Search results for: innovation outcomes

Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev

Abstract:

Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.

Keywords: anesthesia, mastectomies, robotic, hypercarbia

Procedia PDF Downloads 104

Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

Abstract:

Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

Procedia PDF Downloads 254

Authors: Kay Fielden, Eelin Tan, Lan Nguyen

Abstract:

In this research project, data was gathered at a Covid 19 Conference held in June 2021 from industry leaders who discussed the impact of the global pandemic on the status of the New Zealand hospitality industry. Panel discussions on financials, human resources, health and safety, and recovery were conducted. The themes explored for the finance panel were customer demographics, hospitality sectors, financial practices, government impact, and cost of compliance. The aim was to see how the hospitality industry has responded to the global pandemic and the steps that have been taken for the industry to recover or sustain their business. The main research question for this qualitative study is: What are the factors that have impacted on finance for the hospitality industry in New Zealand due to Covid 19? For financials, literature has been gathered to study global effects, and this is being compared with the data gathered from the discussion panel through the lens of resilience theory. Resilience theory applied to the hospitality industry suggests that the challenges imposed by Covid 19 have been the catalyst for government initiatives, technical innovation, engaging local communities, and boosting confidence. Transformation arising from these ground shifts have been a move towards sustainability, wellbeing, more awareness of climate change, and community engagement. Initial findings suggest that there has been a shift in customer base that has prompted regional accommodation providers to realign offers and to become more flexible to attract and maintain this realigned customer base. Dynamic pricing structures have been required to meet changing customer demographics. Flexible staffing arrangements include sharing staff between different accommodation providers, owners with multiple properties adopting different staffing arrangements, maintaining a good working relationship with the bank, and conserving cash. Uncertain times necessitate changing revenue strategies to cope with external factors. Financial support offered by the government has cushioned the financial downturn for many in the hospitality industry, and managed isolation and quarantine (MIQ) arrangements have offered immediate financial relief for those hotels involved. However, there is concern over the long-term effects. Compliance with mandated health and safety requirements has meant that the hospitality industry has streamlined its approach to meeting those requirements and has invested in customer relations to keep paying customers informed of the health measures in place. Initial findings from this study lie within the resilience theory framework and are consistent with findings from the literature.

Keywords: global pandemic, hospitality industry, new Zealand, resilience

Procedia PDF Downloads 96

Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

Abstract:

This paper reports on teenage motherhood and its adverse outcomes on the academic performance, emotional well-being and sexual relationships that adolescent females encounter. Drawing from Ryff’s six dimensions of psychological well-being and Bronfenbrenner’s ecological model which underpinned this study, teenage motherhood has been found to link with multiple factors such as poverty, negative self-esteem, substance abuse, cohabitation, intimate partner violence and ill-health. Furthermore, research indicates that in schools where educators fail to perform their duties as loco-parentis to motivate adolescent females learners who are mothers, absenteeism, poor academic performance and learned helplessness, are likely. The aim of this research was two-fold, namely; (i) to determine the impact of teenage motherhood on the psychological well-being of the teenage mothers and (ii) to investigate the policies which protect the human rights of teenage mothers attending secondary schools. In a qualitative study conducted in one secondary school, Fort Beaufort, Eastern Cape, South Africa, fifteen Xhosa-speaking teenage mothers, aged 15-18 years old, were interviewed. The sample was recruited by means of snow-ball sampling. To safeguard the human dignity of the respondents, informed consent, confidentiality, anonymity and privacy of the respondents were assured. For trustworthiness, this research ensured that credibility, neutrality, and transferability, are met. Following an axial and open coding of responses, five themes were identified; Health issues of teenage mothers, lack of support, violation of human rights, impaired sense of purpose in life and intimate partner-violence. From these findings, it is clear that teenage mothers lack resilience and are susceptible to contract sexually transmitted infections and HIV/AIDS because they are submissive and hopeless. Furthermore, owing to stigma that the teenage mothers' experience from family members, they resort to alcohol and drug abuse, and feel demotivated to bond with their babies. In conclusion, the recommendations are that the Health and Social Development departments collaborate to empower the psychological well-being of teenage mothers. Furthermore, school policies on discrimination should be enacted and consistently implemented.

Keywords: depression, discrimination, self-esteem, teenage mothers

Procedia PDF Downloads 268

Authors: Bilge Ozel

Abstract:

Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

Procedia PDF Downloads 263

Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

Abstract:

Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

Procedia PDF Downloads 167

Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

Abstract:

Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

Procedia PDF Downloads 112

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

Procedia PDF Downloads 106

Authors: Aisha Adam

Abstract:

