Search results for: post disasters
4065 The Effect of Fetal Movement Counting on Maternal Antenatal Attachment
Authors: Esra Güney, Tuba Uçar
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Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery
Procedia PDF Downloads 2724064 Aerobic Exercise Increases Circulating Hematopoietic Stem Cells and Endothelial Progenitor Cells
Authors: Khaled A. shady, Fagr B. Bazeed, Nashwa K. Abousamra, Ihab H. Elberawe, Ashraf E. shaalan, Mohamed A. Sobh
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Physical activity activates a variety of adult stem cells which might be released into the circulation or might be activated in their organ-resident state. A variety of stimuli such as metabolic, mechanical, and hormonal stimuli might by responsible for the mobilization. This study was done to know the changes in hematopoietic stem cells and endothelial progenitor in athletes in the 24 hours following 30 min of aerobic exercise. Methods: Ten healthy male's athlete's (age 20.7± 0.61 y) performed moderate running with 30 min at 80% of velocity of The IAT. Blood samples taken pre-, and immediately, 30 min, 2h, 6h and 24h post-exercise were analyzed for hematopoietic stem cells (HSCs ), endothelial progenitor cells (EPCs(, vascular endothelial growth factor (VEGF), nitric oxide (NO), lactic acid (LA), and white blood cells . HSCs and EPCs were quantified by flow cytometry. Results: After 30min of aerobic exercise significant increases in HSCs, EPC, VEGF, NO, LA and WBCs (p ˂ 0.05). This increase will be at different rates according to the timing of taking blood sample and was in the maximum rate of increase after 30 min of aerobic exercise. HSCs, EPC, NO and WBCs were in the maximum rate of increase 2h post exercise. In addition, VEGF was in the maximum rate of increase immediately post exercise and LA concentration not affected after exercise. Conclusion: These data suggest that HSCs and EPCs increased after aerobic exercise due to increase of VEGF which play an important role in mobilization of stem cells and promotes NO increase which contributes to increase EPCs.Keywords: physical activity, hematopoietic stem cells, mobilization, athletes
Procedia PDF Downloads 1174063 Analytical Investigation of Replaceable Links with Reduced Web Section for Link-to-Column Connections in Eccentrically Braced Frames
Authors: Daniel Y. Abebe, Sijeong Jeong, Jaehyouk Choi
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The use of eccentrically braced frame (EBF) is increasing day by day as EBF possesses high elastic stiffness, stable inelastic response under cyclic lateral loading, and excellent ductility and energy dissipation capacity. The ductility and energy dissipation capacity of EBF depends on the active link beams. Recently, there are two types EBFs; these are conventional EBFs and EBFs with replaceable links. The conventional EBF has a disadvantage during maintenance in post-earthquake. The concept of removable active link beam in EBF is developed to overcome the limitation of the conventional EBF in post-earthquake. In this study, a replaceable link with reduced web section is introduced and design equations are suggested. In addition, nonlinear finite element analysis was conducted in order to evaluate the proposed links.Keywords: EBFs, replaceable link, earthquake disaster, reduced section
Procedia PDF Downloads 3344062 Making the Right Call for Falls: Evaluating the Efficacy of a Multi-Faceted Trust Wide Approach to Improving Patient Safety Post Falls
Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper
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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.Keywords: patient safety, quality improvement, serious incidents, falls, clinical care
Procedia PDF Downloads 1244061 Determining the Effectiveness of Dialectical Behavior Therapy in Reducing the Psychopathic Deviance of Criminals
Authors: Setareh Gerayeli
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The present study tries to determine the effectiveness of dialectical behavior therapy in reducing the psychopathic deviance of employed criminals released from prison. The experimental method was used in this study, and the statistical population included employed criminals released from prison in Mashhad. Thirty offenders were selected randomly as the samples of the study. The MMPI-2 was used to collect data in the pre-test and post-test stages. The behavioral therapy was conducted on the experimental group during fourteen two and a half hour sessions, while the control group did not receive any intervention. Data analysis was conducted by using covariance. The results showed there is a significant difference between the post-test mean scores of the two groups. The findings suggest that dialectical behavior therapy is effective in reducing psychopathic deviance.Keywords: criminals, dialectical behavior therapy, psychopathic deviance, prison
Procedia PDF Downloads 2324060 Analysis of Supply Chain Risk Management Strategies: Case Study of Supply Chain Disruptions
Authors: Marcelo Dias Carvalho, Leticia Ishikawa
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Supply Chain Risk Management refers to a set of strategies used by companies to avoid supply chain disruption caused by damage at production facilities, natural disasters, capacity issues, inventory problems, incorrect forecasts, and delays. Many companies use the techniques of the Toyota Production System, which in a way goes against a better management of supply chain risks. This paper studies key events in some multinationals to analyze the trade-off between the best supply chain risk management techniques and management policies designed to create lean enterprises. The result of a good balance of these actions is the reduction of losses, increased customer trust in the company and better preparedness to face the general risks of a supply chain.Keywords: just in time, lean manufacturing, supply chain disruptions, supply chain management
Procedia PDF Downloads 3384059 Recent Legal Changes in Turkish Commercial Law to Be a Part of International Markets and Their Results
