Search results for: Jean Clark L. Naga

Authors: Jean Pierre Hagenimana, Paulin Ruhato Banguti, Rebecca Lynn Churchill Anderson, Jean de Dieu Tuyishime, Gaston Nyirigira, Eugene Tuyishime

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Background: Little is known regarding the effectiveness of pain protocols and guidelines used in Emergency Departments (ED) in Sub-Saharan Africa (SSA). Therefore, to shed light on this research gap, this study aimed to evaluate the quality of pain management following the implementation of both the WHO pain ladder-based trauma pain management protocol in two Rwandan teaching hospitals. Methods: This was a pre-and post-intervention study. The intervention was a 1-day acute pain course training for ED clinical staff followed by 1 week of mentorship on the use of the WHO pain ladder-based trauma pain management. Results: 261 participants were enrolled in the study (124 before the intervention and 137 after the intervention). The number of patients with undocumented pain scores decreased from 58% to 24% after the intervention (p-value > 0.001), and most patients (62%) had mild pain. In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value > 0.001). Barriers were identified, however, including inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Conclusion: The implementation of the WHO pain ladder-based trauma pain management protocol significantly improved the quality of pain management in both CHUK and CHUB referral Hospital emergency departments. Despite this, some barriers remain, such as inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at the emergency departments in referral hospitals in Rwanda.

Keywords: pain management, trauma, emergency departments, Rwanda

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Authors: Andy H. Clark

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This research looks into the relationship between language comprehension and production with a specific focus on the role of salience in shaping these processes. Salience, our most immediate perception of what is most probable out of all possible situations and outcomes strongly affects our perception and action in language production and comprehension. This study investigates the impact of geographic and emotional attachments to the target language on the differences in the learners’ comprehension and production abilities. Using quantitative research methods (Qualtrics, SPSS), this study examines preferential choices of two groups of Japanese English language learners: those residing in the United States and those in Japan. By comparing and contrasting these two groups, we hope to gain a better understanding of how salience of linguistics cues influences language processing.

Keywords: intercultural pragmatics, salience, production, comprehension, pragmatics, action, perception, cognition

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Authors: Sylvain Amailland, Jean-Hugh Thomas, Charles Pézerat, Romuald Boucheron, Jean-Claude Pascal

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The noise requirements for naval and research vessels have seen an increasing demand for quieter ships in order to fulfil current regulations and to reduce the effects on marine life. Hence, new methods dedicated to the characterization of propeller noise, which is the main source of noise in the far-field, are needed. The study of cavitating propellers in closed-section is interesting for analyzing hydrodynamic performance but could involve significant difficulties for hydroacoustic study, especially due to reverberation and boundary layer noise in the tunnel. The aim of this paper is to present a numerical methodology for the identification of hydroacoustic sources on marine propellers using hydrophone arrays in a large hydrodynamic tunnel. The main difficulties are linked to the reverberation of the tunnel and the boundary layer noise that strongly reduce the signal-to-noise ratio. In this paper it is proposed to estimate the reflection coefficients using an inverse method and some reference transfer functions measured in the tunnel. This approach allows to reduce the uncertainties of the propagation model used in the inverse problem. In order to reduce the boundary layer noise, a cleaning algorithm taking advantage of the low rank and sparse structure of the cross-spectrum matrices of the acoustic and the boundary layer noise is presented. This approach allows to recover the acoustic signal even well under the boundary layer noise. The improvement brought by this method is visible on acoustic maps resulting from beamforming and DAMAS algorithms.

Keywords: acoustic imaging, boundary layer noise denoising, inverse problems, model adaptation

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Authors: Arenkala Kichu

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This paper consolidates and tries to bring out the findings that investigated in Kohima and Mokokchung districts in Nagaland, which is in the northeastern part of India. The aim of this paper is to test the speaking and writing skills of the undergraduate learners who opt functional English as one of their papers. functional English is taught in just two colleges; Fazl Ali College and Kohima Colleges, out of 15 government and 36 private colleges in the state. This research (based on several observations made by Naga researchers) hypothesizes that functional English enhances competencies at the undergraduate level, which would open doors to work, learn more and better prospects. It is expected that learners in Functional English class, which follows the communicative language teaching method, might be the answers to those problems, as to why proficiency level still leaves much to be desired, in spite of the advent of the education over a hundred years ago. This type of teaching follows only in functional English class in these two colleges.

