Search results for: marginal likelihood evidence
4331 The Musician as the Athlete: Psychological Response to Injury
Authors: Shulamit Sternin
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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.Keywords: athlete, injury, musician, psychological response
Procedia PDF Downloads 2054330 Institutional Legitimacy and Professional Boundary: Western Medicine-Trained Doctors' Attitudes and Behaviors toward Traditional Chinese Medicine
Authors: Xiaoli Tian
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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine
Procedia PDF Downloads 1844329 Foreign Banks Taking More Risk: Evidence from Emerging Economies
Authors: Minghua Chen, Rui Wang
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This paper addresses the impact of foreign ownership on the risk-taking behavior of banks. Using bank-level panel data of more than 1,300 commercial banks in 32 emerging economies during 2000-2013, we find that foreign owned banks take on more risk than their domestic counterparts. We further examine several factors that may potentially contribute to foreign banks’ differentiated riskiness from four perspectives, namely, foreign banks’ informational disadvantages, agency problems, the contagious effect of parent banks’ financial conditions and the disparity between home and host markets. We find supportive evidence that these factors play a significant role in affecting foreign banks’ risk-taking.Keywords: bank risk-taking, emerging economies, financial liberalization, foreign banks
Procedia PDF Downloads 4464328 Current and Emerging Pharmacological Treatment for Status Epilepticus in Adults
Authors: Mathew Tran, Deepa Patel, Breann Prophete, Irandokht Khaki Najafabadi
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Status epilepticus is a neurological disorder requiring emergent control with medical therapy. Based on guideline recommendations for adults with status epilepticus, the first-line treatment is to start a benzodiazepine, as they are quick at seizure control. The second step is to initiate a non-benzodiazepine anti-epileptic drug to prevent refractory seizures. Studies show that the anti-epileptic drugs are approximately equivalent in status epilepticus control once a benzodiazepine has been given. This review provides a brief overview of the management of status epilepticus based on evidence from the literature and evidence-based guidelines.Keywords: neurological disorder, seizure, status epilepticus, benzo diazepines, antiepileptic agents
Procedia PDF Downloads 1204327 Do European Hedge Fund Managers Time Market Liquidity?
Authors: Soumaya Ben Kheilifa, Dorra Mezzez Hmaied
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We propose two approaches to examine whether European hedge fund managers can time market liquidity. Using a sample of 1616 European hedge funds, we find evidence of liquidity timing. More importantly, this ability adds economic value to investors. Thus, it represents valuable managerial skill and a major source of European hedge funds’ performance. Also we show that the majority of these funds demonstrate liquidity timing ability especially during liquidity crisis. Finally, it emerged that our main evidence of liquidity timing remains significant after controlling for market timing and volatility timing.Keywords: european hedge funds, liquidity timing ability, market liquidity, crisis
Procedia PDF Downloads 3924326 Digital Forensics Analysis Focusing on the Onion Router Browser Artifacts in Windows 10
Authors: Zainurrasyid Abdullah, Mohamed Fadzlee Sulaiman, Muhammad Fadzlan Zainal, M. Zabri Adil Talib, Aswami Fadillah M. Ariffin
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The Onion Router (Tor) browser is a well-known tool and widely used by people who seeking for web anonymity when browsing the internet. Criminals are taking this advantage to be anonymous over the internet. Accessing the dark web could be the significant reason for the criminal in order for them to perform illegal activities while maintaining their anonymity. For a digital forensic analyst, it is crucial to extract the trail of evidence in proving that the criminal’s computer has used Tor browser to conduct such illegal activities. By applying the digital forensic methodology, several techniques could be performed including application analysis, memory analysis, and registry analysis. Since Windows 10 is the latest operating system released by Microsoft Corporation, this study will use Windows 10 as the operating system platform that running Tor browser. From the analysis, significant artifacts left by Tor browser were discovered such as the execution date, application installation date and browsing history that can be used as an evidence. Although Tor browser was designed to achieved anonymity, there is still some trail of evidence can be found in Windows 10 platform that can be useful for investigation.Keywords: artifacts analysis, digital forensics, forensic analysis, memory analysis, registry analysis, tor browser, Windows 10
Procedia PDF Downloads 1704325 Evidence from the Field: The Case Study of Golitos as an Effective Soccer Program for Autism Spectrum Disorder Children
Authors: J. O. Alvarez, L. Y. Rivera
