguiled. The song’s surreal and dreamlike landscape and its cast of characters, drawn from history, fiction, mythology, theology, and popular culture, lured us in and begged interpretation. What were they doing there? Where is Desolation Row? Do they want to escape from or go to ‘Desolation Row’? What was Dylan writing about and what were his influences? Through literary analysis and historical research, this paper will examine the song’s lyrics, the mid-60s context and Dylan’s vast influences to make sense, offer explanations and make connections. In particular, research findings place the Beat poets and oeuvre as a significant literary influence but it is a rich, multilayered text that straddles traditions and emerges as a paradox – a paradox that has endured and endeared itself to many. As it turns 50 this year, what better way to acknowledge this momentous occasion than at an international English language conference.

Keywords: analysis, Bob Dylan, beat context, desolation row

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Authors: Shantala Herlekar

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Introduction: Entrainment effect of music on cardiovascular parameters is well established. Music is being used in the background by medical students while studying. However, does it really help them relax faster and concentrate better? Objectives: This study was done to compare the effects of classical instrumental background music versus no music on blood pressure response over time and on successively performed divided attention test in Indian and Malaysian 1st-year medical students. Method: 60 Indian and 60 Malaysian first year medical students, with an equal number of girls and boys were randomized into two groups i.e music group and control group thus creating four subgroups. Three different forms of Symbol Digit Modality Test (to test concentration ability) were used as a pre-test, during music/control session and post-test. It was assessed using total, correct and error score. Simultaneously, multiple Blood Pressure recordings were taken as pre-test, during 1, 5, 15, 25 minutes during music/control (+SDMT) and post-test. The music group performed the test with classical instrumental background music while the control group performed it in silence. Results were analyzed using students paired t test. p value < 0.05 was taken as statistically significant. A drop in BP recording was indicative of relaxed state and a rise in BP with task performance was indicative of increased arousal. Results: In Symbol Digit Modality Test (SDMT) test, Music group showed significant better results for correct (p = 0.02) and total (p = 0.029) scores during post-test while errors reduced (p = 0.002). Indian music group showed decline in post-test error scores (p = 0.002). Malaysian music group performed significantly better in all categories. Blood pressure response was similar in music and control group with following variations, a drop in BP at 5minutes, being significant in music group (p < 0.001), a steep rise in values till 15minutes (corresponding to SDMT test) also being significant only in music group (p < 0.001) and the Systolic BP readings in controls during post-test were at lower levels compared to music group. On comparing the subgroups, not much difference was noticed in recordings of Indian student’s subgroups while all the paired-t test values in the Malaysian music group were significant. Conclusion: These recordings indicate an increased relaxed state with classical instrumental music and an increased arousal while performing a concentration task. Music used in our study was beneficial to students irrespective of their nationality and preference of music type. It can act as an “active coping” strategy and alleviate stress within a very short period of time, in our study within a span of 5minutes. When used in the background, during task performance, can increase arousal which helps the students perform better. Implications: Music can be used between lectures for a short time to relax the students and help them concentrate better for the subsequent classes, especially for late afternoon sessions.

Keywords: blood pressure, classical instrumental background music, ethnicity, symbol digit modality test

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Authors: Devesh Motwani, Amey Kashyap

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Interest in cost effective drilling has increased substantially in the past years. Economics associated with drilling fluids is needed to be considered seriously for lesser cost per foot in planning and drilling of a wellbore and the various environmental concerns imposed by international communities related with the constituents of the drilling fluid. Viscofier such as Guar Gum is a high molecular weight polysaccharide from Guar plants, is used to increase viscosity in water-based and brine-based drilling fluids thus enabling more efficient cleaning of the bore. Other applications of this Viscofier are to reduce fluid loss by giving a better colloidal solution, decrease fluid friction and so minimising power requirements and used in hydraulic fracturing to increase the recovery of oil and gas. Guar gum is also used as a surfactant, synthetic polymer and defoamer. This paper presents experimental results to verifying the properties of guar gum as a viscofier and filtrate retainer as well as observing the impact of different quantities of guar gum and Carboxymethyl cellulose (CMC) in a standard sample of water based bentonite mud solution. This is in attempt to make a drilling fluid which contains half of the quantity of drilling mud used and yet is equally viscous to the standardised mud sample. Thus we can see that mud economics will be greatly affected by this approach. However guar gum is thermally stable till 60-65°C thus limited to be used in drilling shallow wells and for a wider thermal range, suitable chrome free additives are required.