Keywords: enhancing competencies, speaking skills, undergraduate level, writing skills

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Authors: J. Chandrasekhar Rao, B. G. Naidu, G. J. Naga Raju, P. Sarita

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Particle Induced X-ray Emission (PIXE) and Inductively Coupled Plasma Mass Spectroscopy (ICP-MS) techniques have been employed in this work to determine the elements present in the root of Cyperus rotundus medicinal plant used in the treatment of rheumatoid arthritis. The elements V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Rb, and Sr were commonly identified and quantified by both PIXE and ICP-MS whereas the elements Li, Be, Al, As, Se, Ag, Cd, Ba, Tl, Pb and U were determined by ICP-MS and Cl, K, Ca, Ti and Br were determined by PIXE. The regional variation of elemental content has also been studied by analyzing the same plant collected from different geographical locations. Information on the elemental content of the medicinal plant would be helpful in correlating its ability in the treatment of rheumatoid arthritis and also in deciding the dosage of this herbal medicine from the metal toxicity point of view. Principal component analysis and cluster analysis were also applied to the data matrix to understand the correlation among the elements.

Keywords: PIXE, CP-MS, elements, Cyperus rotundus, rheumatoid arthritis

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Authors: M. Ramesh Kanthan, S. Naga Nandini Sujatha

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The goal of haze removal algorithms is to enhance and recover details of scene from foggy image. In enhancement the proposed method focus into two main categories: (i) image enhancement based on Adaptive contrast Histogram equalization, and (ii) image edge strengthened Gradient model. Many circumstances accurate haze removal algorithms are needed. The de-fog feature works through a complex algorithm which first determines the fog destiny of the scene, then analyses the obscured image before applying contrast and sharpness adjustments to the video in real-time to produce image the fusion strategy is driven by the intrinsic properties of the original image and is highly dependent on the choice of the inputs and the weights. Then the output haze free image has reconstructed using fusion methodology. In order to increase the accuracy, interpolation method has used in the output reconstruction. A promising retrieval performance is achieved especially in particular examples.

Keywords: single image, fusion, dehazing, multi-scale fusion, per-pixel, weight map

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Authors: Zouhair Haddi, Stephane Delliaux, Jean-Francois Pons, Ismail Kechaf, Jean-Claude De Haro, Mustapha Ouladsine

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Atrial fibrillation (AF) has been considered as the most common cardiac arrhythmia, and a major public health burden associated with significant morbidity and mortality. Nowadays, telemedical approaches targeting cardiac outpatients situate AF among the most challenged medical issues. The automatic, early, and fast AF detection is still a major concern for the healthcare professional. Several algorithms based on univariate analysis have been developed to detect atrial fibrillation. However, the published results do not show satisfactory classification accuracy. This work was aimed at resolving this shortcoming by proposing multivariate data analysis methods for automatic AF detection. Four publicly-accessible sets of clinical data (AF Termination Challenge Database, MIT-BIH AF, Normal Sinus Rhythm RR Interval Database, and MIT-BIH Normal Sinus Rhythm Databases) were used for assessment. All time series were segmented in 1 min RR intervals window and then four specific features were calculated. Two pattern recognition methods, i.e., Principal Component Analysis (PCA) and Learning Vector Quantization (LVQ) neural network were used to develop classification models. PCA, as a feature reduction method, was employed to find important features to discriminate between AF and Normal Sinus Rhythm. Despite its very simple structure, the results show that the LVQ model performs better on the analyzed databases than do existing algorithms, with high sensitivity and specificity (99.19% and 99.39%, respectively). The proposed AF detection holds several interesting properties, and can be implemented with just a few arithmetical operations which make it a suitable choice for telecare applications.

