Search results for: global surgery

Authors: Michael Picard

Abstract:

This proposal offers to shed light on the changing legal geography of the global waste economy. Global waste recycling has become a multi-billion-dollar industry. NASDAQ predicts the emergence of a worldwide 1,296G$ waste management market between 2017 and 2022. Underlining this evolution, a new generation of preferential waste-trade agreements has emerged in the Pacific. In the last decade, Japan has concluded a series of bilateral treaties with Asian countries, and most recently with China. An agreement between Tokyo and Beijing was formalized on 7 May 2008, which forged an economic partnership on waste transfer and mining. The agreement set up International Recycling Zones, where certified recycling plants in China process industrial waste imported from Japan. Under the joint venture, Chinese companies salvage the embedded value from Japanese industrial discards, reprocess them and send them back to Japanese manufacturers, such as Mitsubishi and Panasonic. This circular economy is designed to convert surplus garbage into surplus value. Ever since the opening of Sino-Japanese eco-parks, millions of tons of plastic and e-waste have been exported from Japan to China every year. Yet, quite unexpectedly, China has recently closed its waste market to imports, jeopardizing Japan’s billion-dollar exports to China. China notified the WTO that, by the end of 2017, it would no longer accept imports of plastics and certain metals. Given China’s share of Japanese waste exports, a complete closure of China’s market would require Japan to find new uses for its recyclable industrial trash generated domestically every year. It remains to be seen how China will effectively implement its ban on waste imports, considering the economic interests at stake. At this stage, what remains to be clarified is whether China's ban on waste imports will negatively affect the recycling trade between Japan and China. What is clear, though, is the rapid transformation in the legal geography of waste mining in East-Asia. For decades, East-Asian waste trade had been tied up in an ‘ecologically unequal exchange’ between the Japanese core and the Chinese periphery. This global unequal waste distribution could be measured by the Environmental Stringency Index, which revealed that waste regulation was 39% weaker in the Global South than in Japan. This explains why Japan could legally export its hazardous plastic and electronic discards to China. The asymmetric flow of hazardous waste between Japan and China carried the colonial heritage of international law. The legal geography of waste distribution was closely associated to the imperial construction of an ecological trade imbalance between the Japanese source and the Chinese sink. Thus, China’s recent decision to ban hazardous waste imports is a sign of a broader ecological shift. As a global economic superpower, China announced to the world it would no longer be the planet’s junkyard. The policy change will have profound consequences on the global circulation of waste, re-routing global waste towards countries south of China, such as Vietnam and Malaysia. By the time the Berlin Conference takes place in May 2018, the presentation will be able to assess more accurately the effect of the Chinese ban on the transboundary movement of waste in Asia.

Keywords: Asia, ecological unequal exchange, global waste trade, legal geography

Procedia PDF Downloads 207

Authors: Samson Olasunkanmi Oluga, Teh Chee Send, Gerard Sagaya Raj Rajo

Abstract:

It is ironical that the national anthems of many nations that are in the forefront of the global condemnation of violence of all forms have portions or expressions that propagate various forms of linguistic violence which advocate attacking opponents, going to war, shedding blood and sacrificing lives. These diametrically contradict contemporary yearnings for global tranquility and the ideals of the United Nations established for the maintenance of international peace and harmony aimed at making the world a safe haven for all and sundry. The linguistic violence of many national anthems is manipulatively constructed /presented via the instrumentality of the figurative or rhetorical language. This helps to linguistically embellish the violent ideas communicated and makes them sound somehow better or logical to the target audience with the intention of cognitively manipulating them to accept or rationalize such violent ideas. This paper, therefore, presents the outcome of a linguistic exploration/examination of national anthems which reveals elements or cases manipulative figurative linguistic violence in the anthems of twenty-one (21) nations. The paper details a Socio-Cognitive Critical Discourse Analysis of the manipulative figures of comparison, contrast, indirectness, association and sound used to convey the linguistic violence of the identified national anthems. Finally, the paper advocates the need for linguistic overhaul of affected anthems so that the language of anthems which epitomize nations can be pacific and in tandem with contemporary global trends.

