Search results for: logistics location search

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

Abstract:

Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

Procedia PDF Downloads 98

Authors: Angela Maria Sarmiento

Abstract:

Since the end of the 19th century, the Bora people struggled to survive two stages of colonial domination, which resulted in situations of forced contact with the Western world. Their inclusion in global designs altered the configuration of their local spaces and social practices; thus the Bora language was affected and prone to transformation. This descriptive, interpretive study, within the indigenous and minoritized groups’ research field, aimed at analysing the linguistic attitudes as well as the contextual situation of the Bora language in Providencia, an ancestral territory and a speech community contained in the midst of the Colombian Amazon rainforest. Through the inquiry of their sociolinguistic practices, this study also considered the effects of the course of events derived from the rubber exploitation in the late 19th century, and the arrival of the Capuchin’s mission in the early 20th century. The methodology used in this study had an ethnographic approach, which allowed the researcher to study the social phenomena from the perspective of the participants. Fieldwork, diary, field notes, and semi-structured interviews were conducted and then triangulated with participant observations. The findings of this study suggest that there is a transition from current individual bilingualism towards Spanish monolingualism; this is enhanced by the absence of a functional distribution of the three varieties (Bora, Huitoto, and Spanish). Also, the positive attitudes towards the Spanish language are based on its functionality while positive attitudes towards the Bora language mostly refer to pride and identity. Negative attitudes are only directed towards the Bora language. In the search for the roots of these negative attitudes, appeared the traumatic experiences of the rubber exploitation and the indigenous experiences at the capuchin’s boarding school. Finally, the situation of the Bora language can be configured as a social fact strongly connected to previous years of colonial dominations and to the current and continuous incursion of new global-colonial designs.

Keywords: Bora language, language contact, linguistic attitudes, speech communities

Procedia PDF Downloads 149

Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

Abstract:

Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

Procedia PDF Downloads 77

Authors: Kristýna Weissová

Abstract:

This study is focused on two selected model taxa of invertebrates - Hymenoptera: Aculeata and Lepidopterawithnocturnalactivity, recordedatthesitesof lignite dumps and their surroundings in the North Bohemian Lignite Basin, Czech Republic. There search was conducted on 10 landfills, 3 study areas were determined on each landfill - primary and secondary succession and recultivation. A total of 3,202 individuals belonging to 232 species and 17 families of sagebrushinsects were collected. died, 74%of the species occurred on the primary succes sionare as, that is 2x more species than on the reclaimed areas. Of the total number of species and on all areas, 60 rare species were recorded - 29 vulnerable, 21 endangered, 8 critically endangered, and 2 extinct The areas of primary succession were again confirmed to be the richest in terms of rare species, hosting 39 rare species of Hymenoptera: Aculeata. In addition, bothextinct species were represented only on plots of primary succession. The family Crabronidae had the largestre presentation of species on theareasofleft primary succession, the family Halictidae was the most represented on the reclaimed areas and areas of secondary succession. A total of 3,634 moths were collected, assigned to 262 species and 10 families. A similar number of species occurred on the primary succession and reclaimed areas, but the reclaimed area had a greater abundance. Secondary successionsiteshostedha lf as many species and alsocontainedlow abundance compared to other management types. The results show that there claimed areas host a numerically larger group and more species of moths than the successionalareas. Rare species did not occur at any site. A higher number of days in locations without water bodies, wetland vegetation, and locations with a highre presentation of woody species. It is advisable to combine individual types of landscape management in such a way as to create a colorfulmosaic that supports biodiversity. In particular, we recommend incorporating natural successionintoreclamation plans, which is a refuge for many rare species of invertebrates, which has not yetbeenroutinely and purposefully practiced.

Keywords: hymenoptera: aculeata, lepidoptera, reclamation, succession, post-mining ara

Procedia PDF Downloads 117

Authors: Dalia Kubiliūtė

Abstract:

Lithuania is known as a trusted location for global business institutions, and it attracts investors with it’s competitive environment for financial service providers. Along with the aspiration to offer a strong results-oriented and innovations-driven environment for financial service providers, Lithuanian regulatory authorities consistently implement the European Union's high regulatory standards for financial activities, including sustainability-related disclosures. Since European Union directed its policy towards transition to a climate-neutral, green, competitive, and inclusive economy, additional regulatory requirements for financial market participants are adopted: disclosure of sustainable activities, transparency, prevention of greenwashing, etc. The financial sector is one of the key factors influencing the implementation of sustainability objectives in European Union policies and mitigating the negative effects of climate change –public funds are not enough to make a significant impact on sustainable investments, therefore directing public and private capital to green projects may help to finance the necessary changes. The topic of the study is original and has not yet been widely analyzed in Lithuanian legal discourse. There are used quantitative and qualitative methodologies, logical, systematic, and critical analysis principles; hence the aim of this study is to reveal the problem of the implementation of the regulation on sustainability in the Lithuanian financial sector. Additional regulatory requirements could cause serious changes in financial business operations: additional funds, employees, and time have to be dedicated in order for the companies could implement these regulations. Lack of knowledge and data on how to implement new regulatory requirements towards sustainable reporting causes a lot of uncertainty for financial market participants. And for some companies, it might even be an essential point in terms of business continuity. It is considered that the supervisory authorities should find a balance between financial market needs and legal regulation.