Keywords: atrial fibrillation, multivariate data analysis, automatic detection, telemedicine

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Authors: Jean-François Caron

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The current attempts to develop what we can call 'super soldiers' are problematic in many regards. This is what this text will try to explore by concentrating primarily on the repercussions of this technology and medical research on the physical and psychological integrity of soldiers. It argues that medicines or technologies may affect soldiers’ psychological and mental features and deprive them of their capacity to reflect upon their actions as autonomous subjects and that such a possibility entails serious moral as well as judicial consequences.

Keywords: military research, super soldiers, involuntary intoxication, criminal responsibility

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Authors: Naga Velamakuri, Jyothi K. Reddy

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Quality must be designed into a product and not inspected has become the main motto of all the companies globally. Due to the rapidly increasing technology in the past few decades, the nature of demands from the consumers has become more sophisticated. To sustain this global revolution of innovation in production systems, companies have to take steps to accommodate this technology growth. In this process of understanding the customers' expectations, all the firms globally take steps to deliver a perfect output. Most of these techniques also concentrate on the consistent development and optimization of the product to exceed the expectations. Quality Function Deployment(QFD) and Modular Function Deployment(MFD) are such techniques which rely on the voice of the customer and help deliver the needs. In this paper, Quality Function Deployment and Modular Function Deployment techniques which help in converting the quantitative descriptions to qualitative outcomes are discussed. The area of interest would be to understand the scope of each of the techniques and the application range in product development when these are applied together to any problem. The research question would be mainly aimed at comprehending the limitations using modularity in product development.

Keywords: quality function deployment, modular function deployment, house of quality, methodology

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Authors: Jean-Francois Caron

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This text explores the value of moral acts performed by war criminals, and the extent to which they should alleviate the punishment these individuals ought to receive for violating the rules of war. Without neglecting the necessity of retribution in war crimes cases, it argues from an ethical perspective that we should not rule out the possibility of considering lesser punishments for war criminals who decide to perform a moral act, as it might produce significant positive moral outcomes. This text also analyzes how such a norm could be justified from a moral perspective.

Keywords: war criminals, pardon, amnesty, retribution

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Authors: Guo-Ming Sung, Ramavath Naga Raju Naik

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This paper presents a low power, high speed, sense-amplifier based flip-flop (SAFF). The flip-flop’s power con-sumption and delay are greatly reduced by employing a new conditionally precharge sense-amplifier stage and a single-ended latch stage. Glitch-free and contention-free latch operation is achieved by using a conditional cut-off strategy. The design uses fewer transistors, has a lower clock load, and has a simple structure, all of which contribute to a near-zero setup time. When compared to previous flip-flop structures proposed for similar input/output conditions, this design’s performance and overall PDP have improved. The post layout simulation of the circuit uses 2.91µW of power and has a delay of 65.82 ps. Overall, the power-delay product has seen some enhancements. Cadence Virtuoso Designing tool with CMOS 90nm technology are used for all designs.

Keywords: high-speed, low-power, flip-flop, sense-amplifier

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Authors: Phusit Phukamchanoad, Thananya Santithammakul, Suwaree Yordchim, Pennapa Palapin

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This research gathered local wisdom towards career building of people in Kamchanoad Community, Baan Muang sub-district, Baan Dung district, Udon Thani province. Data was collected through in-depth interviews with village headmen, community board, teachers, monks, Kamchanoad forest managers and revered elderly aged over 60 years old. All of these 30 interviewees have resided in Kamchanoad Community for more than 40. Descriptive data analysis result revealed that the most prominent local wisdom of Kamchanoad community is their beliefs and religion. Most people in the community have strongly maintained local tradition, the festival of appeasing Chao Pu Sri Suttho on the middle of the 6th month of Thai lunar calendar which falls on the same day with Vesak Day. 100 percent of the people in this community are Buddhist. They believe that Naga, an entity or being, taking the form of a serpent, named “Sri Suttho” lives in Kamchanoad forest. The local people worship the serpent and ask for blessings. Another local wisdom of this community is Sinh fabric weaving.

