Search results for: Emergency Action Plan
1087 The Post-Crisis Expansion of European Central Bank Powers: Understanding the Legitimate Boundaries of the ECB's Supervisory Independence and Accountability
Authors: Jakub Gren
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The recent transfer of banking supervision to the ECB has expanded its influence as of a non-majoritarian and technocratic policy-shaper in EU supervisory policies. To fulfil the main policy objectives of the Single Supervisory Mechanism, the ECB has been tasked with building a single supervisory approach to supervised banks across the euro area and is now exclusively responsible for direct supervision of the largest ‘significant’ euro area banks and the oversight of the remaining ‘less significant’ banks. This enhanced supranational position of the ECB significantly alters the EU institutional order and creates powerful incentives to actively pursue integrationist agenda by the ECB. However, this drastic shift has a little impact upon adapting the ECB’s new supervisory mandate to the requirements of democratic legitimacy. Whereas the ECB’s strong pre-crisis independence and limited accountability could be reconciled with democratic principles through a clearly articulated price stability mandate, independence and limited accountability in the context of a more complex supervisory mandate is problematic. Hence, in order to ensure the democratic legitimacy of the ECB/SSM’s supervisory policies, the ECB’s supervisory mandate requires both a lower scope of independence and higher accountability requirements. To address this situation, organizational separation (“Chinese Wall”) between the ECB monetary and supervisory arms was introduced. This separation includes different reporting lines and the relocation of the ECB’s monetary function to a new building complex while leaving its supervisory function at the Euro-tower (“Two Towers”). This paper argues that these measures are not sufficient to establish proper checks and balances on the ECB’s powers to pursue euro zone’s wide supervisory policies. As a remedy, this contribution suggests that the ECB’s Treaties-embedded independence, as set out by art. 130 TFEU, designed to carry out its monetary function shall not be fully applicable to its supervisory function. Indeed functional and conditional reading of this provision to ECB supervisory function could enhance the legitimacy of future ECB’s supervisory action.Keywords: accountability and transparency, democratic governance, financial management, rule of law
Procedia PDF Downloads 2081086 An Evaluation of the Lae City Road Network Improvement Project
Authors: Murray Matarab Konzang
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Lae Port Development Project, Four Lane Highway and other development in the extraction industry which have direct road link to Lae City are predicted to have significant impact on its road network system. This paper evaluates Lae roads improvement program with forecast on planning, economic and the installation of bypasses to ease congestion, effective and convenient transport service for bulk goods and reduce travel time. Land-use transportation study and plans for local area traffic management scheme will be considered. City roads are faced with increased number of traffic and some inadequate road pavement width, poor transport plans, and facilities to meet this transportation demand. Lae also has drainage system which might not hold a 100 year flood. Proper evaluation, plan, design and intersection analysis is needed to evaluate road network system thus recommend improvement and estimate future growth. Repetitive and cyclic loading by heavy commercial vehicles with different axle configurations apply on the flexible pavement which weakens and tear the pavement surface thus small cracks occur. Rain water seeps through and overtime it creates potholes. Effective planning starts from experimental research and appropriate design standards to enable firm embankment, proper drains and quality pavement material. This paper will address traffic problems as well as road pavement, capacities of intersections, and pedestrian flow during peak hours. The outcome of this research will be to identify heavily trafficked road sections and recommend treatments to reduce traffic congestions, road classification, and proposal for bypass routes and improvement. First part of this study will describe transport or traffic related problems within the city. Second part would be to identify challenges imposed by traffic and road related problems and thirdly to recommend solutions after the analyzing traffic data that will indicate current capacities of road intersections and finally recommended treatment for improvement and future growth.Keywords: Lae, road network, highway, vehicle traffic, planning
Procedia PDF Downloads 3611085 Uterine Torsion: A Rare Differential Diagnosis for Acute Abdominal Pain in Pregnancy
Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic
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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus
Procedia PDF Downloads 1651084 Anti Oxidant Ayurvedic Rasyan Herbs Concept to Disease Managment
Authors: Mohammed Khalil Ur Rahman, Khanita Aammatullh
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Rasayana is one of the eight clinical specialities of classical Ayurveda The disease preventive and health promotive approach of ‘Ayurveda’, which takes into consideration the whole body, mind and spirit while dealing with the maintenance of health, promotion of health and treating ailments is holistic and finds increasing acceptability in many regions of the world. Ancient Ayurvedic physicians had developed certain dietary and therapeutic measures to arrest/delay ageing and rejuvenating whole functional dynamics of the body system. This revitalization and rejuvenation is known as the ‘Rasayan chikitsa’ (rejuvenation therapy). Traditionally, Rasayana drugs are used against a plethora of seemingly diverse disorders with no pathophysiological connections according to modern medicine. Though, this group of plants generally possesses strong antioxidant activity, only a few have been investigated in detail. Over about 100 disorders like rheumatoid arthritis, hemorrhagic shock, CVS disorders, cystic fibrosis, metabolic disorders, neurodegenerative diseases, gastrointestinal ulcerogenesis and AIDS have been reported as reactive oxygen species mediated. In this review, the role of free radicals in these diseases has been briefly reviewed. ‘Rasayana’ plants with potent antioxidant activity have been reviewed for their traditional uses, and mechanism of antioxidant action. Fifteen such plants have been dealt with in detail and some more plants with less work have also been reviewed briefly The Rasayanas are rejuvenators, nutritional supplements and possess strong antioxidant activity. They also have antagonistic actions on the oxidative stressors, which give rise to the formation of different free radicals. Ocimum sanctum, Tinospora cordifolia, Emblica officinalis, Convolvulus pluricaulis, Centella asiatica, Bacopa monniera, Withania somnifera, Triphala rasayana, Chyawanprash, Brahma rasayana are very important rasayanas which are described in ayurveda and proved by new researches.Keywords: rasayana, antioxidant activity, Bacopa monniera, Withania somnifera Triphala, chyawanprash
Procedia PDF Downloads 2671083 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?
Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble
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Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.Keywords: paediatric, cycling, trauma, prevention, emergency
Procedia PDF Downloads 2511082 Government of Ghana’s Budget: An Assessment of Its Compliance with Fundamental Budgeting Principles
Authors: Mohammed Sani Abdulai
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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality
Procedia PDF Downloads 2081081 Identifying the Challenges and Opportunities of Using Lesson Study in English Language Teaching Through the Lenses of In-Service Ecuadorian EFL Teachers
Authors: Cherres Sara, Cajas Diego
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This paper explores how EFL teachers understand the process of Lesson Study in Ecuadorian schools and the challenges and opportunities that it brings to the improvement of their teaching practice. Using a narrative research methodology, this study presents the results of the application of the four steps of Lesson Study carried out by seven teachers in four different schools located in the Southern part of Ecuador during four months. Before starting the implementation of the lesson study, 30 teachers were trained on this model. This training was opened to EFL teachers working in public and private schools without any charge. The criteria to select these teachers were first, to be minimum a one-year in-service teacher, second, to have a b2 level of English, and third, to be able to commit to follow the course guidelines. After the course, seven teachers decided to continue with the implementation of the Lesson Study in their respective institutions. During the implementation of the Lesson Study, data was collected through observations, in-depth interviews and teachers’ planning meetings; and analyzed using a thematic analysis. The results of this study are presented using the lenses of seven EFL teachers that explained the challenges and opportunities that the implementation of Lesson Study conveyed. The challenges identified were the limited capacity of reflection and recognition of the activities that required improvement after the class, limited capacity to provide truthful peer feedback, teachers wrong notions about their performance in their classes, difficulties to follow a collaborative lesson plan; and, the disconnection between class activities and the class content. The opportunities identified were teachers’ predisposition to collaborate, teachers’ disposition to attend professional development courses, their commitment to work extra hours in planning meetings, their openness and their desired to be observed in their classes; and, their willingness to share class materials and knowledge. On the other hand, the results show that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations. The authors concluded that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations for example: excessive institutional paperwork and activities that are not connected to the development of students’ competences.Keywords: ELT, lesson study, teachers’ professional development, teachers’ collaboration
Procedia PDF Downloads 741080 Annual August Meetings as a Stimulator for Female Empowerment: Case Study Udi Local Government Area of Enugu State, Nigeria
Authors: Nneka Evelyn Udeh
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Women’s economic participation and empowerment are fundamental to strengthening women’s rights and enabling women to have control over their lives and exert influence in the society. The economic empowerment of women is a prerequisite for sustainable development, pro-poor growth and the achievement of all the millennium development Goals (MDGs). For women to be in development they need to be empowered morally, socially, economically, and financially and this is why women in Udi Local Government Area of Nigeria meet every August, the eighth month of the year to discuss matters relating to the pursuit of women empowerment, community welfare, and national development. This exploratory study depicts how annual august meetings serve as a stimulator for female empowerment with a case study Udi Local Government area of Enugu state, Nigeria. The paper finds that ‘August Meeting’ is a regular annual occurrence in Udi Local Government Area, Enugu State, Nigeria particularly for married women and is designed to better the lot of women, the child, family, the church, and the Community. Through this forum, with its seminars and workshops, women have the opportunity to learn everything about womanhood and how to chart new courses of action and sources of empowerment. The gathering gives women the opportunity to be integrated into their community development projects, and having women as stakeholders and not mere observers helps guarantee a speedy and steady community and overall national development progress. Funds are raised for community development projects through annual dues, levies, donations, fines, sales, income from money-yielding ventures, endowment and investiture. Annual August meeting also known as ‘Mothers Summit’ is indeed a powerful stimulator for female empowerment. Support and invigoration of this women initiative is essential for sustainable emancipation of female gender, not just in Udi Local Government Area of Nigeria but globally.Keywords: women empowerment, annual august meeting, Udi Lga, mothers' summit, stimulator, emancipation, sustainability, community welfare, national development, millennium development goal
Procedia PDF Downloads 3621079 Confidence Building Strategies Adopted in an EAP Speaking Course at METU and Their Effectiveness: A Case Study
Authors: Canan Duzan
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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.Keywords: confidence, EAP, speaking, strategy
Procedia PDF Downloads 4041078 Issues and Problems of Leadership Competencies among Head of Science Panels in Sarawak
Authors: Adawati Suhaili, Kamisah Osman, Mohd Effendi, Ewan Mohd Matore
