Search results for: risk score

Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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Authors: Suzan Odabasi

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Suicide attempts and mental health problems among immigrants have been increasing and have become important public health concerns during the last century. Immigrants may face more difficulties in society because of social conflict, language barriers, inadequate social support, socioeconomic problems, and delay in accessing help. The limited number of research has shown that: first-generation migrants may be at higher risk of mental disorders and a higher prevalence of suicide attempts. The main aim of the proposed work is to identify to what degree each of these pressures is causing higher suicides currently observed. In addition, a comparison will be conducted between females and males and also rural and urban areas for which recent data are available. Specifically, this study investigates how accessing mental health services, the uninsured population rate, socioeconomic factors, and being an immigrant affect Turkish immigrants’ mental health and suicide attempts.

Keywords: access to healthcare, immigration, health economics, mental health economics

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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Authors: Maria Krambia-Kapardis, Andreas Kapardis

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The paper discusses regulatory and legislative measures implemented by various nations in an effort to avert another financial crisis. More specifically, to address the financial crisis, the European Commission followed the practice of other developed countries and implemented a European Economic Recovery Plan in an attempt to overhaul the regulatory and supervisory framework of the financial sector. In 2010 the Commission introduced the European Systemic Risk Board and in 2011 the European System of Financial Supervision. Some experts advocated that the type and extent of financial regulation introduced in the European crisis in the wake of the 2008 crisis has been excessive and counterproductive. In considering how different countries responded to the financial crisis, global regulators have shown a more focused commitment to combat industry misconduct and to pre-empt abusive behavior. Regulators have also increased funding and resources at their disposal; have increased regulatory fines, with an increasing trend towards action against individuals; and, finally, have focused on market abuse and market conduct issues. Financial regulation can be effected, first of all, through legislation. However, neither ex ante or ex post regulation is by itself effective in reducing systemic risk. Consequently, to avert a financial crisis, in their endeavor to achieve both economic efficiency and financial stability, governments need to balance the two approaches to financial regulation. Fiduciary duty is another means by which the behavior of actors in the financial world is constrained and, thus, regulated. Furthermore, fiduciary duties extend over and above other existing requirements set out by statute and/or common law and cover allegations of breach of fiduciary duty, negligence or fraud. Careful analysis of the etiology of the 2008 financial crisis demonstrates the great importance of corporate governance as a way of regulating boardroom behavior. In addition, the regulation of professions including accountants and auditors plays a crucial role as far as the financial management of companies is concerned. In the US, the Sarbanes-Oxley Act of 2002 established the Public Company Accounting Oversight Board in order to protect investors from financial accounting fraud. In most countries around the world, however, accounting regulation consists of a legal framework, international standards, education, and licensure. Accounting regulation is necessary because of the information asymmetry and the conflict of interest that exists between managers and users of financial information. If a holistic approach is to be taken then one cannot ignore the regulation of legislators themselves which can take the form of hard or soft legislation. The science of averting a financial crisis is yet to be perfected and this, as shown by the preceding discussion, is unlikely to be achieved in the foreseeable future as ‘disaster myopia’ may be reduced but will not be eliminated. It is easier, of course, to be wise in hindsight and regulating unreasonably risky decisions and unethical or outright criminal behavior in the financial world remains major challenges for governments, corporations, and professions alike.

Keywords: financial crisis, legislation, regulation, financial regulation

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Authors: Priyanka Manghani, Manthan Patel, Rahul Peddawad

