Search results for: ethical review
513 Corporate Governance Disclosures by South African Auditing Firms
Authors: Rozanne Janet Smith
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This article examined the corporate governance disclosures of the large and medium-sized auditing firms in South Africa. It is important that auditing firms disclose their practice of good corporate governance to the public, as they serve the public interest. The auditing profession has been criticized due to many corporate scandals in recent years. This has undermined the reputation of the profession, with experts and the public questioning whether auditing firms have corporate governance structures in place, and whether they are taking public interest into consideration. In South Africa there is no corporate governance code specifically for audit firms. Auditing firms are encouraged by IRBA to issue a transparency report in which they disclose corporate governance structures and application, but this is not compulsory in South Africa. Moreover, the information issued in these transparency reports is limited and often only focuses on audit quality, and not governance. Through a literature review it was found that the UK is one of only a few countries who has a corporate governance code for audit firms. As South Africa initially used the UK Cadbury report to develop the King IV Code, it was fitting to use the UK Audit Firm Governance Code as a benchmark to determine if audit firms in South Africa are disclosing relevant corporate governance information in their transparency reports and/or integrated reports. This study contributes to the existing body of knowledge by pursuing the following objective: To determine the improvement in the corporate governance disclosures of large and medium-sized auditing firms in South Africa through comparative research. Available data from 2019 will be used and compared to the disclosures in the 2023/2024 transparency and or integrated reports of the large and medium-sized auditing firms in South Africa. To achieve this objective a constructivist research paradigm was applied. Qualitative secondary information was gathered for the analysis. A content analysis was selected to collect the qualitative data by analyzing the integrated reports and/or transparency reports of large and medium-sized auditing firms with 20 or more partners and to determine what is disclosed on their corporate governance practices. These transparency reports and integrated reports were then read and analyzed in depth and compared to the principles stated in the UK Code. Since there are only nine medium-sized and large auditing firms in South Africa, the researcher was able to conduct the content analysis by reading each report in depth. The following six principles which are found in the UK Code were assessed for disclosure. (1) Leadership, (2) Values, (3) INED, (4) Operations, (5) Reporting, and (6) Dialogue. The results reveal that the auditing firms are not disclosing the corporate governance principles and practices to the necessary extent. Although there has been some improvement, the disclosure is not to the extent which it should be. There is still a need for a South African audit firm governance code.Keywords: auditing firms, corporate governance, South Africa, disclosure
Procedia PDF Downloads 24512 Leadership in the Emergence Paradigm: A Literature Review on the Medusa Principles
Authors: Everard van Kemenade
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Many quality improvement activities are planned. Leaders are strongly involved in missions, visions and strategic planning. They use, consciously or unconsciously, the PDCA-cycle, also know as the Deming cycle. After the planning, the plans are carried out and the results or effects are measured. If the results show that the goals in the plan have not been achieved, adjustments are made in the next plan or in the execution of the processes. Then, the cycle is run through again. Traditionally, the PDCA-cycle is advocated as a means to an end. However, PDCA is especially fit for planned, ordered, certain contexts. It fits with the empirical and referential quality paradigm. For uncertain, unordered, unplanned processes, something else might be needed instead of Plan-Do-Check-Act. Due to the complexity of our society, the influence of the context, and the uncertainty in our world nowadays, not every activity can be planned anymore. At the same time organisations need to be more innovative than ever. That provides leaders with ‘wicked tendencies’. However, that raises the question how one can innovate without being able to plan? Complexity science studies the interactions of a diverse group of agents that bring about change in times of uncertainty, e.g. when radical innovation is co-created. This process is called emergence. This research study explores the role of leadership in the emergence paradigm. Aim of the article is to study the way that leadership can support the emergence of innovation in a complex context. First, clarity is given on the concepts used in the research question: complexity, emergence, innovation and leadership. Thereafter a literature search is conducted to answer the research question. The topics ‘emergent leadership’ or ‘complexity leadership’ are chosen for an exploratory search in Google and Google Scholar using the berry picking method. Exclusion criterion is emergence in other disciplines than organizational development or in the meaning of ‘arising’. The literature search conducted gave 45 hits. Twenty-seven articles were excluded after reading the title and abstract because they did not research the topic of emergent leadership and complexity. After reading the remaining articles as a whole one more was excluded because the article used emergent in the limited meaning of ‗arising‘ and eight more were excluded because the topic did not match the research question of this article. That brings the total of the search to 17 articles. The useful conclusions from the articles are merged and grouped together under overarching topics, using thematic analysis. The findings are that 5 topics prevail when looking at possibilities for leadership to facilitate innovation: enabling, sharing values, dreaming, interacting, context sensitivity and adaptivity. Together they form In Dutch the acronym Medusa.Keywords: complexity science, emergence, leadership in the emergence paradigm, innovation, the Medusa principles
Procedia PDF Downloads 29511 ‘Transnationalism and the Temporality of Naturalized Citizenship
Authors: Edward Shizha
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Citizenship is not only political, but it is also a socio-cultural expectation that naturalized immigrants desire for. However, the outcomes of citizenship desirability are determined by forces outside the individual’s control based on legislation and laws that are designed at the macro and exosystemic levels by politicians and policy makers. These laws are then applied to determine the status (permanency or temporariness) of citizenship for immigrants and refugees, but the same laws do not apply to non-immigrant citizens who attain it by birth. While theoretically, citizenship has generally been considered an irrevocable legal status and the highest and most secure legal status one can hold in a state, it is not inviolate for immigrants. While Article 8 of the United Nations Convention on the Reduction of Statelessness provides grounds for revocation of citizenship obtained by immigrants and refugees in host countries, nation-states have their own laws tied to the convention that provide grounds for revocation. Ever since the 9/11 attacks in the USA, there has been a rise in conditional citizenship and the state’s withdrawal of citizenship through revocation laws that denaturalize citizens who end up not merely losing their citizenship but also the right to reside in the country of immigration. Because immigrants can be perceived as a security threat, the securitization of citizenship and the legislative changes have been adopted to specifically allow greater discretionary power in stripping people of their citizenship.The paper ‘Do We Really Belong Here?’ Transnationalism and the Temporality of Naturalized Citizenship examines literature on the temporality of naturalized citizenship and questions whether citizenship, for newcomers (immigrants and refugees), is a protected human right or a privilege. The paper argues that citizenship in a host country is a well sought-after status by newcomers. The question is whether their citizenship, if granted, has a permanent or temporary status and whether it is treated in the same way as that of non-immigrant citizens. The paper further argues that, despite citizenship having generally been considered an irrevocable status in most Western countries, in practice, if not in law, for immigrants and refugees, citizenship comes with strings attached because of policies and laws that control naturalized citizenship. These laws can be used to denationalize naturalized citizens through revocations for those stigmatized as ‘undesirables’ who are threatened with deportation. Whereas non-immigrant citizens (those who attain it by birth) have absolute right to their citizenship, this is seldom the case for immigrants.This paper takes a multidisciplinary approach using Urie Bronfenbrenner’s ecological systems theory, the macrosystem and exo-system, to examine and review literature on the temporality of naturalized citizenship and questions whether citizenship is a protected right or a privilege for immigrants. The paper challenges the human rights violation of citizenship revocation and argues for equality of treatment for all citizens despite how they acquired their citizenship. The fragility of naturalized citizenship undermines the basic rights and securities that citizenship status can provide to the person as an inclusive practice in a diverse society.Keywords: citizenship, citizenship revocation, dual citizenship, human rights, naturalization, naturalized citizenship
Procedia PDF Downloads 75510 Recognizing Juxtaposition Patterns of the Dwelling Units in Housing Cluster: The Case Study of Aghayan Complex: An Example of Rural Residential Development in Qajar Era in Iran
Authors: Outokesh Fatemeh, Jourabchi Keivan, Talebi Maryam, Nikbakht Fatemeh
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Mayamei is a small town in Iran that is located between Shahrud and Sabzevar cities, on the Silk Road. It enjoys a history of approximately 1000 years. An alley entitled ‘Aghayan’ exists in this town that comprises residential buildings of a famous family. Bathhouse, mosque, telegraph center, cistern are all related to this alley. This architectural complex belongs to Sadat Mousavi, who is one of the Mayamei's major grandees and religious household. The alley after construction has been inherited from generation to generation within the family masters. The purpose of this study, which was conducted on Aghayan alley and its associated complex, was to elucidate Iranian vernacular domestic architecture of Qajar era in small towns and villages. We searched for large, medium, and small architectural patterns in the contemplated complex, and tried to elaborate their evolution from past to the present. The other objective of this project was finding a correlation between changes in the lifestyle of the alley’s inhabitants with the form of the building's architecture. Our investigation methods included: literature review especially in regard to historical travelogues, peer site visiting, mapping, interviewing of the elderly people of the Mousavi family (the owners), and examining the available documents especially the 4 meters’ scroll-type testament of 150 years ago. For the analysis of the aforementioned data, an effort was made to discover (1) the patterns of placing of different buildings in respect of the others, (2) finding the relation between function of the buildings with their relative location in the complex, as was considered in the original design, and (3) possible changes of functions of the buildings during the time. In such an investigation, special attention was paid to the chronological changes of lifestyles of the residents. In addition, we tried to take all different activities of the residents into account including their daily life activities, religious ceremonies, etc. By combining such methods, we were able to obtain a picture of the buildings in their original (construction) state, along with a knowledge of the temporal evolution of the architecture. An interesting finding is that the Aghayan complex seems to be a big structure of the horizontal type apartments, which are placed next to each other. The houses made in this way are connected to the adjacent neighbors both by the bifacial rooms and from the roofs.Keywords: Iran, Qajar period, vernacular domestic architecture, life style, residential complex
Procedia PDF Downloads 161509 Bridge the Gap: Livability, Sustainable Development Goals and Pandemics: A Review on Visakhapatnam
Authors: Meenakshi Pappu
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The terms like liveability, Sustainable Development Goals and pandemic have been widely analysed in proving sustainable cities and community living in growing urban areas by 2030. The pandemic has made us all ruminate about how we look into different fast-growing cities which vary in geographical location, climatic zones, terrains, land use and varying cultural backgrounds & traditions belong to the mother soil. India has taken up huge steps to move towards achieving UN-SDGs. Smart city missions have played a vital role in moving towards SDG. Visakhapatnam city is the executive capital in the state of Andhra Pradesh. Located on the Eastern Ghats in South India, it is surrounded by a mountain range on three sides and the Indian Ocean on one side. This unique geographical location and fast urbanization in the last two decades, has put up immense pressure on the natural environment and recourses. It's observed that a lot of investigation to address the existing and proposed land-use, spatial, natural resources, air quality, environmental challenges, and a range of socio-economic, economic challenges were identified during the assessment phase. The citizen concerns with quality and quantity of access to water, sewerage, energy, transportation (public & private) and safety for the public were found out through surveying. Urban infrastructure plays a major part in city building. These cities are occupied by people who come for a better living. This paper aims to provide off-center way of approach to citizens-oriented community habits by addressing SDG 11: Sustainable cities & community by enkindling a characteristic framework of amalgamating 1.eco-design principal, 2. three factors of liveability and 3. a local traditional planning solution. Aiming towards a sustainable development utilized with the focus on the quality of the life and experience of the people who live in urban areas integrating life with soil & water. Building strong social agenda that includes affordable housing for all levels of households, secure and place for good quality public realm for the local people with activity in green corridor, open meeting space & adding recreational places for advantage..Keywords: livability, eco-design, smart city mission, sustainable
Procedia PDF Downloads 184508 Role of Grey Scale Ultrasound Including Elastography in Grading the Severity of Carpal Tunnel Syndrome - A Comparative Cross-sectional Study
Authors: Arjun Prakash, Vinutha H., Karthik N.