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Physical activity can reduce symptomatology in children with autism spectrum disorder (ASD). The sport of soccer has been widely applied as a therapeutic method for ASD children. However, empirical results from soccer programs are not widely known. This paper presents the case study of Golitos, the only dedicated soccer program for children on the island of Puerto Rico, and analyzes its results in the reduction of ASD social and emotional symptoms. The paper shows evidence that suggests that program approach, content, and community-based elements can make a notable difference in the effectiveness of using soccer or sports as therapeutic methods for children with ASD.Keywords: autism, soccer, program, community
Procedia PDF Downloads 1314324 Identity and Mental Adaptation of Deaf and Hard-of-Hearing Students
Authors: N. F. Mikhailova, M. E. Fattakhova, M. A. Mironova, E. V. Vyacheslavova
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For the mental and social adaptation of the deaf and hard-of-hearing people, cultural and social aspects - the formation of identity (acculturation) and educational conditions – are highly significant. We studied 137 deaf and hard-of-hearing students in different educational situations. We used these methods: Big Five (Costa & McCrae, 1997), TRF (Becker, 1989), WCQ (Lazarus & Folkman, 1988), self-esteem, and coping strategies (Jambor & Elliott, 2005), self-stigma scale (Mikhailov, 2008). Type of self-identification of students depended on the degree of deafness, type of education, method of communication in the family: large hearing loss, education in schools for deaf, and gesture communication increased the likelihood of a 'deaf' acculturation. Less hearing loss, inclusive education in public school or school for the hearing-impaired, mixed communication in the family contributed to the formation of 'hearing' acculturation. The choice of specific coping depended on the degree of deafness: a large hearing loss increased coping 'withdrawal into the deaf world' and decreased 'bicultural skills' coping. People with mild hearing loss tended to cover-up it. In the context of ongoing discussion, we researched personality characteristics in deaf and hard on-hearing students, coping and other deafness associated factors depending on their acculturation type. Students who identified themselves with the 'hearing world' had a high self-esteem, a higher level of extraversion, self-awareness, personal resources, willingness to cooperate, better psychological health, emotional stability, higher ability to empathy, a greater satiety of life with feelings and sense and high sense of self-worth. They also actively used strategies, problem-solving, acceptance of responsibility, positive revaluation. Student who limited themselves within the culture of deaf people had more severe hearing loss and accordingly had more communication barriers. Lack of use or seldom use of coping strategies by these students point at decreased level of stress in their life. Their self-esteem have not been challenged in the specific social environment of the students with the same severity of defect, and thus this environment provided sense of comfort (we can assume that from the high scores on psychological health, personality resources, and emotional stability). Students with bicultural acculturation had higher level of psychological resources - they used Positive Reappraisal coping more often and had a higher level of psychological health. Lack of belonging to certain culture (marginality) leads to personality disintegration, social and psychological disadaptation: deaf and hard-of-hearing students with marginal identification had a lower self-estimation level, worse psychological health and personal resources, lower level of extroversion, self-confidence and life satisfaction. They, in fact, become 'risk group' (many of them dropped out of universities, divorced, and one even ended up in the ranks of ISIS). All these data argue the importance of cultural 'anchor' for people with hearing deprivation. Supported by the RFBR No 19-013-00406.Keywords: acculturation, coping, deafness, marginality
Procedia PDF Downloads 2044323 The Study on the Relationship between Momentum Profits and Psychological Factors: Evidence from Taiwan
Authors: Chih-Hsiang Chang
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This study provides insight into the effects of investor sentiment, excess optimism, overconfidence, the disposition effect, and herding formation on momentum profits. This study contributes to the field by providing a further examination of the relationship between psychological factors and momentum profits. The empirical results show that there is no evidence of significant momentum profits in Taiwan’s stock market. Additionally, investor sentiment in Taiwan’s stock market significantly influences its momentum profits.Keywords: momentum profits, psychological factors, herding formation, investor sentiment
Procedia PDF Downloads 3814322 Seroprevalence and Determinants of Toxoplasmosis in Pregnant Women Attending Antenatal Clinic at the University Teaching Hospital, Lusaka, Zambia: A Cross-Sectional Study
Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo
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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia
Procedia PDF Downloads 2324321 Generalized Mean-Field Theory of Phase Unwrapping via Multiple Interferograms
Authors: Yohei Saika
