Search results for: maternal request for cesarean section

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: Merve Ermis, Akif Kutlu, Nihal Eratlı, Mehmet H. Omurtag

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In this study, the free vibration analysis of conical helicoidal rods with two different elliptically oriented cross sections is investigated and the results are compared by the circular cross-section keeping the net area for all cases equal to each other. Problems are solved by using the mixed finite element formulation. Element matrices based on Timoshenko beam theory are employed. The finite element matrices are derived by directly inserting the analytical expressions (arc length, curvature, and torsion) defining helix geometry into the formulation. Helicoidal rod domain is discretized by a two-noded curvilinear element. Each node of the element has 12 DOFs, namely, three translations, three rotations, two shear forces, one axial force, two bending moments and one torque. A parametric study is performed to investigate the influence of elliptical cross sectional geometry and its orientation over the natural frequencies of the conical type helicoidal rod.

Keywords: conical helix, elliptical cross section, finite element, free vibration

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Authors: Mengjie Liu

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This essay aims at responding to the Kant arguments on how to fit the self-caused subject into the deterministic object which follows the natural laws. This essay mainly adopts the approach abstracted from Fichte’s “Wissenshaftslehre” (Doctrine of Science) to picture a possible solution to the conciliation of Kantian dualism. The Fichte approach is based on the unity of the theoretical and practical reason, which can be understood as a philosophical abstraction from ordinary experience combining both subject and object. This essay will discuss the general Kantian dualism problem and Fichte’s unity approach in the first part. Then the essay will elaborate on the achievement of this unity of the subject and object through Fichte’s “the I posits itself” process in the second section. The following third section is related to the ethical unity of subject and object based on the Fichte approach. The essay will also discuss the limitation of Fichte’s approach from two perspectives: (1) the theoretical possibility of the existence of the pure I and (2) Schelling’s statement that the Absolute I is a result rather than the originating act. This essay demonstrates a possible approach to unifying the subject and object supported by Fichte’s “Absolute I” and ethical theories and also points out the limitations of Fichte’s theories.

Keywords: Fichte, identity, Kantian dualism, Wissenshaftslehre

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Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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Authors: S. Hellam, Y. Oulahrir, F. El Mounchid, A. Sadiq, S. Mbarki

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In this paper, we propose a method for three-dimensional (3-D)-model indexing based on defining a new descriptor, which we call new descriptor using spherical harmonics. The purpose of the method is to minimize, the processing time on the database of objects models and the searching time of similar objects to request object. Firstly we start by defining the new descriptor using a new division of 3-D object in a sphere. Then we define a new distance which will be used in the search for similar objects in the database.

Keywords: 3D indexation, spherical harmonic, similarity of 3D objects, measurement similarity

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Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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Authors: Muazzam Ali Khan Khattak

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Next Generation Network is combination of different networks having different technologies. Due to mobile nature of nodes the movement of nodes occurs from one network to another network. Multicasting in such networks is still a hot issue of research because the user in today's world wants reliable communication wherever it lies. Due to heterogeneity of NGN it is very difficult to handle reliable multicast communication. In this paper we proposed an improved scheme for reliable multicast communication in next generation networks. Because multicast communication is very important to deliver same data packets to multiple receivers and minimize the network traffic. This new scheme will make the multicast communication in NGN more reliable and efficient.

Keywords: next generation networks, route request, IPT, NACK, ARQ, DTN

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: electronic medical records, information extraction, logic modeling, ontology, vetted web mining

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Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

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A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

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Authors: Mohammad Mahdi Kioumarsi

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In this paper, using the response surface method (RSM), tornado diagram method and non-linear finite element analysis, the effect of four parameters on residual bending capacity of a corroded RC beam was investigated. The parameters considered are amount of localised cross section reduction, ratio of pit distance on adjacent bars to rebar distance, concrete compressive strength, and rebar tensile strength. The focus is on the influence on the bending ultimate limit state. Based on the obtained results, the effects of the ratio of pit distance to rebar distance (Lp⁄Lr) and the ratio of the localised cross section reduction to the original area of the rebar (Apit⁄A0) were found significant. The interference of localised corrosion on adjacent reinforcement bars reduces the bending capacity of under-reinforced concrete beam. Using the sensitivity analysis could lead to recognize uncertainty parameters, which have the most influences on the performance of the structure.

