Search results for: potential outcome
12482 The Effects of pH on the Electrochromism in Nickel Oxide Films
Authors: T. Taşköprü, M. Zor, E. Turan
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The advantages of nickel oxide as an electrochromic material are its good contrast of transmittance and its suitable use as a secondary electrochromic film with WO3 for electrochromic devices. Electrochromic nickel oxide film was prepared by using a simple and inexpensive chemical deposition bath (CBD) technique onto fluorine-doped tin oxide (FTO) coated glass substrates from nickel nitrate solution. The films were ace centered cubic NiO with preferred orientation in the (2 0 0) direction. The electrochromic (EC) properties of the films were studied as a function of pH (8, 9, 10 and 11) in an aqueous alkaline electrolyte (0.3 M KOH) using cyclic voltammetry (CV). The EC cell was formed with the following configuration; FTO/nickel oxide film/0.3 M KOH/Pt The potential was cycled from 0.1 to 0.6V at diffferent potential sweep rates in the range 10- 50 mV/s. The films exhibit anodic electrochromism, changing colour from transparent to black.CV results of a nickel oxide film showed well-resolved anodic current peak at potential; 45 mV and cathodic peak at potential 28 mV. The structural, morphological, and optical changes in NiO film following the CV were investigated by means of X-ray diffractometer (XRD), field emission electron microscopy (FESEM) and UV-Vis- NIR spectrophotometry. No change was observed in XRD, besides surface morphology undergoes change due to the electrical discharge. The change in tansmittance between the bleached and colored state is 68% for the film deposited with pH=11 precursor.Keywords: nickel oxide, XRD, SEM, cyclic voltammetry
Procedia PDF Downloads 29812481 Surgical Outcomes of Lung Cancer Surgery in Tasmania
Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar
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Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes
Procedia PDF Downloads 8512480 Application of Acid Base Accounting to Predict Post-Mining Drainage Quality in Coalfields of the Main Karoo Basin and Selected Sub-Basins, South Africa
Authors: Lindani Ncube, Baojin Zhao, Ken Liu, Helen Johanna Van Niekerk
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Acid Base Accounting (ABA) is a tool used to assess the total amount of acidity or alkalinity contained in a specific rock sample, and is based on the total S concentration and the carbonate content of a sample. A preliminary ABA test was conducted on 14 sandstone and 5 coal samples taken from coalfields representing the Main Karoo Basin (Highveld, Vryheid and Molteno/Indwe Coalfields) and the Sub-basins (Witbank and Waterberg Coalfields). The results indicate that sandstone and coal from the Main Karoo Basin have the potential of generating Acid Mine Drainage (AMD) as they contain sufficient pyrite to generate acid, with the final pH of samples relatively low upon complete oxidation of pyrite. Sandstone from collieries representing the Main Karoo Basin are characterised by elevated contents of reactive S%. All the studied samples were characterised by an Acid Potential (AP) that is less than the Neutralizing Potential (NP) except for two samples. The results further indicate that the sandstone from the Main Karoo Basin is prone to acid generation as compared to the sandstone from the Sub-basins. However, the coal has a relatively low potential of generating any acid. The application of ABA in this study contributes to an understanding of the complexities governing water-rock interactions. In general, the coalfields from the Main Karoo Basin have much higher potential to produce AMD during mining processes than the coalfields in the Sub-basins.Keywords: Main Karoo Basin, sub-basin, coal, sandstone, acid base accounting (ABA)
Procedia PDF Downloads 42812479 Two-Sided Information Dissemination in Takeovers: Disclosure and Media
Authors: Eda Orhun
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Purpose: This paper analyzes a target firm’s decision to voluntarily disclose information during a takeover event and the effect of such disclosures on the outcome of the takeover. Such voluntary disclosures especially in the form of earnings forecasts made around takeover events may affect shareholders’ decisions about the target firm’s value and in return takeover result. This study aims to shed light on this question. Design/methodology/approach: The paper tries to understand the role of voluntary disclosures by target firms during a takeover event in the likelihood of takeover success both theoretically and empirically. A game-theoretical model is set up to analyze the voluntary disclosure decision of a target firm to inform the shareholders about its real worth. The empirical implication of model is tested by employing binary outcome models where the disclosure variable is obtained by identifying the target firms in the sample that provide positive news by issuing increasing management earnings forecasts. Findings: The model predicts that a voluntary disclosure of positive information by the target decreases the likelihood that the takeover succeeds. The empirical analysis confirms this prediction by showing that positive earnings forecasts by target firms during takeover events increase the probability of takeover failure. Overall, it is shown that information dissemination through voluntary disclosures by target firms is an important factor affecting takeover outcomes. Originality/Value: This study is the first to the author's knowledge that studies the impact of voluntary disclosures by the target firm during a takeover event on the likelihood of takeover success. The results contribute to information economics, corporate finance and M&As literatures.Keywords: takeovers, target firm, voluntary disclosures, earnings forecasts, takeover success
Procedia PDF Downloads 31212478 A Randomized Control Trial Intervention to Combat Childhood Obesity in Negeri Sembilan: The Hebat! Program
Authors: Siti Sabariah Buhari, Ruzita Abdul Talib, Poh Bee Koon