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On the basis of Bayesian inference using the maximizer of the posterior marginal estimate, we carry out phase unwrapping using multiple interferograms via generalized mean-field theory. Numerical calculations for a typical wave-front in remote sensing using the synthetic aperture radar interferometry, phase diagram in hyper-parameter space clarifies that the present method succeeds in phase unwrapping perfectly under the constraint of surface- consistency condition, if the interferograms are not corrupted by any noises. Also, we find that prior is useful for extending a phase in which phase unwrapping under the constraint of the surface-consistency condition. These results are quantitatively confirmed by the Monte Carlo simulation.Keywords: Bayesian inference, generalized mean-field theory, phase unwrapping, multiple interferograms, statistical mechanics
Procedia PDF Downloads 4794320 The Marketing Mix in Small Sized Hotels: A Case of Pattaya, Thailand
Authors: Anyapak Prapannetivuth
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The purpose of this research is to investigate the marketing mix that is perceived to be important for the small sized hotels in Pattaya. Unlike previous studies, this research provides insights through a review of the marketing activities performed by the small sized hotels. Nine owners and marketing manager of small sized hotels and resorts, all local Chonburi people, were selected for an in-depth interview. A snowball sampling process was employed. The research suggests that seven marketing mixes (e.g. Product, Price, Place, Promotion, People, Physical Evidence and Process) were commonly used by these hotels, however, three types – People, price and physical evidence were considered most important by the owners.Keywords: marketing mix, marketing tools, small sized hotels, pattaya
Procedia PDF Downloads 2874319 By-Line Analysis of Determinants Insurance Premiums : Evidence from Tunisian Market
Authors: Nadia Sghaier
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In this paper, we aim to identify the determinants of the life and non-life insurance premiums of different lines for the case of the Tunisian insurance market over a recent period from 1997 to 2019. The empirical analysis is conducted using the linear cointegration techniques in the panel data framework, which allow both long and short-run relationships. The obtained results show evidence of long-run relationship between premiums, losses, and financial variables (stock market indices and interest rate). Furthermore, we find that the short-run effect of explanatory variables differs across lines. This finding has important implications for insurance tarification and regulation.Keywords: insurance premiums, lines, Tunisian insurance market, cointegration approach in panel data
Procedia PDF Downloads 1984318 Correlation of Urinary Waxy Casts with Renal Pathology
Authors: Muner M. B. Mohamed, Vipin Varghese, Dustin Chalmers, Khalid M. G. Mohammed, Juan Carlos Q. Velez
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Background: Urinary waxy casts (uWxC) are traditionally described in textbooks as indicative of chronic renal parenchymal disease. However, data supporting this contention is lacking. uWxC can be seen in the context of various renal syndromes, including acute kidney injury, chronic kidney disease, rapidly progressive glomerulonephritis (GN), and nephrotic syndrome. Thus, we investigated the correlation between the identification of uWxC and renal pathological findings. Methods: We prospectively collected data of patients seen in nephrology consultation with a urine specimen subjected to the microscopic examination of the urinary sediment (MicrExUrSed) over a 3-year period. Within this cohort, we identified cases in which a kidney biopsy was concomitantly performed. We assessed the association of uWxC with glomerular or tubular pathology and with chronicity [interstitial fibrosis and tubular atrophy (IFTA) and glomerular obsolescence (GO)]. Results: Among 683 patients with MicrExUrSed,103 (15%) underwent kidney biopsy and were included. The mean age was 55 years, 51% women, 50% white, and 38% self-identified black. Median serum creatinine was 3.2 (0-7-15.6) mg/dL and not significantly different between those with and without uWxC (4.7 vs 3.8 mg/dL, p=0.13). uWxC was identified in 35 (34%) cases. A glomerulopathy was diagnosed in 79 (77%). Among those with uWxC (n=35), a glomerulopathy was more likely to be found with concomitant acute tubular injury (ATI) than without ATI (57% vs. 23%, p=0.0006), whereas among those without uWxC, glomerulopathies were found with or without concomitant ATI with similar frequency (41% vs. 34%, p=0.48). Overall (n=103), more patients with uWxC had ≥ 20% IFTA compared to those without uWxC (74% vs 51%, p=0.03). Among those with glomerulopathy (n=79), more patients with uWxC had ≥ 20% IFTA compared to those without uWxC (89% vs. 56%, p=0.004). uWxC did not correlate with GO. Conclusion: Identification of uWxC denotes a greater likelihood of finding evidence of ATI superimposed with a glomerulopathy rather than finding an isolated glomerular lesion. uWxC is associated with a greater probability of finding ≥ 20% IFTA in a kidney biopsy specimen, particularly in those with a glomerular pathology. This observation may help clinicians weigh on the suitability of a kidney biopsy when chronicity or coexistence of ATI is in question.Keywords: waxy cast, kidney biopsy, acute tubular injury, glomerulopathy
Procedia PDF Downloads 934317 InfoMiracles in the Qur’an and a Mathematical Proof to the Existence of God
Authors: Mohammad Mahmoud Mandurah
