Search results for: identify skills

Authors: Tobias Milz, L. Macpherson, Varvara Vetrova

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The law is a fundamental pillar of human societies as it shapes, controls and governs how humans conduct business, behave and interact with each other. Recent advances in computer-assisted technologies such as NLP, data science and AI are creating opportunities to support the practice, research and study of this pervasive domain. It is therefore not surprising that there has been an increase in investments into supporting technologies for the legal industry (also known as “legal tech” or “law tech”) over the last decade. A sub-discipline of particular appeal is concerned with assisted legal research. Supporting law researchers and practitioners to retrieve information from the vast amount of ever-growing legal documentation is of natural interest to the legal research community. One tool that has been in use for this purpose since the early nineteenth century is legal citation indexing. Among other use cases, they provided an effective means to discover new precedent cases. Nowadays, computer-assisted network analysis tools can allow for new and more efficient ways to reveal the “hidden” information that is conveyed through citation behavior. Unfortunately, access to openly available legal data is still lacking in New Zealand and access to such networks is only commercially available via providers such as LexisNexis. Consequently, there is a need to create, analyze and provide a legal citation network with sufficient data to support legal research tasks. This paper describes the development and analysis of a legal citation Network for New Zealand containing over 300.000 decisions from 125 different courts of all areas of law and jurisdiction. Using python, the authors assembled web crawlers, scrapers and an OCR pipeline to collect and convert court decisions from openly available sources such as NZLII into uniform and machine-readable text. This facilitated the use of regular expressions to identify references to other court decisions from within the decision text. The data was then imported into a graph-based database (Neo4j) with the courts and their respective cases represented as nodes and the extracted citations as links. Furthermore, additional links between courts of connected cases were added to indicate an indirect citation between the courts. Neo4j, as a graph-based database, allows efficient querying and use of network algorithms such as PageRank to reveal the most influential/most cited courts and court decisions over time. This paper shows that the in-degree distribution of the New Zealand legal citation network resembles a power-law distribution, which indicates a possible scale-free behavior of the network. This is in line with findings of the respective citation networks of the U.S. Supreme Court, Austria and Germany. The authors of this paper provide the database as an openly available data source to support further legal research. The decision texts can be exported from the database to be used for NLP-related legal research, while the network can be used for in-depth analysis. For example, users of the database can specify the network algorithms and metrics to only include specific courts to filter the results to the area of law of interest.

Keywords: case citation network, citation analysis, network analysis, Neo4j

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Authors: Ambali Alade Odebowale, Andargachew Mekonnen Berhe, Haroldo T. Hattori, Andrey E. Miroshnichenko

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Solar thermophotovoltaic systems (STPV) have emerged as a promising solution to overcome the Shockley-Queisser limit, a significant impediment in the direct conversion of solar radiation into electricity using conventional solar cells. The STPV system comprises essential components such as an optical concentrator, selective emitter, and a thermophotovoltaic (TPV) cell. The pivotal element in achieving high efficiency in an STPV system lies in the design of a spectrally selective emitter or absorber. Traditional methods for designing and optimizing selective emitters are often time-consuming and may not yield highly selective emitters, posing a challenge to the overall system performance. In recent years, the application of machine learning techniques in various scientific disciplines has demonstrated significant advantages. This paper proposes a novel nanostructure composed of four-layered materials (SiC/W/SiO2/W) to function as a selective emitter in the energy conversion process of an STPV system. Unlike conventional approaches widely adopted by researchers, this study employs a machine learning-based approach for the design and optimization of the selective emitter. Specifically, a random forest algorithm (RFA) is employed for the design of the selective emitter, while the optimization process is executed using genetic algorithms. This innovative methodology holds promise in addressing the challenges posed by traditional methods, offering a more efficient and streamlined approach to selective emitter design. The utilization of a machine learning approach brings several advantages to the design and optimization of a selective emitter within the STPV system. Machine learning algorithms, such as the random forest algorithm, have the capability to analyze complex datasets and identify intricate patterns that may not be apparent through traditional methods. This allows for a more comprehensive exploration of the design space, potentially leading to highly efficient emitter configurations. Moreover, the application of genetic algorithms in the optimization process enhances the adaptability and efficiency of the overall system. Genetic algorithms mimic the principles of natural selection, enabling the exploration of a diverse range of emitter configurations and facilitating the identification of optimal solutions. This not only accelerates the design and optimization process but also increases the likelihood of discovering configurations that exhibit superior performance compared to traditional methods. In conclusion, the integration of machine learning techniques in the design and optimization of a selective emitter for solar thermophotovoltaic systems represents a groundbreaking approach. This innovative methodology not only addresses the limitations of traditional methods but also holds the potential to significantly improve the overall performance of STPV systems, paving the way for enhanced solar energy conversion efficiency.

Keywords: emitter, genetic algorithm, radiation, random forest, thermophotovoltaic

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Authors: Maria C. Almario, Pam Remer, Jeff Resse, Kathy Moran, Linda Theander Adam

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The identification of victims of human trafficking and consequential service provision is characterized by a significant disconnection between the estimated prevalence of this issue and the number of cases identified. This poses as tremendous problem for human rights advocates as it prevents data collection, information sharing, allocation of resources and opportunities for international dialogues. The current paper introduces the Inclusive Human Trafficking Checklist (IHTC) as a measurement methodology with theoretical underpinnings derived from dialectic theory. The presence of human trafficking in a person’s life is conceptualized as a dynamic and dialectic interaction between vulnerability and exploitation. The current papers explores the operationalization of exploitation and vulnerability, evaluates the metric qualities of the instrument, evaluates whether there are differences in assessment based on the participant’s profession, level of knowledge, and training, and assesses if users of the instrument perceive it as useful. A total of 201 participants were asked to rate three vignettes predetermined by experts to qualify as a either human trafficking case or not. The participants were placed in three conditions: business as usual, utilization of the IHTC with and without training. The results revealed a statistically significant level of agreement between the expert’s diagnostic and the application of the IHTC with an improvement of 40% on identification when compared with the business as usual condition While there was an improvement in identification in the group with training, the difference was found to have a small effect size. Participants who utilized the IHTC showed an increased ability to identify elements of identity-based vulnerabilities as well as elements of fraud, which according to the results, are distinctive variables in cases of human trafficking. In terms of the perceived utility, the results revealed higher mean scores for the groups utilizing the IHTC when compared to the business as usual condition. These findings suggest that the IHTC improves appropriate identification of cases and that it is perceived as a useful instrument. The application of the IHTC as a multidisciplinary instrumentation that can be utilized in legal and human services settings is discussed as a pivotal piece of helping victims restore their sense of dignity, and advocate for legal, physical and psychological reparations. It is noteworthy that this study was conducted with a sample in the United States and later re-tested in Colombia. The implications of the instrument for treatment conceptualization and intervention in human trafficking cases are discussed as opportunities for enhancement of victim well-being, restoration engagement and activism. With the idea that what is personal is also political, we believe that the careful observation and data collection in specific cases can inform new areas of human rights activism.