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Cervical Cancer is a major public health hurdle in the area of women’s health. The most common cause of Cervical Cancer is the Human Papilloma Virus (HPV). Human papilloma virus has various genotypes, with HPV 16 and HPV 18 being the major etiological factor causing carcinoma of the Cervix. Early screening and detection by Papanicolaou Smears (PAP) is an effective method for identifying premalignant and malignant lesions. In case of existing pre- malignant lesions /cervical dysplasia’s found with HPV 16 or 18, appropriate follow up can be done to prevent it from developing into a neoplasm. Aims and Objectives: Primary Aim; To study various abnormal cervical cytology reports as detected by Pap Smear Tests, using the Bethesda System in women at a Tertiary Care Hospital. Secondary Aim; To discuss the importance of Pap smear in Cervical Cancer Screening Program. Materials and Methods: Our study is a prospective study, based on 101 women who attended the Out-patient department of Obstetrics and Gynecology at a tertiary care hospital in age group 20-40 years with chief complaints of white/foul vaginal discharge, post-coital Bleeding, low back pain, irregular menstruation, etc. 60 women, who were tested, of the total no of women, were commercial sex workers, thus being a high-risk group for HPV infection. All women underwent conventional cytology. For all the abnormal smears, further cervical biopsies were done, and the final diagnosis was done on the basis of histopathology (gold standard). Results: In all these patients, 16 patients presented with normal smears out of which 2 belonged to the category of commercial sex workers (3.33%) and 14 being from the normal/control group (34.15%). 44 women presented with inflammatory smears out of which 30 were commercial sex workers (50%) and 14 from the control Group (34.15%). A total of 11 women presented with infectious etiology with 6 being commercial sex workers (10%) and 5 (12.2%) being in the control group. A total of 8 patients presented with low-grade squamous intra epithelial lesion (LSIL) with 7 (11.7%) being commercial sex workers and 1(2.44%) patient belonging to the control group. A Total of 7 patients presented with high-grade squamous intraepithelial lesion (HSIL) with 6 (10%) being commercial sex workers and 1 (2.44%) belonging to the control group. 9 patients in total presented with atypical squamous cells of undetermined significance (ASCUS) with 6(10%) being commercial sex workers and 3 (7.32%) belonging to the control group. Squamous cell carcinoma(SCC) presence was found only in 1(1.7%) commercial sex worker. Conclusion – We conclude that HSIL, LSIL, SCC and sexually related infections are comparatively more common in vulnerable groups such as sex workers due to a variety of factors such as multiple sexual partners and poor genital hygiene. Early screening and follow up interventions are highly needed for them along with Health education for risk factors and to emphasize on the importance of Pap smear screening.

Keywords: cervical cancer, papanicolaou (pap) smear, bethesda system, neoplasm

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Authors: Hussnain Mukhtar, Yu-Pin Lin

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This paper deals with the concept of ecologically engineered system for sustainable agriculture production with the view of sustainable cities development. Sustainable cities offer numerous eco-services to its inhabitants, and where, among other issues, wastewater nutrients can be considered to be a valuable resource to be used for a sustainable enhancement of urban agriculture in wetlands. Existing cities can be transferred from being only consumer of food and other agriculture product into important resource conserving and sustainable generators of these products. The review provides the food production capacity through introduction of wastewater into urban wetlands, potential for nutrient recovery and ecological engineering intervention to reduce the risk of food contamination by pathogens. Finally, we discuss the potential nutrients accumulating in our cities, as an important aspect of sustainable urban development.

Keywords: ecological engineering, nutrient recovery, pathogens, urban agriculture, wetlands

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Authors: Cecilia Teljas

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Many government agencies use social media to supplement their traditional communication channels. Government agencies are typically risk-averse, which makes social media practices problematic. However, this case study of the social media use of the Swedish social insurance agency shows considerable bi-directional communication between the agency and the public. On one hand, the agency’s aims, strategies, ways of working and experiences related to its social media communication practice are analyzed. On the other hand, the communication by both the agency and the public is studied on one of the agency’s Facebook pages. The results showed that it is possible for an agency to provide relevant and accurate information in real-time in social media if identifying and addressing different segments separately. Furthermore, as a result of context adaption this communication was rather informal and the practice can be considered to manifest positive democratic effects due to the increased availability and inclusion.

