Search results for: fire probabilistic risk assessment

Authors: A. Nicknam, N. Eftekhari, A. Mazarei, M. Ganjvar

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This article presents an alternative collapse capacity intensity measure in the three elements form which is influenced by the spectral ordinates at periods longer than that of the first mode period at near and far source sites. A parameter, denoted by β, is defined by which the spectral ordinate effects, up to the effective period (2T_1), on the intensity measure are taken into account. The methodology permits to meet the hazard-levelled target extreme event in the probabilistic and deterministic forms. A MATLAB code is developed involving OpenSees to calculate the collapse capacities of the 8 archetype RC structures having 2 to 20 stories for regression process. The incremental dynamic analysis (IDA) method is used to calculate the structure’s collapse values accounting for the element stiffness and strength deterioration. The general near field set presented by FEMA is used in a series of performing nonlinear analyses. 8 linear relationships are developed for the 8structutres leading to the correlation coefficient up to 0.93. A collapse capacity near field prediction equation is developed taking into account the results of regression processes obtained from the 8 structures. The proposed prediction equation is validated against a set of actual near field records leading to a good agreement. Implementation of the proposed equation to the four archetype RC structures demonstrated different collapse capacities at near field site compared to those of FEMA. The reasons of differences are believed to be due to accounting for the spectral shape effects.

Keywords: collapse capacity, fragility analysis, spectral shape effects, IDA method

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Authors: Cemile Kütmeç Yilmaz, Güler Duru Asiret, Gulcan Bagcivan

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The aim of this study was to evaluate the reliability and validity of the Turkish version of the Carer’s Assessment of Satisfaction Index (CASI-TR). The study was conducted between the dates of June 2016 and September 2017 at the Training and Research Hospital of Aksaray University with the caregiving family members of the inpatients with chronic diseases. For this study, the sample size was calculated as at least 10 individuals for each item (item number (30)X10=300). The study sample included 300 caregiving family members, who provided primer care for at least three months for a patient (who had at least one chronic disease and received inpatient treatment in general internal medicine and palliative care units). Data were collected by using a demographic questionnaire and CASI-TR. Descriptive statistics, and psychometric tests were used for the data analysis. Of those caregivers, 76.7% were female, 86.3% were 65 years old and below, 43.7% were primary school graduates, 87% were married, 86% were not working, 66.3% were housewives, and 60.3% defined their income status as having an income covering one’s expenses. Care recipients often had problems in terms of walking, sleep, balance, feeding and urinary incontinence. The Cronbach Alpha value calculated for the CASI-TR (30 items) was 0,949. Internal consistency coefficients calculated for subscales were: 0.922 for the subscale of ‘caregiver satisfaction related to care recipient’, 0.875 for the subscale of ‘caregiver satisfaction related to themselves’, and 0.723 for the subscale of ‘dynamics of interpersonal relations’. Factor analysis revealed that three factors accounted for 57.67% of the total variance, with an eigenvalue of >1. assessed in terms of significance, we saw that the items came together in a significant manner. The factor load of the items were between 0.311 and 0.874. These results show that the CASI-TR is a valid and reliable scale. The adoption of the translated CASI in Turkey is found reliable and valid to assessing the satisfaction of caregivers. CASI-TR can be used easily in clinics or house visits by nurses and other health professionals for assessing caregiver satisfaction from caregiving.

Keywords: carer’s assessment of satisfaction index, caregiver, validity, reliability

