Search results for: risk factors for flap failure
15888 Study on Water Level Management Criteria of Reservoir Failure Alert System
Authors: B. Lee, B. H. Choi
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The loss of safety for reservoirs brought about by climate change and facility aging leads to reservoir failures, which results in the loss of lives and property damage in downstream areas. Therefore, it is necessary to provide a reservoir failure alert system for downstream residents to detect the early signs of failure (with sensors) in real-time and perform safety management to prevent and minimize possible damage. 10 case studies were carried out to verify the water level management criteria of four levels (attention, caution, alert, serious). Peak changes in water level data were analysed. The results showed that ‘Caution’ and ‘Alert’ were closed to 33% and 66% of difference in level between flood water level and full water level. Therefore, it is adequate to use initial water level management criteria of reservoir failure alert system for the first year. Acknowledgment: This research was supported by a grant (2017-MPSS31-002) from 'Supporting Technology Development Program for Disaster Management' funded by the Ministry of the Interior and Safety(MOIS)Keywords: alert system, management criteria, reservoir failure, sensor
Procedia PDF Downloads 19415887 Numerical Analysis on Triceratops Restraining System: Failure Conditions of Tethers
Authors: Srinivasan Chandrasekaran, Manda Hari Venkata Ramachandra Rao
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Increase in the oil and gas exploration in ultra deep-water demands an adaptive structural form of the platform. Triceratops has superior motion characteristics compared to that of the Tension Leg Platform and Single Point Anchor Reservoir platforms, which is well established in the literature. Buoyant legs that support the deck are position-restrained to the sea bed using tethers with high axial pretension. Environmental forces that act on the platform induce dynamic tension variations in the tethers, causing the failure of tethers. The present study investigates the dynamic response behavior of the restraining system of the platform under the failure of a single tether of each buoyant leg in high sea states. Using the rain-flow counting algorithm and the Goodman diagram, fatigue damage caused to the tethers is estimated, and the fatigue life is predicted. Results shows that under failure conditions, the fatigue life of the remaining tethers is quite alarmingly low.Keywords: fatigue life, pm spectrum, rain flow counting, triceratops, failure analysis
Procedia PDF Downloads 12815886 Prevalence of Microalbuminuria and Its Relation with Various Risk Factors in Type 1 Diabetes Mellitus
Authors: Singh Baljinder, Sharma Navneet
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Microalbuminuria is the earliest detectable marker of diabetic nephropathy. We planned to evaluate the prevalence of microalbuminuria in type 1 diabetics and correlate with various risk factor. We randomly selected 100 type 1 diabetic patients after inclusion and exclusion criteria from DCRC, S. P. Medical College, Bikaner. Clinical examinations for anthropometeric parameters, hypertension, retinopathy, glycaemic status, lipid profile were done and microalbuminuria was estimated by micral test. Microalbuminuria was seen in 38% patients. The mean urinary albumin concentration was 96.61 mg/l in microalbuminuria positive cases, 134 mg/L in hypertensive patients while 74.5 mg/L in normal patients. Mean diabetic duration was 6.43 years in microalbuminurics. Albumin excretion increased significantly with age at onset of 10-18 years and declined thereafter. Microalbuminuria cases exhibited mean cholesterol 181.63 mg%, TG 130.94 mg%, LDL 109.87 mg%, HDL 57.5 mg% and VLDL 30.64 mg%. Mean urinary albumin concentration in patients with retinopathy was 160.52 mg/L while 78.66 mg/L without retinopathy. In multiple stepwise logistic regression analysis, a strong positive association was seen between microalbuminuria and hypertension (OR=5.087, CI=2.1319-12.101), fasting blood sugar (OR=3. 491, CI=1.138-10.70), duration of diabetes (OR=3.41, CI=1.360-8.55) and HbA1c (OR=2.381, CI-=1.1-5.64). The present study indicates that microalbuminuria is a common complication of type 1 diabetes mellitus and can be prevented by careful management of risk factors.Keywords: type 1 diabetes, microalbuminuria, diabetic nephropathy, retinopathy, hypertension
Procedia PDF Downloads 44315885 Factors Effecting the Success and Failure of Social Enterprise in Thailand
Authors: Jatuporn Juyjingam, Pitak Siriwong
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This paper presents a study of factors effecting the success and failure of social enterprise in Thailand identifying communication as one of the criteria for measuring the social impact of social enterprise. The study focused on the communication driver of the SCALERS model. The research examines how communication is viewed in Thailand social enterprise. The research aims to determine how selected social enterprise uses communication in their operations. More specifically, the study aims to 1) describe the profile of social enterprise in Thailand, 2) identify the different roles of communication in the operation of social enterprise in Thailand, 3) determine Thailand social enterprise concept of communication. The study made use of the case study and cross case study research designs. For the profiling of the social enterprises, the case study was used. The researchers made use of the cross-case research design in identifying trends across the ten social enterprises and in determining the social entrepreneurs’ concept of communication. Key informant interviews were conducted with the heads or representatives of selected social enterprises, a three-part interview schedule was used to facilitate data gathering. The three parts included are 1) Profile of social enterprise in Thailand 2) How social enterprises apply communication in their operations 3) What is the key success in using communication among social enterprise in Thailand. This study is an exploratory research.Keywords: communication, social entrepreneurship, social enterprise, sustainability development
Procedia PDF Downloads 49115884 A Description Analysis of Mortality Rate of Human Infection with Avian Influenza A(H7N9) Virus in China
Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li