Keywords: e-government, social media, case study, discourse analysis

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Authors: Seyedeh Faranak Baniahmad, Soroor Yousefi

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Osteoporosis is a bone disease which increases the bone fracture risk, reduces the bone mineral density (BMD) and alters the amount and variety of proteins in bones. Antiresorptive therapy is one the most popular Osteoporosis treatment methods. In this method the bisphosphonates, hormones, calcitonin or the selective estrogen receptor modulators is replaced. In order to reduce undesirable effects and to increase the bioavailability of drug agents, the controlled drug delivery systems have been utilized. In current study, the controlled release of Alendronate from LDH-PCL with (0, 5, 10, 15 % wt. of LDH) was investigated. The results showed that the release of alendronate from the lamellar LDH incorporated into the PCL matrix is much slower than the release of alendronate from the PCL. Therefore such systems are very promising, in which the antiresorptive drug has to remain in the matrix for longer time and can be released in controlled manner.

Keywords: osteoporosis, alendronate, poly (ε–caprolactone), layered double hydroxide

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Authors: E. K. Mendez, N. A. Salazar, C. E. Orrego

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There is undoubted proof that increasing the intake of fruit lessens the risk of hypertension, coronary heart disease, stroke, and probable evidence that lowers the risk of cancer. Proper fruit drying is an excellent alternative to make their shelf-life longer, commercialization easier, and ready-to-eat healthy products or ingredients. The conventional way of drying is by hot air forced convection. However, this process step often requires a very long residence time; furthermore, it is highly energy consuming and detrimental to the product quality. Nowadays, power ultrasound (US) technic has been considered as an emerging and promising technology for industrial food processing. Most of published works dealing with drying food assisted by US have studied the effect of ultrasonic pre-treatment prior to air-drying on food and the airborne US conditions during dehydration. In this work a new approach was tested taking in to account drying time and two quality parameters of mango slices dehydrated by convection assisted by 20 KHz power US applied directly using a holed plate as product support and sound transmitting surface. During the drying of mango (Mangifera indica L.) slices (ca. 6.5 g, 0.006 m height and 0.040 m diameter), their weight was recorded every hour until final moisture content (10.0±1.0 % wet basis) was reached. After previous tests, optimization of three drying parameters - frequencies (2, 5 and 8 minutes each half-hour), air temperature (50-55-60⁰C) and power (45-70-95W)- was attempted by using a Box–Behnken design under the response surface methodology for the optimal drying time, color parameters and rehydration rate of dried samples. Assays involved 17 experiments, including a quintuplicate of the central point. Dried samples with and without US application were packed in individual high barrier plastic bags under vacuum, and then stored in the dark at 8⁰C until their analysis. All drying assays and sample analysis were performed in triplicate. US drying experimental data were fitted with nine models, among which the Verna model resulted in the best fit with R2 > 0.9999 and reduced χ2 ≤ 0.000001. Significant reductions in drying time were observed for the assays that used lower frequency and high US power. At 55⁰C, 95 watts and 2 min/30 min of sonication, 10% moisture content was reached in 211 min, as compared with 320 min for the same test without the use of US (blank). Rehydration rates (RR), defined as the ratio of rehydrated sample weight to that of dry sample and measured, was also larger than those of blanks and, in general, the higher the US power, the greater the RR. The direct contact and intermittent US treatment of mango slices used in this work improve drying rates and dried fruit rehydration ability. This technique can thus be used to reduce energy processing costs and the greenhouse gas emissions of fruit dehydration.

Keywords: ultrasonic assisted drying, fruit drying, mango slices, contact ultrasonic drying

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Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain

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The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.

Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status

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Authors: Adjal Yassine, Semmani Amar

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During the last decades, The risk of collision has been increased, especially in high maritime traffic. As the consequence, the demand is required for safety at sea and environmental protection. For this purpose, the consequences prediction of ship collisions is recommended in order to minimize structural failure. additionally, at the design stage of the ship, damage generated during the collision event must be taken into consideration. This structural failure, in some cases, can develop into the progressive collapse of other structural elements and generate catastrophic consequences. The present study investigates the progressive collapse of ships damaged by collisions using the Non -linear finite element method. The failure criteria are taken into account. The impacted area has a refined mesh in order to have more reliable results. Finally, a parametric study was conducted in this study to highlight the effect of the ship's speed, as well as the different impacted areas of double-bottom ships.