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The global education reform has prompted Malaysia to transform the education system in Malaysia through the Malaysian Education Blueprint (MEB) 2013-2025. This transformation is aimed to achieve the top one-third rank in international assessment. The low achievement of student scientific literacy in TIMMS (Trends in International Mathematics and Science Study ) and PISA (Programme for International Student Assessment) has caused concern to the Ministry Of Education (MOE) despite various reform efforts. Therefore, an alternative action by enhancing the role of the Head of Science Panels (HoSPs) as a key change agent in catalyzing the improvement of student performance should be considered. Highlights of previous studies have shown that subject leadership is able to enhance teacher teaching quality in order to increase student learning. To lead the Science department and guide Science teachers more effectively, HoSPs need to strengthen their leadership skills. However, the issue of weaknesses in the leadership competencies of HoSPs in Malaysia has caused them to lack confidence and ability in leading the Science Department. The main objective of this study is to explore the factors that contribute to the problems faced by HoSPs at Sarawak in their leadership roles. This study used a qualitative design framework and using a semi-structured interview method for data collection. There were six informants involved in the interview consisting of lecturers, Senior Administrative Assistant Teacher and HoSPs. The findings of the study had been identified four main factors that contribute to problems in the leadership competencies of HoSPs in Sarawak, namely leadership practices, leadership structure, academic subjects and school change. The results are significant to the MOE in strengthening the leadership competencies of HoSPs in a more focus for improving the achievement of scientific literacy of students in Malaysia. This study can help improve the Hosps' leadership competencies in Malaysia.Keywords: issues, problems, Malaysia education blueprint, leadership competencies, head of science panels
Procedia PDF Downloads 2021077 Improving Health Workers’ Well-Being in Cittadella Hospital (Province of Padua), Italy
Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto
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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice
Procedia PDF Downloads 741076 A Study on Characteristics of Runoff Analysis Methods at the Time of Rainfall in Rural Area, Okinawa Prefecture Part 2: A Case of Kohatu River in South Central Part of Okinawa Pref
Authors: Kazuki Kohama, Hiroko Ono
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The rainfall in Japan is gradually increasing every year according to Japan Meteorological Agency and Intergovernmental Panel on Climate Change Fifth Assessment Report. It means that the rainfall difference between rainy season and non-rainfall is increasing. In addition, the increasing trend of strong rain for a short time clearly appears. In recent years, natural disasters have caused enormous human injuries in various parts of Japan. Regarding water disaster, local heavy rain and floods of large rivers occur frequently, and it was decided on a policy to promote hard and soft sides as emergency disaster prevention measures with water disaster prevention awareness social reconstruction vision. Okinawa prefecture in subtropical region has torrential rain and water disaster several times a year such as river flood, in which is caused in specific rivers from all 97 rivers. Also, the shortage of capacity and narrow width are characteristic of river in Okinawa and easily cause river flood in heavy rain. This study focuses on Kohatu River that is one of the specific rivers. In fact, the water level greatly rises over the river levee almost once a year but non-damage of buildings around. On the other hand in some case, the water level reaches to ground floor height of house and has happed nine times until today. The purpose of this research is to figure out relationship between precipitation, surface outflow and total treatment water quantity of Kohatu River. For the purpose, we perform hydrological analysis although is complicated and needs specific details or data so that, the method is mainly using Geographic Information System software and outflow analysis system. At first, we extract watershed and then divided to 23 catchment areas to understand how much surface outflow flows to runoff point in each 10 minutes. On second, we create Unit Hydrograph indicating the area of surface outflow with flow area and time. This index shows the maximum amount of surface outflow at 2400 to 3000 seconds. Lastly, we compare an estimated value from Unit Hydrograph to a measured value. However, we found that measure value is usually lower than measured value because of evaporation and transpiration. In this study, hydrograph analysis was performed using GIS software and outflow analysis system. Based on these, we could clarify the flood time and amount of surface outflow.Keywords: disaster prevention, water disaster, river flood, GIS software
Procedia PDF Downloads 1431075 The GRIT Study: Getting Global Rare Disease Insights Through Technology Study
Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis
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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease
Procedia PDF Downloads 1551074 A Meta-Analysis towards an Integrated Framework for Sustainable Urban Transportation within the Concept of Sustainable Cities
Authors: Hande Aladağ, Gökçe Aydın
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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation
Procedia PDF Downloads 3341073 Statecraft: Building a Hindu Nationalist Intellectual Ecosystem in India
Authors: Anuradha Sajjanhar