This study critically examines the transformative impact of automated decision-making (ADM) and artificial intelligence (AI) systems on South African labour law. As AI technologies increasingly infiltrate workplaces, existing liability frameworks face challenges in addressing the unique complexities presented by these innovations. This article explores the necessity of redefining liability to accommodate the nuanced landscape of ADM and AI within South African labour law. It emphasises the importance of ensuring responsible deployment and safeguarding the rights of workers amid evolving technological dynamics. This research investigates the central concern of fairness, bias, and discrimination in ADM and AI decision-making. Focusing on algorithmic bias and discriminatory outcomes, the paper advocates for the integration of mechanisms within the South African legal framework, particularly under the Promotion of Equality and Prevention of Unfair Discrimination Act (PEPUDA) and the Employment Equity Act (EEA). The study scrutinises the shifting dynamics of the employment relationship, calling for clear guidelines on the responsibilities and liabilities of employers, employees, and technology providers. Furthermore, the article analyses legal and policy responses to ADM and AI within South African labour law, exploring potential amendments to legislation, guidelines, and codes of practice. It assesses the role of regulatory bodies, specifically the Commission for Conciliation, Mediation, and Arbitration (CCMA), in overseeing and enforcing responsible practices in the workplace. Lastly, the research evaluates the impact of ADM and AI on human and social rights in the South African context. Emphasising the protection of constitutional rights, including fair labour practices, privacy, and equality, the study proposes remedies and safeguards. It advocates for a multidisciplinary approach involving legal, technological, and ethical considerations to redefine liability in South African labour law effectively. The article contends that a shift from accountability to responsibility is crucial for promoting fairness, antidiscrimination, and the protection of human and social rights in the age of automated decision-making. It calls for collaborative efforts among stakeholders to shape responsible practices and redefine liability in this evolving technological landscape.

Keywords: automated decision-making, artificial intelligence, labour law, vicarious liability

Procedia PDF Downloads 79

Authors: Anna-Akrivi Thomatou, Anastasios Zotos, Eleni C. Mazarakioti, Efthimios Kokkotos, Achilleas Kontogeorgos, Athanasios Ladavos, Angelos Patakas

Abstract:

It is well known that accurate determination of geographic origin to confront mislabeling and adulteration of foods is considered as a critical issue worldwide not only for the consumers, but also for producers and industries. Among agricultural products, rice (Oryza sativa L.) is the world’s third largest crop, providing food for more than half of the world’s population. Consequently, the quality and safety of rice products play an important role in people’s life and health. Despite the fact that rice is predominantly produced in Asian countries, rice cultivation in Greece is of significant importance, contributing to national agricultural sector income. More than 25,000 acres are cultivated in Greece, while rice exports to other countries consist the 0,5% of the global rice trade. Although several techniques are available in order to provide information about the geographical origin of rice, little data exist regarding the ability of these methodologies to discriminate rice production from Greece. Thus, the aim of this study is the comparative evaluation of stable isotope ratio methodology regarding its discriminative ability for geographical origin determination of rice samples produced in Greece compared to those from three other Asian countries namely Korea, China and Philippines. In total eighty (80) samples were collected from selected fields of Central Macedonia (Greece), during October of 2021. The light element (C, N, S) isotope ratios were measured using Isotope Ratio Mass Spectrometry (IRMS) and the results obtained were analyzed using chemometric techniques, including principal components analysis (PCA). Results indicated that the 𝜹 15N and 𝜹 34S values of rice produced in Greece were more markedly influenced by geographical origin compared to the 𝜹 13C. In particular, 𝜹 34S values in rice originating from Greece was -1.98 ± 1.71 compared to 2.10 ± 1.87, 4.41 ± 0.88 and 9.02 ± 0.75 for Korea, China and Philippines respectively. Among stable isotope ratios studied, values of 𝜹 34S seem to be the more appropriate isotope marker to discriminate rice geographic origin between the studied areas. These results imply the significant capability of stable isotope ratio methodology for effective geographical origin discrimination of rice, providing a valuable insight into the control of improper or fraudulent labeling. Acknowledgement: This research has been financed by the Public Investment Programme/General Secretariat for Research and Innovation, under the call “YPOERGO 3, code 2018SE01300000: project title: ‘Elaboration and implementation of methodology for authenticity and geographical origin assessment of agricultural products.

Keywords: geographical origin, authenticity, rice, isotope ratio mass spectrometry

Procedia PDF Downloads 82

Authors: Sonia Saddiqui, Maya Marcus

Abstract:

UTS STEAMpunk Girls is an educational program for young women (aged 12-16), to empower them to be more informed and active members of the 21st century workforce. With the number of STEM graduates on the decline, especially among young women, an additional aim of the program is to trial a STEAM (Science, Technology, Engineering, Arts/Humanities/Social Sciences, Mathematics), inter-disciplinary approach to improving STEM engagement. In-line with UNESCO’s recent focus on promoting ‘transversal competencies’ in future graduates, the program utilised co-design, project-based learning, entrepreneurial processes, and inter-disciplinary learning. The program consists of two phases. Taking a participatory design approach, the first phase (co-design workshops) provided valuable insight into student perspectives around engaging young women in STEM and inter-disciplinary thinking. The workshops positioned 26 young women from three schools as subject matter experts (SMEs), providing a platform for them to share their opinions, experiences and findings around the STEAM disciplines. The second (pilot) phase put the co-design phase findings into practice, with 64 students from four schools working in groups to articulate problems with real-world implications, and utilising design-thinking to solve them. The pilot phase utilised project-based learning to engage young women in entrepreneurial and STEAM frameworks and processes. Scalable program design and educational resources were trialed to determine appropriate mechanisms for engaging young women in STEM and in STEAM thinking. Across both phases, data was collected via longitudinal surveys to obtain pre-program, baseline attitudinal information, and compare that against post-program responses. Preliminary findings revealed students’ improved understanding of the STEM disciplines, industries and professions, improved awareness of STEAM as a concept, and improved understanding regarding inter-disciplinary and design thinking. Program outcomes will be of interest to high-school educators in both STEM and the Arts, Humanities and Social Sciences fields, and will hopefully inform future programmatic approaches to introducing inter-disciplinary STEAM learning in STEM curriculum.

