Search results for: emergency circumstances

Authors: Ada Yurman

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Social reactions to deviant groups with political goals follow two central patterns; one that associates personal characteristics with deviant behavior, and the other that claims that society is to be blamed for deviant behavior. The establishment usually tends towards the former notion and thus disclaims any responsibility for the distress of the underprivileged, while it is usually those who oppose government policies who believe that the fault lies with society. The purpose of the present research was to examine social reactions to the Wadi Salib riots that occurred in Haifa in 1959. These riots represented the first ethnic protest within Israeli society with its ideology of the ingathering of the exiles. The central question was whether this ideology contributed to the development of a different reaction when compared to reactions to similar events abroad. This question was examined by means of analyzing articles in the Israeli press of that period. The Israeli press representing the views of the establishment was at pains to point out that the rioters were criminals, their object being to obstruct the development of society. Opposition party leaders claimed that the rioters lived in poor circumstances, which constituted a direct result of government policies. An analysis of press reports on the Wadi Salib riots indicates a correspondence between the reaction to these events and similar events abroad. Nevertheless, the reaction to the Wadi Salib riots did not only express a conflict between different political camps, but also different symbolic universes. Each group exploited the events at Wadi Salib to prove that their ideology was the legitimate one.

Keywords: riots, media, political deviance, symbolic universe

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Authors: D. Sun, T. F. Lu, A. Zander, M. Trinkle

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This paper investigates the potential use of airborne ultrasonic phased arrays for imaging in outdoor environments as a means of overcoming the limitations experienced by kinect sensors, which may fail to work in the outdoor environments due to the oversaturation of the infrared photo diodes. Ultrasonic phased arrays have been well studied for static media, yet there appears to be no comparable examination in the literature of the impact of a flowing medium on the focusing behaviour of near field focused ultrasonic arrays. This paper presents a method for predicting the sound pressure fields produced by a single ultrasound element or an ultrasonic phased array influenced by airflows. The approach can be used to determine the actual focal point location of an array exposed in a known flow field. From the presented simulation results based upon this model, it can be concluded that uniform flows in the direction orthogonal to the acoustic propagation have a noticeable influence on the sound pressure field, which is reflected in the twisting of the steering angle of the array. Uniform flows in the same direction as the acoustic propagation have negligible influence on the array. For an array impacted by a turbulent flow, determining the location of the focused sound field becomes difficult due to the irregularity and continuously changing direction and the speed of the turbulent flow. In some circumstances, ultrasonic phased arrays impacted by turbulent flows may not be capable of producing a focused sound field.

Keywords: airborne, airflow, focused sound field, ultrasonic phased array

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Authors: Jiang Yuqi

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Aims: The aim is to analyze the facilitators and barriers of family resilience in cancer patients based on the theoretical domain framework, provide a basis for intervention in the family resilience of cancer patients, and identify the progress and enlightenment of existing intervention projects. Methods: NVivo software was used to code the influencing factors using the framework of 14 theoretical domains as primary nodes; secondary nodes were then refined using thematic analysis, and specific influencing factors were aggregated and analyzed for evaluator reliability. Data sources: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, MEDLINE, CNKI, and Wanfang (search dates: from construction to November 2023). Results: A total of 35 papers were included, with 142 coding points across 14 theoretical domains and 38 secondary nodes. The three most relevant theoretical domains are social influences (norms), the environment and resources, and emotions (mood). The factors with the greatest impact were family support, mood, confidence and beliefs, external support, quality of life, economic circumstances, family adaptation, coping styles with illness, and management. Conclusion: The factors influencing family resilience in cancer patients cover most of the theoretical domains in the Theoretical Domains Framework and are cross-cutting, multi-sourced, and complex. Further in-depth exploration of the key factors influencing family resilience is necessary to provide a basis for intervention research.