Keywords: local wisdoms, careers, Kamchanoad Community, career building

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Authors: Lazhar mouloud, Chemat Zoubida, Ouhoumna Faiza

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The main objective of this study, concerns the modeling of breakthrough curves obtained in the adsorption column of malachite green into alginate-encapsulated aluminium pillared clay in fixed bed according to various operating parameters such as the initial concentration, the feed rate and the height fixed bed, applying mathematical models namely: the model of Bohart and Adams, Wolborska, Bed Depth Service Time, Clark and Yoon-Nelson. These models allow us to express the different parameters controlling the performance of the dynamic adsorption system. The results have shown that all models were found suitable for describing the whole or a definite part of the dynamic behavior of the column with respect to the flow rate, the inlet dye concentration and the height of fixed bed.

Keywords: adsorption column, malachite green, pillared clays, alginate, modeling, mathematic models, encapsulation.

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Authors: Amy Clark

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To date, the focus of feminist research surrounding men looking at women, with the analysis of how women make sense of looks between women remains limited and scattered. Drawing upon ethnographic data obtained from an on-going research project, this presentation delves into the embodied experiences of female exercisers within a UK ‘working-class’ gym. By exploring the women’s own accounts of their living, breathing and sensing bodies as they exercise, the researcher attempts to understand how they make sense of the gym space, their embodied selves as well as broader constructions of the gendered body. Utilising a feminist phenomenological approach, this research examines the social-structural position of women in a patriarchal system of gender relations, whilst simultaneously acknowledging and analysing the structural, cultural, and historical forces and location, upon individual lived body experiences and gendered embodiment. The discussion is provided on how the gym can be identified as a sexually objectifying environment, and how women make sense and interpret specific ‘gazes’ encountered within the gym.

Keywords: embodiment, feminism, gazes, sociology

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Authors: Jihad S. Daba, J. P. Dubois

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Understanding the statistics of non-isotropic scattering multipath channels that fade randomly with respect to time, frequency, and space in a mobile environment is very crucial for the accurate detection of received signals in wireless and cellular communication systems. In this paper, we derive stochastic models for the probability density function (PDF) of the shift in the carrier frequency caused by the Doppler Effect on the received illuminating signal in the presence of a dominant line of sight. Our derivation is based on a generalized Clarke’s and a two-wave partially developed scattering models, where the statistical distribution of the frequency shift is shown to be consistent with the power spectral density of the Doppler shifted signal.

Keywords: Doppler shift, filtered Poisson process, generalized Clark’s model, non-isotropic scattering, partially developed scattering, Rician distribution

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Authors: Houssam Hijazi, Laurent Cantrel, Jean-François Paul

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Periodic DFT calculations were performed to study the chemistry of CsI particles and the possible release of volatile iodine from CsI surfaces for nuclear safety interest. The results show that water adsorbs at low temperature associatively on the (011) surface of CsI, while water desorbs at higher temperatures. On the other hand, removing iodine species from the surface requires oxidizing the surface one time for each removed iodide atom. The activation energy of removing I₂ from the surface in the presence of two OH is 1,2 eV.

Keywords: aerosols, CSI, reactivity, DFT, water adsorption

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Authors: S. Kawther, C. Marshall

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Educational neuroscience has the intention of transforming research findings of the underpinning neural processes of learning to educational practices. A main criticism of the field, hitherto, is that less focus has been put on studying the in-progress practical application of these findings. Therefore, this study aims to gain a better understanding of teachers’ perceptions of the practical application and utilization of brain knowledge. This was approached by investigating the answer to 'What are the facilitators and barriers for bringing research from neuroscience to bear on education?'. Following a qualitative design, semi-structured interviews were conducted with 12 teachers who had a proficient course in educational neuroscience. Thematic analysis was performed on the transcribed data applying Braun & Clark’s steps. Findings emerged with four main themes: time, knowledge, teacher’s involvement, and system. These themes revealed that some effective brain-based practices are being engaged in by the teachers. However, the lack of guidance and challenges regarding this implementation were also found. This study discusses findings in light of the development of educational neuroscience implementation.