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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.Keywords: H7N9 virus, Avian Influenza, mortality, China
Procedia PDF Downloads 23415883 Risk Assessment on Construction Management with “Fuzzy Logy“
Authors: Mehrdad Abkenari, Orod Zarrinkafsh, Mohsen Ramezan Shirazi
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Construction projects initiate in complicated dynamic environments and, due to the close relationships between project parameters and the unknown outer environment, they are faced with several uncertainties and risks. Success in time, cost and quality in large scale construction projects is uncertain in consequence of technological constraints, large number of stakeholders, too much time required, great capital requirements and poor definition of the extent and scope of the project. Projects that are faced with such environments and uncertainties can be well managed through utilization of the concept of risk management in project’s life cycle. Although the concept of risk is dependent on the opinion and idea of management, it suggests the risks of not achieving the project objectives as well. Furthermore, project’s risk analysis discusses the risks of development of inappropriate reactions. Since evaluation and prioritization of construction projects has been a difficult task, the network structure is considered to be an appropriate approach to analyze complex systems; therefore, we have used this structure for analyzing and modeling the issue. On the other hand, we face inadequacy of data in deterministic circumstances, and additionally the expert’s opinions are usually mathematically vague and are introduced in the form of linguistic variables instead of numerical expression. Owing to the fact that fuzzy logic is used for expressing the vagueness and uncertainty, formulation of expert’s opinion in the form of fuzzy numbers can be an appropriate approach. In other words, the evaluation and prioritization of construction projects on the basis of risk factors in real world is a complicated issue with lots of ambiguous qualitative characteristics. In this study, evaluated and prioritization the risk parameters and factors with fuzzy logy method by combination of three method DEMATEL (Decision Making Trial and Evaluation), ANP (Analytic Network Process) and TOPSIS (Technique for Order-Preference by Similarity Ideal Solution) on Construction Management.Keywords: fuzzy logy, risk, prioritization, assessment
Procedia PDF Downloads 58615882 A Supply Chain Risk Management Model Based on Both Qualitative and Quantitative Approaches
Authors: Henry Lau, Dilupa Nakandala, Li Zhao
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In today’s business, it is well-recognized that risk is an important factor that needs to be taken into consideration before a decision is made. Studies indicate that both the number of risks faced by organizations and their potential consequences are growing. Supply chain risk management has become one of the major concerns for practitioners and researchers. Supply chain leaders and scholars are now focusing on the importance of managing supply chain risk. In order to meet the challenge of managing and mitigating supply chain risk (SCR), we must first identify the different dimensions of SCR and assess its relevant probability and severity. SCR has been classified in many different ways, and there are no consistently accepted dimensions of SCRs and several different classifications are reported in the literature. Basically, supply chain risks can be classified into two dimensions namely disruption risk and operational risk. Disruption risks are those caused by events such as bankruptcy, natural disasters and terrorist attack. Operational risks are related to supply and demand coordination and uncertainty, such as uncertain demand and uncertain supply. Disruption risks are rare but severe and hard to manage, while operational risk can be reduced through effective SCM activities. Other SCRs include supply risk, process risk, demand risk and technology risk. In fact, the disorganized classification of SCR has created confusion for SCR scholars. Moreover, practitioners need to identify and assess SCR. As such, it is important to have an overarching framework tying all these SCR dimensions together for two reasons. First, it helps researchers use these terms for communication of ideas based on the same concept. Second, a shared understanding of the SCR dimensions will support the researchers to focus on the more important research objective: operationalization of SCR, which is very important for assessing SCR. In general, fresh food supply chain is subject to certain level of risks, such as supply risk (low quality, delivery failure, hot weather etc.) and demand risk (season food imbalance, new competitors). Effective strategies to mitigate fresh food supply chain risk are required to enhance operations. Before implementing effective mitigation strategies, we need to identify the risk sources and evaluate the risk level. However, assessing the supply chain risk is not an easy matter, and existing research mainly use qualitative method, such as risk assessment matrix. To address the relevant issues, this paper aims to analyze the risk factor of the fresh food supply chain using an approach comprising both fuzzy logic and hierarchical holographic modeling techniques. This novel approach is able to take advantage the benefits of both of these well-known techniques and at the same time offset their drawbacks in certain aspects. In order to develop this integrated approach, substantial research work is needed to effectively combine these two techniques in a seamless way, To validate the proposed integrated approach, a case study in a fresh food supply chain company was conducted to verify the feasibility of its functionality in a real environment.Keywords: fresh food supply chain, fuzzy logic, hierarchical holographic modelling, operationalization, supply chain risk
Procedia PDF Downloads 23515881 Osteoprotegerin and Osteoprotegerin/TRAIL Ratio are Associated with Cardiovascular Dysfunction and Mortality among Patients with Renal Failure
Authors: Marek Kuźniewski, Magdalena B. Kaziuk , Danuta Fedak, Paulina Dumnicka, Ewa Stępień, Beata Kuśnierz-Cabala, Władysław Sułowicz
