Search results for: LIFE 2013 call
5555 Principles of Risk Management in Surgery Department
Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei
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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences
Procedia PDF Downloads 3035554 Community Development and Empowerment
Authors: Shahin Marjan Nanaje
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The present century is the time that social worker faced complicated issues in the area of their work. All the focus are on bringing change in the life of those that they live in margin or live in poverty became the cause that we have forgotten to look at ourselves and start to bring change in the way we address issues. It seems that there is new area of needs that social worker should response to that. In need of dialogue and collaboration, to address the issues and needs of community both individually and as a group we need to have new method of dialogue as tools to reach to collaboration. The social worker as link between community, organization and government play multiple roles. They need to focus in the area of communication with new ability, to transfer all the narration of the community to those organization and government and vice versa. It is not relate only in language but it is about changing dialogue. Migration for survival by job seeker to the big cities created its own issues and difficulty and therefore created new need. Collaboration is not only requiring between government sector and non-government sectors but also it could be in new way between government, non-government and communities. To reach to this collaboration we need healthy, productive and meaningful dialogue. In this new collaboration there will not be any hierarchy between members. The methodology that selected by researcher were focusing on observation at the first place, and used questionnaire in the second place. Duration of the research was three months and included home visits, group discussion and using communal narrations which helped to bring enough evidence to understand real need of community. The sample selected randomly was included 70 immigrant families which work as sweepers in the slum community in Bangalore, Karnataka. The result reveals that there is a gap between what a community is and what organizations, government and members of society apart from this community think about them. Consequently, it is learnt that to supply any service or bring any change to slum community, we need to apply new skill to have dialogue and understand each other before providing any services. Also to bring change in the life of those marginal groups at large we need to have collaboration as their challenges are collective and need to address by different group and collaboration will be necessary. The outcome of research helped researcher to see the area of need for new method of dialogue and collaboration as well as a framework for collaboration and dialogue that were main focus of the paper. The researcher used observation experience out of ten NGO’s and their activities to create framework for dialogue and collaboration.Keywords: collaboration, dialogue, community development, empowerment
Procedia PDF Downloads 5885553 Application of Recycled Tungsten Carbide Powder for Fabrication of Iron Based Powder Metallurgy Alloy
Authors: Yukinori Taniguchi, Kazuyoshi Kurita, Kohei Mizuta, Keigo Nishitani, Ryuichi Fukuda
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Tungsten carbide is widely used as a tool material in metal manufacturing process. Since tungsten is typical rare metal, establishment of recycle process of tungsten carbide tools and restore into cemented carbide material bring great impact to metal manufacturing industry. Recently, recycle process of tungsten carbide has been developed and established gradually. However, the demands for quality of cemented carbide tool are quite severe because hardness, toughness, anti-wear ability, heat resistance, fatigue strength and so on should be guaranteed for precision machining and tool life. Currently, it is hard to restore the recycled tungsten carbide powder entirely as raw material for new processed cemented carbide tool. In this study, to suggest positive use of recycled tungsten carbide powder, we have tried to fabricate a carbon based sintered steel which shows reinforced mechanical properties with recycled tungsten carbide powder. We have made set of newly designed sintered steels. Compression test of sintered specimen in density ratio of 0.85 (which means 15% porosity inside) has been conducted. As results, at least 1.7 times higher in nominal strength in the amount of 7.0 wt.% was shown in recycled WC powder. The strength reached to over 600 MPa for the Fe-WC-Co-Cu sintered alloy. Wear test has been conducted by using ball-on-disk type friction tester using 5 mm diameter ball with normal force of 2 N in the dry conditions. Wear amount after 1,000 m running distance shows that about 1.5 times longer life was shown in designed sintered alloy. Since results of tensile test showed that same tendency in previous testing, it is concluded that designed sintered alloy can be used for several mechanical parts with special strength and anti-wear ability in relatively low cost due to recycled tungsten carbide powder.Keywords: tungsten carbide, recycle process, compression test, powder metallurgy, anti-wear ability
Procedia PDF Downloads 2505552 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest
Authors: Jirapat Suriyachaisawat, Ekkit Surakarn
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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.Keywords: cardiac arrest, outcome, in-hospital, ERT
Procedia PDF Downloads 1985551 Time Travel Testing: A Mechanism for Improving Renewal Experience
Authors: Aritra Majumdar
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While organizations strive to expand their new customer base, retaining existing relationships is a key aspect of improving overall profitability and also showcasing how successful an organization is in holding on to its customers. It is an experimentally proven fact that the lion’s share of profit always comes from existing customers. Hence seamless management of renewal journeys across different channels goes a long way in improving trust in the brand. From a quality assurance standpoint, time travel testing provides an approach to both business and technology teams to enhance the customer experience when they look to extend their partnership with the organization for a defined phase of time. This whitepaper will focus on key pillars of time travel testing: time travel planning, time travel data preparation, and enterprise automation. Along with that, it will call out some of the best practices and common accelerator implementation ideas which are generic across verticals like healthcare, insurance, etc. In this abstract document, a high-level snapshot of these pillars will be provided. Time Travel Planning: The first step of setting up a time travel testing roadmap is appropriate planning. Planning will include identifying the impacted systems that need to be time traveled backward or forward depending on the business requirement, aligning time travel with other releases, frequency of time travel testing, preparedness for handling renewal issues in production after time travel testing is done and most importantly planning for test automation testing during time travel testing. Time Travel Data Preparation: One of the most complex areas in time travel testing is test data coverage. Aligning test data to cover required customer segments and narrowing it down to multiple offer sequencing based on defined parameters are keys for successful time travel testing. Another aspect is the availability of sufficient data for similar combinations to support activities like defect retesting, regression testing, post-production testing (if required), etc. This section will talk about the necessary steps for suitable data coverage and sufficient data availability from a time travel testing perspective. Enterprise Automation: Time travel testing is never restricted to a single application. The workflow needs to be validated in the downstream applications to ensure consistency across the board. Along with that, the correctness of offers across different digital channels needs to be checked in order to ensure a smooth customer experience. This section will talk about the focus areas of enterprise automation and how automation testing can be leveraged to improve the overall quality without compromising on the project schedule. Along with the above-mentioned items, the white paper will elaborate on the best practices that need to be followed during time travel testing and some ideas pertaining to accelerator implementation. To sum it up, this paper will be written based on the real-time experience author had on time travel testing. While actual customer names and program-related details will not be disclosed, the paper will highlight the key learnings which will help other teams to implement time travel testing successfully.Keywords: time travel planning, time travel data preparation, enterprise automation, best practices, accelerator implementation ideas