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The existence of InfoMiracles in scripture is evidence that the scripture has a divine origin. It is also evidence to the existence of God. An InfoMiracle is an information-based miracle. The basic component of an InfoMiracle is a piece of information that could not be obtained by a human except through a divine channel. The existence of a sufficient number of convincing InfoMiracles in a scripture necessitates the existence of the divine source to these InfoMiracles. A mathematical equation is developed to prove that the Qur’an has a divine origin, and hence, prove the existence of God. The equation depends on a single variable only, which is the number of InfoMiracles in the Qur’an. The Qur’an is rich with InfoMiracles. It is shown that the existence of less than 30 InfoMiracles in the Qur’an is sufficient proof to the existence of God and that the Qur’an is a revelation from God.Keywords: InfoMiracle, God, mathematical proof, miracle, probability
Procedia PDF Downloads 2184316 Autistic Traits and Multisensory Integration–Using a Size-Weight Illusion Paradigm
Authors: Man Wai Lei, Charles Mark Zaroff
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Objective: A majority of studies suggest that people with Autism Spectrum Disorder (ASD) have multisensory integration deficits. However, normal and even supranormal multisensory integration abilities have also been reported. Additionally, little of this work has been undertaken utilizing a dimensional conceptualization of ASD; i.e., a broader autism phenotype. Utilizing methodology that controls for common potential confounds, the current study aimed to examine if deficits in multisensory integration are associated with ASD traits in a non-clinical population. The contribution of affective versus non-affective components of sensory hypersensitivity to multisensory integration was also examined. Methods: Participants were 147 undergraduate university students in Macau, a Special Administrative Region of China, of Chinese ethnicity, aged 16 to 21 (Mean age = 19.13; SD = 1.07). Participants completed the Autism-Spectrum Quotient, the Sensory Perception Quotient, and the Adolescent/Adult Sensory Profile, in order to measure ASD traits, non-affective, and affective aspects of sensory/perceptual hypersensitivity, respectively. In order to explore multisensory integration across visual and haptic domains, participants were asked to judge which one of two equally weighted, but different sized cylinders was heavier, as a means of detecting the presence of the size-weight illusion (SWI). Results: ASD trait level was significantly and negatively correlated with susceptibility to the SWI (p < 0.05); this correlation was not associated with either accuracy in weight discrimination or gender. Examining the top decile of the non-normally distributed SWI scores revealed a significant negative association with sensation avoiding, but not other aspects of effective or non-effective sensory hypersensitivity. Conclusion and Implications: Within the normal population, a greater degree of ASD traits is associated with a lower likelihood of multisensory integration; echoing was often found in individuals with a clinical diagnosis of ASD, and providing further evidence for the dimensional nature of this disorder. This tendency appears to be associated with dysphoric emotional reactions to sensory input.Keywords: Autism Spectrum Disorder, dimensional, multisensory integration, size-weight illusion
Procedia PDF Downloads 4824315 A Survey on Routh-Hurwitz Stability Criterion
Authors: Mojtaba Hakimi-Moghaddam
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Routh-Hurwitz stability criterion is a powerful approach to determine stability of linear time invariant systems. On the other hand, applying this criterion to characteristic equation of a system, whose stability or marginal stability can be determined. Although the command roots (.) of MATLAB software can be easily used to determine the roots of a polynomial, the characteristic equation of closed loop system usually includes parameters, so software cannot handle it; however, Routh-Hurwitz stability criterion results the region of parameter changes where the stability is guaranteed. Moreover, this criterion has been extended to characterize the stability of interval polynomials as well as fractional-order polynomials. Furthermore, it can help us to design stable and minimum-phase controllers. In this paper, theory and application of this criterion will be reviewed. Also, several illustrative examples are given.Keywords: Hurwitz polynomials, Routh-Hurwitz stability criterion, continued fraction expansion, pure imaginary roots
Procedia PDF Downloads 3294314 Relationship between Financial Reporting Transparency and Investment Efficiency: Evidence from Iran
Authors: Bita Mashayekhi, Hamid Kalhornia
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One of the most important roles of financial reporting is improving the firms’ investment decisions; however, there is not much supporting evidence for this claim in emerging markets like Iran. In this study, the effect of financial reporting transparency in investment efficiency of Iranian firms has been investigated. In order to do this, 336 listed companies on Tehran Stock Exchange (TSE) has been selected for time period 2012 to 2015 as research sample. For testing our main hypothesis, we classified sample firms into two groups based on their deviation from expected investment: under-investment and over-investment cases. The results indicate that there is positive significant relationship between financial transparency and investment efficiency. In the other words, transparency can mitigate both underinvestment and overinvestment situations.Keywords: corporate governance, disclosure, investment decisions, investment efficiency, transparency