Authors: Ibrahim Arslan
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Since 1984, Turkey has experienced a significant transformation in legal and economic matters. The most consequential examples of this transformation in recent years are the renewal of the Commercial Code and the Check Act. Nowadays, the commercial activity is not limited within the boundaries of the country; on the contrary, as required by the global economy, it has an international dimension. For this reason, unlike some other legal principles, the rules regulating the commercial life should be compatible with the international standards as much as possible. Otherwise the development possibility in the global markets will be limited. The Check Act has been adopted in 2009 and the Commercial Code has been adopted in 2011. The Commercial Code has been entered into force on 1 July 2012. The international dimension of check is in-disputable for it is based on the Geneva Convention. However, the Turkish business life has created a unique application of this legal tool. This application is called “post-date” checks. Indeed the majority of the checks being used in the market are post-dated checks. The holders of these checks have waited the date written on the check for presentation and collection. Thus, the actual situation has occurred. This actual situation has been legitimized via Check Act No. 5941 and post dated checks have gained a legal status. In the preparation of the new the Turkish Commercial Code one of the goals is "to ensure that the Turkish commercial law becomes a part of the international market". To achieve this goal, significant changes have been made especially concerning the independent external audition of the corporations, the board structure and public disclosure regulations. These changes aim to facilitate the internationalization of Turkish corporations as well as intensification of foreign direct investments through foreign capital. Although the target has been determined this way, after the adoption but five days before the entry into force of the Turkish Commercial Code No. 6102, a law made backward going alterations concerning independent external audition and public disclosure regulations. Turkish Commercial Code has been currently in force with its altered status. Both the regulations in the Check Act as well as the changes in the Commercial Code are not compatible with the goals introduced by rationale “to ensure Turkish commercial law to be a part of the international market” as such.Keywords: Turkish Commercial Code No. 6102, Turkish Check Act, “post-date” checks, legal changes
Procedia PDF Downloads 2944058 A Scoping Study and Stakeholder Consultation on Mental Health Determinants among Arab Immigrants and Refugees in North America
Authors: Sarah Elshahat, Tina Moffat
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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.Keywords: depression, post-traumatic stress disorder, psychological distress, resilience
Procedia PDF Downloads 1364057 Bi-objective Network Optimization in Disaster Relief Logistics
Authors: Katharina Eberhardt, Florian Klaus Kaiser, Frank Schultmann
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Last-mile distribution is one of the most critical parts of a disaster relief operation. Various uncertainties, such as infrastructure conditions, resource availability, and fluctuating beneficiary demand, render last-mile distribution challenging in disaster relief operations. The need to balance critical performance criteria like response time, meeting demand and cost-effectiveness further complicates the task. The occurrence of disasters cannot be controlled, and the magnitude is often challenging to assess. In summary, these uncertainties create a need for additional flexibility, agility, and preparedness in logistics operations. As a result, strategic planning and efficient network design are critical for an effective and efficient response. Furthermore, the increasing frequency of disasters and the rising cost of logistical operations amplify the need to provide robust and resilient solutions in this area. Therefore, we formulate a scenario-based bi-objective optimization model that integrates pre-positioning, allocation, and distribution of relief supplies extending the general form of a covering location problem. The proposed model aims to minimize underlying logistics costs while maximizing demand coverage. Using a set of disruption scenarios, the model allows decision-makers to identify optimal network solutions to address the risk of disruptions. We provide an empirical case study of the public authorities’ emergency food storage strategy in Germany to illustrate the potential applicability of the model and provide implications for decision-makers in a real-world setting. Also, we conduct a sensitivity analysis focusing on the impact of varying stockpile capacities, single-site outages, and limited transportation capacities on the objective value. The results show that the stockpiling strategy needs to be consistent with the optimal number of depots and inventory based on minimizing costs and maximizing demand satisfaction. The strategy has the potential for optimization, as network coverage is insufficient and relies on very high transportation and personnel capacity levels. As such, the model provides decision support for public authorities to determine an efficient stockpiling strategy and distribution network and provides recommendations for increased resilience. However, certain factors have yet to be considered in this study and should be addressed in future works, such as additional network constraints and heuristic algorithms.Keywords: humanitarian logistics, bi-objective optimization, pre-positioning, last mile distribution, decision support, disaster relief networks
Procedia PDF Downloads 794056 Trade Policy Incentives and Economic Growth in Nigeria
Authors: Emmanuel Dele Balogun