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The rise of authoritarian populist regimes has been accompanied by hardened nationalism and heightened divisions between 'us' and 'them'. Political actors reinforce these sentiments through coercion, but also through inciting fear about imagined threats and by transforming public discourse about policy concerns. Extremist ideas can penetrate national policy, as newly appointed intellectuals and 'experts' in knowledge-producing institutions, such as government committees, universities, and think tanks, succeed in transforming public discourse. While attacking left and liberal academics, universities, and the press, the current Indian government is building new institutions to provide authority to its particularly rigid, nationalist discourse. This paper examines the building of a Hindu-nationalist intellectual ecosystem in India, interrogating the key role of hyper-nationalist think tanks. While some are explicit about their political and ideological leanings, others claim neutrality and pursue their agenda through coded technocratic language and resonant historical narratives. Their key is to change thinking by normalizing it. Six years before winning the election in 2014, India’s Hindu-nationalist party, the BJP, put together its own network of elite policy experts. In a national newspaper, the vice-president of the BJP described this as an intentional shift: from 'being action-oriented to solidifying its ideological underpinnings in a policy framework'. When the BJP came to power in 2014, 'experts' from these think tanks filled key positions in the central government. The BJP has since been circulating dominant ideas of Hindu supremacy through regional parties, grassroots political organisations, and civil society organisations. These think tanks have the authority to articulate and legitimate Hindu nationalism within a credible technocratic policy framework. This paper is based on ethnography and over 50 interviews in New Delhi, before and after the BJP’s staggering election victory in 2019. It outlines the party’s attempt to take over existing institutions while developing its own cadre of nationalist policy-making professionals.Keywords: ideology, politics, South Asia, technocracy
Procedia PDF Downloads 1241072 Solubility of Carbon Dioxide in Methoxy and Nitrile-Functionalized Ionic Liquids
Authors: D. A. Bruzon, G. Tapang, I. S. Martinez
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Global warming and climate change are significant environmental concerns, which require immediate global action in carbon emission mitigation. The capture, sequestration, and conversion of carbon dioxide to other products such as methane or ethanol are ways to control excessive emissions. Ionic liquids have shown great potential among the materials studied as carbon capture solvents and catalysts in the reduction of CO2. In this study, ionic liquids comprising of a methoxy (-OCH3) and cyano (-CN) functionalized imidazolium cation, [MOBMIM] and [CNBMIM] respectively, paired with tris(pentafluoroethyl)trifluorophosphate [FAP] anion were evaluated as effective capture solvents, and organocatalysts in the reduction of CO2. An in-situ electrochemical set-up, which can measure controlled amounts of CO2 both in the gas and in the ionic liquid phase, was used. Initially, reduction potentials of CO2 in the CO2-saturated ionic liquids containing the internal standard cobaltocene were determined using cyclic voltammetry. Chronoamperometric transients were obtained at potentials slightly less negative than the reduction potentials of CO2 in each ionic liquid. The time-dependent current response was measured under a controlled atmosphere. Reduction potentials of CO2 in methoxy and cyano-functionalized [FAP] ionic liquids were observed to occur at ca. -1.0 V (vs. Cc+/Cc), which was significantly lower compared to the non-functionalized analog [PMIM][FAP], with an observed reduction potential of CO2 at -1.6 V (vs. Cc+/Cc). This decrease in the potential required for CO2 reduction in the functionalized ionic liquids shows that the functional groups methoxy and cyano effectively decreased the free energy of formation of the radical anion CO2●⁻, suggesting that these electrolytes may be used as organocatalysts in the reduction of the greenhouse gas. However, upon analyzing the solubility of the gas in each ionic liquid, [PMIM][FAP] showed the highest absorption capacity, at 4.81 mM under saturated conditions, compared to [MOBMIM][FAP] at 1.86 mM, and [CNBMIM][FAP] at 0.76 mM. Also, calculated Henry’s constant determined from the concentration-pressure graph of each functionalized ionic liquid shows that the groups -OCH3 and -CN attached terminal to a C4 alkyl chain do not significantly improve CO2 solubility.Keywords: carbon capture, CO2 reduction, electrochemistry, ionic liquids
Procedia PDF Downloads 4061071 Environmental and Socioeconomic Determinants of Climate Change Resilience in Rural Nigeria: Empirical Evidence towards Resilience Building
Authors: Ignatius Madu
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The study aims at assessing the environmental and socioeconomic determinants of climate change resilience in rural Nigeria. This is necessary because researches and development efforts on building climate change resilience of rural areas in developing countries are usually made without the knowledge of the impacts of the inherent rural characteristics that determine resilient capacities of the households. This has, in many cases, led to costly mistakes, delayed responses, inaccurate outcomes, and other difficulties. Consequently, this assessment becomes crucial not only to policymakers and people living in risk-prone environments in rural areas but also to fill the research gap. To achieve the aim, secondary data were obtained from the Annual Abstract of Statistics 2017, LSMS-Integrated Surveys on Agriculture and General Household Survey Panel 2015/2016, and National Agriculture Sample Survey (NASS), 2010/2011.Resilience was calculated by weighting and adding the adaptive, absorptive and anticipatory measures of households variables aggregated at state levels and then regressed against rural environmental and socioeconomic characteristics influencing it. From the regression, the coefficients of the variables were used to compute the impacts of the variables using the Stochastic Regression of Impacts on Population, Affluence and Technology (STIRPAT) Model. The results showed that the northern States are generally low in resilient indices and are impacted less by the development indicators. The major determining factors are percentage of non-poor, environmental protection, road transport development, landholding, agricultural input, population density, dependency ratio (inverse), household asserts, education and maternal care. The paper concludes that any effort to a successful resilient building in rural areas of the country should first address these key factors that enhance rural development and wellbeing since it is better to take action before shocks take place.Keywords: climate change resilience; spatial impacts; STIRPAT model; Nigeria