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This study aims to develop and evaluate an intervention to improve eating habits, active lifestyle and weight status of overweight and obese children in Negeri Sembilan. The H.E.B.A.T! Program involved children, parents, and school and focused on behaviour and environment modification to achieve its goal. The intervention consists of H.E.B.A.T! Camp, parent’s workshop and school-based activities. A total of 21 children from intervention school and 22 children from control school who had BMI for age Z-score ≥ +1SD participated in the study. Mean age of subjects was 10.8 ± 0.3 years old. Four phases were included in the development of the intervention. Evaluation of intervention was conducted through process, impact and outcome evaluation. Process evaluation found that intervention program was implemented successfully with minimal modification and without having any technical problems. Impact and outcome evaluation was assessed based on dietary intake, average step counts, BMI for age z-score, body fat percentage and waist circumference at pre-intervention (T0), post-intervention 1 (T1) and post-intervention 2 (T2). There was significant reduction in energy (14.8%) and fat (21.9%) intakes (at p < 0.05) at post-intervention 1 (T1) in intervention group. By controlling for sex as covariate, there was significant intervention effect for average step counts, BMI for age z-score and waist circumference (p < 0.05). In conclusion, the intervention made an impact on positive behavioural intentions and improves weight status of the children. It is expected that the HEBAT! Program could be adopted and implemented by the government and private sector as well as policy-makers in formulating childhood obesity intervention.Keywords: childhood obesity, diet, obesity intervention, physical activity
Procedia PDF Downloads 28712477 Screening of Potential Sources of Tannin and Its Therapeutic Application
Authors: Mamta Kumari, Shashi Jain
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Tannins are a unique category of plant phytochemicals especially in terms of their vast potential health-benefiting properties. Researchers have described the capacity of tannins to enhance glucose uptake and inhibit adipogenesis, thus being potential drugs for the treatment of non-insulin dependent diabetes mellitus. Thus, the present research was conducted to find out tannin content of food products. The percentage of tannin in various analyzed sources ranged from 0.0 to 108.53%; highest in kathaa and lowest in ker and mango bark. The percentage of tannins present in the plants, however, varies. Numerous studies have confirmed that the naturally occurring polyphenols are key factor for the beneficial effects of the herbal medicines. Isolation and identification of active constituents from plants, preparation of standardized dose & dosage regimen can play a significant role in improving the hypoglycaemic action.Keywords: tannins, diabetes, polyphenols, antioxidant, hypoglycemia
Procedia PDF Downloads 38412476 Entrepreneurship Skills Acquisition through Education: Impact of the Nurturance of Knowledge, Skills, and Attitude on New Venture Creation
Authors: Satya Ranjan Acharya, Yamini Chandra
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Entrepreneurship through higher education has taken a paradigm shift from traditional classroom lecture series method to a modern approach, which lay emphasis on nurturing competencies, enhancing knowledge, skills, attitudes/abilities (KSA), which has positive impact on the development of core capabilities. The present paper was focused on the analysis of entrepreneurship education as a pedagogical intervention for the post-graduate program offered at the Entrepreneurship Development Institute of India, Gujarat, India. The study is focused on a model with special emphasis on developing KSA and its effect on nurturing entrepreneurial spirit within students. The findings represent demographic and thematic assessment of the implemented pedagogical model with an outcome of students choosing a career in new venture creation or growth/diversification of family owned businesses. This research will be helpful for academicians, research scholars, potential entrepreneurs, ecosystem enablers and students to infer the effectiveness of nurturing entrepreneurial skills and bringing more changes in personal attitudes by the way of enhancing the knowledge and skills required for the execution of an entrepreneurial career. This research is original in nature as it provides an in-depth insight into an implemented model of curriculum, focused on the development and nurturance of basic skills and its impact on the career choice of students.Keywords: attitude, entrepreneurship education, knowledge, new venture creation, pedagogical intervention, skills
Procedia PDF Downloads 17912475 Exposure to Social Media Shared Video-Clips on Irregularities from the 2023 Election in Nigeria and Audience Perception of the Outcome
Authors: Obiakor Casmir Uchenna, Ikegbunam Peter Chierike, Ezeja Perpetual Chisom
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Irregularities have been a major feature of the Nigerian political activities since 1999. The rate at which such impunities thrive in the country has made elections grossly unacceptable among the people because the outcomes have never reflected the wish of the masses. Conscious of this, citizens have subscribed to the use of social media in exposing the ugly faces of the country’s elections which have always been against the less privileged. This study is an exploration of the relationship between exposure to social media shared video-clips and the respondents’ perception of the 2023 presidential election in Nigeria. The general objective of the study is to find out what the respondents make of the election as a result of the video-clips shared on different social media platforms showing electoral irregularities. The study adopted survey research method in studying 378 university undergraduates from NAU, COOU and Paul University selected through purposive sampling technique. The study was premised on the theoretical provision of violation of expectation theory. Findings revealed that the respondents are well exposed to different video-clips showing irregularities on the election. It was also found that the respondents have negative perception of the election. It was concluded that electoral umpire, the government in power and the security apparatus violated the respondents’ expectation from the election based on the pre-election promises made to the citizens. It was recommended among others, that Nigeria must strengthen the various institutions responsible for the conduct of elections if violence will not be made the best option for the poor masses.Keywords: social media shared video-clips, exposure, irregularities, elections, audience perception, outcome
Procedia PDF Downloads 4412474 The Impact of Stigma on the Course of Mental Illness: A Brief Review
Authors: Mariana Mangas, Yaroslava Martins, Ana Matos Pires