Procedia PDF Downloads 1595550 Professional Skills Development of Educational Leaders Through Drama in Education: An Example of Best Practice in Greece
Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou
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Drama in Education (DiE) is a dynamic experiential method that can be used in many interdisciplinary contexts. In the Educational and Social Policy Department, University of Macedonia, Thessaloniki, Greece, DiE is being used as a core method for developing professional competences in pre- and postgraduate courses as well as adult education training programs. In this presentation, an innovative DiE application will be described concerning the development of educational leaders’ skills necessary to meet unprecedented, unexpected challenges in the 21st century schools. In a non-threatening risk-taking no-penalty environment, future educational leaders live-in-role problems, challenges, and dilemmas before having to face similar ones in their profession. Through personal involvement, emotional engagement, and reflection, via individual and group activities, they experience the behaviour, dilemmas, decision-making processes, and informed choices of a recognized leader and are able to make connections with their own life. As pretext serves the life of Alexander the Great, the Macedonian King who defeated the vast Persian empire in the 4th century BC and, by uniting all Greeks, conquered the up-to-date known eastern world thanks to his authentic leadership skills and exceptional personality traits. Since the early years of his education mastered by the famous Greek philosopher Aristotle, Alexander proved his unique qualities by providing the world with the example of an undeniably genuine, inspirational, effective, and most recognizable authentic leader. Through questionnaires and individual interviews, participants in these workshops revealed how they developed active listening, empathy, creativity, imagination, critical strategic and out-of-the-box thinking, cooperation and own vision communicating, crisis management skills, self-efficacy, self-awareness, self-exposure, information management, negotiation and inspiration skills, enhanced sense of responsibility and commitment, and decision-making skills.Keywords: drama in education method, educational leadership, professional competences, skills’ development
Procedia PDF Downloads 1565549 Rice Area Determination Using Landsat-Based Indices and Land Surface Temperature Values
Authors: Burçin Saltık, Levent Genç
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In this study, it was aimed to determine a route for identification of rice cultivation areas within Thrace and Marmara regions of Turkey using remote sensing and GIS. Landsat 8 (OLI-TIRS) imageries acquired in production season of 2013 with 181/32 Path/Row number were used. Four different seasonal images were generated utilizing original bands and different transformation techniques. All images were classified individually using supervised classification techniques and Land Use Land Cover Maps (LULC) were generated with 8 classes. Areas (ha, %) of each classes were calculated. In addition, district-based rice distribution maps were developed and results of these maps were compared with Turkish Statistical Institute (TurkSTAT; TSI)’s actual rice cultivation area records. Accuracy assessments were conducted, and most accurate map was selected depending on accuracy assessment and coherency with TSI results. Additionally, rice areas on over 4° slope values were considered as mis-classified pixels and they eliminated using slope map and GIS tools. Finally, randomized rice zones were selected to obtain maximum-minimum value ranges of each date (May, June, July, August, September images separately) NDVI, LSWI, and LST images to test whether they may be used for rice area determination via raster calculator tool of ArcGIS. The most accurate classification for rice determination was obtained from seasonal LSWI LULC map, and considering TSI data and accuracy assessment results and mis-classified pixels were eliminated from this map. According to results, 83151.5 ha of rice areas exist within study area. However, this result is higher than TSI records with an area of 12702.3 ha. Use of maximum-minimum range of rice area NDVI, LSWI, and LST was tested in Meric district. It was seen that using the value ranges obtained from July imagery, gave the closest results to TSI records, and the difference was only 206.4 ha. This difference is normal due to relatively low resolution of images. Thus, employment of images with higher spectral, spatial, temporal and radiometric resolutions may provide more reliable results.Keywords: landsat 8 (OLI-TIRS), LST, LSWI, LULC, NDVI, rice
Procedia PDF Downloads 2285548 Comparison of Rainfall Trends in the Western Ghats and Coastal Region of Karnataka, India
Authors: Vinay C. Doranalu, Amba Shetty
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In recent days due to climate change, there is a large variation in spatial distribution of daily rainfall within a small region. Rainfall is one of the main end climatic variables which affect spatio-temporal patterns of water availability. The real task postured by the change in climate is identification, estimation and understanding the uncertainty of rainfall. This study intended to analyze the spatial variations and temporal trends of daily precipitation using high resolution (0.25º x 0.25º) gridded data of Indian Meteorological Department (IMD). For the study, 38 grid points were selected in the study area and analyzed for daily precipitation time series (113 years) over the period 1901-2013. Grid points were divided into two zones based on the elevation and situated location of grid points: Low Land (exposed to sea and low elevated area/ coastal region) and High Land (Interior from sea and high elevated area/western Ghats). Time series were applied to examine the spatial analysis and temporal trends in each grid points by non-parametric Mann-Kendall test and Theil-Sen estimator to perceive the nature of trend and magnitude of slope in trend of rainfall. Pettit-Mann-Whitney test is applied to detect the most probable change point in trends of the time period. Results have revealed remarkable monotonic trend in each grid for daily precipitation of the time series. In general, by the regional cluster analysis found that increasing precipitation trend in shoreline region and decreasing trend in Western Ghats from recent years. Spatial distribution of rainfall can be partly explained by heterogeneity in temporal trends of rainfall by change point analysis. The Mann-Kendall test shows significant variation as weaker rainfall towards the rainfall distribution over eastern parts of the Western Ghats region of Karnataka.Keywords: change point analysis, coastal region India, gridded rainfall data, non-parametric
Procedia PDF Downloads 2955547 Mapping the Pain Trajectory of Breast Cancer Survivors: Results from a Retrospective Chart Review
Authors: Wilfred Elliam