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This paper analyzes, using descriptive statistics and econometrics data which span the period 1981 to 2014 to gauge the effects of trade policy incentives on economic growth in Nigeria. It argues that the provided incentives penalize economic growth during pre-trade liberalization eras, but stimulated a rapid increase in total factor productivity during the post-liberalization period of 2000 to 2014. The trend analysis shows that Nigeria maintained high tariff walls in economic regulation eras which became low in post liberalization era. The protections were in favor of infant industries, which were mainly appendages of multinationals but against imports of competing food and finished consumer products. The trade openness index confirms the undue exposure of Nigeria’s economy to the vagaries of international market shocks; while banking sector recapitalization and new listing of telecommunications companies deepened the financial markets in post-liberalization era. The structure of economic incentives was biased in favor of construction, trade and services, but against the real sector despite protectionist policies. Total Factor Productivity (TFP) estimates show that the Nigerian economy suffered stagnation in pre-liberalization eras, but experienced rapid growth rates in post-liberalization eras. The regression results relating trade policy incentives to TFP growth rate yielded a significant but negative intercept suggesting that a non-interventionist policy could be detrimental to economic progress, while protective tariff which limits imports of competing products could spur productivity gains in domestic import substitutes beyond factor growth with market liberalization. The main constraint to the effectiveness of trade policy incentives is the failure of benefiting industries to leverage on the domestic factor endowments of the nation. This paper concludes that there is the need to review the current economic transformation strategies urgently with a view to provide policymakers with a better understanding of the most viable options that could make for rapid success.Keywords: economic growth, macroeconomic incentives, total factor productivity, trade policies
Procedia PDF Downloads 3224055 Primary Analysis of a Randomized Controlled Trial of Topical Analgesia Post Haemorrhoidectomy
Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill
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Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer
Procedia PDF Downloads 1204054 “Thou Shalt Surely Die”: A Game Theory Analysis of the Book of Genesis
Authors: Bo Kampmann Walther
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This essay examines the narratives of the Book of Genesis through the lens of game theory, a mathematical framework for analyzing strategic interactions among rational actors. By treating key figures in Genesis as players in a game, this analysis sheds light on their decisions and the resulting consequences. Focusing primarily on the story of Adam and Eve, the essay utilizes concepts such as game state, saddle point, optimal strategy, and Nash equilibrium to explore the dynamics at play and scrutinize the existence of two kinds of game rules in Genesis: one being global and post-Fall oriented, the other being local and relegated to life in the Garden. The serpent's intervention and the subsequent actions of Adam and Eve are modeled as strategic moves, revealing the complexities and shifts in the game state from harmony in Eden to a world marked by toil and mortality post-Fall.Keywords: game theory, Genesis, strategy, saddle point, nash equilibrium, New Game State
Procedia PDF Downloads 444053 A Post-Occupancy Evaluation of Urban Landscape Greenway– A Case Study of the Taiyuan Greenway in Taichung City
Authors: A. Yu-Chen Chien, B. Ying-Ju Su
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Greenway is a type of linear park which links the planar parklands and connects the open spaces. In the urban environment, except for providing open spaces with recreational function as well as effectively improve the appearance of the surrounding environment, greenway and parkland also creates benefits to the social and psychological aspects of human. In 2014, the statistics of The Ministry of Home Affairs show that citizens in Taichung enjoy the green area at an average of 4.27 square kilometers per person. How to use the existing green space system effectively and enhance the quality of leisure life thus become the major issues today. The study here points out that greenway and parkland and other open spaces are closely related to the daily life of urban residents. Whether the operation could be executed in accordance with the design is our major concern. To explore the issue, we implemented the Post-Occupancy Evaluation of Taiyuan Greenway in Taichung City. In 1956, Taichung city carried out the urban plan according to Howard’s concept about “Garden City” and built the Taiyuan greenway to restrain the urban expansion. 50-year past, due to the population growth and new demands, the government started to reconstruct the program. It is a three stage modification project of “The Townspace Renaissance project in Taiwan” since 2009, of which the greenway construction is the main point. In this research, we mainly focus on the third stage of this program to investigate the user’s preference and degree of satisfaction based on the Post-Occupancy Evaluation about the finished, unfinished, and undergoing construction sectors as well as facilities. We collected and analyzed the data based on the questionnaires and explored the possible facts that might have affected the degree of satisfaction about the greenway modification project based on the chi-square test. We hope to inspect the purpose of the demonstration projects and provide reference to the Taichung government for the modification planning and the greenway design in the future.Keywords: greenway, landscape greenway, post-occupancy evaluation, Taichung city
Procedia PDF Downloads 3304052 Photobiomodulation Activates WNT/β-catenin Signaling for Wound Healing in an in Vitro Diabetic Wound Model
Authors: Dimakatso B. Gumede, Nicolette N. Houreld