Keywords: financial, legal, regulatory, sustainability

Procedia PDF Downloads 105

Authors: Beatriz Mella Lira, Karla Yohannessen, Robin Hickman

Abstract:

The aim of the paper is recognising inequalities through the self-assessment of health-related factors, in the context of daily mobilities in Santiago de Chile. Human capabilities will be used as the theoretical basis for the recognition and assessment of these factors regarding the functioning (what people are currently able to do) and capabilities (what people want to achieve and what is valuable for them), reflecting differences across social groups and among types of transport users. The self-assessment of health-related factors considers perceptions of stress, physical effort, proximity to other transport users, pollution, safety, and comfort. The types of transport users are classified as: private (cars, taxis, colectivos, motos), public (buses and metro) and active (bicycles and walking). The methodology follows a capability-based questionnaire, which was applied in different areas of Santiago de Chile, considering concepts extracted from the human capabilities list. The self-assessment of these health-related factors examines the context of peoples’ mobilities for performing their daily activities, considering socioeconomic differences as income, age, gender, disabilities, residence location and primary mode choice. The paper uses Relative Importance Index (RII) for weighting the relative influence or valuation of the factors. The respondents were asked to rate the importance of each factor on a scale from 1 to 5, in an ascending order of importance. The results suggest that these health-related factors impact not just the perceptions of users, but their well-being and their propensity for achieving their capabilities and the things they value in life. The paper is focused on the development of an applicable approach, measuring factors that should be included in transport project appraisal, as a more comprehensive and complementary method.

Keywords: active transport, health, human capabilities, Santiago de Chile, transport inequalities, transportation planning, urban planning

Procedia PDF Downloads 190

Authors: Ira Joseph

Abstract:

The LNG paradox addresses the issue of how the most expensive form of gas supply, which is LNG, will grow in an end user market where demand is most competitive, which is power generation. In this case, LNG demand growth is under siege from two entirely different directions. At one end is price; it will be extremely difficult for gas to replace coal in Asia due to the low price of coal and the age of the generation plants. Asia's coal fleet, on average, is less than two decades old and will need significant financial incentives to retire before its state lifespan. While gas would cut emissions in half relative to coal, it would also more than double the price of the fuel source for power generation, which puts it in a precarious position. In most countries in Asia other than China, this cost increase, particularly from imports, is simply not realistic when it is also necessary to focus on economic growth and social welfare. On the other end, renewables are growing at an exponential rate for three reasons. One is that prices are dropping. Two is that policy incentives are driving deployment, and three is that China is forcing renewables infrastructure into the market to take a political seat at the global energy table with Saudi Arabia, the US, and Russia. Plus, more renewables will lower import growth of oil and gas in China, if not end it altogether. Renewables are the predator at the gate of gas demand in power generation and in every year that passes, renewables cut into demand growth projections for gas; in particular, the type of gas that is most expensive, which is LNG. Gas does have a role in the future, particularly within a domestic market. Once it crosses borders in the form of LNG or even pipeline gas, it quickly becomes a premium fuel and must be marketed and used this way. Our research shows that gas will be able to compete with batteries as an intermittency and storage tool and does offer a method to harmonize with renewables as part of the energy transition. As a baseload fuel, however, the role of gas, particularly, will be limited by cost once it needs to cross a border. Gas converted into blue or green hydrogen or ammonia is also an option for storage depending on the location. While this role is much reduced from the primary baseload role that gas once aspired to land, it still offers a credible option for decades to come.

Keywords: natural gas, LNG, demand, price, intermittency, storage, renewables

Procedia PDF Downloads 62

Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

Abstract:

Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

Procedia PDF Downloads 239

Authors: U.-B. Schaer, M. Wehr, R. Hodler

Abstract:

Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.