Keywords: co-design, STEM, STEAM, project-based learning, inter-disciplinary

Procedia PDF Downloads 195

Authors: Ling-Lang Huang

Abstract:

Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

Procedia PDF Downloads 119

Authors: Lindsay Foreman

Abstract:

Introduction: Goals have become synonymous with the quest for the good life and the pursuit of happiness, with coaching and positive psychology gaining popularity as an approach in recent decades. And yet mental health is on the rise and the leading cause of disability, wellbeing is on the decline, stress is leading to 50-60% of workday absences and the need for action is indisputable and urgent. Purpose: The purpose of this study is to better understand two things we cannot see, but that play the most significant role in these outcomes - what we think and how we feel. With many working on the assumption that positive thinking and an optimistic outlook are necessary or valuable components of goal pursuit, this study uncovers the reality of the ‘inner-game’ from the coachee's perspective. Method: With a mixed methods design using a Q Method study of subjectivity to ‘make the unseen seen’. First, a wide-ranging universe of subjective thoughts and feelings experienced during goal pursuit are explored. These are generated from literature and a Qualtrics survey to create a Q-Set of 40 statements. Then 19 participants in professional and organisational settings offer their perspectives on these 40 Q-Set statements. Each rank them in a semi-forced distribution from ‘most like me’ to ‘least like me’ using Q-Sort software. From these individual perspectives, clusters of perspectives are identified using factor analysis and four distinct viewpoints have emerged. Findings: These Goal Pursuit Viewpoints offer insight into the states and self-talk experienced by coachees and may not reflect the assumption of positive thinking associated with achieving goals. The four Viewpoints are 1) the Optimistic View, 2) the Realistic View 3) The Dreamer View and 4) The Conflicted View. With only a quarter of the Dreamer View, and a third of the Optimistic view going on to achieve their goals, these assumptions need review. And with all the Realistic Views going on to achieve their goals, the role of self-doubt, overwhelm and anxiousness in goal achievement cannot be overlooked. Contribution: This study offers greater insight and understanding of people's inner experiences as they pursue goals and highlights the necessary and normal negative states associated with goal achievement. It also offers a practical tool of the Q-set statements to help coaches and coachees explore the current state and help navigate the journey towards goal achievement. It calls into question whether goals should always be part of coaching and if values, identity, and purpose may play a greater role than goals.

Keywords: coaching, goals, positive psychology, mindset, leadership, mental health, beliefs, cognition, emotional intelligence

Procedia PDF Downloads 112

Authors: Amr S. Fahil, Eman Ghoneim

Abstract:

Egypt made significant efforts during the past few years to discover significant renewable energy sources. Regions in Egypt that have been identified for geothermal potential investigation include the Gulf of Suez and the Western Desert. One of the most promising sites for the development of Egypt's Northern Western Desert is Siwa Oasis. The geological setting of the oasis, a tectonically generated depression situated in the northernmost region of the Western desert, supports the potential for substantial geothermal resources. Field data obtained from 27 deep oil wells along the Western Desert included bottom-hole temperature (BHT) depth to basement measurements, and geological maps; data were utilized in this study. The major lithological units, elevation, surface gradient, lineaments density, and remote sensing multispectral and topographic were mapped together to generate the related physiographic variables. Eleven thematic layers were integrated in a geographic information system (GIS) to create geothermal maps to aid in the detection of significant potential geothermal spots along the Siwa Oasis and its vicinity. The contribution of total magnetic intensity data with reduction to the pole (RTP) to the first investigation of the geothermal potential in Siwa Oasis is applied in this work. The integration of geospatial data with magnetic field measurements showed a clear correlation between areas of high heat flow and magnetic anomalies. Such anomalies can be interpreted as related to the existence of high geothermal energy and dense rock, which also have high magnetic susceptibility. The outcomes indicated that the study area has a geothermal gradient ranging from 18 to 42 °C/km, a heat flow ranging from 24.7 to 111.3 m.W. k−1, a thermal conductivity of 1.3–2.65 W.m−1.k−1 and a measured amplitude temperature maximum of 100.7 °C. The southeastern part of the Siwa Oasis, and some sporadic locations on the eastern section of the oasis were found to have significant geothermal potential; consequently, this location is suitable for future geothermal investigation. The adopted method might be applied to identify significant prospective geothermal energy locations in other regions of Egypt and East Africa.