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Diabetic foot ulcers (DFUs) are a complication of diabetes mellitus (DM), a metabolic disease caused by insulin resistance or insufficiency, resulting in hyperglycaemia and low-grade chronic inflammation. Current therapies for treating DFUs include wound debridement, glycaemic control, and wound dressing. However, these therapies are moderately effective as there is a recurrence of these ulcers and an increased risk of lower limb amputations. Photobiomodulation (PBM), which is the application of non-invasive low-level light for wound healing at the spectrum of 660-1000 nm, has shown great promise in accelerating the healing of chronic wounds. However, its underlying mechanisms are not clearly defined. Studies have indicated that PBM induces wound healing via the activation of signaling pathways that are involved in tissue repair, such as the transforming growth factor-β (TGF-β). However, other signaling pathways, such as the WNT/β-catenin pathway, which is also critical for wound repair, have not been investigated. This study aimed to elucidate if PBM at 660 nm and a fluence of 5 J/cm² activates the WNT/β-catenin signaling pathway for wound healing in a diabetic cellular model. Human dermal fibroblasts (WS1) were continuously cultured high-glucose (26.5 mM D-glucose) environment to create a diabetic cellular model. A central scratch was created in the diabetic model to ‘wound’ the cells. The diabetic wounded (DW) cells were thereafter irradiated at 660 nm and a fluence of 5 J/cm². Cell migration, gene expression and protein assays were conducted at 24- and 48-h post-PBM. The results showed that PBM at 660 nm and a fluence of 5 J/cm² significantly increased cell migration in diabetic wounded cells at 24-h post-PBM. The expression of CTNNB1, ACTA2, COL1A1 and COL3A1 genes was also increased in DW cells post-PBM. Furthermore, there was increased cytoplasmic accumulation and nuclear localization of β-catenin at 24 h post-PBM. The findings in this study demonstrate that PBM activates the WNT/β-catenin signaling pathway by inducing the accumulation of β-catenin in diabetic wounded cells, leading to increased cell migration and expression of wound repair markers. These results thus indicate that PBM has the potential to improve wound healing in diabetic ulcers via activation of the WNT/β-catenin signaling pathway.Keywords: wound healing, diabetic ulcers, photobiomodulation, WNT/β-catenin, signalling pathway
Procedia PDF Downloads 404051 Accuracy of a 3D-Printed Polymer Model for Producing Casting Mold
Authors: Ariangelo Hauer Dias Filho, Gustavo Antoniácomi de Carvalho, Benjamim de Melo Carvalho
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The work´s purpose was to evaluate the possibility of manufacturing casting tools utilizing Fused Filament Fabrication, a 3D printing technique, without any post-processing on the printed part. Taguchi Orthogonal array was used to evaluate the influence of extrusion temperature, bed temperature, layer height, and infill on the dimensional accuracy of a 3D-Printed Polymer Model. A Zeiss T-SCAN CS 3D Scanner was used for dimensional evaluation of the printed parts within the limit of ±0,2 mm. The mold capabilities were tested with the printed model to check how it would interact with the green sand. With little adjustments in the 3D model, it was possible to produce rapid tools without the need for post-processing for iron casting. The results are important for reducing time and cost in the development of such tools.Keywords: additive manufacturing, Taguchi method, rapid tooling, fused filament fabrication, casting mold
Procedia PDF Downloads 1444050 Ramadan as a Model of Intermittent Fasting: Effects on Gut Hormones, Appetite and Body Composition in Diabetes vs. Controls
Authors: Turki J. Alharbi, Jencia Wong, Dennis Yue, Tania P. Markovic, Julie Hetherington, Ted Wu, Belinda Brooks, Radhika Seimon, Alice Gibson, Stephanie L. Silviera, Amanda Sainsbury, Tanya J. Little
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Fasting has been practiced for centuries and is incorporated into the practices of different religions including Islam, whose followers intermittently fast throughout the month of Ramadan. Thus, Ramadan presents a unique model of prolonged intermittent fasting (IF). Despite a growing body of evidence for a cardio-metabolic and endocrine benefit of IF, detailed studies of the effects of IF on these indices in type 2 diabetes are scarce. We studied 5 subjects with type 2 diabetes (T2DM) and 7 healthy controls (C) at baseline (pre), and in the last week of Ramadan (post). Fasting circulating levels of glucose, HbA1c and lipids, as well as body composition (with DXA) and resting energy expenditure (REE) were measured. Plasma gut hormone levels and appetite responses to a mixed meal were also studied. Data are means±SEM. Ramadan decreased total fat mass (-907±92 g, p=0.001) and trunk fat (-778±190 g, p=0.014) in T2DM but not in controls, without any reductions in lean mass or REE. There was a trend towards a decline in plasma FFA in both groups. Ramadan had no effect on body weight, glycemia, blood pressure, or plasma lipids in either group. In T2DM only, the area under the curve for post-meal plasma ghrelin concentrations increased after Ramadan (pre:6632±1737 vs. post:9025±2518 pg/ml.min-1, p=0.045). Despite this increase in orexigenic ghrelin, subjective appetite scores were not altered by Ramadan. Meal-induced plasma concentrations of the satiety hormone pancreatic polypeptide did not change during Ramadan, but were higher in T2DM compared to controls (post: C: 23486±6677 vs. T2DM: 62193±6880 pg/ml.min-1, p=0.003. In conclusion, Ramadan, as a model for IF appears to have more favourable effects on body composition in T2DM, without adverse effects on metabolic control or subjective appetite. These data suggest that IF may be particularly beneficial in T2DM as a nutritional intervention. Larger studies are warranted.Keywords: type 2 diabetes, obesity, intermittent fasting, appetite regulating hormones
Procedia PDF Downloads 3124049 Fashion Consumption for Fashion Innovators: A Study of Fashion Consumption Behavior of Innovators and Non-Innovators