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Background: The high prevalence of cardiovascular morbidity and mortality among patients with chronic kidney disease (CKD) is observed especially in those undergoing dialysis. Osteoprotegerin (OPG) and its ligands, receptor activator of nuclear factor kappa-B ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) have been associated with cardiovascular complications. Our aim was to study their role as cardiovascular risk factors in stage 5 CKD patients. Methods: OPG, RANKL and TRAIL concentrations were measured in 69 hemodialyzed CKD patients and 35 healthy volunteers. In CKD patients, cardiovascular dysfunction was assessed with aortic pulse wave velocity (AoPWV), carotid artery intima-media thickness (CCA-IMT), coronary artery calcium score (CaSc) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration. Cardiovascular and overall mortality data were collected during a 7-years follow-up. Results: OPG plasma concentrations were higher in CKD patients comparing to controls. Total soluble RANKL was lower and OPG/RANKL ratio higher in patients. Soluble TRAIL concentrations did not differ between the groups and OPG/TRAIL ratio was higher in CKD patients. OPG and OPG/TRAIL positively predicted long-term mortality (all-cause and cardiovascular) in CKD patients. OPG positively correlated with AoPWV, CCA-IMT and NT-proBNP whereas OPG/TRAIL with AoPWV and NT-proBNP. Described relationships were independent of classical and non-classical cardiovascular risk factors, with exception of age. Conclusions: Our study confirmed the role of OPG as a biomarker of cardiovascular dysfunction and a predictor of mortality in stage 5 CKD. OPG/TRAIL ratio can be proposed as a predictor of cardiovascular dysfunction and mortality.Keywords: osteoprotegerin, tumor necrosis factor-related apoptosis-inducing ligand, receptor activator of nuclear factor kappa-B ligand, hemodialysis, chronic kidney disease, cardiovascular disease
Procedia PDF Downloads 32815880 Rolling Contact Fatigue Failure Analysis of Ball Bearing in Gear Box
Authors: Piyas Palit, Urbi Pal, Jitendra Mathur, Santanu Das
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Bearing is an important machinery part in the industry. When bearings fail to meet their expected life the consequences are increased downtime, loss of revenue and missed the delivery. This article describes the failure of a gearbox bearing in rolling contact fatigue. The investigation consists of visual observation, chemical analysis, characterization of microstructures using optical microscopes and hardness test. The present study also considers bearing life as well as the operational condition of bearings. Surface-initiated rolling contact fatigue, leading to a surface failure known as pitting, is a life-limiting failure mode in many modern machine elements, particularly rolling element bearings. Metallography analysis of crack propagation, crack morphology was also described. Indication of fatigue spalling in the ferrography test was also discussed. The analysis suggested the probable reasons for such kind of failure in operation. This type of spalling occurred due to (1) heavier external loading condition or (2) exceeds its service life.Keywords: bearing, rolling contact fatigue, bearing life
Procedia PDF Downloads 16515879 The Analysis of Increment of Road Traffic Accidents in Libya: Case Study City of Tripoli
Authors: Fares Elturki, Shaban Ismael Albrka Ali Zangena, H. A. M. Yahia
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Safety is an important consideration in the design and operation of streets and highways. Traffic and highway engineers working with law enforcement officials are constantly seeking for better methods to ensure safety for motorists and pedestrians. Also, a highway safety improvement process involves planning, implementation, and evaluation. The planning process requires that engineers collect and maintain traffic safety data, identify the hazards location, conduct studies and establish project priorities. Unfortunately, in Libya, the increase in demand for private transportation in recent years, due to poor or lack of public transportation led to some traffic problems especially in the capital (Tripoli). Also, the growth of private transportation has significant influences on the society regarding road traffic accidents (RTAs). This study investigates the most critical factors affect RTAs in Tripoli the capital city of Libya. Four main classifications were chosen to build the questionnaire, namely; human factors, road factors, vehicle factors and environmental factors. Moreover, a quantitative method was used to collect the data from the field, the targeted sample size 400 respondents include; drivers, pedestrian and passengers and relative importance index (RII) were used to rank the factors of one group and between all groups. The results show that the human factors have the most significant impacts compared with other factors. Also, 84% of respondents considered the over speeding as the most significant factor cusses of RTAs while 81% considered the disobedience to driving regulations as the second most influential factor in human factors. Also, the results showed that poor brakes or brake failure factor a great impact on the RTAs among the vehicle factors with nearly 74%, while 79% categorized poor or no street lighting factor as one of the most effective factors on RTAs in road factors and third effecting factor concerning all factors. The environmental factors have the slights influences compared with other factors.Keywords: road traffic accidents, Libya, vehicle factors, human factors, relative importance index
Procedia PDF Downloads 26915878 Risk and Protective Factors for the Health of Primary Care-Givers of Children with Autism Spectrum Disorders or Intellectual Disability: A Narrative Review and Discussion
Authors: Jenny Fairthorne, Yuka Mori, Helen Leonard