Procedia PDF Downloads 1561070 How Childhood Trauma Changes the Recovery Models
Authors: John Michael Weber
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The following research results spanned six months and 175 people addicted to some form of substance, from alcohol to heroin. One question was asked, and the answers were amazing and consistent. The following work is the detailed results of this writer’s answer to his own question and the 175 that followed. A constant pattern took shape throughout the bio-psycho-social assessments, these addicts had “first memories,” the memories were vivid and took place between the ages of three to six years old, to a person those first memories were traumatic. This writer’s personal search into his childhood was not to find an excuse for the way he became, but to explain the reason for becoming an addict. To treat addiction, these memories that have caused Post Traumatic Stress Disorder (PTSD), must be recognized as the catalyst that sparked a predisposition. Cognitive Behavioral Therapy (CBT), integrated with treatment specifically focused on PTSD, gives the addict a better chance at recovery sans relapse. This paper seeks to give the findings of first memories of the addicts assessed and provide the best treatment plan for such an addict, considering, the childhood trauma in congruence with treatment of the Substance Use Disorder (SUD). The question posed was concerning what their first life memory wa It is the hope of this author to take the knowledge that trauma is one of the main catalysts for addiction, will allow therapists to provide better treatment and reduce relapse from abstinence from drugs and alcohol. This research led this author to believe that if treatment of childhood trauma is not a priority, the twelve steps of Alcoholics Anonymous, specifically steps 4 and 5, will not be thoroughly addressed and odds for relapse increase. With this knowledge, parents can be educated on childhood trauma and the effect it has on their children. Parents could be mindful of the fact that the things they perceive as traumatic, do not match what a child, in the developmental years, absorbs as traumatic. It is this author’s belief that what has become the status quo in treatment facilities has not been working for a long time. It is for that reason this author believes things need to change. Relapse has been woven into the fabric of standard operating procedure and that, in this authors view, is not necessary. Childhood Trauma is not being addressed early in recovery and that creates an environment of inevitable relapse. This paper will explore how to break away from the status -quo and rethink the current “evidencebased treatments.” To begin breaking away from status-quo, this ends the Abstract, with hopes an interest has been peaked to read on.Keywords: childood, trauma, treatment, addiction, change
Procedia PDF Downloads 831069 CICAP: Promising Wound Healing Gel from Bee Products and Medicinal Plants
Authors: Laïd Boukraâ
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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds
Procedia PDF Downloads 3401068 Brain-Computer Interfaces That Use Electroencephalography
Authors: Arda Ozkurt, Ozlem Bozkurt
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Brain-computer interfaces (BCIs) are devices that output commands by interpreting the data collected from the brain. Electroencephalography (EEG) is a non-invasive method to measure the brain's electrical activity. Since it was invented by Hans Berger in 1929, it has led to many neurological discoveries and has become one of the essential components of non-invasive measuring methods. Despite the fact that it has a low spatial resolution -meaning it is able to detect when a group of neurons fires at the same time-, it is a non-invasive method, making it easy to use without possessing any risks. In EEG, electrodes are placed on the scalp, and the voltage difference between a minimum of two electrodes is recorded, which is then used to accomplish the intended task. The recordings of EEGs include, but are not limited to, the currents along dendrites from synapses to the soma, the action potentials along the axons connecting neurons, and the currents through the synaptic clefts connecting axons with dendrites. However, there are some sources of noise that may affect the reliability of the EEG signals as it is a non-invasive method. For instance, the noise from the EEG equipment, the leads, and the signals coming from the subject -such as the activity of the heart or muscle movements- affect the signals detected by the electrodes of the EEG. However, new techniques have been developed to differentiate between those signals and the intended ones. Furthermore, an EEG device is not enough to analyze the data from the brain to be used by the BCI implication. Because the EEG signal is very complex, to analyze it, artificial intelligence algorithms are required. These algorithms convert complex data into meaningful and useful information for neuroscientists to use the data to design BCI devices. Even though for neurological diseases which require highly precise data, invasive BCIs are needed; non-invasive BCIs - such as EEGs - are used in many cases to help disabled people's lives or even to ease people's lives by helping them with basic tasks. For example, EEG is used to detect before a seizure occurs in epilepsy patients, which can then prevent the seizure with the help of a BCI device. Overall, EEG is a commonly used non-invasive BCI technique that has helped develop BCIs and will continue to be used to detect data to ease people's lives as more BCI techniques will be developed in the future.Keywords: BCI, EEG, non-invasive, spatial resolution
Procedia PDF Downloads 781067 Financial Markets Performance: From COVID-19 Crisis to Hopes of Recovery with the Containment Polices
Authors: Engy Eissa, Dina M. Yousri