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Authors: Dorothy Kagazi

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The African elephant (Loxodonta africana) remains one of the most crop-damaging species around Kibale National Park, western Uganda. Elephant crop raiding deprives communities of food and incomes, consequently impacting livelihoods, attitude, and support for conservation. It also attracts an aggressive reaction from local communities including the retaliatory killing of a species that is already endangered and listed under Appendix I of the Convention on Endangered Species of Flora and Fauna (CITES). In order to mitigate against elephant crop raiding and minimize conflict, a number of interventions were devised by the government of Uganda such as physical guarding, scare-shooting, excavation of trenches, growing of unpalatable crops and fire lighting all of which have over the years been implemented around the park. These generated varying degrees of effectiveness but largely never solved the problem of elephants crossing into communities to destroy food and shelter which had a negative effect onto sustainable tourism of the communities who often resorted to killing these animals and hence contributing the falling numbers of these animals. It was until government discovered that there are far more effective ways of deterring these animals from crossing to communities that it commissioned a study to deploy the African honeybee (Apis mellifera scutellata) as a deterrent against elephant crop raiding and income enhancement for local people around the park. These efforts led to a number of projects around Kibale National Park where communities were facilitated to keep bees for human-elephant conflict mitigation and rural income enhancement through the sale of honey. These projects have registered tremendous success in reducing crop damage, enhance rural incomes, influence positive attitude change and ultimately secure community support for elephant and park conservation which is a clear manifestation of sustainable tourism development in the area. To address the issue of sustainability, the project was aligned with four major objectives that contributed to the overall goal of maintaining the areas around the parks and the national park itself in such a manner that it remains viable over an infinite period. Among these included determining deterrence effects of bees against elephant crop raiding, assessing the contribution of beekeeping towards rural income enhancement, determining the impact of community involvement of park conservation and management among others. The project deployed 500 improved hives by placing them at specific and previously identified and mapped out elephant crossing points along the park boundary. A control site was established without any intervention to facilitate comparison of findings and data was collected on elephant raiding frequency, patterns, honey harvested, and community attitude towards the park. A socio-economic assessment was also undertaken to ascertain the contribution of beekeeping to incomes and attitude change. In conclusion, human-wildlife conflicts have disturbed conservation and sustainable tourism development efforts. Such success stories like the beekeeping strategy should hence be extensively discussed and widely shared as a conservation technique for sustainable tourism.

Keywords: bees, communities, conservation, elephants

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Authors: Mohsen Farhadloo, Majid Farhadloo

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Aspect-level opinion mining that aims at discovering aspects (aspect identification) and their corresponding ratings (sentiment identification) from customer reviews have increasingly attracted attention of researchers and practitioners as it provides valuable insights about products/services from customer's points of view. Instead of addressing aspect identification and sentiment identification in two separate steps, it is possible to simultaneously identify both aspects and sentiments. In recent years many graphical models based on Latent Dirichlet Allocation (LDA) have been proposed to solve both aspect and sentiment identifications in a single step. Although LDA models have been effective tools for the statistical analysis of document collections, they also have shortcomings in addressing some unique characteristics of opinion mining. Our goal in this paper is to address one of the limitations of topic models to date; that is, they fail to directly model the associations among topics. Indeed in many text corpora, it is natural to expect that subsets of the latent topics have higher probabilities. We propose a probabilistic graphical model called focus-LDA, to better capture the associations among topics when applied to aspect-level opinion mining. Our experiments on real-life data sets demonstrate the improved effectiveness of the focus-LDA model in terms of the accuracy of the predictive distributions over held out documents. Furthermore, we demonstrate qualitatively that the focus-LDA topic model provides a natural way of visualizing and exploring unstructured collection of textual data.

Keywords: aspect-level opinion mining, document modeling, Latent Dirichlet Allocation, LDA, sentiment analysis

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Authors: Olha Yarova

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This study is a collaborative project between the American University of Central Asia and parent association of children with Down syndrome ‘Sunterra’ that took place in Bishkek, Kyrgyzstan. The purpose of the study was to explore whether principles and techniques of applied behavior analysis (ABA) could be used to teach children with Down syndrome socially significant behaviors. ABA is considered to be one of the most effective treatment for children with autism, but little research is done on the particularity of using ABA to children with Down syndrome. The data for the study was received during clinical observations; work with children with Down syndrome and interviews with their mothers. The results show that many ABA principles make the work with children with Down syndrome more effective. Although such children very rarely demonstrate aggressive behavior, they show a lot of escape-driven and attention seeking behaviors that are reinforced by their parents and educators. Thus functional assessment can be done to assess the function of problem behavior and to determine appropriate treatment. Prompting and prompting fading should be used to develop receptive and expressive language skills, and enhance motor development. Even though many children with Down syndrome work for praise, it is still relevant to use tangible reinforcement and to know how to remove them. Based on the results of the study, the training for parents of children with Down syndrome will be developed in Kyrgyzstan, country, where children with Down syndrome are not accepted to regular kindergartens and where doctors in maternity hospitals tell parents that their child will never talk, walk and recognize them