Keywords: economics, guargum, viscofier, CMC, thermal stability

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Preethy Mary Donald, Renjith George

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Oral tori are localized non-neoplastic protuberances of maxilla and mandible. Torus palatinus (TP) is found on the midline of the roof of mouth existing as single growth or in clusters. Torus mandibularis(TM) is located on the lingual aspect of the mandible commonly between canine and premolar region. Etiology of their presence was not clear and was found to be multifactorial. Their variations in relation to age, gender, ethnicity and also the characteristics of TP and TM have become the interest of multiple studies. The objectives of this study were to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) among patients who have visited outpatient department, Faculty of Dentistry, Melaka Manipal Medical College. 108 patients were examined for the presence of oral tori at the outpatient department, Faculty of Dentistry, Melaka-Manipal Medical College. Factors such as age, gender, ethnicity of the patients and size, shape, location of the oral tori were studied. For TP, Malays (62.96%) have been found to have the highest prevalence than Chinese (43.3%) and Indians (35.71%). For TM, Chinese (7.46%) had predominated compared to Malays (7.41%) and Indians (0%). There is no significant association between occurrence of TP and TM with age, gender and ethnicity. For Torus palatinus, the most common size was Grade 1(1-3mm), most common location was molar region, and the most common shape was spindle. For Torus mandibularis, the most frequent location was canine premolar region and exists in unilateral single or bilateral single fashion. The overall prevalence rates were 47.2% for TP and 6.48% for TM. However, there is no significant association between occurrence of TP and TM with age, gender and ethnicity. The results showed variations in clinical characteristics and support the findings that occurrence of tori is a dynamic phenomenon which is multifactorial owing to the environmental factors such as stress from occlusion and dietary habits. It could be due to the genetic make-up of the individual.

Keywords: torus palatinus, torus mandibularis, age, gender

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Authors: Shahla Ali

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In the context of promoting green infrastructure development, new opportunities are emerging to re-examine sustainable development practices. This paper presents an initial exploration of the development of community-investor dispute prevention and facilitation mechanisms in the context of the Belt and Road Initiative (BRI) spanning Asia, Africa, and Europe. Given the widescale impact of China’s multi-jurisdictional development initiative, learning how to coordinate with local communities is vital to realizing inclusive and sustainable growth. In the 20 years since the development of the first multilateral community-investor dispute resolution mechanism developed by the International Finance Centre/World Bank, much has been learned about public facilitation, community engagement, and dispute prevention during the early stages of major infrastructure development programs. This paper will explore initial findings as they relate to initiatives underway along the BRI within the Asian Infrastructure Investment Bank and the Asian Development Bank. Given the borderless nature of sustainability concerns, insights from diverse regions are critical to deepening insights into best practices. Drawing on a case-based methodology, this paper will explore the achievements, challenges, and lessons learned in community-investor dispute prevention and resolution for major infrastructure projects in the greater China region.

Keywords: law and development, dispute prevention, sustainable development, mitigation

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Authors: Norah Salem Al Mosa

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This paper critically examines the ethical position of academic scholarship concerning "women in leadership" in Saudi Arabia, focusing on the context of the Saudi Vision 2030 initiative. While this vision places a strong emphasis on empowering women and increasing their presence in the workforce, women still face significant cultural, organisational, and personal barriers to leadership roles. The existing literature highlights the challenges Saudi women encounter, including the male guardianship system, and international perspectives add complexity to the issue. The debate among scholars about considering cultural context versus highlighting ongoing challenges is explored. The paper underscores that despite efforts to enhance women's representation in leadership positions, progress has been slow due to cultural norms, the absence of legal quotas, and limited access to education and professional development. It raises questions about the seriousness of research efforts and the government's commitment to gender equality in leadership roles, emphasising the need for increased academic scrutiny in this area. Ultimately, the paper aims to enhance understanding of the challenges and opportunities for women in leadership roles, their contributions to corporate governance in Saudi Arabia, and potential implications beyond its borders.

