Search results for: competence management
2238 Explaining the Role of Iran Health System in Polypharmacy among the Elderly
Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi
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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.Keywords: elderly, polypharmacy, health system, qualitative study
Procedia PDF Downloads 1512237 Through the Lens of Forced Displacement: Refugee Women's Rights as Human Rights
Authors: Pearl K. Atuhaire, Sylvia Kaye
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While the need for equal access to civil, political as well as economic, social and cultural rights is clear under the international law, the adoption of the Convention on the Elimination of all forms of Discrimination against women in 1979 made this even clearer. Despite this positive progress, the abuse of refugee women's rights is one of the basic underlying root causes of their marginalisation and violence in their countries of asylum. This paper presents a critical review on the development of refugee women's rights at the international levels and national levels. It provides an array of scholarly literature on this issue and examines the measures taken by the international community to curb the problem of violence against women in their various provisions through the instruments set. It is cognizant of the fact that even if conflict affects both refugee women and men, the effects on women refugees are deep-reaching, due to the cultural strongholds they face. An important aspect of this paper is that it is conceptualised against the fact that refugee women face the problem of sexual and gender based first as refugees and second as women, yet, their rights are stumbled upon. Often times they have been rendered "worthless victims" who are only in need of humanitarian assistance than active participants committed to change their plight through their participation in political, economic and social participation in their societies. Scholars have taken notice of the fact that women's rights in refugee settings have been marginalized and call for a need to incorporate their perspectives in the planning and management of refugee settings in which they live. Underpinning this discussion is feminism theory which gives a clear understanding of the root cause of refugee women's problems. Finally, this paper suggests that these policies should be translated into action at local, national international and regional levels to ensure sustainable peace.Keywords: feminism theory, human rights, refugee women, sexual and gender based violence
Procedia PDF Downloads 3542236 Condition Assessment of Reinforced Concrete Bridge Deck Using Ground Penetrating Radar
Authors: Azin Shakibabarough, Mojtaba Valinejadshoubi, Ashutosh Bagchi
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Catastrophic bridge failure happens due to the lack of inspection, lack of design and extreme events like flooding, an earthquake. Bridge Management System (BMS) is utilized to diminish such an accident with proper design and frequent inspection. Visual inspection cannot detect any subsurface defects, so using Non-Destructive Evaluation (NDE) techniques remove these barriers as far as possible. Among all NDE techniques, Ground Penetrating Radar (GPR) has been proved as a highly effective device for detecting internal defects in a reinforced concrete bridge deck. GPR is used for detecting rebar location and rebar corrosion in the reinforced concrete deck. GPR profile is composed of hyperbola series in which sound hyperbola denotes sound rebar and blur hyperbola or signal attenuation shows corroded rebar. Interpretation of GPR images is implemented by numerical analysis or visualization. Researchers recently found that interpretation through visualization is more precise than interpretation through numerical analysis, but visualization is time-consuming and a highly subjective process. Automating the interpretation of GPR image through visualization can solve these problems. After interpretation of all scans of a bridge, condition assessment is conducted based on the generated corrosion map. However, this such a condition assessment is not objective and precise. Condition assessment based on structural integrity and strength parameters can make it more objective and precise. The main purpose of this study is to present an automated interpretation method of a reinforced concrete bridge deck through a visualization technique. In the end, the combined analysis of the structural condition in a bridge is implemented.Keywords: bridge condition assessment, ground penetrating radar, GPR, NDE techniques, visualization
Procedia PDF Downloads 1482235 Preserving Urban Cultural Heritage with Deep Learning: Color Planning for Japanese Merchant Towns
Authors: Dongqi Li, Yunjia Huang, Tomo Inoue, Kohei Inoue
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With urbanization, urban cultural heritage is facing the impact and destruction of modernization and urbanization. Many historical areas are losing their historical information and regional cultural characteristics, so it is necessary to carry out systematic color planning for historical areas in conservation. As an early focus on urban color planning, Japan has a systematic approach to urban color planning. Hence, this paper selects five merchant towns from the category of important traditional building preservation areas in Japan as the subject of this study to explore the color structure and emotion of this type of historic area. First, the image semantic segmentation method identifies the buildings, roads, and landscape environments. Their color data were extracted for color composition and emotion analysis to summarize their common features. Second, the obtained Internet evaluations were extracted by natural language processing for keyword extraction. The correlation analysis of the color structure and keywords provides a valuable reference for conservation decisions for this historic area in the town. This paper also combines the color structure and Internet evaluation results with generative adversarial networks to generate predicted images of color structure improvements and color improvement schemes. The methods and conclusions of this paper can provide new ideas for the digital management of environmental colors in historic districts and provide a valuable reference for the inheritance of local traditional culture.Keywords: historic districts, color planning, semantic segmentation, natural language processing