Keywords: national anthems, linguistic violence, figurative language, cognitive, manipulation, CDA

Procedia PDF Downloads 324

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

Abstract:

Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

Procedia PDF Downloads 89

Authors: Abderrahim El Maslouhi

Abstract:

The paper aims to analyze an often-overlooked dimension of global constitutionalism, which is the rise of the regulatory state and its impact on parliamentary dynamics in transition regimes. In contrast to Majone’s technocratic vision of convergence towards a single regulatory system based on competence and efficiency, national transpositions of regulatory governance and, in general, the relationship to global standards primarily depend upon a number of distinctive parameters. These include policy formation process, speed of change, depth of parliamentary tradition and greater or lesser vulnerability to the normative conditionality of donors, interstate groupings and transnational regulatory bodies. Based on a comparison between three post-Arab Spring countries -Morocco, Tunisia, and Egypt, whose constitutions have undergone substantive review in the period 2011-2014- and some European Union state members, the paper intends, first, to assess the degree of permeability to global constitutionalism in different contexts. A noteworthy divide emerges from this comparison. Whereas European constitutions still seem impervious to the lexicon of global constitutionalism, the influence of the latter is obvious in the recently drafted constitutions in Morocco, Tunisia, and Egypt. This is evidenced by their reference to notions such as ‘governance’, ‘regulators’, ‘accountability’, ‘transparency’, ‘civil society’, and ‘participatory democracy’. Second, the study will provide a contextual account of internal and external rationales underlying the constitutionalization of regulatory governance in the cases examined. Unlike European constitutionalism, where parliamentarism and the tradition of representative government function as a structural mechanism that moderates the de-parliamentarization effect induced by global constitutionalism, Arab constitutional transitions have led to a paradoxical situation; contrary to the public demands for further parliamentarization, the 2011 constitution-makers have opted for a de-parliamentarization pattern. This is particularly reflected in the procedures established by constitutions and regular legislation, to handle the interaction between lawmakers and regulatory bodies. Once the ‘constitutional’ and ‘independent’ nature of these agencies is formally endorsed, the birth of these ‘fourth power’ entities, which are neither elected nor directly responsible to elected officials, will raise the question of their accountability. Third, the paper shows that, even in the three selected countries, the de-parliamentarization intensity is significantly variable. By contrast to the radical stance of the Moroccan and Egyptian constituents who have shown greater concern to shield regulatory bodies from legislatures’ scrutiny, the Tunisian case indicates a certain tendency to provide lawmakers with some essential control instruments (e. g. exclusive appointment power, adversarial discussion of regulators’ annual reports, dismissal power, later held unconstitutional). In sum, the comparison reveals that the transposition of the regulatory state model and, more generally, sensitivity to the legal implications of global conditionality essentially relies on the evolution of real-world power relations at both national and international levels.

Keywords: Arab legislatures, de-parliamentarization, global constitutionalism, normative conditionality, regulatory state

Procedia PDF Downloads 133

Authors: Su-Lin Yu

Abstract:

In recent years, we have witnessed the growing scholarship on transnational theorizing and activism within disability. In particular, the universalizing discourses of disability formulated in the Global North seem inadequate in engaging the vast diversity of discourses of disability that emerge in global and local policies as well as the everyday experiences of disabled people in the Global South. This study will further consider the future possibilities of how Taiwanese and global disability studies might interchange disability knowledge. First, this study will determine how a local literature of disability can be formed in Taiwan by examining life writings written by Taiwanese disabled women. Both the texts and the personal experiences are treated as social products which can, through their discourses, offer insight into the socio-cultural practices and norms of disability and womanhood in Taiwan. This paper argues that more than by the impairment in itself, the experiences of disabled women are shaped by the social and cultural discourses and practices that define disability and womanhood as well as the normative roles, places, and contexts associated with them. Simultaneous analysis of disability and womanhood exemplifies the way in which disability operates in a complex interaction with the socio-cultural discourses and practices of womanhood, thus producing gender-differentiated disabling obstacles for disabled women. Another purpose of this study is to gain an understanding of the transformative experience of women with disabilities and their perceptions of the self. Designed to provide positive, realistic pictures of the lives of women with disabilities and the social, economic, and political issues they face, their life writings demonstrate how they as disabled women simultaneously struggle with writing a new identity and creating an ethical narrative. These strong and articulate women construct narratives that attempt to recount the remarkable journey that transformed them from dependent women to community activists and writers who speak forcefully about the needs of people with disabilities. More than a story of one woman's struggle for independence, their writing, then, is a testimony to the importance of community building and organizing to enable local people with disabilities to live fulfilling lives.