Keywords: female directors, gender diversity, women on executive positions, Saudi vision 2030

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Authors: Jennifer Wheeldon, Nick de Viggiani, Nikki Cotterill

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Background: Urinary and fecal incontinence affect a significant proportion of older adults aged 65 and over who permanently reside in residential and nursing home facilities. Incontinence symptoms have been linked to comorbidities, an increased risk of infection and reduced quality of life and mental wellbeing of residents. However, continence care provision can often be poor, further compromising the health and wellbeing of this vulnerable population. Objectives: To identify experiences and perceptions of continence care provision in older adult residential care settings and to identify factors that help or hinder good continence care provision. Settings included both residential care homes and nursing homes for older adults. Methods: A qualitative evidence synthesis using systematic review methodology established the current evidence-base. Data from 20 qualitative and mixed-method studies was appraised and synthesized. Following the review process, 10* qualitative interviews with staff working in older adult residential care settings were conducted across six* sites, which included registered managers, registered nurses and nursing/care assistants/aides. Purposive sampling recruited individuals from across England. Both evidence synthesis and interview data was analyzed thematically, both manually and with NVivo software. Results: The evidence synthesis revealed complex barriers and facilitators for continence care provision at three influencing levels: macro (structural and societal external influences), meso (organizational and institutional influences) and micro (day-to-day actions of individuals impacting service delivery). Macro-level barriers included negative stigmas relating to incontinence, aging and working in the older adult social care sector, restriction of continence care resources such as containment products (i.e. pads), short staffing in care facilities, shortfalls in the professional education and training of care home staff and the complex health and social care needs of older adult residents. Meso-level barriers included task-centered organizational cultures, ageist institutional perspectives regarding old age and incontinence symptoms, inadequate care home management and poor communication and teamwork among care staff. Micro-level barriers included poor knowledge and negative attitudes of care home staff and residents regarding incontinence symptoms and symptom management and treatment. Facilitators at the micro-level included proactive and inclusive leadership skills of individuals in management roles. Conclusions: The findings of the evidence synthesis study help to outline the complexities of continence care provision in older adult care homes facilities. Macro, meso and micro level influences demonstrate problematic and interrelated barriers across international contexts, indicating that improving continence care in this setting is extremely challenging due to the multiple levels at which care provision and services are impacted. Both international and national older adult social care policy-makers, researchers and service providers must recognize this complexity, and any intervention seeking to improve continence care in older adult care home settings must be planned accordingly and appreciatively of the complex and interrelated influences. It is anticipated that the findings of the qualitative interviews will shed further light on the national context of continence care provision specific to England; data collection is ongoing*. * Sample size is envisaged to be between 20-30 participants from multiple sites by Spring 2023.

Keywords: continence care, residential and nursing homes, evidence synthesis, qualitative

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Authors: Richa Rai

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The purpose of this study is to analyze the role of the services sector in economic development of Indian economy, especially in the post reform period. Due to adoption of liberalization policy in developing economy like India, international transaction in services has been increased at a rapid pace which compensated to the current account of Balance of Payment which was in a pitiable condition. But this increased share of services in GDP is not commensurate with share in employment, which is a matter of great concern for Indian economy. Although the increased share of service in GDP indicates the advanced stage of growth of the economy, but this theory is not applicable in context of Indian economy completely. In the preliminary stage, this study finds a positive correlation between growth of services and export earnings and gross domestic product and this growth of services is not equal in terms of all aspects on Indian economy, and also all components of services has not been increased at an equal rate. This paper seeks to examine the impact of liberalization in post reform era on the growth of services in India. The analysis is done for the period of 1991 to 2013. Data has been collected from the secondary sources, especially from the website of Reserve Bank of India, World Trade Organization, and United Nation Conference on Trade and Development. The data has been analyzed with the help of appropriate statistical tools (Causality Relation and Group t-test).