Procedia PDF Downloads 882234 Land Cover Change Analysis Using Remote Sensing
Authors: Tahir Ali Akbar, Hirra Jabbar
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Land cover change analysis plays a significant role in understanding the trends of urban sprawl and land use transformation due to anthropogenic activities. In this study, the spatio-temporal dynamics of major land covers were analyzed in the last twenty years (1988-2016) for District Lahore located in the Punjab Province of Pakistan. The Landsat satellite imageries were downloaded from USGS Global Visualization Viewer of Earth Resources Observation and Science Center located in Sioux Falls, South Dakota USA. The imageries included: (i) Landsat TM-5 for 1988 and 2001; and (ii) Landsat-8 OLI for 2016. The raw digital numbers of Landsat-5 images were converted into spectral radiance and then planetary reflectance. The digital numbers of Landsat-8 image were directly converted into planetary reflectance. The normalized difference vegetation index (NDVI) was used to classify the processed images into six major classes of water, buit-up, barren land, shrub and grassland, sparse vegetation and dense vegetation. The NDVI output results were improved by visual interpretation using high-resolution satellite imageries. The results indicated that the built-up areas were increased to 21% in 2016 from 10% in 1988. The decrease in % areas was found in case of water, barren land and shrub & grassland. There were improvements in percentage of areas for the vegetation. The increasing trend of urban sprawl for Lahore requires implementation of GIS based spatial planning, monitoring and management system for its sustainable development.Keywords: land cover changes, NDVI, remote sensing, urban sprawl
Procedia PDF Downloads 3182233 Use of a Symptom Scale Based on Degree of Functional Impairment for Acute Concussion
Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose
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Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.Keywords: checklist, concussion, neurology, scale, sports, symptoms
Procedia PDF Downloads 1532232 Evaluation of Agricultural Drought Impact in the Crop Productivity of East Gojjam Zone
Authors: Walelgn Dilnesa Cherie, Fasikaw Atanaw Zimale, Bekalu W. Asres
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The most catastrophic condition for agricultural production is a drought event, which is also one of the most hydro-metrological-related hazards. According to the combined susceptibility of plants to meteorological and hydrological conditions, agricultural drought is defined as the magnitude, severity, and duration of a drought that affects crop production. The accurate and timely assessment of agricultural drought can lead to the development of risk management strategies, appropriate proactive mechanisms for the protection of farmers, and the improvement of food security. The evaluation of agricultural drought in the East Gojjam zone was the primary subject of this study. To identify the agricultural drought, soil moisture anomalies, soil moisture deficit indices, and Normalized Difference Vegetation Indices (NDVI) are used. The measured welting point, field capacity, and soil moisture were utilized to validate the soil water deficit indices computed from the satellite data. The soil moisture and soil water deficit indices in 2013 in all woredas were minimum; this makes vegetation stress also in all woredas. The soil moisture content decreased in 2013/2014/2019, and 2021 in Dejen, 2014, and 2019 in Awobel Woreda. The max/ min values of NDVI in 2013 are minimum; it dominantly shows vegetation stress and an observed agricultural drought that happened in all woredas. The validation process of satellite and in-situ soil moisture and soil water deficit indices shows a good agreement with a value of R²=0.87 and 0.56, respectively. The study area becomes drought detected region, so government officials, policymakers, and environmentalists pay attention to the protection of drought effects.Keywords: NDVI, agricultural drought, SWDI, soil moisture
Procedia PDF Downloads 852231 The Sustainability of Human Resource Planning for Construction Projects
Authors: Adegbenga Ashiru, Adebimpe L. Ashiru
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The construction industry is considered to work by diversifying personnel. Hence managing human resource is an issue considered to be a highly challenging task. Nonetheless, HR planning for the construction project is a very critical aspect of managing human resource within an expanding nature of construction industry, and there are rising concerns over the failure of construction planning to achieve its goals in spite of the substantial resources allocated to it and as a result of different planning strategies. To justify the above statement, this research was carried out to examine the sustainability of HR planning for construction project. Based on the researcher’s experience, a quantitative approach was adopted that provided a broader understanding of the research and was analysed using descriptive statistics and inferential statistics. The Statistical Package for the Social Sciences (SPSS) was used to obtain the descriptive and inferential statistical analysis. However, research findings showed that literature sources agreed with varying challenges of HR planning on construction projects which were justified by empirical findings. Also, the paper identified four major factors and the key consideration for Project HR Planning (Organisation’s structure with right individuals at right positions and evaluation current resources) will lead to the efficient utilisation implementation of new HR Planning technique and tools for a construction project. Essentially the main reoccurring theme identified was that management of the construction organisations needs to look into the essential factors needed to be considered at the strategic level. Furthermore, leaders leading a construction project team should consider those essential factors needed at the operational level to clarify the numerous functions of HRM in the construction organisations and avoid inconsistencies among several practices on construction projects. The Sustainability of HR planning for construction project policy was indicated and recommendations were made for further future research.Keywords: construction industry, HRM planning in construction, SHRM in construction, HR planning in construction