Keywords: down syndrome, applied behavior analysis, functional assessment, problem behavior, reinforcement

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Authors: Saad Bin Ismail, Muhammad Ateeq Qureshi, Rao Muhammad Zahid Khalil

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In the last few decades, urbanization worldwide has been sprawled manifold, which is denunciated in the growth of urban infrastructure and transportation. Urban Heat Island (UHI) can induce deterioration of the living environment, disabilities, and rises in energy usages. In this study, the prevalence/presence of Surface Urban Heat Island (SUHI) effect in major cities of Pakistan, including Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar has been investigated. Landsat and SPOT satellite images were acquired for the assessment of urban sprawl. MODIS Land Surface Temperature product MOD11A2 was acquired between 1000-1200 hours (local time) for assessment of urban heat island. The results of urban sprawl informed that the extent of Islamabad and Rawalpindi urban area increased from 240 km2 to 624 km2 between 2000 and 2016, accounted 24 km2 per year, Lahore 29 km2, accounted 1.6 km2 per year, Karachi 261 km2, accounted for 16 km2/ per year, Peshawar 63 km2, accounted 4 km2/per year, and Quetta 76 km2/per year, accounted 5 km2/per year approximately. The average Surface Urban Heat Island (SUHI) magnitude is observed at a scale of 0.63 ᵒC for Islamabad and Rawalpindi, 1.25 ᵒC for Lahore, and 1.16 ᵒC for Karachi, which is 0.89 ᵒC for Quetta, and 1.08 ᵒC for Peshawar from 2000 to 2016. The pixel-based maximum SUHI intensity reaches up to about 11.40 ᵒC for Islamabad and Rawalpindi, 15.66 ᵒC for Lahore, 11.20 ᵒC for Karachi, 14.61 ᵒC for Quetta, and 15.22 ᵒC for Peshawar from the baseline of zero degrees Centigrade (ᵒC). The overall trend of SUHI in planned cities (e.g., Islamabad) is not found to increase significantly. Spatial and temporal patterns of SUHI for selected cities reveal heterogeneity and a unique pattern for each city. It is well recognized that SUHI intensity is modulated by land use/land cover patterns (due to their different surface properties and cooling rates), meteorological conditions, and anthropogenic activities. The study concluded that the selected cities (Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar) are examples where dense urban pockets observed about 15 ᵒC warmer than a nearby rural area.

Keywords: urban heat island , surface urban heat island , urbanization, anthropogenic source

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Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

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Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

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Authors: Dimiter M. Dimitrov, Abdullah Sadaawi

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The National Assessment for Schools (NAFS) in Saudi Arabia consists of standardized tests in Mathematics, Reading, and Science for school grade levels 3, 6, and 9. One main goal is to classify students into four categories of NAFS performance (minimal, basic, proficient, and advanced) by schools and the entire national sample. The NAFS scoring and equating is performed on a bounded scale (D-scale: ranging from 0 to 1) in the framework of the recently developed “D-scoring method of measurement.” The specificity of the NAFS measurement framework and data complexity presented both challenges and opportunities to (a) the estimation of score reliability for schools, (b) setting cut-scores for the classification of students into categories of performance, and (c) generating plausible values for distributions of student performance on the D-scale. The estimation of score reliability at the school level was performed in the framework of generalizability theory (GT), with students “nested” within schools and test items “nested” within test forms. The GT design was executed via a multilevel modeling syntax code in R. Cut-scores (on the D-scale) for the classification of students into performance categories was derived via a recently developed method of standard setting, referred to as “Response Vector for Mastery” (RVM) method. For each school, the classification of students into categories of NAFS performance was based on distributions of plausible values for the students’ scores on NAFS tests by grade level (3, 6, and 9) and subject (Mathematics, Reading, and Science). Plausible values (on the D-scale) for each individual student were generated via random selection from a statistical logit-normal distribution with parameters derived from the student’s D-score and its conditional standard error, SE(D). All procedures related to D-scoring, equating, generating plausible values, and classification of students into performance levels were executed via a computer program in R developed for the purpose of NAFS data analysis.