Procedia PDF Downloads 3794313 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 1404312 Integration of an Evidence-Based Medicine Curriculum into Physician Assistant Education: Teaching for Today and the Future
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students.Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant
Procedia PDF Downloads 1254311 An Enhanced Digital Forensic Model for Internet of Things Forensic
Authors: Tina Wu, Andrew Martin
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The expansion of the Internet of Things (IoT) brings a new level of threat. Attacks on IoT are already being used by criminals to form botnets, launch Distributed Denial of Service (DDoS) and distribute malware. This opens a whole new digital forensic arena to develop forensic methodologies in order to have the capability to investigate IoT related crimes. However, existing proposed IoT forensic models are still premature requiring further improvement and validation, many lack details on the acquisition and analysis phase. This paper proposes an enhanced theoretical IoT digital forensic model focused on identifying and acquiring the main sources of evidence in a methodical way. In addition, this paper presents a theoretical acquisition framework of the different stages required in order to be capable of acquiring evidence from IoT devices.Keywords: acquisition, Internet of Things, model, zoning
Procedia PDF Downloads 2714310 Examining the European Central Bank's Marginal Attention to Human Rights Concerns during the Eurozone Crisis through the Lens of Organizational Culture
Authors: Hila Levi
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Respect for human rights is a fundamental element of the European Union's (EU) identity and law. Surprisingly, however, the protection of human rights has been significantly restricted in the austerity programs ordered by the International Monetary Fund (IMF), the European Central Bank (ECB) and the European Commission (EC) (often labeled 'the Troika') in return for financial aid to the crisis-hit countries. This paper focuses on the role of the ECB in the crisis management. While other international financial institutions, such as the IMF or the World Bank, may opt to neglect human rights obligations, one might expect a greater respect of human rights from the ECB, which is bound by the EU Charter of Fundamental Rights. However, this paper argues that ECB officials made no significant effort to protect human rights or strike an adequate balance between competing financial and human rights needs while coping with the crisis. ECB officials were preoccupied with the need to stabilize the economy and prevent a collapse of the Eurozone, and paid only marginal attention to human rights concerns in the design and implementation of Troikas' programs. This paper explores the role of Organizational Culture (OC) in explaining this marginalization. While International Relations (IR) research on Intergovernmental Organizations (IGOs) behavior has traditionally focused on external interests of powerful member states, and on national and economic considerations, this study focuses on particular institutions' internal factors and independent processes. OC characteristics have been identified in OC literature as an important determinant of organizational behavior. This paper suggests that cultural characteristics are also vital for the examination of IGOs, and particularly for understanding the ECB's behavior during the crisis. In order to assess the OC of the ECB and the impact it had on its policies and decisions during the Eurozone crisis, the paper uses the results of numerous qualitative interviews conducted with high-ranking officials and staff members of the ECB involved in the crisis management. It further reviews primary sources of the ECB (such as ECB statutes, and the Memoranda of Understanding signed between the crisis countries and the Troika), and secondary sources (such as the report of the UN High Commissioner for Human Rights on Austerity measures and economic, social, and cultural rights). It thus analyzes the interaction between the ECBs culture and the almost complete absence of human rights considerations in the Eurozone crisis resolution scheme. This paper highlights the importance and influence of internal ideational factors on IGOs behavior. From a more practical perspective, this paper may contribute to understanding one of the obstacles in the process of human rights implementation in international organizations, and provide instruments for better protection of social and economic rights.Keywords: European central bank, eurozone crisis, intergovernmental organizations, organizational culture
Procedia PDF Downloads 1554309 Predicting Root Cause of a Fire Incident through Transient Simulation
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
Procedia PDF Downloads 954308 Empirical Evidence to Beliefs and Perceptions About Mental Health Disorder and Substance Abuse: The Role of a Social Worker
Authors: Helena Baffoe
