Search results for: antenatal care services

Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

Abstract:

Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

Procedia PDF Downloads 112

Authors: Sahar Heidary

Abstract:

Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

Procedia PDF Downloads 69

Authors: Ivan Orozco

Abstract:

Introduction: Forced contraception constitutes part of an effort to control the life and reproductive capacity of women through public health institutions. This phenomenon has affected many Mexican women historically and still persists nowadays. The notion of reproductive governmentality refers to the mechanisms through which different historical configurations of social actors (state institutions, churches, donor agents, NGOs, etc.) use legislative controls, economic incentives, moral mandates, direct coercion, and ethical incitements, to produce, monitor and control reproductive behaviors and practices. This research focuses on the use of these mechanisms by the Mexican State to control women's contraceptive practices in a public hospital. Method: An Institutional Ethnography was carried out, with the objective of knowing women's experiences from their own perspective, as they occur in their daily lives, but at the same time, discovering the structural elements that shape the discourses that promote women's contraception, even against their will. The fieldwork consisted in an observation of the dynamics between different participants within a public hospital and the conduction of interviews with the medical and nursing staff in charge of family planning services, as well as women attending the family planning office. Results: Public health institutions in Mexico are state tools to control and regulate reproduction. There are several strategies that are used for this purpose, for example, health personnel provide insufficient or misleading information to ensure that women agree to use contraceptives; health institutions provide economic incentives to the members of the health staff who reach certain goals in terms of contraceptive placement; young women are forced to go to the family planning service, regardless of the reason they went to the clinic; health campaigns are carried out, consisting of the application of contraceptives outside the health facilities, directly in the communities of people who visit the hospital less frequently. All these mechanisms seek for women to use contraceptives, from the women’s perspective; however, the reception of these discourses is ambiguous. While, for some women, the strategies become coercive mechanisms to use contraceptives against their will, for others, they represent an opportunity to take control over their reproductive lives. Conclusion: Since 1974, the Mexican government has implemented campaigns for the promotion of family planning methods as a means to control population growth. Although it is established in several legislations that the counselling must be carried out with a gender and human rights perspective, always respecting the autonomy of people, these research testify that health personnel uses different strategies to force some women to use contraceptive methods, thereby violating their reproductive rights.

Keywords: feminist research, forced contraception, institutional ethnography, reproductive. governmentality

Procedia PDF Downloads 164

Authors: Chux Gervase Iwu, Simon Nsengimane

Abstract:

Entrepreneurship stimulates socio-economic development in many countries, if not all. It creates jobs and decreases unemployment and inequality. There are other benefits that are accruable from entrepreneurship, namely the empowerment of women and the promotion of better livelihoods. Innovation has become a weapon for business competition, growth, and sustainability. Paradoxically, it is a threat to businesses because products can be duplicated; new products may decrease the market share of existing ones or delete them from the market. This creates a constant competitive environment that calls for updates, innovation, and the invention of new products and services. Thus, the importance of higher education in instilling a good entrepreneurial mindset in students has become even more critical. It can be argued that the business environment is under enormous pressure from several factors, including the fourth industrial revolution, which calls for the adoption and use of information and communication technology, which is the catalyst for many innovations and organisational changes. Therefore, it is crucial that higher education students are equipped with relevant knowledge and skills to respond effectively to the needs of the business environment and create a vibrant entrepreneurship ecosystem. In South Africa, entrepreneurship education or some form of it has been a privilege for economic and management fields of study, leaving behind other fields. Entrepreneurship should not be limited to business faculties but rather extended to other fields of study. This is perhaps the reason for low levels of entrepreneurship uptake among South African graduates if they are compared with the graduates in other countries. There may be other reasons for the low entrepreneurship uptake. Some of these have been documented in extant literature to include (1) not enough time was spent teaching entrepreneurship in the business faculties, (2) the skills components in the curricula are insufficient, and (3) the overall attitudes/mindsets necessary to establish and run sustainable enterprises seem absent. Therefore, four important areas are recognised as crucial for the effective implementation of entrepreneurship education: policy, private sector engagement, curriculum development, and teacher development. The purpose of this research is to better comprehend the views, aspirations, and expectations of students and faculty members to design an entrepreneurial teaching model for higher education institutions. A qualitative method will be used to conduct a purposive interview with undergraduate and graduate students in select higher institutions. Members of faculty will also be included in the sample as well as, where possible, two or more government personnel responsible for higher education policy development. At present, interpretative analysis is proposed for the analysis of the interviews with the support of Atlas Ti. It is hoped that an entrepreneurship education model in the South African context is realised through this study.

Keywords: entrepreneurship education, higher education institution, graduate unemployment, curriculum development

Procedia PDF Downloads 77

Authors: L. Sierra, N. Gambetta, M. A. Garcia-Benau, M. Orta

Abstract:

Financial scandals and financial crisis have led to an international debate on the value of auditing. In recent years there have been significant legislative reforms aiming to increase markets’ confidence in audit services. In particular, there has been a significant debate on the need to improve the communication of auditors with audit reports users as a way to improve its informative value and thus, to improve audit quality. The International Auditing and Assurance Standards Board (IAASB) has proposed changes to the audit report standards. The International Standard on Auditing 701, Communicating Key Audit Matters (KAM) in the Independent Auditor's Report, has introduced new concepts that go beyond the auditor's opinion and requires to disclose the risks that, from the auditor's point of view, are more significant in the audited company information. Focusing on the companies included in the Financial Times Stock Exchange 100 index, this study aims to focus on the analysis of the determinants of the number of KAM disclosed by the auditor in the audit report and moreover, the analysis of the determinants of the different type of KAM reported during the period 2013-2015. To test the hypotheses in the empirical research, two different models have been used. The first one is a linear regression model to identify the client’s characteristics, industry sector and auditor’s characteristics that are related to the number of KAM disclosed in the audit report. Secondly, a logistic regression model is used to identify the determinants of the number of each KAM type disclosed in the audit report; in line with the risk-based approach to auditing financial statements, we categorized the KAM in 2 groups: Entity-level KAM and Accounting-level KAM. Regarding the auditor’s characteristics impact on the KAM disclosure, the results show that PwC tends to report a larger number of KAM while KPMG tends to report less KAM in the audit report. Further, PwC reports a larger number of entity-level risk KAM while KPMG reports less account-level risk KAM. The results also show that companies paying higher fees tend to have more entity-level risk KAM and less account-level risk KAM. The materiality level is positively related to the number of account-level risk KAM. Additionally, these study results show that the relationship between client’s characteristics and number of KAM is more evident in account-level risk KAM than in entity-level risk KAM. A highly leveraged company carries a great deal of risk, but due to this, they are usually subject to strong capital providers monitoring resulting in less account-level risk KAM. The results reveal that the number of account-level risk KAM is strongly related to the industry sector in which the company operates assets. This study helps to understand the UK audit market, provides information to auditors and finally, it opens new research avenues in the academia.

Keywords: FTSE 100, IAS 701, key audit matters, auditor’s characteristics, client’s characteristics

Procedia PDF Downloads 231

Authors: Richard Byrne, Emma Mulliner

Abstract:

Smart cities are a vision for the future that is increasingly becoming a reality. While a key concept of the smart city is the ability to capture, communicate, and process data that has long been produced through day-to-day activities of the city, much of the assessment models in place neglect this fact to focus on ‘smartness’ concepts. Although it is true technology often provides the opportunity to capture and communicate data in more effective ways, there are also human processes involved that are just as important. The growing importance with regards to the use and ownership of data in society can be seen by all with companies such as Facebook and Google increasingly coming under the microscope, however, why is the same scrutiny not applied to cities? The research area is therefore of great importance to the future of our cities here and now, while the findings will be of just as great importance to our children in the future. This research aims to understand the influence data is having on organisations operating throughout the smart cities sector and employs a mixed-method research approach in order to best answer the following question: Would a data-based evaluation model for smart cities be more appropriate than a smart-based model in assessing the development of the smart city? A fully comprehensive literature review concluded that there was a requirement for a data-driven assessment model for smart cities. This was followed by a documentary analysis to understand the root source of data integration to the smart city. A content analysis of city data platforms enquired as to the alternative approaches employed by cities throughout the UK and draws on best practice from New York to compare and contrast. Grounded in theory, the research findings to this point formulated a qualitative analysis framework comprised of: the changing environment influenced by data, the value of data in the smart city, the data ecosystem of the smart city and organisational response to the data orientated environment. The framework was applied to analyse primary data collected through the form of interviews with both public and private organisations operating throughout the smart cities sector. The work to date represents the first stage of data collection that will be built upon by a quantitative research investigation into the feasibility of data network effects in the smart city. An analysis into the benefits of data interoperability supporting services to the smart city in the areas of health and transport will conclude the research to achieve the aim of inductively forming a framework that can be applied to future smart city policy. To conclude, the research recognises the influence of technological perspectives in the development of smart cities to date and highlights this as a challenge to introduce theory applied with a planning dimension. The primary researcher has utilised their experience working in the public sector throughout the investigation to reflect upon what is perceived as a gap in practice of where we are today, to where we need to be tomorrow.

Keywords: data, planning, policy development, smart cities

Procedia PDF Downloads 310

Authors: Sara Saboonian, Pierre Filion

Abstract:

There are two distinct planning approaches attempting to transform the North American suburb so as to reduce its adverse environmental impacts. The first one, the recentralization approach, proposes intensification, multi-functionality and more reliance on public transit and walking. It thus offers an alternative to the prevailing low-density, spatial specialization and automobile dependence of the North American suburb. The second approach concentrates instead on the provision of green infrastructure, which rely on natural systems rather than on highly engineered solutions to deal with the infrastructure needs of suburban areas. There are tensions between these two approaches as recentralization generally overlooks green infrastructure, which can be space consuming (as in the case of water retention systems), and thus conflicts with the intensification goals of recentralization. The research investigates three Canadian planned suburban centres in the Greater Toronto Area, where recentralization is the current planning practice, despite rising awareness of the benefits of green infrastructure. Methods include reviewing the literature on green infrastructure planning, a critical analysis of the Ontario provincial plans for recentralization, surveying residents’ preferences regarding alternative suburban development models, and interviewing officials who deal with the local planning of the three centres. The case studies expose the difficulties in creating planned suburban centres that accommodate green infrastructure while adhering to recentralization principles. Until now, planners have been mostly focussed on recentralization at the expense of green infrastructure. In this context, the frequent lack of compatibility between recentralization and the space requirements of green infrastructure explains the limited presence of such infrastructures in planned suburban centres. Finally, while much attention has been given in the planning discourse to the economic and lifestyle benefits of recentralization, much less has been made of the wide range of advantages of green infrastructure, which explains limited public mobilization over the development of green infrastructure networks. The paper will concentrate on ways of combining recentralization with green infrastructure strategies and identify the aspects of the two approaches that are most compatible with each other. The outcome of such blending will marry high density, public-transit oriented developments, which generate walkability and street-level animation, with the presence of green space, naturalized settings and reliance on renewable energy. The paper will advance a planning framework that will fuse green infrastructure with recentralization, thus ensuring the achievement of higher density and reduced reliance on the car along with the provision of critical ecosystem services throughout cities. This will support and enhance the objectives of both green infrastructure and recentralization.