Keywords: cancer, survivors, family resilience, theoretical domains framework, literature review

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Authors: Uroš Durlević, Ivan Novković, Nina Čegar, Stefanija Stojković

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Snow avalanches represent one of the most dangerous natural phenomena in mountain regions worldwide. Material and human casualties caused by snow avalanches can be very significant. In this study, using geographic information systems and remote sensing, the natural conditions of the Šar Mountains were analyzed for geospatial modeling of dry slab avalanches. For this purpose, the Fuzzy Analytic Hierarchy Process (FAHP) multi-criteria analysis method was used, within which fifteen environmental criteria were analyzed and evaluated. Based on the existing analyzes and results, it was determined that a significant area of the Šar Mountains is very highly susceptible to the occurrence of dry slab avalanches. The obtained data can be of significant use to local governments, emergency services, and other institutions that deal with natural disasters at the local level. To our best knowledge, this is one of the first research in the Republic of Serbia that uses the FAHP method for geospatial modeling of dry slab avalanches.

Keywords: GIS, FAHP, Šar Mountains, snow avalanches, environmental protection

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Authors: Karen V. Lee

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The significance of this study involves autoethnographic research about a music teacher learning about the socialization of gender issues in teaching. Mentorship involving intervention helps with the consequences influencing a transgendered music teacher. Basic storytelling methodology involves the qualitative method of research as a theoretical framework where the author provides a storied reflection about political issues surrounding teachers and the sociology of gender. Sub-themes involve counseling, adult education to ensure students and teachers receive social, emotional, physical, spiritual, and educational resources that evoke visceral, emotional responses from the audience. Major findings share how stories are helpful resources for others who struggle with the socialization of gender. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist having his sex reassignment surgery during his undergraduate education degree. In conclusion, the research is a reflexive storied framework that embraces a positive outlook about a transgendered teacher during his masectomy. The sensory experience seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of the sociology of gender and society provides transformative aspects that contributes to social change. Overall, the surgery surrounding the story about transgendered issues are not uncommon in society. Thus, continued education supports the moral mission to help teachers overcome and understand issues of gender that can socially impacts their professional lives as teachers.

Keywords: sociology of gender, transgender, music teachers, story, autoethnography as research, ideology

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Authors: Zahra Bakhtiari

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Middle East countries confront a multitude of main environmental challenges which are inevitable. The unstable economic and political structure which dominates numerous middle East countries makes it difficult to react effectively to unfavorable climate change impacts. This study applies a qualitative methodology and relies on secondary literature aimed to investigate how countries in the Middle East are balancing economic security and climatic security in terms of budgeting, infrastructure investment, political engagement (domestically through discourses or internationally in terms of participation in international organizations or bargaining, etc.) There has been provided an outline of innovative measures in both economic and environmental fields that are in progress in the Middle East countries and what capacity they have for economic development and environmental adaptation, as well as what has already been performed. The primary outcome is that countries that rely more on infrastructure investment such as negative emissions technologies (NET) through green social capital enterprises and political engagement, especially nationally determined contributions (NDCs) commitments and United Nations Framework Convention on Climate Change (UNFCCC), experience more economic and climatological security balance in the Middle East. Since implementing these measures is not the same in all countries in the region, we see different levels of balance between climate security and economic security. The overall suggestion is that the collaboration of both the bottom-up and top-down approaches helps create strategic environmental strategies which are in line with the economic circumstances of each country and creates the desired balance.

Keywords: climate change, economic growth, sustainability, the Middle East, green economy, renewable energy

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Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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Authors: Hatice Özbek, Caner Çil, Ahmet Rodoplu