Keywords: magnetic data, SRTM, depth to basement, remote sensing, GIS, geothermal gradient, heat flow, thermal conductivity

Procedia PDF Downloads 103

Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

Abstract:

Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

Procedia PDF Downloads 450

Authors: Samuel Owoade, Zainab Idowu, Idris Ajibade, Abel Uzoka

Abstract:

Cloud computing adoption continues to soar, with 83% of enterprise workloads estimated to be in the cloud by 2022. However, this rapid migration raises security concerns, needing strong security management solutions to safeguard sensitive data and essential applications. This paper investigates the critical role of technical project managers in orchestrating security management initiatives for cloud environments, evaluating their responsibilities, challenges, and best practices for assuring the resilience and integrity of cloud infrastructures. Drawing from a comprehensive review of industry reports and interviews with cloud security experts, this research highlights the multifaceted landscape of security management in cloud environments. Despite the rapid adoption of cloud services, only 25% of organizations have matured their cloud security practices, indicating a pressing need for effective management strategies. This paper proposes a strategy framework adapted to the demands of technical project managers, outlining the important components of effective cloud security management. Notably, 76% of firms identify misconfiguration as a major source of cloud security incidents, underlining the significance of proactive risk assessment and constant monitoring. Furthermore, the study emphasizes the importance of technical project managers in facilitating cross-functional collaboration, bridging the gap between cybersecurity professionals, cloud architects, compliance officers, and IT operations teams. With 68% of firms seeing difficulties integrating security policies into their cloud systems, effective communication and collaboration are critical to success. Case studies from industry leaders illustrate the practical use of security management projects in cloud settings. These examples demonstrate the importance of technical project managers in using their expertise to address obstacles and generate meaningful outcomes, with 92% of firms reporting improved security practices after implementing proactive security management tactics. In conclusion, this research underscores the critical role of technical project managers in safeguarding cloud environments against evolving threats. By embracing their role as guardians of the cloud realm, project managers can mitigate risks, optimize resource utilization, and uphold the trust and integrity of cloud infrastructures in an era of digital transformation.

Keywords: cloud security, security management, technical project management, cybersecurity, cloud infrastructure, risk management, compliance

Procedia PDF Downloads 48

Authors: Abdurahman Anwar Shfa

Abstract:

Addis Ababa is among the fastest-growing urban areas in the country. There are many new constructions of public and private condominiums and large new low rising residential buildings for residents. But the wide range of heaving problems of expansive soil in the city become a major difficulty for the construction sector, especially in low rising buildings, by causing different problems such as distortion and cracking of floor slabs, cracks in grade beams, and walls, jammed or misaligned Doors and Windows; failure of blocks supporting grade beams. Hence an attractive and economical design solution may be required for such type of problem. Therefore, this research works to publicize a recent innovation called the Granular Anchor Pile system for the reduction of the heave effect of expansive soil. This research is written for the objective of numerical investigation of the behavior of Granular Anchor Pile under the heave using Finite element analysis PLAXIS 3D program by means of studying the effect of different parameters like length of the pile, diameter of pile, and pile group by applying prescribed displacement of 10% of pile diameter at the center of granular pile anchor. An additional objective is examining the suitability of Granular Anchor Pile as an alternative solution for heave problems in expansive soils mostly for low rising buildings found in Addis Ababa City, especially in Bole Sub-City, by considering different factors such as the local availability of construction materials, economy for the construction, installation process condition, environmental benefit, time consumption and performance of the pile. Accordingly, the performance of the pile improves when the length of the pile increases. This is due to an increase in the self-weight of the pile and friction mobilized between the pile and soil interface. Additionally, the uplift capacity of the pile decreases when increasing the pile diameter and spacing between the piles in the group due to a reduction in the number of piles in the group. But, few cases show that the uplift capacity of the pile increases with increasing the pile diameter for a constant number of piles in the group and increasing the spacing between the pile and in the case of single pile capacity. This is due to the increment of piles' self-weight and surface area of the pile group and also the decrement of stress overlap in the soil caused by piles respectively. According to the suitability analysis, it is observed that Granular Anchor Pile is sensible or practical to apply for the actual problem of Expansive soil in a low rising building constructed in the country because of its convenience for all considerations.

Keywords: expansive soil, granular anchor pile, PLAXIS, suitability analysis

Procedia PDF Downloads 27

Authors: Muhammad Younas, Zimal Naveed

Abstract:

Introduction : TB is caused by the bacillus Mycobacterium tuberculosis, which is spread when people who are sick with TB expel bacteria into the air (e.g. by coughing). The 30 high TB burden countries accounted for 87% of all estimated incident cases worldwide, and eight of these countries accounted for more than two thirds of the global total: India (27%), Indonesia (10%), China (7.1%), the Philippines (7.0%), Pakistan (5.7%), Nigeria (4.5%), Bangladesh (3.6%) and the Democratic Republic of the Congo (3.0%). Objective : To analyze prevalence of tuberculosis among the people who presented at THQ hospital Bhalwal between April 2024 to June 2024. Method : Total of 9200 patients presented in the OPD of THQ hospital Bhalwal were included in the study. These presumed cases underwent diagnostic testing by sputum for AFB, Gene expert and chest x rays. The data was then classified based Pulmonary and Extra-pulmonary TB disease and further classified on the basis of bacteriology positive and clinically diagnosed TB. The registered TB cases were then classified in 8 age groups in years and according to the gender. All the registered TB cases were then tested for HIV to observe the relation between Tuberculosis and HIV. Results : The total of 9200 patients presented to OPD during the period of 3 months between April 2024 to June 2024. Total registered cases of Tuberculosis were 161 (comprising 153 new cases and 8 cases after treatment failure). Out of the new cases 83 were males and 70 female cases were identified. The majority of males that were identified lies between age 55-64 and 65 and above while the majority of females that were diagnosed lies in the age group of 5-14 and 15-24. All the registered cases were then tested for HIV but none of them were found to be positive. Conclusion : According to World Health Organisation Global Tuberculosis Report, the incidence of Tubeculosis per 100000 people was 258, equivalent to 0.258 %. However, the study reveals an exceptionally high frequency of TB cases. The prevalence of Tuberculosis per 100000 people was found to be 1750 which is equivalent to 1.75 %. The study revealed that larger proportion of the population is currently affected by TB compared to the global average incidence reported by the WHO. The findings of the study indicates that the prevalence of tuberculosis (TB) among females is most common in the younger population, specifically between the ages of 5 to 24, and particularly within the peak fertility age group of 15 to 24 years. The health of women in their peak fertility years is crucial for maternal and child health outcomes. This highlights the need for targeted public health interventions in this area to manage and reduce the burden of TB.