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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study
Procedia PDF Downloads 101507 Agroecology: Rethink the Local in the Global to Promote the Creation of Novelties
Authors: Pauline Cuenin, Marcelo Leles Romarco Oliveira
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Based on their localities and following their ecological rationality, family-based farmers have experimented, adapted and innovated to improve their production systems continuously for millennia. With the technological package transfer processes of the so-called Green Revolution for agricultural holdings, farmers have become increasingly dependent on ready-made "recipes" built from so-called "universal" and global knowledge to face the problems that emerge in the management of local agroecosystems, thus reducing their creative and experiential capacities. However, the production of novelties within farms is fundamental to the transition to more sustainable agro food systems. In fact, as the fruits of local knowledge and / or the contextualization of exogenous knowledge, novelties are seen as seeds of transition. By presenting new techniques, new organizational forms and epistemological approaches, agroecology was pointed out as a way to encourage and promote the creative capacity of farmers. From this perspective, this theoretical work aims to analyze how agroecology encourages the innovative capacity of farmers, and in general, the production of novelties. For this, an analysis was made of the theoretical and methodological bases of agroecology through a literature review, specifically looking for the way in which it articulates the local with the global, complemented by an analysis of agro ecological Brazilian experiences. It was emphasized that, based on the peasant way of doing agriculture, that is, on ecological / social co-evolution or still called co-production (interaction between human beings and living nature), agroecology recognizes and revalues peasant involves the deep interactions of the farmer with his site (bio-physical and social). As a "place science," practice and movement, it specifically takes into consideration the local and empirical knowledge of farmers, which allows questioning and modifying the paradigms that underpin the current agriculture that have disintegrated farmers' creative processes. In addition to upgrade the local, agroecology allows the dialogue of local knowledge with global knowledge, essential in the process of changes to get out of the dominant logic of thought and give shape to new experiences. In order to reach this articulation, agroecology involves new methodological focuses seeking participatory methods of study and intervention that express themselves in the form of horizontal spaces of socialization and collective learning that involve several actors with different knowledge. These processes promoted by agroecology favor the production of novelties at local levels for expansion at other levels, such as the global, through trans local agro ecological networks.Keywords: agroecology, creativity, global, local, novelty
Procedia PDF Downloads 223506 An Assessment of Government Entrepreneurship Programs for Women in Sabah Malaysia
Authors: Imelda Albert Gisip, Tarsiah T. Z. Taman
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In Asia, particularly in Malaysia women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia which aims to accelerate the entrepreneurship among young women in Sabah Malaysia. Entrepreneurs is seen as essential for growth, job creation and social progress and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner, to achieve targets and goals that coincide with the development needs of the state. One of the government’s agenda is to put its efforts more strongly to ensure that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process which specifically developed to accelerate entrepreneurship sector particularly for women entrepreneurs in Sabah by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem including six months intensive courses, guided through "hands-holding”, collaborations with strategic partners and easy access to government's assistance. Since its inception, the program has significantly impact society’s wellbeing particularly in empowering young women entrepreneurs in Sabah for the past six years and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving women’s enterprise sector in Malaysia needs an overall enabling environment that allows development opportunities for women entrepreneurs including access to resources and support services. Since achieving the goal of women entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach and long-term commitment. Thus, this paper presents how Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women, while addressing the few existing gender-specific hurdles.Keywords: entrepreneurship programs, women, Sabah, Malaysia
Procedia PDF Downloads 24505 Urban Green Transitioning in The Face of Current Global Change: The Management Role of the Local Government and Residents
Authors: Titilope F. Onaolapo, Christiana A. Breed, Maya Pasgaard, Kristine E. Jensen, Peta Brom
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In the face of fast-growing urbanization in most of the world's developing countries, there is a need to understand and address the risk and consequences involved in the indiscriminate use of urban green space. Tshwane city in South Africa has the potential to become one of the world's top biodiversity cities as South Africa is ranked one of the mega countries in biodiversity conservation, and Tshwane metropolitan municipality is the city with the wealthiest biodiversity with grassland biomes. In this study, we focus on the potentials and challenges of urban green transitioning from the Global South perspective with Tshwane city as the case study. We also address the issue of management conflicts that have resulted in informal and illegal activities in and around green spaces, with consequences such as land degradation, loss of livelihoods and biodiversity, and socio-ecological imbalances. A desk study review of eight policy frameworks related to green urban planning and development was done based on four GI principles: multifunctionality, connectivity, interdisciplinary and social inclusion. We interviewed 15 key informants in related departments in the city and administered 200 survey questionnaires among residents. We also had several workshops the other researchers and experts on biodiversity and ecosystem. We found out there is no specific document dedicated to green space management, and where green infrastructure was mentioned, it was focused on as an approach to climate mitigation and adaptation. Also, residents perceive green and open spaces as extra land that could be developed at will. We demonstrated the use of collaborative learning approaches in ecological and development research and the tying research to the existing frameworks, programs, and strategies. Based on this understanding. We outlined the need to incorporate principles of green infrastructure in policy frameworks on spatial planning and environmental development. Furthermore, we develop a model for co-management of green infrastructures by stakeholders, such as residents, developers, policymakers, and decision-makers, to maximize benefits. Our collaborative, interdisciplinary projects pursue SDG multifunctionality of goals 11 and 15 by simultaneously addressing issues around Sustainable Cities and Communities, Climate Action, Life on Land, and Strong Institutions, and halt and reverse land degradation and biodiversity.Keywords: governance, green infrastructure, South Africa, sustainable development, urban planning, Tshwane
Procedia PDF Downloads 122504 Examining the Concept of Sustainability in the Scenery Architecture of Naqsh-e-Jahan Square
Authors: Mahmood Naghizadeh, Maryam Memarian, Hourshad Irvash
