Search results for: international fashion weeks

Authors: Khalid Huwaydi Alshammari

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The paper examined the extent to which it was necessary for the Saudi Arabian Monetary Agency (SAMA), as a central bank, to update the Banking Control Law 1966 (BCL) in order to gain full independence, while ensuring that SAMA would have enough flexibility to develop the banking industry yet make sound decisions with regard to the issuance of new regulations related to banking supervision.Using a comparative study approach, the paper looked to find the best practices around these issues. The Bank of England, which was recently granted full independence, presented a good opportunity for a case study. The perspectives of the World Bank, the International Monetary Fund and commercial banks in Saudi Arabia are examined, including an analysis of their recommendations regarding SAMA regulations on banking supervision. This paper found several issues are important for SAMA as the central bank in a country which is a member of the G20, and which has recently faced unstable oil prices. The paper also discusses conflicts of interest which arose when the Saudi government became a shareholder in commercial banks while simultaneously regulating SAMA through the Ministry of Finance, resulting in a monopoly which disabled free competition in the banking market. The paper recommends further steps for SAMA to develop the banking industry, which is an important arm of Saudi’s economy, and examines the challenges SAMA faces in updating regulations such as the BCL under Sharia law. The author also suggests practical solutions to the difficulties. The paper found these difficulties could be avoiding them if SAMA focuses on Islamic banking product, and fixed the lacks of regulations of the related laws.

Keywords: Saudi Arabian monetary agency, comparative study, banking control law 1966, the bank of England

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Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Andre Bechuke

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The quality of every learning programme in Higher Education (HE) is dependent on the planning, design, and development of the curriculum decisions. These curriculum development decisions are highly influenced by the knowledge of the end-user, who are not always just the students. When curriculum experts plan, design and develop learning programmes, they always have the end-users in mind throughout the process. Without proper knowledge of the end-user(s), the design and development of a learning programme might be flawed. Curriculum experts often struggle to determine who the real end-user is. As such, it is even more challenging to establish what needs to be known about the end user that should inform the plan, design, and development of a learning programme. This research sought suggest approaches to guide curriculum experts to identify the end-user(s), taking into consideration the pressure and influence other agencies and structures or stakeholders (industry, students, government, universities context, lecturers, international communities, professional regulatory bodies) have on the design of a learning programme and the graduates of the programmes. Considering the influence of these stakeholders, which is also very important, the task of deciding who the real end-user of the learning programme becomes very challenging. This study makes use of criteria 1 and 18 of the Council on Higher Education criteria for programme accreditation to guide the process of identifying the end-users when developing a learning programme. Criterion 1 suggests that designers must ensure that the programme is consonant with the institution’s mission, forms part of institutional planning and resource allocation, meets national requirements and the needs of students and other stakeholders, and is intellectually credible. According to criterion 18, in designing a learning programme, steps must be taken to enhance the employability of students and alleviate shortages of expertise in relevant fields. In conclusion, there is hardly ever one group of end-users to be considered for developing a learning programme, and the notion that students are the end-users is not true, especially when the graduates are unable to use the qualification for employment.

Keywords: council on higher education, curriculum design and development, higher education, learning programme

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Authors: Felix O. Omosele

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Several studies have established that electronic voting machines are prone to multi-faceted challenges. One of which is their capacity to lose votes after the ballots might have been cast. Therefore, the international consensus appears to favour the use of electronic voting machines that are accompanied with verifiable audit paper audit trail (VVPAT). At present, there is no known study that has evaluated the impacts (or otherwise) of this verification and auditing on the authentication, admissibility and evidential weight of electronically-obtained electoral data. This legal inquiry is important as elections are sometimes won or lost in courts and on the basis of such data. This gap will be filled by the present research work. Using the United States of America as a case study, this paper employed a qualitative legal analysis of several of its appellate courts’ judicial opinions. This analysis equally unearths the necessary statutory rules and regulations that are important to the research problem. The objective of the research is to highlight the roles played by VVPAT on electoral evidence- as seen from the eyes of the court. The preliminary outcome of this qualitative analysis shows that the admissibility and weight attached to ‘Computer Evidence from e-voting machines (CEEM)’ are often treated with general standards applied to other computer-stored evidence. These standards sometimes fail to embrace the peculiar challenges faced by CEEM, particularly with respect to their tabulation and transmission. This paper, therefore, argues that CEEM should be accorded unique consideration by courts. It proposes the development of a legal standard which recognises verification and auditing as ‘weight enhancers’ for electronically-obtained electoral data.