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Background: Pain is a prevalent and debilitating symptom among breast cancer patients, impacting their quality of life and overall well-being. The experience of pain in this population is multifaceted, influenced by a combination of disease-related factors, treatment side effects, and individual characteristics. Despite advancements in cancer treatment and pain management, many breast cancer patients continue to suffer from chronic pain, which can persist long after the completion of treatment. Understanding the progression of pain in breast cancer patients over time and identifying its correlates is crucial for effective pain management and supportive care strategies. The purpose of this research is to understand the patterns and progression of pain experienced by breast cancer survivors over time. Methods: Data were collected from breast cancer patients at Hartford Hospital at four time points: baseline, 3, 6 and 12 weeks. Key variables measured include pain, body mass index (BMI), fatigue, musculoskeletal pain, sleep disturbance, and demographic variables (age, employment status, cancer stage, and ethnicity). Binomial generalized linear mixed models were used to examine changes in pain and symptoms over time. Results: A total of 100 breast cancer patients aged 18 years old were included in the analysis. We found that the effect of time on pain (p = 0.024), musculoskeletal pain (p= <0.001), fatigue (p= <0.001), and sleep disturbance (p-value = 0.013) were statistically significant with pain progression in breast cancer patients. Patients using aromatase inhibitors have worse fatigue (<0.05) and musculoskeletal pain (<0.001) compared to patients with Tamoxifen. Patients who are obese (<0.001) and overweight (<0.001) are more likely to report pain compared to patients with normal weight. Conclusion: This study revealed the complex interplay between various factors such as time, pain, sleep disturbance in breast cancer patient. Specifically, pain, musculoskeletal pain, sleep disturbance, fatigue exhibited significant changes across the measured time points, indicating a dynamic pain progression in these patients. The findings provide a foundation for future research and targeted interventions aimed at improving pain in breast cancer patient outcomes.Keywords: breast cancer, chronic pain, pain management, quality of life
Procedia PDF Downloads 315546 Serum Zinc Level in Patients with Multidrug Resistant Tuberculosis
Authors: Nilima Barman, M. Atiqul Haque, Debabrata Ghosh
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Background: Zinc, one of the vital micronutrients, has an incredible role in the immune system. Hypozincemia affects host defense by reducing the number of circulating T cells and phagocytosis activity of other cells which ultimately impair cell-mediated immunity 1, 2. The immune system is detrimentally suppressed in multidrug-resistant tuberculosis (MDR-TB) 3, 4, a major threat of TB control worldwide5. As zinc deficiency causes immune suppression, we assume that it might have a role in the development of MDR-TB. Objectives: To estimate the serum zinc level in newly diagnosed multidrug resistant tuberculosis (MDR-TB) in comparison with that of newly diagnosed pulmonary TB (NdPTB) and healthy individuals. Materials and Methods: This study was carried out in the department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka in collaboration with National Institute of Diseases of the Chest Hospital (NIDCH), Bangladesh from March’ 2012 to February 2013. A total of 337 respondents, of them 107 were MDR TB patients enrolled from NIDCH, 69 were NdPTB and 161 were healthy adults. All NdPTB patients and healthy adults were randomly selected from Sirajdikhan subdistrict of Munshiganj District. It is a rural community 22 kilometer south from capital city Dhaka. Serum zinc level was estimated by atomic absorption spectrophotometry method from early morning fasting blood sample. The evaluation of serum zinc level was done according to normal range from 70 to120 µgm/dL6. Results: Males were predominant in study groups (p>0.05). Mean (sd) serum zinc levels in MDR-TB, NdPTB and healthy adult group were 65.14 (12.52), 75.22(15.89), and 87.98 (21.80) μgm/dL respectively and differences were statistically significant (F=52.08, P value<0.001). After multiple comparison test (Bonferroni test) significantly lower level of serum zinc was found in MDRTB group than NdPTB and healthy adults (p<.001). Point biserial correlation showed a negative association of having MDR TB and serum zinc level (r= -.578; p value <0.001). Conclusion: The significant low level of serum zinc in MDR-TB patients suggested impaired immune status. We recommended for further exploration of low level of serum zinc as risk factor of MDR TB.Keywords: Bangladesh, immune status, multidrug-resistant tuberculosis, serum zinc
Procedia PDF Downloads 5895545 Spectral Response Measurements and Materials Analysis of Ageing Solar Photovoltaic Modules
Authors: T. H. Huang, C. Y. Gao, C. H. Lin, J. L. Kwo, Y. K. Tseng
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The design and reliability of solar photovoltaic modules are crucial to the development of solar energy, and efforts are still being made to extend the life of photovoltaic modules to improve their efficiency because natural aging is time-consuming and does not provide manufacturers and investors with timely information, accelerated aging is currently the best way to estimate the life of photovoltaic modules. In this study, the accelerated aging of different light sources was combined with spectral response measurements to understand the effect of light sources on aging tests. In this study, there are two types of experimental samples: packaged and unpackaged and then irradiated with full-spectrum and UVC light sources for accelerated aging, as well as a control group without aging. The full-spectrum aging was performed by irradiating the solar cell with a xenon lamp like the solar spectrum for two weeks, while the accelerated aging was performed by irradiating the solar cell with a UVC lamp for two weeks. The samples were first visually observed, and infrared thermal images were taken, and then the electrical (IV) and Spectral Responsivity (SR) data were obtained by measuring the spectral response of the samples, followed by Scanning Electron Microscopy (SEM), Raman spectroscopy (Raman), and X-ray Diffraction (XRD) analysis. The results of electrical (IV) and Spectral Responsivity (SR) and material analyses were used to compare the differences between packaged and unpackaged solar cells with full spectral aging, accelerated UVC aging, and unaged solar cells. The main objective of this study is to compare the difference in the aging of packaged and unpackaged solar cells by irradiating different light sources. We determined by infrared thermal imaging that both full-spectrum aging and UVC accelerated aging increase the defects of solar cells, and IV measurements demonstrated that the conversion efficiency of solar cells decreases after full-spectrum aging and UVC accelerated aging. SEM observed some scorch marks on both unpackaged UVC accelerated aging solar cells and unpackaged full-spectrum aging solar cells. Raman spectroscopy examines the Si intensity of solar cells, and XRD confirms the crystallinity of solar cells by the intensity of Si and Ag winding peaks.Keywords: solar cell, aging, spectral response measurement
Procedia PDF Downloads 1035544 Diagnostic Contribution of the MMSE-2:EV in the Detection and Monitoring of the Cognitive Impairment: Case Studies
Authors: Cornelia-Eugenia Munteanu
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The goal of this paper is to present the diagnostic contribution that the screening instrument, Mini-Mental State Examination-2: Expanded Version (MMSE-2:EV), brings in detecting the cognitive impairment or in monitoring the progress of degenerative disorders. The diagnostic signification is underlined by the interpretation of the MMSE-2:EV scores, resulted from the test application to patients with mild and major neurocognitive disorders. The original MMSE is one of the most widely used screening tools for detecting the cognitive impairment, in clinical settings, but also in the field of neurocognitive research. Now, the practitioners and researchers are turning their attention to the MMSE-2. To enhance its clinical utility, the new instrument was enriched and reorganized in three versions (MMSE-2:BV, MMSE-2:SV and MMSE-2:EV), each with two forms: blue and red. The MMSE-2 was adapted and used successfully in Romania since 2013. The cases were selected from current practice, in order to cover vast and significant neurocognitive pathology: mild cognitive impairment, Alzheimer’s disease, vascular dementia, mixed dementia, Parkinson’s disease, conversion of the mild cognitive impairment into Alzheimer’s disease. The MMSE-2:EV version was used: it was applied one month after the initial assessment, three months after the first reevaluation and then every six months, alternating the blue and red forms. Correlated with age and educational level, the raw scores were converted in T scores and then, with the mean and the standard deviation, the z scores were calculated. The differences of raw scores between the evaluations were analyzed from the point of view of statistic signification, in order to establish the progression in time of the disease. The results indicated that the psycho-diagnostic approach for the evaluation of the cognitive impairment with MMSE-2:EV is safe and the application interval is optimal. The alternation of the forms prevents the learning phenomenon. The diagnostic accuracy and efficient therapeutic conduct derive from the usage of the national test norms. In clinical settings with a large flux of patients, the application of the MMSE-2:EV is a safe and fast psycho-diagnostic solution. The clinicians can draw objective decisions and for the patients: it doesn’t take too much time and energy, it doesn’t bother them and it doesn’t force them to travel frequently.Keywords: MMSE-2, dementia, cognitive impairment, neuropsychology
