Search results for: emergency measures

Authors: G. Kaushik, A. Gupta, S. Lalwani, K. D. Soni, S. Kumar, S. Sagar

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Objective: Alcohol is a leading risk factor associated with the disability and death due to RTI. Present study aims to demonstrate the demographic profile, injury pattern, physiological parameters of victims of trauma following alcohol consumption arriving in the emergency department (ED) and mortality in alcohol intoxicated trauma patients admitted to Apex Trauma Center in Delhi. Design and Methods: Present study was performed in randomly selected 182 alcohol breath analyzer tested RTI patients from the emergency department of Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences, New Delhi for over a period of 3 months started from September 2013 to November 2013. Results: A total 182 RTI patients with blunt injury were selected between 30-40 years of age and equally distributed to male and female group. Of these, 93 (51%) were alcohol negative and 89 (49%) were alcohol positive. In 89 alcohol positive patients, 47 (53%) had Artificial Airway as compared to 17 (18%), (p < 0.001) in the other group. The Glasgow Coma Scale (GCS) score was lower (p < 0.001) and higher Injury Severity Score (ISS) was observed in alcohol positive group as compared to other group (p < 0.03). Increased number of patients (58%) were admitted to Intensive Care Unit (ICU), in alcohol positive group (p < 0.001) and they were in ICU for longer time compare to other group (p < 0.001). The alcohol positive patients were on ventilator support for longer duration as compared to non-alcoholic group (p < 0.001). Mortality rate was higher in alcohol intoxicated patients as compared to non-alcoholic RTI patients, however, the difference was not statistically significant. Conclusion: This study revealed that GCS, mean ISS, ICU stay, ventilation time etc. might have considerable impact on mortality in alcohol intoxicated patients as compared to non-alcoholic group.

Keywords: road traffic injuries, alcohol, trauma, emergency department

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Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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Authors: Selin Guleroglu, Ilker Kahraman, E. Selahattin Umdu

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In today’s world, the building sector has a significant impact on primary energy consumption and CO₂ emissions. While new buildings must have high energy performance as indicated by the Energy Performance Directive in Buildings (EPBD), published by the European Union (EU), the energy performance of the existing buildings must also be enhanced with cost-efficient methods. Turkey has a high historical building density similar to south European countries, and the high energy consumption is the main contributor in the energy consumptioın of Turkey, which is rather higher than European counterparts. Historic buildings spread around Turkey for four main climate zones covering very similar climate characteristics to both the north and south European countries. The case study building is determined as the most common building type in Turkey. This study aims to investigate energy retrofit measures covering but not limited to passive and active measures to improve the energy performance of the historical buildings located in different climatic zones within the limits of preservation of the historical value of the building as a crucial constraint. Passive measures include wall, window, and roof construction elements, and active measures HVAC systems in retrofit scenarios. The proposed methodology can help to reach up to 30% energy saving based on primary energy consumption. DesignBuilder, an energy simulation tool, is used to determine the energy performance of buildings with suggested retrofit measures, and the Net Present Value (NPV) method is used for cost analysis of them. Finally, the most efficient energy retrofit measures for all buildings are determined by analyzing primary energy consumption and the cost performance of them. Results show that heat insulation, glazing type, and HVAC system has an important role in energy saving. Also, it found that these parameters have a different positive or negative effect on building energy consumption in different climate zones. For instance, low e glazing has a positive impact on the energy performance of the building in the first zone, while it has a negative effect on the building in the forth zone. Another important result is applying heat insulation has minimum impact on building energy performance compared to other zones.

Keywords: energy performance, climatic zones, historic building, energy retrofit measures, NPV

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Authors: Anastasia Sorokina

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Self-reported language proficiency measures have been widely used by researchers and have been proven to be an accurate tool to assess actual language proficiency. L1 attrition researchers also rely on self-reported measures. More specifically, can-do-scales has gained popularity in the discipline of L1 attrition research. The can-do-scales usually contain statements about language (e.g., “I can write e-mails”); participants are asked to rate each statement on a scale from 1 (I cannot do it at all) to 5 (I can do it without any difficulties). Despite its popularity, no studies have examined can-do-scales’ reliability at measuring the actual level of L1 attrition. Do can-do-scales positively correlate with lexical diversity, syntactic complexity, and fluency? The present study analyzed speech samples of 35 Russian-English attriters to examine whether their self-reported proficiency correlates with their actual L1 proficiency. The results of Pearson correlation demonstrated that can-do-scales correlated with lexical diversity, syntactic complexity, and fluency. These findings provide a valuable contribution to the L1 attrition research by demonstrating that can-do-scales can be used as a reliable tool to measure L1 attrition.