Keywords: gender, disability, representation, agency

Procedia PDF Downloads 295

Authors: Rima A. Ajlouni

Abstract:

The discovery of quasi-periodic structures in material science is revealing an exciting new class of symmetries, which has never been explored before. Due to their unique structural and visual properties, these symmetries are drawing interest from many scientific and design disciplines. Especially, in art and architecture, these symmetries can provide a rich source of geometry for exploring new patterns, forms, systems, and structures. However, the structural systems of these complicated symmetries are still posing a perplexing challenge. While much of their local order has been explored, the global governing system is still unresolved. Understanding their unique global long-range order is essential to their generation and application. The recent discovery of dodecagonal quasi-periodic patterns in historical Islamic architecture is generating a renewed interest into understanding the mathematical principles of traditional Islamic geometry. Astonishingly, many centuries before its description in the modern science, ancient artists, by using the most primitive tools (a compass and a straight edge), were able to construct patterns with quasi-periodic formations. These ancient patterns can be found all over the ancient Islamic world, many of which exhibit formations with 5, 8, 10 and 12 quasi-periodic symmetries. Based on the examination of these historical patterns and derived from the generating principles of Islamic geometry, a global multi-level structural model is presented that is able to describe the global long-range order of dodecagonal quasi-periodic formations in Islamic Architecture. Furthermore, this method is used to construct new quasi-periodic tiling systems as well as generating their deflation and inflation rules. This method can be used as a general guiding principle for constructing infinite patches of dodecagon-based quasi-periodic formations, without the need for local strategies (tiling, matching, grid, substitution, etc.) or complicated mathematics; providing an easy tool for scientists, mathematicians, teachers, designers and artists, to generate and study a wide range of dodecagonal quasi-periodic formations.

Keywords: dodecagonal, Islamic architecture, long-range order, quasi-periodi

Procedia PDF Downloads 400

Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

Abstract:

Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

Procedia PDF Downloads 215

Authors: Mara Balestrieri

Abstract:

Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

Procedia PDF Downloads 69

Authors: Anna Savchenko

Abstract:

The dissolution of the Soviet Union brought about a wave of decolonisation throughout the Soviet space in the 1990s. While this emancipation ushered in an era of reform in the newly independent states, it also opened up the opportunity for countries such as Ukraine to be (re)colonised by a different ruling power: the European Union. Ukraine’s relationship with the EU has been further complicated by the fact that the country’s political leadership has aligned itself with a Western agenda of democratisation. This article challenges the neoliberal belief that the global market can spurn democratisation by analysing the way in which market privatisation in Ukraine has allowed for mass corruption to flourish. I submit that neoliberalism, or the sheer force of the global market, is just as colonising as modern-day imperialism has proven to be by providing an analytical synthesis of Russia and Ukraine’s century-old conflict. The EU’s demonstrated inability to mediate cross-border conflict in the region foreshadows that Ukraine may have been economically colonised by another failing state.

Keywords: neoliberalism, imperealism, Russian-Ukrainian conflict, democratisation, colonisation

Procedia PDF Downloads 180

Authors: Saima Akbar

Abstract:

The global financial crisis severely and adversely impacted the Pakistanis’ financial setups with far-reaching consequences for its victims. This study aimed to analyze the various determinants of the banks’ financial performance in Pakistan. The stepwise multiple regression analysis and pre-post analysis were carried out in this regard by using SPSS ver 22. The study found that the assets quality is the most influential determinant of return over assets followed by bank size and solvency. Advances, liquidity, investments, and size have positive while poor assets quality and deposits have a negative impact on the return over assets. The comparison of the pre-crisis and post-crisis coefficient values of the independent variables revealed that the global financial crisis had exerted a significant impact on the relative ability of the financial performance determinants to explain variations in return over assets.