Authors: Vaishali P. Joshi, Pallav Joshi
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The objective of this study is to examine the differences fashion innovators and non-fashion innovators in their fashion consumption behavior in terms of their pre-purchase behavior, purchase behavior and post purchase behavior. The questionnaire was distributed to a female college student for data collection for achieving the objective of the first part of the study. Question-related to fashion innovativeness and fashion consumption behavior was asked. The sample was comprised of 81 college females ages 18 through 30 who were attending Business Management degree. A series of attitude questions was used to categorize respondents on the Innovativeness Scale. 32 respondents with a score of 21 and above were designated as Fashion innovators and the remainder (49) as Non-fashion innovators. Findings showed that there exist significant differences between innovators and non-innovators in their fashion consumption behavior. Data was analyzed through frequency distribution table. Many differences were found in the behavior of innovators and non-innovators in terms of their pre-purchase, actual purchase, and post-purchase behavior.Keywords: fashion, innovativeness, consumption behavior, purchase
Procedia PDF Downloads 5604048 An Application of Quantile Regression to Large-Scale Disaster Research
Authors: Katarzyna Wyka, Dana Sylvan, JoAnn Difede
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Background and significance: The following disaster, population-based screening programs are routinely established to assess physical and psychological consequences of exposure. These data sets are highly skewed as only a small percentage of trauma-exposed individuals develop health issues. Commonly used statistical methodology in post-disaster mental health generally involves population-averaged models. Such models aim to capture the overall response to the disaster and its aftermath; however, they may not be sensitive enough to accommodate population heterogeneity in symptomatology, such as post-traumatic stress or depressive symptoms. Methods: We use an archival longitudinal data set from Weill-Cornell 9/11 Mental Health Screening Program established following the World Trade Center (WTC) terrorist attacks in New York in 2001. Participants are rescue and recovery workers who participated in the site cleanup and restoration (n=2960). The main outcome is the post-traumatic stress symptoms (PTSD) severity score assessed via clinician interviews (CAPS). For a detailed understanding of response to the disaster and its aftermath, we are adapting quantile regression methodology with particular focus on predictors of extreme distress and resilience to trauma. Results: The response variable was defined as the quantile of the CAPS score for each individual under two different scenarios specifying the unconditional quantiles based on: 1) clinically meaningful CAPS cutoff values and 2) CAPS distribution in the population. We present graphical summaries of the differential effects. For instance, we found that the effect of the WTC exposures, namely seeing bodies and feeling that life was in danger during rescue/recovery work was associated with very high PTSD symptoms. A similar effect was apparent in individuals with prior psychiatric history. Differential effects were also present for age and education level of the individuals. Conclusion: We evaluate the utility of quantile regression in disaster research in contrast to the commonly used population-averaged models. We focused on assessing the distribution of risk factors for post-traumatic stress symptoms across quantiles. This innovative approach provides a comprehensive understanding of the relationship between dependent and independent variables and could be used for developing tailored training programs and response plans for different vulnerability groups.Keywords: disaster workers, post traumatic stress, PTSD, quantile regression
Procedia PDF Downloads 2844047 Post-Harvest Biopreservation of Fruit and Vegetables with Application of Lactobacillus Strains
Authors: Judit Perjessy, Zsolt Zalan, Ferenc Hegyi, Eniko Horvath-Szanics, Krisztina Takacs, Andras Nagy, Adel Klupacs, Erika Koppany-Szabo, Zhirong Wang, Kaituo Wang, Muying Du, Jianquan Kan
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The post-harvest diseases cause great economic losses in the fruit and vegetables; the prevention of these deterioration has great importance. Against the fungi, which cause most of the diseases, are extensively used the fungicides. However, there are increasing consumer concerns over the presence of pesticide residues in food. An alternative and in recent years, increasingly studied method for the prevention of the diseases is biocontrol, where antagonistic microorganisms are used for the control of fungi. The genera of Lactobacillus is well known and extensively studied, but its applicability as biocontrol agents in post-harvest preservation of fruit and vegetables is poorly investigated. However these bacteria can be found on the surface of the plants and have great antimicrobial activity. In our study we have investigated the chitinase activity, the antifungal effect and the applicability of several Lactobacillus strains to select potential biocontrol agents. We investigated the determination of the environmental parameters of a gene (encoding chitinase) expression and we also investigated the relationship between actual antifungal activity and potential chitinase activity. Mixed cultures were also developed to enhance the antifungal activity and determined the optimal mold spore and bacteria concentration ratio for the appropriate efficacy. Five Lactobacillus strains (L. acidophilus N2, L. delbrueckii subsp. bulgaricus B397, L. sp. 2231, L. sake subsp. sake 2471, L. buchneri 1145) possess chitinase-coding gene from the 43 investigated Lactobacillus strains. Proteins with similar molecular weight and separation properties like bacterial chitinases were detected from these strains, which also possess chitin-binding property. Nevertheless, they were inactive, lacks the chitinolytic activity. In point of the cumulative activity of inhibition, our results showed that certain strains were statistically significant in a positive direction compared to other strains, e.g., L. rhamnosus VT1 and L. Casey 154 have shown great general antifungal effect against 11 molds from the genera Penicillium and Botrytis and isolated from spoiled fruit and vegetables. Also, some mixed cultures (L. rhamnosus VT1 - L. Plantarum 299v) showed significant antifungal effects against the indigenous molds on the surface of apple fruit during the industrial storage experiment. Thus, they could be promising for post-harvest biopreservation.Keywords: biocontrol, chitinase, Lactobacillus, post-harvest