Keywords: large-scale assessment, reliability, generalizability theory, plausible values

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Vidya Iyer, Suresh Babu Loganathan, Yuan Hwa Lee, Kwong Fah Koh

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Introduction: It has been recommended that every patient undergoes careful preoperative evaluation in a preoperative clinic to improve theatre utilization, reduce bed occupancy and avoid unnecessary cancellation due to inadequate optimisation, communication and administrative errors. It also gives an opportunity to counsel patients regarding different aspects of anaesthesia. Methodology: A retrospective audit of all the patients seen in preoperative assessment clinic, referral letters of all the patients postponed / referred to other sub specialities in the perioperative period from June 2012 - June 2013 was done. In our clinic, we retrieved patient records who were awaiting surgery pending clearance by other sub specialities. Those patients, who could continue with their scheduled date of surgery after having been referred, were not included in the file. We also studied details of same day cancellations from the data base, during the same study period. The reasons for cancellation were examined and defined as avoidable and unavoidable. Results: Less than 0.5% was postponed from the scheduled day of surgery. Less than 0.5% was cancelled on the day of surgery. Conclusions: Patients who undergo pre anaesthetic evaluation in a well-established clinic results in adequate preoperative patient optimisation, avoids unnecessary preoperative admission, efficient theatre utilisation and greater patient satisfaction. The benefits are the result of guidelines and timely update of them which are used by the junior doctors and trainees who run the clinic and a dedicated specialist to supervise them.

Keywords: preoperative assessment, clinic, referrals, cancellation

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Authors: Grygorii Kostromin, Vladyslav Povoroznyuk

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Chronic venous diseases (CVD) are one of the common, though controversial problems in medicine. It is generally accepted that this pathology predominantly occurs in women. The issue of excessive weight as a risk factor for CVD is still considered debatable. To the author's best knowledge, today in Ukraine, there are barely any studies that describe the relationship between CVD and obesity. Our study aims to determine the association between age, body composition, obesity and CVD in postmenopausal women. The study was conducted in D. F. Chebotarev Institute of Gerontology, National Academy of Medical Sciences of Ukraine. We have examined 96 postmenopausal women aged 46-85 years (mean age – 66.19 ± 0.96 years), who were divided into two groups depending on the presence of CVD. The women were examined by vascular surgeons. For the diagnosis of CVD, we used clinical, anatomic and pathophysiologic classifications. We also performed clinical, ultrasound and densitometry examinations. We found that the CVD frequency in postmenopausal women increased with age (from 72% in those aged 45-59 years to 84% in those aged 75-89 years). A significant correlation between the total fat mass and age was determined in postmenopausal women with CVD. We also observed a significant correlation between the lower extremities’ fat mass and age in both examined groups. A significant correlation between body mass index and age was determined only in postmenopausal women without CVD.