Keywords: pre-crisis, post-crisis, coefficient values, determinants

Procedia PDF Downloads 270

Authors: Shu Tao

Abstract:

Based on a global fuel consumption data product (PKU-FUEL-2007) compiled recently and a series of databases for emission factors of various sources, global emission inventories of a number of greenhouse gases and air pollutants, including CO2, CO, SO2, NOx, primary particulate matter (total, PM 10, and PM 2.5), black carbon, organic carbon, mercury, volatile organic carbons, and polycyclic aromatic hydrocarbons, from combustion sources have been developed. The inventories feather high spatial and sectorial resolutions. The spatial resolution of the inventories are 0.1 by 0.1 degree, based on a sub-national disaggregation approach to reduce spatial bias due to uneven distribution of per person fuel consumption within countries. The finely resolved inventories provide critical information for chemical transport modeling and exposure modeling. Emissions from more than 60 sources in energy, industry, agriculture, residential, transportation, and wildfire sectors were quantified in this study. With the detailed sectorial information, the inventories become an important tool for policy makers. For residential sector, a set of models were developed to simulate temporal variation of fuel consumption, consequently pollutant emissions. The models can be used to characterize seasonal as well as inter-annual variations in the emissions in history and to predict future changes. The models can even be used to quantify net change of fuel consumption and pollutant emissions due to climate change. The inventories has been used for model ambient air quality, population exposure, and even health effects. A few examples of the applications are discussed.

Keywords: air pollutants, combustion, emission inventory, sectorial information

Procedia PDF Downloads 367

Authors: Peter Carter

Abstract:

Comprehensive climate change indicators and trends inform the state of the climate (system) with respect to present and future climate change scenarios and the urgency of mitigation and adaptation. With data records now going back for many decades, indicator trends can complement model projections. They are provided as datasets by several climate monitoring centers, reviewed by state of the climate reports, and documented by the IPCC assessments. Up-to-date indicators are provided here. Rates of change are instructive, as are extremes. The indicators include greenhouse gas (GHG) emissions (natural and synthetic), cumulative CO2 emissions, atmospheric GHG concentrations (including CO2 equivalent), stratospheric ozone, surface ozone, radiative forcing, global average temperature increase, land temperature increase, zonal temperature increases, carbon sinks, soil moisture, sea surface temperature, ocean heat content, ocean acidification, ocean oxygen, glacier mass, Arctic temperature, Arctic sea ice (extent and volume), northern hemisphere snow cover, permafrost indices, Arctic GHG emissions, ice sheet mass, sea level rise, and stratospheric and surface ozone. Global warming is not the most reliable single metric for the climate state. Radiative forcing, atmospheric CO2 equivalent, and ocean heat content are more reliable. Global warming does not provide future commitment, whereas atmospheric CO2 equivalent does. Cumulative carbon is used for estimating carbon budgets. The forcing of aerosols is briefly addressed. Indicator interactions are included. In particular, indicators can provide insight into several crucial global warming amplifying feedback loops, which are explained. All indicators are increasing (adversely), most as fast as ever and some faster. One particularly pressing indicator is rapidly increasing global atmospheric methane. In this respect, methane emissions and sources are covered in more detail. In their application, indicators used in assessing safe planetary boundaries are included. Indicators are considered with respect to recent published papers on possible catastrophic climate change and climate system tipping thresholds. They are climate-change-policy relevant. In particular, relevant policies include the 2015 Paris Agreement on “holding the increase in the global average temperature to well below 2°C above pre-industrial levels and pursuing efforts to limit the temperature increase to 1.5°C above pre-industrial levels” and the 1992 UN Framework Convention on Climate change, which has “stabilization of greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system.”

Keywords: climate change, climate change indicators, climate change trends, climate system change interactions

Procedia PDF Downloads 100

Authors: Nurudeen Oluwasola Lasisi

Abstract:

The COVID-19 is an infection caused by coronavirus, which has been designated as a pandemic in the world. In this paper, we proposed a model to study the effect of distancing and wearing masks on the transmission of COVID-19 infection dynamics. The invariant region of the model is established. The COVID-19 free equilibrium and the reproduction number of the model were obtained. The local and global stability of the model is determined using the linearization technique method and Lyapunov method. It was found that COVID-19 free equilibrium state is locally asymptotically stable in feasible region Ω if R₀ < 1 and globally asymptomatically stable if R₀ < 1, otherwise unstable if R₀ > 1. More so, numerical analysis and simulations of the dynamics of the COVID-19 infection are presented.