Keywords: admissibility of computer evidence, electronic voting, qualitative legal analysis, voting machines in the USA

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Authors: Elena Pozdnyakova

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“Government Relations” is a field of knowledge presently taught at the majority of universities around the globe. English as the default language can become the language of teaching since the issues discussed are both global and national in character. However for this field of knowledge key concepts and their word representations in English don’t often coincide with those in other languages. International master’s degree students abroad as well as students, taught the course in English at their national universities, are exposed to difficulties, connected with correct conceptualizing of terminology of GR in British and American academic traditions. The study was carried out during the GR English language course elaboration (pilot research: 2013 -2015) at Moscow State Institute of Foreign Relations (University), Russian Federation. Within this period, English language instructors designed and elaborated the three-semester course of GR. Methodologically the course design was based on elaboration model with the special focus on conceptual elaboration sequence and theoretical elaboration sequence. The course designers faced difficulties in concept selection and theoretical elaboration sequence. To improve the results and eliminate the problems with concept selection, a new, corpus-based approach was worked out. The computer-based tool WordSmith 6.0 was used with the aim to build a model of key concept selection. The corpus of GR English texts consisted of 1 million words (the study corpus). The approach was based on measuring effect size, i.e. the percent difference of the frequency of a word in the study corpus when compared to that in the reference corpus. The results obtained proved significant improvement in the process of concept selection. The corpus-based model also facilitated theoretical elaboration of teaching materials.

Keywords: corpus-based study, English as the default language, key concepts, measuring effect size, model of key concept selection

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Authors: Anthony Oppong Kyekyeku, Sussana Antwi-Boasiako, Emmanuel De-Graft Johnson Owusu Ansah

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In this observational study, the performance of a known conventional storage system was tested and evaluated for fitness for its intended purpose. The system has a scope extended for the storage of dry cocoa beans. System sensitivity, reproducibility and uncertainties are not known in details. This study discusses the system performance in the context of existing literature on factors that influence the quality of cocoa beans during storage. Controlled conditions were defined precisely for the system to give reliable base line within specific established procedures. Minitab® 17 and R statistical software (R-3.3.1) were used for the statistical analyses. The approach to the storage system testing was to observe and compare through laboratory test methods the quality of the cocoa beans samples before and after storage. The samples were kept in Kilner jars and the temperature of the storage environment controlled and monitored over a period of 408 days. Standard test methods use in international trade of cocoa such as the cut test analysis, moisture determination with Aqua boy KAM III model and bean count determination were used for quality assessment. The data analysis assumed the entire population as a sample in order to establish a reliable baseline to the data collected. The study concluded a statistically significant mean value at 95% Confidence Interval (CI) for the performance data analysed before and after storage for all variables observed. Correlational graphs showed a strong positive correlation for all variables investigated with the exception of All Other Defect (AOD). The weak relationship between the before and after data for AOD had an explained variability of 51.8% with the unexplained variability attributable to the uncontrolled condition of hidden infestation before storage. The current study concluded with a high-performance criterion for the storage system.

Keywords: benchmarking performance data, cocoa beans, hidden infestation, storage system validation

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Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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Authors: S. K. Balashanmugam, Padmavati Manchikanti, S. R. Subramanian

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The question of legal liability over injury arising out of the import and the introduction of GM food emerges as a crucial issue confronting to promote GM food and its derivatives. There is a greater possibility of commercialized GM food from the exporting country to enter importing country where status of approval shall not be same. This necessitates the importance of fixing a liability mechanism to discuss the damage, if any, occurs at the level of transboundary movement or at the market. There was a widespread consensus to develop the Cartagena Protocol on Biosafety and to give for a dedicated regime on liability and redress in the form of Nagoya Kuala Lumpur Supplementary Protocol on the Liability and Redress (‘N-KL Protocol’) at the international context. The national legal frameworks based on this protocol are not adequately established in the prevailing food legislations of the developing countries. The developing economy like India is willing to import GM food and its derivatives after the successful commercialization of Bt Cotton in 2002. As a party to the N-KL Protocol, it is indispensable for India to formulate a legal framework and to discuss safety, liability, and regulatory issues surrounding GM foods in conformity to the provisions of the Protocol. The liability mechanism is also important in the case where the risk assessment and risk management is still in implementing stage. Moreover, the country is facing GM infiltration issues with its neighbors Bangladesh. As a precautionary approach, there is a need to formulate rules and procedure of legal liability to discuss any kind of damage occurs at transboundary trade. In this context, the proposed work will attempt to analyze the liability regime in the existing Food Safety and Standards Act, 2006 from the applicability and domestic compliance and to suggest legal and policy options for regulatory authorities.