Keywords: environmental-based planning, green infrastructure, multi-functionality, recentralization

Procedia PDF Downloads 131

Authors: Jacqueline P. Davies

Abstract:

Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

Procedia PDF Downloads 287

Authors: Mirim Kim, Won-Oak Oh

Abstract:

Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

Procedia PDF Downloads 164

Authors: Ma. Cecilia D. Licuan

Abstract:

The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

Procedia PDF Downloads 126

Authors: Hossein Rezaie

Abstract:

Academic institutions, esp. universities, have been known as cradles of learning and teaching great thinkers while creating the type of knowledge that is supposed to be bereft of utilitarian motives. Nonetheless, it seems that such intellectual centers have entered into a competition with each other for attracting the attention of potential clients. The traditional values of (higher) education such as nurturing criticality and fostering intellectuality in students have been replaced with strategic planning, quality assurance, performance assessment, and academic audits. Not being immune from the whims and wishes of marketization, the system of higher education in the UK has been recalibrated by policy makers to address the demand and supply of student education, academic research and other university activities on the basis of monetary factors. As an immediate example in this vein, the Russell Group in the UK, which is comprised of 24 leading UK research universities, has explicitly expressed it policy on its official website as follows: ‘Russell Group universities are global businesses competing for staff, students and funding with the best in the world’. Furthermore, certain attempts have been made to corporatize the system of HE which have been manifested in remodeling of university governing bodies on corporate lines and developing measurement scales for indicating the performance of teaching practitioners. Nevertheless, it seems that such structural changes in policies toward the system of HE have bearing on the practices of practitioners and educators as well as the identity of students who are the customers of educational services. The effects of marketization have been examined mainly in terms of students’ perceptions and motivation, institutional policies and university management. However, the teaching practitioner side seems to be an under-studied area with regard to any changes in its expectations, satisfaction and perception of professional identity in the aftermath of introducing market-wise values into HE of the UK. As a result, this research aims to investigate the possible outcomes of market-driven values on the practitioner side of HE in the UK and finally seeks to address the following research questions: 1-How is the change in the mission of HE in the UK reflected in institutional documents? 1-A- How is the change of mission represented in job adverts? 1-B- How is the change of mission represented in university prospectuses? 2-How are teaching practitioners represented regarding their roles and obligations in the prospectuses and job ads published by UK HE institutions? In order to address these questions, the researcher will analyze 30 prospectuses and job ads published by Russel Group universities by taking Critical Discourse Analysis as his point of departure and the analytical methods of genre analysis and Systemic Functional Linguistics to probe into the generic features and representation of participants, in this case teaching practitioners, in the selected corpus.

Keywords: higher education, job advertisements, marketization of higher education, prospectuses

Procedia PDF Downloads 247

Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang

Abstract:

Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.

Keywords: case fatality rate, dengue, dengue vaccine, the elderly

Procedia PDF Downloads 281

Authors: Sara Bonetti

Abstract:

The use of quantitative data to support policies and justify investments has become imperative in many fields including the field of education. However, the topic of data literacy has only marginally touched the early care and education (ECE) field. In California, within the ECE workforce, there is a group of professionals working in policy and advocacy that use quantitative data regularly and whose educational and professional experiences have been neglected by existing research. This study aimed at analyzing these experiences in accessing, using, and producing quantitative data. This study utilized semi-structured interviews to capture the differences in educational and professional backgrounds, policy contexts, and power relations. The participants were three key professionals from county-level organizations and one working at a State Department to allow for a broader perspective at systems level. The study followed Núñez’s multilevel model of intersectionality. The key in Núñez’s model is the intersection of multiple levels of analysis and influence, from the individual to the system level, and the identification of institutional power dynamics that perpetuate the marginalization of certain groups within society. In a similar manner, this study looked at the dynamic interaction of different influences at individual, organizational, and system levels that might intersect and affect ECE professionals’ experiences with quantitative data. At the individual level, an important element identified was the participants’ educational background, as it was possible to observe a relationship between that and their positionality, both with respect to working with data and also with respect to their power within an organization and at the policy table. For example, those with a background in child development were aware of how their formal education failed to train them in the skills that are necessary to work in policy and advocacy, and especially to work with quantitative data, compared to those with a background in administration and/or business. At the organizational level, the interviews showed a connection between the participants’ position within the organization and their organization’s position with respect to others and their degree of access to quantitative data. This in turn affected their sense of empowerment and agency in dealing with data, such as shaping what data is collected and available. These differences reflected on the interviewees’ perceptions and expectations for the ECE workforce. For example, one of the interviewees pointed out that many ECE professionals happen to use data out of the necessity of the moment. This lack of intentionality is a cause for, and at the same time translates into missed training opportunities. Another interviewee pointed out issues related to the professionalism of the ECE workforce by remarking the inadequacy of ECE students’ training in working with data. In conclusion, Núñez’s model helped understand the different elements that affect ECE professionals’ experiences with quantitative data. In particular, what was clear is that these professionals are not being provided with the necessary support and that we are not being intentional in creating data literacy skills for them, despite what is asked of them and their work.