Keywords: distancing, reproduction number, wearing of mask, local and global stability, modelling, transmission

Procedia PDF Downloads 136

Authors: Bavneet Kaur Sidhu, Manoj Tiwari

Abstract:

Global Developmental Delay (GDD) is a common pediatric condition. Etiologies of GDD might, however, differ in developing countries. In the last decade, sporadic families are being reported in various countries. As to the author’s best knowledge, many risk factors and their correlation with the prevalence of GDD have been studied but its statistical correlation has not been done. Thus we propose the present study by targeting the risk factor, prevalence and their statistical correlation with GDD. FMR1 gene was studied to confirm the disease and its penetrance. A complete questionnaire-based performance was designed for the statistical studies having a personal, past and present medical history along with their socio-economic status as well. Methods: We distributed the children’s age in 4 different age groups having 5-year intervals and applied structural equation modeling (SEM) techniques, Spearman’s rank correlation coefficient, Karl Pearson correlation coefficient, and chi-square test.Result: A total of 1100 families were enrolled for this study; among them, 330 were clinically and biologically confirmed (radiological studies) for the disease, 204 were males (61.8%), 126 were females (38.18%). We found that 27.87% were genetic and 72.12 were sporadic, out of 72.12 %, 43.277% cases from urban and 56.72% from the rural locality, the mothers' literacy rate was 32.12% and working women numbers were 41.21%. Conclusions: There is a significant association between mothers' age and GDD prevalence, which is also followed by mothers' literacy rate and mothers' occupation, whereas there was no association between fathers' age and GDD.

Keywords: global developmental delay, FMR1 gene, spearman’ rank correlation coefficient, structural equation modeling

Procedia PDF Downloads 127

Authors: Nisha Budhwar, Sunita Daniel

Abstract:

In this paper, we analyse the stability of the SEIR model of malaria with infective immigrants which was recently formulated by the authors. The model consists of an SEIR model for the human population and SI Model for the mosquitoes. Susceptible humans become infected after they are bitten by infectious mosquitoes and move on to the Exposed, Infected and Recovered classes respectively. The susceptible mosquito becomes infected after biting an infected person and remains infected till death. We calculate the reproduction number R0 using the next generation method and then discuss about the stability of the equilibrium points. We use the Lyapunov function to show the global stability of the equilibrium points.

Keywords: equilibrium points, exposed, global stability, infective immigrants, Lyapunov function, recovered, reproduction number, susceptible

Procedia PDF Downloads 355

Authors: Sandeep Reddy, Sonia Allan, Simon Coghlan, Paul Cooper

Abstract:

Artificial Intelligence (AI) and its application in medicine has generated ample interest amongst policymakers and clinicians. Successes with AI in medical imaging interpretation and clinical decision support are paving the way for its incorporation into routine healthcare delivery. While there has been a focus on the development of ethical principles to guide its application in healthcare, challenges of this application go beyond what ethics principles can address thus requiring robust governance frameworks. Also, while ethical challenges of medical artificial intelligence are being discussed, the ethics of deploying AI in lower-income countries receive less attention than in other developed economies. This creates an imperative not only for sound ethical guidelines but also for robust governance frameworks to regulate AI in medicine around the world. In this article, we discuss what components need to be considered in developing these governance frameworks and who should lead this worldwide effort.

Keywords: artificial intelligence, global health, governance, ethics

Procedia PDF Downloads 144

Authors: Ehsan Ahmed Yahia

Abstract:

Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

Procedia PDF Downloads 95

Authors: Hayden R Schott, John M Felder III

Abstract:

Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

Procedia PDF Downloads 82

Authors: Santhosh Srinivasan, Vipul Garhiya, Shahul Hamid Khan

Abstract:

Environmental performance along with social performance is becoming vital factors for industries to achieve global standards. With a good environmental policy global industries are differentiating them from their competitors. This paper concentrates on multi stage, multi product and multi period manufacturing network. Single objective mathematical models for a total cost for the entire forward supply chain and reverse chain are considered. Here five different problems are considered by varying the number of facilities for illustration. M-MOGA, Shuffle Frog Leaping algorithm (SFLA) and CPLEX are used for finding the optimal solution for the mathematical model.