Keywords: learning program, nursing students, peer learning, skill training

Procedia PDF Downloads 124

Authors: Michael Sinclair, Andrea Ghermandi, Sheela A. Moses, Joseph Sabu

Abstract:

Passively crowdsourced data, such as geotagged photographs from social media, represent an opportunistic source of location-based and time-specific behavioral data for ecosystem services analysis. Such data have innovative applications for environmental management and protection, which are replicable at wide spatial scales and in the context of both developed and developing countries. Here we test one such innovation, based on the analysis of the metadata of online geotagged photographs, to investigate the provision of recreational services by the entire network of wetland ecosystems in the state of Kerala, India. We estimate visitation to individual wetlands state-wide and extend, for the first time to a developing region, the emerging application of cultural ecosystem services modelling using data from social media. The impacts of restoration of wetland areal extension and water quality improvement are explored as a means to inform more sustainable management strategies. Findings show that improving water quality to a level suitable for the preservation of wildlife and fisheries could increase annual visits by 350,000, an increase of 13% in wetland visits state-wide, while restoring previously encroached wetland area could result in a 7% increase in annual visits, corresponding to 49,000 visitors, in the Ashtamudi and Vembanad lakes alone, two large coastal Ramsar wetlands in Kerala. We discuss how passive crowdsourcing of social media data has the potential to improve current ecosystem service analyses and environmental management practices also in the context of developing countries.

Keywords: coastal wetlands, cultural ecosystem services, India, passive crowdsourcing, social media, wetland restoration

Procedia PDF Downloads 157

Authors: Nikica Mihaljević

Abstract:

Published in 2023, "Tre ciotole. Rituali per un anno di crisi" is a collection of short stories completely disconnected from one another in regard to topics and the representation of characters. However, these short stories complete and somehow continue each other in a particular way. The book happens to be Murgia's last book, as the author died a few months later after the book's publication and it appears as a kind of summary of all her previous literary works. Namely, in her previous publications, Murgia already stressed certain characters' particularities, such as solitude and alienation from others, which are at the center of attention in this literary work, too. What all the stories present in "Tre ciotole" have in common is the dealing with characters' identity and self-awareness through the challenges they confront and the way the characters live their emotions in relation to the surrounding space. Although the challenges seem similar, the spatial element around the characters is different, but it confirms each time that characters' emotions, and, consequently, their self-awareness, can be formed and built only through their connection and relation to the surrounding space. In that way, the reader creates an imaginary network of complex relations among characters in all the short stories, which gives him/her the opportunity to search for a way to break out of the usual patterns that tend to be repeated while characters focus on building self-awareness. The aim of the paper is to determine and analyze the role of spatial elements in the creation of characters' emotions and in the process of self-awareness. As the spatial element changes or gets transformed and/or substituted, in the same way, we notice the arise of the unconscious desire for self-harm in the characters, which damages their self-awareness. Namely, the characters face a crisis that they cannot control by inventing other types of crises that can be controlled. That happens to be their way of acting in order to find the way out of the identity crisis. Consequently, we expect that the results of the analysis point out the similarities in the short stories in characters' depiction as well as to show the extent to which the characters' identities depend on the surrounding space in each short story. In this way, the results will highlight the importance of spatial elements in characters' identity formation in Michela Murgia's short stories and also summarize the importance of the whole Murgia's literary opus.

Keywords: Italian literature, short stories, environment, spatial element, emotions, characters

Procedia PDF Downloads 57

Authors: Salma I. Dwidar, Amal A. Abdelsattar

Abstract:

Alexandria city is one of the greatest cities in the world. It confronted different civilizations throughout the ages due to its special geographical location and climate which left many archaeological areas of great heritage (Ptolemaic, Greek, Romanian, especially sunken monuments, Coptic, Islamic, and finally, the Modern). Also, Alexandria city contains areas with different patterns of urban planning, both Hellenistic and compacted planning which merited the diversity in planning. Despite the magnitude of this city, which contains all the elements of tourism, the city was not included in the tourism map of Egypt properly comparing with similar cities in Egypt. This paper discusses the importance of heritage areas in Alexandria and the relationship between heritage areas and modern buildings. It highlights the absence of a methodology to deal with heritage areas as touristic areas. Also, the paper aims to develop multiple touristic routes to visit archaeological areas and other sights of significance in Alexandria. The research methodology is divided into two main frameworks. The first framework is a historical study of the urban development of Alexandria and the most important remaining monuments throughout the ages, as well as an analytical study of sunken monuments and their importance in increasing the rate of tourism. Moreover, it covers a study of the importance of the Library of Alexandria and its effect on the international focus of the city. The second framework focuses on the proposal of some tourism routes to visit the heritage areas, archaeological monuments, sunken monuments and the sights of Alexandria. The study concludes with the proposal of three tourism routes. The first route, which is the longest one, passes by all the famous monuments of the city as well as its modern sights. The second route passes through the heritage areas, sunken monuments, and Library of Alexandria. The third route includes the sunken monuments and Library of Alexandria. These three tourism routes will ensures the touristic development of the city which leads to the economic growth of the city and the country.