Keywords: commercialization, food safety, FSSAI, genetically modified foods, India, liability

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Authors: Stephen M. Magu

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The 9/11 and Christmas bombing attacks in the United States are mostly associated with the inability of intelligence agencies to connect dots based on intelligence that was already available. The 1998, 2002, 2013 and several 2014 terrorist attacks in Kenya, on the other hand, are probably driven by a completely different dynamic: the invisible hand of corruption. The World Bank and Transparency International annually compute the Worldwide Governance Indicators and the Corruption Perception Index respectively. What perhaps is not adequately captured in the corruption metrics is the impact of corruption on terrorism. The World Bank data includes variables such as the control of corruption, (estimates of) government effectiveness, political stability and absence of violence/terrorism, regulatory quality, rule of law and voice and accountability. TI's CPI does not include measures related to terrorism, but it is plausible that there is an expectation of some terrorism impact arising from corruption. This paper, by examining the incidence, frequency and total number of terrorist attacks that have occurred especially since 1990, and further examining the specific cases of Kenya and Nigeria, argues that in addition to having major effects on governance, corruption has an even more frightening impact: that of facilitating and/or violating security mechanisms to the extent that foreign nationals can easily obtain identification that enables them to perpetuate major events, targeting powerful countries' interests in countries with weak corruption-fighting mechanisms. The paper aims to model interactions that demonstrate the cost/benefit analysis and agents' rational calculations as being non-rational calculations, given the ultimate impact. It argues that eradication of corruption is not just a matter of a better business environment, but that it is implicit in national security, and that for anti-corruption crusaders, this is an argument more potent than the economic cost / cost of doing business argument.

Keywords: corruption, global south, identification, passports, terrorism

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Authors: Shuko Takeshita

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This study investigates the identity formation of mixed-race children in Japan. From the latter half of the 1980s to the mid-2000s, Japan experienced an 'intermarriage boom,' which was soon followed by a fairly significant number of children born to these unions. These children are now coming of age. Among mixed-race children, some embraced both cultural traditions, while others chose a monocultural path despite exposure to two cultural traditions as they grew up. What factors are involved in shaping the identity of mixed-race children? How does identity formation actually occur in these children? This study addresses these questions through an interview survey of 139 cross-cultural families since 1999, including 23 Pakistani-Japanese families, 20 Turkish-Japanese families, 26 families comprising other international Muslim husbands and Japanese wives, 33 Filipino-Japanese families, and 37 Brazilian-Japanese families. The results of this two-decade-long study reveal that in cases where one cannot tell at first glance that children are mixed race, there is a tendency for them to hide their mixed background due to fear of bullying at school, as well as for their parents to encourage them to do this. To pass as a Japanese is one strategy for avoiding discrimination and prejudice, and it can provide a measure of ethnic security or a way of coping with social intolerance. Certainly, among my informants, there are some children who were bullied or teased at school, and as a result, they stopped attending or transferred to other schools. But the mixed-race experience is not always a negative thing in Japan. There is clearly a double standard involved in that mixed-race children of a Caucasian parent are more readily accepted by society than those of a non-Caucasian parent. The perceived social status of mixed-race individuals is usually understood in relation to the hierarchical positionings of monoracial groups. Mixed-race children could be guaranteed the right to enjoy the benefit of maintaining and developing an identity as a Japanese, in addition to one more identity. We need to encourage a new awareness of the children as agents for a transition from a monocultural system to a multicultural system in Japanese society.

Keywords: identity formation, intermarriage, mixed race, multicultural children

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Authors: Malini Ganapathy, Sarjit Kaur

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Maximising learning with higher-order thinking skills with Information and Communications Technology (ICT) has been deep-rooted and emphasised in various developed countries such as the United Kingdom, the United States of America and Singapore. The transformation of the education curriculum in the Malaysia Education Development Plan (PPPM) 2013-2025 focuses on the concept of Higher Order Thinking (HOT) skills which aim to produce knowledgeable students who are critical and creative in their thinking and can compete at the international level. HOT skills encourage students to apply, analyse, evaluate and think creatively in and outside the classroom. In this regard, the National Education Blueprint (2013-2025) is grounded based on high-performing systems which promote a transformation of the Malaysian education system in line with the vision of Malaysia’s National Philosophy in achieving educational outcomes which are of world class status. This study was designed to investigate ESL students’ learning practices on the emphasis of promoting HOTs while using ICT in their curricula. Data were collected using a stratified random sampling where 100 participants were selected to take part in the study. These respondents were a group of undergraduate students who undertook ESL courses in a public university in Malaysia. A three-part questionnaire consisting of demographic information, students’ learning experience and ICT utilization practices was administered in the data collection process. Findings from this study provide several important insights on students’ learning experiences and ICT utilization in developing HOT skills.