Procedia PDF Downloads 1544046 Predictors of Clinical Failure After Endoscopic Lumbar Spine Surgery During the Initial Learning Curve
Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li
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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery
Procedia PDF Downloads 1544045 Utilization of Learning Resources in Enhancing the Teaching of Science and Technology Courses in Post Primary Institutions in Nigeria
Authors: Isah Mohammed Patizhiko
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This paper aimed at discussing the important role learning resources play in enhancing the teaching and learning of science and technology courses in post primary institution in Nigeria. The paper highlighted the importance learning resources contributed to the effective understanding of the learners. The use of learning resources in the teaching of these courses will encourage teachers to be more exploratory and the learners to have more understanding. In this paper, different range of learning resources particularly common learning resources (learning resources not design primarily for education purposes) to enrich their teaching. The paper also highlighted how ordinary resource can be turned into an educational resource. Recommendations were proffered in the sourcing of learning resources ie from the market, library, institutions, museums, and dump refuse and concluded that good demonstration on the use of resources will engage the learner’s interest and will develop higher level of conceptual understanding in the learning area.Keywords: enhance, learning, resources, science and technology, teaching
Procedia PDF Downloads 3984044 Upward Spread Forced Smoldering Phenomenon: Effects and Applications
Authors: Akshita Swaminathan, Vinayak Malhotra
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Smoldering is one of the most persistent types of combustion which can take place for very long periods (hours, days, months) if there is an abundance of fuel. It causes quite a notable number of accidents and is one of the prime suspects for fire and safety hazards. It can be ignited with weaker ignition and is more difficult to suppress than flaming combustion. Upward spread smoldering is the case in which the air flow is parallel to the direction of the smoldering front. This type of smoldering is quite uncontrollable, and hence, there is a need to study this phenomenon. As compared to flaming combustion, a smoldering phenomenon often goes unrecognised and hence is a cause for various fire accidents. A simplified experimental setup was raised to study the upward spread smoldering, its effects due to varying forced flow and its effects when it takes place in the presence of external heat sources and alternative energy sources such as acoustic energy. Linear configurations were studied depending on varying forced flow effects on upward spread smoldering. Effect of varying forced flow on upward spread smoldering was observed and studied: (i) in the presence of external heat source (ii) in the presence of external alternative energy sources (acoustic energy). The role of ash removal was observed and studied. Results indicate that upward spread forced smoldering was affected by various key controlling parameters such as the speed of the forced flow, surface orientation, interspace distance (distance between forced flow and the pilot fuel). When an external heat source was placed on either side of the pilot fuel, it was observed that the smoldering phenomenon was affected. The surface orientation and interspace distance between the external heat sources and the pilot fuel were found to play a huge role in altering the regression rate. Lastly, by impinging an alternative energy source in the form of acoustic energy on the smoldering front, it was observed that varying frequencies affected the smoldering phenomenon in different ways. The surface orientation also played an important role. This project highlights the importance of fire and safety hazard and means of better combustion for all kinds of scientific research and practical applications. The knowledge acquired from this work can be applied to various engineering systems ranging from aircrafts, spacecrafts and even to buildings fires, wildfires and help us in better understanding and hence avoiding such widespread fires. Various fire disasters have been recorded in aircrafts due to small electric short circuits which led to smoldering fires. These eventually caused the engine to catch fire that cost damage to life and property. Studying this phenomenon can help us to control, if not prevent, such disasters.Keywords: alternative energy sources, flaming combustion, ignition, regression rate, smoldering
Procedia PDF Downloads 1444043 Improving Patient Outcomes for Aspiration Pneumonia
Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu
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Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions
Procedia PDF Downloads 624042 Impact of the Dog-Technic for D1-D4 and Longitudinal Stroke Technique for Diaphragm on Peak Expiratory Flow (PEF) in Asthmatic Patients
Authors: Victoria Eugenia Garnacho-Garnacho, Elena Sonsoles Rodriguez-Lopez, Raquel Delgado-Delgado, Alvaro Otero-Campos, Jesus Guodemar-Perez, Angelo Michelle Vagali, Juan Pablo Hervas-Perez