Keywords: chronic venous disease, risk factors, age, obesity, postmenopausal women

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Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

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Authors: Célia Barreto Carvalho, Carolina da Motta, Marina Sousa, Joana Cabral, Ana Luísa Carvalho, Ermelindo Peixoto

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The aim of the current study was to develop and validate a Response to Stressful Situations Scale (RSSS) for the Portuguese population. This scale assesses the degree of stress experienced in scenarios that can constitute positive, negative and more neutral stressors, and also describes the physiological, emotional and behavioral reactions to those events according to their intensity. These scenario include typical stressor scenarios relevant to patients with schizophrenia, which are currently absent from most scale, assessing specific risks that these stressors may bring on subjects, which may prove useful in non-clinical and clinical populations (i.e. patients with mood or anxiety disorders, schizophrenia). Results from Principal Components Analysis and Confirmatory Factor Analysis of on two adult samples from general population allowed to confirm a three-factor model with good fit indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI = 0.914, RMSEA = 0.055, P( rmsea ≤ 0.005) = 0.096; PCFI = 0.781. Further data analysis on the scale revealed that RSSS is an adequate assessment tool of stress response in adults to be used in further research and clinical settings, with good psychometric characteristics, adequate divergent and convergent validity, good temporal stability and high internal consistency.

Keywords: assessment, stress events, stress response, stress vulnerability

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Authors: Chih-Hung Liang, Jung-Jung Chen, Shen-Shih Chiang

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Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health, which are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases and cancer. Cordyceps militaris (CM) is a well-known traditional medicine in Asian countries and a rich source of biologically active components. Black rice (Oryza sativa L.) is a special cultivar of rice that contains rich anthocyanins and regarded as a health-promoting food in China and other Eastern. The aim of this study was to investigate the anti-obesity effect of Cordyceps militaris fermented black rice (CB) on HFD-induced BALB/c mice model. The results indicated that administration of low and high dosage of CB powder significantly reduced the body weights (7.38% and 7.78%), body fat ratio (2.37% and 2.78%), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared to the HF group (p<0.05). Histopathological analysis showed that the score of fatty liver in HF group (5.0) was significantly higher than CB groups (2.1 and 3.6) (p<0.05). In conclusion, Cordyceps militaris fermented black rice can reduce the body weight via inhibition of the fat accumulation in liver and body and possess the anti-obesity potency.

Keywords: Cordyceps militaris, black rice, obesity, HFD-induced mice

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Authors: Mohammed S. Mohammed, Asmaa M. S. Mohammed

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Background: To achieve the quality of cancer care, the oncologic academic programs should be continuously developed with establishing new ones. We highlighted three disciplines, Clinical nutrition, medical biophysics and radiobiology and Psycho-oncology programs; without a doubt, the Egyptian National Cancer Institute, in ‎the accreditation era, will be establishing them ‎ due to their importance in improving the skills of cancer practitioners. Methods: The first suggested program in Clinical Nutrition that is dealing with the assessment of the patient's well-being before, during and after treatment to avoid the defects in the metabolism resulting from the cancer disease and its treatment by giving the supplements in the patient's diet. The second program is Medical Biophysics and Radiobiology, which there's no denying that it ‎is ‎provided ‎in Cairo University as a good program in the faculty of science but lacks the clinical ‎practice. Hence, it is probably better to establish this program in our institute to ‎improve the ‎practitioner skills and introduce a tailored radiation therapy regimen for every patient according to ‎their characteristic profile.‎ While patients are receiving their treatment, the risk of post-traumatic stress disorder arises, so the importance of the third program, Psycho-Oncology, is clearly obtained. This program is concerned with the psychological, social, behavioral, and ethical aspects of cancer. The area of multi-disciplinary interest has boundaries with the major specialties in oncology: the clinical disciplines (surgery, medicine, pediatrics, and radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. Results: It is a prospective academic plan which is compatible with the institutional vision and its strategic plan. Conclusion: In this context, evaluating and understanding the suggested academic programs has become a mandatory part of cancer care. And it is essential to be provided by the NCI.