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Introduction: Stigmatization is a common problem to overcome for people suffering from chronic diseases. It usually follows mental disorders and complicates the course of illness and reduces quality of life for people with mental illness. Objective: unsystematic review concerning stigma and mental illness, its impact on psychiatric disease and strategies to eradicate stigma. Methods: A search was conducted on PubMed, using keywords 'stigma' and 'mental illness'. Results and Discussion: Stigma is a psychosocial process that identifies individuals by the negative label of their differences. Stigma often brings a loss of occupational success and social support, reduced functioning and lower quality of life. The sense of stigma is common in individuals with mental illness and has considerable negative repercussions: delays treatment achievement, promotes social isolation, stress and maladaptive coping behaviors and it is associated with higher symptom levels, placing these individuals at higher risk for a poorer outcome and prognoses. Conclusion: Given the interrelation between stigma, symptoms, treatment seeking and disease management, stigma is a key construct in mental illness upon which anti-stigma initiatives may have considerable therapeutic potential. It will take multidisciplinary interventions to overcome mental illness stigma, including changes in social policy, attitudes and practices among mental health professionals, liaison between general public and people with a mental illness under conditions of equity and parity, family support, and easy access to evidence-based treatments.Keywords: discrimination, stigma, mental illness, quality of life
Procedia PDF Downloads 33212473 AFM Probe Sensor Designed for Cellular Membrane Components
Authors: Sarmiza Stanca, Wolfgang Fritzsche, Christoph Krafft, Jürgen Popp
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Independent of the cell type a thin layer of a few nanometers thickness surrounds the cell interior as the cellular membrane. The transport of ions and molecules through the membrane is achieved in a very precise way by pores. Understanding the process of opening and closing the pores due to an electrochemical gradient across the membrane requires knowledge of the pore constitutive proteins. Recent reports prove the access to the molecular level of the cellular membrane by atomic force microscopy (AFM). This technique also permits an electrochemical study in the immediate vicinity of the tip. Specific molecules can be electrochemically localized in the natural cellular membrane. Our work aims to recognize the protein domains of the pores using an AFM probe as a miniaturized amperometric sensor, and to follow the protein behavior while changing the applied potential. The intensity of the current produced between the surface and the AFM probe is amplified and detected simultaneously with the surface imaging. The AFM probe plays the role of the working electrode and the substrate, a conductive glass on which the cells are grown, represent the counter electrode. For a better control of the electric potential on the probe, a third electrode Ag/AgCl wire is mounted in the circuit as a reference electrode. The working potential is applied between the electrodes with a programmable source and the current intensity in the circuit is recorded with a multimeter. The applied potential considers the overpotential at the electrode surface and the potential drop due to the current flow through the system. The reported method permits a high resolved electrochemical study of the protein domains on the living cell membrane. The amperometric map identifies areas of different current intensities on the pore depending on the applied potential. The reproducibility of this method is limited by the tip shape, the uncontrollable capacitance, which occurs at the apex and a potential local charge separation.Keywords: AFM, sensor, membrane, pores, proteins
Procedia PDF Downloads 30212472 Energy Potential of Turkey and Evaluation of Solar Energy Technology as an Alternative Energy
Authors: Naci Büyükkaracığan, Murat Ahmet Ökmen
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Emerging demand for energy in developing countries rapid population growth and industrialization are causing a rapid increase, such as Turkey. Energy is an important and indispensable factor in the industry. At the same time, energy is one of the main indicators that reflect a country's economic and social development potential. There is a linear relationship between the energy consumption and social development, and in parallel this situation, it is seen that energy consumption increase with economic growth and prosperity. In recent year’s, energy sources consumption is increasingly continuing, because of population growth and economy in Turkey. 80% of the energy used in Turkey is supplied from abroad. At the same time, while almost all of the energy obtained from our country is met by hydropower. Alternatively, studies of determining and using potential renewable energy sources such as solar energy have been realized for recent years. In this study, first of all, the situation of energy sources was examined in Turkey. Information of reserve/capacity, production and consumption values of energy sources were emphasized. For this purpose, energy production and consumption, CO2 emission and electricity energy consumption of countries were investigated. Energy consumption and electricity energy consumption per capita were comparatively analyzed.Keywords: energy potential, alternative energy sources, solar energy, Turkey
Procedia PDF Downloads 43012471 Development of an Omaha System-Based Remote Intervention Program for Work-Related Musculoskeletal Disorders (WMSDs) Among Front-Line Nurses
Authors: Tianqiao Zhang, Ye Tian, Yanliang Yin, Yichao Tian, Suzhai Tian, Weige Sun, Shuhui Gong, Limei Tang, Ruoliang Tang