Keywords: archeological buildings, heritage buildings, heritage tourism, planning of Islamic cities

Procedia PDF Downloads 143

Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

Abstract:

Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

Procedia PDF Downloads 373

Authors: Lawrence Babatunde Ogunsanya

Abstract:

The university has been in existence, in one form or another, for over a thousand years and has contributed in multiple ways to modern society. It is considered a center of culture, aesthetic direction, and moral forces shaping the civilized society. Universities also contribute in important ways to the economic health and physical landscape of neighborhoods and cities, serving as permanent fixtures of the urban economy and the built environment. Due to the size and location of university campuses, they put demands on the urban character, systems, and infrastructure of the neighboring communities. These demands or impacts have substantial implications for the built environment. It is important to understand the impacts university campuses have on their surrounding communities and urban environments because the destiny of the university is inextricably linked to the destiny of the adjacent neighborhoods. This paper identifies the diverse factors generated by universities in shaping the built environments of their local communities within different spatial contexts such as urban, rural, and township regions situated in South Africa.By applying a mixed methods approach in four university campuses within the province of KwaZulu-Natal in South Africa. Several data collection instruments were used, such as in-depth interviews, a survey, remote sensing, and onsite observations. The thematic findings revealed numerous factors which influence the morphology of neighbourhood built environments and the myriad of relationships the university has with its local community. This paper also reveals that the university campus is more than a precinct which accommodates buildings and academic endeavours, the role of the university in this century has changed dramatically from its traditional roots of being an elite enclave of academics to a more inclusive and engaged entity that is concerned about providing relevant holistic solutions to society’s current challenges in the built environment.

Keywords: university campus, built environment, architecture, neighborhood planning

Procedia PDF Downloads 127

Authors: Bihan Qaimari

Abstract:

In many areas of the world there are political conflicts the consequences of which have an inevitable impact on the educational system. Palestine is one such country where the experience of political conflict, going back over many years, has had a devastating effect on the development and maintenance of a stable educational environment for children and their teachers. Up to now there have been few studies that have focussed on the effects of living and working in a war zone on the professional identity of teachers. The aim of this study is to explore how the formation of Palestinian teachers’ professional identity is affected by their experience of the current political conflict its impact on the school social culture. In order to gain an in-depth understanding of the impact of political violence on the formation of the professional identity of Palestinian teachers, a qualitative multiple case-study approach was adopted which draws on sociocultural theories of identity formation. An initial study was first conducted in six schools and this was followed by an in-depth study of teachers working in three further primary schools. Data sources included participant observation, a research diary, semi-structured group and individual interviews. Grounded theory, constant-comparative methods, and discourse analysis procedures were used to interpret the data. The findings suggest that the Palestinian primary school teachers negotiate multiple conflicting identities through their every day experiences of political conflict and the schools’ social culture. This tension is formed as a result of the historical cultural meaning that teachers construct about themselves and within the current unstable and unsettling conditions that exist in their country. In addition, the data indicate that the geographical location of the schools in relation of their proximity to the events of the political conflict also had an influence on the degree of tension inherent in teachers’ professional identity. The study makes significant theoretical, practical, and methodical contributions to the study of the formation of teachers’ professional identity in countries affected by political conflict.

Keywords: identity, political conflict, Palestine, teacher's professional identity

Procedia PDF Downloads 413

Authors: Manju Bala Jassi

Abstract:

The Covid 19 pandemic has badly mauled Dubai’s GDP heavily dependent on hospitality, tourism, entertainment, logistics, property and the retail sectors. In the context of the World Health protocols on social distancing for better maintenance of health and hygiene, the revival of the battered tourism and hospitality sectors has serious lessons for designers- interiors and public places. The tangible and intangible aesthetic elements and design –ambiance, materials, furnishings, colors, lighting and interior with architectural design issues of tourism and hospitality need a rethink to ensure a memorable tourist experience. Designers ought to experiment with sustainable places of tourism and design, develop, build and projects are aesthetic and leave as little negative impacts on the environment and public as possible. In short, they ought to conceive public spaces that makes use of little untouched materials and energy, and creates pollution and waste that are minimal. The spaces can employ healthier and more resource-efficient prototypes of construction, renovation, operation, maintenance, and demolition and thereby mitigate the environment impacts of the construction activities and it is sustainable These measures encompass the hospitality sector that includes hotels and restaurants which has taken the hardest fall from the pandemic. The paper sought to examine building energy efficiency and materials and design employed in public places, green buildings to achieve constructive sustainability and to establish the benefits of utilizing energy efficiency, green materials and sustainable design; to document diverse policy interventions, design and Spatial dimensions of tourism and hospitality sectors; to examine changes in the hospitality, aviation sector especially from a design perspective regarding infrastructure or operational constraints and additional risk-mitigation measures; to dilate on the nature of implications for interior designers and architects to design public places to facilitate sustainable tourism and hospitality while balancing convenient space and their operations' natural surroundings. The qualitative research approach was adopted for the study. The researcher collected and analyzed data in continuous iteration. Secondary data was collected from articles in journals, trade publications, government reports, newspaper/ magazine articles, policy documents etc. In depth interviews were conducted with diverse stakeholders. Preliminary data indicates that designers have started imagining public places of tourism and hospitality against the backdrop of the government push and WHO guidelines. For instance, with regard to health, safety, hygiene and sanitation, Emirates, the Dubai-based airline has augmented health measures at the Dubai International Airport and on board its aircraft. It has leveraged high tech/ Nano-tech, social distancing to encourage least human contact, flexible design layouts to limit the occupancy. The researcher organized the data into thematic categories and found that the Government of Dubai has initiated comprehensive measures in the hospitality, tourism and aviation sectors in compliance with the WHO guidelines.