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Automotive lighting is the leading function in the configuration of vehicle architecture. Especially headlights and taillights from external lighting functions are among the structures that determine the stylistic character of the vehicle. At the same time, the fact that lighting functions are related to many other functions brings along difficulties in design. Customers expect maximum quality from the vehicle. In these circumstances, it is necessary to make designs that aim to keep the performance of bulbs with limited working lives at the highest level. With this study, the factors that influence the working lives of filament lamps were examined and bulb explosions that can occur sooner than anticipated in the future were prevented while the vehicle was still in the design phase by determining the relations with electrical, dynamical and static variables. Especially the filaments of the bulbs used in the front lighting of the vehicle are deformed in a shorter time due to the high voltage requirement. In addition to this, rear lighting lamps vibrate as a result of the tailgate opening and closing and cause the filaments to be exposed to high stress. With this study, the findings that cause bulb explosions were evaluated. Among the most important findings: 1. The structure of the cables to the lighting functions of the vehicle and the effect of the voltage values are drawn; 2. The effect of the vibration to bulb throughout the life of the vehicle; 3 The effect of the loads carried to bulb while the vehicle doors are opened and closed. At the end of the study, the maximum performance was established in the bulb lifetimes with the optimum changes made in the vehicle architecture based on the findings obtained.

Keywords: vehicle architecture, automotive lighting functions, filament lamps, bulb lifetime

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Sebastian Kohlstädt, Michael Vynnycky, Stephan Goeke, Jan Jäckel, Andreas Gebauer-Teichmann

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This paper summarizes the progress in the latest computational fluid dynamics research towards the modeling in of lost core viability in high-pressure die casting. High-pressure die casting is a process that is widely employed in the automotive and neighboring industries due to its advantages in casting quality and cost efficiency. The degrees of freedom are however somewhat limited as it has been so far difficult to use lost cores in the process. This is right now changing and the deployment of lost cores is considered a future growth potential for high-pressure die casting companies. The use of this technology itself is difficult though. The strength of the core material, as chiefly salt is used, is limited and experiments have shown that the cores will not hold under all circumstances and process designs. For this purpose, the publicly available CFD library foam-extend (OpenFOAM) is used, and two additional fluid models for incompressible and compressible two-phase flow are implemented as fluid solver models into the FSI library. For this purpose, the volume-of-fluid (VOF) methodology is used. The necessity for the fluid-structure interaction (FSI) approach is shown by a simple CFD model geometry. The model is benchmarked against analytical models and experimental data. Sufficient agreement is found with the analytical models and good agreement with the experimental data. An outlook on future developments concludes the paper.

Keywords: CFD, fluid-structure interaction, high-pressure die casting, multiphase flow

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Authors: Keigh D. Guinto, Ma. Romina M. Santos

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One of the most catastrophic natural disasters in the Philippines is floods. Twelve (12) million people reside in Metro Manila, National Capital Region (NCR), prone to flooding. A flood can cause widespread devastation resulting in damaged properties and infrastructures and loss of life. By using the analytical hierarchy process, six (6) parameters were selected, namely elevation, slope, lithology, distance from the river, river network density, and flow accumulation. Ranking of these parameters demonstrates that distance from the river with 25.31% and river density with 17.30% ranked the highest causative factor to flooding. This is followed by flow accumulation with 16.72%, elevation with 15.33%, slope with 13.53%, and the least flood causative factor is lithology with 11.8%. The generated flood susceptibility map of Mandaluyong has three (3) classes: high susceptibility, moderate susceptibility, and low susceptibility. The flood susceptibility map generated in this study can be used as an aid for planning flood mitigation, land use planning, and general public awareness. This study can also be used for emergency management and can be applied in the disaster risk management of Mandaluyong.

Keywords: analytical hierarchy process, assessment, flood, geographic information system

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Authors: Rashida Suleiman, Asamoah Jnr. Boakye, Suleiman Ahmed Ibn Ahmed

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In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. MYCIN is a groundbreaking illustration of a clinical decision support system (CDSS), which was developed to assist physicians in the diagnosis and treatment of bacterial infections by providing suggestions for antibiotic regimens. MYCIN was one of the earliest expert systems to demonstrate how CDSSs may assist human decision-making in complicated areas. Relevant databases were searched using google scholar, PubMed and general Google search, which were peculiar to clinical decision support systems. The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of MYCIN, a clinical decision support system. Inferences drawn from the articles showed some usage of MYCIN for problem-based learning among clinicians and students in some countries. Furthermore, the data demonstrated that MYCIN had completed clinical testing at Stanford University Hospital following years of research. The system (MYCIN) was shown to be extremely accurate and effective in diagnosing and treating bacterial infections, and it demonstrated how CDSSs might enhance clinical decision-making in difficult circumstances. Despite the challenges MYCIN presents, the benefits of its usage to clinicians, students and software developers are enormous.