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Background: Primary care-givers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have poorer health and quality of life (QoL) than primary care-givers (hereafter referred to as just care-givers) of typically developing children. We aimed to review original research which described factors impacting the health of care-givers of children with ASD or ID and to discuss how these factors might influence care-giver health. Methods: We searched Web of Knowledge, Medline, Scopus and Google Scholar using selections of words from each of three groups. The first comprised terms associated with ASD and ID and included autism, pervasive development disorder, intellectual disability, mental retardation, disability, disabled, Down and Asperger. The second included terms related to health such as depression, physical, mental, psychiatric, psychological and well-being. The third was terms related to care-givers such as mother, parent and care-giver. We included an original paper in our review if it was published between 1st January 1990 and 31st December, 2016, described original research in a peer-reviewed journal and was written in English. Additional criteria were that the research used a study population of 15 persons or more; described a risk or protective factor for the health of care-givers of a child with ASD, ID or a sub-type (such as ASD with ID or Down syndrome). Using previous research, we developed a simple and objective five-level tool to assess the strength of evidence provided by the reviewed papers. Results: We retained 33 papers. Factors impacting primary care-giver health included child behaviour, level of support, socio-economic status (SES) and diagnostic issues. Challenging child behaviour, the most commonly identified risk factor for poorer care-giver health and QoL was reported in ten of the studies. A higher level of support was associated with improved care-giver health and QoL. For example, substantial evidence indicated that family support reduced care-giver burden in families with a child with ASD and that family and neighbourhood support was associated with improved care-giver mental health. Higher socio-economic status (SES) was a protective factor for care-giver health and particularly maternal health. Diagnostic uncertainty and an unclear prognosis are factors which can cause the greatest concern to care-givers of children with ASD and those for whom a cause of their child’s ID has not been identified. We explain how each of these factors might impact caregiver health and how they might act differentially in care-givers of children with different types of ASD or ID (such as Down syndrome and ASD without ID). Conclusion: Care-givers of children with ASD may be more likely to experience many risk factors and less likely to experience the protective factors we identified for poorer mental health. Interventions to reduce risk factors and increase protective factors could pave the way for improved care-giver health. For example, workshops to train care-givers to better manage challenging child behaviours and earlier diagnosis of ASD (and particularly ASD without ID) would seem likely to improve care-giver well-being. Similarly, helping to expand support networks might reduce care-giver burden and stress leading to improved health.Keywords: autism, caregivers, health, intellectual disability, mothers, review
Procedia PDF Downloads 15715877 Failure Inference and Optimization for Step Stress Model Based on Bivariate Wiener Model
Authors: Soudabeh Shemehsavar
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In this paper, we consider the situation under a life test, in which the failure time of the test units are not related deterministically to an observable stochastic time varying covariate. In such a case, the joint distribution of failure time and a marker value would be useful for modeling the step stress life test. The problem of accelerating such an experiment is considered as the main aim of this paper. We present a step stress accelerated model based on a bivariate Wiener process with one component as the latent (unobservable) degradation process, which determines the failure times and the other as a marker process, the degradation values of which are recorded at times of failure. Parametric inference based on the proposed model is discussed and the optimization procedure for obtaining the optimal time for changing the stress level is presented. The optimization criterion is to minimize the approximate variance of the maximum likelihood estimator of a percentile of the products’ lifetime distribution.Keywords: bivariate normal, Fisher information matrix, inverse Gaussian distribution, Wiener process
Procedia PDF Downloads 31515876 Effect Of Selected Food And Nutrition Environments On Prevalence Of Cardio-Metabolic Risk Factors With Emphasis On Worksite Environment In Urban Delhi
Authors: Deepa Shokeen, Bani Tamber Aeri
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Food choice is a complex process influenced by the interplay of multiple factors, including physical, socio-cultural and economic factors comprising macro or micro level food environments. While a clear understanding of the relationship between what we eat and the environmental context in which these food choices are made is still needed; it has however now been shown that food environments do play a significant role in the obesity epidemic and increasing cardio-metabolic risk factors. Evidence in other countries indicates that the food environment may strongly influence the prevalence of obesity and cardio-metabolic risk factors among young adults. Although in the Indian context, data does indicate the associations between sedentary lifestyle, stress, faulty diets but very little evidence supports the role of food environment in influencing cardio-metabolic health among employed adults. Thus, this research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. Methodology: The objective of the present study is to assess the effect of selected food and nutrition environments with emphasis on worksite environment and to analyse its impact on the food choices and dietary behaviour of the employees (25-45 years of age) of the organizations under study. In the proposed study an attempt will be made to randomly select various worksite environments from Delhi and NCR. The study will be conducted in two phases. In phase I, Information will be obtained on their socio-demographic profile and various factors influencing their food choices including most commonly consumed foods and most frequently visited eating outlets in and around the work place. Data will also be gathered on anthropometry (height, weight, waist circumference), biochemical parameters (lipid profile and fasting glucose), blood pressure and dietary intake. Based on the findings of phase I, a list of the most frequently visited eating outlets in and around the workplace will be prepared in Phase II. These outlets will then be subjected to nutrition environment assessment survey (NEMS). On the basis of the information gathered from phase I and phase II, influence of selected food and nutrition environments on food choice, dietary behaviour and prevalence of cardio-metabolic risk factors among employed adults will be assessed. Expected outcomes: The proposed study will try to ascertain the impact of selected food and nutrition environments on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behavior of the adults. In addition to this, anthropometry blood pressure and biochemical assessment of the subjects will be done to assess the prevalence of cardio-metabolic risk factors. If the findings indicate that the work environment, where most of these young adults spend their productive hours of the day, influence their health, than perhaps steps maybe needed to make these environments more conducive to health.Keywords: food and nutrition environment, cardio-metabolic risk factors, India, worksite environment