Keywords: closed loop supply chain, genetic algorithm, random search, multi period, green supply chain

Procedia PDF Downloads 388

Authors: Delphine Duval, Morgan Mangeas, Charlie Huveneers, Adam Barnett, Laurent Vigliola

Abstract:

The global number of shark bites has increased over the past four decades with, however, high regional variability both in space and time. A systematic review, aligned with the 2020 PRISMA guidelines, explored the peer-reviewed literature published between 1960 and 2023 to identify factors potentially explaining trends in human-shark interactions. Results revealed that variations in the frequency of human-shark interactions could be explained by a plethora of factors, including changes in prey availability, environmental conditions, human and shark population density and behavior, as well as habitat destruction. However, to our best knowledge, only five studies have conducted statistical assessments of the relative contribution of these factors. The increased number in human-shark interactions and the frequent clusters of shark bites within short timeframes offer opportunities to test the causative factors that may explain trends in unprovoked shark bites. it study aims to evaluate the impact of marine protected areas (MPAs) on the number of human-shark interactions, using data from the Global Shark Attack File and the World Database on Protected Areas. Results indicate contrasting effects of MPAs at different spatial scales. Enhancing our understanding of the factors contributing to shark bites is essential for improving risk reduction policies for humans and conservation plans for shark populations.

Keywords: unprovoked shark interactions, marine protected areas, attack risk, human-wildlife interaction

Procedia PDF Downloads 37

Authors: Jessica Bain, Greg Thoma, Marty Matlock, Jeyam Subbiah, Ebenezer Kwofie

Abstract:

The environmental impact and particulate matter emissions (PM) associated with the production and packaging of 1 kg of almonds were evaluated using life cycle assessment (LCA). The assessment began at the point of ready to harvest with a system boundary was a cradle-to-gate assessment of almond packaging in California. The assessment included three scenarios of off-ground harvesting of almonds. The three general off-ground harvesting scenarios with variations include the harvested almonds solar dried on a paper tarp in the orchard, the harvested almonds solar dried on the floor in a separate lot, and the harvested almonds dried mechanically. The life cycle inventory (LCI) data for almond production were based on previously published literature and data provided by Almond Board of California (ABC). The ReCiPe 2016 method was used to calculate the midpoint impacts. Using consequential LCA model, the global warming potential (GWP) for the three harvesting scenarios are 2.90, 2.86, and 3.09 kg CO2 eq/ kg of packaged almond for scenarios 1, 2a, and 3a, respectively. The global warming potential for conventional harvesting method was 2.89 kg CO2 eq/ kg of packaged almond. The particulate matter emissions for each scenario per hectare for each off-ground harvesting scenario is 77.14, 9.56, 66.86, and 8.75 for conventional harvesting and scenarios 1, 2, and 3, respectively. The most significant contributions to the overall emissions were from almond production. The farm gate almond production had a global warming potential of 2.12 kg CO2 eq/ kg of packaged almond, approximately 73% of the overall emissions. Based on comparisons between the GWP and PM emissions, scenario 2a was the best tradeoff between GHG and PM production.

Keywords: life cycle assessment, low moisture foods, sustainability, LCA

Procedia PDF Downloads 80

Authors: Ch. Surawut, D. Sukawat

Abstract:

In order to utilize results from global climate models, dynamical and statistical downscaling techniques have been developed. For dynamical downscaling, usually a limited area numerical model is used, with associated high computational cost. This research proposes dynamic equation for specific space-time regional climate downscaling from the Educational Global Climate Model (EdGCM) for Southeast Asia. The equation is for surface air temperature. These equations provide downscaling values of surface air temperature at any specific location and time without running a regional climate model. In the proposed equations, surface air temperature is approximated from ground temperature, sensible heat flux and 2m wind speed. Results from the application of the equation show that the errors from the proposed equations are less than the errors for direct interpolation from EdGCM.