Keywords: brain-based, educational neuroscience, neuroeducation, neuroscience-informed

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Authors: Sélima Baccar, Ephraim Clark

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This paper can be considered as a new perspective to analyse credit spreads. A comprehensive empirical analysis of conditional variance of credit spreads indices is performed using various GARCH models. Based on a comparison between traditional and asymmetric GARCH models with alternative functional forms of the conditional density, we intend to identify what macroeconomic and financial factors have driven daily changes in the US Dollar credit spreads in the period from January 2011 through January 2013. The results provide a strong interdependence between credit spreads and the explanatory factors related to the conditions of interest rates, the state of the stock market, the bond market liquidity and the exchange risk. The empirical findings support the use of asymmetric GARCH models. The AGARCH and GJR models outperform the traditional GARCH in credit spreads modelling. We show, also, that the leptokurtic Student-t assumption is better than the Gaussian distribution and improves the quality of the estimates, whatever the rating or maturity.

Keywords: corporate bonds, default risk, credit spreads, asymmetric garch models, student-t distribution

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Authors: Edwin Cartledge, Jack Clark, Mazaher Molaei-Chalchooghi

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The mixing in the crystallization step of active pharmaceutical ingredient manufacturers was studied via advanced modeling tools to enable a successful scale-up. A virtual representation of the vessel was created, and computational fluid dynamics were used to simulate multiphase flow and, thus, the mixing environment within this vessel. The study identified a significant dead zone in the vessel underneath the impeller and found that increasing the impeller speed and power did not improve the mixing. A series of sensitivity analyses found that to improve mixing, the vessel had to be redesigned, and found that optimal mixing could be obtained by adding two extra cylindrical baffles. The same two baffles from the simulated environment were then constructed and added to the process vessel. By identifying these potential issues before starting the manufacture and modifying the vessel to ensure good mixing, this study mitigated a failed crystallization and potential batch disposal, which could have resulted in a significant loss of high-value material.

Keywords: active pharmaceutical ingredient, baffles, computational fluid dynamics, mixing, modelling

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Authors: Oscar Javier Herrera Ochoa, Ivan Dario Romero Fonseca

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This paper presents a design of a model for planning the distribution logistics operation. The significance of this work relies on the applicability of this fact to the analysis of small and medium enterprises (SMEs) of dry freight in Bogotá. Two stages constitute this implementation: the first one is the place where optimal planning is achieved through a hybrid model developed with mixed integer programming, which considers the transhipment operation based on a combined load allocation model as a classic transshipment model; the second one is the specific routing of that operation through the heuristics of Clark and Wright. As a result, an integral model is obtained to carry out the step by step planning of the distribution of dry freight for SMEs in Bogotá. In this manner, optimum assignments are established by utilizing transshipment centers with that purpose of determining the specific routing based on the shortest distance traveled.

Keywords: transshipment model, mixed integer programming, saving algorithm, dry freight transportation

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Authors: Liuyao Chai, Colin Clark

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Analysis of 574 participants in a simulated two-person distributive negotiation revealed that the first price 245 (42.7%) of these participants actually asked/offered for the item under negotiation (a used car) differed from the first price they previously stated they intended to ask/offer during their negotiation. This discrepancy between a negotiator’s intended first asking/offer price and his/her actual first asking/offer price had a significant and economically consequential impact on both the course and the outcomes of the negotiations studied. Participants whose actual first price remained the same as their intended first price tended to secure better negotiation outcomes. Moreover, participants who changed their intended first price tended to obtain relatively lower outcomes regardless of whether their modified first announced price had created a negotiating position that was ‘stronger’ or ‘weaker’ than if they had opened with their intended first price. Subsequent investigation of over twenty negotiation behaviours and pre-negotiation perceptual variables within this dataset indicated that the three types of first price announcers—i.e. intended first asking/offer price ‘weakeners’, ‘maintainers’ and ‘strengtheners’— comprised persons who tended to have significantly different pre-negotiation perceptions and behaved in systematically different ways during their negotiation. Typically, the most negative, outcome-compromising consequences of changing, weakening or strengthening an intended first price occurred at the very beginning of a negotiation when participants exchanged their actual first asking/offer prices.