Keywords: export earnings, GDP, gross domestic product, liberalization, services

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Authors: Maria Do Carmo Baracho De Alencar, Marciene Campos Fialho, Maria Do Carmo Vitório Ramos

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The subjects affected by Repetitive Strain Injury/Work Related Musculoskeletal Disorder (RSI/WRMSD) face an everyday life marked by pain, feelings of worthlessness and incapacity caused by the disease, and aggravated often because of discrimination society. Aim: To investigate the experiences and feelings of workers affected by RSI/WRMSD in removal from work situations and to understand the repercussions on mental health. Methods: Clinical records of workers were consulted, opened from July 1, 2014, to July 1, 2015, at the Reference Center for Worker's Health, in Santos city-SP. Selection of workers affected by RSI /WRMSD and who had experienced the removal from work situation due to the disease, and invitation to participate in the study. Semi-structured and individual interviews were carried out based on a pre-elaborated script, and for thematic content analysis. Results: Of a total of 502 medical records, 157 were selected, and of these, 18 workers participated in the interviews, both gender, most of them with low education level, aged between 35 and 56 years, and from different professions. Diseases affected several physical body regions and some workers had more than one body region affected by chronic pain. In the testimonies emerged the psychic suffering by the process of illness at work, fear of dismissal, invisibility of pain, in medical expertise attendance, by the incapacity to perform tasks that were easily achievable, with feelings of uselessness, revolt, and injustice, among others. Conclusion: The workers need to be readapted to new life situations, and the study promotes reflections on the need for more interdisciplinary actions and of the Psychology to the workers affected by RSI/ WRMSD.

Keywords: repetitive strain injury, cumulative trauma disorder, absence from work, mental health, occupational health

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Authors: Cris Bravo

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Social entrepreneurship is a new and exciting topic that holds a great promise in helping alleviate the social problems of the world. As a new subject, the meaning of the term is too broad and this is counterproductive in trying to build understanding around the concept. The purpose of this study is to identify and compare the elements of social entrepreneurship as defined by seven international organizations leading social entrepreneurship projects: Ashoka Foundation, Skoll Foundation, Schwab Foundation and Yunus Center; as well as from three other institutions fostering social entrepreneurship: Global Social Benefit Institute, BRAC University, and Socialab. The study used document analysis from Skoll Foundation, Schwab Foundation, Yunus Center and Ashoka Foundation; and open ended interview to experts from the Global Social Benefit Institute at Santa Clara University in United States, BRAC University from Bangladesh, and Socialab from Argentina. The study identified three clearly differentiated schools of thought, based on their views on revenue, scalability, replicability and geographic location. While this study is by no means exhaustive, it provides an indication of the patterns of ideas fostered by important players in the field. By clearly identifying the similarities and differences in the concept of social entrepreneurship, research and practitioners are better equipped to build on the subject, and to promote more adequate and accurate social policies to foster the development of social entrepreneurship.

Keywords: replicability, revenue, scalability, schools of thought, social entrepreneurship

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Authors: Ahmed F. Abdel Qader

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Viral marketing has resulted in a lot of excitement recently as a novel technology in the field of marketing. The need of porting institutions to attract new customers for sporting products and services has increased, especially as many international and Arab clubs rely on them for most of their funding. These organizations, especially clubs, have outlets for selling their products and services; therefore, they are in need for new approaches that are related to modern communication and innovative distribution methods that can depend on the present audience in conveying e-ads to other users in light of the increase in social media users in the Arab world. This study aims at developing a marketing plan for sporting products and services through viral marketing of social media users. The researcher used the descriptive method. The sample consisted of 1991 social media users in 13 Arab countries. The questionnaire consisted of five themes and 42 items. Allan Dib 'one-page marketing plan' was used to develop the sporting products and services marketing plan. The study found that participants reported watching e-ads of sporting products and services that appeared during browsing social media pages; Facebook was the most used means for receiving ads about sporting products and services; sharing the product’s ad depends on the availability of incentives; purchasing sporting products and services takes place after a recommendation by a relative or a friend; and their evaluation of sporting products and services depends on the experiences of other people. The study recommends that the proposed plan should be used in marketing sporting products and services.

Keywords: viral marketing, sporting products, social media, Arab world

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