Keywords: exploitation, human trafficking, measurement, vulnerability, screening

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Authors: Denisa Denglerova, Radim Sip

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Academic sources as well as international agreements and national documents define inclusion in terms of several criteria: equal opportunities, fulfilling individual needs, development of human resources, community participation. In order for these criteria to be met, the community must be cohesive. Community cohesion, which is a relatively new concept, is not determined by homogeneity, but by the acceptance of diversity among the community members and utilisation of its positive potential. This brings us to a central category of inclusion - appreciating diversity and using it to a positive effect. However, school diversity is a real phenomenon, which schools need to tackle more and more often. This is also indicated by the number of publications focused on diversity in schools. These sources present recent analyses of using identity as a tool of coping with the demands of a diversified society. The aim of this study is to identify and describe in detail the processes taking place in selected schools, which contribute to their pro-inclusive character. The research is designed around a multiple case study of three pro-inclusive schools. Paradigmatically speaking, the research is rooted in situational epistemology. This is also related to the overall framework of interpretation, for which we are going to use innovative methods of situational analysis. In terms of specific research outcomes this will manifest itself in replacing the idea of “objective theory” by the idea of “detailed cartography of a social world”. The cartographic approach directs both the logic of data collection and the choice of methods of their analysis and interpretation. The research results include detection of the following sensitive concepts: Key persons. All participants can contribute to promoting an inclusion-friendly environment; however, some do so with greater motivation than others. These could include school management, teachers with a strong vision of equality, or school counsellors. They have a significant effect on the transformation of the school, and are themselves deeply convinced that inclusion is necessary. Accordingly, they select suitable co-workers; they also inspire some of the other co-workers to make changes, leading by example. Employees with strongly opposing views gradually leave the school, and new members of staff are introduced to the concept of inclusion and openness from the beginning. Manifestations of school openness in working with diversity on all important levels. By this we mean positive manipulation with diversity both in the relationships between “traditional” school participants (directors, teachers, pupils) and school-parent relationships, or relationships between schools and the broader community, in terms of teaching methods as well as ways how the school culture affects the school environment. Other important detected concepts significantly helping to form a pro-inclusive environment in the school are individual and parallel classes; freedom and responsibility of both pupils and teachers, manifested on the didactic level by tendencies towards an open curriculum; ways of asserting discipline in the school environment.

Keywords: inclusion, diversity, education, sensitive concept, situational analysis

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Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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Authors: Nisa Mohan

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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.

Keywords: adverse drug events, clinical coders, decision making, hospital admissions

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Authors: Cristina Costescu, Carmen David, Adrian Roșan

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Executive functions (EF) and emotion regulation strategies are processes that allow individuals to function in an adaptative way and to be goal-oriented, which is essential for success in daily living activities, at school, or in social contexts. The Emotion Regulation and Executive Functioning Scale for Children and Adolescents (REMEX) represents an empirically based tool (based on the model of EF developed by Diamond) for evaluating significant dimensions of child and adolescent EFs and emotion regulation strategies, mainly in school contexts. The instrument measures the following dimensions: working memory, inhibition, cognitive flexibility, executive attention, planning, emotional control, and emotion regulation strategies. Building the instrument involved not only a top-down process, as we selected the content in accordance with prominent models of FE, but also a bottom-up one, as we were able to identify valid contexts in which FE and ER are put to use. For the construction of the instrument, we implemented three focus groups with teachers and other professionals since the aim was to develop an accurate, objective, and ecological instrument. We used the focus group method in order to address each dimension and to yield a bank of items to be further tested. Each dimension is addressed through a task that the examiner will apply and through several items derived from the main task. For the validation of the instrument, we plan to use item response theory (IRT), also known as the latent response theory, that attempts to explain the relationship between latent traits (unobservable cognitive processes) and their manifestations (i.e., observed outcomes, responses, or performance). REMEX represents an ecological scale that integrates a current scientific understanding of emotion regulation and EF and is directly applicable to school contexts, and it can be very useful for developing intervention protocols. We plan to test his convergent validity with the Childhood Executive Functioning Inventory (CHEXI) and Emotion Dysregulation Inventory (EDI) and divergent validity between a group of typically developing children and children with neurodevelopmental disorders, aged between 6 and 9 years old. In a previous pilot study, we enrolled a sample of 40 children with autism spectrum disorders and attention-deficit/hyperactivity disorder aged 6 to 12 years old, and we applied the above-mentioned scales (CHEXI and EDI). Our results showed that deficits in planning, bebavior regulation, inhibition, and working memory predict high levels of emotional reactivity, leading to emotional and behavioural problems. Considering previous results, we expect our findings to provide support for the validity and reliability of the REMEX version as an ecological instrument for assessing emotion regulation and EF in children and for key features of its uses in intervention protocols.

Keywords: executive functions, emotion regulation, children, item response theory, focus group

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Authors: Robert Caulk

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A generalized framework for adaptive machine learning deployments in algorithmic trading is introduced, tested, and released as open-source code. The presented software aims to test the hypothesis that recent data contains enough information to form a probabilistically favorable short-term price prediction. Further, the framework contains various adaptive machine learning techniques that are geared toward generating profit during strong trends and minimizing losses during trend changes. Results demonstrate that this adaptive machine learning approach is capable of capturing trends and generating profit. The presentation also discusses the importance of defining the parameter space associated with the dynamic training data-set and using the parameter space to identify and remove outliers from prediction data points. Meanwhile, the generalized architecture enables common users to exploit the powerful machinery while focusing on high-level feature engineering and model testing. The presentation also highlights common strengths and weaknesses associated with the presented technique and presents a broad range of well-tested starting points for feature set construction, target setting, and statistical methods for enforcing risk management and maintaining probabilistically favorable entry and exit points. The presentation also describes the end-to-end data processing tools associated with FreqAI, including automatic data fetching, data aggregation, feature engineering, safe and robust data pre-processing, outlier detection, custom machine learning and statistical tools, data post-processing, and adaptive training backtest emulation, and deployment of adaptive training in live environments. Finally, the generalized user interface is also discussed in the presentation. Feature engineering is simplified so that users can seed their feature sets with common indicator libraries (e.g. TA-lib, pandas-ta). The user also feeds data expansion parameters to fill out a large feature set for the model, which can contain as many as 10,000+ features. The presentation describes the various object-oriented programming techniques employed to make FreqAI agnostic to third-party libraries and external data sources. In other words, the back-end is constructed in such a way that users can leverage a broad range of common regression libraries (Catboost, LightGBM, Sklearn, etc) as well as common Neural Network libraries (TensorFlow, PyTorch) without worrying about the logistical complexities associated with data handling and API interactions. The presentation finishes by drawing conclusions about the most important parameters associated with a live deployment of the adaptive learning framework and provides the road map for future development in FreqAI.