Keywords: localised corrosion, concrete beam, sensitivity analyses, ultimate capacity

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Mengjie Liu

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This essay mainly analyses the representation of the Apollo and Dionysus spirits in Hermann Hesse’s novel “Steppenwolf.” This analysis adopts a theoretical approach based on Fredrich Nietzsche’s theory of the two separate art worlds, dream and intoxication, which corresponds to the two art deities, Apollo and Dionysus. The essay will discuss Friedrich Nietzsche’s art and aesthetic theory of dream and intoxication in the first part. Then the essay will elaborate on the representation of the Apollo spirit and dream in “Steppenwolf” in the second section from two aspects: (1) Harry Haller’s (the main character) self-recognition and semblance with Hermina. (2) The realization of Hermina’s prophecy of the dream. Then the essay will analyze the representation of the Dionysus spirit and the intoxication in the third part by demonstrating Harry Haller’s self-forgetting and melting into the crowd. The essay will combine the two spirits in the fourth section and discuss the relationship between dream and intoxication as the stimulator (dream) and the realizing (intoxication). This essay takes Nietzsche’s theory as the basic foundation while also drawing sources from psychological analysis theories and other literature sources.

Keywords: dream, intoxication, Nietzsche, Steppenwolf

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Authors: Lev Bertovsky

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The purpose of this study was to determine the reasons for the formation of false testimony from witnesses and make recommendations on the recognition of such cases. During the studies, which were based on the achievements of professionals in the field of psychology, as well as personal investigative practice, the stages of perception of the information were studied, as well as the process of its reclaim from the memory and transmission to the communicator upon request. Based on the principles of the human brain, kinds of conscientious witness mistakes were systematized. Proposals were formulated for the optimization of investigative actions in cases where the witnesses make an honest mistake with respect to the effects previously observed by them.

Keywords: criminology, eyewitness testimony, honest mistake, information, investigator, investigation, questioning

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Authors: Ewa Mojs, Katarzyna Wiechec, Maia Kubiak, Wlodzimierz Samborski

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Interactions between mother’s psychological condition and child’s health status are complex and derive from the nature of the mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in the aspect of growth hormone therapy. The study was based on a group of 101 mothers of originally short-statured children – 70 with growth hormone deficiency (GHD) treated with recombinant human growth hormone (rhGH) and 31 undergoing the diagnostic process, without any treatment. Collected medical data included child's gender, height and weight, chronological age, bone age delay, and rhGH therapy duration. For all children, the height SDS and BMI SDS were calculated. To evaluate anxiety in mothers, the Spielberger State-Trait Anxiety Inventory (STAI) was used. Obtained results revealed low trait anxiety levels, with no statistically significant differences between the groups. State anxiety levels were average when mothers of all children were analyzed together, but when divided into groups, statistical differences appeared. Mothers of children without diagnosis and treatment had significantly higher levels of state anxiety than mothers of children with GHD receiving appropriate therapy. These results show, that the occurrence of growth failure in children is not related to high maternal trait anxiety, but the lack of diagnosis and lack of appropriate treatment generates higher levels of maternal state anxiety than the process of rh GH therapy in the offspring. Commencement of growth hormone therapy induce a substantial reduction of the state anxiety in mothers, and the duration of treatment causes its further decrease.

Keywords: anxiety, development, growth hormone deficiency, motherhood

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Authors: Mateusz Frydrych

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The construction of diaphragm walls as excavation shoring as well as part of deep foundations is widely used in geotechnical engineering. Today's design challenges lie in the optimal dimensioning of the cross-section, which is demanded by technological considerations. Also in force is the issue of optimization and sustainable use of construction materials, including reduction of carbon footprint, which is currently a relevant challenge for the construction industry. The author presents the concept of an approach to achieving increased efficiency of diaphragm wall excavation shoring by using structural compression technology. The author proposes to implement prestressed tendons in a non-linear manner in the reinforcement cage. As a result bending moment is reduced, which translates into a reduction in the amount of steel needed in the section, a reduction in displacements, and a reduction in the scratching of the casing, including the achievement of better tightness. This task is rarely seen and has not yet been described in a scientific way in the literature. The author has developed a dynamic numerical model that allows the dimensioning of the cross-section of a prestressed shear wall, as well as the study of casing displacements and cross-sectional forces in any defined computational situation. Numerical software from the Sofistik - open source development environment - was used for the study, and models were validated in Plaxis software . This is an interesting idea that allows for optimizing the execution of construction works and reducing the required resources by using fewer materials and saving time. The author presents the possibilities of a prestressed diaphragm wall, among others, using. The example of a diaphragm wall working as a cantilever at the height of two underground floors without additional strutting or stability protection by using ground anchors. This makes the execution of the work more criminal for the contractor and, as a result, cheaper for the investor.