Procedia PDF Downloads 27515875 An Exploration Survival Risk Factors of Stroke Patients at a General Hospital in Northern Taiwan
Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang
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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.Keywords: stroke, risk, pneumonia, survival
Procedia PDF Downloads 23915874 Development of a Biomechanical Method for Ergonomic Evaluation: Comparison with Observational Methods
Authors: M. Zare, S. Biau, M. Corq, Y. Roquelaure
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A wide variety of observational methods have been developed to evaluate the ergonomic workloads in manufacturing. However, the precision and accuracy of these methods remain a subject of debate. The aims of this study were to develop biomechanical methods to evaluate ergonomic workloads and to compare them with observational methods. Two observational methods, i.e. SCANIA Ergonomic Standard (SES) and Rapid Upper Limb Assessment (RULA), were used to assess ergonomic workloads at two simulated workstations. They included four tasks such as tightening & loosening, attachment of tubes and strapping as well as other actions. Sensors were also used to measure biomechanical data (Inclinometers, Accelerometers, and Goniometers). Our findings showed that in assessment of some risk factors both RULA & SES were in agreement with the results of biomechanical methods. However, there was disagreement on neck and wrist postures. In conclusion, the biomechanical approach was more precise than observational methods, but some risk factors evaluated with observational methods were not measurable with the biomechanical techniques developed.Keywords: ergonomic, observational method, biomechanical methods, workload
Procedia PDF Downloads 38315873 A Scenario-Based Experiment Comparing Managerial and Front-Line Employee Apologies in Terms of Customers' Perceived Justice, Satisfaction, and Commitment
Authors: Ioana Dallinger, Vincent P. Magnini
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Due to the many moving parts and high human component, mistakes and failures sometimes occur during transactions in service environments. Because a certain portion of such failures is unavoidable, many service providers constantly look for guidance regarding optimal ways by which they should manage failures and recoveries. Through the use of a scenario-based experiment, the findings of this study run counter to the empowerment approach (i.e. that frontline employees should be empowered to resolve failure situations on their own doing). Specifically, this study finds that customers’ perceptions of distributive, procedural, and interactional justice are significantly higher [p-values < .05] when a manager delivers an apology as opposed to the frontline provider. Moreover, customers’ satisfaction with the recovery and commitment to the firm are also significantly stronger [p-values < .05] when a manager apologizes. Interestingly, this study also empirically tests the effects of combined apologies of both the manager and employee and finds that the combined approach yields better results for customers’ interactional justice perceptions and for their satisfaction with recovery, but not for their distributive or procedural justice perceptions or consequent commitment to the firm. This study can serve a springboard for further research. For example, perceptions and attitudes regarding employee empowerment vary based upon country culture. Furthermore, there are likely a number of factors that can moderate the cause and effect relationship between a failure recovery and customers’ post-recovery perceptions [e.g. the severity of the failure].Keywords: apology, empowerment, service failure recovery, service recovery
Procedia PDF Downloads 29215872 Neural Network Analysis Applied to Risk Prediction of Early Neonatal Death
Authors: Amanda R. R. Oliveira, Caio F. F. C. Cunha, Juan C. L. Junior, Amorim H. P. Junior
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Children deaths are traumatic events that most often can be prevented. The technology of prevention and intervention in cases of infant deaths is available at low cost and with solid evidence and favorable results, however, with low access cover. Weight is one of the main factors related to death in the neonatal period, so the newborns of low birth weight are a population at high risk of death in the neonatal period, especially early neonatal period. This paper describes the development of a model based in neural network analysis to predict the mortality risk rating in the early neonatal period for newborns of low birth weight to identify the individuals of this population with increased risk of death. The neural network applied was trained with a set of newborns data obtained from Brazilian health system. The resulting network presented great success rate in identifying newborns with high chances of death, which demonstrates the potential for using this tool in an integrated manner to the health system, in order to direct specific actions for improving prognosis of newborns.Keywords: low birth weight, neonatal death risk, neural network, newborn
Procedia PDF Downloads 44215871 Integrating Concepts in Positive Psychology with Suicide Prevention in Children and Adolescents
Authors: S. Wietrzychowski