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Following the rise in the world population and the upward growth of urbanization, the design, planning, and management of the site scenery for the purpose of presentation and expansion of sustainable site scenery has turned to be the greatest concern to experts. Since the fundamental principles of the site scenery change more and less haphazardly over time, sustainable site scenery can be viewed as an ideal goal because both sustainability and dynamism come into view in urban site scenery and it wouldn’t be designed according to a set of pre-determined principles. Sustainable site scenery, as the ongoing interaction between idealism and pragmatism with sustainability factors, is a dynamic phenomenon created by bringing cultural, historical, social and natural scenery together. Such an interaction is not to subdue other factors but to reinforce the aforementioned factors. The sustainable site scenery is a persistently occurring event not only has attenuated over time but has gained strength. The sustainability of a site scenery or an event over time depends on its site identity which grows out of its continuous association with the past. The sustainability of a site scene or an event in a time frame intertwined with the identity of the place from past to present. This past history supports the present and future of the scene. The result of such a supportive role is the sustainability of site scenery. Isfahan Naqsh-e-Jahan Square is one of the most outstanding squares in the world and the best embodiment of Iranian site scenery architecture. This square is an arena that brings people together and a dynamic city center comprising various urban and religious complexes, spaces and facilities and is considered as one of the most favorable traditional urban space of Iran. Such a place can illustrate many factors related to sustainable site scenery. One the other hand, there are still no specific principles concerning sustainability in the architecture of site scenery. Meanwhile, sustainability is recognized as a rather modern view in architecture. The purpose of this research is to identify factors involved in sustainability in general and to examine their effects on site scenery architecture in particular. Finally, these factors will be studied with taking Naqsh-e-Jahan Square into account. This research adopts an analytic-descriptive approach that has benefited from the review of literature available in library studies and the documents related to sustainability and site scenery architecture. The statistical population used for the purpose of this research includes square constructed during the Safavid dynasty and Naqsh-e-Jahan Square was picked out as the case study. The purpose of this paper is to come up with a rough definition of sustainable site scenery and demonstrate this concept by analyzing it and recognizing the social, economic and ecological aspects of this project.Keywords: Naqsh-e-Jahan Square, site scenery architecture, sustainability, sustainable site scenery
Procedia PDF Downloads 312503 Reducing Unnecessary CT Aorta Scans in the Emergency Department
Authors: Ibrahim Abouelkhir
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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency
Procedia PDF Downloads 10502 Reasons for the Selection of Information-Processing Framework and the Philosophy of Mind as a General Account for an Error Analysis and Explanation on Mathematics
Authors: Michael Lousis
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This research study is concerned with learner’s errors on Arithmetic and Algebra. The data resulted from a broader international comparative research program called Kassel Project. However, its conceptualisation differed from and contrasted with that of the main program, which was mostly based on socio-demographic data. The way in which the research study was conducted, was not dependent on the researcher’s discretion, but was absolutely dictated by the nature of the problem under investigation. This is because the phenomenon of learners’ mathematical errors is due neither to the intentions of learners nor to institutional processes, rules and norms, nor to the educators’ intentions and goals; but rather to the way certain information is presented to learners and how their cognitive apparatus processes this information. Several approaches for the study of learners’ errors have been developed from the beginning of the 20th century, encompassing different belief systems. These approaches were based on the behaviourist theory, on the Piagetian- constructivist research framework, the perspective that followed the philosophy of science and the information-processing paradigm. The researcher of the present study was forced to disclose the learners’ course of thinking that led them in specific observable actions with the result of showing particular errors in specific problems, rather than analysing scripts with the students’ thoughts presented in a written form. This, in turn, entailed that the choice of methods would have to be appropriate and conducive to seeing and realising the learners’ errors from the perspective of the participants in the investigation. This particular fact determined important decisions to be made concerning the selection of an appropriate framework for analysing the mathematical errors and giving explanations. Thus the rejection of the belief systems concerning behaviourism, the Piagetian-constructivist, and philosophy of science perspectives took place, and the information-processing paradigm in conjunction with the philosophy of mind were adopted as a general account for the elaboration of data. This paper explains why these decisions were appropriate and beneficial for conducting the present study and for the establishment of the ensued thesis. Additionally, the reasons for the adoption of the information-processing paradigm in conjunction with the philosophy of mind give sound and legitimate bases for the development of future studies concerning mathematical error analysis are explained.Keywords: advantages-disadvantages of theoretical prospects, behavioral prospect, critical evaluation of theoretical prospects, error analysis, information-processing paradigm, opting for the appropriate approach, philosophy of science prospect, Piagetian-constructivist research frameworks, review of research in mathematical errors
Procedia PDF Downloads 190501 The Flooding Management Strategy in Urban Areas: Reusing Public Facilities Land as Flood-Detention Space for Multi-Purpose
Authors: Hsiao-Ting Huang, Chang Hsueh-Sheng
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Taiwan is an island country which is affected by the monsoon deeply. Under the climate change, the frequency of extreme rainstorm by typhoon becomes more and more often Since 2000. When the extreme rainstorm comes, it will cause serious damage in Taiwan, especially in urban area. It is suffered by the flooding and the government take it as the urgent issue. On the past, the land use of urban planning does not take flood-detention into consideration. With the development of the city, the impermeable surface increase and most of the people live in urban area. It means there is the highly vulnerability in the urban area, but it cannot deal with the surface runoff and the flooding. However, building the detention pond in hydraulic engineering way to solve the problem is not feasible in urban area. The land expropriation is the most expensive construction of the detention pond in the urban area, and the government cannot afford it. Therefore, the management strategy of flooding in urban area should use the existing resource, public facilities land. It can archive the performance of flood-detention through providing the public facilities land with the detention function. As multi-use public facilities land, it also can show the combination of the land use and water agency. To this purpose, this research generalizes the factors of multi-use for public facilities land as flood-detention space with literature review. The factors can be divided into two categories: environmental factors and conditions of public facilities. Environmental factors including three factors: the terrain elevation, the inundation potential and the distance from the drainage system. In the other hand, there are six factors for conditions of public facilities, including area, building rate, the maximum of available ratio etc. Each of them will be according to it characteristic to given the weight for the land use suitability analysis. This research selects the rules of combination from the logical combination. After this process, it can be classified into three suitability levels. Then, three suitability levels will input to the physiographic inundation model for simulating the evaluation of flood-detention respectively. This study tries to respond the urgent issue in urban area and establishes a model of multi-use for public facilities land as flood-detention through the systematic research process of this study. The result of this study can tell which combination of the suitability level is more efficacious. Besides, The model is not only standing on the side of urban planners but also add in the point of view from water agency. Those findings may serve as basis for land use indicators and decision-making references for concerned government agencies.Keywords: flooding management strategy, land use suitability analysis, multi-use for public facilities land, physiographic inundation model
Procedia PDF Downloads 358500 Godalisation: A Revisionist Conceptual Framework for Singapore’s Artistic Identity
Authors: Bernard Tan