Keywords: English as a second language students, critical and creative thinking, learning, information and communication technology and higher order thinking skills

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Khalil Ahmad Kakar

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In developing countries increasing the automobile and low capacity public transport (para-transit) which are creating congestion, pollution, noise, and traffic accident are the most critical quandary. These issues are under the analysis of assessors to break down the puzzle and propose sustainable urban public transport system. Kabul city is one of those urban areas that the inhabitants are suffering from lack of tolerable and friendly public transport system. The city is the most-populous and overcrowded with around 4.5 million population. The para-transit is the only dominant public transit system with a very poor level of services and low capacity vehicles (6-20 passengers). Therefore, this study after detailed investigations suggests bus rapid transit (BRT) system in Kabul City. It is aimed to mitigate the role of informal transport and decreases congestion. The research covers three parts. In the first part, aggregated travel demand modelling (four-step) is applied to determine the number of users for para-transit and assesses BRT network based on higher passenger demand for public transport mode. In the second part, state preference (SP) survey and binary logit model are exerted to figure out the utility of existing para-transit mode and planned BRT system. Finally, the impact of predicted BRT system on para-transit is evaluated. The extracted outcome based on high travel demand suggests 10 km network for the proposed BRT system, which is originated from the district tenth and it is ended at Kabul International Airport. As well as, the result from the disaggregate travel mode-choice model, based on SP and logit model indicates that the predicted mass rapid transit system has higher utility with the significant impact regarding the reduction of para-transit.

Keywords: BRT, para-transit, travel demand modelling, Kabul City, logit model

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Authors: Ekaterina A. Redkina

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The necessity and importance of teaching professionally oriented content in English needs no proof nowadays. Consequently, the ability to share personal ESP teaching experience seems of great importance. This paper is based on the 8-year ESP and EFL teaching experience at the Moscow State Linguistic University, Moscow, Russia, and presents theoretical analysis of specifics, possible problems, and perspectives of teaching Psychology in English to Russian psychology-students. The paper concerns different issues that are common for different ESP classrooms, and familiar to different teachers. Among them are: designing ESP curriculum (for psychologists in this case), finding the balance between content and language in the classroom, main teaching principles (the 4 C’s), the choice of assessment techniques and teaching material. The main objective of teaching psychology in English to Russian psychology students is developing knowledge and skills essential for professional psychologists. Belonging to international professional community presupposes high-level content-specific knowledge and skills, high level of linguistic skills and cross-cultural linguistic ability and finally high level of professional etiquette. Thus, teaching psychology in English pursues 3 main outcomes, such as content, language and professional skills. The paper provides explanation of each of the outcomes. Examples are also given. Particular attention is paid to the lesson structure, its objectives and the difference between a typical EFL and ESP lesson. There is also made an attempt to find commonalities between teaching ESP and CLIL. There is an approach that states that CLIL is more common for schools, while ESP is more common for higher education. The paper argues that CLIL methodology can be successfully used in ESP teaching and that many CLIL activities are also well adapted for professional purposes. The research paper provides insights into the process of teaching psychologists in Russia, real teaching experience and teaching techniques that have proved efficient over time.

Keywords: ESP, CLIL, content, language, psychology in English, Russian students

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Authors: Lucilla Crosta, Anthony Edwards

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Companies and the market place nowadays struggle to find employees with adequate skills in relation to anticipated growth of their businesses. At least half of workers will need to undertake some form of up-skilling process in the next five years in order to remain aligned with the requests of the market . In order to meet these challenges, there is a clear need to explore the potential uses of AI (artificial Intelligence) based tools in assessing transversal skills (critical thinking, communication and soft skills of different types in general) of workers and adult students while empowering them to develop those same skills in a reliable trustworthy way. Companies seek workers with key transversal skills that can make a difference between workers now and in the future. However, critical thinking seems to be the one of the most imprtant skill, bringing unexplored ideas and company growth in business contexts. What employers have been reporting since years now, is that this skill is lacking in the majority of workers and adult students, and this is particularly visible trough their writing. This paper investigates how critical thinking and communication skills are currently developed in Higher Education environments through use of AI tools at postgraduate levels. It analyses the use of a branch of AI namely Machine Learning and Big Data and of Neural Network Analysis. It also examines the potential effect the acquisition of these skills through AI tools and what kind of effects this has on employability This paper will draw information from researchers and studies both at national (Italy & UK) and international level in Higher Education. The issues associated with the development and use of one specific AI tool Edulai, will be examined in details. Finally comparisons will be also made between these tools and the more recent phenomenon of Chat GPT and forthcomings and drawbacks will be analysed.