Keywords: collsion, strucural failure, ship, finite element analysis

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Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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Authors: Dulal Bhaumik, Fei Jie, Runa Bhaumik, Bikas Sinha

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Human brain is an amazingly complex network. Aberrant activities in this network can lead to various neurological disorders such as multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and autism. fMRI has emerged as an important tool to delineate the neural networks affected by such diseases, particularly autism. In this paper, we propose mixed-effects models together with an appropriate procedure for controlling false discoveries to detect disrupted connectivities in whole brain studies. Results are illustrated with a large data set known as Autism Brain Imaging Data Exchange or ABIDE which includes 361 subjects from 8 medical centers. We believe that our findings have addressed adequately the small sample inference problem, and thus are more reliable for therapeutic target for intervention. In addition, our result can be used for early detection of subjects who are at high risk of developing neurological disorders.

Keywords: ABIDE, autism spectrum disorder, fMRI, mixed-effects model

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Authors: Jeff Dickie

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This research paper combined grounded coding and research questions with the objective to investigate conflict resolution in the classroom. The students’ answers concerning teaching were coded according to phrasal meanings which revealed concepts. These concept codes then became input data into theoretical frameworks. The investigation indicated two conflicts: whether the information was valid and whether to make the study effort which was discussed as perceptions of teacher’s competence in helping to learn. The relevant factors in helping to learn were predominately emotional. These factors were important in the negotiation process to develop relationships. Information validity seemed to be the motivator to begin and participate effectively with the learning process. In effect, confidence in the learning negotiation process with the focus towards relationship building with the subject matter seemed to be the motivator to make the study effort.

Keywords: coding, confidence, competence, conflict resolution, risk, trust, relationship building

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Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

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Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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Authors: Shailendra M. Pradhan, Upendra M. Pradhan

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Disasters are perennial features of human civilization. The recurring earthquakes, floods, cyclones, among others, that result in massive loss of lives and devastation, is a grim reminder of the fact that, despite all our success stories of development, and progress in science and technology, human society is perennially at risk to disasters. The apparent threat of climate change and global warming only severe our disaster risks. Darjeeling hills, situated along Eastern Himalayan region of India, and famous for its three Ts – tea, tourism and toy-train – is also equally notorious for its disasters. The recurring landslides and earthquakes, the cyclone Aila, and the Ambootia landslides, considered as the largest landslide in Asia, are strong evidence of the vulnerability of Darjeeling hills to natural disasters. Given its geographical location along the Hindu-Kush Himalayas, the region is marked by rugged topography, geo-physically unstable structure, high-seismicity, and fragile landscape, making it prone to disasters of different kinds and magnitudes. Most of the studies on disasters in Darjeeling hills are, however, scientific and geographical in orientation that focuses on the underlying geological and physical processes to the neglect of social and political conditions. This has created a tendency among the researchers and policy-makers to endorse and promote a particular type of discourse that does not consider the social and political aspects of disasters in Darjeeling hills. Disaster, this paper argues, is a complex phenomenon, and a result of diverse factors, both physical and human. The hazards caused by the physical and geological agents, and the vulnerabilities produced and rooted in political, economic, social and cultural structures of a society, together result in disasters. In this sense, disasters are as much a result of political and economic conditions as it is of physical environment. The human aspect of disasters, therefore, compels us to address intricating social and political challenges that ultimately determine our resilience and vulnerability to disasters. Set within the above milieu, the aims of the paper are twofold: a) to provide a political and sociological account of disasters in Darjeeling hills; and, b) to identify and address the root causes of its vulnerabilities to disasters. In situating disasters in Darjeeling Hills, the paper adopts the Pressure and Release Model (PAR) that provides a theoretical insight into the study of social and political aspects of disasters, and to examine myriads of other related issues therein. The PAR model conceptualises risk as a complex combination of vulnerabilities, on the one hand, and hazards, on the other. Disasters, within the PAR framework, occur when hazards interact with vulnerabilities. The root causes of vulnerability, in turn, could be traced to social and political structures such as legal definitions of rights, gender relations, and other ideological structures and processes. In this way, the PAR model helps the present study to identify and unpack the root causes of vulnerabilities and disasters in Darjeeling hills that have largely remained neglected in dominant discourses, thereby providing a more nuanced and sociologically sensitive understanding of disasters.