Procedia PDF Downloads 3522230 Unpacking the Summarising Event in Trauma Emergencies: The Case of Pre-briefings
Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner
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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.Keywords: summarising, medical emergencies, interaction analysis, shared/mental models
Procedia PDF Downloads 942229 Neuroprotective Effects of Gly-Pro-Glu-Thr-Ala-Phe-Leu-Arg, a Peptide Isolated from Lupinus angustifolius L. Protein Hydrolysate
Authors: Maria Del Carmen Millan-Linares, Ana Lemus Conejo, Rocio Toscano, Alvaro Villanueva, Francisco Millan, Justo Pedroche, Sergio Montserrat-De La Paz
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GPETAFLR (Glycine-Proline-Glutamine-Threonine-Alanine-Phenylalanine-Leucine-Arginine) is a peptide isolated from Lupinus angustifolius L. protein hydrolysate (LPH). Herein, the effect of this peptide was investigated in two different models of neuroinflammation: in the immortalized murine microglia cell line BV-2 and in a high-fat-diet-induced obesity mouse model. Methods and Results: Effects of GPETAFLR on neuroinflammation were evaluated by RT-qPCR, flow cytometry, and ELISA techniques. In BV-2 microglial cells, Lipopolysaccharides (LPS) enhanced the release of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) whereas GPETAFLR decreased pro-inflammatory cytokine levels and increased the release of the anti-inflammatory cytokine IL-10 in BV2 microglial cells. M1 (CCR7 and iNOS) and M2 (Arg-1 and Ym-1) polarization markers results showed how the GPETAFLR octapeptide was able to decrease M1 polarization marker expression and increase the M2 polarization marker expression compared to LPS. Animal model results indicate that GPETAFLR has an immunomodulatory capacity, both decreasing pro-inflammatory cytokine IL-6 and increasing the anti-inflammatory cytokine IL-10 in brain tissue. Polarization markers in the brain tissue were also modulated by GPETAFLR that decreased the pro-inflammatory expression (M1) and increased the anti-inflammatory expression (M2). Conclusion: Our results suggest that GPETAFLR isolated from LPH has significant potential for management of neuroinflammatory conditions and offer benefits derived from the consumption of Lupinus angustifolius L. in the prevention of neuroinflammatory-related diseases.Keywords: GPETAFLR peptide, BV-2 cell line, neuroinflammation, cytokines, high-fat-diet
Procedia PDF Downloads 1482228 The Differences in Organizational Citizenship Behavior Based on Work Status of Hotels Employees in Bali in Terms of Quality of Work Life
Authors: Ni Wayan Sinthia Widiastuti, Komang Rahayu Indrawati
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The increasing number of tourists coming to Bali, causing accommodation facilities, such as hotels have increased. The existence of hotel needs will be the source of labor and cost efficiency, so that hotel management employs employees with different working status. The hospitality industry is one of the sectors that require organizational citizenship behavior because, the main goal of every hotel, in general, was to provide the best service and quality to tourists. The purpose of this study was to determine the differences in organizational citizenship behavior based on work status of employees at the Hotel in Bali in terms of quality of work life. Research sample was chosen randomly through two-stage cluster sampling which succeeds to obtain 126 samples from 11 hotels in Denpasar, Bali. The subjects consisted of 64 employees with Employment Agreement of Uncertain Time or who is often called a permanent employee and 62 employees with Employment Agreement of Certain Time or better known as contract employees, outsourcing, and daily workers. Instruments in this study were the scale of organizational citizenship behavior and the scale of quality of work life. The results of ANCOVA analysis showed there were differences in organizational citizenship behavior based on employee work status in terms of quality of work life. Differences in organizational citizenship behavior and quality of work life based on work status of employees using comparative test was analysis by independent sample t-test shows there were differences in organizational citizenship behavior and quality of work life between employees with different working status in hotels in Bali. The result of the regression analysis showed the functional relationship between quality of work life and organizational citizenship behavior.Keywords: hotel in Bali, organizational citizenship behavior, quality of work life, work status of employees
Procedia PDF Downloads 2862227 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation
Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj
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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization
Procedia PDF Downloads 1952226 Optimizing Glycemic Control with AI-Guided Dietary Supplements: A Randomized Trial in Type 2 Diabetes
Authors: Evgeny Pokushalov, Claire Garcia, Andrey Ponomarenko, John Smith, Michael Johnson, Inessa Pak, Evgenya Shrainer, Dmitry Kudlay, Leila Kasimova, Richard Miller