Keywords: clinical decision support system, MYCIN, diagnosis, bacterial infections, support systems

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Authors: Siyuan Cai

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COVID-19 has triggered the planning circles to think about how to improve the city's ability to respond to public health emergencies. From the perspective of the community, this article reviews the risk cases in Wuhan Chenjiadun Community and other communities under the epidemic, and analyzes the response to public health emergencies such as infectious disease outbreaks in the excellent cases of resilient epidemic prevention communities. Then, combined with the planning of the living circle, it demonstrates the necessity of integrating the concept of resilience into the 15-minute community living circle to make up for the shortcomings of infectious disease prevention. Finally, it is proposed to strictly control the source and tail of the epidemic in the layout of the living circle, daily health and epidemic emergency should be taken into account in planning, community medical resources should be decentralized in management, and the application of smart technologies in the planning of living circle should be fully emphasized, so as to improve the community's ability to respond to public health emergencies.

Keywords: pandemic, resilient cities, resilient community, 15-minute community life circle

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Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

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Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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Authors: Kyllie Cripps

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In Australia, not dissimilar to other jurisdictions with indigenous populations, indigenous women are more likely to experience violence than any other section of society. In recent years in response to horrific examples of Indigenous women’s deaths, Australian Coronial courts have investigated, wanting to know more about the circumstances that led to the deaths. This paper critically examined 12 Coronial Court investigations from around Australia, analyzing them thematically. The analysis highlighted the differential vulnerability of indigenous women to intimate partner homicides. In all the cases reviewed, it was evident that the women’s deaths, in most instances were entirely preventable. Evidence was also presented demonstrating that services were aware of the women’s heightened risks but were unable to sufficiently coordinate themselves to provide wrap around support to minimise the risk of violence and to maximise the women’s safety. Consequently, putting the women in environments where their deaths were both predictable and inevitable. The profound system failings at the intersections of law, policy, and practice have ultimately cost indigenous women their lives. This paper firstly explores the nuances of the Coronial Court findings – demonstrating the similarities and differences present within the cases. Part two interrogates the reported system failings, and part three considers potential improvements in system integration to prevent future deaths. The paper concludes recognizing that Indigenous women play important valued roles in indigenous communities, their loss has profound costs and consequences, and to honor their memory, we must learn from their deaths and improve responses to intimate partner violence.

Keywords: homicide, intimate partner violence, indigenous women

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Authors: Cathryn Robinson, Bernard McKenna, David Rooney

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This paper argues that the application of values-based leadership increasingly challenges leaders in rules-based organisations, particularly in bureaucratic organisations such as the military, public service, police, and emergency services. Leaders are grappling to reconcile how to enact values-based leadership and decision-making when they are bound by rules, policies, and procedures. This interpretive study used a multi-faceted vignette (critical incident) as the basis of an interview with air force officers at three levels: executive, senior, and junior. In this way, practice is forced to intersect with discourse. The findings revealed a shared set of discourse themes (legal; rules; safety and risk; operational practice/theatre discourses), but also clear dialectical tensions. These tensions were evident in executive officers and senior leaders emphasizing rules and information themes, whereas junior officers emphasized decision making, collateral, and situation. These findings reveal discourse and practice incommensurability that could have grave implications in the conduct of war.