Keywords: AGE, AFB, female, male

Procedia PDF Downloads 29

Authors: Jaleh Mohammad Aliha, Rezvan Razazi, Nasim Naderi

Abstract:

Introduction: Despite the progress in new effective drugs in the treatment of heart failure, the disease still accompanied with frequent hospitalization, impaired quality of life, early mortality and significant economic burden. Patients with chronic disease and consequently patients with heart failure need the knowledge and optimal health literacy to improve the quality of life and minimize the rate of rehopitalizatio. So, considering to importance of knowledge and health literacy in this patients as well as contradictory literature, this study conducted to investigate the relationship between health literacy and Knowledge of heart failure with rehospitalization in patients with heart failure admitted to heart failure clinic in Rajai Heart center in 1394. Methods: The cross-sectional method with convenience sampling method was used in this study. After obtaining the necessary permissions from the ethics committee and the Shahid Rajai Heart center, 238 patients who were older than 18 years and had ejection fraction 35% or less with the ability to read and write and lack of psychiatric, neurological and cognitive disorders and signed the informed consent were recruited. Data collection were perfomed through demographic data questionnaire, short standard health literacy questionnaire 'Short-TOFHLA-16' and Vanderwall (2005) knowledge of heart failure questionnaire. Reliability was assessed by internal consistency method and Cronbach's alpha for both questionnaires was more than 0.7. Then data were analysed by SPSS-20 with descriptive statistic and analytical statistic such as T-test, Chi-square and ANOVA. Results: The majority of patients were male (66%), married (80%) and had age between 50 to 70 years old (42%). The majority of studied men and women have good health literacy and About half of them have adequate knowledge about heart failure. Fisher's exact test showed that there was a significant statistical correlation between health literacy and knowlegh about heart failure. In other words, higher health literacy associated with more knowledge about their condition. Also findings showed that there was no significant statistical correlation between health literacy and knowledge about heart failure and frequency of CCU and emergency admissions. Conclusion: The study results showed that the higher health literacy, associated with the greater knowledge about heart failure and patients' perception about caring recommendations and disease outcomes. Therefore, the knowledge about heart failure and factors which related to severity of the disease, is the important issue to problem identification and treatment and reduction of rehospitalization.

Keywords: health literacy, heart failure, knowlegde, rehospitalization

Procedia PDF Downloads 397

Authors: Yu-Wen Chen, Szu-Wei Huang, Chung-Hsiang Mu, Kelvin Cheng

Abstract:

This paper developed a data-driven based model to deal with the causality between the Continuous Emission Monitoring System (CEMS, by Environmental Protection Administration, Taiwan) in industrial factories, and the air quality around environment. Compared to the heavy burden of traditional numerical models of regional weather and air pollution simulation, the lightweight burden of the proposed model can provide forecasting hourly with current observations of weather, air pollution and emissions from factories. The observation data are included wind speed, wind direction, relative humidity, temperature and others. The observations can be collected real time from Open APIs of civil IoT Taiwan, which are sourced from 439 weather stations, 10,193 qualitative air stations, 77 national quantitative stations and 140 CEMS quantitative industrial factories. This study completed a causal inference engine and gave an air pollution forecasting for the next 12 hours related to local industrial factories. The outcomes of the pollution forecasting are produced hourly with a grid resolution of 1km*1km on IIoTC (Industrial Internet of Things Cloud) and saved in netCDF4 format. The elaborated procedures to generate forecasts comprise data recalibrating, outlier elimination, Kriging Interpolation and particle tracking and random walk techniques for the mechanisms of diffusion and advection. The solution of these equations reveals the causality between factories emission and the associated air pollution. Further, with the aid of installed real-time flue emission (Total Suspension Emission, TSP) sensors and the mentioned forecasted air pollution map, this study also disclosed the converting mechanism between the TSP and PM2.5/PM10 for different region and industrial characteristics, according to the long-term data observation and calibration. These different time-series qualitative and quantitative data which successfully achieved a causal inference engine in cloud for factory management control in practicable. Once the forecasted air quality for a region is marked as harmful, the correlated factories are notified and asked to suppress its operation and reduces emission in advance.