Keywords: critical thinking, artificial intelligence, higher education, soft skills, chat GPT

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Authors: Eunice Chiamaka Allen-Ngbale

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Prior to bill of lading (BOL), merchants travelled along with their goods; then recorded the goods in the ship’s mates’ register; and finally started selling the goods while in transit by way of BOL, indicative that BOL is negotiable. Common law doctrine of privity of contract did not allow the transfer of right to sue to a non-party to the contract. This created hardship to cargo owners, which made many jurisdictions enact laws in this regard. Bill of Lading Act 1855 (BLA) was enacted in the United Kingdom, which applied as statute of general application under section 375 Merchant Shipping Act 1990 (MSA) in Nigeria; and conferred contractual rights of the suit on consignees and endorsees, but on the passing of ownership upon or by reason of such consignment or endorsement on the shipment of the goods simultaneously. The repeal of section 375 MSA by section 439 MSA 2007 created a lacuna, and the doctrine of privity of contract is the extant law in Nigeria. The aim of this study is to evaluate laws governing the transfer of the contractual right of suit to a third party under the bill of lading in Nigeria. The specific objectives of this study are to ascertain: (i) whether the extant law of common law doctrine of privity of the contract covers the transfer of the right of suit to the third party under the bill of lading in Nigeria; (ii) impediment(s) of the common law to transfer such right in Nigeria in the absence of any legislation; (iii) the level of applicability of the doctrine of privity of contract as it relates to transfer of the contractual right of suit to third party under the bill of lading in Nigeria; and (iv) whether to proffer possible suggestion on how to fill the lacuna left by the repeal of Merchant Shipping Act 1990. This work adopted a doctrinal approach with reliance on primary and secondary source materials. It finds that the common law doctrine of privity of contract in Nigeria is retrogressive. This work recommends for amendment of the relevant statute to cure this defect/lacuna like other commonwealth nations for best international practices.

Keywords: contract of carriage by sea, doctrine of privity of contract, lawful holder of bill of lading, third party right of suit

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Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce

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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.

Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis

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Authors: Hermanus J. Moolman

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The COVID-19 pandemic had a severe impact on the society and companies in South Africa. This raises questions about the position of creditors of companies facing financial distress and the actions that directors should take to cater to the interests of creditors. The extent to which directors owe their duties and consideration to creditors has been the subject of debate. The directors of a solvent company owe their duties to the company in favour of its shareholders. When the company becomes insolvent, creditors are the beneficiaries of the directors’ duties. However, the intermittent phase between solvency and insolvency, otherwise referred to as the realm of insolvency, is not accounted for. The purpose of this paper is to determine whether South African company law appropriately addresses the duties that directors owe to creditors and the extent of consideration given to creditors’ interests when the company is in the realm of insolvency and has started business rescue proceedings. A comparative study on South Africa, the United States of America, the United Kingdom and international instruments was employed to achieve the purpose statement. In the United States of America and the United Kingdom, the focus shifts from shareholders to the best interests of creditors when business recue proceedings commence. Such an approach is not aligned with the purpose of the Companies Act of 2008 that calls for a balance of interests of all persons affected by a company’s financial distress and will not be suitable for the South African context. Business rescue in South Africa is relatively new when compared to the practices of the United States of America and the United Kingdom, and the entrepreneurial landscape in South Africa is still evolving. The interests of creditors are not the only interests at risk when a company is financially distressed. It is recommended that an enlightened creditor value approach is adopted for South Africa, where the interests of creditors, albeit paramount, are balanced with those of other stakeholders. This approach optimises a gradual shift in the duties of directors from shareholders to creditors, without disregarding the interests of shareholders.

Keywords: business rescue, shareholders, creditors, financial distress, balance of interests, alternative remedies, company law

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Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

Procedia PDF Downloads 258

Authors: Chondrogianni Dimitra, Yorgos J. Stephanedes

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The impact of the economic crisis, coupled with the aging of the city's old core, is reflected in central Athens. Public and private users, residents, employees, visitors desire the quality upgrading of abandoned buildings and public spaces through environmental upgrading and sustainable mobility, and promotion of the international metropolitan character of the city. In the study, a strategy for reshaping the character and function of the historic Athenian triangle is proposed, aiming at its economic, environmental, and social sustainable development through feasible, meaningful, and non-landscaping solutions of low cost and high positive impact. Sustainable mobility is the main principle in re-planning the study area and transforming it into a “Low Pollution and Limited Vehicle Traffic Zone” is the main strategy. Τhe proposed measures include the development of pedestrian mobility networks by expanding the pedestrian roads and limited-traffic routes, of bicycle networks based on the approved Metropolitan Bicycle Route of Athens, of public transportation networks with new lines of electric mini-buses, and of new regulations for vehicle mobility in the historic triangle. In addition, complementary actions are proposed regarding the provision of Wi-Fi on fixed track media, development of applications that facilitate combined travel and provide real-time data, integration of micromobility (roller skates, Segway, Hoverboard), and its enhancement as a flexible means of personal mobility, and development of car-sharing, ride-sharing and dynamic carpooling initiatives.