Keywords: dynamic equation, downscaling, inverse distance, weight interpolation

Procedia PDF Downloads 298

Authors: Sophie Mills, Constantinos Aristotelous, Leila L. Touil, Richard C. W. James

Abstract:

Objectives: Historical studies of the anatomy of the spinal accessory nerve (SAN) have reported conflicting results regarding its relationship with the internal jugular vein (IJV). A literature review was undertaken to establish the prevalence of anatomical variations of the SAN encountered during routine neck dissection surgery in order to increase awareness and reduce morbidity associated with iatrogenic SAN injury. Materials and Methods: The largest systematic review to date was performed using PRISMA-ScR guidelines, which yielded nine articles following the application of inclusion and exclusion criteria. A case report is also included, which demonstrates the rare anatomical relationship of the SAN traversing a fenestrated IJV, seen for the first time in the senior author’s career. Results: The mean number of dissections per study was 119, of which 55.6% (n=5) studies were performed on cadaver subjects, and 44.4% (n=4) were surgical dissections. Incidences of the SAN lateral to the IJV and medial to the IJV ranged from 38.9%-95.7% and 2.8%-57.4%, respectively. Over half of the studies reported incidences of the SAN traversing the IJV in 0.9%-2.8% of dissections. One study reported an isolated variant of the SAN dividing around the IJV with a prevalence of 0.5%. Conclusion: At the level of the posterior belly of the digastric muscle, the surgeon can anticipate the identification of the SAN lateral to the IJV in approximately three-quarters of cases, whilst around one-quarter are estimated to be medial. A mean of 1.6% of SANs traverses a fenestration of the vein. It is essential for surgeons to be aware of these anatomical variations and their prevalence to prevent injury to vital structures during surgery.

Keywords: anatomical variant, internal jugular vein, neck dissection, spinal accessory nerve

Procedia PDF Downloads 135

Authors: Ya-Yi Yen

Abstract:

The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

Procedia PDF Downloads 139

Authors: Yaron Covo, Tamar Kofman, Shira Palti

Abstract:

Over the recent decades, debates about the engagement of fans in football governance have focused on the club level and national level, emphasizing the significance of fans’ involvement in increasing the connection of clubs with the community, and in safeguarding the transparency, accountability, and clubs’ financial stability. This paper will offer a different conceptual justification for providing fans with access to decision-making processes in football. First, it will suggest that the participation of fans is necessary for addressing discriminatory practices against women in football stadiums. Second, it will argue that fans’ involvement in football governance is important not only at the club and national level but also at the global level, relying on the principles of Global Administrative Law. In contemporary men’s football, female fans face different forms of discrimination. Iranian women are still prohibited from attending football games at the domestic level; In Saudi Arabia, female fans are only permitted to enter designated family areas; Qatar – the host of the 2022 FIFA world cup – requires women to attend matches wearing modest clothing. Similarly, in Turkey, Lebanon, UAE, and Algeria, women face cultural barriers when attending men’s football games. In other countries, female fans suffer from subtle discrimination, including micro-aggressions, misogyny, sexism, and noninstitutionalized exclusion. Despite the vital role of fans in world football and the importance of football for many women’s lives, little has been done to address this problem. While FIFA recognizes that these discriminatory practices contradict its statutes, this recognition fails to materialize into meaningful change. This paper will argue that FIFA’s omission stems from two interrelated characteristics of world football: (1) the ultra-masculine nature of the game; (2) the insufficient recognition of fans’ significance. While fans have been given a voice in various football bodies on the domestic level, FIFA has yet to allow the representation of fans as stakeholders in world football governance. Since fans are a more heterogeneous group than players, the voices of those fans who do not fit the ultra-masculine model are not heard. Thus, by focusing mainly on male players, FIFA reproduces the hegemonic masculinity that feeds back into fan dynamics and marginalizes female fans. To rectify this problem, we will call on FIFA to provide fans and female fans in particular, with voice mechanisms and access to decision-making processes. In addition to its impact on the formation of fans’ identities, such a move will allow fans to demand better enforcement of existing anti-discrimination norms and new regulations to address their needs. The literature has yet to address the relationship between fans’ gender discrimination and global football governance. Building on Global Administrative Law scholarship and feminist theories, this paper will aim to fill this gap.