Keywords: data literacy, early childhood professionals, intersectionality, quantitative data

Procedia PDF Downloads 253

Authors: Chantal Maille

Abstract:

This paper is about gender-based analysis plus (GBA+), an intersectional gender policy used in Canada to assess the impact of policies and programs for men and women from different origins. It looks at Canada’s political culture to explain the nature of its gender policies. GBA+ is defined as an analysis method that makes it possible to assess the eventual effects of policies, programs, services, and other initiatives on women and men of different backgrounds because it takes account of gender and other identity factors. The ‘plus’ in the name serves to emphasize that GBA+ goes beyond gender to include an examination of a wide range of other related identity factors, such as age, education, language, geography, culture, and income. The point of departure for GBA+ is that women and men are not homogeneous populations and gender is never the only factor in defining a person’s identity; rather, it interacts with factors such as ethnic origin, age, disabilities, where the person lives, and other aspects of individual and social identity. GBA+ takes account of these factors and thus challenges notions of similarity or homogeneity within populations of women and men. Comparative analysis based on sex and gender may serve as a gateway to studying a given question, but women, men, girls, and boys do not form homogeneous populations. In the 1990s, intersectionality emerged as a new feminist framework. The popularity of the notion of intersectionality corresponds to a time when, in hindsight, the damage done to minoritized groups by state disengagement policies in concert with global intensification of neoliberalism, and vice versa, can be measured. Although GBA+ constitutes a form of intersectionalization of GBA, it must be understood that the two frameworks do not spring from a similar logic. Intersectionality first emerged as a dynamic analysis of differences between women that was oriented toward change and social justice, whereas GBA is a technique developed by state feminists in a context of analyzing governmental policies and aiming to promote equality between men and women. It can nevertheless be assumed that there might be interest in such a policy and program analysis grid that is decentred from gender and offers enough flexibility to take account of a group of inequalities. In terms of methodology, the research is supported by a qualitative analysis of governmental documents about GBA+ in Canada. Research findings identify links between Canadian gender policies and its political culture. In Canada, diversity has been taken into account as an element at the basis of gendered analysis of public policies since 1995. The GBA+ adopted by the government of Canada conveys an opening to intersectionality and a sensitivity to multiculturalism. The Canadian Multiculturalism Act, adopted 1988, proposes to recognize the fact that multiculturalism is a fundamental characteristic of the Canadian identity and heritage and constitutes an invaluable resource for the future of the country. In conclusion, Canada’s distinct political culture can be associated with the specific nature of its gender policies.

Keywords: Canada, gender-based analysis, gender policies, political culture

Procedia PDF Downloads 222

Authors: Geyang Xia

Abstract:

In many countries, governments have responded to the growing demand for educational resources through school district systems, and there is substantial evidence that school district systems have been effective in promoting inter-district and inter-school equity in educational resources. However, the scarcity of quality educational resources has brought about varying levels of education among different school districts, making it a common choice for many parents to buy a house in the school district where a quality school is located, and they are even willing to bear huge commuting costs for this purpose. Moreover, this is evidenced by the fact that parents of families in school districts with quality education resources have longer average commute lengths and longer average commute distances than parents in average school districts. This "unequal traveling" under the influence of the school district system is more common in school districts at the primary level of education. This further reinforces the differential hierarchy of educational resources and raises issues of inequitable educational public services, education-led residential segregation, and gentrification of school district housing. Against this background, this paper takes Nanjing, a famous educational city in China, as a case study and selects the school districts where the top 10 public elementary schools are located. The study first identifies the spatio-temporal behavioral trajectory dataset of these high-quality school district households by using spatial vector data, decrypted cell phone signaling data, and census data. Then, by constructing a "house-school-work (HSW)" commuting pattern of the population in the school district where the high-quality educational resources are located, and based on the classification of the HSW commuting pattern of the population, school districts with long employment hours were identified. Ultimately, the mechanisms and patterns inherent in this unequal commuting are analyzed in terms of six aspects, including the centrality of school district location, functional diversity, and accessibility. The results reveal that the "unequal commuting" of Nanjing's high-quality school districts under the influence of the school district system occurs mainly in the peripheral areas of the city, and the schools matched with these high-quality school districts are mostly branches of prestigious schools in the built-up areas of the city's core. At the same time, the centrality of school district location and the diversity of functions are the most important influencing factors of unequal commuting in high-quality school districts. Based on the research results, this paper proposes strategies to optimize the spatial layout of high-quality educational resources and corresponding transportation policy measures.

Keywords: school-district system, high quality school district, commuting pattern, unequal traveling

Procedia PDF Downloads 98

Authors: Dmytro Symak

Abstract:

The experience in other countries shows that, the role of accreditation of higher education as one of the types of quality assurance process for providing educational services increases. This was the experience of highly developed countries such as USA, Canada, France, Germany, because without proper quality assurance process is impossible to achieve a successful future of the nation and the state. In most countries, the function of Higher Education Accreditation performs public authorities, in particular, such as the Ministry of Education. In the US, however, the quality assurance process is independent on the government and implemented by private non-governmental organization - the Council of Higher Education Accreditation. In France, the main body that carries out accreditation of higher education is the Ministry of National Education. As part of the Bologna process is the mutual recognition and accreditation of degrees. While higher education institutions issue diplomas, but the ministry could award the title. This is the main level of accreditation awarded automatically by state universities. In total, there are in France next major level of accreditation of higher education: - accreditation for a visa: Accreditation second level; - recognition of accreditation: accreditation of third level. In some areas of education to accreditation ministry should adopt formal recommendations on specific organs. But there are also some exceptions. Thus, the French educational institutions, mainly large Business School, looking for non-French accreditation. These include, for example, the Association to Advance Collegiate Schools of Business, the Association of MBAs, the European Foundation for Management Development, the European Quality Improvement System, a prestigious EFMD Programme accreditation system. Noteworthy also German accreditation system of education. The primary here is a Conference of Ministers of Education and Culture of land in the Federal Republic of Germany (Kultusministerkonferenz or CCM) was established in 1948 by agreement between the States of the Federal Republic of Germany. Among its main responsibilities is to ensure quality and continuity of development in higher education. In Germany, the program of bachelors and masters must be accredited in accordance with Resolution Kultusministerkonerenz. In Ukraine Higher Education Accreditation carried out the Ministry of Education, Youth and Sports of Ukraine under four main levels. Ukraine's legislation on higher education based on the Constitution Ukraine consists of the laws of Ukraine ‘On osvititu’ ‘On scientific and technical activity’, ‘On Higher osvititu’ and other legal acts and is entirely within the competence of the state. This leads to considerable centralization and bureaucratization of the process. Thus, analysis of expertise shined can conclude that reforming the system of accreditation and quality of higher education in Ukraine to its integration into the global space requires solving a number of problems in the following areas: improving the system of state certification and licensing; optimizing the network of higher education institutions; creating both governmental and non-governmental organizations to monitor the process of higher education in Ukraine and so on.