Keywords: Darjeeling, disasters, PAR, vulnerabilities

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Authors: Cecilia Amponsem-Boateng, Timothy B. Oppong, Haiyan Yang, Guangcai Duan

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The human palm has been identified as one of the richest habitats for human microbial accommodation making hand hygiene essential to primary prevention of infection. Since the hand is in constant contact with fomites which have been proven to be mostly contaminated, building hand hygiene habits is essential for the prevention of infection. This research was conducted to assess the hand hygiene habits of Ghanaian youths in Accra. This study used a survey as a quantitative method of research. The findings of the study revealed that out of the 254 participants who fully answered the questionnaire, 22% had the habit of washing their hands after outings while only 51.6% had the habit of washing their hands after using the bathroom. However, about 60% of the participants said they sometimes ate with their hands while 28.9% had the habit of eating with the hand very often, a situation that put them at risk of infection from their hands since some participants had poor handwashing habits; prompting the need for continuous education on hand hygiene.

Keywords: hand hygiene, hand hygiene habit, hand washing, hand sanitizer use

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Authors: E. Dahlen

Abstract:

Inflation can be calculated from either the prices of consumer products or from salaries. This paper presents a logical exercise that shows it is easier to calculate inflation from salaries than from consumer products. While the prices of consumer products may change due to technological advancement, such as automation, which must be corrected for, salaries do not. If technological advancements are not accounted for within calculations based on consumer product prices, inflation can be confused with real wage changes, since both inflation and real wage changes affect the prices of consumer products. The method employed in this paper is a logical exercise. Logical arguments are presented that suggest the existence of many different feasible ways by which inflation can be determined. Then a short mathematical exercise will be presented which shows that one of these methods –using salaries – contains the fewest number of unknown parameters, and hence, is the preferred method, since the risk of mistakes is lower. From the results, it can be concluded that salaries, rather than consumer products, should be used to calculate inflation.

Keywords: inflation, logic, math, real wages

Procedia PDF Downloads 306

Authors: Azzouzi Fadoua

Abstract:

This study focuses on the diagnosis of the dynamics of natural resources in a semi-arid mountainous weakened by natural vulnerability and anthropogenic action. This is evident in the forms of hydraulic erosion and degradation of agricultural land. The rate of this damaged land is 53%, with a strong presence of concentrated erosion; this shows that balanced and semi-balanced environments are less apparent to the Watershed, representing 47%. The results revealed the crucial role of the slopes and the density of the hydraulic networks to facilitate the transport of fine elements, at the level of the slopes with low vegetation intensity, to the lake of the dam. Something that endangers the siltation of the latter. After the study of natural and anthropogenic elements, it turned out that natural vulnerability is an integral part of the current dynamic, especially when it coincides with the overexploitation of natural resources, in this case, the exploitation of steep slopes for the cultivation of cereals and overgrazing. This causes the soil to pile up and increase the rate of runoff.

Keywords: watershed, erosion, natural vulnerability, anthropogenic

Procedia PDF Downloads 131

Authors: Po-Chen Chen, Tsung-Han Yang, Zhi-Wei Zheng, Shih-Tsang Tang

Abstract:

Falls are the most common accidents during mountain hiking, especially in high-altitude environments with unstable terrain or adverse weather. Balance ability is a crucial factor in hiking, effectively ensuring hiking safety and reducing the risk of injuries. If balance ability can be assessed simply and effectively, hikers can identify their weaknesses and conduct targeted training to improve their balance ability, thereby reducing injury risks. With the widespread use of smartphones and their built-in inertial sensors, this project aims to develop a simple Inertial Measurement Unit (IMU) balance measurement technique based on smartphones. This will provide hikers with an easy-to-use, low-cost tool for assessing balance ability, monitoring training effects in real-time, and continuously tracking balance ability through uploading cloud data uploads, facilitating personal athletic performance.