Keywords: fans, FIFA, football governance, gender discrimination, global administrative law, human rights

Procedia PDF Downloads 145

Authors: Jonathan De Rothewelle

Abstract:

A pandemic, such as that of COVID-19, can be a time of panic and stress; concerns about health supersede others such as work and leisure. With such concern comes the seeking of crucial information— information that, during a global health crisis, could mean the difference between life and death. Whether newspapers, cable news, or radio, media plays an important role in the transmission of medical information to the general public. Moreover, the news media in particular must uphold its obligation to the public to only disseminate factual, useful information. The circulation of misinformation, whether explicit or implicit, may profoundly impact global health. Using a discursive analytic framework founded in linguistics, the images and headlines of top coverage of COVID-19 from the most influential media outlets will be examined. Micro-analyses reveal what may be interpreted as evidence of sensationalism, which may be argued to a form of misinformation, and ultimately a departure from ethical media. Withdrawal from responsible reporting and publishing, expressly in times of epidemic, may cause further confusion and panic.

Keywords: public health, pandemic, public education, media

Procedia PDF Downloads 145

Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

Procedia PDF Downloads 99

Authors: Mansour H. Alkmim, Adriano T. Fabro, Marcus V. G. De Morais

Abstract:

In this paper, a global direct search optimization algorithm to reduce vibration of a tuned liquid column damper (TLCD), a class of passive structural control device, is presented. The objective is to find optimized parameters for the TLCD under stochastic load from different wind power spectral density. A verification is made considering the analytical solution of an undamped primary system under white noise excitation. Finally, a numerical example considering a simplified wind turbine model is given to illustrate the efficacy of the TLCD. Results from the random vibration analysis are shown for four types of random excitation wind model where the response PSDs obtained showed good vibration attenuation.

Keywords: generalized pattern search, parameter optimization, random vibration analysis, vibration suppression

Procedia PDF Downloads 272

Authors: Kayla Youhanaie, Kenneth Dott, Greg Gillis-Smith

Abstract:

Access to clean water is a global challenge that affects nearly one-third of the world’s population. A lack of safe drinking water negatively affects a person’s health, safety, and economic status. However, many regions of the world that face this clean water challenge also have high solar energy potential. To address this worldwide issue and utilize available resources, a solar-powered water purification device was developed that could be implemented in communities around the world that lack access to potable water. The device uses ozone to destroy water-borne pathogens and sand filtration to filter out particulates from the water. To select the best method for this application, a quantitative energy efficiency comparison of three water purification methods was conducted: heat, UV light, and ozone. After constructing an initial prototype, the efficacy of the device was tested using agar petri dishes to test for bacteria growth in treated water samples at various time intervals after applying the device to contaminated water. The results demonstrated that the water purification device successfully removed all bacteria and particulates from the water within three minutes, making it safe for human consumption. These results, as well as the proposed design that utilizes widely available resources in target communities, suggest that the device is a sustainable solution to address the global water crisis and could improve the quality of life for millions of people worldwide.

Keywords: clean water, solar powered water purification, ozonation, sand filtration, global water crisis

Procedia PDF Downloads 67

Authors: Jihye Jeon

Abstract:

This paper analyzes the political and economic issues that people with disabilities face related to globalization; how people with disabilities have been adapting globalization and surviving under worldwide competition system. It explains that economic globalization exacerbates inequality and deprivation of people with disabilities. The rising tide of neo-liberal welfare policies emphasized efficiency, downsized social expenditure for people with disabilities, excluded people with disabilities against labor market, and shifted them from welfare system to nothing. However, there have been people with disabilities' political responses to globalization, which are characterized by a global network of people with disabilities as well as participation to global governance. Their resistance can be seen as an attempt to tackle the problems that economic globalization has produced. It is necessary paradigm shift of disability policy from dependency represented by disability benefits to independency represented by labor market policies for people with disabilities.

Keywords: economic globalization, people with disability, deprivation, welfare cut, disability right movement, resistance

Procedia PDF Downloads 458