Procedia PDF Downloads 5155543 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units
Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz
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Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit
Procedia PDF Downloads 2825542 Fake Importers Behavior in the Algerian City – The Case of the City of Eulma
Authors: Mohamed Gherbi
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The informal trade has invaded the Algerian cities, especially in their peripherals. About 1368 informal markets have been registrated during 2013 where the important ones are known by Doubaï Markets. They appeared since the adoption of the new system of the economy market in 1990. It permitted the intervention of new actors: the importers but also the fake ones. The majority of them were 'ex-Trabendistes' who have chosen to settle and invest in big and small cities of center and east of Algeria, mainly Algiers, El Eulma, Aïn El Fekroun, Tadjnenent, and Aïn M’lila. This study will focus on the case of the city of El Eulma which contains more of 1000 importers (most of them are fake). They have changed the image and architecture of some important streets of the city, without respecting rules of urbanism such as those included in the building permit for instance. The case of 'Doubaï' place in El Eulma illustrates this situation. This area is not covered by a Soil Occupation Plan (responsible of the design of urban spaces), even if this last covers other zones nearby surrounding of it. These importers helped by the wholesale and retail traders installed in 'Doubaï' place, have converted spaces inside and outside of residential buildings in deposits and sales of goods. They have squatted sidewalks to expose their goods imported predominantly from the South-East Asian countries. The scenery that reigns resembles partly to the bazaar of the Middle East and Chinese cities like Yiwu. These signs characterize the local ambiance and give the particularity to this part of the city. A customer tide from different cities and outside of Algeria comes daily to visit this district. The other zones surrounding have underwent the same change and have followed the model of 'Doubaï' place. Consequently, the mechanical movement has finished by stifling an important part of the city and the prices of land and real estate have reached exorbitant values and can be compared to prices charged in Paris due to the rampant speculation that has reached alarming dimensions. Similarly, renting commercial premises did not escape this logic. This paper will explain the reasons responsible of this change, the logic of importers through their acts in different spaces of the city.Keywords: Doubaï place, design of urban spaces, fake importers, informal trade
Procedia PDF Downloads 4155541 The Impact of Corruption on Exports and Innovation in Small and Medium-Sized Enterprises: The Case of Tunisia
Authors: Moujib Bahri, Rahim Kallel, Ouafa Sakka
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Corruption is a phenomenon that increases uncertainty and risk of SMEs as it undermines the quality of the business environment and the easy access to public services. Our research builds on existing research on corruption's effects on economic growth at the firm level. Several papers have analyzed the effect of firms’ payments of bribes on their performance; however, only limited research has investigated the link between corruption, innovation, and exports. Drawing on principal-agent theory, we explore how corruption weakens the institutional context and makes the business environment unsound and not conducive to innovation and exports. This study employs data from The Enterprise Surveys conducted in Tunisia between March 2013 and July 2014 by the World Bank, the European Bank for Reconstruction and Development (EBRD) and the European Investment Bank (EIB). The main objective of this survey was to gain a better understanding of Tunisian firms’ perception of the environment in which they operate. Since 2011, the country's political situation has become fragile and unstable, and public services are perceived as inefficient and corrupt. We test our hypotheses on a sample of 537 Tunisian manufacturing SMEs using structural equation modeling and path analysis. We find that political instability leads to higher level of corruption, and that excessive business licensing regulations create a fertile ground for bribery. Our findings do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to innovation and exports. Instead, our results support the sanding hypothesis according to which corruption hinders innovation activities and exports. Furthermore, corruption is found to, negatively and significantly, impact firms’ ownership of quality certificates. Our results suggest that, in an environment with a high level of corruption, governments and policymakers interested in assisting SMEs with their innovation and export activities should have a better control on corruption to allow them developing those activities without being forced to bribe government officers.Keywords: corruption, innovation, exports, SMEs
Procedia PDF Downloads 1805540 MR Imaging Spectrum of Intracranial Infections: An Experience of 100 Cases in a Tertiary Hospital in Northern India
Authors: Avik Banerjee, Kavita Saggar
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Infections of the nervous system and adjacent structures are often life-threatening conditions. Despite the recent advances in neuroimaging evaluation, the diagnosis of unclear infectious CNS disease remains a challenge. Our aim is to evaluate the typical and atypical neuro-imaging features of the various routinely encountered CNS infected patients so as to form guidelines for their imaging recognition and differentiation from tumoral, vascular and other entities that warrant a different line of therapy.Keywords: central nervous system (CNS), Cerebro Spinal Fluid (Csf), Creutzfeldt Jakob Disease (CJD), progressive multifocal leukoencephalopathy (PML)
Procedia PDF Downloads 3015539 Locating the Role of Informal Urbanism in Building Sustainable Cities: Insights from Ghana
Authors: Gideon Abagna Azunre