Keywords: prestressed diaphragm wall, Plaxis, Sofistik, innovation, FEM, optimisation

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Authors: K. Raghu, Altafhusen P. Pinjar

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Cold-formed steel section are extensively used in industry and many other non-industry constructions worldwide, it is relatively a new concept in India. Cold-formed steel sections have been developed as more economical building solutions to the alternative heavier hot-rolled sections in the commercial and residential markets. Cold‐formed steel (CFS) structural members are commonly manufactured with perforations to accommodate plumbing, electrical, and heating conduits in the walls and ceilings of buildings. Current design methods available to engineers for predicting the strength of CFS members with perforations are prescriptive and limited to specific perforation locations, spacing, and sizes. The Direct Strength Method (DSM), a relatively new design method for CFS members validated for members with and without perforations, predicts the ultimate strength of general CFS members with the elastic buckling properties of the member cross section. The design compression strength and flexural strength of Indian (IS 811-1987) standard sections is calculated as per North American Specification (AISI-S100 2007) and software CUFSM 4.05.

Keywords: direct strength, cold formed, perforations, CUFSM

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Authors: Parinaz Arashnia, Farzad Hatami, Saeed Ghaffarpour Jahromi

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Using steel in bridges’ construction because of their desired tensile and compressive strength and light weight especially in large spans was widely popular. Disadvantages of steel such as corrosion, buckling and weaknesses in high temperature and unsuitable weld could be solve with using Fibres Reinforced Polymer (FRP) profiles. The FRP is a remarkable class of composite polymers that can improve structural elements behaviour like corrosion resistance, fir resistance with good proofing and electricity and magnetic non-conductor. Nowadays except FRP reinforced bars and laminates, FRP I-beams are made and studied. The main reason for using FRP profiles is, prevent of corrosion and increase the load carrying capacity and durability, especially in large spans in bridges’ deck. In this paper, behaviour of I-section glass fibres reinforced polymer (GFRP) beam is discussed under point loads with numerical models and results has been compared and verified with experimental tests.

Keywords: glass fibres reinforced polymer, composite, I-section beam, durability, finite element method, numerical model

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Authors: Vaishali Joshi, Pallav Joshi

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The main objective of this study is to examine the fashion consumption behavior of females with respect to their age group. Differences were studied in the pre-purchase, purchase and post-purchase behavior of females belonging to three age cohorts such as Generation X, Generation Y, and Generation Z. Quantitative approach was used to conduct this research. Data was collected through structured questionnaire. The questionnaire consisted of three sections. Section one included a question of the source of information of purchasing fashion apparels which measure the pre-purchase behavior. Section two measures purchase behavior which included two questions: i. motivations for purchasing fashion apparel and ii. important attributes considered for purchasing fashion apparel. The last section included a question regarding disposal of fashion apparel which measures the post-purchase behavior. Hundred females were selected as the respondents for this study through convenience sampling in the fashion streets. They were categorized into three age groups and then the results were analyzed. Four hypotheses were developed after reviewing the existing literature. Regression analysis was conducted for testing the hypothesis. Hypothesis one was accepted which stated that ‘social influence’ as a source of information for purchasing fashion apparels decreases with age. Hypothesis two was accepted which suggested that motivation of ‘Attention seeking’ for purchasing fashion apparel decreases with age. Hypothesis three and four also accepted which suggested that the importance of ‘Quality’ and ‘Price’ increases with age but hypothesis five was rejected which suggested that the importance of ‘Fit’ increases with age and last but not the least hypothesis six was accepted which suggested that the ‘duration’ of using fashion apparel increases with age. Limitation of the study deals with the sample of only female respondents. Implication can be made from this research in the field of Fashion apparel industry with respect to consumer segmentation and better marketing approaches can be implemented by the marketers form this study. Further research can be concluded by including male respondents also.

Keywords: fashion, consumption behavior, age cohorts, motivation

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Authors: Jot Prakash Kaur

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The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.

