Search results for: reduced private care use

Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

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A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

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Authors: Djehich Mohamed Yousri

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In recent years, the world has witnessed a phenomenon of displacement that is unprecedented in history. The number of refugees has reached record levels, due to wars, persecution, many conflicts and repression in a number of countries. The interest of United Nations bodies and international and regional organizations in the issue of refugees has increased, as they have defined a refugee and thus Determining who is entitled to this legal protection, and the 1951 Convention for the Protection of Refugees defines rights for refugee protection and sets obligations that they must perform. The institutional mechanisms for refugee protection are represented in the various agencies that take care of refugee affairs. At the forefront of these agencies is the United Nations High Commissioner for Refugees, as well as the various efforts provided by the International Committee of the Red Cross and the United Nations Relief and Works Agency for Palestine Refugees in the Middle East (UNRWA).

Keywords: protection, refugees, international, persecution, legal

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Authors: José M Martín-Moreno, Rafaela Pérez, Jesús Ruiz

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In this paper we use a small open economy Dynamic Stochastic General Equilibrium Model (DSGE) for the Spanish economy to search for a deeper characterization of the determinants of Spain’s macroeconomic fluctuations throughout the period 1970-2008. In order to do this, we distinguish between tradable and non-tradable goods to take into account the fact that the presence of non-tradable goods in this economy is one of the largest in the world. We estimate a DSGE model with supply and demand shocks (sectorial productivity, public spending, international real interest rate and preferences) using Kalman Filter techniques. We find the following results. First of all, our variance decomposition analysis suggests that 1) the preference shock basically accounts for private consumption volatility, 2) the idiosyncratic productivity shock accounts for non-tradable output volatility, and 3) the sectorial productivity shock along with the international interest rate both greatly account for tradable output. Secondly, the model closely replicates the time path observed in the data for the Spanish economy and finally, the model captures the main cyclical qualitative features of this economy reasonably well.

Keywords: business cycle, DSGE models, Kalman filter estimation, small open economy

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Authors: Cindy Sithole, Didier Nyembwe, Peter Olubambi

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The sand casting process involves pattern making, mould making, metal pouring and shake out. Every step in the sand moulding process is very critical for production of good quality castings. However, waste generated during the sand moulding operation and lack of quality are matters that influences performance inefficiencies and lack of competitiveness in South African foundries. Defects produced from the sand moulding process are only visible in the final product (casting) which results in increased number of scrap, reduced sales and increases cost in the foundry. The purpose of this Research is to propose six sigma technique (DMAIC, Define, Measure, Analyze, Improve and Control) intervention in sand moulding foundries and to reduce variation caused by deficiencies in the sand moulding process in South African foundries. Its objective is to create sustainability and enhance productivity in the South African foundry industry. Six sigma is a data driven method to process improvement that aims to eliminate variation in business processes using statistical control methods .Six sigma focuses on business performance improvement through quality initiative using the seven basic tools of quality by Ishikawa. The objectives of six sigma are to eliminate features that affects productivity, profit and meeting customers’ demands. Six sigma has become one of the most important tools/techniques for attaining competitive advantage. Competitive advantage for sand casting foundries in South Africa means improved plant maintenance processes, improved product quality and proper utilization of resources especially scarce resources. Defects such as sand inclusion, Flashes and sand burn on were some of the defects that were identified as resulting from the sand moulding process inefficiencies using six sigma technique. The courses were we found to be wrong design of the mould due to the pattern used and poor ramming of the moulding sand in a foundry. Six sigma tools such as the voice of customer, the Fishbone, the voice of the process and process mapping were used to define the problem in the foundry and to outline the critical to quality elements. The SIPOC (Supplier Input Process Output Customer) Diagram was also employed to ensure that the material and process parameters were achieved to ensure quality improvement in a foundry. The process capability of the sand moulding process was measured to understand the current performance to enable improvement. The Expected results of this research are; reduced sand moulding process variation, increased productivity and competitive advantage.