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Asthma is a heterogeneous disease which has always had a drug treatment. Osteopathic treatment that we propose is aimed, seen through a dorsal manipulation (Dog Technic D1-D4) and a technique for diaphragm (Longitudinal Stroke) forced expiratory flow in spirometry changes there are in particular that there is an increase in the volumes of the Peak Flow and Post intervention and effort and that the application of these two techniques together is more powerful if we applied only a Longitudinal (Stroke). Also rating if this type of treatment will have repercussions on breathlessness, a very common symptom in asthma. And finally to investigate if provided vertebra pain decreased after a manipulation. Methods—Participants were recruited between students and professors of the University, aged 18-65, patients (n = 18) were assigned randomly to one of the two groups, group 1 (longitudinal Stroke and manipulation dorsal Dog Technic) and group 2 (diaphragmatic technique, Longitudinal Stroke). The statistical analysis is characterized by the comparison of the main indicator of obstruction of via area PEF (peak expiratory flow) in various situations through the peak flow meter Datospir Peak-10. The measurements were carried out in four phases: at rest, after the stress test, after the treatment, after treatment and the stress test. After each stress test was evaluated, through the Borg scale, the level of Dyspnea on each patient, regardless of the group. In Group 1 in addition to these parameters was calculated using an algometer spinous pain before and after the manipulation. All data were taken at the minute. Results—12 Group 1 (Dog Technic and Longitudinal Stroke) patients responded positively to treatment, there was an increase of 5.1% and 6.1% of the post-treatment PEF and post-treatment, and effort. The results of the scale of Borg by which we measure the level of Dyspnea were positive, a 54.95%, patients noted an improvement in breathing. In addition was confirmed through the means of both groups group 1 in which two techniques were applied was 34.05% more effective than group 2 in which applied only a. After handling pain fell by 38% of the cases. Conclusions—The impact of the technique of Dog-Technic for D1-D4 and the Longitudinal Stroke technique for diaphragm in the volumes of peak expiratory flow (PEF) in asthmatic patients were positive, there was a change of the PEF Post intervention and post-treatment, and effort and showed the most effective group in which only a technique was applied. Furthermore this type of treatment decreased facilitated vertebrae pain and was efficient in the improvement of Dyspnea and the general well-being of the patient.Keywords: ANS, asthma, manipulation, manual therapy, osteopathic
Procedia PDF Downloads 2884041 Ifrs Adoption, Enforcement, and the Value Relevant of Accounting Amounts: The Particular Case of South Africa
Authors: Edward Chamisa, Colin C. Smith, Hamutyinei H. Pamburai, Abdul C. Abdulla
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South Africa (SA) adopted International Financial Reporting Standards (IFRS) for listed firms effective 1 January 2005. However, it was not until 2011 that substantial financial reporting enforcement changes were introduced, which were meant to ensure compliance with IFRS. This innovative setting allows us to examine the value relevance of accounting amounts during the (1) pre-IFRS adoption period (2002-2004); (2) post-IFRS adoption, but pre-enforcement changes period (2006-2010); and (3) post-enforcement changes period (2011-2012). The results show that accounting amounts were most value relevant in the post-enforcement changes period (R2, 75.5%) compared to both the pre-IFRS adoption period (adjusted R2 is 24.3%) and the period after IFRS adoption but before enforcement changes (adjusted R2 is 37.5%). Also, during the 2008 financial crisis, the equity book value per share was significantly value relevant (at 1%) but not earnings per share, whereas before the crisis, the opposite was true. We make two important contributions to the literature. First, we identify SA as an innovative setting that allows researchers to examine separately the effects of IFRS adoption and enforcement changes on capital markets and accounting quality. This is a departure from prior studies that are dominated by the European Union setting, where IFRS adoption occurred contemporaneously with enforcement and other regulatory changes. Second, we provide preliminary findings which suggest that while the adoption of IFRS seems to have improved the financial reporting quality of accounting amounts of SA listed firms, its impact appears to be limited unless combined with effective enforcement.Keywords: international financial reporting standards (ifrs), ifrs adoption, financial reporting enforcement, value relevance, price model, equity book value, earnings per share
Procedia PDF Downloads 704040 Religious Reform and Secularism
Authors: Djehich Mohamed Yousri
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Religious Reform and Secularism present the title of the research paper (Religious Reform and Secularism) is the subject of this research paper. The researcher proceeded to address it through three main axes, in addition to an introduction and a conclusion that indicated the most important results of the study. Where the first axis dealt with the concept of the secular, while the second axis dealt with religious reform, and we devoted the third axis to discussing the relationship between them. It is a treatment that requires the researcher, at the level of methodology, to critically rethink the concepts of (religious) and (secular), and accompany the radical revisions that have been made in the field of (post-secular) studies in this regard. The paper concluded that caution should be exercised in dealing with the terms "religious reform" and "secularism". There are different and diverse viewpoints on (religious reform) and on (secularism) as well, and therefore it is wrong, according to the perspective of the paper, to deal with either of them as representing one comprehensive, homogeneous, closed and semantically stable category. ) or (secularism) with a set of diverse and divergent points of view from each other, a path that ultimately leads to confusion, confusion, ambiguity and misunderstanding.Keywords: secularism, post-secularism, religious reform, concept of religion, the concept of secularism