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Context: In the United States, there have been significant advancements in programs aimed at improving the lives of individuals with mental health disorders and substance abuse problems. However, public attitudes and beliefs regarding these issues have not improved correspondingly. This study aims to explore the perceptions and beliefs surrounding mental health disorders and substance abuse in the context of data analytics in the field of social work. Research Aim: The aim of this research is to provide empirical evidence on the beliefs and perceptions regarding mental health disorders and substance abuse. Specifically, the study seeks to answer the question of whether being diagnosed with a mental disorder implies a diagnosis of substance abuse. Additionally, the research aims to analyze the specific roles that social workers can play in addressing individuals with mental disorders. Methodology: This research adopts a data-driven methodology, acquiring comprehensive data from the Substance Abuse and Mental Health Services Administration (SAMHSA). A noteworthy causal connection between mental disorders and substance abuse exists, a relationship that current literature tends to overlook critically. To address this gap, we applied logistic regression with an Instrumental Variable approach, effectively mitigating potential endogeneity issues in the analysis in order to ensure robust and unbiased results. This methodology allows for a rigorous examination of the relationship between mental disorders and substance abuse. Empirical Findings: The analysis of the data reveals that depressive, anxiety, and trauma/stressor mental disorders are the most common in the United States. However, the study does not find statistically significant evidence to support the notion that being diagnosed with these mental disorders necessarily implies a diagnosis of substance abuse. This suggests that there is a misconception among the public regarding the relationship between mental health disorders and substance abuse. Theoretical Importance: The research contributes to the existing body of literature by providing empirical evidence to challenge prevailing beliefs and perceptions regarding mental health disorders and substance abuse. By using a novel methodological approach and analyzing new US data, the study sheds light on the cultural and social factors that influence these attitudes.Keywords: mental health disorder, substance abuse, empirical evidence, logistic regression with IV
Procedia PDF Downloads 644307 Surprise Fraudsters Before They Surprise You: A South African Telecommunications Case Study
Authors: Ansoné Human, Nantes Kirsten, Tanja Verster, Willem D. Schutte
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Every year the telecommunications industry suffers huge losses due to fraud. Mobile fraud, or generally, telecommunications fraud is the utilisation of telecommunication products or services to acquire money illegally from or failing to pay a telecommunication company. A South African telecommunication operator developed two internal fraud scorecards to mitigate future risks of application fraud events. The scorecards aim to predict the likelihood of an application being fraudulent and surprise fraudsters before they surprise the telecommunication operator by identifying fraud at the time of application. The scorecards are utilised in the vetting process to evaluate the applicant in terms of the fraud risk the applicant would present to the telecommunication operator. Telecommunication providers can utilise these scorecards to profile customers, as well as isolate fraudulent and/or high-risk applicants. We provide the complete methodology utilised in the development of the scorecards. Furthermore, a Determination and Discrimination (DD) ratio is provided in the methodology to select the most influential variables from a group of related variables. Throughout the development of these scorecards, the following was revealed regarding fraudulent cases and fraudster behaviour within the telecommunications industry: Fraudsters typically target high-value handsets. Furthermore, debit order dates scheduled for the end of the month have the highest fraud probability. The fraudsters target specific stores. Applicants who acquire an expensive package and receive a medium-income, as well as applicants who obtain an expensive package and receive a high income, have higher fraud percentages. If one month prior to application, the status of an account is already in arrears (two months or more), the applicant has a high probability of fraud. The applicants with the highest average spend on calls have a higher probability of fraud. If the amount collected changes from month to month, the likelihood of fraud is higher. Lastly, young and middle-aged applicants have an increased probability of being targeted by fraudsters than other ages.Keywords: application fraud scorecard, predictive modeling, regression, telecommunications
Procedia PDF Downloads 1204306 Recent Advances in the Valorization of Goat Milk: Nutritional Properties and Production Sustainability
Authors: A. M. Tarola, R. Preti, A. M. Girelli, P. Campana