Keywords: Covid 19, design, Dubai, hospitality, public spaces, tourism

Procedia PDF Downloads 168

Authors: Dheyaa Hussein, Peter Armstrong

Abstract:

The phenomenon of visual disorder is prominent in contemporary townscapes. This paper provides a theoretical framework for the assessment of visual consistency in townscape in order to achieve more favourable outcomes for users. In this paper, visual consistency refers to the amount of similarity between adjacent components of townscape. The paper investigates parameters which relate to visual consistency in townscape, explores the relationships between them and highlights their significance. The paper uses arithmetic methods from outside the domain of urban design to enable the establishment of an objective approach of assessment which considers subjective indicators including users’ preferences. These methods involve the standard of deviation, colour distance and the distance between points. The paper identifies urban space as a key representative of the visual parameters of townscape. It focuses on its two components, geometry and colour in the evaluation of the visual consistency of townscape. Accordingly, this article proposes four measurements. The first quantifies the number of vertices, which are points in the three-dimensional space that are connected, by lines, to represent the appearance of elements. The second evaluates the visual surroundings of urban space through assessing the location of their vertices. The last two measurements calculate the visual similarity in both vertices and colour in townscape by the calculation of their variation using methods including standard of deviation and colour difference. The proposed quantitative assessment is based on users’ preferences towards these measurements. The paper offers a theoretical basis for a practical tool which can alter the current understanding of architectural form and its application in urban space. This tool is currently under development. The proposed method underpins expert subjective assessment and permits the establishment of a unified framework which adds to creativity by the achievement of a higher level of consistency and satisfaction among the citizens of evolving townscapes.

Keywords: townscape, urban design, visual assessment, visual consistency

Procedia PDF Downloads 315

Authors: Ian Jones, Jonathan Griffiths

Abstract:

Laser welding offers the potential for making very precise joints in plastics products, both in terms of the joint location and the amount of heating applied. These methods have allowed the production of complex products such as microfluidic devices where channels and structure resolution below 100 µm is regularly used. However, to date, the dimension of welds made using lasers has been limited by the focus spot size that is achievable from the laser source. Theoretically, the minimum spot size possible from a laser is comparable to the wavelength of the radiation emitted. Practically, with reasonable focal length optics the spot size achievable is a few factors larger than this, and the melt zone in a plastics weld is larger again than this. The narrowest welds feasible to date have therefore been 10-20 µm wide using a near-infrared laser source. The aim of this work was to prepare laser absorber tracks and channels less than 10 µm wide in PMMA thermoplastic using EB lithography followed by sealing of channels using laser welding to carry out welds with widths of the order of 1 µm, below the resolution limit of the near-infrared laser used. Welded joints with a width of 1 µm have been achieved as well as channels with a width of 5 µm. The procedure was based on the principle of transmission laser welding using a thin coating of infrared absorbent material at the joint interface. The coating was patterned using electron-beam lithography to obtain the required resolution in a reproducible manner and that resolution was retained after the transmission laser welding process. The joint strength was ratified using larger scale samples. The results demonstrate that plastics products could be made with a high density of structure with resolution below 1 um, and that welding can be applied without excessively heating regions beyond the weld lines. This may be applied to smaller scale sensor and analysis chips, micro-bio and chemical reactors and to microelectronic packaging.

Keywords: microchannels, polymer, EB lithography, laser welding

Procedia PDF Downloads 402

Authors: Emily C. Shepard, Caroline Sweeney, Jessica Grimm, Sophie Jacobs, Lauren Thompson, Lisa L. Weyandt

Abstract:

Adolescence is a critical phase of development in which individuals are prone to more risky behavior while also facing potentially life-changing decisions. The balance of increased behavioral risk and responsibility indicates the importance of executive functioning ability. In recent years, executive function training has emerged as a technique to enhance this cognitive ability. The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. After reviewing 3110 articles, a total of 24 articles were identified which examined the role of executive functioning training techniques among adolescents (age 10-19). Articles retrieved demonstrated points of comparison across psychiatric and medical diagnosis, location of training, and stage of adolescence. Typically developing samples, as well as those with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), conduct disorder, and physical health concerns were found, allowing for the comparison of the efficacy of techniques considering physical and psychological heterogeneity. Among typically developing adolescents, executive functioning training yielded nonsignificant or low effect size improvements in executive functioning, and in some cases executive functioning ability was decreased following the training. In special populations, including those with ADHD, (ASD), conduct disorder, and physical health concerns significant differences and larger effect sizes in executive functioning were seen following treatment, particularly among individuals with ADHD. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.