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The paper presents a conceptual framework which serves as an art model of Singapore artistic identity. Specifically, the study examines Singapore's artistic identity through the artworks of the country’s significant artists covering the period 1950s to the present. Literature review will discuss the challenges of favouring or choosing one artist over the other. Methodology provides an overview of the perspectives of local artists and surveys Singapore’s artistic histories through qualitative interviews and case studies. Analysis from qualitative data reveals that producing works of accrued visual significance for the country which captures it zeitgeist further strengthens artist’s artistic identity, and consequently, their works remembered by future generations. The paper presents a conceptual framework for Singapore’s artistic identity by categorising it into distinctive categories or Periods: Colonial Period (pre-1965); Nation Building Period (1965-1988); Globalisation Period (1989-2000); Paternal Production Period (2001-2015); and A New Era (2015-present). Godalisation, coined from God and Globalisation – by artist and art collector, Teng Jee Hum – is a direct reference to the godlike influence on Singapore by its founding Father, Mr Lee Kuan Yew, the country’s first Prime Minister who steered the city state “from Third World to First” for close to half a century, from 1965 to his passing in 2015. A detailed schema showing important factors in different art categories: key global geopolitics, key local social-politics, and significant events will be analysed in depth. Main artist groups or artist initiatives which evolved in Singapore during the different Periods from pre-1965 to the present will be categorized and discussed. Taken as a whole, all these periods collectively add up to the Godalisation Era; impacted by the social-political events and historical period of the nation, and captured through the visual representation of the country’s significant artists in their attempt at either visualizing or mythologizing the Singapore Story. The author posits a co-relation between a nation’s economic success and the value or price appreciation of the country’s artist of significance artworks. The paper posed a rhetorical question: “Which Singapore’s artist will historian of the future – and by extension, the people of the country from future generations – remember? Who will remain popular? Whilst which artists will be forgotten.” The searching question: “Who will survive, be remembered in the annals of history and, above all, how to ensure the survival of one’s nation artistic identity? The art that last will probably be determined by the future, in the future, where art historians pontificate from a later vantage point.Keywords: artistic identity, art collection, godalisation, singapore
Procedia PDF Downloads 39499 Electronic Structure Studies of Mn Doped La₀.₈Bi₀.₂FeO₃ Multiferroic Thin Film Using Near-Edge X-Ray Absorption Fine Structure
Authors: Ghazala Anjum, Farooq Hussain Bhat, Ravi Kumar
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Multiferroic materials are vital for new application and memory devices, not only because of the presence of multiple types of domains but also as a result of cross correlation between coexisting forms of magnetic and electrical orders. In spite of wide studies done on multiferroic bulk ceramic materials their realization in thin film form is yet limited due to some crucial problems. During the last few years, special attention has been devoted to synthesis of thin films like of BiFeO₃. As they allow direct integration of the material into the device technology. Therefore owing to the process of exploration of new multiferroic thin films, preparation, and characterization of La₀.₈Bi₀.₂Fe₀.₇Mn₀.₃O₃ (LBFMO3) thin film on LaAlO₃ (LAO) substrate with LaNiO₃ (LNO) being the buffer layer has been done. The fact that all the electrical and magnetic properties are closely related to the electronic structure makes it inevitable to study the electronic structure of system under study. Without the knowledge of this, one may never be sure about the mechanism responsible for different properties exhibited by the thin film. Literature review reveals that studies on change in atomic and the hybridization state in multiferroic samples are still insufficient except few. The technique of x-ray absorption (XAS) has made great strides towards the goal of providing such information. It turns out to be a unique signature to a given material. In this milieu, it is time honoured to have the electronic structure study of the elements present in the LBFMO₃ multiferroic thin film on LAO substrate with buffer layer of LNO synthesized by RF sputtering technique. We report the electronic structure studies of well characterized LBFMO3 multiferroic thin film on LAO substrate with LNO as buffer layer using near-edge X-ray absorption fine structure (NEXAFS). Present exploration has been performed to find out the valence state and crystal field symmetry of ions present in the system. NEXAFS data of O K- edge spectra reveals a slight shift in peak position along with growth in intensities of low energy feature. Studies of Mn L₃,₂- edge spectra indicates the presence of Mn³⁺/Mn⁴⁺ network apart from very small contribution from Mn²⁺ ions in the system that substantiates the magnetic properties exhibited by the thin film. Fe L₃,₂- edge spectra along with spectra of reference compound reveals that Fe ions are present in +3 state. Electronic structure and valence state are found to be in accordance with the magnetic properties exhibited by LBFMO/LNO/LAO thin film.Keywords: magnetic, multiferroic, NEXAFS, x-ray absorption fine structure, XMCD, x-ray magnetic circular dichroism
Procedia PDF Downloads 158498 Integrating System-Level Infrastructure Resilience and Sustainability Based on Fractal: Perspectives and Review
Authors: Qiyao Han, Xianhai Meng
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Urban infrastructures refer to the fundamental facilities and systems that serve cities. Due to the global climate change and human activities in recent years, many urban areas around the world are facing enormous challenges from natural and man-made disasters, like flood, earthquake and terrorist attack. For this reason, urban resilience to disasters has attracted increasing attention from researchers and practitioners. Given the complexity of infrastructure systems and the uncertainty of disasters, this paper suggests that studies of resilience could focus on urban functional sustainability (in social, economic and environmental dimensions) supported by infrastructure systems under disturbance. It is supposed that urban infrastructure systems with high resilience should be able to reconfigure themselves without significant declines in critical functions (services), such as primary productivity, hydrological cycles, social relations and economic prosperity. Despite that some methods have been developed to integrate the resilience and sustainability of individual infrastructure components, more work is needed to enable system-level integration. This research presents a conceptual analysis framework for integrating resilience and sustainability based on fractal theory. It is believed that the ability of an ecological system to maintain structure and function in face of disturbance and to reorganize following disturbance-driven change is largely dependent on its self-similar and hierarchical fractal structure, in which cross-scale resilience is produced by the replication of ecosystem processes dominating at different levels. Urban infrastructure systems are analogous to ecological systems because they are interconnected, complex and adaptive, are comprised of interconnected components, and exhibit characteristic scaling properties. Therefore, analyzing resilience of ecological system provides a better understanding about the dynamics and interactions of infrastructure systems. This paper discusses fractal characteristics of ecosystem resilience, reviews literature related to system-level infrastructure resilience, identifies resilience criteria associated with sustainability dimensions, and develops a conceptual analysis framework. Exploration of the relevance of identified criteria to fractal characteristics reveals that there is a great potential to analyze infrastructure systems based on fractal. In the conceptual analysis framework, it is proposed that in order to be resilient, urban infrastructure system needs to be capable of “maintaining” and “reorganizing” multi-scale critical functions under disasters. Finally, the paper identifies areas where further research efforts are needed.Keywords: fractal, urban infrastructure, sustainability, system-level resilience
Procedia PDF Downloads 274497 Protecting the Financial Rights of Non-Member Spouses: Addressing the Exploitation of Retirement Benefits in South African Divorce Law
Authors: Ronelle Prinsloo