Keywords: business communication, negotiation, persuasion, intended first asking/offer prices, bargaining

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Authors: V. Naga Sravan Kumar Varma, H. G. Shivakumar

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The aim of the study was to develop dual sensitive poly (N-isopropylacrylamide-co-acrylic acid) (PNA) nanogels(NGs) and studying its applications for Anti-Cancer therapy. NGs were fabricated by free radical polymerization using different amount of N-isopropylacrylamide and acrylic acid. A study for polymer composition over the effect on LCST in different pH was evaluated by measuring the absorbance at 500nm using UV spectrophotometer. Further selected NG’s were evaluated for change in hydrodynamic diameters in response to pH and temperature. NGs which could sharply respond to low pH value of cancer cells at body temperature were loaded with Fluorouracil (5-FU) using equilibrium swelling method and studied for drug release behaviour in different pH. A significant influence of NGs polymer composition over pH dependent LCST was observed. NGs which were spherical with an average particle size of 268nm at room temperature, shrinked forming an irregular shape when heated above to their respective LCST. 5FU loaded NGs did not intervene any difference in pH depended LCST behaviour of NGs. The in vitro drug release of NGs exhibited a pH and thermo-dependent control release. The cytoxicity study of blank carrier to MCF7 cell line showed no cytotoxicity. The results indicated that PNA NGs could be used as a potential drug carrier for anti-cancer therapy.

Keywords: pH and thermo-sensitive, nanogels, P(NIPAM-co-AAc), anti-cancer, 5-FU

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Authors: Vathya Anindita Putri, Henny Saptatia Drajati Nugrahani

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This research aims to explore the representation of Nordic mythology in the commercial film titled “Thor” produced by the Marvel Cinematic Universe. First, the Nordic mythology adaptation and representation in “Thor” compared to other media. Second, the importance of using the mise en scene technique, the comprehensive portrayal of Nordic mythology and the audience's experiences in enjoying the film. This research is conducted using qualitative methods. The two research questions are analyzed using three theories: Adaptation theory by Robert Stam, Mise en Scene theory by Jean-Luc Godard, and Cultural Criticism theory by Michel Foucault. Robert Stam emphasizes the importance of social and historical in understanding film adaptations. Film adaptations always occur in a specific cultural and historical context; therefore, authors and producers must consider these factors when creating a successful adaptation. Jean-Luc Godard uses the “politiques des auteurs” approach to understand that films are not just cultural products made for entertainment, but they are works of art by authors and directors. It is important to explore how authors and directors convey their ideas and emotions in their films, in this case, a film set in Nordic mythology. Foucault takes an approach to analyzing power that considers how power operates and influences social relationships in a specific context. Foucault’s theory is used to analyze how the representation of Nordic mythology is used as an instrument of power by the Marvel Cinematic Universe to influence how the audience views Nordic mythology. The initial findings of this research are that the fusion of Nordic mythology with modern superhero storytelling in the film “Thor” produced by Marvel, is successful. The film contains conflicts in the modern world and represents the symbolism of Nordic mythology. The rich and interesting atmosphere of Nordic mythology is presented through epic battle scenes, captivating character roles, and the use of visual effects that make the film more vivid and real.

Keywords: adaptation theory, cultural criticism theory, film criticism, Marvel cinematic universe, Mise en Scene theory, Nordic mythology

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Authors: Insaf Ajili, Malik Mallem, Jean-Yves Didier

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Motion recognition from videos is actually a very complex task due to the high variability of motions. This paper describes the challenges of human motion recognition, especially motion representation step with relevant features. Our descriptor vector is inspired from Laban Movement Analysis method. We propose discriminative features using the Random Forest algorithm in order to remove redundant features and make learning algorithms operate faster and more effectively. We validate our method on MSRC-12 and UTKinect datasets.