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This systematic review incorporates concepts used in the field of positive psychology in order to integrate important elements into suicide prevention programs for children and adolescents. The goal of this review is to help students and professionals gain insight to available prevention programs for suicide and to incorporate aspects of positive psychology into these programs. Evidence-based interventions such as Positive Youth Development will be discussed in detail in its relation to prevention and positive psychology. Concepts such as hope, optimism, coping, and resilience will be related to these interventions in order to improve these interventions. The review will also explain how these programs can help prevent suicidal thoughts and/or behaviors. Research on mentorship programs and early intervention programs will be included and related to the aforementioned positive psychology concepts. Since children and adolescents are such a vulnerable population, the review will highlight specific considerations for working with children in order to prevent risk factors for suicide and to build protective factors. This review will discuss the effectiveness of school-based programs that are integrated with positive psychology. Elements of these programs that have been shown to be most effective in preventing suicide in schools will also be identified. As a result of this presentation, participants will be able to 1) List at least 2 evidence-based suicide prevention programs, 2) Understand the connection between specific positive psychology concepts and suicide prevention, 3) Identify at least 3 factors which protect against suicide, 4) Describe at least 3 risk factors for suicide, and 5) Think critically about the positive elements of suicide prevention programs.Keywords: children, adolescents, suicide, positive
Procedia PDF Downloads 37515870 Consumption of Fat Burners Leads to Acute Liver Failure: A Systematic Review protocol
Authors: Anjana Aggarwal, Sheilja Walia
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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements
Procedia PDF Downloads 7615869 Study on the Post-Traumatic Stress Disorder and Its Psycho-Social-Genetic Risk Factors among Tibetan Alolescents in Heavily-Hit Area Three Years after Yushu Earthquake in Qinghai Province, China
Authors: Xiaolian Jiang, Dongling Liu, Kun Liu
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Aims: To examine the prevalence of POST-TRAUMATIC STRESS DISORDER (PTSD) symptoms among Tibetan adolescents in heavily-hit disaster area three years after Yushu earthquake, and to explore the interactions of the psycho-social-genetic risk factors. Methods: This was a three-stage study. Firstly, demographic variables,PTSD Checklist-Civilian Version (PCL-C),the Internality、Powerful other、Chance Scale,(IPC),Coping Style Scale(CSS),and the Social Support Appraisal(SSA)were used to explore the psychosocial factors of PTSD symptoms among adolescent survivors. PCL-C was used to examine the PTSD symptoms among 4072 Tibetan adolescents,and the Structured Clinical Interview for DSM-IV Disorders(SCID)was used by psychiatrists to make the diagnosis precisely. Secondly,a case-control trial was used to explore the relationship between PTSD and gene polymorphisms. 287adolescents diagnosed with PTSD were recruited in study group, and 280 adolescents without PTSD in control group. Polymerase chain reaction-restriction fragment length polymorphism technology(PCR-RFLP)was used to test gene polymorphisms. Thirdly,SPSS 22.0 was used to explore the interactions of the psycho-social-genetic risk factors of PTSD on the basis of the above results. Results and conclusions: 1.The prevalence of PTSD was 9.70%. 2.The predictive psychosocial factors of PTSD included earthquake exposure, support from others, imagine, abreact, tolerant, powerful others and family support. 3.Synergistic interactions between A1 gene of DRD2 TaqIA and the external locus of control, negative coping style, severe earthquake exposure were found. Antagonism interactions between A1 gene of DRD2 TaqIA and poor social support was found. Synergistic interactions between A1/A1 genotype and the external locus of control, negative coping style were found. Synergistic interactions between 12 gene of 5-HTTVNTR and the external locus of control, negative coping style, severe earthquake exposure were found. Synergistic interactions between 12/12 genotype and the external locus of control, negative coping style, severe earthquake exposure were also found.Keywords: adolescents, earthquake, PTSD, risk factors
Procedia PDF Downloads 14515868 Perceived Social Support, Resilience and Relapse Risk in Recovered Addicts
Authors: Islah Ud Din, Amna Bibi
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The current study was carried out to examine the perceived social support, resilience and relapse risk in recovered addicts. A purposive sampling technique was used to collect data from recovered addicts. A multidimensional scale of perceived social support by was used to measure the perceived social support. The brief Resilience Scale (BRS) was used to assess resilience. The Stimulant Relapse Risk Scale (SRRS) was used to examine the relapse risk. Resilience and Perceived social support have substantial positive correlations, whereas relapse risk and perceived social support have significant negative associations. Relapse risk and resilience have a strong inverse connection. Regression analysis was used to check the mediating effect of resilience between perceived social support and relapse risk. The findings revealed that perceived social support negatively predicted relapse risk. Results showed that Resilience plays a role as partial mediation between perceived social support and relapse risk. This Research will allow us to explore and understand the relapse risk factor and the role of perceived social support and resilience in recovered addicts. The study's findings have immediate consequences in the prevention of relapse. The study will play a significant part in drug rehabilitation centers, clinical settings and further research.Keywords: perceived social support, resilience, relapse risk, recovered addicts, drugs addiction
Procedia PDF Downloads 1915867 Evaluating the Impact of Marine Protected Areas on Human-Shark Interactions at a Global Scale
Authors: Delphine Duval, Morgan Mangeas, Charlie Huveneers, Adam Barnett, Laurent Vigliola