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COVID-19 has hit massively the world economy, financial markets and even societies’ livelihood. The infectious disease caused by the most recently discovered coronavirus was claimed responsible for a shrink in the global economy by 4.4% in 2020. Shortly after the first case in Wuhan was identified, a quick surge in the number of confirmed cases in China was evident and a vast spread worldwide is recorded with cases surpassing the 500,000 cases. Irrespective of the disease’s trajectory in each country, a call for immediate action and prompt government intervention was needed. Given that there is no one-size-fits-all approach across the world, a number of containment and adoption policies were embraced. It was starting by enforcing complete lockdown like China to even stricter policies targeted containing the spread of the virus, augmenting the efficiency of health systems, and controlling the economic outcomes arising from this crisis. Hence, this paper has three folds; first, it examines the impact of containment policies taken by governments on controlling the number of cases and deaths in the given countries. Second, to assess the ramifications of COVID-19 on financial markets measured by stock returns. Third, to study the impact of containment policies measured by the government response index, the stringency index, the containment health index, and the economic support index on financial markets performance. Using a sample of daily data covering the period 31st of January 2020 to 15th of April 2021 for the 10 most hit countries in wave one by COVID-19 namely; Brazil, India, Turkey, Russia, UK, USA, France, Germany, Spain, and Italy. The aforementioned relationships were tested using Panel VAR Regression. The preliminary results showed that the number of daily deaths had an impact on the stock returns; moreover, the health containment policies and the economic support provided by the governments had a significant effect on lowering the impact of COVID-19 on stock returns.Keywords: COVID-19, government policies, stock returns, VAR
Procedia PDF Downloads 1861066 Studying Perceived Stigma, Economic System Justification and Social Mobility Beliefs of Socially Vulnerable (Poor) People: The Case of Georgia
Authors: Nazi Pharsadanishvili, Anastasia Kitiashvili
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The importance of studying the social-psychological features of people living in poverty is often emphasized in international research. Building a multidimensional economic framework for reducing poverty grounded in people’s experiences and values is the main goal of famous Poverty Research Centers (such as Oxford Poverty and Human Development Initiative, Abdul Latif Jameel Poverty Action Lab). The aims of the proposed research are to investigate the following characteristics of socially vulnerable people living in Georgia: 1) The features of the perceived stigma of poverty; 2) economic system justification and social justice beliefs; 3) Perceived social mobility and actual attempts at upward social mobility. Qualitative research was conducted to address the indicated research goals and descriptive research questions. Conducting in-depth interviews was considered to be the most appropriate method to capture the vivid feelings and experiences of people living in poverty. 17 respondents (registered in the unified database of socially vulnerable families) participated in in-depth interviews. According to the research results, socially vulnerable people living in Georgia perceive stigma targeted toward them. Two sub-dimensions were identified in perceived stigma: experienced stigma and internalized stigma. Experienced stigma reflects the instances of being discriminated and perceptions of negative treatment from other members of society. Internalized stigma covers negative personal emotions, the feelings of shame, the fear of future stigmatization, and self-isolation. The attitudes and justifications of the existing economic system affect people’s attempts to cope with poverty. Complex analysis of those results is important during the planning and implementing of social welfare reforms. Particularly, it is important to implement poverty stigma reduction mechanisms and help socially vulnerable people to see real perspectives on upward social mobility.Keywords: coping with poverty, economic system justification, perceived stigma of poverty, upward social mobility
Procedia PDF Downloads 1931065 Study on Improvement the Performance of Construction Project Using Lean Principles
Authors: Sumaya Adina
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The productivity of the construction industry has faced numerous challenges, rising costs, and scarce resources over the past forty years; therefore, one approach for improving and enhancing the framework is the use of lean techniques. Lean method outcomes from the use of a brand-form of manufacturing control in production. At a time when sustainability and efficiency are essential, lean offers a clear path to make the construction industry fit for the future. An excessive number of construction professionals and experts have efficiently optimised development initiatives using lean construction (LC) techniques to reduce waste, maximise value creation, and focus on the process that creates real added value and continuous improvement, strengthening flexibility and adaptability. The present research has been undertaken to study the improvement in the performance of construction projects using lean principles. The study work is divided into three stages. Initially, a questionnaire survey was conducted on visual management techniques to improve the performance of the construction projects. The questionnaire was distributed to civil engineers, architects, site managers, project managers, and full-time executives, with nearly 100 questionnaires shared with respondents. A total of 83 responses were received to determine the reliability of the data, and analysis was done using SPSS software. In the second stage, the impact of value stream mapping on the real-time project is determined and its performance in the form of time and cost reduction is evaluated. The case study examines a bunker-building project located in Kabul Afghanistan; the project was planned conventionally without considering the lean concepts. To reduce overall kinds of waste in the project, a plan was developed using the Vico Control software to visualize the value stream of the project. Finally, the impact of value stream mapping on the project's total cash flow is evaluated and compared by plotting the total cash flow curve using Vico software. As a result, labour costs were reduced by 33%. The duration of the project was reduced by 17% reducing the duration of the project also improved the cash flow of the entire project by 14% and increased the cash flow from negative 67% to negative 44%.Keywords: lean construction, cost and time overrun, value stream mapping, construction effeciency