Keywords: continuous emission monitoring system, total suspension particulates, causal inference, air pollution forecast, IoT

Procedia PDF Downloads 81

Authors: Felix Golla

Abstract:

In an era where technology increasingly intersects with education, the potential of chatbots and ChatGPT agents in enhancing student learning experiences in higher education is both significant and timely. This study explores the integration of these AI-driven tools in educational settings, emphasizing their design and functionality to meet the specific needs of students. Recognizing the gap in literature concerning student-centered AI applications in education, this research offers valuable insights into the role and efficacy of chatbots and ChatGPT agents as educational tools. Employing qualitative research methodologies, the study involved conducting semi-structured interviews with university students. These interviews were designed to gather in-depth insights into the students' experiences and expectations regarding the use of AI in learning environments. The High-Performance Cycle Model, renowned for its focus on goal setting and motivation, served as the theoretical framework guiding the analysis. This model helped in systematically categorizing and interpreting the data, revealing the nuanced perceptions and preferences of students regarding AI tools in education. The major findings of the study indicate a strong preference among students for chatbots and ChatGPT agents that offer personalized interaction, adaptive learning support, and regular, constructive feedback. These features were deemed essential for enhancing student engagement, motivation, and overall learning outcomes. Furthermore, the study revealed that students perceive these AI tools not just as passive sources of information but as active facilitators in the learning process, capable of adapting to individual learning styles and needs. In conclusion, this study underscores the transformative potential of chatbots and ChatGPT agents in higher education. It highlights the need for these AI tools to be designed with a student-centered approach, ensuring their alignment with educational objectives and student preferences. The findings contribute to the evolving discourse on AI in education, suggesting a paradigm shift towards more interactive, responsive, and personalized learning experiences. This research not only informs educators and technologists about the desirable features of educational chatbots but also opens avenues for future studies to explore the long-term impact of AI integration in academic curricula.

Keywords: chatbot design in education, high-performance cycle model application, qualitative research in AI, student-centered learning technologies

Procedia PDF Downloads 63

Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

Abstract:

Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

Procedia PDF Downloads 206

Authors: E. Nigris, F. Passalacqua

Abstract:

Relating to the recent researches in the field of faculty development, this paper aims to present a pilot training programme realized at the University of Milano-Bicocca to improve teaching skills of faculty members. A total of 57 professors (both full professors and associate professors) were trained during the pilot programme in three editions of the workshop, focused on promoting skills for teaching large classes. The study takes into account: 1) the theoretical framework of the programme which combines the recent tradition about professional development and the research on in-service training of school teachers; 2) the structure and the content of the training programme, organized in a 12 hours-full immersion workshop and in individual consultations; 3) the educational specificity of the training programme which is based on the relation between 'general didactic' (active learning metholodies; didactic communication) and 'disciplinary didactics' (didactic transposition and reconstruction); 4) results about the impact of the training programme, both related to the workshop and the individual consultations. This study aims to provide insights mainly on two levels of the training program’s impact ('behaviour change' and 'transfer') and for this reason learning outcomes are evaluated by different instruments: a questionnaire filled out by all 57 participants; 12 in-depth interviews; 3 focus groups; conversation transcriptions of workshop activities. Data analysis is based on a descriptive qualitative approach and it is conducted through thematic analysis of the transcripts using analytical categories derived principally from the didactic transposition theory. The results show that the training programme developed effectively three major skills regarding different stages of the 'didactic transposition' process: a) the content selection; a more accurated selection and reduction of the 'scholarly knowledge', conforming to the first stage of the didactic transposition process; b) the consideration of students’ prior knowledge and misconceptions within the lesson design, in order to connect effectively the 'scholarly knowledge' to the 'knowledge to be taught' (second stage of the didactic transposition process); c) the way of asking questions and managing discussion in large classrooms, in line with the transformation of the 'knowledge to be taught' in 'taught knowledge' (third stage of the didactic transposition process).

Keywords: didactic communication, didactic transposition, instructional development, teaching large classroom

Procedia PDF Downloads 136

Authors: Ramin Tafazzoli, Rahime Zamanfashami, Amir Mohagheghzadeh

Abstract:

Entrepreneurship is the driving engine of countries’ economic development and has a determinant role in the economic, social and cultural improvement of the societies. Entrepreneurship and its impact on countries’ destiny, result in the planner and policy makers’ attempts to explore and extend it in various aspects. These days, all countries follow their social capital development and human resource quality improvement to achieve the strategic national objectives, economic growth, value creation, cultural dynamism, civil excellence and social solidarity, pursuing the sustainable development based on innovation, entrepreneurial technology , knowledge management and knowledge-focused in various levels and areas. Because of the rapid economic and cultural changes in recent decades and also the emerged need for reinforcing the knowledge-based structures and wealth generation via knowledge, a convenient infrastructure is strongly required for generating science and technology. Devoting attention to entrepreneurship and training and fostering the students who have the essential abilities and skills for creating a suitable business unit, is one of the duties of each university. New expectations necessitate that universities in the development trend by way of entrepreneurship, play a prominent role. Since, higher education has an important role in training and fostering the specialist human resource in the society, attention to the academic entrepreneurship help to develop this issue better. The higher education, relying on its core mission (training and researching) be expected to help the path where exploit and apply the created capabilities and also to cause the development in the society. In this term, the higher education play an essential role to expanse and extent the entrepreneurial concepts by establishing the entrepreneurship universities. Therefore, it is necessary to constitute and establish the entrepreneurship university to solve the problems and improve the development trend. The entrepreneurial courses follow the objectives such as: informing, creating culture, entrepreneurial morality, technical knowledge, entrepreneurial skills transferring, preparing the audiences or researching, job creation, business establishing and its preservation. According to the vision 1404 of Islamic republic of Iran in which the society has to include the advanced knowledge in the field of technology and science generation and also economic growth. In this essay, we investigate the entrepreneurship concepts, entrepreneurship university characteristics, entrepreneurship organizations values, entrepreneurship education process, meanwhile paying attention to that fact which the university can play an essential role in entrepreneurs training by education, culture and science. At the end, we present some suggestion and some solution for obstacles, emphasizing on the vision.