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In South Africa, married retirement fund members can manipulate the legal framework to prevent their spouses from accessing shared retirement benefits during divorce proceedings. The current legal structure allows retirement fund members to accelerate the accrual of their benefits, often by resigning or purchasing living annuities before the finalization of a divorce. This action effectively places these benefits beyond the reach of their spouses, leading to substantial financial prejudice, particularly for financially weaker spouses, typically women. The research highlights that South African courts, including the Supreme Court of Appeal (SCA), have not adequately scrutinized the implications of these actions. Specifically, the SCA has ruled that the capital and proceeds from living annuities are not subject to division during divorce, which undermines the financial rights of non-member spouses. The court's failure to consider the source of the money used to purchase these annuities and its potential inclusion in the joint estate or accrual system is a significant concern. The South African Law Reform Commission has recognized this issue, noting the negative impact on financially weaker spouses. The article critiques the lack of legislative response to this problem despite its significant implications for the equitable distribution of marital assets. The current legal framework, particularly the definition of "pension interest" and the provisions under sections 7(7) and 7(8) of the Divorce Act, is inadequate in addressing the complexities surrounding the sharing of retirement benefits in divorce cases. The article argues for a comprehensive review and reform of the law to ensure that retirement benefits are treated as patrimonial assets, subject to division upon the occurrence of any trigger event, such as resignation, retirement, or retrenchment. The need for such reform is urgent to prevent economically disadvantaged spouses from being unjustly deprived of their fair share of retirement benefits. In conclusion, the article advocates for legislative amendments to the Divorce Act, specifically section 7(7), to clarify that pension interests automatically form part of the joint estate, regardless of whether divorce proceedings are underway. This change would safeguard the financial rights of non-member spouses and ensure a more equitable distribution of retirement benefits during divorce. Failure to address this issue perpetuates economic inequality and leaves financially weaker spouses vulnerable during divorce proceedings.Keywords: Constitution of South Africa, non-member spouse, retirement benefits, spouse
Procedia PDF Downloads 20496 Learning in Multicultural Workspaces: A Case of Aged Care
Authors: Robert John Godby
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To be responsive now and in the future, workplaces must address the demands of multicultural teams as they become more common elements of the global labor force. This is especially the case for aged care due to the aging population, industry growth and migrant recruitment. This research identifies influences on and improvements for learning in these environments. Its unique contribution is to illuminate how culturally diverse workplaces can work and learn together more effectively. A mixed-methods approach was used to gather data about this topic in two phases. Firstly, the research methods included a survey of 102 aged care workers around Australia from two multi-site aged care organisations. The questionnaire elicited both quantitative and qualitative data about worker characteristics and perspectives on working and learning in aged care. Secondly, a case study of one aged care worksite was formulated drawing on worksite information and interviews with workers. A review of the literature suggests that learning in multicultural work environments is influenced by three main factors: 1) the individual workers themselves, 2) their interaction with each other and 3) the environment in which they work. There are various accounts of these three factors, how they are manifested and how they lead to a change in workers’ disposition, knowledge, or expertise when confronted with new circumstances. The study has found that a key individual factor influencing learning is cultural background. Their unique view of the world was shown to affect their approach to both their work and co-working. Interactional factors suggest that the high requirement for collaboration in aged care positively supports learning in this context; however, it can be hindered by cultural bias and spoken accent. The study also found that environmental factors, such as disruptions caused by the pandemic, were another key influence. For example, the need to wear face masks hindered the communication needed for workplace learning. This was especially challenging due to the diverse language backgrounds and abilities within the teams. Potential improvements for learning in multicultural aged care work environments were identified. These include more frequent and structured inter-peer learning (e.g. buddying), communication training (e.g. English language usage for both native and non-native speaking workers) and support for cross-cultural habitude (e.g. recognizing and adapting to cultural differences). Workplace learning in cross-cultural aged care environments is an area that is not extensively dealt with in the literature. This study addresses this gap and holds the potential to contribute practical insights to aged care and other diverse industries.Keywords: cross-cultural learning, learning in aged care, migrant learning, workplace learning
Procedia PDF Downloads 159495 Intellectual Property Rights (IPR) in the Relations among Nations: Towards a Renewed Hegemony or Not
Authors: Raju K. Thadikkaran
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Introduction: The IPR have come to the centre stage of development discourse today for a variety of reasons: It ranges from the arbitrariness in the enforcement, overlapping and mismatch with various international agreements and conventions, divergence in the definition, nature and content and the duration as well as severe adverse consequences to technologically weak developing countries. In turn, the IPR have acquired prominence in the foreign policy making as well as in the relations among nations. Quite naturally, there is ample scope for an examination of the correlation between Technology, IPR and International Relations in the contemporary world. Nature and Scope: A cursory examination of the realm of IPR and its protection shall reveals the acute divergence that exists in the perspectives, on all matters related to the very definition, nature, content, scope and duration. The proponents of stronger protection, mostly technologically advanced countries, insist on a stringent IP Regime whereas technologically weak developing countries seem to advocate for flexibilities. From the perspective of developing countries like India, one of the most crucial concerns is related to the patenting of life forms and the protection of TK and BD. There have been several instances of Bio-piracy and Bio-prospecting of the resources related to BD and TK from the Bio-rich Global South. It is widely argued that many provisions in the TRIPS are capable of offsetting the welcome provisions in the CBD such as the Access and Benefit Sharing and Prior Informed Consent. The point that is being argued out is as to how the mismatch between the provisions in the TRIPS Agreement and the CBD could be addressed in a healthy manner so that the essential minimum legitimate interests of all stakeholders could be secured thereby introducing a new direction to the international relations. The findings of this study reveal that the challenges roused by the TRIPS Regime over-weigh the opportunities. The mismatch in the provisions in this regard has generated various crucial issues such as Bio-piracy and Bio-prospecting. However, there is ample scope for managing and protecting IP through institutional innovation, legislative, executive and administrative initiative at the global, national and regional levels. The Indian experience is quite reflective of the same and efforts are being made through the new national IPR policy. This paper, employing Historical Analytical Method, has Three Sections. The First Section shall trace the correlation between the Technology, IPR and international relations. The Second Section shall review the issues and potential concerns in the protection and management of IP related to the BD and TK in the developing countries in the wake of the TRIPS and the CBD. The Final Section shall analyze the Indian Experience in this regard and the experience of the bio-rich Kerala in particular.Keywords: IPR, technology and international relations, bio-diversity, traditional knowledge
Procedia PDF Downloads 375494 Possibilities and Challenges for District Heating
Authors: Louise Ödlund, Danica Djuric Ilic