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This study evaluated the efficacy of an AI-guided dietary supplement regimen compared to a standard physician-guided regimen in managing Type 2 diabetes (T2D). A total of 160 patients were randomly assigned to either the AI-guided group (n=80) or the physician-guided group (n=80) and followed over 90 days. The AI-guided group received 5.3 ± 1.2 supplements per patient, while the physician-guided group received 2.7 ± 0.6 supplements per patient. The AI system personalized supplement types and dosages based on individual genetic and metabolic profiles. The AI-guided group showed a significant reduction in HbA1c levels from 7.5 ± 0.8% to 7.1 ± 0.7%, compared to a reduction from 7.6 ± 0.9% to 7.4 ± 0.8% in the physician-guided group (mean difference: -0.3%, 95% CI: -0.5% to -0.1%; p < 0.01). Secondary outcomes, including fasting plasma glucose, HOMA-IR, and insulin levels, also improved more in the AI-guided group. Subgroup analyses revealed that the AI-guided regimen was particularly effective in patients with specific genetic polymorphisms and elevated metabolic markers. Safety profiles were comparable between both groups, with no serious adverse events reported. In conclusion, the AI-guided dietary supplement regimen significantly improved glycemic control and metabolic health in T2D patients compared to the standard physician-guided approach, demonstrating the potential of personalized AI-driven interventions in diabetes management.Keywords: Type 2 diabetes, AI-guided supplementation, personalized medicine, glycemic control, metabolic health, genetic polymorphisms, dietary supplements, HbA1c, fasting plasma glucose, HOMA-IR, personalized nutrition
Procedia PDF Downloads 92225 Integrated Business Model Innovation in Nigerian Higher Education: Challenges and Prospects
Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue
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This paper explores challenges and prospects in Nigerian higher education. The paper develops an integrated business model that aimed to innovate Nigeria higher education system. A survey and semi-structured interview among Nigerian higher education academics, students and graduates are used to explore the challenges and prospects. The study provides a comparison between lecturers, students and graduates opinions to evaluate challenges and prospects in Nigerian higher institutions. The study found to achieve efficient and effectiveness innovation in Nigerian higher education, there is a need for higher institutions to collaborate with industry professionals and other stakeholders such as company management, and government policy makers in designing higher education institutions curricula. The study found that the curriculum design and delivery need to blend theoretical understanding and real-life experience from industry, and with social cultural influences related to Nigerian environment. This will enable lecturers to organise their teaching and assessments such that students can learn around theoretical and practical study themes. The curriculum design and delivery need to link the core ideas to challenging problems in society, nationally and globally. Hence, this approach will support business start-ups and social entrepreneurship which resolve key societal problems. The study suggests that higher education executives, directors, deans, head of departments, and even individual academics need to emulate innovative business managers to create value-adding products and services from innovative research and academic work.Keywords: higher education, curriculum innovation, business model innovation, teaching and research excellence, economic development
Procedia PDF Downloads 2712224 Pyrethroid Resistance and Its Mechanism in Field Populations of the Sand Termite, Psammotermes hypostoma Desneux
Authors: Mai. M. Toughan, Ahmed A. A. Sallam, Ashraf O. Abd El-Latif
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Termites are eusocial insects that are found on all continents except Antarctica. Termites have serious destructive impact, damaging local huts and crops of poor subsistence. The annual cost of termite damage and its control is determined in the billions globally. In Egypt, most of these damages are due to the subterranean termite species especially the sand termite, P. hypostoma. Pyrethroids became the primary weapon for subterranean termite control, after the use of chlorpyrifos as a soil termiticide was banned. Despite the important role of pyrethroids in termite control, its extensive use in pest control led to the eventual rise of insecticide resistance which may make many of the pyrethroids ineffective. The ability to diagnose the precise mechanism of pyrethroid resistance in any insect species would be the key component of its management at specified location for a specific population. In the present study, detailed toxicological and biochemical studies was conducted on the mechanism of pyrethroid resistance in P. hypostoma. The susceptibility of field populations of P. hypostoma against deltamethrin, α-cypermethrin and ƛ-cyhalothrin was evaluated. The obtained results revealed that the workers of P. hypostoma have developed high resistance level against the tested pyrethroids. Studies carried out through estimation of detoxification enzyme activity indicated that enhanced esterase and cytochrome P450 activities were probably important mechanisms for pyrethroid resistance in field populations. Elevated esterase activity and also additional esterase isozyme were observed in the pyrethroid-resistant populations compared to the susceptible populations. Strong positive correlation between cytochrome P450 activity and pyrethroid resistance was also reported. |Deltamethrin could be recommended as a resistance-breaking pyrethroid that is active against resistant populations of P. hypostoma.Keywords: Psammotermes hypostoma, pyrethroid resistance, esterase, cytochrome P450
Procedia PDF Downloads 1752223 Effects of Blood Pressure According to Age on End-Stage Renal Disease Development in Diabetes Mellitus Patients: A Nationwide Population-Based Cohort Study
Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim
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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure
Procedia PDF Downloads 1292222 Evaluating Aquaculture Farmers Responses to Climate Change and Sustainable Practices in Kenya
Authors: Olalekan Adekola, Margaret Gatonye, Paul Orina
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The growing demand for farmed fish by underdeveloped and developing countries as a means of contributing positively towards eradication of hunger, food insecurity, and malnutrition for their fast growing populations has implications to the environment. Likewise, climate change poses both an immediate and future threat to local fish production with capture fisheries already experiencing a global decline. This not only raises fundamental questions concerning how aquaculture practices affect the environment, but also how ready are aquaculture farmers to adapt to climate related hazards. This paper assesses existing aquaculture practices and approaches to adapting to climate hazards in Kenya, where aquaculture has grown rapidly since the year 2009. The growth has seen rise in aquaculture set ups mainly along rivers and streams, importation of seed and feed and intensification with possible environmental implications. The aquaculture value chain in the context of climate change and their implication for practice is further investigated, and the strategies necessary for an improved implementation of resilient aquaculture system in Kenya is examined. Data for the study are collected from interviews, questionnaires, two workshops and document analysis. Despite acclaimed nutritional benefit of fish consumption in Kenya, poor management of effluents enriched with nitrogen, phosphorus, organic matter, and suspended solids has implications not just on the ecosystem, goods, and services, but is also potential source of resource-use conflicts especially in downstream communities and operators in the livestock, horticulture, and industrial sectors. The study concluded that aquaculture focuses on future orientation, climate resilient infrastructure, appropriate site selection and invest on biosafety as the key sustainable strategies against climate hazards.Keywords: aquaculture, resilience, environment, strategies, Kenya
Procedia PDF Downloads 1612221 Gender Differences in Communication Styles: An Analysis of the Language of Earnings Conference Calls
Authors: Chiara De Amicis, Sonia Falconieri, Mesut Tastan
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In this study, we analyze the language employed by Chief Executive Officers (CEOs) and Chief Financial Officers (CFOs) during earnings conference calls from a gender perspective. We find evidences that conference calls held by female CEOs and/or CFOs exhibit a higher level of optimism compared to conference calls held by male CEOs and/or CFOs. Moreover, female managers tend to present and discuss firm performances with less vagueness as compared to their male colleagues. We then observe the market reaction around each earnings conference call: while manager optimism is perceived as a good signal by investors, manager vagueness significantly dampens the market reaction around the call. Whether the gender of the CEO and/or the CFO delivering the conference call affects investors’ perceptions about the firm performance is still an open question. Some evidences show that the language employed by female managers conveys more valuable information for market participants as compared to the language employed by their male counterparts. This study contributes to a growing literature in finance and accounting that uses textual analysis to assess the informativeness of corporate disclosure. To our knowledge, this is the first paper that aims at answering the question whether the gender of firm’s top managers does matter when it comes to assess the informativeness of corporate spoken communication. We believe that our results will be of relevance for future research in the field. Moreover, our evidence may be used in support of the debate if a larger participation by women in the management of companies should be encouraged or not.Keywords: conference calls, even study, gender, market reaction, textual analysis
Procedia PDF Downloads 1942220 In a Situation of Great Distress: Cross Border Migration and the Quest for Enduring Security in North-East Nigeria
Authors: Nuhu Bitrus Mailabari
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Nigeria is a highly multifarious nation trapped between affluence and affliction. On one hand, the state has vast territorial size, economic strength, relative internal cohesion, and good external linkages. On the other, it is bedeviled with enormous challenges. It is common knowledge that the North-East geo-political zone has suffered colossal destruction for the most part of the last ten years due to the activities of the insurgent group Boko Haram. Several factors (political, economic, religious, socio-cultural) have been credited with the heightened insecurity in the region. Without a doubt, the security crisis in the region has rekindled several discussions critical to Nigeria’s security architecture. However, the debate on finding an enduring solution to the devastation in the North East continually neglects the nexus between cross border migration and national security. Using content analysis, this paper debates two main issues that continue to affect security in the North East. One, the cumulative impact of the Economic Community of West African States (ECOWAS) protocol on the free movement of people and goods. Two, the porous nature of Nigeria’s borders. Theoretically, the paper will rely on the systems theory because of its broad focus on structure, linkage, and process. The work concludes in twofold. First, that cross border migration and poor border management processes further worsened the political and socio-economic conditions of a region that is already in a bad state. Secondly, in addition to the existing strategies, Nigeria must develop a holistic approach including new methods of handling cross border movements in solving the security issues.Keywords: border, cross border, migration, Nigeria, northeast region, security