Keywords: machine learning, market trend detection, open-source, adaptive learning, parameter space exploration

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Authors: Young Ik Suh, Sanghak Lee, Tywan G. Martin

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An increasing number of athletes, across all sports, are moving from their home countries to play in foreign countries. The migration of athletes, coaches, managers, and administrators within and between nations is an important aspect of the social and cultural changes taking place in modern, global sports. It is especially important to understand the context of these migrations as they are critical factors in the successful development of sports policies. In previous decades, efforts have been made to understand the motives of migrating athletes from a variety of sports, including rugby, cricket, baseball, and soccer. These studies focused on the athletes’ motivations, experiences as migrants, and recruit process. However, few studies have been conducted in order to understand athletes’ constraints of migration. The concept of constraints in leisure studies refers to the barriers that exist between an individual’s desire for participation and an individual’s real participation. The study of constraints is not a new topic in the fields of sports and recreation. In addition to understanding the motives that drive athletes to work or play in foreign countries, it is also important to recognize that negative dimensions exist that stop some athletes from migrating. Furthermore, little research has explored what makes athletes consider playing in small and unknown volleyball markets, such as the Korean Volleyball League (V-League). The V-League is a professional men’s and women’s volleyball league, started in 2005. It consists of seven men’s clubs, and six women’s clubs and each team has one foreign player. In addition, several limitations are placed on the foreign players, such as on height, position, and salary to play in the V-League. Thus, the main focus of the present research is to understand why foreign athletes (e.g., European, American, Brazil, etc.) are attracted to the V-League, which has a smaller market compared to its neighbors (i.e., China, Japan, and The Philippines). In addition, the current study seeks to identify the negative factors that prevent athletes from playing in the V-League. The participants for this study will be foreign volleyball players participating in the V-League. The investigators will provide a brief introduction to this study and inform the potential participants that they can choose whether to participate in this study. In terms of theoretical saturation, at least 12 participants are generally an adequate number to reach saturation, if they belong to a relatively homogenous group based on culture and ethnicity. This study utilizes a qualitative approach in order to understand the migration experiences foreign volleyball athletes playing in the V-League. The proposed study represents ongoing research to support work conducted by the investigators to understand the possible motivations and constraints for foreign volleyball players playing in the V-League. In addition, significant contributions to scholarship in the field of sports, psychology, and coaching studies will be an outcome of this study along with additions to the body of knowledge in several disciplines, including psychology, sociology, and social work.

Keywords: athletes’ migration, motivation, constraints, volleyball

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Authors: Ivana Knezevic, Kenneth D. Candido, N. Nick Knezevic

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Background: While pain intensity scales remain generally accepted assessment tool, and the numeric pain rating score is highly subjective, we nevertheless rely on them to make a judgment about treatment effects. Misinterpretation of pain can lead practitioners to underestimate or overestimate the patient’s medical condition. The purpose of this study was to analyze how the numeric rating pain scores given by patients with low back pain correlate with their functional activity levels. Methods: We included 100 consecutive patients with radicular low back pain (LBP) after the Institutional Review Board (IRB) approval. Pain scores, numeric rating scale (NRS) responses at rest and in the movement,Oswestry Disability Index (ODI) questionnaire answers were collected 10 times through 12 months. The ODI questionnaire is targeting a patient’s activities and physical limitations as well as a patient’s ability to manage stationary everyday duties. Statistical analysis was performed by using SPSS Software version 20. Results: The average duration of LBP was 14±22 months at the beginning of the study. All patients included in the study were between 24 and 78 years old (average 48.85±14); 56% women and 44% men. Differences between ODI and pain scores in the range from -10% to +10% were considered “normal”. Discrepancies in pain scores were graded as mild between -30% and -11% or +11% and +30%; moderate between -50% and -31% and +31% and +50% and severe if differences were more than -50% or +50%. Our data showed that pain scores at rest correlate well with ODI in 65% of patients. In 30% of patients mild discrepancies were present (negative in 21% and positive in 9%), 4% of patients had moderate and 1% severe discrepancies. “Negative discrepancy” means that patients graded their pain scores much higher than their functional ability, and most likely exaggerated their pain. “Positive discrepancy” means that patients graded their pain scores much lower than their functional ability, and most likely underrated their pain. Comparisons between ODI and pain scores during movement showed normal correlation in only 39% of patients. Mild discrepancies were present in 42% (negative in 39% and positive in 3%); moderate in 14% (all negative), and severe in 5% (all negative) of patients. A 58% unknowingly exaggerated their pain during movement. Inconsistencies were equal in male and female patients (p=0.606 and p=0.928).Our results showed that there was a negative correlation between patients’ satisfaction and the degree of reporting pain inconsistency. Furthermore, patients talking opioids showed more discrepancies in reporting pain intensity scores than did patients taking non-opioid analgesics or not taking medications for LBP (p=0.038). There was a highly statistically significant correlation between morphine equivalents doses and the level of discrepancy (p<0.0001). Conclusion: We have put emphasis on the patient education in pain evaluation as a vital step in accurate pain level reporting. We have showed a direct correlation with patients’ satisfaction. Furthermore, we must identify other parameters in defining our patients’ chronic pain conditions, such as functionality scales, quality of life questionnaires, etc., and should move away from an overly simplistic subjective rating scale.

Keywords: pain score, functionality scales, low back pain, lumbar

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Authors: Veli Durmus, Mert Uydaci

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Every patient who needs to get a medical treatment should share health-related personal data with healthcare providers. Therefore, personal health data plays an important role to make health decisions and identify health threats during every encounter between a patient and caregivers. In other words, health data can be defined as privacy and sensitive information which is protected by various health laws and regulations. In many cases, the data are an outcome of the confidential relationship between patients and their healthcare providers. Globally, almost all nations have own laws, regulations or rules in order to protect personal data. There is a variety of instruments that allow authorities to use the health data or to set the barriers data sharing across international borders. For instance, Directive 95/46/EC of the European Union (EU) (also known as EU Data Protection Directive) establishes harmonized rules in European borders. In addition, the General Data Protection Regulation (GDPR) will set further common principles in 2018. Because of close policy relationship with EU, this study provides not only information on regulations, directives but also how they play a role during the legislative process in Turkey. Even if the decision is controversial, the Board has recently stated that private or public healthcare institutions are responsible for the patient call system, for doctors to call people waiting outside a consultation room, to prevent unlawful processing of personal data and unlawful access to personal data during the treatment. In Turkey, vast majority private and public health organizations provide a service that ensures personal data (i.e. patient’s name and ID number) to call the patient. According to the Board’s decision, hospital or other healthcare institutions are obliged to take all necessary administrative precautions and provide technical support to protect patient privacy. However, this application does not effectively and efficiently performing in most health services. For this reason, it is important to draw a legal framework of personal health data by stating what is the main purpose of this regulation and how to deal with complicated issues on personal health data in Turkey. The research is descriptive on data protection law for health care setting in Turkey. Primary as well as secondary data has been used for the study. The primary data includes the information collected under current national and international regulations or law. Secondary data include publications, books, journals, empirical legal studies. Consequently, privacy and data protection regimes in health law show there are some obligations, principles and procedures which shall be binding upon natural or legal persons who process health-related personal data. A comparative approach presents there are significant differences in some EU member states due to different legal competencies, policies, and cultural factors. This selected study provides theoretical and practitioner implications by highlighting the need to illustrate the relationship between privacy and confidentiality in Personal Data Protection in Health Law. Furthermore, this paper would help to define the legal framework for the health law case studies on data protection and privacy.