Keywords: critical incident, discourse analysis, rules-based, values-based

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Authors: Yiannis Vacanas, Kyriacos Themistocleous, Athos Agapiou, Diofantos Hadjimitsis

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Building Information Modelling (BIM) technology is considered by construction professionals as a very valuable process in modern design, procurement and project management. Construction professionals of all disciplines can use a single 3D model which BIM technology provides, to design a project accurately and furthermore monitor the progress of construction works effectively and efficiently. Unmanned Aerial Vehicles (UAVs), a technology initially developed for military applications, is now without any difficulty accessible and has already been used by commercial industries, including the construction industry. UAV technology has mainly been used for collection of images that allow visual monitoring of building and civil engineering projects conditions in various circumstances. UAVs, nevertheless, have undergone significant advances in equipment capabilities and now have the capacity to acquire high-resolution imagery from many angles in a cost effective manner, and by using photogrammetry methods, someone can determine characteristics such as distances, angles, areas, volumes and elevations of an area within overlapping images. In order to examine the potential of using a combination of BIM and UAV technologies in construction project management, this paper presents the results of a case study of a typical road construction project where the combined use of the two technologies was used in order to achieve efficient and accurate as-built data collection of the works progress, with outcomes such as volumes, and production of sections and 3D models, information necessary in project progress monitoring and efficient project management.

Keywords: BIM, project management, project monitoring, UAV

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Authors: Ibrahim A. Al-Sulaihi, Khalid S. Al-Gahtani, Abdullah M. Al-Sugair, Aref A. Abadel

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Achieving environmental sustainability is one of the important issues considered in many countries’ vision. Green/Sustainable building is widely used terminology for describing a friendly environmental construction. Applying sustainable practices has a significant importance in various fields, including construction field that consumes an enormous amount of resource and causes a considerable amount of waste. The need for sustainability is increased in the regions that suffering from the limitation of natural resource and extreme weather conditions such as Saudi Arabia. Since buildings designs are getting sophisticated, the need for tools, which support decision-making for sustainability issues, is increasing, especially in the design and preconstruction stages. In this context, Building Information Modeling (BIM) can aid in performing complex building performance analyses to ensure an optimized sustainable building design. Accordingly, this paper introduces a roadmap towards developing a systematic approach for presenting the sustainability of buildings using BIM. The approach includes set of main processes including; identifying the sustainability parameters that can be used for sustainability assessment in Saudi Arabia, developing sustainability assessment method that fits the special circumstances in the Kingdom, identifying the sustainability requirements and BIM functions that can be used for satisfying these requirements, and integrating these requirements with identified functions. As a result, the sustainability-BIM approach can be developed which helps designers in assessing the sustainability and exploring different design alternatives at the early stage of the construction project.

Keywords: green buildings, sustainability, BIM, rating systems, environment, Saudi Arabia

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Authors: A. Mohamed, A. El-Hamalawi, M. Frost, A. Connell

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Often design standards do not provide guidance or formulae for the calculation of stresses on buried pipelines caused by external loads. Frequently engineers rely on other methods and published sources of information to calculate such imposed stresses and a variety of methods can be used. This paper reviews three current approaches to soil pipeline interaction modelling to predict stresses on buried pipelines subjected to soil overburden and traffic loading. The traditional approach to use empirical stress formulas to calculate circumferential bending stresses on pipelines. The alternative approaches considered are the use of a finite element package to compute an estimate of circumferential bending stress and a proprietary stress analysis system (SURFLOAD) to estimate the circumferential bending stress. The results from analysis using the methods are presented and compared to experimental results in terms of predicted and measured circumferential stresses. This study shows that the approach used to assess externally generated stress is important and can lead to an over-conservative analysis. Using FE analysis either through SURFLOAD or a general FE package to predict circumferential stress is the most accurate way to undertake stress analysis due to traffic and soil loads. Although conservative, classical empirical methods will continue to be applied to the analysis of buried pipelines, an opportunity exists, therefore, in many circumstances, to use applied numerical techniques, made possible by advances in finite element analysis.