Procedia PDF Downloads 131064 Effects of Macroprudential Policies on BankLending and Risks
Authors: Stefanie Behncke
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This paper analyses the effects of different macroprudential policy measures that have recently been implemented in Switzerland. Among them is the activation and the increase of the countercyclical capital buffer (CCB) and a tightening of loan-to-value (LTV) requirements. These measures were introduced to limit systemic risks in the Swiss mortgage and real estate markets. They were meant to affect mortgage growth, mortgage risks, and banks’ capital buffers. Evaluation of their quantitative effects provides insights for Swiss policymakers when reassessing their policy. It is also informative for policymakers in other countries who plan to introduce macroprudential instruments. We estimate the effects of the different macroprudential measures with a Differences-in-Differences estimator. Banks differ with respect to the relative importance of mortgages in their portfolio, their riskiness, and their capital buffers. Thus, some of the banks were more affected than others by the CCB, while others were more affected by the LTV requirements. Our analysis is made possible by an unusually informative bank panel data set. It combines data on newly issued mortgage loans and quantitative risk indicators such as LTV and loan-to-income (LTI) ratios with supervisory information on banks’ capital and liquidity situation and balance sheets. Our results suggest that the LTV cap of 90% was most effective. The proportion of new mortgages with a high LTV ratio was significantly reduced. This result does not only apply to the 90% LTV, but also to other threshold values (e.g. 80%, 75%) suggesting that the entire upper part of the LTV distribution was affected. Other outcomes such as the LTI distribution, the growth rates of mortgages and other credits, however, were not significantly affected. Regarding the activation and the increase of the CCB, we do not find any significant effects: neither LTV/LTI risk parameters nor mortgage and other credit growth rates were significantly reduced. This result may reflect that the size of the CCB (1% of relevant residential real estate risk-weighted assets at activation, respectively 2% at the increase) was not sufficiently high enough to trigger a distinct reaction between the banks most likely to be affected by the CCB and those serving as controls. Still, it might be have been effective in increasing the resilience in the overall banking system. From a policy perspective, these results suggest that targeted macroprudential policy measures can contribute to financial stability. In line with findings by others, caps on LTV reduced risk taking in Switzerland. To fully assess the effectiveness of the CCB, further experience is needed.Keywords: banks, financial stability, macroprudential policy, mortgages
Procedia PDF Downloads 3651063 To Corelate Thyroid Dysfunction in Pregnancy with Preterm Labor
Authors: Pushp Lata Sankhwar
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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor
Procedia PDF Downloads 951062 Healthcare Fire Disasters: Readiness, Response and Resilience Strategies: A Real-Time Experience of a Healthcare Organization of North India
Authors: Raman Sharma, Ashok Kumar, Vipin Koushal
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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.Keywords: healthcare, fires, smoke, management, strategies
Procedia PDF Downloads 721061 Understanding Complexity at Pre-Construction Stage in Project Planning of Construction Projects
Authors: Mehran Barani Shikhrobat, Roger Flanagan
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The construction planning and scheduling based on using the current tools and techniques is resulted deterministic in nature (Gantt chart, CPM) or applying a very little probability of completion (PERT) for each task. However, every project embodies assumptions and influences and should start with a complete set of clearly defined goals and constraints that remain constant throughout the duration of the project. Construction planners continue to apply the traditional methods and tools of “hard” project management that were developed for “ideal projects,” neglecting the potential influence of complexity on the design and construction process. The aim of this research is to investigate the emergence and growth of complexity in project planning and to provide a model to consider the influence of complexity on the total project duration at the post-contract award pre-construction stage of a project. The literature review showed that complexity originates from different sources of environment, technical, and workflow interactions. They can be divided into two categories of complexity factors, first, project tasks, and second, project organisation management. Project tasks may originate from performance, lack of resources, or environmental changes for a specific task. Complexity factors that relate to organisation and management refer to workflow and interdependence of different parts. The literature review highlighted the ineffectiveness of traditional tools and techniques in planning for complexity. However, this research focus on understanding the fundamental causes of the complexity of construction projects were investigated through a questionnaire with industry experts. The results were used to develop a model that considers the core complexity factors and their interactions. System dynamics were used to investigate the model to consider the influence of complexity on project planning. Feedback from experts revealed 20 major complexity factors that impact project planning. The factors are divided into five categories known as core complexity factors. To understand the weight of each factor in comparison, the Analytical Hierarchy Process (AHP) analysis method is used. The comparison showed that externalities are ranked as the biggest influence across the complexity factors. The research underlines that there are many internal and external factors that impact project activities and the project overall. This research shows the importance of considering the influence of complexity on the project master plan undertaken at the post-contract award pre-construction phase of a project.Keywords: project planning, project complexity measurement, planning uncertainty management, project risk management, strategic project scheduling