Procedia PDF Downloads 1642219 Molecular Mechanism on Inflammation and Antioxidant Role of Pterocarpus Marsupiumin in Experimental Hyperglycaemia
Authors: Leelavinothan Pari , Ayyasamy Rathinam
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Diabetes mellitus (DM) is a major and growing public health problem throughout the world. Pterocarpus marsupium (Roxb.) (Family: Fabaceae) is widely used as a traditional medicine to treat various diseases including diabetes. However, the molecular mechanism of Pterocarpus marsupium has not been investigated so far. Two fractions (2.5% and 5%) of extract from the medicinal plant, Pterocarpus marsupium (PME) were conducted in a dose dependent manner in streptozotocin (45 mg/kg b.w.) induced type 2 diabetic rats. Each fraction of PME was administered to diabetic rats intragastrically at a dose of 50, 100 and 200 mg/kg b.w for 45 days. The effective dose 200 mg/kg b.w of 5% fraction was more pronounced in reducing the levels of blood glucose (95.65 mg/dL) and glycosylated hemoglobin (HbA1c) (0.41 mg/g Hb), and increasing the plasma insulin (16.20 µU/mL) level. Moreover, PME (200 mg/kg b.w) significantly ameliorated lipid peroxidation products (thiobarbituric reactive substances, lipid hydroperoxides) enzymatic (superoxide dismutase, catalase and glutathione peroxidase) and non-enzymatic antioxidants (Vitamin C, Vitamin E and reduced glutathione) levels. The altered activities of the key enzymes of lipid metabolism along with the lipid profile in diabetic rats were significantly reverted to near normal levels by the administration of PME 5% 200 mg/kg b.w fraction. PME (200 mg/kg b.w) has the ability to reduce the inflammatory cytokines, such as TNF-α, IL-6 mRNA, as well as protein expression and apoptotic marker, such as caspase-3 enzyme in diabetic hepatic tissue. The above biochemical findings were also supported by histological studies such as improvement in pancreas and liver. Pterocarpus marsupium could effectively reduce the hyperglycemia, oxidative-stress, inflammation and hyperlipedimea in diabetic rats; hence it could be a useful drug in the management of diabetes without any side effects.Keywords: diabetes mellitus, streptozotocin, Pterocarpus marsupium, lipid peroxidation, Antioxidants, inflammatory cytokines
Procedia PDF Downloads 3762218 The Social Area Disclosure to Reduce Conflicts between Community and the State: A Case of Mahakan Fortress, Bangkok
Authors: Saowapa Phaithayawat
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The purposes of this study are 1) to study the over 20-year attempt of Mahakan fort community to negotiate with Bangkok Metropolitan Administration (BMA) to remain in their residential area belonging to the state, and 2) to apply the new social and cultural dimension between the state and the community as an alternative for local participation in keeping their residential area. This is a qualitative research, and the findings reveal that the community claimed their ancestors’ right as owners of this piece of land for over 200 years. The community, therefore, requested to take part in the preservation of land, culture and local intellect and the area management in terms of being a learning resource on the cultural road in Rattanakosin Island. However, BMA imposed the law concerning the community area relocation in Rattanakosin Island. The result of law enforcement led to the failure of the area relocation, and the hard hit on physical structure of the area including the overall deterioration of the cultural road renovated in the year 1982, the 200 years’ celebration of Bangkok. The enforcement of law by the state required the move of the community, and the landscape improvement based on the capital city plan. However, this enforcement resulted in the unending conflicts between the community and the state, and the solution of this problem was unclear. At the same time the community has spent a long time opposing the state’s action, and preparing themselves by administrating the community behind Mahakan fortress with community administrative committee under the suggestion of external organization by registering all community members, providing funds for community administration. At the meantime the state lacked the continuation of the enforcement due to political problem and BMA’s administration problem. It is, therefore, suggested that an alternative solution to this problem lie at the negotiation between the state and the community with the purpose of the collaboration between the two to develop the area under the protective law of each side.Keywords: Pom-Mahakan community, reduction of conflicts, social area disclosure, residential area
Procedia PDF Downloads 3142217 Flexural Behavior of Geocell Reinforced Subgrade with Demolition Waste as Infill Material
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The use of geocell in subgrade has been previously studied by various researchers in the past. It was observed that the infill material used could affect the performance of the geocell reinforced subgrade. So, the use of waste materials as infill in geocell reinforced subgrade may prove to be more effective, economical, and environment-friendly. The performance of demolition waste as an infill was studied using flexure testing, and we compared the results with that of the other infill materials; soil and sand. Flexural behaviour is very important to the geosynthetic application in pavements as it acts as a the geocell reinforcement acts as flexible layer embedded in pavements and leads to an improvement in stress distribution and reduction in stress on the soil subgrade. The flexural behaviour was determined using four-point bending tests and results were expressed in terms of modulus improvement factor (MIF) and load-deflection behaviour. The geocell reinforced subgrade with different infill materials was tested for flexural behaviour in a polywood-polywood three-layered beam model. The deflections of the three-layered model beam were measured for the corresponding load increments. Elastic modulus of the soil-geocell composite was calculated using closed-form solutions. Geocells were prepared from geonets with three different aspect ratios 0.45, 0.67, and 1. The demolition waste infilled geocell mattress with aspect ratio 0.67 showed improved flexural behavior with MIF of 2.67 followed by soil and sand. Owing to its improved flexural resistance as seen from the MIF and load-deflection behivour, crushed demolition waste can be effectively used as infill material for geocell reinforced subgrade, thereby reducing the difficulties in the management of demolition waste and improving the load distribution of weaker subgrade.Keywords: demolition waste, flexural behavior, geocell, modulus improvement factor