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Introduction: Healthcare workers, especially the nurses all over the world, are highly vulnerable to work-related musculoskeletal disorders (WMSDs), experiencing high rates of neck, shoulder, and low back injuries, due to the unfavorable working conditions. To reduce WMSDs among nursing personnel, many workplace interventions have been developed and implemented. Unfortunately, the ongoing Covid-19 (SARS-CoV-2) pandemic has posed great challenges to the ergonomic practices and interventions in healthcare facilities, particularly the hospitals, since current Covid-19 mitigation measures, such as social distancing and working remotely, has substantially minimized in-person gatherings and trainings. On the other hand, hospitals throughout the world have been short-staffed, resulting in disturbance of shift scheduling and more importantly, the increased job demand among the available caregivers, particularly the doctors and nurses. With the latest development in communication technology, remote intervention measures have been developed as an alternative, without the necessity of in-person meetings. The Omaha System (OS) is a standardized classification system for nursing practices, including a problem classification system, an intervention system, and an outcome evaluation system. This paper describes the development of an OS-based ergonomic intervention program. Methods: First, a comprehensive literature search was performed among worldwide electronic databases, including PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), between journal inception to May 2020, resulting in a total of 1,418 scientific articles. After two independent screening processes, the final knowledge pool included eleven randomized controlled trial studies to develop the draft of the intervention program with Omaha intervention subsystem as the framework. After the determination of sample size needed for statistical power and the potential loss to follow-up, a total of 94 nurses from eight clinical departments agreed to provide written, informed consent to participate in the study, which were subsequently assigned into two random groups (i.e., intervention vs. control). A subgroup of twelve nurses were randomly selected to participate in a semi-structured interview, during which their general understanding and awareness of musculoskeletal disorders and potential interventions was assessed. Then, the first draft was modified to reflect the findings from these interviews. Meanwhile, the tentative program schedule was also assessed. Next, two rounds of consultation were conducted among experts in nursing management, occupational health, psychology, and rehabilitation, to further adjust and finalize the intervention program. The control group had access to all the information and exercise modules at baseline, while an interdisciplinary research team was formed and supervised the implementation of the on-line intervention program through multiple social media groups. Outcome measures of this comparative study included biomechanical load assessed by the Quick Exposure Check and stresses due to awkward body postures. Results and Discussion: Modification to the draft included (1) supplementing traditional Chinese medicine practices, (2) adding the use of assistive patient handling equipment, and (3) revising the on-line training method. Information module should be once a week, lasting about 20 to 30 minutes, for a total of 6 weeks, while the exercise module should be 5 times a week, each lasting about 15 to 20 minutes, for a total of 6 weeks.Keywords: ergonomic interventions, musculoskeletal disorders (MSDs), omaha system, nurses, Covid-19
Procedia PDF Downloads 16912470 Prediction of Marijuana Use among Iranian Early Youth: an Application of Integrative Model of Behavioral Prediction
Authors: Mehdi Mirzaei Alavijeh, Farzad Jalilian
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Background: Marijuana is the most widely used illicit drug worldwide, especially among adolescents and young adults, which can cause numerous complications. The aim of this study was to determine the pattern, motivation use, and factors related to marijuana use among Iranian youths based on the integrative model of behavioral prediction Methods: A cross-sectional study was conducted among 174 youths marijuana user in Kermanshah County and Isfahan County, during summer 2014 which was selected with the convenience sampling for participation in this study. A self-reporting questionnaire was applied for collecting data. Data were analyzed by SPSS version 21 using bivariate correlations and linear regression statistical tests. Results: The mean marijuana use of respondents was 4.60 times at during week [95% CI: 4.06, 5.15]. Linear regression statistical showed, the structures of integrative model of behavioral prediction accounted for 36% of the variation in the outcome measure of the marijuana use at during week (R2 = 36% & P < 0.001); and among them attitude, marijuana refuse, and subjective norms were a stronger predictors. Conclusion: Comprehensive health education and prevention programs need to emphasize on cognitive factors that predict youth’s health-related behaviors. Based on our findings it seems, designing educational and behavioral intervention for reducing positive belief about marijuana, marijuana self-efficacy refuse promotion and reduce subjective norms encourage marijuana use has an effective potential to protect youths marijuana use.Keywords: marijuana, youth, integrative model of behavioral prediction, Iran
Procedia PDF Downloads 55012469 Biochar as a Strong Adsorbent for Multiple-Metal Removal from Contaminated Water
Authors: Eman H. El-Gamal, Mai E. Khedr, Randa Ghonim, Mohamed Rashad
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In the past few years, biochar - a highly carbon-rich material produced from agro-wastes by pyrolysis process - was used as an effective adsorbent for heavy metals removal from polluted water. In this study, different types of biochar (rice straw 'RSB', corn cob 'CCB', and Jatropha shell 'JSB' were used to evaluate the adsorption capacity of heavy metals removal from multiple-metal solutions (Cu, Mn, Zn, and Cd). Kinetics modeling has been examined to illustrate potential adsorption mechanisms. The results showed that the potential removal of metal is dependent on the metal and biochar types. The adsorption capacity of the biochars followed the order: RSB > JSB > CCB. In general, RSB and JSB biochars presented high potential removal of heavy metals from polluted water, which was higher than 90 and 80% after 2 hrs of contact time for all metals, respectively. According to the kinetics data, the pseudo-second-order model was agreed strongly with Cu, Mn, Zn, and Cd adsorption onto the biochars (R2 ≥ 0.97), indicating the dominance of specific adsorption process, i.e., chemisorption. In conclusion, this study revealed that RSB and JSB biochar have the potential to be a strong adsorbent for multiple-metal removal from wastewater.Keywords: adsorption, biochar, chemisorption, polluted water
Procedia PDF Downloads 14212468 Predictors of Glycaemic Variability and Its Association with Mortality in Critically Ill Patients with or without Diabetes