Keywords: defects, foundries, quality improvement, sand moulding, six sigma (DMAIC)

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Authors: Robert Saputra, Tomas Havlicek

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This study discusses the design of collaborative rural governance strategies to enhance the rural economy through Village-owned Enterprises (VOE) in Riau Province, Indonesia. Using Soft Systems Methodology (SSM) combined with Textual Network Analysis (TNA) in the Rich Picture stage of SSM, we investigated the current state of VOE management. Significant obstacles identified include insufficient business feasibility analyses, lack of managerial skills, misalignment between strategy and practice, and inadequate oversight. To address these challenges, we propose a collaborative strategy involving regional governments, academic institutions, NGOs, and the private sector. This strategy emphasizes community needs assessments, efficient resource mobilization, and targeted training programs. A dedicated working group will ensure continuous monitoring and iterative improvements. Our research highlights the novel integration of SSM with TNA, providing a robust framework for improving VOE management and demonstrating the potential of collaborative efforts in driving rural economic development.

Keywords: village-owned enterprises (VOE), rural economic development, soft system methodology (SSM), textual network analysis (TNA), collaborative governance

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: M. Illias Kanchan

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The death of a woman during pregnancy and childbirth is not only a health issue, but also a matter of social injustice. This study makes an attempt to explore the association between maternal death and associated factors in West Bengal using the approaches of facility-based and community-based maternal death review. Bivariate and binary logistic regression analysis have been performed to understand the causes and circumstances of maternal deaths in West Bengal. Delay in seeking care was the major contributor in maternal deaths, near about one-third women died due to this factor. The most common cause of maternal death is found to be hypertensive disorders of pregnancy or eclampsia. We believe that these deaths can be averted by reducing hypertensive disorders of pregnancy or eclampsia.

Keywords: maternal death, facility-based, community-based, review, west Bengal, eclampsia

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Authors: Abdelbaset Rabaiah

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e-Government mobile applications provide an extension for effective e-government services in today’s omniconnected world. They constitute part of m-government platforms. This study explores the usefulness, availability, discoverability and maturity of such applications. While this study impacts theory by addressing a relatively lacking area, it impacts practice more. The outcomes of this study suggest valuable recommendations for practitioners-developers of e-government applications. The methodology followed is to examine a large number of e-government smartphone applications. The focus is on applications available at the Google Play Store. Moreover, the study investigates applications published on government portals of a number of countries. A sample of 15 countries is researched. The results show a diversity in the level of discoverability, development, maturity, and usage of smartphone apps dedicated for use of e-government services. It was found that there are major issues in discovering e-government applications on both the Google Play Store and as-well-as on local government portals. The study found that only a fraction of mobile government applications was published on the Play Store. Only 19% of apps were multilingual, and 43% were developed by third parties including private individuals. Further analysis was made, and important recommendations are suggested in this paper for a better utilization of e-government smartphone applications. These recommendations will result in better discoverability, maturity, and usefulness of e-government applications.

Keywords: mobile applications, e-government, m-government, Google Play Store

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Authors: Tao Feng, Fei Xing, Ye Lu, Jun Li Fang

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NDN is a kind of future Internet architecture. Due to the NDN design introduces four privacy challenges,Many research institutions began to care about the privacy issues of naming data network(NDN).In this paper, we are in view of the major NDN’s privacy issues to investigate privacy protection,then put forwards more effectively anonymous transfer policy for NDN.Firstly,based on mutual anonymity communication for MP2P networks,we propose NDN mutual anonymity protocol.Secondly,we add interest package authentication mechanism in the protocol and encrypt the coding coefficient, security of this protocol is improved by this way.Finally, we proof the proposed anonymous transfer protocol security and anonymity.

Keywords: NDN, mutual anonymity, anonymous routing, network coding, authentication mechanism

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Authors: Aurélie Cassiers

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In this presentation, an overview is given of the freedom of states to legislate concerning abortion. Today, access to safe and legal abortion is still a hot topic in many countries in the world. Abortion policies try to strike a balance between women’s rights to self-determination and private life on the one hand, and the protection of the life of unborn children on the other. Each country has different religious, cultural and political views on abortion, and therefore specific legislations. However, citizens may submit a complaint at international courts when they find their national legislation too restrictive. The study is discussed of the development of the ECtHR, UNCHR, and IACHR case law, regarding the question of the ‘right to abort’ and indirectly of the protection of the unborn children. Each relevant case is analyzed to answer the following questions: Is the unborn child protected, and if so, how? Why does the woman want to abort and how is her interest or right protected? How is a fair balance reached between the different interests? Is the state completely free to write policies that restrict abortion? What are the factors to determine the margin of appreciation of the state? In conclusion, does this specific court recognize a right to abort, and if so, under which conditions? To conclude, this presentation shows that each court has its own perspective on and perception of abortion, and its own criteria to determine whether the state is complying with international norms regarding individual liberty and protection of the children.