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Goat dairy products are gaining popularity worldwide. In developing countries, but also in many marginal regions of the Mediterranean area, goats represent a great part of the economy and ensure food security. In fact, these small ruminants are able to convert efficiently poor weedy plants and small trees into traditional products of high nutritional quality, showing great resilience to different climatic and environmental conditions. In developed countries, goat milk is appreciated for the presence of health-promoting compounds, bioactive compounds such as conjugated linoleic acids, oligosaccharides, sphingolipids and polyammines. This paper focuses on the recent advances in literature on the nutritional properties of goat milk and on innovative techniques to improve its quality as to become a promising functional food. The environmental sustainability of different methodologies of production has also been examined. Goat milk is valued today as a food of high nutritional value and functional properties as well as small environmental footprint. It is widely consumed in many countries due to high nutritional value, lower allergenic potential, and better digestibility when compared to bovine milk, that makes this product suitable for infants, elderly or sensitive patients. The main differences in chemical composition between a cow and goat milk rely on fat globules that in goat milk are smaller and in fatty acids that present a smaller chain length, while protein, fat, and lactose concentration are comparable. Milk nutritional properties have demonstrated to be strongly influenced by animal diet, genotype, and welfare, but also by season and production systems. Furthermore, there is a growing interest in the dairy industry in goat milk for its relatively high concentration of prebiotics and a good amount of probiotics, which have recently gained importance for their therapeutic potential. Therefore, goat milk is studied as a promising matrix to develop innovative functional foods. In addition to the economic and nutritional value, goat milk is considered a sustainable product for its small environmental footprint, as they require relatively little water and land, and less medical treatments, compared to cow, these characteristics make its production naturally vocated to organic farming. Organic goat milk production has becoming more and more interesting both for farmers and consumers as it can answer to several concerns like environment protection, animal welfare and economical sustainment of rural populations living in marginal lands. These evidences make goat milk an ancient food with novel properties and advantages to be valorized and exploited.Keywords: goat milk, nutritional quality, bioactive compounds, sustainable production, animal welfare
Procedia PDF Downloads 1504305 Evidence of Climate Change from Statistical Analysis of Temperature and Rainfall Data of Kaduna State, Nigeria
Authors: Iliya Bitrus Abaje
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This study examines the evidence of climate change scenario in Kaduna State from the analysis of temperature and rainfall data (1976-2015) from three meteorological stations along a geographic transect from the southern part to the northern part of the State. Different statistical methods were used in determining the changes in both the temperature and rainfall series. The result of the linear trend lines revealed a mean increase in average temperature of 0.73oC for the 40 years period of study in the State. The plotted standard deviation for the temperature anomalies generally revealed that years of temperatures above the mean standard deviation (hotter than the normal conditions) in the last two decades (1996-2005 and 2006-2015) were more than those below (colder than the normal condition). The Cramer’s test and student’s t-test generally revealed an increasing temperature trend in the recent decades. The increased in temperature is an evidence that the earth’s atmosphere is getting warmer in recent years. The linear trend line equation of the annual rainfall for the period of study showed a mean increase of 316.25 mm for the State. Findings also revealed that the plotted standard deviation for the rainfall anomalies, and the 10-year non-overlapping and 30-year overlapping sub-periods analysis in all the three stations generally showed an increasing trend from the beginning of the data to the recent years. This is an evidence that the study area is now experiencing wetter conditions in recent years and hence climate change. The study recommends diversification of the economic base of the populace with emphasis on moving away from activities that are sensitive to temperature and rainfall extremes Also, appropriate strategies to ameliorate the scourge of climate change at all levels/sectors should always take into account the recent changes in temperature and rainfall amount in the area.Keywords: anomalies, linear trend, rainfall, temperature
Procedia PDF Downloads 3184304 Modulation of Receptor-Activation Due to Hydrogen Bond Formation
Authors: Sourav Ray, Christoph Stein, Marcus Weber