Keywords: buried pipelines, circumferential bending stress, finite element analysis, soil overburden, soil pipeline interaction analysis (SPIA), traffic loadings

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Authors: Manjie Li, Xiangju Cheng, Yongcan Chen

Abstract:

With rapid development of industrialization and urbanization, water environmental deterioration is widespread in majority of urban rivers, which seriously affects city image and life satisfaction of residents. As an emergency measure to improve water quality, clean water diversion is introduced for water environmental management. Lubao River and Southwest River, two urban rivers in typical plain tidal river network, are identified as technically and economically feasible for the application of clean water diversion. One-dimensional hydrodynamic-water quality model is developed to simulate temporal and spatial variations of water level and water quality, with satisfactory accuracy. The mathematical model after calibration is applied to investigate hydrodynamic and water quality variations in rivers as well as determine the optimum operation scheme of water diversion. Assessment system is developed for evaluation of positive and negative effects of water diversion, demonstrating the effectiveness of clean water diversion and the necessity of pollution reduction.

Keywords: assessment system, clean water diversion, hydrodynamic-water quality model, tidal river network, urban rivers, water environment improvement

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Authors: Funmilayo Lanrewaju Amao, Amos Olusegun Amao, Odetoye Adeola Sunday, Joseph Joshua Olu

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There is a high magnitude of housing inadequacy in urban centers in Nigeria. This is manifested in quantitative and qualitative terms. Severe overcrowding and insanitary physical environment characterize the housing in the urban centers. The culminating effect of this is the growth of slum areas. This paper takes a critical look at inter-allia history and anatomy, general characteristic, present condition, root causes, official responses and reactions, possible solution and advocacy housing in central city slum of Ibadan. It also examines slum development and consequent deviant behaviors in the inner-city neighborhoods of Ibadan, the capital city of Oyo State, Nigeria. Residing there are many underemployed and unemployed individuals, these are miscreants who are generally socially frustrated. The activities of this group of people are a cause of concern. Deleterious and anti-social behaviors such as prostitution and house burglary are commonplace in the neighborhoods. The paper examines building conditions in the neighborhoods and the nexus with the deviant behavior of the inhabitants. The paper affirms that there is monumental deficiency in housing quality, while the design and the arrangement of the buildings into spatial units significantly influence the behavior of the residents. The paper suggests a two-prong approach in dealing with the situation. This involves urban renewal and slum upgrading programmes on the one hand, and an improvement in the socio-economic circumstances of the inhabitants, especially an increase in employment opportunity on the other.

Keywords: slum, behavior, housing, poverty, environmental degeneration

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Authors: Ichiro Mukai

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The purpose of this study is to investigate whether firms applying International Financial Reporting Standards (IFRS), provide high-quality and comparable earnings information that is useful for decision making of information users relative to firms applying local Generally Accepted Accounting Principles (GAAP). Focus is placed on the earnings quality of listed firms in several developed countries: Australia, Canada, France, Germany, Japan, the United Kingdom (UK), and the United States (US). Except for Japan and the US, the adoption of IFRS is mandatory for listed firms in these countries. In Japan, the application of IFRS is allowed for specific listed firms. In the US, the foreign firms listed on the US securities market are permitted to apply IFRS but the listed domestic firms are prohibited from doing so. In this paper, the differences in earnings quality are compared between firms applying local GAAP and those applying IFRS in each country and industry category, and the reasons of differences in earnings quality are analyzed using various factors. The results show that, although the earnings quality of firms applying IFRS is higher than that of firms applying local GAAP, this varies with country and industry category. Thus, even if a single set of global accounting standards is used for all listed firms worldwide, it is difficult to establish comparability of financial information among global firms. These findings imply that various circumstances surrounding firms, industries, and countries etc. influence business operations and affect the differences in earnings quality.