Keywords: higher education, accreditation, decentralization, education institutions

Procedia PDF Downloads 337

Authors: G. Bravo, D. Lopez, A. Iriarte

Abstract:

Several organizations and governments have created a demand for information about the environmental impacts of agricultural products. Today, the export oriented fruit sector in Chile is being challenged to quantify and reduce their environmental impacts. Chile is the largest southern hemisphere producer and exporter of sweet cherry fruit. Chilean sweet cherry production reached a volume of 80,000 tons in 2012. The main destination market for the Chilean cherry in 2012 was Asia (including Hong Kong and China), taking in 69% of exported volume. Another important market was the United States with 16% participation, followed by Latin America (7%) and Europe (6%). Concerning geographical distribution, the Chilean conventional cherry production is focused in the center-south area, between the regions of Maule and O’Higgins; both regions represent 81% of the planted surface. The Life Cycle Assessment (LCA) is widely accepted as one of the major methodologies for assessing environmental impacts of products or services. The LCA identifies the material, energy, material, and waste flows of a product or service, and their impact on the environment. There are scant studies that examine the impacts of sweet cherry cultivation, such as acidification and eutrophication. Within this context, the main objective of this study is to evaluate, using the LCA, the acidification and eutrophication impacts of sweet cherry production in Chile. The additional objective is to identify the agricultural inputs that contributed significantly to the impacts of this fruit. The system under study included all the life cycle stages from the cradle to the farm gate (harvested sweet cherry). The data of sweet cherry production correspond to nationwide representative practices and are based on technical-economic studies and field information obtained in several face-to-face interviews. The study takes into account the following agricultural inputs: fertilizers, pesticides, diesel consumption for agricultural operations, machinery and electricity for irrigation. The results indicated that the mineral fertilizers are the most important contributors to the acidification and eutrophication impacts of the sheet cherry cultivation. Improvement options are suggested for the hotspot in order to reduce the environmental impacts. The results allow planning and promoting low impacts procedures across fruit companies, as well as policymakers, and other stakeholders on the subject. In this context, this study is one of the first assessments of the environmental impacts of sweet cherry production. New field data or evaluation of other life cycle stages could further improve the knowledge on the impacts of this fruit. This study may contribute to environmental information in other countries where there is similar agricultural production for sweet cherry.

Keywords: acidification, eutrophication, life cycle assessment, sweet cherry production

Procedia PDF Downloads 271

Authors: Ishrat Zakia Sultana

Abstract:

The consistent persecution, ethnic cleansing, and genocide against the Rohingya in Burma resulted four major influxes of the Rohingya people to the neighboring country Bangladesh. After the latest influx of October 2016 and August 2017, the total number of Rohingya in Bangladesh stands somewhere between 900,000 to over one million, placing Bangladesh much ahead with the number of refugees compared to Dadaab and Kakuma in Kenya, Bidibidi in Uganda and Zaatari in Jordan. While Bangladesh received recognition and appreciation for receiving a huge number of the Rohingya, one of the fundamental human rights of the Rohingya – education – has never been fulfilled in Bangladesh. The Ministry of Disaster Management and Relief of the government of Bangladesh has been looking after the Rohingya and managing various programs for the Rohingya. On its website, the Ministry claims that it provides the basic supports/services to the Rohingya, including providing education. In practice, however, education for the Rohingya include only the provisions for registered Rohingya refugees – who are a very small number of populations among the entire Rohingya hosted in Bangladesh – and that is only up to grade 7 within the registered camps at Teknaf and Ukhia of Cox’s Bazar district of the country. There is no answer of the question, ‘What’s next’? Although refugees in Canada, Sudan, Turkey and other countries have been allowed to go to mainstream schools, Rohingya refugees in Bangladesh are not allowed to do so legally. Due to the lack of proof of nationality of the Rohingya, the government of Bangladesh imposes restrictions on their access to Bangladeshi schools. However, despite their vulnerability and statelessness, many Rohingyas are desperate to pursue education outside the camps and find their own way not only within Cox’s Bazar but also even in the capital city of the country. But they must hide their refugee identity to accomplish this. My research aims to explore how they manage to get admission amid government restrictions on their access to education in the mainstream institutions in Bangladesh. It will reveal how Rohingya people use adopted identity to get access to education in Bangladesh, and how they apply their own techniques to achieve their goals without having government approved identity. This research examined the strategies the Rohingya applied to manage documents related to their identity to ensure their admission to Bangladeshi education institutions – in schools, colleges, and universities. The research employed a qualitative approach. It used semi structured individual interviews and Focused Group Discussions (FGDs) with 20 male and female Rohingya refugees who are 18 years old and above, and have enrolled in Bangladeshi education institutions with adopted identity. Also I interviewed 5 local community members and policy makers to understand their perceptions and roles in this process. The findings of this research will allow the policy makers to rethink the outcomes of the restrictions on Rohingya’s education in Bangladesh, the ramifications of the denial of Rohingya’s access to education, and initiate policy dialogues on how to allow Rohingya refugees to pursue education in Bangladesh in legal way.