Procedia PDF Downloads 804039 Effect of Season on Semen Production of Nubian and Saanen Bucks in Sudan
Authors: E. A. Babiker, S. A. Makawi
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The influence of the season (autumn, winter, and summer) on semen production in Nubian and Saanen bucks was studied. Seven mature bucks (4 Nubian and 3 Saanen) were used in this study to prepare semen samples which were collected with an artificial vagina. The samples were extended in Tris-egg yolk-glycerol-glucose extender, frozen, and stored in liquid nitrogen at –196 0C for 48 hours. Straws were thawed in water at –37 0C for 15 seconds before sperm evaluation (post-thaw sperm motility). There was a significant seasonal variation in both semen quantity (volume, concentration, and the total number of spermatozoa per ejaculate) and quality (percentage of sperm motility, percentage of post-thaw sperm motility, and dead spermatozoa). Greater ejaculate volumes were observed during summer and autumn in comparison to winter. Higher values of sperms concentration were observed during autumn, while the lowest sperm concentration values were observed during summer. Higher values of sperm motility were observed during autumn in comparison to summer. Lower values of dead spermatozoa were recorded during autumn, while the highest percentages of dead spermatozoa were observed during summer for the two breeds of bucks. The influence of season on post-thaw sperm motility was significant. Semen frozen during autumn and winter had the highest values, while during summer, lower mean values were observed. The best semen was produced during autumn and winter, while during summer, poor semen quality was recorded.Keywords: season, Nubian, Saanen, semen production, Sudan
Procedia PDF Downloads 1134038 The Effect of Technology- facilitated Lesson Study toward Teacher’s Computer Assisted Language Learning Competencies
Authors: Yi-Ning Chang
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With the rapid advancement of technology, it has become crucial for educators to adeptly integrate technology into their teaching and develop a robust Computer-Assisted Language Learning (CALL) competency. Addressing this need, the present study adopted a technology-based Lesson Study approach to assess its impact on the CALL competency and professional capabilities of EFL teachers. Additionally, the study delved into teachers' perceptions of the benefits derived from participating in the creation of technologically integrated lesson plans. The iterative process of technology-based Lesson Study facilitated ample peer discussion, enabling teachers to flexibly design and implement lesson plans that incorporate various technological tools. This 15-week study included 10 in- service teachers from a university of science and technology in the central of Taiwan. The collected data included pre- and post- lesson planning scores, pre- and post- TPACK survey scores, classroom observation forms, designed lesson plans, and reflective essays. The pre- and post- lesson planning and TPACK survey scores were analyzed employing a pair-sampled t test; students’ reflective essays were respectively analyzed applying content analysis. The findings revealed that the teachers’ lesson planning ability and CALL competencies were improved. Teachers perceived a better understanding of integrating technology with teaching subjects, more effective teaching skills, and a deeper understanding of technology. Pedagogical implications and future studies are also discussed.Keywords: CALL, language learning, lesson study, lesson plan
Procedia PDF Downloads 414037 A Literature Review on the Use of Information and Communication Technology within and between Emergency Medical Teams during a Disaster
Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon
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In a disaster event, sharing patient information between the pre-hospitals Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre-EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors which are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality and the data were analysed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system which can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analysed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospitals staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.Keywords: communication, emergency communication services, emergency medical teams, emergency physicians, emergency nursing, paramedics, information and communication technology, communication systems
Procedia PDF Downloads 864036 Reinforced Concrete Design Construction Issues and Earthquake Failure-Damage Responses
Authors: Hasan Husnu Korkmaz, Serra Zerrin Korkmaz
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Earthquakes are the natural disasters that threat several countries. Turkey is situated on a very active earthquake zone. During the recent earthquakes, thousands of people died due to failure of reinforced concrete structures. Although Turkey has a very sufficient earthquake code, the design and construction mistakes were repeated for old structures. Lack of the control mechanism during the construction process may be the most important reason of failure. The quality of the concrete and poor detailing of steel or reinforcement is the most important headings. In this paper, the reasons of failure of reinforced concrete structures were summarized with relevant photos. The paper is beneficial for civil engineers as well as architect who are in the process of construction and design of structures in earthquake zones.Keywords: earthquake, reinforced concrete structure, failure, material
Procedia PDF Downloads 365