Keywords: clinical nutrition, psycho-oncology, medical biophysics and radiobiology, medical education

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Authors: Beverly Komen

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Online crimes have been on the rise in the recent days, especially with the hit of the covid-19 pandemic. The coronavirus pandemic has led to an unprecedented rise in screen time, this means more families are relying on technology and digital solutions to keep children learning, spending more time on the virtual platforms can leave children vulnerable to online abuse and exploitation. With ease access of affordable phones, internet, and increased online activities, all children are at risk of being abused online hence making the digital space unsafe for children. With these increased use of technology and its accessibility, children are at risk of facing challenges such as access to inappropriate content, online grooming, identity theft, cyber bullying, among other risks. The big question is; as we enjoy the benefits brought in by technology, how do we ensure that our children are save in this digital space? With the analysis of the current trends, there is a gap in knowledge on people’s understanding on child online protection and safety measures when using the digital space. A survey conducted among 50 parents in Nairobi in Kenya indicated that there is a gap in knowledge on online protection of children and over 50 % of the participants shared that for sure they have no idea on how to protect children online. This paper seeks to address the concept of child protection in the digital space and come up with viable solutions in protecting children from online vices.

Keywords: child protection, digital space, online risks, online grooming, cyber bulying, online child sexual exploitation, and abuse

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Authors: Gizem Akcan, Erdinc Ozturk

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When it is examined as historically, it has caught attention that homosexual people try to behave as heterosexual or come out to have a place in community. Homosexual people have identity confusion during identity development, they have high levels of need for absolute truth and their psychological well being is affected negatively because of high levels of need for absolute truth and they have problems about self concept clarity. People who have problems about self concept clarity have problems on problem solving and show lots of symptoms of stress. People who have clear self concept use healthier coping strategies to solve problems. The purpose of this study is to show whether need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity or not on homosexual men. The participants of this study were 200 homosexual men. The ages of participants were 20-50. In addition, Demographic Information Form, Self Concept Clarity Scale, Need for Absolute Truth Scale, Stres Self-Assessment Checklist and Problem Solving Inventory were applied to the participants. The assessment of the data was made with confirmatory factor analysis and structural equation modeling analysis. According to the results of this study, need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity on homosexual men.

Keywords: need for absolute truth, self concept clarity, symptoms of stress, problem solving

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Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

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Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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Authors: David Lloyd, David Owen, Martin Jardine

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Introduction: European weight regulations with respect to food products require a full understanding of regulation guidelines to assure regulatory compliance. It is suggested that the complexity of regulation leads to practices which result to over filling of food packages by food processors. Purpose: To establish current practices by food processors and the financial, sustainable and societal impacts on the food supply chain of ineffective food production practices. Methods: An analysis of food packing controls with 10 companies of varying food categories and quantitative based research of a further 15 food processes on the confidence in weight control analysis of finished food packs within their organisation. Results: A process floor analysis of manufacturing operations focussing on 10 products found over fill of packages ranging from 4.8% to 20.2%. Standard deviation figures for all products showed a potential for reducing average weight of the pack whilst still retain the legal status of the product. In 20% of cases, an automatic weight analysis machine was in situ however weight packs were still significantly overweight. Collateral impacts noted included the effect of overfill on raw material purchase and added food miles often on a global basis with one raw material alone creating 10,000 extra food miles due to the poor weight control of the processing unit. A case study of a meat and bakery product will be discussed with the impact of poor controls resulting from complex legislation. The case studies will highlight extra energy costs in production and the impact of the extra weight on fuel usage. If successful a risk assessment model used primarily on food safety but adapted to identify waste /sustainability risks will be discussed within the presentation.

Keywords: legislation, overfill, profile, waste

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Authors: Fayaz Moosavi, Saeid Moradyfard

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One of the methods in avoiding management fraud and increasing the quality of financial information, is the notification of qualitative features of financial information, including conservatism characteristic. Although taking a conservatism approach, while boosting the quality of financial information, is able to reduce the informational risk and the cost of capital stock of commercial department, by presenting an improper image about the situation of the commercial department, raises the risk of failure in returning the main and capital interest, and consequently the cost of capital of the commercial department. In order to know if conservatism finally leads to the increase or decrease of the cost of capital or does not have any influence on it, information regarding accepted companies in Tehran stock exchange is utilized by application of pooling method from 2007 to 2012 and it included 124 companies. The results of the study revealed that there is an opposite and meaningful relationship between conditional conservatism and the cost of capital of the company. In other words, if bad and unsuitable news and signs are reflected sooner than good news in accounting profit, the cost of capital of the company increases. In addition, there is a positive and meaningful relationship between the cost of capital and lack of information asymmetry.