Keywords: corruption, integrity pact, procurement, vigilance

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Authors: Ryan C. Zlomek

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The value of using comics in the literacy classroom has been explored since the 1930s. At that point in time researchers had begun to implement comics into daily lesson plans and, in some instances, had started the development process for comics-supported curriculum. In the mid-1950s, this type of research was cut short due to the work of psychiatrist Frederic Wertham whose research seemingly discovered a correlation between comic readership and juvenile delinquency. Since Wertham’s allegations the comics medium has had a hard time finding its way back to education. Now, over fifty years later, the definition of literacy is in mid-transition as the world has become more visually-oriented and students require the ability to interpret images as often as words. Through this transition, comics has found a place in the field of literacy education research as the shift focuses from traditional print to multimodal and media literacies. Comics are now believed to be an effective resource in bridging the gap between these different types of literacies. This paper seeks to better understand what students learn from the process of reading comics and how those skills line up with the core principles of media literacy education in the United States. In the first section, comics are defined to determine the exact medium that is being examined. The different conventions that the medium utilizes are also discussed. In the second section, the comics reading process is explored through a dissection of the ways a reader interacts with the page, panel, gutter, and different comic conventions found within a traditional graphic narrative. The concepts of intersubjective acts and visualization are attributed to the comics reading process as readers draw in real world knowledge to decode meaning. In the next section, the learning processes that comics encourage are explored parallel to the core principles of media literacy education. Each principle is explained and the extent to which comics can act as an intermediary for this type of education is theorized. In the final section, the author examines comics use in his computer science and technology classroom. He lays out different theories he utilizes from Scott McCloud’s text Understanding Comics and how he uses them to break down media literacy strategies with his students. The article concludes with examples of how comics has positively impacted classrooms around the United States. It is stated that integrating comics into the classroom will not solve all issues related to literacy education but, rather, that comics can be a powerful multimodal resource for educators looking for new mediums to explore with their students.

Keywords: comics, graphics novels, mass communication, media literacy, metacognition

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Authors: Mya Achike

Abstract:

Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

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Authors: Semih Erdogan

Abstract:

In this paper, the normal and shear stress distributions in Vlasov beams are determined by two-dimensional triangular finite element formulations. The proposed formulations take into account the warping effects along the beam axis. The shape of the considered beam sections may be arbitrary and varied throughout its length. The stiffness matrices and force vectors are derived for transversal forces, uniform torsion, and nonuniform torsion. The proposed finite element algorithm is validated by comparing the analytical solutions, structural engineering books, and related articles. The numerical examples include beams with different cross-section types such as solid, thick-walled, closed-thin-walled, and open-thin-walled sections. Materials defined in the examples are homogeneous, isotropic, and linearly elastic. Through these examples, the study demonstrates the capability of the proposed method to address a wide range of practical engineering scenarios.

Keywords: Vlasov beams, warping function, nonuniform torsion, finite element method, normal and shear stresses, cross-section properties

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Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

Procedia PDF Downloads 388

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

Abstract:

The geometry of RVOT is extremely complicated. It is an irregular block with an ellipsoidal cross-section, whose dimensions decrease toward the pulmonary valve and measure 33.82 (IQR 30,51-39,36), 28.82 (IQR 26,11-32,22), 27.95 ± 4,11 for width [mm] and 33.41 ± 6,14, 26.99 ± 4,41, 26.91 ± 4,00 [mm] for depth, in the basal, middle and subpulmonary parts, respectively. In a sagittal section view, the RVOT heads upward and slightly backward. Its anterior perimeter has an average length of 41.96 mm and inclines to the transverse plane at an angle of 50.77° (IQR 46,53°-58,70°). In the posterior region, the RVOT is shorter (18.17mm) and flexes anteriorly. Therefore, the slope of the upper part of the rear wall to the transverse plane is an acute angle (open toward the rear) of 44,58° (IQR 37,30°-51,25°), while in the lower part it is an angle close to a right angle of 94,30°±15,44°. In addition, the thickness of the RVOT wall in the diastolic phase, at the posterior perimeter at the base, in the middle of the length and subpulmonary measure 3,80 mm ± 0,88 mm, 3,56 mm ± 0,73 mm, 3,56 mm ± 0,65 mm, respectively. In frontal cross-section, the RVOT rises on the interventricular septum, which makes it possible to distinguish the septal and supraseptal parts on its left periphery. The angles (facing the vertices to the right) of the inclination of these parts to the transverse plane are 75.5° (IQR 66,44°-81,11°) and 107.01° (IQR 99,09 – 115,23°), respectively, which allows us to conclude that the direction of the RVOT long axis changes from left to right. The above analysis shows that there is no single RVOT axis. Two axes can be distinguished, the one for the upper RVOT being more backward and leftward. The aforementioned forward deflection of the posterior wall and the RVOT's elevation over the interventricular septum, suggest that access to the subpulmonary region may be difficult. It should be emphasized that this area is often the target for ablation of ventricular arrhythmias. The small thickness of the RVOT posterior wall, with its difficult geometry, may favor its perforation into the pericardium or ascending aorta.