Keywords: abortion, international courts, unborn children, women rights

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Marziyeh Heydari, Hossein Shokouhmand

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This article presents a numerical study of natural convection of a heat source embedded on the up wall of an enclosure filled with nanofluid. The bottom and vertical walls of the enclosure are maintained at a relatively low temperature. The type of nanofluid and solid volume fraction of nanoparticle on the heat transfer performance is studied. The results indicated that adding nanoparticle into pure paraffin improves heat transfer. The results are presented over a wide range of Rayleigh numbers(Ra=〖10〗^3 〖-10〗^5), the volume fraction of nanoparticles (0≤ɸ≤0.4%). For an enclosure, the Nusselt number of a cu-paraffin nanofluid was reduced by increasing the volume fraction of nanoparticles above 0.2%.

Keywords: nanofluid, heat transfer, heat source, enclosure

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Authors: Safaa S. Hassan, Mohammed H. Elbakry, Safwat A. Mangoura, Zainab M. Omar

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Background: Liver fibrosis is the main reason for increased mortality in chronic liver disease. It has no standard treatment. Antioxidants from a variety of sources are capable of slowing or preventing oxidation of other molecules. Aim: to evaluate the hepatoprotective effect of vit. C, vit. E and gallic acid in comparison to silymarin in the rat model of carbon tetrachloride induced liver fibrosis and their possible mechanisms of action. Material& Methods: A total number of 60 adult male albino rats 160-200gm were divided into six equal groups; received subcutaneous (s.c) injection for 8 weeks. Group I: as control. Group II: received 1.5 mL/kg of CCL4 .Group III: CCL4 and co- treatment with silymarin 100mg/kg p.o. daily. Group IV: CCL4 and co-treatment with vit. C 50mg/kg p.o. daily. Group V: CCL4 and co-treatment with vit. E 200mg/kg. p.o. Group VI: CCL4 and co-treatment with Gallic acid 100mg/kg. p.o. daily. Liver was processed for histological and immunohistochemical examination. Levels of AST, ALT, ALP, reduced GSH, MDA, SOD and hydroxyproline concentration were measured and evaluated statistically. Results: Light and electron microscopic examination of liver of group II exhibited foci of altered cells with dense nuclei and vacuolated, granular cytoplasm, mononuclear cell infiltration in portal areas, profuse collagen fiber deposits were found around portal tract, more intense staining α-SMA-positive cells occupied most of the liver fibrosis tissue, electron lucent areas in the cytoplasm of the hepatocytes, margination of nuclear chromatin. Treatment by any of the antioxidants variably reduced the hepatic structural changes induced by CCL4. Biochemical analysis showed that carbon tetrachloride significantly increased the levels of serum AST, ALT, ALP, hepatic malondialdehyde and hydroxyproline content. Moreover, it decreased the activities of superoxide dismutase and glutathione. Treatment with silymarin, gallic acid, vit. C and vit. E decreased significantly the AST, ALT, and ALP levels in plasma, MDA and hydroxyproline and increased the activities of SOD and glutathione in liver tissue. The effect of administration of CCl4 was improved with the used antioxidants in variable degrees. The most efficient antioxidant was silymarin followed by gallic acid and vit. C then vit. E. It is possibly due to their antioxidant effect, free radical scavenging properties and the reduction of oxidant dependent activation and proliferation of HSCs. Conclusion: So these antioxidants can be a promising drugs candidate for ameliorating liver fibrosis better than the use of the drugs and their side effects.

Keywords: antioxidant, ccl4, gallic acid, liver fibrosis

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Authors: H. Nematifar, D. Sanavi Khoshnoud, S. Feyz

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Bi0.82La0.2Fe1-xCrxO3 (BLFCxO, x = 0.0, 0.02, 0.05 and 0.08) nanoparticles were successfully synthesized by a sol-gel method. The X-ray diffraction (XRD) patterns indicate that the lattice parameters decrease for x ≤ 0.05, firstly, and then they increase for x > 0.05. A transformation from rhombohedral structure to orthorhombic structure occurs at x = 0.08. The transmission electron microscopy (TEM) analysis shows that the average nanoparticle size is about 60-70 nm. The remnant magnetisation (Mr) increases gradually with x to 0.02, then decreases with further increasing x up to 0.05, and finally enchases abruptly in x = 0.08. The coercivity (HC) increases gradually with x to 0.05, and then significantly reduced with increasing Cr substitution. The magnetic ordering temperature (TN) decreases with Cr doping concentration. The M-H curves of all samples exhibit a wasp-waist hysteresis loop in low magnetic region. This property can play an important role for the applications of some multiferroic nano-device.