Authors: Haoming Ma, Guo Yu, Peiru Zhou
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Background: Previous studies show that dysglycemia, mostly hyperglycemia, hypoglycemia and glycemic variability(GV), are associated with excess mortality in critically ill patients, especially those without diabetes. Glycemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association. However, there is limited data pertaining to the relationship between different clinical factors and glycemic variability and clinical outcomes categorized by their DM status. This retrospective study of 958 intensive care unit(ICU) patients was conducted to investigate the relationship between GV and outcome in critically ill patients and further to determine the significant factors that contribute to the glycemic variability. Aim: We hypothesize that the factors contributing to mortality and the glycemic variability are different from critically ill patients with or without diabetes. And the primary aim of this study was to determine which dysglycemia (hyperglycemia\hypoglycemia\glycemic variability) is independently associated with an increase in mortality among critically ill patients in different groups (DM/Non-DM). Secondary objectives were to further investigate any factors affecting the glycemic variability in two groups. Method: A total of 958 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The glycemic variability was defined as the coefficient of variation (CV) of blood glucose. The main outcome was death during hospitalization. The secondary outcome was GV. The logistic regression model was used to identify factors associated with mortality. The relationships between GV and other variables were investigated using linear regression analysis. Results: Information on age, APACHE II score, GV, gender, in-ICU treatment and nutrition was available for 958 subjects. Predictors remaining in the final logistic regression model for mortality were significantly different in DM/Non-DM groups. Glycemic variability was associated with an increase in mortality in both DM(odds ratio 1.05; 95%CI:1.03-1.08,p<0.001) or Non-DM group(odds ratio 1.07; 95%CI:1.03-1.11,p=0.002). For critically ill patients without diabetes, factors associated with glycemic variability included APACHE II score(regression coefficient, 95%CI:0.29,0.22-0.36,p<0.001), Mean BG(0.73,0.46-1.01,p<0.001), total parenteral nutrition(2.87,1.57-4.17,p<0.001), serum albumin(-0.18,-0.271 to -0.082,p<0.001), insulin treatment(2.18,0.81-3.55,p=0.002) and duration of ventilation(0.006,0.002-1.010,p=0.003).However, for diabetes patients, APACHE II score(0.203,0.096-0.310,p<0.001), mean BG(0.503,0.138-0.869,p=0.007) and duration of diabetes(0.167,0.033-0.301,p=0.015) remained as independent risk factors of GV. Conclusion: We found that the relation between dysglycemia and mortality is different in the diabetes and non-diabetes groups. And we confirm that GV was associated with excess mortality in DM or Non-DM patients. Furthermore, APACHE II score, Mean BG, total parenteral nutrition, serum albumin, insulin treatment and duration of ventilation were significantly associated with an increase in GV in Non-DM patients. While APACHE II score, mean BG and duration of diabetes (years) remained as independent risk factors of increased GV in DM patients. These findings provide important context for further prospective trials investigating the effect of different clinical factors in critically ill patients with or without diabetes.Keywords: diabetes, glycemic variability, predictors, severe disease
Procedia PDF Downloads 18312467 Analyzing the Effects of a Psychological Intervention on Black Students’ Sense of Belonging in Physics and Math: Exploring Differential Impacts for Historically Black Colleges and Universities and Predominantly White Institutions
Authors: Terrell Strayhorn
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The lack of diversity in science, technology, engineering, and mathematics (STEM) fields is a persistent and concerning issue. One contributing factor to the underrepresentation of minority groups in STEM fields is a lack of sense of belonging, which can lead to lower levels of academic engagement, motivation, and achievement. In particular, Black students have been shown to experience lower levels of sense of belonging in STEM compared to their white peers. This study aimed to explore the effects of a psychological intervention on Black students' sense of belonging in physics and math courses at historically Black colleges and universities (HBCUs) and predominantly white institutions (PWIs). The study used a randomized controlled trial design and included 305 Black undergraduate students enrolled in physics or math courses at HBCUs and PWIs in the United States. Participants were randomly assigned to either an intervention group or a control group. The intervention consisted of a brief psychological, video-based intervention designed to enhance sense of belonging, which was delivered in a single session. The control group received no intervention. The primary outcome measure was sense of belonging in physics and math courses, as assessed by a validated self-report measure. Other outcomes included academic engagement, motivation, and achievement as measured by physics and math (course) grades. Preliminary results show that the intervention has a significant positive effect on Black students' sense of belonging in physics and math courses, with a moderate effect size. The intervention also had a significant positive effect on academic engagement and motivation, but not on academic achievement. Importantly, the effects of the intervention were larger for Black students enrolled at PWIs compared to those enrolled at HBCUs. Findings, at present, suggest that a brief psychological web-based intervention can enhance Black students' sense of belonging in physics and math courses, and that the effects may be particularly strong for Black students enrolled at PWIs, although they are not negligible for Black students at HBCUs. This is an important finding given the persistent underrepresentation of Black students in STEM fields, the growing number of Black students at PWIs, and the potential for enhancing sense of belonging to improve academic outcomes and increase diversity in these fields. The study has several limitations, including a relatively small sample size and a lack of long-term follow-up. Future research could explore the generalizability of these findings to other minority groups and other STEM fields, as well as the potential for longer-term interventions to sustain and enhance the effects observed in this study. Overall, this study highlights the potential for psychological interventions to enhance sense of belonging and improve academic outcomes for Black students in STEM courses, and underscores the importance of addressing sense of belonging as a key factor in promoting diversity and equity in STEM fields.Keywords: sense of belonging, achievement, racial equity, postsecondary education, intervention