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The global number of shark bites has increased over the past four decades with, however, high regional variability both in space and time. A systematic review, aligned with the 2020 PRISMA guidelines, explored the peer-reviewed literature published between 1960 and 2023 to identify factors potentially explaining trends in human-shark interactions. Results revealed that variations in the frequency of human-shark interactions could be explained by a plethora of factors, including changes in prey availability, environmental conditions, human and shark population density and behavior, as well as habitat destruction. However, to our best knowledge, only five studies have conducted statistical assessments of the relative contribution of these factors. The increased number in human-shark interactions and the frequent clusters of shark bites within short timeframes offer opportunities to test the causative factors that may explain trends in unprovoked shark bites. it study aims to evaluate the impact of marine protected areas (MPAs) on the number of human-shark interactions, using data from the Global Shark Attack File and the World Database on Protected Areas. Results indicate contrasting effects of MPAs at different spatial scales. Enhancing our understanding of the factors contributing to shark bites is essential for improving risk reduction policies for humans and conservation plans for shark populations.Keywords: unprovoked shark interactions, marine protected areas, attack risk, human-wildlife interaction
Procedia PDF Downloads 3615866 Strategies to Promote Safety and Reduce the Vulnerability of Urban Worn-out Textures to the Potential Risk of Earthquake
Authors: Bahareh Montakhabi
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Earthquake is known as one of the deadliest natural disasters, with a high potential for damage to life and property. Some of Iran's cities were completely destroyed after major earthquakes, and the people of the region suffered a lot of mental, financial and psychological damage. Tehran is one of the cities located on the fault line. According to experts, the only city that could be severely damaged by a moderate earthquake in Earthquake Engineering Intensity Scale (EEIS) (70% destruction) is Tehran because Tehran is built precisely on the fault. Seismic risk assessment (SRA) of cities in the scale of urban areas and neighborhoods is the first phase of the earthquake crisis management process, which can provide the information required to make optimal use of available resources and facilities in order to reduce the destructive effects and consequences of an earthquake. This study has investigated strategies to promote safety and reduce the vulnerability of worn-out urban textures in the District 12 of Tehran to the potential risk of earthquake aimed at prioritizing the factors affecting the vulnerability of worn-out urban textures to earthquake crises and how to reduce them, using the analytical-exploratory method, analytical hierarchy process (AHP), Expert choice and SWOT technique. The results of SWAT and AHP analysis of the vulnerability of the worn-out textures of District 12 to internal threats (1.70) and external threats (2.40) indicate weak safety of the textures of District 12 regarding internal and external factors and a high possibility of damage.Keywords: risk management, vulnerability, worn-out textures, earthquake
Procedia PDF Downloads 19115865 Influence of the Eccentricity of a Concentrated Load on the Behavior of Multilayers Slabs
Authors: F. Bouzeboudja, K. Ait-Tahar
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The method of strengthening of concrete works by composite materials is a practice which knows currently an important development. From this perspective, we propose to make a contribution to the analysis of the behavior of concrete slabs reinforced with composite fabrics, arranged in parallel folds according to the thickness of the slab. The analysis of experimentally obtained modes of failure confirms, generally, that the ruin of the structure occurs essentially by punching. Accordingly, our work is directed to the analysis of the behavior of reinforced slabs towards the punching. An experimental investigation is realized. For that purpose, a set of trial specimens was made. The reinforced specimens are subjected to an essay of punching, by making vary the direction of the eccentricity. The first experimental results show that the ultimate loads, as well as the transition from the flexion failure mode to the punching failure mode, are governed essentially by the eccentricity.Keywords: composites, concrete slabs, failure, laminate, punching
Procedia PDF Downloads 23415864 Reliability and Probability Weighted Moment Estimation for Three Parameter Mukherjee-Islam Failure Model
Authors: Ariful Islam, Showkat Ahmad Lone
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The Mukherjee-Islam Model is commonly used as a simple life time distribution to assess system reliability. The model exhibits a better fit for failure information and provides more appropriate information about hazard rate and other reliability measures as shown by various authors. It is possible to introduce a location parameter at a time (i.e., a time before which failure cannot occur) which makes it a more useful failure distribution than the existing ones. Even after shifting the location of the distribution, it represents a decreasing, constant and increasing failure rate. It has been shown to represent the appropriate lower tail of the distribution of random variables having fixed lower bound. This study presents the reliability computations and probability weighted moment estimation of three parameter model. A comparative analysis is carried out between three parameters finite range model and some existing bathtub shaped curve fitting models. Since probability weighted moment method is used, the results obtained can also be applied on small sample cases. Maximum likelihood estimation method is also applied in this study.Keywords: comparative analysis, maximum likelihood estimation, Mukherjee-Islam failure model, probability weighted moment estimation, reliability
Procedia PDF Downloads 26715863 Health Risk Assessment and Source Apportionment of Elemental Particulate Contents from a South Asian Future Megacity
Authors: Afifa Aslam, Muhammad Ibrahim, Abid Mahmood, Muhammad Usman Alvi, Fariha Jabeen, Umara Tabassum