Keywords: L1 attrition, can-do-scales, lexical diversity, syntactic complexity

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Authors: Afrah S. M. Al-Mahfadi

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Climate change is a global issue that has significant impacts on water resources, resulting in environmental, economic, and political consequences. Groundwater reserves, particularly in coastal areas, are facing depletion, leading to serious problems in regions such as Yemen. This study focuses on the western coastal region of Yemen, which already faces risks such as water crises, food insecurity, and widespread poverty. Climate change exacerbates these risks by causing high temperatures, sea level rise, inadequate sea level rise, and inadequate environmental policies. Research Aim: The aim of this research is to provide a comprehensive overview of the impact of climate change on the western coastal region of Yemen. Specifically, the study aims to analyze the relationship between climate change and the loss of fresh groundwater resources in this area. Methodology: The research utilizes a combination of a literature review and three case studies conducted through site visits. Arch-GIS mapping is employed to analyze and visualize the relationship between climate change and the depletion of fresh groundwater resources. Additionally, data on precipitation from 1981 to 2020 and scenarios of projected sea level rise (SLR) are considered. Findings: The study reveals several future issues resulting from climate change. It is projected that the annual temperature will increase while the rainfall rate will decrease. Furthermore, the sea level is expected to rise by approximately 0.30 to 0.72 meters by 2100. These factors contribute to the loss of wetlands, the retreat of shorelines and estuaries, and the intrusion of seawater into the coastal aquifer, rendering drinking water from wells increasingly saline. Data Collection and Analysis Procedures: Data for this research are collected through a literature review, including studies on climate change impacts in coastal areas and the hydrogeology of the study region. Furthermore, three case studies are conducted through site visits. Arch-GIS mapping techniques are utilized to analyze the relationship between climate change and the loss of fresh groundwater resources. Historical precipitation data from 1981 to 2020 and scenarios of projected sea level rise are also analyzed. Questions Addressed: (1) What is the impact of climate change on the western coastal region of Yemen? (2) How does climate change affect the availability of fresh groundwater resources in this area? Conclusion: The study concludes that the western coastal region of Yemen is facing significant challenges due to climate change. The projected increase in temperature, decrease in rainfall, and rise in sea levels have severe implications, such as the loss of wetlands, shorelines, and estuaries. Additionally, the intrusion of seawater into the coastal aquifer further exacerbates the issue of saline drinking water. Urgent measures are needed to address climate change, including improving water management, implementing integrated coastal zone planning, raising awareness among stakeholders, and implementing emergency projects to mitigate the impacts. Recommendations: To mitigate the adverse effects of climate change, several recommendations are provided. These include improving water management practices, developing integrated coastal zone planning strategies, raising awareness among all stakeholders, improving health and education, and implementing emergency projects to combat climate change. These measures aim to enhance adaptive capacity and resilience in the face of future climate change impacts.

Keywords: climate change, groundwater, coastal wetlands, Yemen

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Authors: Lynda C. Mbadugha, Bankole Awuzie, Kwanda Khumalo, Lindokuhle Matsebula, Masenoke Kgaditsi

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Inadequate waste management remains a fundamental issue in the majority of cities around the globe, but it becomes a threat when it concerns informal settlements. Although studies have evaluated the performance of waste management measures, only a few have addressed that with a focus on South African informal settlements and the reasons for their apparent ineffectiveness in such locations. However, there may be evidence of variations in the extant problems due to the uniqueness of each location and the factors influencing the performance. Thus, there is a knowledge deficit regarding implementing waste management measures in South African informal settlements. This study seeks to evaluate the efficacy of waste management measures in the Alaska informal settlement in South Africa to assess the previously collected data of other areas using the degree of correlation. The research investigated a real-world scenario in the specified location using a case study approach and multiple data sources. The findings described various waste management practices used in Alaska's informal settlements; however, a correlation was found between the performance of these measures and those already used. The observed differences are primarily attributable to the physical characteristics of the locations, the lack of understanding of the environmental and health consequences of careless waste disposal, and the negative attitudes of the residents toward waste management practices. This study elucidates waste management implementation in informal settlements. It contributes to the relevant bodies of knowledge by describing these practices in South Africa. This paper's practical value emphasizes the general waste management characteristics of South Africa's informal settlements to facilitate the planning and provision of necessary interventions. The study concludes that the enablers and inhibitors are mainly political, behavioral, and environmental concerns.