Keywords: BiFeO3, sol-gel preparation, nanoparticles, magnetic materials, thermal analysis

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Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

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Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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Authors: Giuseppe Timperio, Robert de Souza

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Logistics operations in the context of disaster response are characterized by a high degree of complexity due to the combined effect of a large number of stakeholders involved, time pressure, uncertainties at various levels, massive deployment of goods and personnel, and gigantic financial flow to be managed. It also involves several autonomous parties such as government agencies, militaries, NGOs, UN agencies, private sector to name few, to have a highly collaborative approach especially in the critical phase of the immediate response. This is particularly true in the context of L3 emergencies that are the most severe, large-scale humanitarian crises. Decision-making processes in disaster management are thus extremely difficult due to the presence of multiple decision-makers involved, and the complexity of the tasks being tackled. Hence, in this paper, we look at applying ICT based solutions to enable a speedy and effective decision making in the golden window of humanitarian operations. A high-level view of ICT based solutions in the context of logistics operations for humanitarian response in Southeast Asia is presented, and their viability in a real-life case about logistics network design is explored.

Keywords: decision support, disaster preparedness, humanitarian logistics, network design

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Authors: Hien T. T. Ho, Tsunemi Watanabe

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The regulatory and market pressures on the restriction of nonylphenol and its ethoxylates in textile articles have confronted the textile manufacturers, particularly those in developing countries. This study aimed to examine the tentative behavior of the textile manufacturers in Vietnam from the perspectives of attitude and the perceptions of technical and organizational adaptabilities, risks, benefits, and barriers. Personal interviews were conducted with five technical specialists from four textile firms and one chemical supplier. The environmental regulatory and market situations regarding the chemical use in Vietnam were also described. The findings revealed two main opposing trends of chemical substitution depending on the market orientation of firms that governed the patterns of risk and benefit perception. The indirect influence of perceived adaptabilities on firm tentative behavior through perceived risks was elucidated, which initiated a conceptual model of firm’s behavior combining the organizational-based and the rational-based relationships. The intermediary role of non-governmental textile and garment industrial/ trade associations is highlighted to strengthen private firm’s informative capacity.

Keywords: firm behavior, institutional analysis, organizational adaptation, technical adaptation

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Authors: Vipan Kumar Sohpal, Rajesh K Sharma

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Diminishing of conventional fuels and hysterical vehicles emission leads to deterioration of the environment, which emphasize the research to work on biofuels. Biofuels from different sources attract the attention of research due to low emission and biodegradability. Emission of carbon monoxide, carbon dioxide and H-C reduced drastically using Biofuels (B-20) combustion. Contrary to the conventional fuel, engine emission results indicated that nitrous oxide emission is higher in Biofuels. So this paper examines and compares the nitrogen oxide emission of Jatropha Curcus (JCO) B-20% blends with the vegetable oil. In addition to that computational analysis of crude non edible oil performed to assess the impact of composition on emission quality. In conclusion, JCO have the potential feedstock for the biodiesel production after the genetic modification in the plant.

Keywords: jatropha curcus, computational analysis, emissions, NOx biofuels

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: Safa Moussoud

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Contrary to modern misconceptions, women in the Muslim Middle Ages enjoyed a generous degree of liberty both in the public and private sphere. Poetry was a significant component of public life throughout the Muslim Civilization as its vitality and multi-generic nature acted as a way for medieval Muslims to communicate with each other. As such, a continuity of poetic literary heritage was preserved through multiple centuries and dynasties. This paper will argue that Muslim women were active participants in medieval Muslim society’s social and public sphere and therefore, can be seen as vital contributors to the intellectual and literary creation of the Muslim Civilization. This paper will examine poetry written by Safiyya al-Baghddadiya and Salma bint al-Qaratisi from the Abbasid period, as well as Wallada bint al-Mustakfi from the Andalusian period and focus particularly at the poetesses’ modes of self-expression regarding beauty and sexuality to argue that Medieval Muslim women enjoyed creative and literary liberty thus allowing them to proclaim their subjectivity publicly through poetry. By emphasizing women’s involvement in the social aspects of Medieval Muslim societies, this paper will ultimately urge for a more thorough investigation of Muslim women’s role and function in the making of the Muslim Civilization.