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From a system perspective, there are several benefits of DH. A possibility to utilize the excess heat from waste incineration and biomass-based combined heat and power (CHP) production (e.g. possibility to utilize the excess heat from electricity production) are two examples. However, in a future sustainable society, the benefits of DH may be less obvious. Due to the climate changes and increased energy efficiency of buildings, the demand for space heating is expected to decrease. Due to the society´s development towards circular economy, a larger amount of the waste will be material recycled, and the possibility for DH production by the energy recovery through waste incineration will be reduced. Furthermore, the benefits of biomass-based CHP production will be less obvious since the marginal electricity production will no longer be linked to high greenhouse gas emissions due to an increased share of renewable electricity capacity in the electricity system. The purpose of the study is (1) to provide an overview of the possible development of other sectors which may influence the DH in the future and (2) to detect new business strategies which would enable for DH to adapt to the future conditions and remain competitive to alternative heat production in the future. A system approach was applied where DH is seen as a part of an integrated system which consists of other sectors as well. The possible future development of other sectors and the possible business strategies for DH producers were searched through a systematic literature review In order to remain competitive to the alternative heat production in the future, DH producers need to develop new business strategies. While the demand for space heating is expected to decrease, the space cooling demand will probably increase due to the climate changes, but also due to the better insulation of buildings in the cases where the home appliances are the heat sources. This opens up a possibility for applying DH-driven absorption cooling, which would increase the annual capacity utilization of the DH plants. The benefits of the DH related to the energy recovery from the waste incineration will exist in the future since there will always be a need to take care of materials and waste that cannot be recycled (e.g. waste containing organic toxins, bacteria, such as diapers and hospital waste). Furthermore, by operating central controlled heat pumps, CHP plants, and heat storage depending on the intermittent electricity production variation, the DH companies may enable an increased share of intermittent electricity production in the national electricity grid. DH producers can also enable development of local biofuel supply chains and reduce biofuel production costs by integrating biofuel and DH production in local DH systems.Keywords: district heating, sustainable business strategies, sustainable development, system approach
Procedia PDF Downloads 84493 Opportunities and Challenges in Midwifery Education: A Literature Review
Authors: Abeer M. Orabi
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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.Keywords: barriers, challenges, midwifery education, educational programs
Procedia PDF Downloads 115492 Post-Traumatic Stress Disorder and Problem Alcohol Use in Women: Systematic Analysis
Authors: Neringa Bagdonaite
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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis
Procedia PDF Downloads 183491 Anesthetic Considerations for Spinal Cord Stimulators
Authors: Abuzar Baloach
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Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS
Procedia PDF Downloads 7490 Adverse Childhood Experience of Domestic Violence and Domestic Mental Health Leading to Youth Violence: An Analysis of Selected Boroughs in London
Authors: Sandra Smart-Akande, Chaminda Hewage, Imtiaz Khan, Thanuja Mallikarachchi
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According to UK police-recorded data, there has been a substantial increase in knife-related crime and youth violence in the UK since 2014 particularly in the London boroughs. These crime rates are disproportionally distributed across London with the majority of these crimes occurring in the highly deprived areas of London and among young people aged 11 to 24 with large discrepancies across ethnicity, age, gender and borough of residence. Comprehensive studies and literature have identified risk factors associated with a knife carrying among youth to be Adverse Childhood Experience (ACEs), poor mental health, school or social exclusion, drug dealing, drug using, victim of violent crime, bullying, peer pressure or gang involvement, just to mention a few. ACEs are potentially traumatic events that occur in childhood, this can be experiences or stressful events in the early life of a child and can lead to an increased risk of damaging health or social outcomes in the latter life of the individual. Research has shown that children or youths involved in youth violence have had childhood experience characterised by disproportionate adverse childhood experiences and substantial literature link ACEs to be associated with criminal or delinquent behavior. ACEs are commonly grouped by researchers into: Abuse (Physical, Verbal, Sexual), Neglect (Physical, Emotional) and Household adversities (Mental Illness, Incarcerated relative, Domestic violence, Parental Separation or Bereavement). To the author's best knowledge, no study to date has investigated how household mental health (mental health of a parent or mental health of a child) and domestic violence (domestic violence on a parent or domestic violence on a child) is related to knife homicides across the local authorities areas of London. This study seeks to address the gap by examining a large sample of data from the London Metropolitan Police Force and Characteristics of Children in Need data from the UK Department for Education. The aim of this review is to identify and synthesise evidence from data and a range of literature to identify the relationship between adverse childhood experiences and youth violence in the UK. Understanding the link between ACEs and future outcomes can support preventative action.Keywords: adverse childhood experiences, domestic violence, mental health, youth violence, prediction analysis, London knife crime
Procedia PDF Downloads 120489 Impact of Natural and Artificial Disasters, Lackadaisical and Semantic Approach in Risk Management, and Mitigation Implication for Sustainable Goals in Nigeria, from 2009 to 2022
Authors: Wisdom Robert Duruji, Moses Kanayochukwu Ifoh, Efeoghene Edward Esiemunobo
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This study examines the impact of natural and artificial disasters, lackadaisical and semantic approach in risk management, and mitigation implication for sustainable development goals in Nigeria, from 2009 to 2022. The study utilizes a range of research methods to achieve its objectives. These include literature review, website knowledge, Google search, news media information, academic journals, field-work and on-site observations. These diverse methods allow for a comprehensive analysis on the impact and the implications being study. The study finds that paradigm shift from remediating seismic, flooding, environmental pollution and degradation natural disasters by Nigeria Emergency Management Agency (NEMA), to political and charity organization; has plunged risk reduction strategies to embezzling opportunities. However, this lackadaisical and semantic approach in natural disaster mitigation, invariably replicates artificial disasters in Nigeria through: Boko Haram terrorist organization, Fulani herdsmen and farmers conflicts, political violence, kidnapping for ransom, ethnic conflicts, Religious dichotomy, insurgency, secession protagonists, unknown-gun-men, and banditry. This study also, finds that some Africans still engage in self-imposed slavery through human trafficking, by nefariously stow-away to Europe; through Libya, Sahara desert and Mediterranean sea; in search for job opportunities, due to ineptitude in governance by their leaders; a perilous journey that enhanced artificial disasters in Nigeria. That artificial disaster fatality in Nigeria increased from about 5,655 in 2009 to 114,318 in 2018; and to 157,643 in 2022. However, financial and material loss of about $9.29 billion was incurred in Nigeria due to natural disaster, while about $70.59 billion was accrued due to artificial disaster; from 2009 to 2018. Although disaster risk mitigation and politics can synergistically support sustainable development goals; however, they are different entities, and need for distinct separations in Nigeria, as in reality and perception. This study concluded that referendum should be conducted in Nigeria, to ascertain its current status as a nation. Therefore it is recommended that Nigerian governments should refine its naturally endowed crude oil locally; to end fuel subsidy scam, corruption and poverty in Nigeria!Keywords: corruption, crude oil, environmental risk analysis, Nigeria, referendum, terrorism
Procedia PDF Downloads 44488 Caregivers Roles, Care Home Management, Funding and Administration in Challenged Communities: Focus in North Eastern Nigeria
Authors: Chukwuka Justus Iwegbu
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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria
Procedia PDF Downloads 107487 Assessing Professionalism, Communication, and Collaboration among Emergency Physicians by Implementing a 360-Degree Evaluation
Authors: Ahmed Al Ansari, Khalid Al Khalifa
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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.Keywords: MSF system, emergency, validity, generalizability
Procedia PDF Downloads 357486 Effect of Institutional Structure on Project Managers Performance in Construction Projects: A Case Study in Nigeria