Keywords: angle, geometry, operation access, position, RVOT, shape

Procedia PDF Downloads 85

Authors: F. Saleh, F. Lyall, A. Abdulsid, L. Marks

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Background: Labour in human is a complex biological process that involves interactions of neurological, hormonal and inflammatory pathways, with the placenta being a key regulator of these pathways. It is known that uterine contractions and labour pain cause physiological changes in gene expression in maternal and fetal blood, and in placenta during labour. Oxidative and inflammatory stress pathways are implicated in labour and they may cause alteration of placental gene expression. Additionally, in placental tissues, labour increases the expression of genes involved in placental oxidative stress, inflammatory cytokines, angiogenic regulators and apoptosis. Recently, Hydrogen Sulphide (H2S) has been considered as an endogenous gaseous mediator which promotes vasodilation and exhibits cytoprotective anti-inflammatory properties. The endogenous H2S is synthesised predominantly by two enzymes: cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). As the H2S pathway has anti-oxidative and anti-inflammatory characteristics thus, we hypothesised that the expression of CBS and CSE in placental tissues would alter during labour. Methods: CBS and CSE expressions were examined in placentas using western blotting and RT-PCR in inner, middle and outer placental zones in placentas obtained from healthy non labouring women who delivered by caesarian section. These were compared with the equivalent zone of placentas obtained from women who had uncomplicated labour and delivered vaginally. Results: No differences in CBS and CSE mRNA or protein levels were found between the different sites within placentas in either the labour or non-labour group. There were no significant differences in either CBS or CSE expression between the two groups at the inner site and middle site. However, at the outer site there was a highly significant decrease in CBS protein expression in the labour group when compared to the non-labour group (p = 0.002). Conclusion: To the best of author’s knowledge, this is the first report to suggest that, CBS is expressed in a spatial manner within the human placenta. Further work is needed to clarify the precise function and mechanism of this spatial regulation although it is likely that inflammatory pathways regulation is a complex process in which this plays a role.

Keywords: anti-inflammatory, hydrogen sulphide, labour, oxidative stress

Procedia PDF Downloads 223

Authors: Y. Khulief, S. Bashmal, S. Said, D. Al-Otaibi, K. Mansour

Abstract:

The prediction of flow rates at which the vibration-induced instability takes place in tubular heat exchangers due to cross-flow is of major importance to the performance and service life of such equipment. In this paper, the semi-analytical model for square tube arrays was extended and utilized to study the triangular tube patterns. A laboratory test rig with instrumented test section is used to measure the fluidelastic coefficients to be used for tuning the mathematical model. The test section can be made of any bundle pattern. In this study, two test sections were constructed for both the normal triangular and the rotated triangular tube arrays. The developed scheme is utilized in predicting the onset of flow-induced instability in the two triangular tube arrays. The results are compared to those obtained for two other bundle configurations. The results of the four different tube patterns are viewed in the light of TEMA predictions. The comparison demonstrated that TEMA guidelines are more conservative in all configurations considered

Keywords: fluid-structure interaction, cross-flow, heat exchangers,

Procedia PDF Downloads 252

Authors: Ririt Aprilin Sumarsono

Abstract:

Composite member (concrete and steel) has been widely advanced for structural utilization due to its best performance in resisting load, reducing the total weight of the structure, increasing stiffness, and other available advantages. On the other hand, the environment load such as corrosion (e.g. chloride ingress) creates significant time-dependent degradation for steel. Analysis performed in this paper is mainly considered uniform corrosion for evaluating the composite beam without examining the pit corrosion as the initial corrosion formed. Corrosion level in terms of weight loss is modified in yield stress and modulus elasticity of steel. Those two mechanical properties are utilized in this paper for observing the stresses due to corrosion attacked. As corrosion level increases, the effective width of the composite beam in the concrete section will be wider. The position of a neutral axis of composite section will indicate the composite action due to corrosion of composite beam so that numerous shear connectors provided must be reconsidered. Flexure capacity quantification provides stresses, and shear capacity calculation derives connectors needed in overcoming the shear problem for composite beam under corrosion. A model of simply supported composite beam examined in this paper under uniform corrosion where the stresses as the focus of the evaluation. Principal stress at the first stage of composite construction decline as the corrosion level incline, parallel for the second stage stress analysis where the tension region held by the steel undergoes lower capacity due to corrosion. Total stresses of the composite section for steel to be born significantly decreases particularly in the outermost fiber of tension side. Whereas, the available compression side is smaller as the corrosion level increases so that the stress occurs on the compression side shows reduction as well. As a conclusion, the increment of corrosion level will degrade both compression and tension side of stresses.

Keywords: composite beam, modulus of elasticity, stress analysis, yield strength, uniform corrosion

Procedia PDF Downloads 264

Authors: Chun-Hao Lai, Yu-Fang Huang, Pei-Wei Wang, Meng-Han Lin, Mei-Lien Chen

Abstract:

Nonylphenol (NP) is a degradation product of nonylphenol ethoxylates (NPEOs). It is a well-known endocrine disruptor which may cause estrogenic effects. The growing fetus and infants are more vulnerable to exposure to NP than adults. It is important to know the levels and influences of prenatal exposure to NP. The aims of this study were (1) to determine the levels of prenatal exposure among Taiwanese, (2) to evaluate the potential risk for the infants who were breastfed and exposed to NP through the milk. (3) To investigate the correlation between birth outcomes and prenatal exposure to NP. We analyzed thirty one pairs of maternal urines, placentas, first month’ breast milk by high-performance liquid chromatography coupling with fluorescence detector. The questionnaire included socio- demographics, lifestyle, delivery method, dietary and work history. Information about the birth outcomes were obtained from medical records. The daily intake of NP from breast milk was calculated using deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in placenta, and breast milk in the first month were 31.2 (1.8) ng/g, 17.2 (1.6) ng/g, respectively. The medium of daily intake NP in breast milk was 1.33 μg/kg-bw/day in the first month. We found negative association between NP levels of placenta and birth height. And we observed negative correlation between maternal urine NP levels and birth weight. In this study, we could provide the NP exposure profile among Taiwan pregnant women and the daily intake of NP in Taiwan infants. Prenatal exposure to higher levels of NP may increase the risk of lower birth weight and shorter birth height.

Keywords: nonylphenol, mother, fetus, placenta, breast milk, urine

Procedia PDF Downloads 215

Authors: Ozlem Karabulutlu, Kiymet Yesilcicek Calik, Nazli Akar

Abstract:

Objectives: To examine fear of childbirth according to parity, gestational age, prenatal education, and obstetric history. Methods: The study was performed as a questionnaire design in a State Hospital in Kars, Turkey with 403 unselected pregnant who were recruited from the delivery unit. The data were collected via 3 questionnaires; the first with sociodemographic and obstetric features, the second with Wijma Delivery Expectance/Experience Questionnaire (W-DEQ) scale, and the third with the scale of Beck Anxiety Inventory (BAI). Results: The W-DEQ and BAI scores were higher in nulliparous than multiparous woman (W-DEQ 67.08±28.33, 59.87±26.91, P=0.039<0.05, BAI 18.97±9.5, 16.65±11.83, P=0.0009<0.05 respectively). Moreover, W-DEQ and BAI scores of pregnant whose gestational week was ≤37 / ≥41 and who didn’t receive training and had vaginal delivery was higher than those whose gestational week was 38-40 weeks and who received prenatal training and had cesarean delivery (W-DEQ 67.54±29.20, 56.44±22.59, 69.72±25.53 p<0.05, BAI 21.41±9.07; 15.77±11.20, 18.36±10.57 p<0.05 respectively). Both in nulliparous and multiparous, as W-DEQ score increases BAI score increases too (r=0.256; p=0.000<0.05). Conclusions: Severe fear of childbirth and anxiety was more common in nulliparous women, preterm and post-term pregnancy and who did not receive prenatal training and had vaginal delivery.

Keywords: Beck Anxiety Inventory (BAI), fear of birth, parity, pregnant women, Wijma Delivery Expectance/Experience Questionnaire (W-DEQ)

Procedia PDF Downloads 263