Keywords: Rohingya, Refugee, Bangladesh, Education

Procedia PDF Downloads 64

Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

Abstract:

Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

Procedia PDF Downloads 229

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

Abstract:

People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

Procedia PDF Downloads 114

Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

Abstract:

The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

Procedia PDF Downloads 144

Authors: Sophie Baudel, Aline Duplaa, Jean Muller, Stephan Lauriol, Yann Bernard

Abstract:

Argos is the main satellite telemetry system used by the wildlife research community, since its creation in 1978, for animal tracking and scientific data collection all around the world, to analyze and understand animal migrations and behavior. The marine mammals' biology is one of the major disciplines which had benefited from Argos telemetry, and conversely, marine mammals biologists’ community has contributed a lot to the growth and development of Argos use cases. The Argos constellation with 6 satellites in orbit in 2017 (Argos 2 payload on NOAA 15, NOAA 18, Argos 3 payload on NOAA 19, SARAL, METOP A and METOP B) is being extended in the following years with Argos 3 payload on METOP C (launch in October 2018), and Argos 4 payloads on Oceansat 3 (launch in 2019), CDARS in December 2021 (to be confirmed), METOP SG B1 in December 2022, and METOP-SG-B2 in 2029. Argos 4 will allow more frequency bands (600 kHz for Argos4NG, instead of 110 kHz for Argos 3), new modulation dedicated to animal (sea turtle) tracking allowing very low transmission power transmitters (50 to 100mW), with very low data rates (124 bps), enhancement of high data rates (1200-4800 bps), and downlink performance, at the whole contribution to enhance the system capacity (50,000 active beacons per month instead of 20,000 today). In parallel of this ‘institutional Argos’ constellation, in the context of a miniaturization trend in the spatial industry in order to reduce the costs and multiply the satellites to serve more and more societal needs, the French Space Agency CNES, which designs the Argos payloads, is innovating and launching the Argos ANGELS project (Argos NEO Generic Economic Light Satellites). ANGELS will lead to a nanosatellite prototype with an Argos NEO instrument (30 cm x 30 cm x 20cm) that will be launched in 2019. In the meantime, the design of the renewal of the Argos constellation, called Argos For Next Generations (Argos4NG), is on track and will be operational in 2022. Based on Argos 4 and benefitting of the feedback from ANGELS project, this constellation will allow revisiting time of fewer than 20 minutes in average between two satellite passes, and will also bring more frequency bands to improve the overall capacity of the system. The presentation will then be an overview of the Argos system, present and future and new capacities coming with it. On top of that, use cases of two Argos hardware modules will be presented: the goniometer pathfinder allowing recovering Argos beacons at sea or on the ground in a 100 km radius horizon-free circle around the beacon location and the new Argos 4 chipset called ‘Artic’, already available and tested by several manufacturers.

Keywords: Argos satellite telemetry, marine protected areas, oceanography, maritime services

Procedia PDF Downloads 182

Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

Abstract:

Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

Procedia PDF Downloads 60

Authors: Hanee Ryu

Abstract:

The supporting policies for renewable energy have been designed to deploy renewable energy technology targeting domestic market. The government encourages market creation through obligations such as FIT or RPS on an energy supplier. With these policy measures, the securing vast market needs to induce technology development. Furthermore, it is crucial that ensuring developing market can make the environment nurture the renewable energy industry. Overseas expansion to countries being in demand is essential under immature domestic market. Extending its business abroad can make the domestic company get the knowledge through learning-by-doing. Besides, operation in the countries to be rich in renewable resources such as weather conditions helps to develop proven track record required for verifying technologies. This paper figures out the factor to hamper the global market entry and build up the strategies to overcome difficulties. Survey conducted renewable energy company having overseas experiences at least once. Based on the survey we check the obstacle against exporting home goods and services. As a result, securing funds is salient fact to proceed to business. It is difficult that only private bank or investment agencies participate in the project under uncertainty which renewable energy development project bears inherently. These uncertainties need public fund such as ODA to encourage private sectors to start a business. Furthermore, international organizations such as IRENA or multilateral development banks as WBG play a role to guarantee the investment including risk insurance against uncertainty. It can also manage excavation business cooperating with developing countries and supplement inadequate government funding involved. With survey results strategies to obtain the order, the international organization places are categorized according to the type of getting a contract. This paper suggests 3 types approaching to the international organization project (going through international competitive bidding, using ODA and project financing) and specifies the role of government to support the domestic firms with running out of funds. Under renewable energy industry environment where hard to being created as a spontaneous market, government policy approach needs to motivate the actors to get into the business. It is one of the good strategies that countries with the low demand of renewable energies participate in the project international agencies order in the developing countries having abundant resources. This provides crucial guidance for the formulation of renewable energy development policy and planning with consideration of business opportunities and funding.