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Many factors cause air pollution in Pakistan, which poses a significant threat to human health. Diesel fuel and gasoline motor vehicles, as well as industrial companies, pollute the air in Pakistan's cities. The study's goal is to determine the level of air pollution in a Pakistani industrial city and to establish risk levels for the health of the population. We measured the intensity of air pollution by chemical characterization and examination of air samples collected at stationary remark sites. The PM10 levels observed at all sampling sites, including residential, commercial, high-traffic, and industrial areas were well above the limits imposed by Pakistan EPA, the United States EPA, and WHO. We assessed the health risk via chemical factors using a methodology approved for risk assessment. All Igeo index values greater than one were considered moderately contaminated or moderately to severely contaminated. Heavy metals have a substantial risk of acute adverse effects. In Faisalabad, Pakistan, there was an enormously high risk of chronic effects produced by a heavy metal acquaintance. Concerning specified toxic metals, intolerable levels of carcinogenic risks have been determined for the entire population. As a result, in most of the investigated areas of Faisalabad, the indices and hazard quotients for chronic and acute exposure exceeded the permissible level of 1.0. In the current study, re-suspended roadside mineral dust, anthropogenic exhaust emissions from traffic and industry, and industrial dust were identified as major emission sources of elemental particulate contents. Because of the unacceptable levels of risk in the research area, it is strongly suggested that a comprehensive study of the population's health status as a result of air pollution should be conducted for policies to be developed against these risks.Keywords: elemental composition, particulate pollution, Igeo index, health risk assessment, hazard quotient
Procedia PDF Downloads 8515862 Prevalence of SARS-CoV-2 Infection and Associated Risk Factors in Selected Health Facilities of Tigray, Ethiopia: Cross-Sectional Study Design, 2023
Authors: Weldegerima Gebremedhin Hagos
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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.Keywords: prevalence, SARS-CoV-2, infection, risk factors
Procedia PDF Downloads 4615861 The Promotion of a Risk Culture: a Descriptive Study of Ghanaian Banks
Authors: Gerhard Grebe, Johan Marx
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The aim of the study is to assess the state of operational risk management and the adoption of an appropriate risk culture in Ghanaian banks. The Bank of Ghana (BoG) joined the Basel Consultative Group (BCG) of the Basel Committee on Bank Supervision (BCBS) in 2021 and is proceeding with the implementation of the Basel III international regulatory framework for banks. The BoG’s Directive about risk management encourages, inter alia, the creation of an appropriate risk culture by Ghanaian banks. However, it is not evident how the risk management staff of Ghanaian banks experience the risk culture and the implementation of operational risk management in the banks where they are employed. Ghana is a developing economy, and it is addressing challenges with its organisational culture. According to Transparency International, successive Ghanaian governments claim to be fighting corruption, but little success has been achieved so far. This points to a possible lack of accountability, transparency, and integrity in the environment in which Ghanaian banks operate and which could influence their risk culture negatively. Purposive sampling was used for the survey, and the questionnaire was completed byGhanaian bank personnel who specializesin operational risk management, risk governance, and compliance, bank supervision, risk analyses, as well as the implementation of the operational risk management requirements of the Basel regulatory frameworks. The respondents indicated that they are fostering a risk culture and implementing monitoring and reporting procedures; the three lines of defence (3LOD); compliance; internal auditing; disclosure of operational risk information; and receiving guidance from the bank supervisor in an attempt to improve their operational risk management practices. However, the respondents reported the following challenges with staff members who are not inside the risk management departments(in order of priority), namelydemonstrating a risk culture, training and development; communication; reporting and disclosure; roles and responsibilities; performance appraisal; and technological and environmental barriers. Recommendations to address these challenges are providedKeywords: ghana, operational risk, risk culture, risk management
Procedia PDF Downloads 11515860 Studies on the Prevalence and Determination of Associated Risk Factors of Babesia in Goats of District Toba Tek Singh, Punjab, Pakistan
Authors: Tauseef-ur-Rehman, Rao Zahid Abbas, Wasim Babar, Arbab Sikandar
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Babesiosis is an infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host (variety of vertebrates) including small ruminants and is responsible for decreased livestock output and hence economic losses. A cross-sectional study was designed in order to evaluate the prevalence of Babesia and its relation with various associated factors in district Toba Tek Singh, Central Punjab, Pakistan in 2009-2010. A total 10.84% (50/461) out of 461 examined cases for Babesia were found positive for Babesia infection. Month-wise peak prevalence was observed in July (17.95%), while no positive case was recorded in Dec-2009 and Jan-2010. The prevalence of infection in different goat breeds was found as non-significant (P < 0.05) for Babesia infection. The prevalence of Babesia was found significantly (P < 0.05) dependent to the goat age and sex. The feeding system, housing system, floor type and herd size revealed strong correlation with Babesia prevalence, while watering system and body conditions were found to be non-significant (P < 0.05), and hence it is suggested that with the improvement of management precautions Babesiosis can be avoided.Keywords: Babesia, goat, prevalence, Pakistan, risk factors
Procedia PDF Downloads 51015859 The Medical Student Perspective on the Role of Doubt in Medical Education
Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa
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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.Keywords: ethics, medical student, doubt, medical education, faith
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