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Informal urbanism is perhaps the most ubiquitous urban phenomenon in sub-Saharan Africa (SSA) and Ghana specifically. Estimates suggest that about two-fifths of urban dwellers (37.9%) in Ghana live in informal settlements, while two-thirds of the working labour force are within the informal economy. This makes Ghana invariably an ‘informal country.’ Informal urbanism involves economic and housing activities that are – in law or in practice – not covered (or insufficiently covered) by formal regulations. Many urban folks rely on informal urbanism as a survival strategy due to limited formal waged employment opportunities or rising home prices in the open market. In an era of globalizing neoliberalism, this struggle to survive in cities resonates with several people globally. For years now, there have been intense debates on the utility of informal urbanism – both its economic and housing dimensions – in developing sustainable cities. While some scholars believe that informal urbanism is beneficial to the sustainable city development agenda, others argue that it generates unbearable negative consequences and it symbolizes lawlessness and squalor. Consequently, the main aim of this research was to dig below the surface of the narratives to locate the role of informal urbanism in the quest for sustainable cities. The research geographically focused on Ghana and its burgeoning informal sector. Also, both primary and secondary data were utilized for the analysis; Secondary data entailed a synthesis of the fragmented literature on informal urbanism in Ghana, while primary data entailed interviews with informal stakeholders (such as informal settlement dwellers), city authorities, and planners. These two data sets were weaved together to discover the nexus between informal urbanism and the tripartite dimensions of sustainable cities – economic, social, and environmental. The results from the research showed a two-pronged relationship between informal urbanism and the three dimensions of sustainable city development. In other words, informal urbanism was identified to both positively and negatively affect the drive for sustainable cities. On the one hand, it provides employment (particularly to women), supplies households’ basic needs (shelter, health, water, and waste management), and enhances civic engagement. However, on the other hand, it perpetuates social and gender inequalities, insecurity, congestion, and pollution. The research revealed that a ‘black and white’ interpretation and policy approach is incapable of capturing the complexities of informal urbanism. Therefore, trying to eradicate or remove it from the urbanscape because it exhibits some negative consequences means cities will lose their positive contributions. The inverse also holds true. A careful balancing act is necessary to maximize the benefits and minimize the costs. Overall, the research presented a de-colonial theorization of informal urbanism and thus followed post-colonial scholars’ clarion call to African cities to embrace the paradox of informality and find ways to integrate it into the city-building process.Keywords: informal urbanism, sustainable city development, economic sustainability, social sustainability, environmental sustainability, Ghana
Procedia PDF Downloads 1075538 Technology in Commercial Law Enforcement: Tanzania, Canada, and Singapore Comparatively
Authors: Katarina Revocati Mteule
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The background of this research arises from global demands for fair business opportunities. As one of responses to these demands, nations embarked on reforms in commercial laws. In 1990s Tanzania resorted to economic transformation through liberalization to attract more investments included reform in commercial laws enforcement. This research scrutinizes the effectiveness of reforms in Tanzania in comparison with Canada and Singapore and the role of technology. The methodology to be used is doctrinal legal research mixed with international comparative legal research. It involves comparative analysis of library, online, and internet resources as well as Case Laws and Statutory Laws. Tanzania, Canada and Singapore are sampled comparators basing on their distinct level of economic development. The criteria of analysis includes the nature of reforms, type of technology, technological infrastructure and human resource technical competence in each country. As the world progresses towards reforms in commercial laws, improvements in law, policy, and regulatory frameworks are paramount. Specifically, commercial laws are essential in contract enforcement and dispute resolution and how it copes with modern technologies is a concern. Harnessing the best technology is necessary to cope with the modernity in world businesses. In line with this, Tanzania is improving its business environment, including law enforcement mechanisms that are supportive to investments. Reforms such as specialized commercial law enforcement coupled with alternative dispute resolutions such as arbitration, mediation, and reconciliation are emphasized. Court technology as one of the reform tools given high priority. This research evaluates the progress and the effectiveness of the reforms in Commercial Laws towards friendly business environment in Tanzania in comparison with Canada and Singapore. The experience of Tanzania is compared with Canada and Singapore to see what to improve for each country to enhance quick and fair enforcement of commercial law. The research proposes necessary global standards of procedures and in national laws to offer a business-friendly environment and the use of appropriate technology. Solutions are proposed in tackling the challenges of delays in enforcing Commercial Laws such as case management, funding, legal and procedural hindrances, laxity among staff, and abuse of Court process among litigants, all in line with modern technology. It is the finding of the research that proper use of technology has managed to reduce case backlogs and time taken to resolve a commercial dispute, to increase court integrity by minimizing human contacts in commercial law enforcement which may lead to solicitation of favors and saving of parties’ time due to online service. Among the three countries, each one is facing a distinct challenge due to the level of poverty and remoteness from online service. How solutions are found in one country is a lesson to another. To conclude, this paper is suggesting solutions for improving the commercial law enforcement mechanisms in line with modern technology. The call for technological transformation is essential for the enforcement of commercial laws.Keywords: commercial law, enforcement, technology
Procedia PDF Downloads 585537 Kinetic Study of Municipal Plastic Waste
Authors: Laura Salvia Diaz Silvarrey, Anh Phan
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Municipal Plastic Waste (MPW) comprises a mixture of thermoplastics such as high and low density polyethylene (HDPE and LDPE), polypropylene (PP), polystyrene (PS) and polyethylene terephthalate (PET). Recycling rate of these plastics is low, e.g. only 27% in 2013. The remains were incinerated or disposed in landfills. As MPW generation increases approximately 5% per annum, MPW management technologies have to be developed to comply with legislation . Pyrolysis, thermochemical decomposition, provides an excellent alternative to convert MPW into valuable resources like fuels and chemicals. Most studies on waste plastic kinetics only focused on HDPE and LDPE with a simple assumption of first order decomposition, which is not the real reaction mechanism. The aim of this study was to develop a kinetic study for each of the polymers in the MPW mixture using thermogravimetric analysis (TGA) over a range of heating rates (5, 10, 20 and 40°C/min) in N2 atmosphere and sample size of 1 – 4mm. A model-free kinetic method was applied to quantify the activation energy at each level of conversion. Kissinger–Akahira–Sunose (KAS) and Flynn–Wall–Ozawa (FWO) equations jointly with Master Plots confirmed that the activation energy was not constant along all the reaction for all the five plastic studied, showing that MPW decomposed through a complex mechanism and not by first-order kinetics. Master plots confirmed that MPW decomposed following a random scission mechanism at conversions above 40%. According to the random scission mechanism, different radicals are formed along the backbone producing the cleavage of bonds by chain scission into molecules of different lengths. The cleavage of bonds during random scission follows first-order kinetics and it is related with the conversion. When a bond is broken one part of the initial molecule becomes an unsaturated one and the other a terminal free radical. The latter can react with hydrogen from and adjacent carbon releasing another free radical and a saturated molecule or reacting with another free radical and forming an alkane. Not every time a bonds is broken a molecule is evaporated. At early stages of the reaction (conversion and temperature below 40% and 300°C), most products are not short enough to evaporate. Only at higher degrees of conversion most of cleavage of bonds releases molecules small enough to evaporate.Keywords: kinetic, municipal plastic waste, pyrolysis, random scission
Procedia PDF Downloads 3545536 Adoption of Electronic Logistics Management Information System for Life-Saving Maternal, Neonatal and Child Health Medicines: A Bangladesh Perspective
Authors: Mohammad Julhas Sujan, Md. Ferdous Alam