Procedia PDF Downloads 1481060 Progress in Replacing Antibiotics in Farm Animal Production
Authors: Debabrata Biswas
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The current trend in the development of antibiotic resistance by multiple bacterial pathogens has resulted in a troubling loss of effective antibiotic options for human. The emergence of multi-drug-resistant pathogens has necessitated higher dosages and combinations of multiple antibiotics, further exacerbating the problem of antibiotic resistance. Zoonotic bacterial pathogens, such as Salmonella, Campylobacter, Shiga toxin-producing Escherichia coli (such as enterohaemorrhagic E. coli or EHEC), and Listeria are the most common and predominant foodborne enteric infectious agents. It was observed that these pathogens gained/developed their ability to survive in the presence of antibiotics either in farm animal gut or farm environment and researchers believe that therapeutic and sub-therapeutic antibiotic use in farm animal production might play an important role in it. The mechanism of action of antimicrobial components used in farm animal production in genomic interplay in the gut and farm environment, has not been fully characterized. Even the risk of promoting the exchange of mobile genetic elements between microbes specifically pathogens needs to be evaluated in depth, to ensure sustainable farm animal production, safety of our food and to mitigate/limit the enteric infection with multiple antibiotic resistant bacterial pathogens. Due to the consumer’s demand and considering the current emerging situation, many countries are in process to withdraw antibiotic use in farm animal production. Before withdrawing use of the sub-therapeutic antibiotic or restricting the use of therapeutic antibiotics in farm animal production, it is essential to find alternative natural antimicrobials for promoting the growth of farm animal and/or treating animal diseases. Further, it is also necessary to consider whether that compound(s) has the potential to trigger the acquisition or loss of genetic materials in zoonotic and any other bacterial pathogens. Development of alternative therapeutic and sub-therapeutic antimicrobials for farm animal production and food processing and preservation and their effective implementation for sustainable strategies for farm animal production as well as the possible risk for horizontal gene transfer in major enteric pathogens will be focus in the study.Keywords: food safety, natural antimicrobial, sustainable farming, antibiotic resistance
Procedia PDF Downloads 2751059 Integrated Safety Net Program for High-Risk Families in New Taipei City
Authors: Peifang Hsieh
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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.Keywords: cross department, high-risk families, public-private partnership, integrated safety net
Procedia PDF Downloads 3041058 A Life History of a Female Counselor Participated in Sewol Ferry Disaster Counseling Korea: Based on Qualitative Analysis of Mandelbaum's Life History
Authors: Donghun Lee, Jiyoung Shin, Youjin Kim, Jin Joo Kim
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The sinking of Sewol ferry occurred in Korea on the morning of 16 April 2014 while carrying 476 people. In all, 304 passengers, mostly secondary school students from Danwon High School in Ansan City died in the disaster. The sinking of Sewol ferry has resulted in widespread social and political turmoil within South Korea. Many criticize the actions of the captain and crews of the ferry as well as the ferry operator and the regulators who oversaw its operations. However, huge criticism has been directed at the South Korean government for its national disaster response system. This disaster has made Korean government build up a new disaster management and psychological support system. The purpose of this study was to understand developmental and change process of a female counselor in her late fifties participated in Sewol ferry disaster counseling for a year. She has participated in providing as a counselor counseling and psychological support for the victims' families of Sewol ferry disaster, additionally as a director of community youth counseling center operated by local government by establishing governmental psychological supports plan for recovering collective trauma in the community, through which she have gotten self-reflection of whole her life. For in-depth interview data analysis, Mandelbaum’s three conceptual frameworks were employed; dimensions, turnings, and adaptation. The result of the study indicates extracted categories of life dimension, turning point and adaptation. The details of these categories are ‘having a self-image in youth’, ‘marriage in fairy-tale’, ‘unexpected death of husband’, ‘taking a step forward from darkness’, the way of counselor’, nice grown child’, ‘Sewol ferry disaster’ in life dimension, ‘death in front of life’, ‘milestone in life, counseling’ in turning points, ‘before Sewol ferry disaster’, ‘after Sewol ferry disaster’ in adaptation. Life history methods revealed the counselor’s internal developmental process by analyzing what Sewol ferry disaster influenced on an individual life, especially a counselor's one, what changes she went through, and how she adapted herself to that. Based on the results, discussions and suggestions are provided.Keywords: development and change, disaster counseling, identity of female counselor, Mandelbaum’s life history, Sewol ferry
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