Keywords: conditional conservatism, lack of information asymmetry, the cost of capital, stock exchange

Procedia PDF Downloads 257

Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi

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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.

Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise

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Authors: Timea Harmath-Tánczos

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Drug-resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily doses. About a third of patients with epilepsy suffer from drug resistance. Cognitive assessment has a crucial role in the diagnosis and clinical management of epilepsy. Previous studies have addressed the clinical targets and indications for measuring neuropsychological functions; best to our knowledge, no studies have examined it in a Hungarian therapy-resistant population. To fill this gap, we investigated the Hungarian diagnostic protocol between 18 and 65 years of age. This study aimed to describe and analyze neuropsychological functions in patients with drug-resistant epilepsy and identify factors associated with neuropsychology deficits. We perform a prospective case-control study comparing neuropsychological performances in 50 adult patients and 50 healthy individuals between March 2023 and July 2023. Neuropsychological functions were examined in both patients and controls using a full set of specific tests (general performance level, motor functions, attention, executive facts., verbal and visual memory, language, and visual-spatial functions). Potential risk factors for neuropsychological deficit were assessed in the patient group using a multivariate analysis. The two groups did not differ in age, sex, dominant hand and level of education. Compared with the control group, patients with drug-resistant epilepsy showed worse performance on motor functions and visuospatial memory, sustained attention, inhibition and verbal memory. Neuropsychological deficits could therefore be systematically detected in patients with drug-resistant epilepsy in order to provide neuropsychological therapy and improve quality of life. The analysis of the classical and complex indices of the special neuropsychological tasks presented in the presentation can help in the investigation of normal and disrupted memory and executive functions in the DRE.

Keywords: drug-resistant epilepsy, Hungarian diagnostic protocol, memory, executive functions, cognitive neuropsychology

Procedia PDF Downloads 63

Authors: Pedro Llanos, Diego García

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Spaceflight is considered the last frontier in terms of science, technology, and engineering. But it is also the next frontier in terms of human physiology and performance. After more than 200,000 years humans have evolved under earth’s gravity and atmospheric conditions, spaceflight poses environmental stresses for which human physiology is not adapted. Hypoxia, accelerations, and radiation are among such stressors, our research involves suborbital flights aiming to develop effective countermeasures in order to assure sustainable human space presence. The physiologic baseline of spaceflight participants is subject to great variability driven by age, gender, fitness, and metabolic reserve. The objective of the present study is to characterize different physiologic variables in a population of STEM practitioners during an aerobatic flight. Cardiovascular and pulmonary responses were determined in Science Astronaut Candidates (SACs) during unusual attitude aerobatic flight indoctrination. Physiologic data recordings from 20 subjects participating in high-G flight training were analyzed. These recordings were registered by wearable sensor-vest that monitored electrocardiographic tracings (ECGs), signs of dysrhythmias or other electric disturbances during all the flight. The same cardiovascular parameters were also collected approximately 10 min pre-flight, during each high-G/unusual attitude maneuver and 10 min after the flights. The ratio (pre-flight/in-flight/post-flight) of the cardiovascular responses was calculated for comparison of inter-individual differences. The resulting tracings depicting the cardiovascular responses of the subjects were compared against the G-loads (Gs) during the aerobatic flights to analyze cardiovascular variability aspects and fluid/pressure shifts due to the high Gs. In-flight ECG revealed cardiac variability patterns associated with rapid Gs onset in terms of reduced heart rate (HR) and some scattered dysrhythmic patterns (15% premature ventricular contractions-type) that were considered as triggered physiological responses to high-G/unusual attitude training and some were considered as instrument artifact. Variation events were observed in subjects during the +Gz and –Gz maneuvers and these may be due to preload and afterload, sudden shift. Our data reveal that aerobatic flight influenced the breathing rate of the subject, due in part by the various levels of energy expenditure due to the increased use of muscle work during these aerobatic maneuvers. Noteworthy was the high heterogeneity in the different physiological responses among a relatively small group of SACs exposed to similar aerobatic flights with similar Gs exposures. The cardiovascular responses clearly demonstrated that SACs were subjected to significant flight stress. Routine ECG monitoring during high-G/unusual attitude flight training is recommended to capture pathology underlying dangerous dysrhythmias in suborbital flight safety. More research is currently being conducted to further facilitate the development of robust medical screening, medical risk assessment approaches, and suborbital flight training in the context of the evolving commercial human suborbital spaceflight industry. A more mature and integrative medical assessment method is required to understand the physiology state and response variability among highly diverse populations of prospective suborbital flight participants.