Keywords: discriminative LMA features, features reduction, human motion recognition, random forest

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Authors: Samson Henry Dogo, Allan Clark, Elena Kulinskaya

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The objective in meta-analysis is to combine results from several independent studies in order to create generalization and provide evidence based for decision making. But recent studies show that the magnitude of effect size estimates reported in many areas of research finding changed with year publication and this can impair the results and conclusions of meta-analysis. A number of sequential methods have been proposed for monitoring the effect size estimates in meta-analysis. However they are based on statistical theory applicable to fixed effect model (FEM). For random-effects model (REM), the analysis incorporates the heterogeneity variance, tau-squared and its estimation create complications. In this paper proposed the use of Gombay and Serbian (2005) truncated CUSUM-type test with asymptotically valid critical values for sequential monitoring of REM. Simulation results show that the test does not control the Type I error well, and is not recommended. Further work required to derive an appropriate test in this important area of application.

Keywords: meta-analysis, random-effects model, sequential test, temporal changes in effect sizes

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

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Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Heather Clark, Jon Kelly

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Burnout among healthcare professionals has been elevated to a high level of concern. The descriptions of the healthcare workplace often include language such as, stressful, long hours, rotating shifts, weekends and holidays, and exhausting. New graduate healthcare professionals are being sent into the workplace with little to no coping skills, knowledge of signs and symptoms of burnout, or resources that are available. The authors of this study created a university course entitled 'coping in your profession' that enrolled registered nurses, licensed practical nurses, EMTs, nurse assistants, and medical assistants. The course addresses burnout, self-analysis, incivility, coping mechanisms, and organizational responsibilities for employee well-being. The students were surveyed using QualtricsXM that included a pre-course and post-course analysis. Pre-course results showed high levels of individual experiences with burnout and limited knowledge of resources to combat burnout. Post-course results included personal growth and that students’ perception of burnout can be prevented at both the individual and the organization levels. Students also indicated that few to no resources to combat burnout existed at their place of employment. Addressing burnout at the educational level helps prepare graduates with the knowledge and tools to combat burnout at the individual and organization level.

Keywords: burnout, coping, healthcare workers, incivility, resilience

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Authors: Jesús Ulloa

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The creation, rise, and consolidation of far right-wing, ultranationalist, and eurosceptic parties in Europe after the Second World War pose a real threat towards the disintegration of the European Union. Starting more than thirty years ago with Jean-Marie Le Pen's FN and Margaret Thatcher's policies, to Marine Le Pen's current FN and anti-immigration proposals along with Nigel Farage's UKIP and their intentions to leave the European Union, the progress of right-wing parties should be noted, taking into account that they may have very important differences within their postures but that they also reach common ground in certain areas. The actual disintegration of the EU would represent an enormous failure of the new liberal world order. Through this essay, the roots of this political parties will be analyzed and the conclusion of whether the disintegration may become a reality or if the principles of cooperation and unity will prevail will be answered.

Keywords: eurosceptic, ultarnationalist, right-wing, European Union

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Authors: Ladislas Havugimana, Véronique Zinnen, Mary Hadley, Jean Claude Mwumvaneza, Francois Régis Habarugira, Silas Rudasingwa, Victor Ndaruhutse, Evelyne Bocquet

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Rwanda's health systems face various challenges, including low health infrastructure coverage (the objective is to have at least one health center per administrative sector) and insufficient qualified human resources for infrastructure maintenance and financing. Moreover, there is no policy for the preventive maintenance of infrastructures for the health sector. This paper presents action research conducted in seven districts, focusing on the impact of health infrastructure's quality on maternal and neonatal care, with the support of the Belgian cooperation agency through Enable Barame project.

Keywords: health infrastructure, maintenance, maternity, neonatology

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Authors: Hachmi Ben Ameur, Jean Luc Prigent

Abstract:

We propose an extension of the CPPI method, which is based on conditional floors. In this framework, we examine in particular the TIPP and margin based strategies. These methods allow keeping part of the past gains and protecting the portfolio value against future high drawdowns of the financial market. However, as for the standard CPPI method, the investor can benefit from potential market rises. To control the risk of such strategies, we introduce both Value-at-Risk (VaR) and Expected Shortfall (ES) risk measures. For each of these criteria, we show that the conditional floor must be higher than a lower bound. We illustrate these results, for a quite general ARCH type model, including the EGARCH (1,1) as a special case.

Keywords: CPPI, conditional floor, ARCH, VaR, expected ehortfall

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