Keywords: exporting strategies, multilateral development banks, promoting in developing countries, renewable energy technologies

Procedia PDF Downloads 518

Authors: Ebru Ozgur Guler, Huseyin Guler, Sera Sanli

Abstract:

Social Progress Index (SPI) whose fundamentals have been thrown in the World Economy Forum is an index which aims to form a systematic basis for guiding strategy for inclusive growth which requires achieving both economic and social progress. In this research, it has been aimed to determine the relations among “Basic Human Needs” (BHN) (including four variables of ‘Nutrition and Basic Medical Care’, ‘Water and Sanitation’, ‘Shelter’ and ‘Personal Safety’) and “Opportunity” (OPT) (that is composed of ‘Personal Rights’, ‘Personal Freedom and Choice’, ‘Tolerance and Inclusion’, and ‘Access to Advanced Education’ components) dimensions of 2016 SPI for 138 countries which take place in the website of Social Progress Imperative by carrying out canonical correlation analysis (CCA) which is a data reduction technique that operates in a way to maximize the correlation between two variable sets. In the interpretation of results, the first pair of canonical variates pointing to the highest canonical correlation has been taken into account. The first canonical correlation coefficient has been found as 0.880 indicating to the high relationship between BHN and OPT variable sets. Wilk’s Lambda statistic has revealed that an overall effect of 0.809 is highly large for the full model in order to be counted as statistically significant (with a p-value of 0.000). According to the standardized canonical coefficients, the largest contribution to BHN set of variables has come from ‘shelter’ variable. The most effective variable in OPT set has been detected to be ‘access to advanced education’. Findings based on canonical loadings have also confirmed these results with respect to the contributions to the first canonical variates. When canonical cross loadings (structure coefficients) are examined, for the first pair of canonical variates, the largest contributions have been provided by ‘shelter’ and ‘access to advanced education’ variables. Since the signs for structure coefficients have been found to be negative for all variables; all OPT set of variables are positively related to all of the BHN set of variables. In case canonical communality coefficients which are the sum of the squares of structure coefficients across all interpretable functions are taken as the basis; amongst all variables, ‘personal rights’ and ‘tolerance and inclusion’ variables can be said not to be useful in the model with 0.318721 and 0.341722 coefficients respectively. On the other hand, while redundancy index for BHN set has been found to be 0.615; OPT set has a lower redundancy index with 0.475. High redundancy implies high ability for predictability. The proportion of the total variation in BHN set of variables that is explained by all of the opposite canonical variates has been calculated as 63% and finally, the proportion of the total variation in OPT set that is explained by all of the canonical variables in BHN set has been determined as 50.4% and a large part of this proportion belongs to the first pair. The results suggest that there is a high and statistically significant relationship between BHN and OPT. This relationship is generally accounted by ‘shelter’ and ‘access to advanced education’.

Keywords: canonical communality coefficient, canonical correlation analysis, redundancy index, social progress index

Procedia PDF Downloads 218

Authors: Gideon C. Joseph

Abstract:

The ability to localize mobile devices is quite important, as some applications may require location information of these devices to operate or deliver better services to the users. Although there are several ways of acquiring location data of mobile devices, the WLAN fingerprinting approach has been considered in this work. This approach uses the Received Signal Strength Indicator (RSSI) measurement as a function of the position of the mobile device. RSSI is a quantitative technique of describing the radio frequency power carried by a signal. RSSI may be used to determine RF link quality and is very useful in dense traffic scenarios where interference is of major concern, for example, indoor environments. This research aims to design a system that can predict the location of a mobile device, when supplied with the mobile’s RSSIs. The developed system takes as input the RSSIs relating to the mobile device, and outputs parameters that describe the location of the device such as the longitude, latitude, floor, and building. The relationship between the Received Signal Strengths (RSSs) of mobile devices and their corresponding locations is meant to be modelled; hence, subsequent locations of mobile devices can be predicted using the developed model. It is obvious that describing mathematical relationships between the RSSIs measurements and localization parameters is one option to modelling the problem, but the complexity of such an approach is a serious turn-off. In contrast, we propose an intelligent system that can learn the mapping of such RSSIs measurements to the localization parameters to be predicted. The system is capable of upgrading its performance as more experiential knowledge is acquired. The most appealing consideration to using such a system for this task is that complicated mathematical analysis and theoretical frameworks are excluded or not needed; the intelligent system on its own learns the underlying relationship in the supplied data (RSSI levels) that corresponds to the localization parameters. These localization parameters to be predicted are of two different tasks: Longitude and latitude of mobile devices are real values (regression problem), while the floor and building of the mobile devices are of integer values or categorical (classification problem). This research work presents artificial neural network based intelligent systems to model the relationship between the RSSIs predictors and the mobile device localization parameters. The designed systems were trained and validated on the collected WLAN fingerprint database. The trained networks were then tested with another supplied database to obtain the performance of trained systems on achieved Mean Absolute Error (MAE) and error rates for the regression and classification tasks involved therein.

Keywords: indoor localization, WLAN fingerprinting, neural networks, classification, regression

Procedia PDF Downloads 347

Authors: Dongming Feng, Fangyin Zhang, Liling Cao

Abstract:

Horizontally curved steel-concrete composite box girders are extensively used in highway bridges. They consist of reinforced concrete deck on top of prefabricated steel box section beam which exhibits a high torsional rigidity to resist torsional effects induced by the curved structural geometry. This type of structural system is often constructed in two stages. The composite section will take the tension mainly by the steel box and, the compression by the concrete deck. The steel girders are delivered in large pre-fabricated U-shaped sections that are designed for ease of construction. They are then erected on site and overlaid by cast-in-place reinforced concrete deck. The functionality of the composite section is not achieved until the closed section is formed by fully cured concrete. Since this kind of composite section is built in two stages, the erection of the open steel box presents some challenges to contractors. When the reinforced concrete slab is cast-in-place, special care should be taken on bracings that can prevent the open U-shaped steel box from global and local buckling. In the case of multiple steel boxes, the design detailing should pay enough attention to the installation requirement of the bracings connecting adjacent steel boxes to prevent the global buckling. The slope in transverse direction and grade in longitudinal direction will result in some local deformation of the steel boxes that affect the connection of the bracings. During the design phase, it is common for engineers to model the curved composite box girder using one-dimensional beam elements. This is adequate to analyze the global behavior, however, it is unable to capture the local deformation which affects the installation of the field bracing connection. The presence of the local deformation may become a critical component to control the construction tolerance, and overlooking this deformation will produce inadequate structural details that eventually cause misalignment in field and erection failure. This paper will briefly describe the construction issues we encountered in real structures, investigate the difference between beam element modeling and shell/solid element modeling, and their impact on the different construction stages. P-delta effect due to the slope and curvature of the composite box girder is analyzed, and the secondary deformation is compared to the first-order response and evaluated for its impact on installation of lateral bracings. The paper will discuss the rational approach to prepare construction documents and recommendations are made on the communications between engineers, erectors, and fabricators to smooth out construction process.

Keywords: buckling, curved composite box girder, stage construction, structural detailing

Procedia PDF Downloads 122

Authors: Hahido Samaras

Abstract:

In many cases, especially with the pandemic playing a major role in fast-tracking the growth of the digital industry, online learning has become a necessity or even a standard educational model nowadays, reliably overcoming barriers such as location, time and cost and frequently combined with a face-to-face format (e.g., in blended learning). This being the case, it is evident that students in many parts of the world, as well as their parents, will increasingly need to become aware of the pros and cons of online versus traditional courses. This fast-growing mode of learning, accelerated during the years of the pandemic, presents an abundance of exciting options especially matched for a large number of secondary school students in remote places of the world where access to stimulating educational settings and opportunities for a variety of learning alternatives are scarce, adding advantages such as flexibility, affordability, engagement, flow and personalization of the learning experience. However, online learning can also present several challenges, such as a lack of student motivation and social interactions in natural settings, digital literacy, and technical issues, to name a few. Therefore, educational researchers will need to conduct further studies focusing on the benefits and weaknesses of online learning vs. traditional learning, while instructional designers propose ways of enhancing student motivation and engagement in virtual environments. Similarly, teachers will be required to become more and more technology-capable, at the same time developing their knowledge about their students’ particular characteristics and needs so as to match them with the affordances the technology offers. And, of course, schools, education programs, and policymakers will have to invest in powerful tools and advanced courses for online instruction. By developing digital courses that incorporate intentional opportunities for community-building and interaction in the learning environment, as well as taking care to include built-in design principles and strategies that align learning outcomes with learning assignments, activities, and assessment practices, rewarding academic experiences can derive for all students. This paper raises various issues regarding the effectiveness of online learning on students by reviewing a large number of research studies related to the usefulness and impact of online learning following the COVID-19-induced digital education shift. It also discusses what students, teachers, decision-makers, and parents have reported about this mode of learning to date. Best practices are proposed for parties involved in the development of online learning materials, particularly for secondary school students, as there is a need for educators and developers to be increasingly concerned about the impact of virtual learning environments on student learning and wellbeing.

Keywords: blended learning, online learning, secondary schools, virtual environments

Procedia PDF Downloads 100

Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

Abstract:

Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

Procedia PDF Downloads 169

Authors: Baikuntha Prasad Acharya, Elizabeth Halpenny

Abstract:

Small tourism enterprises (STEs) are primary providers of services and attractions in many destinations of less developed countries; they are considered the lifeblood of tourism sector. Furthermore, in rural community destinations of such countries including Nepal, STEs are regarded as alternative tools for advancing economic and sociocultural transformations. Many families in rural Nepali destinations are venturing into small tourism entrepreneurship so that their poverty can be reduced and they can live a sustained life. Most these communities are utilizing their lifestyles and natural and cultural heritages as tourism attractions. This study aimed to understand the sustainability of the STEs in rural destinations by synthesizing observations from Ghalegaon and Ghandruk of the Annapurna Conservation Area in western Nepal. Ghalegaon has community-based homestays and Ghandruk has independently owned and operated small tourism businesses such as cafes, tea houses, lodges, guest houses, and hotels, etc. The community-based homestays of Ghalegaon are compared with the independently owned and operated STEs of Ghandruk. The data were collected through multiple sources: 1) survey of tourists (n=112) and households (n=191); 2) interviews (n=14) with the locals, 3) group discussions (n=10) with different local groups including that of regional tourism players, experts and policy makers, 4) observations, and 5) document analysis. The STEs of both communities were first analyzed by understanding their level of sustainability as businesses, and then were explored how they were impacting on respective communities’ sustainability. The survey indicators and guidelines for interviews and group discussions were adapted to the Nepalese context based on four pillars of sustainability: economic, social, cultural and environmental; an additional dimension of management was also included, particularly for the STEs. The findings have shown a weaker economic and management dimensions of Ghalegaon’s Homestay than that of Ghandruk’s STEs. Some interesting social complexities of rural tourism and entrepreneurship were also revealed. This study’s findings do not much resonate to what Nepal government’s current rural tourism strategies that have been envisioned and prioritized for, particularly that the rural homestay tourism opportunities enhance inclusiveness of women and other deprived communities by spreading the benefits to the grassroots level. The study has highlighted several important applied implications to the local tourism management committees, tourism operators and associations, and regional and national tourism authorities. Further studies are advisable in other similar contexts in Nepal and in other countries to see whether there are variances in the findings.

Keywords: Nepal, rural tourism communities, small tourism enterprises, sustainability

Procedia PDF Downloads 335