Keywords: g force, aerobatic maneuvers, suborbital flight, hypoxia, commercial astronauts

Procedia PDF Downloads 118

Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

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This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

Procedia PDF Downloads 162

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

Procedia PDF Downloads 164

Authors: Habibullah Pathan

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The present study aims to explore problems faced by English Language Teachers (ELT) while implementing the Outcome Based Education (OBE) model in engineering universities of Sindh. OBE is an emerging model initiative of the International Engineering Alliance. Traditional educational systems are teacher-centered or curriculum-centered, in which learners are not able to achieve desired outcomes, but the OBE model enables learners to know the outcomes before the start of the program. OBE is a circular process that begins from the needs and demands of society to stakeholders who ask the experts to produce the alumnus who can fulfill the needs and ends up getting new enrollment in the respective programs who can work according to the demands. In all engineering institutions, engineering courses besides English language courses are taught on the OBE model. English language teachers were interviewed to learn the in-depth of the problems faced by them. The study found that teachers were facing problems including pedagogical, OBE training, assessment, evaluation and administrative support. This study will be a guide for public and private English language teachers to cope with these challenges while teaching the English language on the OBE model. OBE is an emerging model by which the institutions can produce such a product that can meet the demands.

Keywords: problems of ELT teachers, outcome based education (OBE), implementing, assessment

Procedia PDF Downloads 75

Authors: Louisa Browne Kirk

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In recent press interviews to promote Portrait de la jeune fille en feu (2019, translated to Portrait of a Lady on Fire in English), director and screenwriter Céline Sciamma and actors Adèle Haenel and Noémie Merlant repeatedly state that they understand the film as (if not uniquely, then unusually) produced via and supportive of ‘the female gaze’. Such a way of seeing stands in opposition to ‘the male gaze’, first theorised by Laura Mulvey as the way in which the female figure is a bearer, not maker, of meaning, a silent signifier through and against whom the male creator/viewer produces his fantasies and obsessions. What, then, is the female gaze? How does a woman produce meaning in and through film? Portrait de la jeune fille en feu and another very recent film, Little Women (2019, directed by Greta Gerwig), are unlikely companion films that understand the female gaze to be the act of one woman looking at another woman, a looking that is mediated through the production of art. In Sciamma’s film this looking is sexual and mediated through painting and in Gerwig’s film looking is familial and mediated through writing. In the schema of these films, art, love, looking and meaning are produced through collaboration. The painted and the painter, the written and the writer, are no longer rendered as subject and object but as dual creators, both always seeing and seen. The gaze of the cinematic woman, mediated through shared artistic practice, is ‘the desire-that-gives’.

Keywords: female gaze, Gerwig, Sciamma, shared artistic practice

Procedia PDF Downloads 170

Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

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Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: cardiovascular risk, homocysteine, malondialdehyde, metformin, minerals, type 2 diabetes, vitamin B12

Procedia PDF Downloads 312