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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.Keywords: adaption, eLMIS, MNCH, live-saving medicines
Procedia PDF Downloads 1625535 Effect of Sanitary-Environmental Conditions of Diabetic Hypertension Incidence of Displaced Persons
Authors: Radmila Maksimovic, Sonja Ketin, Rade Biocanin, Jelena Maksimovic
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The abnormal conditions of life and work genetic factors often play a major role in incidence of diabetes-diabetes, heart disease and vascular disease, jaundice, and post traumatic stress. Trauma and post traumatic stress are most common in the displaced persons,and the focus of this paper is to shed light on this issue in former Yugoslavia, Yugoslavia and now in our country. This is caused by increased beta-cell sensitivity to viruses, the development of autoimmune antibodies against its own pancreascells, degenerative changes in cells that r esult in change of structure and insulin. In this paper, we dealt with traumatic events and long-term psycho social consequences for internally displaced persons, several years after displacement, and found a high level of PTSD symptoms. This stress is present in almost 1/3 of internally displaced persons, and every sixth person is suffering from PTSD in the past. Respondents generally suffer from symptoms of intrusion, but there was a large number of symptoms, avoidance and increased arousal. We also found that gender, age andeducation related to the symptoms. Females, and older respondents and internally displaced persons with lower levels of education how a higher level of PTSD symptoms, especially symptoms of intrusion and increase darousal. It is a highly traumatized sample in which more than 1/2 of respondents experienced more than three traumatic events in life,although the number of traumas experienced before, during and after the conflict varies.We found that during the war, internally displaced persons haveexperienced more traumatic events compared with the periodbefore and after the conflict. Trauma are different in type. No significant correlation between the number of experienced trauma and PTSD, suggesting that it is necessary to further study the structure of past traumas and the intermediary effects of certain risk factors and protective factors.Keywords: living environment, displaced persons, jaundice, diabetes, trauma, diabetic hypertension, post-traumatic stress (PTSD), treatment
Procedia PDF Downloads 3935534 Premature Departure of Active Women from the Working World: One Year Retrospective Study in the Tunisian Center
Authors: Lamia Bouzgarrou, Amira Omrane, Malika Azzouzi, Asma Kheder, Amira Saadallah, Ilhem Boussarsar, Kamel Rejeb
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Introduction: Increasing the women’s labor force participation is a political issue in countries with developed economies and those with low growth prospects. However, in the labor market, women continue to face several obstacles, either for the integration or for the maintenance at work. This study aims to assess the prevalence of premature withdrawal from working life -due to invalidity or medical justified early retirement- among active women in the Tunisian center and to identify its determinants. Material and methods: We conducted a cross-sectional study, over one year, focusing on the agreement for invalidity or early retirement for premature usury of the body- delivered by the medical commission of the National Health Insurance Fund (CNAM) in the central Tunisian district. We exhaustively selected women's files. Data related to Socio-demographic characteristics, professional and medical ones, were collected from the CNAM's administrative and medical files. Results: During the period of one year, 222 women have had an agreement for premature departure of their professional activity. Indeed, 149 women (67.11%) benefit of from invalidity agreement and 20,27% of them from favorable decision for early retirement. The average age was 50 ± 6 years with extremes of 23 and 62 years, and 18.9% of women were under 45 years. Married women accounted for 69.4% and 59.9% of them had at least one dependent child in charge. The average professional seniority in the sector was 23 ± 8 years. The textile-clothing sector was the most affected, with 70.7% of premature departure. Medical reasons for withdrawal from working life were mainly related to neuro-degenerative diseases in 46.8% of cases, rheumatic ones in 35.6% of cases and cardiovascular diseases in 22.1% of them. Psychiatric and endocrine disorders motivated respectively 17.1% and 13.5% of these departures. The evaluation of the sequels induced by these pathologies concluded to an average permanent partial disability equal to 61.4 ± 17.3%. The analytical study concluded that the agreement of disability or early retirement was correlated with the insured ‘age (p = 10-3), the professional seniority (p = 0.003) and the permanent partial incapacity (PPI) rate assessed by the expert physician (p = 0.04). No other social or professional factors were correlated with this decision. Conclusion: Despite many advances in labour law and Tunisian legal text on employability, women still exposed to several social and professional inequalities (payment inequality, precarious work ...). Indeed, women are often pushed to accept working in adverse conditions, thus they are more vulnerable to develop premature wear on the body and being forced to premature departures from the world of work. These premature withdrawals from active life are not only harmful to the concerned women themselves, but also associated with considerable costs for the insurance organism and the society. In order to ensure maintenance at work for women, a political commitment is imperative in the implementation of global prevention strategies and the improvement of working conditions, particularly in our socio-cultural context.Keywords: Active Women , Early Retirement , Invalidity , Maintenance at Work
Procedia PDF Downloads 1525533 Managing Early Stakeholder Involvement at the Early Stages of a Building Project Life Cycle
Authors: Theophilus O. Odunlami, Hasan Haroglu, Nader Saleh-Matter
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The challenges facing the construction industry are often worsened by the compounded nature of projects coupled with the complexity of key stakeholders involved at different stages of the project. Projects are planned to achieve outlined benefits in line with the business case; however, a lack of effective management of key stakeholders can result in unrealistic delivery aspirations, unnecessary re-works, and overruns. The aim of this study is to examine the early stages of a project lifecycle and investigate the stakeholder management and involvement processes and their impact on the successful delivery of the project. The research engaged with conventional construction organisations and project personnel and stakeholders on diverse projects, using a research strategy to analyse existing project case studies, narrative enquiries, interviews, and surveys using a combined qualitative, quantitative, and mixed method of analysis. Research findings have shown that the involvement of stakeholders at different levels during the early stages has pronounced effects on project delivery; it helps to forge synergy and promotes a clear understanding of individual responsibilities, strengths, and weaknesses. This has often fostered a positive sense of productive collaboration right through the early stages of the project. These research findings intend to contribute to the development of a process framework for stakeholder and project team involvement in the early stages of a project. This framework will align with the selection criteria for stakeholders, contractors, and resources, ultimately contributing to the successful completion of projects. The primary question addressed in this study is stakeholder involvement and management of the early stages of a building project life cycle impacts project delivery. Findings showed that early-stage stakeholder involvement and collaboration between project teams and contractors significantly contribute to project success. However, a strong and healthy communication strategy would be required to maintain the flow of value-added ideas among stakeholders at the early stages to benefit the project at the execution stage.Keywords: early stages, project lifecycle, stakeholders, decision-making strategy, project framework