Keywords: data protection, personal data, privacy, healthcare, health law

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Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

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Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

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Authors: Chen Shuwen, Nunthapin Chantachaimongkol

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Since the world has moved into a transitional period, known as globalization; the business environment is now more complicated than ever before. Corporate information has become a matter of great importance for stakeholders, in order to understand the current situation. As a result of this, the concept of corporate governance has been broadly introduced to manage and control the affairs of corporations while businesses are required to disclose both financial and non-financial information to public via various communication channels such as the annual report, the financial report, the company’s website, etc. However, currently there are several other issues related to asymmetric information such as moral hazard or adverse selection that still occur intensively in workplaces. To prevent such problems in the business, it is required to have an understanding of what factors strengthen their transparency, accountability, fairness, and responsibility. Under aforementioned arguments, this paper aims to propose a conceptual framework that enables an investigation on how corporate governance mechanism influences disclosure efficiency of listed companies in the Association of Southeast Asia Nations (ASEAN) and the factors that should be considered for further development of good behaviors, particularly in regards to voluntary disclosure practices. To achieve its purpose, extensive reviews of literature are applied as a research methodology. It is divided into three main steps. Firstly, the theories involved with both corporate governance and disclosure practices such as agency theory, contract theory, signaling theory, moral hazard theory, and information asymmetry theory are examined to provide theoretical backgrounds. Secondly, the relevant literatures based on multi- perspectives of corporate governance, its attributions and their roles on business processes, the influences of corporate governance mechanisms on business performance, and the factors determining corporate governance characteristics as well as capability are reviewed to outline the parameters that should be included in the proposed model. Thirdly, the well-known regulatory document OECD principles and previous empirical studies on the corporate disclosure procedures are evaluated to identify the similarities and differentiations with the disclosure patterns in the ASEAN. Following the processes and consequences of the literature review, abundant factors and variables are found. Further to the methodology, additional critical factors that also have an impact on the disclosure behaviors are addressed in two groups. In the first group, the factors which are linked to the national characteristics - the quality of national code, legal origin, culture, the level of economic development, and so forth. Whereas in the second group, the discoveries which refer to the firm’s characteristics - ownership concentration, ownership’s rights, controlling group, and so on. However, because of research limitations, only some literature are chosen and summarized to form part of the conceptual framework that explores the relationship between corporate governance and the disclosure practices of listed companies in ASEAN.

Keywords: corporate governance, disclosure practice, ASEAN, listed company

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Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

Procedia PDF Downloads 63

Authors: Einat Waizbard, Emilio Ferrer, Meghan Miller, Brianna Heath, Derek S. Andrews, Sally J. Rogers, Christine Wu Nordahl, Marjorie Solomon, David G. Amaral

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Background: Autism symptoms are comprised of social-communication deficits and restricted/repetitive behaviors (RRB). The severity of these symptoms can change during childhood, with differences between boys and girls. From the literature, it was found that young autistic girls show a stronger tendency to decrease and a weaker tendency to increase their overall autism symptom severity levels compared to young autistic boys. It is not clear, however, which symptoms are driving these sex differences across childhood. In the current study, we evaluated the trajectories of independent autism symptoms across childhood and compared the patterns of change in such symptoms between boys and girls. Method: The study included 183 children diagnosed with autism (55 girls) evaluated three times across childhood, at ages 3, 6 and 11. We analyzed 22 independent items from the Autism Diagnostic Observation Scheudule-2 (ADOS-2), the gold-standard assessment tool for autism symptoms, each item representing a specific autism symptom. First, we used latent growth curve models to estimate the trajectories for the 22 ADOS-2 items for each child in the study. Second, we extracted the factor scores representing the individual slopes for each ADOS-2 item (i.e., slope representing that child’s change in that specific item). Third, we used factor analysis to identify common patterns of change among the ADOS-2 items, separately for boys and girls, i.e., which autism symptoms tend to change together and which change independently across childhood. Results: The best-emerging patterns for both boys and girls identified four common factors: three factors representative of changes in social-communication symptoms and one factor describing changes in RRB. Boys and girls showed the same pattern of change in RRB, with four items (e.g., speech abnormalities) changing together across childhood and three items (e.g., mannerisms) changing independently of other items. For social-communication deficits in boys, three factors were identified: the first factor included six items representing initiating and engaging in social-communication (e.g., quality of social overtures, conversation), the second factor included five items describing responsive social-communication (e.g., response to name) and the third factor included three items related to different aspects of social-communication (e.g., level of language). Girls’ social-communications deficits also loaded onto three factors: the first factor included five items (e.g., unusual eye contact), the second factor included six items (e.g., quality of social response), and the third factor included four items (e.g., showing). Some items showed similar patterns of change for both sexes (e.g., responsive joint attention), while other items showed differences (e.g., shared enjoyment). Conclusions: Girls and boys had different patterns of change in autism symptom severity across childhood. For RRB, both sexes showed similar patterns. For social-communication symptoms, however, there were both similarities and differences between boys and girls in the way symptoms changed over time. The strongest patterns of change were identified for initiating and engaging in social communication for boys and responsive social communication for girls.

Keywords: autism spectrum disorder, autism symptom severity, symptom trajectories, sex differences

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Authors: Hamda M. Al-Ali

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From addressing fundamental questions about the history of the solar system to exploring other planets for any signs of life have always been the core of human space exploration. This triggered humans to explore whether other planets such as Mars could support human life on them. Therefore, many planned space missions to other planets have been designed and conducted to examine the feasibility of human survival on them. However, space missions are expensive and consume a large number of various resources to be successful. To overcome these problems, material efficiency shall be maximized through the use of reusable launch vehicles (RLV) rather than disposable and expendable ones. Material efficiency is defined as a way to achieve service requirements using fewer materials to reduce CO2 emissions from industrial processes. Materials such as aluminum-lithium alloys, steel, Kevlar, and reinforced carbon-carbon composites used in the manufacturing of spacecrafts could be reused in closed-loop cycles directly or by adding a protective coat. Material efficiency is a fundamental principle of a circular economy. The circular economy aims to cutback waste and reduce pollution through maximizing material efficiency so that businesses can succeed and endure. Five strategies have been proposed to improve material efficiency in the space industry, which includes waste minimization, introduce Key Performance Indicators (KPIs) to measure material efficiency, and introduce policies and legislations to improve material efficiency in the space sector. Another strategy to boost material efficiency is through maximizing resource and energy efficiency through material reusability. Furthermore, the environmental effects associated with the rapid growth in the number of space missions include black carbon emissions that lead to climate change. The levels of emissions must be tracked and tackled to ensure the safe utilization of space in the future. The aim of this research paper is to examine and suggest effective methods used to improve material efficiency in space missions so that space and Earth become more environmentally and economically sustainable. The objectives used to fulfill this aim are to identify the materials used in space missions that are suitable to be reused in closed-loop cycles considering material efficiency indicators and circular economy concepts. An explanation of how spacecraft materials could be re-used as well as propose strategies to maximize material efficiency in order to make RLVs possible so that access to space becomes affordable and reliable is provided. Also, the economic viability of the RLVs is examined to show the extent to which the use of RLVs has on the reduction of space mission costs. The environmental and economic implications of the increase in the number of space missions as a result of the use of RLVs are also discussed. These research questions are studied through detailed critical analysis of the literature, such as published reports, books, scientific articles, and journals. A combination of keywords such as material efficiency, circular economy, RLVs, and spacecraft materials were used to search for appropriate literature.