Keywords: accruals, earnings quality, IFRS, information comparability

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Authors: Mohammadreza Ashouri, Majid Bayatian

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Analysis of fire data is a way for the implementation of any plan to improve the level of safety in cities. Such an analysis is able to reveal signs of changes in a given period and can be used as a measure of safety. The information of about 66,341 fires (from 2002 to 2012) released by Tehran Safety Services and Fire-Fighting Organization and data on the population and the number of households provided by Tehran Municipality and the Statistical Yearbook of Iran were extracted. Using the data, the fire changes, the rate of injuries, and mortality rate were determined and analyzed. The rate of injuries and mortality rate of fires per one million population of Tehran were 59.58% and 86.12%, respectively. During the study period, the number of fires and fire stations increased by 104.38% and 102.63%, respectively. Most fires (9.21%) happened in the 4th District of Tehran. The results showed that the recorded fire data have not been systematically planned for fire prevention since one of the ways to reduce injuries caused by fires is to develop a systematic plan for necessary actions in emergency situations. To determine a reliable source for fire prevention, the stages, definitions of working processes and the cause and effect chains should be considered. Therefore, a comprehensive statistical system should be developed for reported and recorded fire data.

Keywords: fire statistics, fire analysis, accident prevention, Tehran

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Authors: Adem Öğüt, M. Tahir Demirsel

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Rapid changes and developments today, besides the opportunities and facilities they offer to the organization, may also be a source of danger and difficulties due to the uncertainty. In order to take advantage of opportunities and to take the necessary measures against possible uncertainties, organizations must always follow the changes and developments that occur in the business environment and develop flexible structures and strategies for the alternative cases. Perceived environmental uncertainty is an outcome of managers’ perceptions of the combined complexity, instability and unpredictability in the organizational environment. An environment that is perceived to be complex, changing rapidly, and difficult to predict creates high levels of uncertainty about the appropriate organizational responses to external circumstances. In an uncertain and complex environment, organizations experiencing cutthroat competition may be successful by developing their corporate entrepreneurial ability. Corporate entrepreneurship is a process that includes many elements such as innovation, creating new business, renewal, risk-taking and being predictive. Successful corporate entrepreneurship is a critical factor which has a significant contribution to gain a sustainable competitive advantage, to renew the organization and to adapt the environment. In this context, the objective of this study is to investigate the effect of perceived environmental uncertainty of managers on corporate entrepreneurship performance. The research was conducted on 222 business executives in one of the major industrial zones of Turkey, Konya Organized Industrial Zone (KOS). According to the results, it has been observed that there is a positive statistically significant relationship between perceived environmental uncertainty and corporate entrepreneurial activities.

Keywords: corporate entrepreneurship, entrepreneurship, industrial zone, perceived environmental uncertainty, uncertainty

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Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Describing clinical cases according to a clinical charting standard that enforces interoperability and enables connected care services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. This article presented a multi-tenant extension to the problem-oriented medical record that we have prototyped previously upon using the GraphQL Application Programming Interface to represent the notion of a problem list. Our implemented extension enables physicians and patients to collaboratively describe the patient case via using multi chatbots to collaboratively describe the patient case using the SOAP charting standard. Our extension also connects the described SOAP patient case with the HL7 FHIR (Health Interoperability Resources) medical record for connecting the patient case to the bench data.

Keywords: problem-oriented medical record, graphQL, chatbots, SOAP

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Kasamon Aramvanitch, Karn Suttapanit, Yahya Mankong, Nussareen Yaemluksanalert, Sansanee Meesawad

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Introduction : Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar. Methods : This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar. Results : 125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081). Conclusion : It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.