Procedia PDF Downloads 1322216 Role of Non-Timber Forest Products in Local Livelihood and Household Economies in Resource-Rich vs. Resource Poor Forest Area of Mizoram
Authors: Uttam Kumar Sahoo, K. Lalhmingsangi, J. H. Lalremruati
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Non-timber forest resources particularly the high-value, low volume NTFPs has drawn interest as an activity all over the world during the past three decades that could raise standards of living for the rural folks while being compatible with forest conservation. This is particularly true for the people living in and around or fringes of protected areas. However, the economics that plays between resources’ stock and its utilization by the humans is yet to be validated and evaluated logistically. A study was therefore designed to understand the linkages between resource (especially NTFPs) availability and their utilization, existing threats to this biodiversity conservation and the role of NTFPs within the livelihood systems of those households that are most directly involved in creating conservation threats. About 25% of the households were sampled from the two sites ‘resource-rich’ and ‘resource poor’ area of Dampa Tiger Reserve (Western boundary). Our preliminary findings suggest that the collection of relatively high-volume and low value NTFPs such as fuelwood, fodder has caused degradation of forest resources while the low-volume and high-value NTFPs such as wild edible mushrooms, vegetables, other specialty food products, inputs to crafts, medicinal plants have resulted into species promotion/conservation through their domestication in traditional agroforestry systems including home gardens and/or collateral protection of the Tiger Reserve. It is thus suggested that proper assessment of these biodiversities, their direct and indirect valuation, market and non-market profits etc be carried out in greater details which would result in prescribing effective management plans around the park.Keywords: household economy, livelihood strategies, non-timber forest products, species conservation
Procedia PDF Downloads 1902215 Sublethal Effect of Tebufenozide, an Ecdysteroid Agonist, on the Reproduction of German Cockroach (Blattodea: Blattellidae)
Authors: Samira Kilani-Morakchi, Amina Badi, Nadia Aribi
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German cockroach, Blattella germanica, is known to be an important pest due to its high reproductive potential and its ability to build up large infectious populations. The infestations were generally controlled by neurotoxic insecticides including organophosphates (OP), carbamate and pyrethroids. An alternative cockroach’s control approach is the use insect growth regulators (IGRs). The relative fewer effects of these chemicals on non-target insects and animals, and their favourable environmental fate, make them attractive insecticides for inclusion in integrated pest management programmes. The juvenoids and chitin synthesis inhibitors are two classes of IGRs that have received the most attention for useful chemicals to manage German cockroaches while ecdysone agonists were mostly used to control Lepidopteran species. In the present study, the sublethal effects of the non-sreroidal ecdysone agonist tebufenozide were evaluated topically on adults of the B. germanica. The effects on reproduction were observed in adults females of cockroaches that survived exposure to LD25 (146 µg/g of insect) of tebufenozide. Dissection of treated females showed a clear reduction in both the number of oocytes per paired ovaries and the size of basal oocytes, as compared to controls. In addition, tebufenozide significantly reduced the mating success of pairs and altered the fertility as shown through the reduction of ootheca development and total absence of viable nymph. Tebufenozide disrupted the German cockroach reproduction by interfering with homeostasis of the insect hormones. In conclusion, the overall results suggested that tebufenozide can be used as a biorational insecticide for controlling cockroaches.Keywords: B. germanica, ecdysteroid agonist, tebufenozide, reproduction
Procedia PDF Downloads 2962214 Applying the Information System to Enhance the Management of Perioperative Nursing
Authors: Ya-Yi Yen
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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting
Procedia PDF Downloads 1432213 Neuron Point-of-Care Stem Cell Therapy: Intrathecal Transplant of Autologous Bone Marrow-Derived Stem Cells in Patients with Cerebral Palsy
Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia
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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders
Procedia PDF Downloads 4142212 Feasibility Study on the Use of HEMS for Thermal Comfort and Energy Saving in Japanese Residential Buildings
Authors: K. C. Rajan, H. B. Rijal, Kazui Yoshida, Masanori Shukuya