Keywords: adolescence, attention-deficit hyperactivity disorder, executive function, executive function training, traumatic brain injury

Procedia PDF Downloads 191

Authors: Yusif Habib

Abstract:

The Volta River Basin (VRB) is a transboundary resource shared by Six (6) the West African States. It’s utilization spans across irrigation, hydropower generation, domestic/household water use, transportation, industrial processing, among others. Simultaneously, mineral resources such as gold are mined within the VRB catchment. Typically, the extraction/mining operation is earth-surface excavation; known as Artisanal and Small-scale mining. We developed a conceptual framework in the context of Water-Energy-Food (WEF) Nexus to delineate the trade-offs and synergies between the mineral extractive operation’s impact on Agricultural systems, specifically, cereal crops (e.g. Maize, Millet, and Rice) and the environment (water and soil quality, deforestation, etc.) on the VRB. Thus, the study examined the trade-offs and synergies through the WEF nexus lens to explore the extent of an eventual overarching mining preference for gold exploration with high economic returns as opposed to the presumably low yearly harvest and household income from food crops production to inform intervention prioritization. Field survey (household, expert, and stakeholder consultation), bibliometric analysis/literature review, scenario, and simulation models, including land-use land cover (LULC) analyses, were conducted. The selected study area(s) in Ghana was the location where the mineral extractive operation’s presence and impact are widespread co-exist with the Agricultural systems. Overall, the study proposes mechanisms of the virtuous cycle through FEW Nexus instead of the presumably existing vicious cycle to inform decision making and policy implementation.

Keywords: agriculture, environmental sustainability, gold Mining, synergies, trade-off, water-energy-food nexus

Procedia PDF Downloads 166

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

Procedia PDF Downloads 134

Authors: Eyad H. R. Fadda, Jawaher K. Al Rashdieah, Aysha H. Al Rashdieh

Abstract:

Urban Sprawl is a phenomenon that many regions in the Sultanate of Oman suffer from in general and in Welayat Barka in particular. It is considered a human phenomenon that causes many negative effects as it has increased in the last time clearly, and this study aims to diagnose the current status of urban growth taking place in Walayat Barka. The objective of this study is to monitor and follow up on the most prominent changes and developments taking place in Barka in the period from 2002 to 2019 and provide suggestions to the decision-makers to reduce the negative effects of the phenomenon. The study methodology depends on the descriptive and analytical approach to describe the phenomenon and its analysis and knowledge of the factors that helped in urban expansion in the Barka, using a number of studies and interviews with the specialists, both in governmental and private institutions, as well as with individuals who own land, real estate, and others. Geographic Information Systems (GIS) and Remote Sensing (ERDAS software) have been used to analyze the satellite images that helped in obtaining results that reflect the changes Barka, in addition to knowing the natural and human determinants that stand on Urban Sprawl Expansion. The study concluded that the geographical location of Barka has a significant role in its urban expansion, as it is the closest state to the capital Muscat, as this expansion continues toward the southern and south-western directions, as this expansion has significant negative effects represented in the low number of agricultural lands due to the continuous change in land use. In addition, it was found that there are two types of natural determinants of urban expansion in Barka, which are consumed land from the Sea of Oman and from the western sands.

Keywords: GIS applications, remote sensing, urbanization, urban sprawl expansion trends

Procedia PDF Downloads 112

Authors: Jennifer Isabelle Rios Rendón, Ursula Sanchez, Dana Lee Baker

Abstract:

Disability Policy in México has witnessed numerous changed throughout the years. Physical disabilities are more often recognized in Mexican culture. However, with an emerging focus on neurological disabilities or differences in individuals’ new policies are needed to serve better and understand the needs of these populations. The need to understand and communicate with local leaders is imperative, as the lens used to analyze autism has historically been from a Western school of thought. We are looking to comprehend the disability policy subsystem in México - specifically how autism is perceived, the language used to describe it, and how it ties to the cultural stigma of disabilities that exist in México. Therefore, to understand this, we seek to interview multiple policy leaders on their experience in autism and disability policy. The goal is to conduct qualitative research through interviews with local autism and disability leaders in México. This methodology aims to answer the questions of what language commonly and culturally is utilized in disability policy, the context of how autism is perceived in México, and in general, the lived experience of the disability policy leaders that take part in this effort in México. Local activists and policy leaders were initially found through an online search then collected using snowball sampling. The interviews were conducted through a series of pre-formulated questions that the policy leader answered via email or a phone conversation with the researchers. Acknowledging the importance of language and accessibility, the need for the content to be in both English and Spanish as well as auditory and visual is essential to take steps in the inclusion of a Neurodiverse group of leaders. This work is a demonstration of the framework of the investigation which hopes to create a more complete understanding of the policy and political culture around autism in México. Results of the project include new insight into the developing relationship between the President Andrés Manuel López Obrador’s administration, disability activists, and neurodiverse communities. The project contributes to denormalizing the legacy of white supremacy in autism related, historically rooted in the assumption that autism occurs predominantly in white communities.