Keywords: access to space, circular economy, material efficiency, reusable launch vehicles, spacecraft materials

Procedia PDF Downloads 91

Authors: Nader Mohamed

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The Late Cretaceous deposits are well developed through-out Egypt. This is due to a ‎transgression phase associated with the subsidence caused by the neo-Tethyan rift event that ‎took place across the northern margin of Africa, resulting in a period of dominantly marine ‎deposits in the Gulf of Suez. The Late Cretaceous Nezzazat Group represents the Cenomanian, ‎Turonian and clastic sediments of the Lower Senonian. The Nezzazat Group has been divided ‎into four formations namely, from base to top, the Raha Formation, the Abu Qada Formation, ‎the Wata Formation and the Matulla Formation. The Cenomanian Raha and the Lower Senonian ‎Matulla formations are the most important clastic sequence in the Nezzazat Group because they ‎provide the highest net reservoir thickness and the highest net/gross ratio. This study emphasis ‎on Matulla formation located in the eastern part of the Gulf of Suez. The three stratigraphic ‎surface sections (Wadi Sudr, Wadi Matulla and Gabal Nezzazat) which represent the exposed ‎Coniacian-Santonian sediments in Sinai are used for correlating Matulla sediments of Ras ‎Budran field. Cutting description, petrographic examination, log behaviors, biostratigraphy with ‎outcrops are used to identify the reservoir characteristics, lithology, facies environment logs and ‎subdivide the Matulla formation into three units. The lower unit is believed to be the main ‎reservoir where it consists mainly of sands with shale and sandy carbonates, while the other ‎units are mainly carbonate with some streaks of shale and sand. Reservoir modeling is an ‎effective technique that assists in reservoir management as decisions concerning development ‎and depletion of hydrocarbon reserves, So It was essential to model the Matulla reservoir as ‎accurately as possible in order to better evaluate, calculate the reserves and to determine the ‎most effective way of recovering as much of the petroleum economically as possible. All ‎available data on Matulla formation are used to build the reservoir structure model, lithofacies, ‎porosity, permeability and water saturation models which are the main parameters that describe ‎the reservoirs and provide information on effective evaluation of the need to develop the oil ‎potentiality of the reservoir. This study has shown the effectiveness of; 1) the integration of ‎geological data to evaluate and subdivide Matulla formation into three units. 2) Lithology and ‎facies environment interpretation which helped in defining the nature of deposition of Matulla ‎formation. 3) The 3D reservoir modeling technology as a tool for adequate understanding of the ‎spatial distribution of property and in addition evaluating the unlocked new reservoir areas of ‎Matulla formation which have to be drilled to investigate and exploit the un-drained oil. 4) This ‎study led to adding a new room of production and additional reserves to Ras Budran field. ‎

Keywords: geology, oil and gas, geoscience, sequence stratigraphy

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Authors: Olatokunbo Yakeem

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Human trafficking is a crime against gross violations of human rights. Trafficking in persons is a severe socio-economic dilemma that affects the national and international dimensions. Human trafficking or modern-day-slavery emanated from slavery, and it has been in existence before the 6ᵗʰ century. Today, no country is exempted from dehumanizing human beings, and as a result, it has been an international issue. The United Nations (UN) presented the International Protocol to fight human trafficking worldwide, which brought about the international definition of human trafficking. The protocol is to prevent, suppress, and punish trafficking in persons, especially women and children. The trafficking protocol has a link with transnational organised crime rather than migration. Over a hundred and fifty countries nationwide have enacted their criminal and panel code trafficking legislation from the UN trafficking protocol. Sex trafficking is the most common type of exploitation of women and children. Other forms of this crime involve exploiting vulnerable victims through forced labour, child involvement in warfare, domestic servitude, debt bondage, and organ removal for transplantation. Trafficking of women and children into sexual exploitation represents the highest form of human trafficking than other types of exploitation. Trafficking of women and children can either happen internally or across the border. It affects all kinds of people, regardless of their race, social class, culture, religion, and education levels. However, it is more of a gender-based issue against females. Furthermore, human trafficking can lead to life-threatening infections, mental disorders, lifetime trauma, and even the victim's death. The study's significance is to explore why the root causes of women and children trafficking in Nigeria are based around poverty, entrusting children in the hands of relatives and friends, corruption, globalization, weak legislation, and ignorance. The importance of this study is to establish how the national, regional, and international organisations are using the 3P’s Protection, Prevention, and Prosecution) to tackle human trafficking. The methodology approach for this study will be a qualitative paradigm. The rationale behind this selection is that the qualitative method will identify the phenomenon and interpret the findings comprehensively. The data collection will take the form of semi-structured in-depth interviews through telephone and email. The researcher will use a descriptive thematic analysis to analyse the data by using complete coding. In summary, this study aims to recommend to the Nigerian federal government to include human trafficking as a subject in their educational curriculum for early intervention to prevent children from been coerced by criminal gangs. And the research aims to find the root causes of women and children trafficking. Also, to look into the effectiveness of the strategies in place to eradicate human trafficking globally. In the same vein, the research objective is to investigate how the anti-trafficking bodies such as law enforcement and NGOs collaborate to tackle the upsurge in human trafficking.

Keywords: children, Nigeria, trafficking, women

Procedia PDF Downloads 167

Authors: Elena Kokkoni, Prasanna Kannappan, Ashkan Zehfroosh, Effrosyni Mavroudi, Kristina Strother-Garcia, James C. Galloway, Jeffrey Heinz, Rene Vidal, Herbert G. Tanner

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Early immobility affects the motor, cognitive, and social development. Current pediatric rehabilitation lacks the technology that will provide the dosage needed to promote mobility for young children at risk. The addition of socially assistive robots in early interventions may help increase the mobility dosage. The aim of this study is to examine the feasibility of an early intervention paradigm where non-walking infants experience independent mobility while socially interacting with robots. A dynamic environment is developed where both the child and the robot interact and learn from each other. The environment involves: 1) a range of physical activities that are goal-oriented, age-appropriate, and ability-matched for the child to perform, 2) the automatic functions that perceive the child’s actions through novel activity recognition algorithms, and decide appropriate actions for the robot, and 3) a networked visual data acquisition system that enables real-time assessment and provides the means to connect child behavior with robot decision-making in real-time. The environment was tested by bringing a two-year old boy with Down syndrome for eight sessions. The child presented delays throughout his motor development with the current being on the acquisition of walking. During the sessions, the child performed physical activities that required complex motor actions (e.g. climbing an inclined platform and/or staircase). During these activities, a (wheeled or humanoid) robot was either performing the action or was at its end point 'signaling' for interaction. From these sessions, information was gathered to develop algorithms to automate the perception of activities which the robot bases its actions on. A Markov Decision Process (MDP) is used to model the intentions of the child. A 'smoothing' technique is used to help identify the model’s parameters which are a critical step when dealing with small data sets such in this paradigm. The child engaged in all activities and socially interacted with the robot across sessions. With time, the child’s mobility was increased, and the frequency and duration of complex and independent motor actions were also increased (e.g. taking independent steps). Simulation results on the combination of the MDP and smoothing support the use of this model in human-robot interaction. Smoothing facilitates learning MDP parameters from small data sets. This paradigm is feasible and provides an insight on how social interaction may elicit mobility actions suggesting a new early intervention paradigm for very young children with motor disabilities. Acknowledgment: This work has been supported by NIH under grant #5R01HD87133.