Procedia PDF Downloads 6512466 Hydrogeophysical Investigations of Groundwater Resources and Demarcation of Saltwater-Freshwater Interface in Kilwa Kisiwani Island, Se Tanzania
Authors: Simon R. Melchioly, Ibrahimu C. Mjemah, Isaac M. Marobhe
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The main objective of this research was to identify new potential sources of groundwater resources using geophysical methods and also to demarcate the saltwater - freshwater interface. Kilwa Kisiwani Island geologically is covered mostly by Quaternary alluvial sediments, sand, and gravel. The geophysical techniques employed during the research include Vertical Electrical Sounding (VES), Earth Resistivity Tomography (ERT), and Transient Electromagnetics (TEM). Two-dimensional interpolated geophysical results show that there exist freshwater lenses formations that are potential aquifers on the Island with resistivity values ranging from 11.68 Ωm to 46.71 Ωm. These freshwater lenses are underlain by formation with brackish water in which the resistivity values are varying between 3.89 Ωm and 1.6 Ωm. Saltwater with resistivity less than 1 Ωm is found at the bottom being overlaid by brackish saturated formation. VES resistivity results show that 89% (16 out of 18) of the VES sites are potential for groundwater resources drilling while TEM results indicate that 75% (12 out of 16) of TEM sites are potential for groundwater borehole drilling. The recommended drilling depths for potential sites in Kilwa Kisiwani Island show that the maximum depth is 25 m and the minimum being 10 m below ground surface. The aquifer structure in Kilwa Kisiwani Island is a shallow, unconfined freshwater lenses floating above the seawater and the maximum thickness of the aquifer is 25 m for few selected VES and TEM sites while the minimum thickness being 10 m.Keywords: groundwater, hydrogeophysical, Kilwa Kisiwani, freshwater, saltwater, resistivity
Procedia PDF Downloads 19112465 Topical Nonsteroidal Anti-Inflammatory Eye Drops and Oral Acetazolamide for Macular Edema after Uncomplicated Phacoemulsification: Outcome and Predictors of Non-Response
Authors: Wissam Aljundi, Loay Daas, Yaser Abu Dail, Barbara Käsmann-Kellner, Berthold Seitz, Alaa Din Abdin
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Purpose: To investigate the effectiveness of nonsteroidal anti-inflammatory eye drops (NSAIDs) combined with oral acetazolamide for postoperative macular edema (PME) after uncomplicated phacoemulsification (PE) and to identify predictors of non-response. Methods: We analyzed data of uncomplicated PE and identified eyes with PME. First-line therapy included topical NSAIDs combined with oral acetazolamide. In case of non-response, triamcinolone was administered subtenonally. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: 94 eyes out of 9750 uncomplicated PE developed PME, of which 60 eyes were included. Follow-ups occurred 6.4±1.8, 12.5±3.7, and 18.6±6.0 weeks after diagnosis. BCVA and CMT improved significantly in all follow-ups. 40 eyes showed response to first-line therapy at first follow-up (G1). The remaining 20 eyes showed no response and required subtenon triamcinolone (G2), of which 11 eyes showed complete regression at the second follow-up and 4 eyes at the third follow-up. 5 eyes showed no response and required intravitreal injection. Multivariate linear regression model showed that diabetes mellitus (DM) and increased cumulative dissipated energy (CDE) are predictors of non-response. Conclusion: Topical NSAIDs with acetazolamide resulted in complete regression of PME in 67% of all cases. DM and increased CDE might be considered as predictors of nonresponse to this treatment.Keywords: postoperative macular edema, intravitreal injection, cumulative energy, irvine gass syndrome, pseudophakie
Procedia PDF Downloads 11212464 Visual Outcome After 360-Degree Retinectomy in Total Rhegmatogenous Retinal Detachment with Advanced Proliferative Vitreoretinopathy: A Case Series
Authors: Andriati Nadhilah Widyarini, Ezra Margareth
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Introduction: Rhegmatogenous retinal detachment is a condition where there’s a break in the retina, which allows the vitreous to directly enter the subretinal space. Proliferative vitreoretinopathy (PVR) may develop due to this condition and can result in a new break, which could cause traction on the previously detached retina. Various methods of therapy can be done to treat this complication. Case: This case series involved 2 eyes of 2 patients who had total retinal detachment with advanced PVR. Pars plana vitrectomy was performed, and a 360-degree retinectomy procedure with perfluorocarbon liquid usage was done. This was followed by endo laser retinopexy to surround the border of retinectomy. 5000 cs silicone oil was used in 1 eye, whereas 12% of perfluoropropane gas was used in the other eye as a tamponade. These procedures were performed with meticulous attention to prevent any fluid from entering the subretinal space. Postoperative examination showed attachment of the retina and improvement of the patient’s visual acuity. Both eyes’ intraocular pressure was in the normal range. One eye developed retinal displacement, but no other complications occurred. Discussion: Rhegmatogenous retinal detachment with advanced PVR is a complex situation for vitreoretinal surgeons. PVR is characterized by the growth and migration of preretinal or subretinal membranes. PVR is the most common cause of retinal reattachment failure. A 360-degree retinectomy is an alternative surgical method to overcome this condition. Objectives of this procedure are releasing retinal traction caused by PVR, reducing the recurrence rate of PVR, and reattaching the retina to the pigment epithelial surface. Conclusion: 360-degree retinectomy provides satisfactory retinal reattachment and visual outcome improvement in rhegmatogenous retinal detachment with advanced PVR.Keywords: RRD, retinectomy, pars plana, advanced PVR
Procedia PDF Downloads 4412463 Assessing Perinatal Mental Illness during the COVID-19 Pandemic: A Review of Measurement Tools
Authors: Mya Achike