Procedia PDF Downloads 1005532 What Children Do and Do Not Like about Taking Part in Sport: Using Focus Groups to Investigate Thoughts and Feelings of Children with Hearing Loss
Authors: S. Somerset, D. J. Hoare, P. Leighton
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Limited participation in physical activity and sport has been linked to poorer mental and physical health in children. Studies have shown that children who participate in sports benefit from improved social skills, self-confidence, communication skills and a better quality of life. Children who participate in sport are also more likely to continue their participation into their adult life. Deaf or hard of hearing children should have the same opportunities to participate in sport and receive the benefits as their hearing peers. Anecdotal evidence suggests this isn’t always the case. This is concerning given there are 45,000 children in the UK with permanent hearing loss. The aim of this study was to understand what encourages or discourages deaf or hard of hearing children to take part in sports. Ethical approval for the study was obtained from the University of Nottingham School of Medicine ethics committee. We conducted eight focus groups with deaf or hard of hearing children aged 10 to 15 years. A total of 45 children (19 male, 26 female) recruited from local schools and sports clubs took part. Information was gathered on the children’s thoughts and feelings about participation in sport. This included whether they played sports and who with, whether they did or did not like sport, and why they got involved in sport. Focus groups were audio recorded and transcribed. Transcripts were analysed using thematic analysis. Several key themes were identified as being associated with levels of sports participation. These included friendships, family and communication. Deaf or hard of hearing children with active siblings had participated in more sports. Communication was a common theme throughout regardless of the type of hearing-assistive technology a child used. Children found communication easier during sport if they were allowed to use their technology and had particular difficulty during sports such as swimming. Children expressed a desire not to have to identify themselves at a club as having a hearing loss. This affected their confidence when participating in sport. Not surprisingly, children who are deaf or hard of hearing are more likely to participate in sport if they have a good support network of parents, coaches and friends. The key barriers to participation for these children are communication, lack of visual information, lack of opportunity and a lack of awareness. By addressing these issues more deaf and hard of hearing children will take part in sport and will continue their participation.Keywords: barrier, children, deaf, participation, hard of hearing, sport
Procedia PDF Downloads 4245531 Building Care Networks for Patients with Life-Limiting Illnesses: Perspectives from Health Care and Social Service Providers
Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant
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Comprehensive and compassionate palliative care and support requires an integrated system of care that draws on formal health and social service providers working together with community and informal networks to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the community supports, services, and informal networks that health care professionals and social service providers rely on to allow their patients to die in their homes and communities. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers that arise as health care and social service providers attempt to build networks of care for patients with life limiting illnesses and families. Three main findings emerged: First, the variability that arises due to systemic barriers in accessing and providing care; second, the exceptionally challenging workload that providers are facing as they work to address complex social care needs (housing, disability, food security), along with escalating palliative care needs; and, finally, the lack of structural support that providers and informal care networks receive. Conclusion: These findings will facilitate and build stronger person-centred/relationship-centred principles and practices between providers, patients, community, and informal care networks by highlighting the systemic barriers to accessing and providing person-centred care. Further, they will have important implications for future partnerships in integrated care delivery programs and initiatives, community policies, education programs, and provincial and national palliative care strategies.Keywords: public health palliative care, palliative care nursing, care networks, informal care, integrated health care
Procedia PDF Downloads 965530 Narrative Identity Predicts Borderline Personality Disorder Features in Inpatient Adolescents up to Six Months after Admission
Authors: Majse Lind, Carla Sharp, Salome Vanwoerden
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Narrative identity is the dynamic and evolving story individuals create about their personal pasts, presents, and presumed futures. This storied sense of self develops in adolescence and is crucial for fostering a sense of self-unity and purpose in life. A growing body of work has shown that several characteristics of narrative identity are disturbed in adults suffering from borderline personality disorder (BPD). Very little research, however, has explored the stories told by adolescents with BPD features. Investigating narrative identity early in the lifespan and in relation to personality pathology is crucial; BPD is a developmental disorder with early signs appearing already in adolescence. In the current study, we examine narrative identity (focusing on themes of agency and communion) coded from self-defining memories derived from the child attachment interview in 174 inpatient adolescents (M = 15.12, SD = 1.52) at the time of admission. The adolescents’ social cognition was further assessed on the basis of their reactions to movie scenes (i.e., the MASC movie task). They also completed a trauma checklist and self-reported BPD features at three different time points (i.e., at admission, at discharge, and 6 months after admission). Preliminary results show that adolescents who told stories containing themes of agency and communion evinced better social cognition, and lower emotional abuse on the trauma checklist. In addition, adolescents who disclosed stories containing lower levels of agency and communion demonstrated more BPD symptoms at all three time points, even when controlling for the occurrence of traumatic life events. Surprisingly, social cognitive abilities were not significantly associated with BPD features. These preliminary results underscore the importance of narrative identity as an indicator, and potential cause, of incipient personality pathology. Thus, focusing on diminished themes of narrative-based agency and communion in early adolescence could be crucial in preventing the development of personality pathology over time.Keywords: borderline personality disorder, inpatient adolescents, narrative identity, follow-ups
Procedia PDF Downloads 1575529 An Evolutionary Approach for Automated Optimization and Design of Vivaldi Antennas
Authors: Sahithi Yarlagadda