Keywords: ntubation, Intratracheal, Spinal Injuries, Multiple trauma

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Authors: Samiya Siddique, Taslima Akter Elma, Shahrina Mahzabin, Tamanna Jerin, Mohammed Russedul Islam

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In the maneuver and designing of highway engineering, pavement performance is a principal concern. Quality of construction and materials, traffic volume, climate, etc. are the factors that affect the performance of asphalt concrete. Modified asphalt requires to attain greater strength and stability even at inimical circumstances. In this point of view, pyrolytic carbon black (PCB), which is a by-product of waste tire pyrolysis, holds incomparable properties that individualizes it from other conventional fillers by making it an imminent modifier of bitumen. Optimum asphalt content of 60/70 penetration grade asphalt is determined 5% through the Marshall Stability and Flow test for the wearing course of flexible pavement. 5, 10, and 15 percentages of PCB are then used with neat asphalt for modification. Deviations of physical and rheological properties are investigated on both PCB modified and neat asphalt by going through several laboratory tests such as penetration, softening point, and ductility tests. The obtained results reveal that the performance of paving asphalt can be upgraded by modifying it with PCB. With the increasing percentage of PCB, ductility is gradually decreased, and also penetration grade is gradually reduced from 60/70 to 30/40. Furthermore, asphalt mixtures modified with PCB demonstrate higher stability and lower flow values. The research discloses that the apposite percentage of PCB used in asphalt concrete plays a significant role in the advancement of pavement performances and reutilizing of waste tires.

Keywords: asphalt modification, pavement performances, pyrolytic carbon black, marshall stability, wearing course

Procedia PDF Downloads 134

Authors: Nancy Mackin

Abstract:

Historically, architects from Aalto to Gaudi to Wright have looked to the architectural knowledge of long-resident peoples for forms and structural principles specifically adapted to the regional climate, geology, materials availability, and culture. In this research, structures traditionally built by Inuit peoples in a remote region of the Canadian high Arctic provides a folio of architectural ideas that are increasingly relevant during these times of escalating carbon emissions and climate change. ‘Green architecture from the Thawing Arctic’ researches, draws, models, and reconstructs traditional buildings of Inuit (Eskimo) peoples in three remote, often inaccessible Arctic communities. Structures verified in pre-contact oral history and early written history are first recorded in architectural drawings, then modeled and, with the participation of Inuit young people, local scientists, and Elders, reconstructed as emergency shelters. Three full-sized building types are constructed: a driftwood and turf-clad A-frame (spring/summer); a stone/bone/turf house with inwardly spiraling walls and a fan-shaped floor plan (autumn); and a parabolic/catenary arch-shaped dome from willow, turf, and skins (autumn/winter). Each reconstruction is filmed and featured in a short video. Communities found that the reconstructed buildings and the method of involving young people and Elders in the reconstructions have on-going usefulness, as follows: 1) The reconstructions provide emergency shelters, particularly needed as climate change worsens storms, floods, and freeze-thaw cycles and scientists and food harvesters who must work out of the land become stranded more frequently; 2) People from the communities re-learned from their Elders how to use materials from close at hand to construct impromptu shelters; 3) Forms from tradition, such as windbreaks at entrances and using levels to trap warmth within winter buildings, can be adapted and used in modern community buildings and housing; and 4) The project initiates much-needed educational and employment opportunities in the applied sciences (engineering and architecture), construction, and climate change monitoring, all offered in a culturally-responsive way. Elders, architects, scientists, and young people added innovations to the traditions as they worked, thereby suggesting new sustainable, culturally-meaningful building forms and materials combinations that can be used for modern buildings. Adding to the growing interest in bio-mimicry, participants looked at properties of Arctic and subarctic materials such as moss (insulation), shrub bark (waterproofing), and willow withes (parabolic and catenary arched forms). ‘Green Architecture from the Thawing Arctic’ demonstrates the effective, useful architectural oeuvre of a resilient northern people. The research parallels efforts elsewhere in the world to revitalize long-resident peoples’ architectural knowledge, in the interests of designing sustainable buildings that reflect culture, heritage, and identity.

Keywords: architectural culture and identity, climate change, forms from nature, Inuit architecture, locally sourced biodegradable materials, traditional architectural knowledge, traditional Inuit knowledge

Procedia PDF Downloads 508