Keywords: regeneration plans, sustainable mobility, environmental upgrading, athens historical triangle

Procedia PDF Downloads 167

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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In recent years childhood obesity has increased to pan-epidemic proportions along with a concomitant increase in obesity-associated morbidity. Birth weight is an important determinant of later adult health, with neonates at both ends of the birth weight spectrum at risk of future health complications. Consequently, infants who are born large for gestational age (LGA) are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. Adipose tissue plays a role in linking events in fetal growth to the subsequent development of adult diseases. In addition to its role as a storage depot for fat, adipose tissue produces and secrets a number of hormones of importance in modulating metabolism and energy homeostasis. Cord blood leptin level has been positively correlated with fetal adiposity at birth. It is established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given body mass index indicating a genetic predisposition in the occurrence of obesity. To our knowledge, studies have never been conducted in Sri Lanka to determine the relationship between adipocytokine profile in cord blood and anthropometric parameters in newborns. Thus, the objective of this study is to establish the above relationship for the Sri Lankan population to implement awareness programs to minimize childhood obesity in the future. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of leptin was measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured. Pearson’s correlation was used to assess the relationship between leptin and anthropometric parameters while the Mann-Whitney U test was used to assess the differences in cord blood leptin levels between small for gestational age (SGA), appropriate for gestational age (AGA) and LGA infants. There was a significant difference (P < 0.05) between the cord blood leptin concentrations of LGA infants (12.67 ng/mL ± 2.34) and AGA infants (7.10 ng/mL ± 0.90). However, a significant difference was not observed between leptin levels of SGA infants (8.86 ng/mL ± 0.70) and AGA infants. In both male and female neonates, umbilical leptin levels showed significant positive correlations (P < 0.05) with birth weight of the newborn, pre-pregnancy maternal weight and pre pregnancy BMI between the infants of large and appropriate for gestational ages. Increased concentrations of leptin levels in the cord blood of large for gestational age infants suggest that they may be involved in regulating fetal growth. Leptin concentration of Sri Lankan population was not significantly deviated from published data of Asian populations. Fetal leptin may be an important predictor of neonatal adiposity; however, interventional studies are required to assess its impact on the possible risk of childhood obesity.

Keywords: appropriate for gestational age, childhood obesity, leptin, anthropometry

Procedia PDF Downloads 188

Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

Procedia PDF Downloads 661

Authors: Ouchemoukh Salim, Amessis-Ouchemoukh Nadia, Guenaoui Nawel, Moumeni Lynda, Zaidi Hicham, Otmani Amar, Sadou Dyhia

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Honey is a hive food rich in carbohydrates and water and it also has a lot of nutrients (enzymes, minerals, organic acids, phytochemicals...). It is used in different nutritional and therapeutic fields. Algerian honey was studied for its physicochemical parameters, nutritional values (moisture, brix, pH, electrical conductivity, and amounts of HMF, proteins, proline, total phenolic compounds and flavonoids) and some biological activities (antioxidant, anti-inflammatory and enzymatic anti-browning). The antioxidant activities of the samples were estimated using different methods (ABTS, DPPH free radicals scavenging, reducing power, and chelating ferrous activity). All honeys were acidic (3.45≤pH≤4.65). The color varied from mimosa yellow to dark brown. The specific rotation was levorotatory in most honey samples, and the electrical conductivity, hydroxymethylfurfural, and proline values agreed with the international honey requirements. For anti-inflammatory activity, the results showed that the inhibiting capacity of the denaturation of the BSA of the honey analyzed varied from 15 to 75 % with a maximum of activity at the concentration of 0,5 mg/ml. All honey exhibited enzymatic anti-browning on different slices of fruits. In fact, the results showed that the controls have the greatest browning unit compared to the honeys studied and PPO and POD enzymes had the lowest enzyme activity. High significant correlations were found between the color of honey, its antioxidant content and its biological activities (antioxidant, anti-inflammatory and enzymatic anti-browning). The dark color of honey is a good indicator of the best biological properties, therefore, the best nutritional and therapeutic values.

Keywords: honey, physico-chemical parameters, bioactive compounds, biological properties