Keywords: factors, informal settlement, performance, waste management

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

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Authors: Ayyoub Jamali, Alena Kozlova

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The Russian invasion of Ukraine has tested the mettle of the international community, prompting not only States but also non-state actors to take deterrent action in response. Indeed, international sports organisations, namely FIFA and UEFA, have been rather successful in shifting the power dynamics by introducing a complete ban on the Russian national and club teams. This article aims to inquire into the human rights implications of such actions taken by international sports organisations. First, the article departs from an assessment of the legal status of FIFA and UEFA under international law and reflects on how a legal link could be established vis-à-vis their human rights obligations. Second, it examines the human rights aspects of the impugned measures by FIFA and UEFA on the part of the Russian athletes, further scrutinising them against the international human rights law principle of non-discrimination through a proportionality test. Last, it draws basic pathways for how possible human rights violations committed in the context of measures adopted by such organisations could be remedied, outlining the challenges of arbitration and litigation in Switzerland.

Keywords: FIFA, UEFA, FUR, ban, human rights, Russia, Ukraine, non-state actors

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Authors: Negin Binesh, Mohammad Hossein Niksokhan, Amin Sarang

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Best Management Practices (BMPs) are considered as one of the most important structural adaptive measures to climate change and urban development challenges in recent decades. However, not every location is appropriate for applying BMPs in the watersheds. In this paper, location prioritization of two kinds of BMPs was done: Pourous pavement and Detention pond. West Flood-Diversion (WFD) catchment in northern parts of Tehran, Iran, was considered as the case study. The methodology includes integrating the results of Storm Water Management Model (SWMM) into Fuzzy Analytic Hierarchy Process (FAHP) method using Geographic Information System (GIS). The results indicate that mostly suburban areas of the watershed in northern parts are appropriate for applying detention basin, and downstream high-density urban areas are more suitable for using permeable pavement.

Keywords: adaptive measures, BMPs, location prioritization, urban flooding

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Authors: Seyed Habib A. Rahmati, Mohsen Sadegh Amalnick

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Different terms of the statistical process control (SPC) has sketch in the fuzzy environment. However, measurement system analysis (MSA), as a main branch of the SPC, is rarely investigated in fuzzy area. This procedure assesses the suitability of the data to be used in later stages or decisions of the SPC. Therefore, this research focuses on some important measures of MSA and through a new method introduces the measures in fuzzy environment. In this method, which works based on Buckley approach, imprecision and vagueness nature of the real world measurement are considered simultaneously. To do so, fuzzy version of the gauge capability (Cg and Cgk) are introduced. The method is also explained through example clearly.

Keywords: measurement, SPC, MSA, gauge capability (Cg and Cgk)

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Authors: Bidzina Matsaberidze, Anna Sikharulidze, Gia Sirbiladze, Bezhan Ghvaberidze

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In the modern world emergency management decision support systems are actively used by state organizations, which are interested in extreme and abnormal processes and provide optimal and safe management of supply needed for the civil and military facilities in geographical areas, affected by disasters, earthquakes, fires and other accidents, weapons of mass destruction, terrorist attacks, etc. Obviously, these kinds of extreme events cause significant losses and damages to the infrastructure. In such cases, usage of intelligent support technologies is very important for quick and optimal location-transportation of emergency service in order to avoid new losses caused by these events. Timely servicing from emergency service centers to the affected disaster regions (response phase) is a key task of the emergency management system. Scientific research of this field takes the important place in decision-making problems. Our goal was to create an expert knowledge-based intelligent support system, which will serve as an assistant tool to provide optimal solutions for the above-mentioned problem. The inputs to the mathematical model of the system are objective data, as well as expert evaluations. The outputs of the system are solutions for Fuzzy Multi-Objective Emergency Location-Transportation Problem (FMOELTP) for disasters’ regions. The development and testing of the Intelligent Support System were done on the example of an experimental disaster region (for some geographical zone of Georgia) which was generated using a simulation modeling. Four objectives are considered in our model. The first objective is to minimize an expectation of total transportation duration of needed products. The second objective is to minimize the total selection unreliability index of opened humanitarian aid distribution centers (HADCs). The third objective minimizes the number of agents needed to operate the opened HADCs. The fourth objective minimizes the non-covered demand for all demand points. Possibility chance constraints and objective constraints were constructed based on objective-subjective data. The FMOELTP was constructed in a static and fuzzy environment since the decisions to be made are taken immediately after the disaster (during few hours) with the information available at that moment. It is assumed that the requests for products are estimated by homeland security organizations, or their experts, based upon their experience and their evaluation of the disaster’s seriousness. Estimated transportation times are considered to take into account routing access difficulty of the region and the infrastructure conditions. We propose an epsilon-constraint method for finding the exact solutions for the problem. It is proved that this approach generates the exact Pareto front of the multi-objective location-transportation problem addressed. Sometimes for large dimensions of the problem, the exact method requires long computing times. Thus, we propose an approximate method that imposes a number of stopping criteria on the exact method. For large dimensions of the FMOELTP the Estimation of Distribution Algorithm’s (EDA) approach is developed.