Keywords: entrepreneurship, entrepreneur university, higher education, university

Procedia PDF Downloads 430

Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

Abstract:

Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

Procedia PDF Downloads 77

Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

Abstract:

Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

Procedia PDF Downloads 194

Authors: Lea Boidin, Martha Baydoun, Bertrand Leroux, Olivier Morales, Samir Acherar, Celine Frochot, Nadira Delhem

Abstract:

Ovarian cancer (OC) is one of the most defying diseases in gynecologic oncology. Even though surgery remains crucial in the therapy of patients with primary ovarian cancer, recurrent recidivism calls for the development of new therapy protocols to propose for patients dealing with this cancer. FRα is described as a tumor‐associated antigen in OC, where FRα expression is usually linked with more poorly differentiated, aggressive tumors. The Photodynamic treatment (PDT) available data have shown improvements in the uptake of small tumors and in the induction of a proper anti-tumoral immune response. In order to target specifically peritoneal metastatis, which overexpress FRα, a new-patented PS coupled with folic acid has been developed in our team. Herein we propose PDT using this new patented PS for PDT applied in an in vivo mice model. The efficacy of the treatment was evaluated in mice without and with PBMC reconstitution. Mice were divided into four groups: Non-Treated, PS, Light Only, and PDT Treated and subjected to illumination by laser set at 668nm with a duration of illumination of 45 minutes (or 1 min of illumination followed by 2 minutes of pause repeated 45 times). When mice were not reconstituted and after fractionized PDT protocol, a significant decrease in the tumor volume was noticed. An induction in the anti-tumoral cytokine IFNγ chaperoned this decrease while a subsequent inhibition in the cytokine TGFβ. Even more crucial, when mice were reconstituted and upon PDT, the fold of tumor decrease was even higher. An immune response was activated decoded with an increase in NK, CD3 +, LT helper and Cytotoxic T cells. Thereafter, an increase in the expression of the cytokines IFNγ and TNFα were noticed while an inhibition in TGFβ, IL8 and IL10 accompanied this immune response activation. Therefore, our work has shown for the first time that a fractionized PDT protocol using a folate-targeted PDT is effective for treatment of ovarian cancer. The interest in using PDT in this case, goes beyond the local induction of tumor apoptosis only, but can promote subsequent anti-tumor response. Most of the therapies currently used to treat ovarian cancer, have an uncooperative outcomes on the host immune response. The readiness of a tumor adjuvant treatment like PDT adequate in eliminating the tumor and in concert stimulating anti-tumor immunity would be weighty.

Keywords: folate receptor, ovarian cancer, photodynamic therapy, humanized mice model

Procedia PDF Downloads 103

Authors: Agnetha Schuchardt, Jennifer Hartmann, Laura Schulte, Roman Peperhove, Lars Gerhold

Abstract:

If critical infrastructures fail, even for a short period of time, it can have significant negative consequences for the affected population. This is especially true for the food sector that is strongly interlinked with other sectors like the power supply. A blackout could lead to several cities being without food supply for numerous days, simply because cash register systems do no longer work properly. Following the public opinion, securing the food supply in emergencies is considered a task of the state, however, in the German context, the key players are private enterprises and private households. Both are not aware of their responsibility and both cannot be forced to take any preventive measures prior to an emergency. This problem became evident to officials and politicians so that the law covering food security was revised in order to include private stakeholders into mitigation processes. The paper will present a scientific review of governmental and regulatory literature. The focus is the inclusion of the food industry through a law reform and the challenges that still exist. Together with legal experts, an analysis of regulations will be presented that explains the development of the law reform concerning food security and emergency storage in Germany. The main findings are that the existing public food emergency storage is out-dated, insufficient and too expensive. The state is required to protect food as a critical infrastructure but does not have the capacities to live up to this role. Through a law reform in 2017, new structures should to established. The innovation was to include the private sector into the civil defense concept since it has the required knowledge and experience. But the food industry is still reluctant. Preventive measures do not serve economic purposes – on the contrary, they cost money. The paper will discuss respective examples like equipping supermarkets with emergency power supply or self-sufficient cash register systems and why the state is not willing to cover the costs of these measures, but neither is the economy. The biggest problem with the new law is that private enterprises can only be forced to support food security if the state of emergency has occurred already and not one minute earlier. The paper will cover two main results: the literature review and an expert workshop that will be conducted in summer 2018 with stakeholders from different parts of the food supply chain as well as officials of the public food emergency concept. The results from this participative process will be presented and recommendations will be offered that show how the private economy could be better included into a modern food emergency concept (e. g. tax reductions for stockpiling).