Procedia PDF Downloads 56

Authors: D. Tappi

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In the past decades, the idea of innovation moved from being considered the result of development to being seen as its means. Innovation and its diffusion are indeed keys to the development and economic catch-up of a country. However, the process of diffusing existing innovation in low income countries has demonstrated dependent on inadequate infrastructures and institutions. The paper examines the role of disruptive innovation in bridging the technology gap between high- and low-income countries, overcoming the lack in infrastructures and institutions. In particular, the focus of this paper goes to the role of disruptive innovation in people transportation in Nigeria. Uber, Taxify, and Smartcab are covering a small and interesting market that was underserved, between the high-end private driver markets, the personal car owners and the low-priced traditional cab and the Keke (tricycle). Indeed the small Nigerian middle class and international community have found in the sharing people transportation market a safe, reasonably priced means of transportation in Nigerian big cities. This study uses mainly qualitative data collection methods in the form of semi-structured interviews with major players and users and quantitative data analysis in the form of a survey among users in order to assess the role of these new transportation modes in shaping the market and even creating a new niche. This paper shows how the new sharing economy in people transportation is creating new solutions to old problems as well as creating new challenges for both the existing market players and institutions. By doing so, the paper shows how disruptive innovations applied to low income countries, not only can overcome the lacking infrastructure problem but could also help bridge the technology gap between those and high income countries. This contribution proves that it is indeed exactly because the market presents these obstacles that disruptive innovations can succeed in countries such as Nigeria.

Keywords: development, disruptive innovation, sharing economy, technology gap

Procedia PDF Downloads 120

Authors: B. Baba Ahmed, P. Yanogo, B. Djibryl. N. Medas

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Introduction: Polio is a highly contagious viral infection, with children under 5 years of age being the most affected. It is a public health emergency of international concern. Polio surveillance in Mauritania has been ongoing since 1998 and has achieved "polio free" status in 2007. our objective is to analyse a pidemiological surveillance database of poliomyélitis in Mauritania from 2012-2019. Method: A transversal descriptive analysis of poliomyélitis database was carried out in Mauritania from 2012-2019.An exhaustive sampling was done on all suspected polio cases recorded in the database from 2012 -2019. This study used EPI-INFO 7.4 for frequency calculation for qualitative variables, mean and standard deviation for quantitative variables. Results: We found 459 suspected cases of polio over the study period with an average rate of acute non-polio flaccid paralysis of 25.4 cases/100,000 children under 15 years of age. The age group 0-6 years represented 75.2%. Males constituted 50.2%. Females represented 49.78% with a ratio of M/F=1.Among the 422 observations, the average age is 4 years +/- 3.38. The four regions, TIRIS-ZEMMOUR, INCHIRI, TAGANT, NOUACHCHOTT OUEST recorded the lowest percentages of notifications, respectively (3.28%; 3.93%; 4.37%; 4.8%). 99.34% [98.09-99.78] of cases presented acute flaccid paralysis. And 56.77% [52.19-61.23], had limb asymmetry. We showed that 82.93% [79.21-86.10], had fever. we found that 89.5% of suspected polio cases were investigated before 48 hours. And 88.39% of suspected cases had two adequate samples taken 48 hours apart and within 14 days after the onset of symptoms. Only 30.95% of samples arrived at the referral laboratory before 72 hours. Conclusion: This study has shown that Mauritania has achieved the objectives in most of the quantitative performance indicators of polio surveillance. This study has shown a low notification of cases in the northern and central regions of the country. There is a problem with the transport of samples to the laboratory.

Keywords: analysis, data base, Epi-Info, polio

Procedia PDF Downloads 175

Authors: Marc Polo, Núria Arbonés Arán

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Amsterdam is considered one of the great European capitals, which concentrates the headquarters of various multinational companies and which, in addition, enjoys a huge tourist attraction. Its typical residential buildings next to the canals, the museums, or its striking "Red Light District" are a great focus of attraction. In 2019 almost 9 million tourists visited it, but few of them traveled to the farthest neighborhood in the city: Amsterdam-Zuidoost (Amsterdam-Southeast). This neighborhood is geographically separated from the urban core, which makes it an exclave of Amsterdam as it does not border any of the other boroughs. Bijlmermeer neighborhood is the largest of the Amsterdam-Zuidoost, and it was born in the 1960s with the expectations of becoming the city of the future. Its main architect, Siegfried Nassuth, was inspired by the Swiss Le Corbusier to design nearly 18,000 homes, most of which were in high-rise tower blocks and built together, forming a recognizable "honeycombed" pattern. For more than 40 years, a series of infrastructure and social vicissitudes have made the neighborhood outline quite different as it was expected to be. It helped also varied elements such as ethnicity, demolitions, or unoccupied apartments. The called “city of the future” became home to immigrants, drug addicts, and vandals, and the conflicts denigrated the Amsterdam-Zuidoost. This work analyzes the evolution of the Bijlmermeer from its origins and illustrates relevant international referents able to help the area. The purpose of the work is to show how different variations along the recent history didn't help enough, but how there are positive perspectives for the future taking advantage of the food as a creative issue. The research, based on academic literature, existing material in different stadiums, plus the analysis of the city imaginaries, will help to concrete relevant elements in terms of innovation, creativity, and disruption. Despite of radical renewal that is taking place, the research will demonstrate that there are still new opportunities for the old Bijlmermeer.