Keywords: activity recognition, human-robot interaction, machine learning, pediatric rehabilitation

Procedia PDF Downloads 274

Authors: Itzel Amaro-Estrada, Eduardo Vergara-Rivera, Virginia Juarez-Flores, Mayra Cobaxin-Cardenas, Rosa Estela Quiroz, Jesus F. Preciado, Sergio Rodriguez-Camarillo

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Bovine anaplasmosis is an infectious, tick-borne disease caused mainly by Anaplasma marginale; typical signs include anemia, fever, abortion, weight loss, decreased milk production, jaundice, and potentially death. Sick bovine can recover when antibiotics are administered; however, it usually remains as carrier for life, being a risk of infection for susceptible cattle. Anaplasma marginale is an obligate intracellular Gram-negative bacterium with genetic composition highly diverse among geographical isolates. There are currently no vaccines fully effective against bovine anaplasmosis; therefore, the economic losses due to disease are present. Vaccine formulation became a hard task for several pathogens as Anaplasma marginale, but peptide-based vaccines are an interesting proposal way to induce specific responses. Phage-displayed peptide libraries have been proved one of the most powerful technologies for identifying specific ligands. Screening of these peptides libraries is also a tool for studying interactions between proteins or peptides. Thus, it has allowed the identification of ligands recognized by polyclonal antiserums, and it has been successful for the identification of relevant epitopes in chronic diseases and toxicological conditions. Protective immune response to bovine anaplasmosis includes high levels of immunoglobulins subclass G2 (IgG2) but not subclass IgG1. Therefore, IgG2 from the serum of protected bovine can be useful to identify ligands, which can be part of an immunogen for cattle. In this work, phage display random peptide library Ph.D. ™ -12 was incubating with IgG2 or blood sera of immunized bovines against A. marginale as targets. After three rounds of biopanning, several candidates were selected for additional analysis. Subsequently, their reactivity with sera immunized against A. marginale, as well as with positive and negative sera to A. marginale was evaluated by immunoassays. A collection of recognized peptides tested by ELISA was generated. More than three hundred phage-peptides were separately evaluated against molecules which were used during panning. At least ten different peptides sequences were determined from their nucleotide composition. In this approach, three phage-peptides were selected by their binding and affinity properties. In the case of the development of vaccines or diagnostic reagents, it is important to evaluate the immunogenic and antigenic properties of the peptides. Immunogenic in vitro and in vivo behavior of peptides will be assayed as synthetic and as phage-peptide for to determinate their vaccine potential. Acknowledgment: This work was supported by grant SEP-CONACYT 252577 given to I. Amaro-Estrada.

Keywords: bovine anaplasmosis, peptides, phage display, veterinary vaccines

Procedia PDF Downloads 125

Authors: Hideaki Endo, Mika Goto

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The global outbreak of the COVID-19 pandemic has seriously affected railway businesses. The number of railway passengers decreased due to the decline in the number of commuters and business travelers to avoid crowded trains and a sharp drop in inbound tourists visiting Japan. This has affected not only railway businesses but also related businesses, including hotels, leisure businesses, and retail businesses at station buildings. In 2021, the companies were divided into profitable and loss-making companies. This division suggests that railway companies, particularly loss-making companies, needed to decrease operational inefficiency. To measure the impact of COVID-19 and discuss the sustainable management strategies of railway companies, we examine the cost inefficiency of Japanese listed railway companies by applying stochastic frontier analysis (SFA) to their operational and financial data. First, we employ the stochastic frontier cost function approach to measure inefficiency. The cost frontier function is formulated as a Cobb–Douglas type, and we estimated parameters and variables for inefficiency. This study uses panel data comprising 26 Japanese-listed railway companies from 2005 to 2020. This period includes several events deteriorating the business environment, such as the financial crisis from 2007 to 2008 and the Great East Japan Earthquake of 2011, and we compare those impacts with those of the COVID-19 pandemic after 2020. Second, we identify the characteristics of the best-practice railway companies and examine the drivers of cost inefficiencies. Third, we analyze the factors influencing cost inefficiency by comparing the profiles of the top 10 railway companies and others before and during the pandemic. Finally, we examine the relationship between cost inefficiency and the implementation of efficiency measures for each railway company. We obtained the following four findings. First, most Japanese railway companies showed the lowest cost inefficiency (most efficient) in 2014 and the highest in 2020 (least efficient) during the COVID-19 pandemic. The second worst occurred in 2009 when it was affected by the financial crisis. However, we did not observe a significant impact of the 2011 Great East Japan Earthquake. This is because no railway company was influenced by the earthquake in this operating area, except for JR-EAST. Second, the best-practice railway companies are KEIO and TOKYU. The main reason for their good performance is that both operate in and near the Tokyo metropolitan area, which is densely populated. Third, we found that non-best-practice companies had a larger decrease in passenger kilometers than best-practice companies. This indicates that passengers made fewer long-distance trips because they refrained from inter-prefectural travel during the pandemic. Finally, we found that companies that implement more efficiency improvement measures had higher cost efficiency and they effectively used their customer databases through proactive DX investments in marketing and asset management.

Keywords: COVID-19 pandemic, stochastic frontier analysis, railway sector, cost efficiency

Procedia PDF Downloads 55

Authors: Bruna F. Oliveira, Teresa I. Gonçalves, Marcelo M. Sousa, Sandra M. Pimenta, Octávio F. Ramalho, José B. Cruz, Flávia V. Barbosa

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The EU Circular Economy action plan, launched in 2020, is one of the major initiatives to promote the transition into a more sustainable industry. The circular economy is a popular concept used by many companies nowadays. Some industries are better forwarded to this reality than others, and the tannery industry is a sector that needs more attention due to its strong environmental impact caused by its dimension, intensive resources consumption, lack of recyclability, and second use of its products, as well as the industrial effluents generated by the manufacturing processes. For these reasons, the zero-waste goal and the European objectives are further being achieved. In this context, a need arises to provide an effective methodology that allows to determine the level of circularity of tannery companies. Regarding the complexity of the circular economy concept, few factories have a specialist in sustainability to assess the company’s circularity or have the ability to implement circular strategies that could benefit the manufacturing processes. Although there are several methodologies to assess circularity in specific industrial sectors, there is not an easy go-to methodology applied in factories aiming for cleaner production. Therefore, a straightforward methodology to assess the level of circularity, in this case of a tannery industry, is presented and discussed in this work, allowing any company to measure the impact of its activities. The methodology developed consists in calculating the Overall Circular Index (OCI) by evaluating the circularity of four key areas -energy, material, economy and social- in a specific factory. The index is a value between 0 and 1, where 0 means a linear economy, and 1 is a complete circular economy. Each key area has a sub-index, obtained through key performance indicators (KPIs) regarding each theme, and the OCI reflects the average of the four sub-indexes. Some fieldwork in the appointed company was required in order to obtain all the necessary data. By having separate sub-indexes, one can observe which areas are more linear than others. Thus, it is possible to work on the most critical areas by implementing strategies to increase the OCI. After these strategies are implemented, the OCI is recalculated to check the improvements made and any other changes in the remaining sub-indexes. As such, the methodology in discussion works through continuous improvement, constantly reevaluating and improving the circularity of the factory. The methodology is also flexible enough to be implemented in any industrial sector by adapting the KPIs. This methodology was implemented in a selected Portuguese small and medium-sized enterprises (SME) tannery industry and proved to be a relevant tool to measure the circularity level of the factory. It was witnessed that it is easier for non-specialists to evaluate circularity and identify possible solutions to increase its value, as well as learn how one action can impact their environment. In the end, energetic and environmental inefficiencies were identified and corrected, increasing the sustainability and circularity of the company. Through this work, important contributions were provided, helping the Portuguese SMEs to achieve the European and UN 2030 sustainable goals.