Authors: Ebuka Valentine Iroha, Tsunemi Watanabe, Satoshi Tsuchiya
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Project management practices play an important role in construction project performance and are one of project managers' essential key performance indicators. Previous studies have explored the poor performance of the construction industry, with project delays and cost overruns identified to contribute largely to numerous abandoned projects. These challenges are attributed to insufficient project management practices and a lack of utilization of project managers. The actual causes of inadequate project management practices and underutilization of project managers have been rarely discussed. This study tends to bridge the gap by identifying and assessing the actual causes of insufficient project management practices and underutilization of project managers. This study differs from past studies investigating the causes of poor performance by using institutional analysis methods to identify and analyze the factors influencing project management practices and proper utilization of project managers. Based on a comprehensive literature review, this study identified some factors embedded in the construction industry that influence the institutional environment and weaken the laws and regulations. These factors were used as the basis for semi-structured interview questions to investigate their impacts on project management practices and project managers. The data collected were coded into a four-level framework for institutional analysis. This method was used to analyze the interrelationships between the identified embedded factors, institutional laws and regulations, and construction organizations to understand how these influences result in the underutilization of project managers. The study found that the underutilization of project managers consists of two subsystems, including underutilization and lowering commitment. The first subsystem, corruption, political influence, religious and tribal discrimination, and organizational culture, were found to affect the institutional structure. These embedded factors weaken the industry’s governance mechanism, forcing project managers to prioritize corrupt practices over project demands. The ineffectiveness of the existing laws and regulations worsens the situation, supporting unfair working conditions and contributing to the underperformance of project managers. This situation leads to the development of the second subsystem, which is characterized by a lack of opportunities for career development and minimal incentives within construction organizations. The findings provide significant potential for addressing systemic challenges in the construction industry, particularly the underutilization of project managers and enhancing organizational support measures to improve project management practices and mitigate the adverse effects of corruption.Keywords: construction industry, project management, poor performance, embedded factors, project managers underutilization
Procedia PDF Downloads 38485 Method for Selecting and Prioritising Smart Services in Manufacturing Companies
Authors: Till Gramberg, Max Kellner, Erwin Gross
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This paper presents a comprehensive investigation into the topic of smart services and IIoT-Platforms, focusing on their selection and prioritization in manufacturing organizations. First, a literature review is conducted to provide a basic understanding of the current state of research in the area of smart services. Based on discussed and established definitions, a definition approach for this paper is developed. In addition, value propositions for smart services are identified based on the literature and expert interviews. Furthermore, the general requirements for the provision of smart services are presented. Subsequently, existing approaches for the selection and development of smart services are identified and described. In order to determine the requirements for the selection of smart services, expert opinions from successful companies that have already implemented smart services are collected through semi-structured interviews. Based on the results, criteria for the evaluation of existing methods are derived. The existing methods are then evaluated according to the identified criteria. Furthermore, a novel method for the selection of smart services in manufacturing companies is developed, taking into account the identified criteria and the existing approaches. The developed concept for the method is verified in expert interviews. The method includes a collection of relevant smart services identified in the literature. The actual relevance of the use cases in the industrial environment was validated in an online survey. The required data and sensors are assigned to the smart service use cases. The value proposition of the use cases is evaluated in an expert workshop using different indicators. Based on this, a comparison is made between the identified value proposition and the required data, leading to a prioritization process. The prioritization process follows an established procedure for evaluating technical decision-making processes. In addition to the technical requirements, the prioritization process includes other evaluation criteria such as the economic benefit, the conformity of the new service offering with the company strategy, or the customer retention enabled by the smart service. Finally, the method is applied and validated in an industrial environment. The results of these experiments are critically reflected upon and an outlook on future developments in the area of smart services is given. This research contributes to a deeper understanding of the selection and prioritization process as well as the technical considerations associated with smart service implementation in manufacturing organizations. The proposed method serves as a valuable guide for decision makers, helping them to effectively select the most appropriate smart services for their specific organizational needs.Keywords: smart services, IIoT, industrie 4.0, IIoT-platform, big data
Procedia PDF Downloads 89484 The Relationship between Elderly People with Depression and Built Environment Factors
Authors: Hung-Chun Lin, Tzu-Yuan Chao
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As the population aging has become an inevitable trend globally, issues of improving the well-being of elderly people in urban areas have been a challenging task for urban planners. Recent studies of ageing trend have also expended to explore the relationship between the built environment and mental condition of elderly people. These studies have proved that even though the built environment may not necessarily play the decisive role in affecting mental health, it can have positive impacts on individual mental health by promoting social linkages and social networks among older adults. There has been a great amount of relevant research examined the impact of the built environment attributes on depression in the elderly; however, most were conducted in the Western countries. Little attention has been paid in Asian cities with contrarily high density and mix-use urban contexts such as Taiwan regarding how the built environment attributes related to depression in elderly people. Hence, more empirical cross-principle studies are needed to explore the possible impacts of Asia urban characteristics on older residents’ mental condition. This paper intends to focus on Tainan city, the fourth biggest metropolis in Taiwan. We first analyze with data from National Health Insurance Research Database to pinpoint the empirical study area where residing most elderly patients, aged over 65, with depressive disorders. Secondly, we explore the relationship between specific attributes of the built environment collected from previous studies and elderly individuals who suffer from depression, under different socio-cultural and networking circumstances. To achieve the results, the research methods adopted in this study include questionnaire and database analysis, and the results will be proceeded by correlation analysis. In addition, through literature review, by generalizing the built environment factors that have been used in Western research to evaluate the relationship between built environment and older individuals with depressive disorders, a set of local evaluative indicators of the built environment for future studies will be proposed as well. In order to move closer to develop age-friendly cities and improve the well-being for the elderly in Taiwan, the findings of this paper can provide empirical results to grab planners’ attention for how built environment makes the elderly feel and to reconsider the relationship between them. Furthermore, with an interdisciplinary topic, the research results are expected to make suggestions for amending the procedures of drawing up an urban plan or a city plan from a different point of view.Keywords: built environment, depression, elderly, Tainan
Procedia PDF Downloads 123