Keywords: epsilon-constraint method, estimation of distribution algorithm, fuzzy multi-objective combinatorial programming problem, fuzzy multi-objective emergency location/transportation problem

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Authors: Aleksandra Ristic

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The Coronavirus Disease – 2019 hit Europe in February 2020, and infections took place in four waves. It left consequences and demanded changes for the future. More than half of European countries responded quickly by declaring a state of emergency and introducing various containment measures that have had a major impact on individuals’ lives in recent years. Closing public lives was largely achieved by limited access and/or closing public institutions and services, including the closure of educational institutions. Teaching in classrooms converted to distance learning. In the research, we used a quantitative study to analyze various factors of distance learning that influenced pupils in different segments: teachers’ availability, family support, entire online conference learning, successful distance learning, time for themselves, reliable sources, teachers’ feedback, successful distance learning, online participation classes, motivation and teachers’ communication and theoretical review of the importance of digital skills, e-learning Index, World comparison of e-learning in the past, digital education plans for the field of Europe. We have gathered recommendations and distance learning solutions to improve the learning process by strengthening teachers and creating more tiered strategies for setting and achieving learning goals by the children.

Keywords: availability, digital skills, distance learning, resources

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Sunil Chaudhary, Rajendra Bahadur Thapa, Eleni Berki, Marko Helenius

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The increasing number of Internet and mobile phone users, and essentially those, who use these electronic media to perform online transactions makes Nepal lucrative for phishing attacks. It is one of the reasons behind escalating phishing attacks in the country. Therefore, in this paper we examine various phishing attempts and real scenarios in Nepal to determine the seriousness of the problem. We also want to find out how prepared are the Internet and mobile phone users and how well-equipped are the private sector and government authorities responsible to handle cybercrime in the country. We considered five areas of research study, i.e., legal measures, technical and procedural measures, organizational structure, capacity building and international cooperation. These constitute important factors in cyber security and are recommended by the Global Cyber security Agenda (GCA). On the basis of our findings, we provide essential suggestions to make anti-phishing measures more appropriate to Nepalese State and society.

Keywords: internet banking, mobile banking, e-commerce, phishing, anti-phishing, Nepal

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Margarita Grushanina

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After several prominent central banks including European Central Bank (ECB), Federal Reserve System (Fed), Bank of Japan and Bank of England employed unconventional monetary policies in the aftermath of the financial crisis of 2008-2009 the problem of identification of the effects from such policies became of great interest. One of the main difficulties in identification of shocks from unconventional monetary policy measures in structural VAR analysis is that they often are anticipated, which leads to a non-fundamental MA representation of the VAR model. Moreover, the unconventional monetary policy actions may indirectly transmit to markets information about the future stance of the interest rate, which raises a question of the plausibility of the assumption of orthogonality between shocks from unconventional and conventional policy measures. This paper offers a method of identification that takes into account the abovementioned issues. The author uses factor-augmented VARs to increase the information set and identification through heteroskedasticity of error terms and rank restrictions on the errors’ second moments’ matrix to deal with the cross-correlation of the structural shocks.