Keywords: autism, disability leaders, disability policy, México, Neurodiversity

Procedia PDF Downloads 138

Authors: Fiona Bei Na Tan, Glen Wen Kiat Ho, Ee Leen Liow, Li Yin Tan, Sean Wei Loong Ho

Abstract:

Background: Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Objectives: Our aim is to highlight a case report of pneumothorax post shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors associated with developing a pneumothorax during or after shoulder arthroscopy. Case Report: We report the case of a 75-year-old male non-smoker who underwent left shoulder arthroscopy without regional anaesthesia and in the left lateral position. The general anaesthesia and surgery were uncomplicated. The patient was desaturated postoperatively and was found to have a pneumothorax on examination and chest X-ray. A chest tube drain was inserted promptly into the right chest. He had an uncomplicated postoperative course. Methods: PubMed Medline and Cochrane database search was carried out using the terms shoulder arthroplasty, pneumothorax, pneumomediastinum, and subcutaneous emphysema. We selected full-text articles written in English. Results: Thirty-two articles were identified and thoroughly reviewed. Based on our inclusion and exclusion criteria, 14 articles, which included 20 cases of pneumothorax during or after shoulder arthroscopy, were included. Eighty percent (16/20) of pneumothoraxes occurred postoperatively. In the articles that specify the side of pneumothorax, 91% (10/11) occur on the ipsilateral side of the arthroscopy. Eighty-eight percent (7/8) of pneumothoraxes occurred when subacromial decompression was performed. Fifty-six percent (9/16) occurred in patients placed in the lateral decubitus position. Only 30% (6/20) occurred in current or ex-smokers, and only 25% (5/20) had a pre-existing lung condition. Overall, of the articles that posit a mechanism, 75% (9/12) deem the pathogenesis to be multifactorial. Conclusion: The exact mechanism of pneumothorax is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should have a low threshold to obtain diagnostic plain radiographs in the event of clinical suspicion.

Keywords: rotator cuff repair, decompression, pressure, complication

Procedia PDF Downloads 67

Authors: M. S. Aparna, Pushparaj Shetty D.

Abstract:

Nowadays social networking sites have become so popular that the producers or the sellers look for these sites as one of the best options to target the right audience to market their products. There are several tools available to monitor or analyze the social networks. Our task is to identify the right community web pages and find out the behavior analysis of the members by using these tools and formulate an appropriate strategy to market the products or services to achieve the set goals. The advertising becomes more effective when the information of the product/ services come from a known source. The strategy explores great buying influence in the audience on referral marketing. Our methodology proceeds with critical budget analysis and promotes viral influence propagation. In this context, we encompass the vital bits of budget evaluation such as the number of optimal seed nodes or primary influential users activated onset, an estimate coverage spread of nodes and maximum influence propagating distance from an initial seed to an end node. Our proposal for Buyer Prediction mathematical model arises from the urge to perform complex analysis when the probability density estimates of reliable factors are not known or difficult to calculate. Order Statistics and Buyer Prediction mapping function guarantee the selection of optimal influential users at each level. We exercise an efficient tactics of practicing community pages and user behavior to determine the product enthusiasts on social networks. Our approach is promising and should be an elementary choice when there is little or no prior knowledge on the distribution of potential buyers on social networks. In this strategy, product news propagates to influential users on or surrounding networks. By applying the same technique, a user can search friends who are capable to advise better or give referrals, if a product interests him.