Keywords: circular economy, circularity index, sustainability, tannery industry, zero-waste

Procedia PDF Downloads 54

Authors: Ine Huybrechts, Anja Declercq, Emily Verté, Peter Raeymaeckers, Sibyl Anthierens

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Goal-oriented care is a concept gaining increased interest as an approach to go towards more coordinated and integrated primary care. It places patients’ personal life goals at the core of health care support, hereby shifting the focus from “what’s the matter with this patient” to “what matters to this patient.” In Flanders/Belgium, various primary care providers, health and social care organizations and governmental bodies have picked up this concept and have initiated actions to facilitate this approach. The implementation of goal-oriented care not only happens on the micro-level, but it also requires efforts on the meso- and macro-level. Within implementation research, there is a growing recognition that the context in which an intervention takes place strongly relates to its implementation outcomes. However, when investigating contextual variables, the external context and its impact on implementation processes is often overlooked. This study aims to explore how we can better identify and understand the external context and how it relates to the mechanism of change within the implementation process of goal-oriented care in Flanders/Belgium. Results can be used to support and guide initiatives to introduce innovative approaches such as goal-oriented care inside an organization or in the broader primary care landscape. We have conducted qualitative research, performing in-depth interviews with n=23 respondents who have affinity with the implementation of goal-oriented care within their professional function. This lead to in-depth insights from a wide range of actors, with meso-level and/or macro-level perspectives on the implementation of goal-oriented care. This means that we have interviewed actors that are not only involved with initiatives to implement goal-oriented care, but also actors that actively give form to the external context in which goal-oriented care is implemented. Data were collected using a semi-structured interview guide, audio recorded, and analyzed first inductively and then deductively using various theories and concepts that derive from organizational research. Our preliminary findings suggest t Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care. hat organizational theories can help understand the mechanism of change of implementation processes with a macro-level perspective. Institutional theories, contingency theories, resources dependency theories and others can expose the mechanism of change for an innovation such as goal-oriented care. Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care.

Keywords: goal-oriented care, implementation processes, organizational theories, person-centered care, implementation research

Procedia PDF Downloads 64

Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

Procedia PDF Downloads 47

Authors: Maciej Szeląg

Abstract:

The changing nature of environmental impacts, in which cement composites are operating, are causing in the structure of the material a number of phenomena, which result in volume deformation of the composite. These strains can cause composite cracking. Cracks are merging by propagation or intersect to form a characteristic structure of cracks known as the cluster cracks. This characteristic mesh of cracks is crucial to almost all building materials, which are working in service loads conditions. Particularly dangerous for a cement matrix is a sudden load of elevated temperature – the thermal shock. Resulting in a relatively short period of time a large value of a temperature gradient between the outer surface and the material’s interior can result in cracks formation on the surface and in the volume of the material. In the paper, in order to analyze the geometry of the cluster cracks of the cement pastes, the image analysis tools were used. Tested were 4 series of specimens made of two different Portland cement. In addition, two series include microsilica as a substitute for the 10% of the cement. Within each series, specimens were performed in three w/b indicators (water/binder): 0.4; 0.5; 0.6. The cluster cracks were created by sudden loading the samples by elevated temperature of 250°C. Images of the cracked surfaces were obtained via scanning at 2400 DPI. Digital processing and measurements were performed using ImageJ v. 1.46r software. To describe the structure of the cluster cracks three stereological parameters were proposed: the average cluster area - A ̅, the average length of cluster perimeter - L ̅, and the average opening width of a crack between clusters - I ̅. The aim of the study was to identify and evaluate the relationships between measured stereological parameters, and the compressive strength and the bulk density of the modified cement pastes. The tests of the mechanical and physical feature have been carried out in accordance with EN standards. The curves describing the relationships have been developed using the least squares method, and the quality of the curve fitting to the empirical data was evaluated using three diagnostic statistics: the coefficient of determination – R2, the standard error of estimation - Se, and the coefficient of random variation – W. The use of image analysis allowed for a quantitative description of the cluster cracks’ geometry. Based on the obtained results, it was found a strong correlation between the A ̅ and L ̅ – reflecting the fractal nature of the cluster cracks formation process. It was noted that the compressive strength and the bulk density of cement pastes decrease with an increase in the values of the stereological parameters. It was also found that the main factors, which impact on the cluster cracks’ geometry are the cement particles’ size and the general content of the binder in a volume of the material. The microsilica caused the reduction in the A ̅, L ̅ and I ̅ values compared to the values obtained by the classical cement paste’s samples, which is caused by the pozzolanic properties of the microsilica.

Keywords: cement paste, cluster cracks, elevated temperature, image analysis, microsilica, stereological parameters

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Authors: Moen Torill, Rismark Marit, Astrid M. Solvberg

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In Norway, every municipality shall provide an educational psychological service, EPS, to support kindergartens and schools in their work with children and youths with special needs. The EPS focus its work on individuals, aiming to identify special needs and to give advice to teachers and parents when they ask for it. In addition, the service also give priority to prevention and system intervention in kindergartens and schools. To master these big tasks university courses are established to support EPS counsellors' continuous learning. There is, however, a need for more in-depth and systematic knowledge on how they experience the courses they attend. In this study, EPS counsellors’ reflection logs during a particular course are investigated. The research question is: what are the content and priorities of the reflections that are communicated in the logs produced by the educational psychological counsellors during a post-graduate course? The investigated course is a credit course organized over a one-year period in two one-semester modules. The altogether 55 students enrolled in the course work as EPS counsellors in various municipalities across Norway. At the end of each day throughout the course period, the participants wrote reflection logs about what they had experienced during the day. The data material consists of 165 pages of typed text. The collaborating researchers studied the data material to ascertain, differentiate and understand the meaning of the content in each log. The analysis also involved the search for similarity in content and development of analytical categories that described the focus and primary concerns in each of the written logs. This involved constant 'critical and sustained discussions' for mutual construction of meaning between the co-researchers in the developing categories. The process is inspired by Grounded Theory. This means that the concepts developed during the analysis derived from the data material and not chosen prior to the investigation. The analysis revealed that the concept 'Useful' frequently appeared in the participants’ reflections and, as such, 'Useful' serves as a core category. The core category is described through three major categories: (1) knowledge sharing (concerning direct and indirect work with students with special needs) with colleagues is useful, (2) reflections on models and theoretical concepts (concerning students with special needs) are useful, (3) reflection on the role as EPS counsellor is useful. In all the categories, the notion of useful occurs in the participants’ emphasis on and acknowledgement of the immediate and direct link between the university course content and their daily work practice. Even if each category has an importance and value of its own, it is crucial that they are understood in connection with one another and as interwoven. It is the connectedness that gives the core category an overarching explanatory power. The knowledge from this study may be a relevant contribution when it comes to designing new courses that support continuing professional development for EPS counsellors, whether for post-graduate university courses or local courses at the EPS offices or whether in Norway or other countries in the world.