Keywords: factor-augmented VARs, identification through heteroskedasticity, monetary policy, structural VARs

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Authors: Radmila Hajkova, Jiri Palecek, Hana Malachova, Alena Oulehlova

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Ensuring of continuity of business is the basic strategy of every company. Continuity of organization activities includes comprehensive procedures that help in solving unexpected situations of natural and anthropogenic character (for example flood, blaze, economic situations). Planning of continuity operations is a process that helps identify critical processes and implement plans for the security and recovery of key processes. The aim of this article demonstrates application of system approach to managing business continuity called business continuity management systems in military issues. This article describes the life cycle of business continuity management which is based on the established cycle PDCA (plan-do-check-act). After this is carried out by activities which are making by the University of Defence during activation of forces and means of the Integrated rescue system in case of emergencies - accidents at a nuclear power plant in Czech republic. Activities of various stages of deployment earmarked forces and resources are managed and evaluated by using MCMS application (military continuity management system).

Keywords: business continuity management system, emergency management, military, nuclear safety

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Authors: Edén Bojórquez, Victor Baca, Alfredo Reyes-Salazar, Jorge González

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In this paper, simplified equations to predict maximum inter-story drift demands of steel framed buildings are proposed in terms of two ground motion intensity measures based on the acceleration spectral shape. For this aim, the maximum inter-story drifts of steel frames with 4, 6, 8 and 10 stories subjected to narrow-band ground motion records are estimated and compared with the spectral acceleration at first mode of vibration Sa(T1) which is commonly used in earthquake engineering and seismology, and with a new parameter related with the structural response known as INp. It is observed that INp is the parameter best related with the structural response of steel frames under narrow-band motions. Finally, equations to compute maximum inter-story drift demands of steel frames as a function of spectral acceleration and INp are proposed.

Keywords: intensity measures, spectral shape, steel frames, peak demands

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Authors: Javad Izadi, Sahar Majioud

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This study presents an approach of assessing the choice of performance measures of companies in the United Kingdom after the application of IFRS in 2005. The aim of this study is to investigate the effects of IFRS on the choice of performance evaluation methods for UK companies. We analyse through an econometric model the relationship of the dependent variable, the firm’s performance, which is a nominal variable with the independent ones. Independent variables are split into two main groups: the first one is the group of accounting-based measures: Earning per share, return on assets and return on equities. The second one is the group of market-based measures: market value of property plant and equipment, research and development, sales growth, market to book value, leverage, segment and size of companies. Concerning the regression used, it is a multinomial logistic regression performed on a sample of 130 UK listed companies. Our finding shows after IFRS adoption, and companies give more importance to some variables such as return on equities and sales growth to assess their performance, whereas the return on assets and market to book value ratio does not have as much importance as before IFRS in evaluating the performance of companies. Also, there are some variables that have no impact on the performance measures anymore, such as earning per share. This article finding is empirically important for business in subjects related to IFRS and companies’ performance measurement.

Keywords: performance’s Measure, nominal variable, econometric model, evaluation methods

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Authors: Hanneke J. A. Smaling, Mandy Visser

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One way to reduce the risk of COVID-19 infection is by preventing close interpersonal contact with distancing measures. These social distancing measures presented challenges to the health and wellbeing of people with dementia and their informal and professional caregivers. This study describes the concerns and recommendations of informal and professional caregivers for COVID-19 policy for home care and long-term care for people with dementia during the first and second COVID-19 wave in the Netherlands. In this qualitative interview study, 20 informal caregivers and 20 professional caregivers from home care services and long-term care participated. Interviews were analyzed using an inductive thematic analysis approach. Both informal and professional caregivers worried about getting infected or infecting others with COVID-19, the consequences of the distancing measures, and quality of care. There was a general agreement that policy in the second wave was better informed compared to the first wave. At an organizational level, the policy was remarkably flexible. Recommendations were given for dementia care (need to offer meaningful activities, improve the organization of care, more support for informal caregivers), policy (national vs. locally organization, social isolation measures, visitor policy), and communication. Our study contributes to the foundation of future care decisions by (inter)national policymakers, politicians, and healthcare organizations during the course of the COVID-19 pandemic, underlining the need for balance between safety and autonomy for people with dementia.