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Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools
Procedia PDF Downloads 13012462 The Biocompatibility and Osteogenic Potential of Experimental Calcium Silicate Based Root Canal Sealer, Capseal
Authors: Seok Woo Chang
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Aim: Capseal I and Capseal II are calcium silicate and calcium phosphate based experimental root canal sealer. The aim of this study was to evaluate the biocompatibility and mineralization potential of Capseal I and Capseal II. Materials and Methods: The biocompatibility and mineralization-related gene expression (alkaline phosphatase (ALP), bone sialoprotein (BSP), and osteocalcin (OCN)) of Capseal I and Capseal II were compared using methylthiazol tetrazolium assay and reverse transcription-polymerization chain reaction analysis, respectively. The results were analyzed by Kruskal-Wallis test. P-value of < 0.05 was considered significant. Result: Both Capseal I and Capseal II were favorable in biocompatibility and influenced the messenger RNA expression of ALP and BSP. Conclusion: Within the limitation of this study, Capseal is biocompatible and have mineralization promoting potential, and thus could be a promising root canal sealer.Keywords: biocompatibility, mineralization-related gene expression, Capseal I, Capseal II
Procedia PDF Downloads 27312461 Potential Field Functions for Motion Planning and Posture of the Standard 3-Trailer System
Authors: K. Raghuwaiya, S. Singh, B. Sharma, J. Vanualailai
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This paper presents a set of artificial potential field functions that improves upon; in general, the motion planning and posture control, with theoretically guaranteed point and posture stabilities, convergence and collision avoidance properties of 3-trailer systems in a priori known environment. We basically design and inject two new concepts; ghost walls and the Distance Optimization Technique (DOT) to strengthen point and posture stabilities, in the sense of Lyapunov, of our dynamical model. This new combination of techniques emerges as a convenient mechanism for obtaining feasible orientations at the target positions with an overall reduction in the complexity of the navigation laws. The effectiveness of the proposed control laws were demonstrated via simulations of two traffic scenarios.Keywords: artificial potential fields, 3-trailer systems, motion planning, posture, parking and collision, free trajectories
Procedia PDF Downloads 37312460 Maternal and Neonatal Outcomes in Women Undergoing Bariatric Surgery: A Systematic Review and Meta-Analysis
Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides
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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight
Procedia PDF Downloads 40212459 Using Risk Management Indicators in Decision Tree Analysis
Authors: Adel Ali Elshaibani
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Risk management indicators augment the reporting infrastructure, particularly for the board and senior management, to identify, monitor, and manage risks. This enhancement facilitates improved decision-making throughout the banking organization. Decision tree analysis is a tool that visually outlines potential outcomes, costs, and consequences of complex decisions. It is particularly beneficial for analyzing quantitative data and making decisions based on numerical values. By calculating the expected value of each outcome, decision tree analysis can help assess the best course of action. In the context of banking, decision tree analysis can assist lenders in evaluating a customer’s creditworthiness, thereby preventing losses. However, applying these tools in developing countries may face several limitations, such as data availability, lack of technological infrastructure and resources, lack of skilled professionals, cultural factors, and cost. Moreover, decision trees can create overly complex models that do not generalize well to new data, known as overfitting. They can also be sensitive to small changes in the data, which can result in different tree structures and can become computationally expensive when dealing with large datasets. In conclusion, while risk management indicators and decision tree analysis are beneficial for decision-making in banks, their effectiveness is contingent upon how they are implemented and utilized by the board of directors, especially in the context of developing countries. It’s important to consider these limitations when planning to implement these tools in developing countries.Keywords: risk management indicators, decision tree analysis, developing countries, board of directors, bank performance, risk management strategy, banking institutions
Procedia PDF Downloads 5312458 Molecular Electrostatic Potential in Z-3N(2-Ethoxyphenyl), 2-N'(2-Ethoxyphenyl) Imino Thiazolidin-4-one Molecule by Ab Initio and DFT Methods
Authors: Manel Boulakoud, Abdelkader Chouaih, Fodil Hamzaoui
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In the present work we are interested in the determination of the Molecular electrostatic potential (MEP) in Z-3N(2-Ethoxyphenyl), 2-N’(2-Ethoxyphenyl) imino thiazolidin-4-one molecule by ab initio and Density Functional Theory (DFT) in the ground state. The MEP is related to the electronic density and is a very useful descriptor in understanding sites for electrophilic attack and nucleophilic reactions as well as hydrogen bonding interactions. First, geometry optimization was carried out using Hartree–Fock (HF) and DFT methods with 6-311G(d,p) basis set. In order to get more information on the molecule, its stability has been analyzed by natural bond orbital (NBO) analysis. Mulliken population analyses have been calculated. Finally, the molecular electrostatic potential (MEP) and HOMO-LUMO energy levels have been performed. The calculated HOMO and LUMO energies show also the charge transfer within the molecule. The energy gap obtained is about 4 eV which explain the stability of the studied compound. The obtained molecular electrostatic potential from the two methods confirms the nature of the electron charge transfer at the molecular shell and locate the electropositive part and the electronegative part in molecular scale of the title compound.Keywords: DFT, ab initio, HOMO-LUMO, organic compounds
Procedia PDF Downloads 52712457 One Year Follow up of Head and Neck Paragangliomas: A Single Center Experience
Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa
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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.Keywords: clinical outcomes, head and neck, management, paragangliomas
Procedia PDF Downloads 13812456 Shari'ah Governance in Islamic Banking and Finance - A Comparison Between Malaysia and Other Selected Countries, Current Challenges and Potential Solution
Authors: Muhamad Badri Bin Othman
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As a role model and leading country in the world that establishes and promotes Islamic banking and finance, Malaysia has set up and come up with a set of standards and frameworks to govern its Shari’ah function towards implementing the desired outcome of Islamic banking and finance as new source of wealth creation. This paper, examines and highlights, at the very minimum, the importance and application of Shari’ah governance in Islamic banking and finance in Malaysia as a leading country in Islamic banking and finance. This paper also, compares on Shari’ah governance, which is being adopted between Malaysia and other selected countries namely, Pakistan, Bahrain, Kuwait, United Arab Emirates (UAE) and Qatar. This paper also, aims at highlighting the current challenges and issues faced by the scholars in Shari’ah Supervisory Board (SSB) in deliberating their opinions and fatwa towards the implementation of new products in Islamic banking industry to promote innovation among the industry players. The author of this paper will highlight the major challenges and issues faced by the SSB members of Islamic banks in Malaysia, taking into account the complexity of the operation wise and products of Islamic banking, and how they overcome those challenges and issues identified. This will be done through a series of face-to-face interview sessions which will be conducted with a few prominent figures of Islamic banking and finance scholars in Malaysia to highlight the issues and challenges they are facing towards Islamic financial innovation and subsequently finding solutions for the identified issues and challenges.Keywords: Shari’ah governance, Shari’ah supervisory board (SSB), Issues and challenges, Islamic financial innovation
Procedia PDF Downloads 41512455 Presenting the Mathematical Model to Determine Retention in the Watersheds
Authors: S. Shamohammadi, L. Razavi
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This paper based on the principle concepts of SCS-CN model, a new mathematical model for computation of retention potential (S) presented. In the mathematical model, not only precipitation-runoff concepts in SCS-CN model are precisely represented in a mathematical form, but also new concepts, called “maximum retention” and “total retention” is introduced, and concepts of potential retention capacity, maximum retention, and total retention have been separated from each other. In the proposed model, actual retention (F), maximum actual retention (Fmax), total retention (S), maximum retention (Smax), and potential retention (Sp), for the first time clearly defined, so that Sp is not variable, but a function of morphological characteristics of the watershed. Indeed, based on the mathematical relation of the conceptual curve of SCS-CN model, the proposed model provides a new method for the computation of actual retention in watershed and it simply determined runoff based on. In the corresponding relations, in addition to Precipitation (P), Initial retention (Ia), cumulative values of actual retention capacity (F), total retention (S), runoff (Q), antecedent moisture (M), potential retention (Sp), total retention (S), we introduced Fmax and Fmin referring to maximum and minimum actual retention, respectively. As well as, ksh is a coefficient which depends on morphological characteristics of the watershed. Advantages of the modified version versus the original model include a better precision, higher performance, easier calibration and speed computing.Keywords: model, mathematical, retention, watershed, SCS
Procedia PDF Downloads 44912454 Directly Observed Treatment Short-Course (DOTS) for TB Control Program: A Ten Years Experience
Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes
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Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis
Procedia PDF Downloads 33912453 Risk Issues for Controlling Floods through Unsafe, Dual Purpose, Gated Dams
Authors: Gregory Michael McMahon
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Risk management for the purposes of minimizing the damages from the operations of dams has met with opposition emerging from organisations and authorities, and their practitioners. It appears that the cause may be a misunderstanding of risk management arising from exchanges that mix deterministic thinking with risk-centric thinking and that do not separate uncertainty from reliability and accuracy from probability. This paper sets out those misunderstandings that arose from dam operations at Wivenhoe in 2011, using a comparison of outcomes that have been based on the methodology and its rules and those that have been operated by applying misunderstandings of the rules. The paper addresses the performance of one risk-centric Flood Manual for Wivenhoe Dam in achieving a risk management outcome. A mixture of engineering, administrative, and legal factors appear to have combined to reduce the outcomes from the risk approach. These are described. The findings are that a risk-centric Manual may need to assist administrations in the conduct of scenario training regimes, in responding to healthy audit reporting, and in the development of decision-support systems. The principal assistance needed from the Manual, however, is to assist engineering and the law to a good understanding of how risks are managed – do not assume that risk management is understood. The wider findings are that the critical profession for decision-making downstream of the meteorologist is not dam engineering or hydrology, or hydraulics; it is risk management. Risk management will provide the minimum flood damage outcome where actual rainfalls match or exceed forecasts of rainfalls, that therefore risk management will provide the best approach for the likely history of flooding in the life of a dam, and provisions made for worst cases may be state of the art in risk management. The principal conclusion is the need for training in both risk management as a discipline and also in the application of risk management rules to particular dam operational scenarios.Keywords: risk management, flood control, dam operations, deterministic thinking
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