Keywords: critical infrastructure, disaster control, emergency food storage, food security, private economy, resilience

Procedia PDF Downloads 182

Authors: Christian Skowronski, Andrew Shanholtzer, Brent Yelton, Muayad Almahariq, Daniel J. Krauss

Abstract:

Prostate cancer has the third highest incidence rate and is the second leading cause of cancer death for men in the United States. Of the diagnostic tools available for intermediate-risk prostate cancer, magnetic resonance imaging (MRI) provides superior soft tissue delineation serving as a valuable tool for both diagnosis and treatment planning. Currently, there is minimal data regarding the practical utility of MRI for evaluation of intermediate-risk prostate cancer. As such, the National Comprehensive Cancer Network’s guidelines indicate MRI as optional in intermediate-risk prostate cancer evaluation. This project aims to elucidate whether MRI affects radiation treatment decisions for intermediate-risk prostate cancer. This was a retrospective study evaluating 210 patients with intermediate-risk prostate cancer, treated with definitive radiotherapy at our institution between 2019-2020. NCCN risk stratification criteria were used to define intermediate-risk prostate cancer. Patients were divided into two groups: those with pretreatment prostate MRI, and those without pretreatment prostate MRI. We compared the use of external beam radiotherapy, brachytherapy alone, brachytherapy boost, and androgen depravation therapy between the two groups. Inverse probability of treatment weighting was used to match the two groups for age, comorbidity index, American Urologic Association symptoms index, pretreatment PSA, grade group, and percent core involvement on prostate biopsy. Wilcoxon Rank Sum and Chi-squared tests were used to compare continuous and categorical variables. Of the patients who met the study’s eligibility criteria, 133 had a prostate MRI and 77 did not. Following propensity matching, there were no differences between baseline characteristics between the two groups. There were no statistically significant differences in treatments pursued between the two groups: 42% vs 47% were treated with brachytherapy alone, 40% vs 42% were treated with external beam radiotherapy alone, 18% vs 12% were treated with external beam radiotherapy with a brachytherapy boost, and 24% vs 17% received androgen deprivation therapy in the non-MRI and MRI groups, respectively. This analysis suggests that pretreatment MRI does not significantly impact radiation therapy or androgen deprivation therapy decisions in patients with intermediate-risk prostate cancer. Obtaining a pretreatment prostate MRI should be used judiciously and pursued only to answer a specific question, for which the answer is likely to impact treatment decision. Further follow up is needed to correlate MRI findings with their impacts on specific oncologic outcomes.

Keywords: magnetic resonance imaging, prostate cancer, definitive radiotherapy, gleason score 7

Procedia PDF Downloads 85

Authors: Getenet Dessie, Jinhu Li, Son Nghiem, Tinh Doan

Abstract:

Background: Concerns regarding malnutrition have evolved from focusing solely on single forms to addressing the simultaneous occurrence of multiple types, commonly referred to as the double or triple burden of malnutrition. Nevertheless, data concerning the concurrent occurrence of various types of malnutrition are scarce. Therefore, this systematic review and meta-analysis aims to assess the pooled prevalence of the double burden of malnutrition among children under five in Sub-Saharan Africa and other least-developed countries (LDCs). Methods: Electronic, web-based searches were conducted from January 15 to June 28, 2023, across several databases, including PubMed, Embase, Google Scholar, and the World Health Organization's Hinari portal, as well as other search engines, to identify primary studies published up to June 28, 2023. Laboratory-based cross-sectional studies on children under the age of five were included. Two independent authors assessed the risk of bias and the quality of the identified articles. The primary outcomes of this study were micronutrient deficiencies and the comorbidity of stunting and anemia, as well as wasting and anemia. The random-effects model was utilized for analysis. The association of identified variables with the various forms of malnutrition was also assessed using adjusted odds ratios (AOR) with a 95% confidence interval (CI). This review was registered in PROSPERO with the reference number CRD42023409483. Findings: The electronic search generated 6,087 articles, 93 of which matched the inclusion criteria for the final meta-analysis. Micronutrient deficiencies were prevalent among children under five in Sub-Saharan Africa and other LDCs, with rates ranging from 16.63% among 25,169 participants for vitamin A deficiency to 50.90% among 3,936 participants for iodine deficiency. Iron deficiency anemia affected 20.56% of the 63,121 participants. The combined prevalence of wasting anemia and stunting anemia was 5.41% among 64,709 participants and 19.98% among 66,016 participants, respectively. Both stunting and vitamin A supplementation were associated with vitamin A and iron deficiencies, with adjusted odds ratios (AOR) of 1.54 (95% CI: 1.01, 2.37) and 1.37 (95% CI: 1.21, 1.55), respectively. Interpretation: The prevalence of the double burden of malnutrition among children under the age of five was notably high in Sub-Saharan Africa and other LDCs. These findings indicate a need for increased attention and a focus on understanding the factors influencing this double burden of malnutrition.

Keywords: children, Sub-Saharan Africa, least developed countries, double burden of malnutrition, systematic review, meta-analysis

Procedia PDF Downloads 75