Keywords: covid-19, dementia, home care, long-term care, policy

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Authors: Navneet Kaur, Amarpreet Singh

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In Vehicular Adhoc Networks, Data Dissemination is a challenging task. There are number of techniques, types and protocols available for disseminating the data but in order to preserve limited bandwidth and to disseminate maximum data over networks makes it more challenging. There are broadcasting, multicasting and geocasting based protocols. Multicasting based protocols are found to be best for conserving the bandwidth. One such protocol named BEAM exists that improves the performance of Vehicular Adhoc Networks by reducing the number of in-network message transactions and thereby efficiently utilizing the bandwidth during an emergency situation. But this protocol may result in multicar chain collision as there was no V2V communication. So, this paper proposes a new protocol named Enhanced Bandwidth Efficient Cluster Based Multicasting Protocol (EBECM) that will overcome the limitations of existing BEAM protocol. And Simulation results will show the improved performance of EBECM in terms of Routing overhead, throughput and PDR when compared with BEAM protocol.

Keywords: BEAM, data dissemination, emergency situation, vehicular adhoc network

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Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

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In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

Procedia PDF Downloads 175

Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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Authors: V. Sobotková, B. Šarapatka, M. Dumbrovský, J. Uhrová, M. Bednář

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The paper deals with the influence of implemented conservation measures on the quality of surface water resources. Recently, a new process of complex land consolidation in the Czech Republic has provided a unique opportunity to improve the quality of the environment and sustainability of crop production by means of better soil and water conservation. The most important degradation factor in our study area in the Hubenov drinking water reservoir catchment basin was water erosion together with loss of organic matter. Hubenov Reservoir water resources were monitored for twenty years (1990–2010) to collect water quality data for nitrate nitrogen (N-NO3-), total P, and undissolved substances. Results obtained from measurements taken before and after land consolidation indicated a decrease in the linear trend of N-NO3- and total P concentrations, this was achieved through implementation of conservation measures limiting soil degradation in the Hubenov reservoir catchment area.

Keywords: complex land consolidation, degradation, land use, soil and water conservation, surface water resources

Procedia PDF Downloads 329

Authors: Oded Hochman

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We first show that current measures of welfare changes in the whole economy do not apply to an economy with cities. In addition, since such measures are defined over a partial equilibrium, they capture only partially the effect of a welfare change. We then define a unique and additive measure that we term the modified economic surplus (mES) which fully captures the welfare effects caused by a change in the price of a nationally traded good. We show that the price change causes, on the one hand a change of land rents in the economy and, on the other hand, an equal change of mES that can be estimated by measuring areas in the price-quantity national demand and supply plane. We construct for each city a cost function from which we derive a city’s and, after aggregation, an economy-wide demand and supply functions of nationwide prices and of either the unearned incomes (Marshalian functions) or the utility levels (compensated functions).

Keywords: city cost function, welfare measures, modified compensated variation, modified economic surplus, unearned income function, differential land rents, city size

Procedia PDF Downloads 288

Authors: William Thomas Worster

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This paper will highlight the failure of international adjudication to prevent a state from evading an order of provisional measures by simply issuing a diplomatic assurance to the court. This practice changes the positions of the litigants as equals before a court, prevents the court from inquiring into the reliability of the political pledge as it would with assurances from a state to an individual, and diminishes the court’s ability to control its own proceedings in the face of concerns over sovereignty. Both the European Court of Human Rights (ECtHR) and International Court of Justice (ICJ) will entertain these kinds of unilateral pledges, but they consider them differently when the declaration is made between states or between a state and an individual, and when made directly to the court. In short, diplomatic assurances issued between states or to individuals are usually considered not to be legally binding and are essentially questions of fact, but unilateral assurances issued directly to an international court are questions of law, and usually legally binding. At the same time, orders for provisional measures are now understood also to be legally binding, yet international courts will sometimes permit a state to substitute an assurance in place of an order for provisional measures. This emerging practice has brought the nature of a state as a sovereign capable of creating legal obligations into the forum of adjudication where the parties should have equality of arms and permitted states to create legal obligations that escape inquiry into the reliability of the outcome. While most recent practice has occurred at the ICJ in state-to-state litigation, there is some practice potentially extending the practice to human rights courts. Especially where the litigants are factually unequal – a state and an individual – this practice is problematic since states could more easily overcome factual failings in their pledges and evade the control of the court. Consider, for example, the potential for evading non-refoulement obligations by extending the current diplomatic assurances practice from the state-to-state context to the state-to-court context. The dual nature of assurances, as both legal and factual instruments, should be considered as addressed to distinct questions, each with its own considerations, and that we need to be more demanding about their precise legal and factual effects.

Keywords: unilateral, diplomacy, assurances, undertakings, provisional measures, interim measures

Procedia PDF Downloads 144

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

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Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

Procedia PDF Downloads 156