Keywords: amsterdam, bijlmermeer, creativity, food

Procedia PDF Downloads 117

Authors: Maryam Pirdehghan

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During the Ba'ath Party's rule in Iraq, propaganda was utilized to justify and to promote Saddam Hussein's image in the collective memory as the greatest Arab leader. Consequently, urban walls were routinely covered with images of Saddam. Relying on these images, the regime aimed to provide a basis for evoking meanings in the public opinion, which would supposedly strengthen Saddam’s power and reconstruct facts to legitimize his political ideology. Nonetheless, Saddam was not always portrayed with common and explicit elements but in certain periods of his rule, the paintings depicted him in an unusual context, where various historical and contemporary elements were combined in a narrative background. Therefore, an understanding of the implied socio-political references of these elements is required to fully elucidate the impact of these images on forming the memory and collective unconscious of the Iraqi people. To obtain such understanding, one needs to address the following questions: a) How Saddam Hussein is portrayed in mural during his rule? b) What of elements and mythical-historical narratives are found in the paintings? c) Which Saddam's political views were subject to the collective memory through mural? Employing visual semiotics, this study reveals that during Saddam Hussein's regime, the paintings were initially simple portraits but gradually transformed into narrative images, characterized by a complex network of historical, mythical and religious elements. These elements demonstrate the transformation of a secular-nationalist politician into a Muslim ruler who tried to instill three major policies in domestic and international relations i.e. the arabization of Iraq, as well as the propagation of pan-arabism ideology (first period), the implementation of anti-Israel policy (second period) and the implementation of anti-American-British policy (last period).

Keywords: Ba'ath Party, Saddam Hussein, mural, Iraq, propaganda, collective memory

Procedia PDF Downloads 326

Authors: Ubaid Ur Rahman, Waqar Younas, Sooraj Kumar Chhabira

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Environmentally sustainable building construction has experienced significant growth during the past 10 years at international level. This paper shows that the conceptual framework adopts sustainability techniques in construction to develop environment friendly building called green building. Waste occurs during the different construction phases which causes the environmental problems like, deposition of waste on ground surface creates major problems such as bad smell. It also gives birth to different health diseases and produces toxic waste agent which is specifically responsible for making soil infertile. Old recycled building material is used in the construction of new building. Sustainable construction is economical and saves energy sources. Sustainable construction is the major responsibility of designer and project manager. The designer has to fulfil the client demands while keeping the design environment friendly. Project manager has to deliver and execute sustainable construction according to sustainable design. Steel is the most appropriate sustainable construction material. It is more durable and easily recyclable. Steel occupies less area and has more tensile and compressive strength than concrete, making it a better option for sustainable construction as compared to other building materials. New technology like green roof has made the environment pleasant, and has reduced the construction cost. It minimizes economic, social and environmental issues. This paper presents an overview of research related to the material use of green building and by using this research recommendation are made which can be followed in the construction industry. In this paper, we go through detailed analysis on construction material. By making suitable adjustments to project management practices it is shown that a green building improves the cost efficiency of the project, makes it environmental friendly and also meets future generation demands.

Keywords: sustainable construction, green building, recycled waste material, environment

Procedia PDF Downloads 245

Authors: M. Shaheed Hartley

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Science and mathematics are regarded as gateway subjects in South Africa as they are the perceived route to careers in science, engineering, technology and mathematics (STEM). One of the biggest challenges that the country faces is the poor achievement of learners in these two learning areas in the external high school exit examination. To compound the problem many national and international benchmark tests paint a bleak picture of the state of science and mathematics in the country. In an attempt to address this challenge, the education department of the Eastern Cape Province invited the Science Learning Centre of the University of the Western Cape to provide training to their science teachers in the form of a structured course conducted on a part-time basis in 2010 and 2011. The course was directed at improving teachers’ content knowledge, pedagogical strategies and practical and experimental skills. A total of 41 of the original 50 science teachers completed the course and received their certificates in 2012. As part of their continuous professional development, 31 science teachers enrolled for BEd Hons in science education in 2013 and 28 of them completed the course in 2014. These students graduated in 2015. Of the 28 BEd Hons students who completed the course 23 registered in 2015 for Masters in Science Education and were joined by an additional 3 students. This paper provides a reflection by science educators on the training, supervision and mentorship provided to them as students of science education. The growth and development of students through their own reflection and understanding as well as through the eyes of the lecturers and supervisors that took part in the training provide the evaluation of the professional development process over the past few years. This study attempts to identify the merits, challenges and limitations of this project and the lessons to be learnt on such projects. It also documents some of the useful performance indicators with a view to developing a framework for good practice for such programmes.

Keywords: reflection, science education, professional development, rural schools

Procedia PDF Downloads 195

Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

Procedia PDF Downloads 127