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The electricity consumption in the Japanese household sector has increased with higher rate than that of other sectors. This may be because of aging and information oriented society that requires more electrical appliances to make the life better and easier, under this circumstances, energy saving is one of the essential necessity in Japanese society. To understand the way of energy use and demand response of the residential occupants, it is important to understand the structure of energy used. Home Energy Management System (HEMS) may be used for understanding the pattern and the structure of energy used. HEMS is a visualization system of the energy usage by connecting the electrical equipment in the home and thereby automatically control the energy use in each device, so that the energy saving is achieved. Therefore, the HEMS can provide with the easiest way to understand the structure of energy use. The HEMS has entered the mainstream of the Japanese market. The objective of this study is to understand the pattern of energy saving and cost saving in different regions including Japan during HEMS use. To observe thermal comfort level of HEMS managed residential buildings in Japan, the field survey was made and altogether, 1534 votes from 37 occupants related to thermal comfort, occupants’ behaviors and clothing insulation were collected and analyzed. According to the result obtained, approximately 17.9% energy saving and 8.9% cost saving is possible if HEMS is applied effectively. We found the thermal sensation and overall comfort level of the occupants is high in the studied buildings. The occupants residing in those HEMS buildings are satisfied with the thermal environment and they have accepted it. Our study concluded that the significant reduction in Japanese residential energy use can be achieved by the proper utilization of the HEMS. Better thermal comfort is also possible with the use of HEMS if energy use is managed in a rationally effective manner.Keywords: energy reduction, thermal comfort, HEMS utility, thermal environment
Procedia PDF Downloads 2882211 Regression Analysis in Estimating Stream-Flow and the Effect of Hierarchical Clustering Analysis: A Case Study in Euphrates-Tigris Basin
Authors: Goksel Ezgi Guzey, Bihrat Onoz
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The scarcity of streamflow gauging stations and the increasing effects of global warming cause designing water management systems to be very difficult. This study is a significant contribution to assessing regional regression models for estimating streamflow. In this study, simulated meteorological data was related to the observed streamflow data from 1971 to 2020 for 33 stream gauging stations of the Euphrates-Tigris Basin. Ordinary least squares regression was used to predict flow for 2020-2100 with the simulated meteorological data. CORDEX- EURO and CORDEX-MENA domains were used with 0.11 and 0.22 grids, respectively, to estimate climate conditions under certain climate scenarios. Twelve meteorological variables simulated by two regional climate models, RCA4 and RegCM4, were used as independent variables in the ordinary least squares regression, where the observed streamflow was the dependent variable. The variability of streamflow was then calculated with 5-6 meteorological variables and watershed characteristics such as area and height prior to the application. Of the regression analysis of 31 stream gauging stations' data, the stations were subjected to a clustering analysis, which grouped the stations in two clusters in terms of their hydrometeorological properties. Two streamflow equations were found for the two clusters of stream gauging stations for every domain and every regional climate model, which increased the efficiency of streamflow estimation by a range of 10-15% for all the models. This study underlines the importance of homogeneity of a region in estimating streamflow not only in terms of the geographical location but also in terms of the meteorological characteristics of that region.Keywords: hydrology, streamflow estimation, climate change, hydrologic modeling, HBV, hydropower
Procedia PDF Downloads 1292210 Study of Evapotranspiration for Pune District
Authors: Ranjeet Sable, Mahotsavi Patil, Aadesh Nimbalkar, Prajakta Palaskar, Ritu Sagar
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The exact amount of water used by various crops in different climatic conditions is necessary to step for design, planning, and management of irrigation schemes, water resources, scheduling of irrigation systems. Evaporation and transpiration are combinable called as evapotranspiration. Water loss from trees during photosynthesis is called as transpiration and when water gets converted into gaseous state is called evaporation. For calculation of correct evapotranspiration, we have to choose the method in such way that is should be suitable and require minimum climatic data also it should be applicable for wide range of climatic conditions. In hydrology, there are multiple correlations and regression is generally used to develop relationships between three or more hydrological variables by knowing the dependence between them. This research work includes the study of various methods for calculation of evapotranspiration and selects reasonable and suitable one Pune region (Maharashtra state). As field methods are very costly, time-consuming and not give appropriate results if the suitable climate is not maintained. Observation recorded at Pune metrological stations are used to calculate evapotranspiration with the help of Radiation Method (RAD), Modified Penman Method (MPM), Thornthwaite Method (THW), Blaney-Criddle (BCL), Christiansen Equation (CNM), Hargreaves Method (HGM), from which Hargreaves and Thornthwaite are temperature based methods. Performance of all these methods are compared with Modified Penman method and method which showing less variation with standard Modified Penman method (MPM) is selected as the suitable one. Evapotranspiration values are estimated on a monthly basis. Comparative analysis in this research used for selection for raw data-dependent methods in case of missing data.Keywords: Blaney-Criddle, Christiansen equation evapotranspiration, Hargreaves method, precipitations, Penman method, water use efficiency
Procedia PDF Downloads 2712209 Psychiatric Risk Assessment in the Emergency Department: The Impact of NEAT on the Management of Mental Health Patients
Authors: Euan Donley
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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.Keywords: assessment, emergency, risk, psychiatric
Procedia PDF Downloads 516