Keywords: balance, IMU, smartphone, wearable devices

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Authors: H. J. Kim, G. C. Park, K. C. Kim, J. H. Shin

Abstract:

Cavities are frequently found beneath conduits on pile foundations in old embankments. Cavity reduces seepage length significantly and consequently causes piping failure of embankments. Case studies of embankment failures indicate that the relative settlement between ground and pile supported-concrete conduit was the main reason of the cavity. In this paper, an attempt to simulate the cavity-induced piping failure mechanism was made using finite element numerical method. Piping potential is examined by carrying out parametric study for influencing factors such as cavity length, water level, and flow conditions. The concentration of hydraulic gradient adjacent to cavity was found. It is found that the hydraulic gradient close to the cavity exceeds considerably the critical hydraulic gradient causing piping. Piping failure potential due to the existence of cavity is evaluated and contour map for the potential risk of an embankment for piping failure is proposed.

Keywords: cavity, hydraulic gradient, levee, piping

Procedia PDF Downloads 503

Authors: I. Erins, J. Erina

Abstract:

The aim of the present article is to determine the impact of the external and internal factors of bank performance on the profitability indicators of the CEE countries banks in the period from 2006 to 2012. On the basis of research conducted abroad on bank and macroeconomic profitability indicators, in order to obtain research results, the authors evaluated return on average assets (ROAA) and return on average equity (ROAE) indicators of the CEE countries banks. The authors analyzed profitability indicators of banks using descriptive methods, SPSS data analysis methods as well as data correlation and linear regression analysis. The authors concluded that most internal and external indicators of bank performance have no direct effect on the profitability of the banks in the CEE countries. The only exceptions are credit risk and bank size which affect one of the measures of bank profitability–return on average equity.

Keywords: banks, CEE countries, profitability ROAA, ROAE

Procedia PDF Downloads 353

Authors: Sinarwati Mohamad Suhaili, Naomie Salim, Mohamad Nazim Jambli

Abstract:

Sequence-to-sequence (seq2seq) models augmented with attention mechanisms are playing an increasingly important role in automated customer service. These models, which are able to recognize complex relationships between input and output sequences, are crucial for optimizing chatbot responses. Central to these mechanisms are neural attention weights that determine the focus of the model during sequence generation. Despite their widespread use, there remains a gap in the comparative analysis of different attention weighting functions within seq2seq models, particularly in the domain of chatbots using the Customer Support Twitter (CST) dataset. This study addresses this gap by evaluating four distinct attention-scoring functions—dot, multiplicative/general, additive, and an extended multiplicative function with a tanh activation parameter — in neural generative seq2seq models. Utilizing the CST dataset, these models were trained and evaluated over 10 epochs with the AdamW optimizer. Evaluation criteria included validation loss and BLEU scores implemented under both greedy and beam search strategies with a beam size of k=3. Results indicate that the model with the tanh-augmented multiplicative function significantly outperforms its counterparts, achieving the lowest validation loss (1.136484) and the highest BLEU scores (0.438926 under greedy search, 0.443000 under beam search, k=3). These results emphasize the crucial influence of selecting an appropriate attention-scoring function in improving the performance of seq2seq models for chatbots. Particularly, the model that integrates tanh activation proves to be a promising approach to improve the quality of chatbots in the customer support context.

Keywords: attention weight, chatbot, encoder-decoder, neural generative attention, score function, sequence-to-sequence

Procedia PDF Downloads 65

Authors: Wen Chiat Lee, K. Kuperan Viswanathan

Abstract:

Illegal, Unreported and unregulated (IUU) fishing brings great losses to the economies of the fishing nations. Understanding the reasons contributing to IUU fishing is crucial in reducing it. Economic, institutional and social factors are key drivers of IIU fishing. The economic factor is the main contributor to IUU fishing. The two possible ways to curb the IUU fishing is highlighted. One way is to reduce the revenue from IUU fishing and another way is to increase the cost of IUU fishing. There are three costs of IUU fishing that can be increased namely the operating, capital and risk costs. Approaches for reducing the economic rent or profit from IUU fishing are developed and directions for reducing IUU fishing are also suggested. Improved registration of fishing vessels, preventing entry of illegal fish products and most importantly, developing co-management of fisheries are the ways forward for reducing IUU fishing. All governments in ASEAN must work in tandem with the stakeholders involved such as fishers, fishermen agencies or associations to exchange information for reducing the transaction cost of IUU fishing.