Keywords: viral marketing, social network analysis, community web pages, buyer prediction, influence propagation, budget constraints

Procedia PDF Downloads 263

Authors: Bremmy Laksono, Riksa Parikrama, Nur A. Rosyada, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome (DS) is a chromosomal abnormality characterised by complete 21 chromosome trisomy (classical or non-disjunction), or partial 21 chromosome trisomy (mosaicism), or chromosome rearrangement involving chromosome 21 (translocation). This study was carried out to describe the frequency of DS patients in a research institution in the city of Bandung, Indonesia. This descriptive study also provides a picture of the residential location and surrounding area of their dwellings. This study involved people with DS in various age whose chromosome were evaluated by conventional karyotyping method and FISH. Data were collected from 60 patients with DS from a total 150 patients during the period of September 2015 to August 2016 who were referred to Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Results showed that the most common type of DS was non-disjunction (93%), followed by mosaicism (5%), no patient with translocation DS (0%), and a very rare type of tetrasomy 21 (2%). There were 39 males (65%) and 21 females (35%) of DS patient. Most of them live in suburban area beyond Bandung city (55%) while the rest live inside urban area of Bandung city (45%). They live mostly in dense area of greater Bandung area (65%) and only a few live in mid-density area (25%) and the least live in sparse populated area (10%). Their houses are mostly located in residential estate area (55%), nearby industrial area (37%), and around agricultural area (8%). Based on the study, it could be concluded that non-disjunction DS is the most common type. DS patients referred to the laboratory mostly came from dense residential zone in suburban area outside Bandung city. The low number of DS patients referred to the laboratory for chromosome analysis was the highlight to improve health service for people with genetic disorder. This study offered several information regarding area of DS patients’ residence and the condition of neighbourhood in Bandung city where they live as well.

Keywords: chromosome, descriptive, Down syndrome, prevalence

Procedia PDF Downloads 282

Authors: Durjoy Lahiri, Vishal Madhukar Sawale, Ashwani Bhat, Souvik Dubey, Gautam Das, Biman Kanti Roy, Suparna Chatterjee, Goutam Gangopadhyay

Abstract:

Crossed aphasia has been an area of considerable interest for cognitive researchers as it offers a fascinating insight into cerebral lateralization for language function. We conducted an observational study in the stroke unit of a tertiary care neurology teaching hospital in eastern India on subjects with crossed aphasia over a period of four years. During the study period, we detected twelve cases of crossed aphasia in strongly right-handed patients, caused by ischemic stroke. The age, gender, vernacular language and educational status of the patients were noted. Aphasia type and severity were assessed using Bengali version of Western Aphasia Battery (validated). Computed tomography, magnetic resonance imaging and angiography were used to evaluate the location and extent of the ischemic lesion in brain. Our series of 12 cases of crossed aphasia included 7 male and 5 female with mean age being 58.6 years. Eight patients were found to have Broca’s aphasia, 3 had trans-cortical motor aphasia and 1 patient suffered from global aphasia. Nine patients were having very severe aphasia and 3 suffered from mild aphasia. Mirror-image type of crossed aphasia was found in 3 patients, whereas 9 had anomalous variety. In our study crossed aphasia was found to be more frequent in males. Anomalous pattern was more common than mirror-image. Majority of the patients had motor-type aphasia and no patient was found to have pure comprehension deficit. We hypothesize that in Bengali-speaking right-handed population, lexical-semantic system of the language network remains loyal to the left hemisphere even if the phonological output system is anomalously located in the right hemisphere.

Keywords: aphasia, crossed, lateralization, language function, vascular

Procedia PDF Downloads 194

Authors: Tamekloe Michael Kossivi, Kenichi Matsui

Abstract:

Irrigation access is one of the essential rural development investment options that can significantly improve smallholder farmers’ agriculture productivity. Investment in irrigation infrastructural development to supply adequate water could improve food security, growth in income for farmers, poverty alleviation, and improve business and livelihood. This paper assesses smallholder farmers’ constraints and the needs to adopt small-scale irrigation for crops production in the South Tongu District of Ghana. The data collection involved database search, questionnaire survey, interview, and field work. The structured questionnaire survey was administered from September to November 2020 among 120 respondents in six purposively sampled irrigation communities in the District. The questions focused on small-scale irrigation development constraints and needs. As a result, we found that the respondents relied mainly on rainfall for agriculture production. They did not have adequate irrigation access. Even though the District is blessed with open arable lands and rich water sources for rice and vegetable production on a massive scale, water sources like the Lower Volta River, Tordzi River, and Avu Lagoon were not close enough to the respondents. The respondents faced inadequate credit support (100%), unreliable rainfall (76%), insufficient water supply (54%), and unreliable water delivery challenges on their farms (53%). Physical constraints for the respondents to adopt irrigation included flood (77%), drought (93%), inadequate irrigation technology (59%), and insufficient technical know-how (65%). Farmers were interested in investing in irrigation infrastructural development to enhance productivity on their farms only if they own the farmlands. External support from donors on irrigation systems did not allow smallholder farmers to control irrigation facilities.

Keywords: constraints, food security, needs, smallholder farmers, small-scale irrigation

Procedia PDF Downloads 138

Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

Abstract:

Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

Procedia PDF Downloads 446

Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

Abstract:

Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: colorectal cancer, Hail Region, changing pattern, distal shift

Procedia PDF Downloads 209