Keywords: constructing and circulating knowledge, educational-psychological counsellor, higher education, professional development

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Authors: Umeda Junaydova

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Legal aid is a key element of access to justice. According to UN Principles and Guidelines on Access to Legal Aid in Criminal Justice Systems, state members bear the obligation to put in place accessible, effective, sustainable, and credible legal aid systems. Regarding this obligation, developing countries, such as Tajikistan, faced challenges in terms of financing this system. Thus, many developed nations have launched rule-of-law programs to support these states and ensure access to justice for all. Following independence from the Soviet Union, Tajikistan committed to introducing the rule of law and providing access to justice. This newly established country was weak, and the sudden outbreak of civil war aggravated the situation even more. The country needed external support and opened its door to attract foreign donors to assist it in its way to development. In 2015, Tajikistan, with the financial support of development partners, was able to establish a state-funded legal aid system that provides legal assistance to vulnerable and marginalized populations, including in criminal cases. In the beginning, almost the whole system was financed from donor funds; by that time, the contribution of the government gradually increased, and currently, it covers 80% of the total budget. All these governments' actions toward ensuring access to criminal legal aid for disadvantaged groups look promising; however, the reality is completely different. Currently, not all disadvantaged people are covered by these services, and their cases are most of the time considered without appropriate defense, which leads to violation of fundamental human rights. This research presents a comprehensive exploration of the interplay between donor assistance and the effectiveness of legal aid services in Tajikistan, with a specific focus on criminal cases involving vulnerable groups, such as women and children. In the context of Tajikistan, this study addresses a pressing concern: despite substantial financial support from international donors, state-funded legal aid services often fall short of meeting the needs of poor and vulnerable populations. The study delves into the underlying complexities of this issue and examines the structural, operational, and systemic challenges faced by legal aid providers, shedding light on the factors contributing to the ineffectiveness of legal aid services. Furthermore, it seeks to identify the root causes of these issues, revealing the barriers that hinder the delivery of adequate legal aid services. The research adopts a socio-legal methodology to ensure an appropriate combination of multiple methodologies. The findings of this research hold significant implications for both policymakers and practitioners, offering insights into the enhancement of legal aid services and access to justice for disadvantaged and marginalized populations in Tajikistan. By addressing these pressing questions, this study aims to fill the gap in legal literature and contribute to the development of a more equitable and efficient legal aid system that better serves the needs of the most vulnerable members of society.

Keywords: access to justice, legal aid, rule of law, rights for council

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Authors: Krupali Mukeshkumar, Jinesh Shah

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Background: Bilateral Sagittal Split Osteotomy (BSSO), used for the correction of mandibular deformities, is a common oral and maxillofacial surgical procedure. Inferior alveolar nerve dysfunction is commonly reported post-operatively by patients as paresthesia or anesthesia. The current literature lacks a consensus on the incidence of inferior alveolar nerve dysfunction as patients are not routinely assessed pre and post-operatively with an objective assessment. The range of incidence varies from 9% to 85% of patients, with some authors arguing that 100% of patients experience nerve dysfunction immediately post-surgery. Systematic reviews have shown a difference between incidence rates at different follow-up periods using objective and subjective methods. Aim: To identify the incidence of inferior alveolar nerve dysfunction following BSSO. Gold standard: Nerve dysfunction incidence rates similar or lower than current literature of 83% day one post-operatively and 18.4% at one year follow up. Setting: A retrospective cross-sectional audit of patients treated between 2017-2019 at the Royal Stoke University Hospital, Maxillofacial and Orthodontic departments. Sample: All patients who underwent a BSSO (with or without le fort one osteotomy) between 2017–2019 were identified from the database. Patients with pre-existing neurosensory disturbance, those who had a genioplasty at the same time and those with no follow-up were excluded. The sample consisted of 121 patients, 37 males and 84 females between the ages of 17-50 years at the time of surgery. Methods: Clinical records of 121 cases were reviewed to assess the age, sex, type of mandibular osteotomy, status of the nerve during the surgical procedure, type of bony split and incidence of nerve dysfunction at follow-up appointments. The surgical procedure was carried out by three Maxillo-facial surgeons and follow-up appointments were carried out in the Orthodontic and Oral and Maxillo-facial departments. Results: 120 patients were treated to correct the mandibular facial deformity and 1 patient was treated for sleep apnoea. Seventeen patients had a mandibular setback and 104 patients had mandibular advancement. 68 patients reported inferior alveolar nerve dysfunction at one week following their surgery. Seventy-six patients had temporary paresthesia present between 2 weeks and 12 months post-surgery. 13 patients had persistent nerve dysfunction at 12 months, of which 1 had a bad bony split during the BSSO. The incidence of nerve dysfunction postoperatively was 6.6% after 1 day, 56.1% at 1 week, 62.8% at 2 weeks, 59.5% between 3-6 weeks, 43.0% between 8-16 weeks and 10.7% at 1 year. Conclusions: The results of this audit show a similar incidence rate to the research gold standard at the one-year follow-up. Future Recommendations: No changes to surgical procedure or technique are indicated, but a need for improved documentation and a standardized approach for assessment of post-operative nerve dysfunction would be beneficial.

Keywords: bilateral sagittal split osteotomy, inferior alveolar nerve, mandible, nerve dysfunction

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Authors: Maria Reznakova, Michala Strnadova, Lukas Reznak

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Successful achievement of strategic goals requires an effective performance management system, i.e. determining the appropriate indicators measuring the rate of goal achievement. Assuming that the goal of the owners is to grow the assets they invested in, it is vital to identify the key performance indicators, which contribute to value creation. These indicators are known as value drivers. Based on the undertaken literature search, a value driver is defined as any factor that affects the value of an enterprise. The important factors are then monitored by both financial and non-financial indicators. Financial performance indicators are most useful in strategic management, since they indicate whether a company's strategy implementation and execution are contributing to bottom line improvement. Non-financial indicators are mainly used for short-term decisions. The identification of value drivers, however, is problematic for companies which are not publicly traded. Therefore financial ratios continue to be used to measure the performance of companies, despite their considerable criticism. The main drawback of such indicators is the fact that they are calculated based on accounting data, while accounting rules may differ considerably across different environments. For successful enterprise performance management it is vital to avoid factors that may reduce (or even destroy) its value. Among the known factors reducing the enterprise value are the lack of capital, lack of strategic management system and poor quality of production. In order to gain further insight into the topic, the paper presents results of the research identifying factors that adversely affect the performance of mechanical engineering enterprises in the Czech Republic. The research methodology focuses on both the qualitative and the quantitative aspect of the topic. The qualitative data were obtained from a questionnaire survey of the enterprises senior management, while the quantitative financial data were obtained from the Analysis Major Database for European Sources (AMADEUS). The questionnaire prompted managers to list factors which negatively affect business performance of their enterprises. The range of potential factors was based on a secondary research – analysis of previously undertaken questionnaire surveys and research of studies published in the scientific literature. The results of the survey were evaluated both in general, by average scores, and by detailed sub-analyses of additional criteria. These include the company specific characteristics, such as its size and ownership structure. The evaluation also included a comparison of the managers’ opinions and the performance of their enterprises – measured by return on equity and return on assets ratios. The comparisons were tested by a series of non-parametric tests of statistical significance. The results of the analyses show that the factors most detrimental to the enterprise performance include the incompetence of responsible employees and the disregard to the customers‘ requirements.

Keywords: business value, financial ratios, performance measurement, value drivers

Procedia PDF Downloads 204