Keywords: Illegal, unreported and unregulated (IUU) fishing, co-management, fisheries management, economic rent framework

Procedia PDF Downloads 218

Authors: Abdelghani Leghouchi

Abstract:

This study aims to predict the consequences associated with the propagation of the flood wave that may occur after the failure of the Taksebt dam and suggest an efficient emergency action plan (EAP) for mitigation purposes. To achieve the objectives of this study, the hydrodynamic model HEC-RAS 2D was used for the flood routing of the dam break wave, which gave an estimate of the hydraulic characteristics downstream the Taksebt dam. Geospatial analysis of the simulation results conducted in a Geographic information system (GIS) environment showed that many residential areas are considered to be in danger in case of the Taksebt dam break event. Based on the obtained results, an emergency actions plan was suggested to moderate the causalities in the downstream area at risk. Overall, the present study showed that the integration of 2D hydraulic modeling and GIS provides great capabilities in providing realistic view of the dam break wave propagation that enhances assessing the associated risks and proposing appropriate mitigation measures.

Keywords: taksebt dam, dam break, wave propagation time, HEC-RAS 2D

Procedia PDF Downloads 91

Authors: A. Ardianto, M. A. Putera Agung, S. Pramusandi

Abstract:

Power waterway is one of dam structures and as an intake vertical tunnel or well function for hydroelectric power plants in Jatigede area, Sumedang, West Java. Gate shaft is also one of parts the power waterway system. The paper concerns some consideration in determining a critical state parameter on the back stability analysis of gate shaft or excavation wall stability during excavation. Study analysis was carried out using without and with reinforcement system. Results study showed that reinforcement shaft could reduce the total displacement and safety factor could increases significantly. Based on the back calculation results, it was recommended to install some reinforcement materials and drainage system to reduce pore water pressure.

Keywords: power waterway, reinforcement, displacement, safety

Procedia PDF Downloads 393

Authors: Devineni Vijay Bhaskar, Yendluri Raja

Abstract:

We recommend a model for traffic sign detection stranded on Convolutional Neural Networks (CNN). We first renovate the unique image into the gray scale image through with support vector machines, then use convolutional neural networks with fixed and learnable layers for revealing and understanding. The permanent layer can reduction the amount of attention areas to notice and crop the limits very close to the boundaries of traffic signs. The learnable coverings can rise the accuracy of detection significantly. Besides, we use bootstrap procedures to progress the accuracy and avoid overfitting problem. In the German Traffic Sign Detection Benchmark, we obtained modest results, with an area under the precision-recall curve (AUC) of 99.49% in the group “Risk”, and an AUC of 96.62% in the group “Obligatory”.

Keywords: convolutional neural network, support vector machine, detection, traffic signs, bootstrap procedures, precision-recall curve

Procedia PDF Downloads 100

Authors: Naoyuki Sugihashi, Toshiharu Kishi

Abstract:

The probability of occurrence of thermal cracks in mass concrete in Japan is evaluated by the cracking probability diagram that represents the relationship between the thermal cracking index and the probability of occurrence of cracks in the actual structure. In this paper, we propose a method to directly calculate the cracking probability, following a probabilistic theory by modeling the variance of tensile stress and tensile strength. In this method, the relationship between the variance of tensile stress and tensile strength, the thermal cracking index, and the cracking probability are formulated and presented. In addition, standard deviation of tensile stress and tensile strength was identified, and the method of calculating cracking probability in a general construction controlled environment was also demonstrated.

Keywords: thermal crack control, mass concrete, thermal cracking probability, durability of concrete, calculating method of cracking probability

Procedia PDF Downloads 322