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A new class of drug candidates, initially derived from mathematical modeling of ligand-receptor interactions, activate the μ-opioid receptor (MOR) preferentially at acidic extracellular pH-levels, as present in injured tissues. This is of commercial interest because it may preclude the adverse effects of conventional MOR agonists like fentanyl, which include but are not limited to addiction, constipation, sedation, and apnea. Animal studies indicate the importance of taking the pH value of the chemical environment of MOR into account when designing new drugs. Hydrogen bonds (HBs) play a crucial role in stabilizing protein secondary structure and molecular interaction, such as ligand-protein interaction. These bonds may depend on the pH value of the chemical environment. For the MOR, antagonist naloxone and agonist [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO) form HBs with ionizable residue HIS 297 at physiological pH to modulate signaling. However, such interactions were markedly reduced at acidic pH. Although fentanyl-induced signaling is also diminished at acidic pH, HBs with HIS 297 residue are not observed at either acidic or physiological pH for this strong agonist of the MOR. Molecular dynamics (MD) simulations can provide greater insight into the interaction between the ligand of interest and the HIS 297 residue. Amino acid protonation states are adjusted to the model difference in system acidity. Unbiased and unrestrained MD simulations were performed, with the ligand in the proximity of the HIS 297 residue. Ligand-receptor complexes were embedded in 1-palmitoyl-2-oleoyl-sn glycero-3-phosphatidylcholine (POPC) bilayer to mimic the membrane environment. The occurrence of HBs between the different ligands and the HIS 297 residue of MOR at acidic and physiological pH values were tracked across the various simulation trajectories. No HB formation was observed between fentanyl and HIS 297 residue at either acidic or physiological pH. Naloxone formed some HBs with HIS 297 at pH 5, but no such HBs were noted at pH 7. Interestingly, DAMGO displayed an opposite yet more pronounced HB formation trend compared to naloxone. Whereas a marginal number of HBs could be observed at even pH 5, HBs with HIS 297 were more stable and widely present at pH 7. The HB formation plays no and marginal role in the interaction of fentanyl and naloxone, respectively, with the HIS 297 residue of MOR. However, HBs play a significant role in the DAMGO and HIS 297 interaction. Post DAMGO administration, these HBs might be crucial for the remediation of opioid tolerance and restoration of opioid sensitivity. Although experimental studies concur with our observations regarding the influence of HB formation on the fentanyl and DAMGO interaction with HIS 297, the same could not be conclusively stated for naloxone. Therefore, some other supplementary interactions might be responsible for the modulation of the MOR activity by naloxone binding at pH 7 but not at pH 5. Further elucidation of the mechanism of naloxone action on the MOR could assist in the formulation of cost-effective naloxone-based treatment of opioid overdose or opioid-induced side effects.Keywords: effect of system acidity, hydrogen bond formation, opioid action, receptor activation
Procedia PDF Downloads 1754303 Bayesian Optimization for Reaction Parameter Tuning: An Exploratory Study of Parameter Optimization in Oxidative Desulfurization of Thiophene
Authors: Aman Sharma, Sonali Sengupta
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The study explores the utility of Bayesian optimization in tuning the physical and chemical parameters of reactions in an offline experimental setup. A comparative analysis of the influence of the acquisition function on the optimization performance is also studied. For proxy first and second-order reactions, the results are indifferent to the acquisition function used, whereas, while studying the parameters for oxidative desulphurization of thiophene in an offline setup, upper confidence bound (UCB) provides faster convergence along with a marginal trade-off in the maximum conversion achieved. The work also demarcates the critical number of independent parameters and input observations required for both sequential and offline reaction setups to yield tangible results.Keywords: acquisition function, Bayesian optimization, desulfurization, kinetics, thiophene
Procedia PDF Downloads 1824302 Investigating Transformative Practices in the Bangladeshi Classroom
Authors: Rubaiyat Jahan, Nasreen Sultana Mitu
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This paper examines the theoretical construct of transformative practices, and reports some evidence of transformative practices from a couple of Bangladeshi English teachers. The idea of transformative practices calls for teachers’ capabilities to invest their intellectual labor in teaching with an assumption that along with the academic advancement of the learners, it aims for the personal transformation for both the learners as well for themselves. Following an ethnographic research approach, data for this study were collected through in-depth interviews, informal talks and classroom observations for a period of one year. In relevance to the English classroom of the Bangladeshi context, from this study, references of transformative practices have been underlined from the participant teachers’ views on English language teaching as well as from their actual practices. According to data of this research, some evidence of transformative practices in the form of critical language awareness and personal theories of practices emerge from the participants’ articulation of the beliefs on teaching; and from the participant teachers’ classroom practices evidence of self-directed acts of teaching, self-directed acts of professional development, and liberatory autonomy have been highlighted as the reflections of transformative practices. The implication of this paper refers to the significance of practicing teachers’ articulation of beliefs and views on teaching along with their orientation to critical pedagogical relations.Keywords: critical language awareness, personal theories of practice, teacher autonomy, transformative practices
Procedia PDF Downloads 221