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The design of antenna is constrained by mathematical and geometrical parameters. Though there are diverse antenna structures with wide range of feeds yet, there are many geometries to be tried, which cannot be customized into predefined computational methods. The antenna design and optimization qualify to apply evolutionary algorithmic approach since the antenna parameters weights dependent on geometric characteristics directly. The evolutionary algorithm can be explained simply for a given quality function to be maximized. We can randomly create a set of candidate solutions, elements of the function's domain, and apply the quality function as an abstract fitness measure. Based on this fitness, some of the better candidates are chosen to seed the next generation by applying recombination and permutation to them. In conventional approach, the quality function is unaltered for any iteration. But the antenna parameters and geometries are wide to fit into single function. So, the weight coefficients are obtained for all possible antenna electrical parameters and geometries; the variation is learnt by mining the data obtained for an optimized algorithm. The weight and covariant coefficients of corresponding parameters are logged for learning and future use as datasets. This paper drafts an approach to obtain the requirements to study and methodize the evolutionary approach to automated antenna design for our past work on Vivaldi antenna as test candidate. The antenna parameters like gain, directivity, etc. are directly caged by geometries, materials, and dimensions. The design equations are to be noted here and valuated for all possible conditions to get maxima and minima for given frequency band. The boundary conditions are thus obtained prior to implementation, easing the optimization. The implementation mainly aimed to study the practical computational, processing, and design complexities that incur while simulations. HFSS is chosen for simulations and results. MATLAB is used to generate the computations, combinations, and data logging. MATLAB is also used to apply machine learning algorithms and plotting the data to design the algorithm. The number of combinations is to be tested manually, so HFSS API is used to call HFSS functions from MATLAB itself. MATLAB parallel processing tool box is used to run multiple simulations in parallel. The aim is to develop an add-in to antenna design software like HFSS, CSTor, a standalone application to optimize pre-identified common parameters of wide range of antennas available. In this paper, we have used MATLAB to calculate Vivaldi antenna parameters like slot line characteristic impedance, impedance of stripline, slot line width, flare aperture size, dielectric and K means, and Hamming window are applied to obtain the best test parameters. HFSS API is used to calculate the radiation, bandwidth, directivity, and efficiency, and data is logged for applying the Evolutionary genetic algorithm in MATLAB. The paper demonstrates the computational weights and Machine Learning approach for automated antenna optimizing for Vivaldi antenna.Keywords: machine learning, Vivaldi, evolutionary algorithm, genetic algorithm
Procedia PDF Downloads 1105528 Organizational Culture of a Public and a Private Hospital in Brazil
Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes
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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.Keywords: nursing management, organizational culture, quality of care, interpersonal relationships
Procedia PDF Downloads 4405527 Ratification of the United Nations Convention for the Promotion and Protection of Their Human Rights and the Paradoxes of the Discriminatory Right to Acquire the Status of Persons with Disabilities in Cameroon
Authors: Dakeyi Athanase
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The ratification of an international human rights legal instrument provides signatory States with an opportunity to assume a set of obligations and rights for the benefit of their citizens, offering increased possibilities, opportunities, and means to access an improved quality of life – to be, to appear, and to become. Developed nations typically experience cultural, political, social, economic, legal, and regulatory transformations in response to this transition. In a methodologically proactive approach, mechanisms undergo a visible and comprehensible process of qualitative and quantitative change. Conversely, in nations undergoing development, the response to such ratification varies. Some demonstrate positive policy changes, while others remain stagnant or regress. Cameroon falls into the second category, despite efforts, as it legally prohibits 50% of its population with disabilities from acquiring the status of a person with a disability. The overarching goal of this communication is to highlight these deficiencies and their detrimental effects on various aspects of life, fostering awareness among beneficiaries and advocating for more inclusive transformations in the country. Our project employs a popular and participatory methodological approach by involving beneficiaries and their organizations in its preparation. It is also inclusive, representing the diversity of disabilities and engaging natural and legal persons from various backgrounds. Active consultations occur at all levels of the activities. Anticipated outcomes include raising awareness globally among nations, international cooperation organizations, NGOs, and other inclusive development actors. We seek their support for local advocacy efforts to fully implement the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Concurrently, we hope they express solidarity with the victims in Cameroon who have been left behind and recommend legal reforms to align domestic and international legislation with the promotion and protection of disability rights.Keywords: droit, convention, handicap, discrimination, participation, inclusion
Procedia PDF Downloads 545526 Assessing of Social Comfort of the Russian Population with Big Data
Authors: Marina Shakleina, Konstantin Shaklein, Stanislav Yakiro
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The digitalization of modern human life over the last decade has facilitated the acquisition, storage, and processing of data, which are used to detect changes in consumer preferences and to improve the internal efficiency of the production process. This emerging trend has attracted academic interest in the use of big data in research. The study focuses on modeling the social comfort of the Russian population for the period 2010-2021 using big data. Big data provides enormous opportunities for understanding human interactions at the scale of society with plenty of space and time dynamics. One of the most popular big data sources is Google Trends. The methodology for assessing social comfort using big data involves several steps: 1. 574 words were selected based on the Harvard IV-4 Dictionary adjusted to fit the reality of everyday Russian life. The set of keywords was further cleansed by excluding queries consisting of verbs and words with several lexical meanings. 2. Search queries were processed to ensure comparability of results: the transformation of data to a 10-point scale, elimination of popularity peaks, detrending, and deseasoning. The proposed methodology for keyword search and Google Trends processing was implemented in the form of a script in the Python programming language. 3. Block and summary integral indicators of social comfort were constructed using the first modified principal component resulting in weighting coefficients values of block components. According to the study, social comfort is described by 12 blocks: ‘health’, ‘education’, ‘social support’, ‘financial situation’, ‘employment’, ‘housing’, ‘ethical norms’, ‘security’, ‘political stability’, ‘leisure’, ‘environment’, ‘infrastructure’. According to the model, the summary integral indicator increased by 54% and was 4.631 points; the average annual rate was 3.6%, which is higher than the rate of economic growth by 2.7 p.p. The value of the indicator describing social comfort in Russia is determined by 26% by ‘social support’, 24% by ‘education’, 12% by ‘infrastructure’, 10% by ‘leisure’, and the remaining 28% by others. Among 25% of the most popular searches, 85% are of negative nature and are mainly related to the blocks ‘security’, ‘political stability’, ‘health’, for example, ‘crime rate’, ‘vulnerability’. Among the 25% most unpopular queries, 99% of the queries were positive and mostly related to the blocks ‘ethical norms’, ‘education’, ‘employment’, for example, ‘social package’, ‘recycling’. In conclusion, the introduction of the latent category ‘social comfort’ into the scientific vocabulary deepens the theory of the quality of life of the population in terms of the study of the involvement of an individual in the society and expanding the subjective aspect of the measurements of various indicators. Integral assessment of social comfort demonstrates the overall picture of the development of the phenomenon over time and space and quantitatively evaluates ongoing socio-economic policy. The application of big data in the assessment of latent categories gives stable results, which opens up possibilities for their practical implementation.Keywords: big data, Google trends, integral indicator, social comfort
Procedia PDF Downloads 200