Keywords: Arabo-Islamic society, medieval Muslims, Muslim poetesses, self-expression

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Authors: Jutta Hämmerle-Uhl, Georg Penn, Gerhard Pötzelsberger, Andreas Uhl

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Iris codes contain bits with different entropy. This work investigates different strategies to reduce the size of iris code templates with the aim of reducing storage requirements and computational demand in the matching process. Besides simple sub-sampling schemes, also a binary multi-resolution representation as used in the JBIG hierarchical coding mode is assessed. We find that iris code template size can be reduced significantly while maintaining recognition accuracy. Besides, we propose a two stage identification approach, using small-sized iris code templates in a pre-selection satge, and full resolution templates for final identification, which shows promising recognition behaviour.

Keywords: iris recognition, compact iris code, fast matching, best bits, pre-selection identification, two-stage identification

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Authors: Moses Abrahamson

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This paper examines Edgar Degas’s The Rehearsal of the Ballet Onstage (1874) through the lens of gaze, spatiality, and women’s labor within the context of 19th-century Parisian modernity. Degas’s depiction of ballet dancers, who were often subject to sexual exploitation by wealthy patrons of the Paris Opera, extends beyond a mere aesthetic rendering of performance. Instead, the painting highlights the Opera’s backstage dynamics, where class and gender intersect through power imbalances. By analyzing the gazes of the Opera’s male patrons and ballet masters, the paper explores the implicit commodification of the dancers, drawing on Mulvey’s theory of the male gaze and its manifestation in the portrayal of working-class women. Degas’s positioning of these figures, coupled with his perspective as both artist and patron, reveals his engagement with the spatial layout of the Opera and the modern social hierarchies it embodies. The painting serves as a microcosm of broader sociocultural transformations, where Degas reflects on the labor of ballet dancers as both private toil and public spectacle, connecting his artistic process to the gendered and classed politics of modern Parisian society.

Keywords: class dynamics, male gaze, spatiality, modernity

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Authors: Ezeoke Callistus Obiora, Ezeoke Nneka Angela

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The study investigated the effect of deficit financing on macroeconomic variables in Nigeria. The specific objectives included to find out the relationship between deficit financing and GDP, interest rate, inflation rate, money supply, exchange rate and private investment respectively on a time series covering a period of 44 years (1970 – 2013). The Ordinary Least Square multiple regression produced statistics for the coefficient of determination (R2), F-test, t-test used for the interpretation of the study. The findings revealed that Deficit financing has significant positive effect on GDP and exchange rate. Again, deficit financing has a positive and insignificant relationship inflation, money supply and investment. Only interest rate recorded negative yet insignificant relationship with deficit financing. The implications of the findings are that deficit financing can be a veritable tool for boosting economic development in Nigeria, but the influential positively rising exchange rate implies that deficit financing devalues the Naira exchange rate to other currencies indicating that deficit financing can affect Nigerians competitive advantage at the world market. Thus, the study concludes that deficit financing has not encouraged economic growth in Nigeria.

Keywords: deficit financing, money supply, exchange rate, inflation, GDP, investment, Nigeria

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Authors: Asima Mehaboob Khan, Rizwan Taj

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Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.

Keywords: knowledge, attitude, practices, medical ethics

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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: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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Authors: K. Shaloom Mbambu, M. Pascal Tshimbalanga, K. Ruth Mutala, K. Roger Kabuya, N. Dieudonné Kabeya, Y. L. Kabeya Mukeba

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In this article, the authors examine the even more worrying situation of girls in sub-Saharan Africa. Two-girls on five are private of Global Education, which represents a real loss to the development of communities and countries. Cultural traditions, poverty, violence, early and forced marriages, early pregnancies, and many other gender inequalities were the causes of this cancer development. Namely, "it is no more efficient development tool that is educating girls." The non-schooling of girls and their lack of supervision by liberal professions have serious consequences for the life of each of them. To improve the conditions of their inferior status, girls to men introduce poverty and health risks. Raising awareness among parents and communities on the importance of girls' education, improving children's access to school, girl-boy equality with their rights, creating income, and generating activities for girls, girls, and girls learning of liberal trades to make them self-sufficient. Organizations such as the United Nations Organization can save the children. ASEAD and the AEDA group are predicting the impact of this cancer on the development of a nation's future generation must be preserved.

Keywords: young girl, Sub-Saharan Africa, higher and vocational education, development, society, environment

Procedia PDF Downloads 254

Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

Procedia PDF Downloads 444

Authors: Zoltan Sebestyen, Eszter Barta-Rajnai, Emma Jakab, Zsuzsanna Czegeny

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Extraction of the energy content of lignocellulosic biomass is one of the possible pathways to reduce the greenhouse gas emission derived from the burning of the fossil fuels. The application of the bioenergy can mitigate the energy dependency of a country from the foreign natural gas and the petroleum. The diversity of the plant materials makes difficult the utilization of the raw biomass in power plants. This problem can be overcome by the application of thermochemical techniques. Pyrolysis is the thermal decomposition of the raw materials under inert atmosphere at high temperatures, which produces pyrolysis gas, biooil and charcoal. The energy content of these products can be exploited by further utilization. The differences in the chemical and physical properties of the raw biomass materials can be reduced by the use of torrefaction. Torrefaction is a promising mild thermal pretreatment method performed at temperatures between 200 and 300 °C in an inert atmosphere. The goal of the pretreatment from a chemical point of view is the removal of water and the acidic groups of hemicelluloses or the whole hemicellulose fraction with minor degradation of cellulose and lignin in the biomass. Thus, the stability of biomass against biodegradation increases, while its energy density increases. The volume of the raw materials decreases so the expenses of the transportation and the storage are reduced as well. Biooil is the major product during pyrolysis and an important by-product during torrefaction of biomass. The composition of biooil mostly depends on the quality of the raw materials and the applied temperature. In this work, thermoanalytical techniques have been used to study the qualitative and quantitative composition of the pyrolysis and torrefaction oils of a woody (black locust) and two herbaceous samples (rape straw and wheat straw). The biooil contains C5 and C6 anhydrosugar molecules, as well as aromatic compounds originating from hemicellulose, cellulose, and lignin, respectively. In this study, special emphasis was placed on the formation of the lignin monomeric products. The structure of the lignin fraction is different in the wood and in the herbaceous plants. According to the thermoanalytical studies the decomposition of lignin starts above 200 °C and ends at about 500 °C. The lignin monomers are present among the components of the torrefaction oil even at relatively low temperatures. We established that the concentration and the composition of the lignin products vary significantly with the applied temperature indicating that different decomposition mechanisms dominate at low and high temperatures. The evolutions of decomposition products as well as the thermal stability of the samples were measured by thermogravimetry/mass spectrometry (TG/MS). The differences in the structure of the lignin products of woody and herbaceous samples were characterized by the method of pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS). As a statistical method, principal component analysis (PCA) has been used to find correlation between the composition of lignin products of the biooil and the applied temperatures.

Keywords: pyrolysis, torrefaction, biooil, lignin

Procedia PDF Downloads 329

Authors: Simon Bambey, Edward Lim, Kai Corley-Jory, Pooya Taheri

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The main goal of this paper is to propose a simple and low-cost microcontroller-based laser communication link. To demonstrate that laser communication is a viable and efficient means for transmitting data, a transceiver capable of transfer rates of approximately 0.7 kB/s is prototyped. The hardware used for the transceiver consists of Commercial Off-The-Shelf (COTS) lasers, photodiodes, and the Arduino Mega 2560 which is an open-source and easy-to-use microcontroller-based platform intended for making interactive projects. A graphic user interface utilizing the Meteor framework is developed to facilitate the communication between the user and transceiver. The developed transceiver prototype is capable of receiving and transmitting data at significant ranges with no loss of information. Furthermore, stable and secure communication is achieved through several mechanisms developed to manage simultaneous sending and receiving, in addition to detecting physical interruptions during transmission. The design setup is scalable and with further development can be transformed into a fiber-optic transmission system. Due to its nature, laser communication is very secure and can provide a safe and private communication link. Overall, this paper demonstrates how laser communication can be an economical, durable, and effective means of information transfer.

Keywords: Arduino microcontrollers, laser applications, user interfaces, wireless communication

Procedia PDF Downloads 302