Search results for: general surgery
5142 Survival Analysis after a First Ischaemic Stroke Event: A Case-Control Study in the Adult Population of England.
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.
Procedia PDF Downloads 1845141 Anxiety and Self-Perceived L2 Proficiency: A Comparison of Which Can Better Predict L2 Pronunciation Performance
Authors: Jiexuan Lin, Huiyi Chen
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The development of L2 pronunciation competence remains understudied in the literature and it is not clear what may influence learners’ development of L2 pronunciation. The present study was an attempt to find out which of the two common factors in L2 acquisition, i.e., foreign language anxiety or self-perceived L2 proficiency, can better predict Chinese EFL learners’ pronunciation performance. 78 first-year English majors, who had received a three-month pronunciation training course, were asked to 1) fill out a questionnaire on foreign language classroom anxiety, 2) self-report their L2 proficiency in general, in speaking and in pronunciation, and 3) complete an oral and a written test on their L2 pronunciation (the score of the oral part indicates participants’ pronunciation proficiency in oral production, and the score of the written part indexes participants’ ability in applying pronunciation knowledge in comprehension.) Results showed that the pronunciation scores were negatively correlated with the anxiety scores, and were positively correlated with the self-perceived pronunciation proficiency. But only the written scores in the L2 pronunciation test, not the oral scores, were positively correlated with the L2 self-perceived general proficiency. Neither the oral nor the written scores in the L2 pronunciation test had a significant correlation with the self-perceived speaking proficiency. Given the fairly strong correlations, the anxiety scores and the self-perceived pronunciation proficiency were put in regression models to predict L2 pronunciation performance. The anxiety factor alone accounted for 13.9% of the variance and the self-perceived pronunciation proficiency alone explained 12.1% of the variance. But when both anxiety scores and self-perceived pronunciation proficiency were put in a stepwise regression model, only the anxiety scores had a significant and unique contribution to the L2 pronunciation performance (4.8%). Taken together, the results suggested that the learners’ anxiety level could better predict their L2 pronunciation performance, compared with the self-perceived proficiency levels. The obtained data have the following pedagogical implications. 1) Given the fairly strong correlation between anxiety and L2 pronunciation performance, the instructors who are interested in predicting learners’ L2 pronunciation proficiency may measure their anxiety level, instead of their proficiency, as the predicting variable. 2) The correlation of oral scores (in the pronunciation test) with pronunciation proficiency, rather than with speaking proficiency, indicates that a) learners after receiving some amounts of training are to some extent able to evaluate their own pronunciation ability, implying the feasibility of incorporating self-evaluation and peer comments in course instruction; b) the ‘proficiency’ measure used to predict pronunciation performance should be used with caution. The proficiency of specific skills seemingly highly related to pronunciation (i.e., speaking in this case) may not be taken for granted as an effective predictor for pronunciation performance. 3) The correlation between the written scores with general L2 proficiency is interesting.Keywords: anxiety, Chinese EFL learners, L2 pronunciation, self-perceived L2 proficiency
Procedia PDF Downloads 3595140 Global Health Access to Reproductive Care: Vesicovaginal Fistulas and Obstetrics in Pakistan
Authors: Aena Iqbal
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The lack of access to maternal and reproductive health in Pakistan poses a great threat to global public health. Obstetric issues, including vesicovaginal fistulas (VVF), are the most common in South Asian countries, leaving women in a more vulnerable state. Koohi Goth Women’s Hospital offers free VVF operations, which draws in women from all over Pakistan. Although reproductive health is being handled, mental health is often neglected in these scenarios. Using a series of questions inspired by the Warwick Edinburgh Model, this paper builds on the results from interviewing women who have received vesicovaginal fistula repair surgery on their mental health, a taboo topic in Pakistan.Keywords: obstetrics, VVF, Pakistan, reproductive health
Procedia PDF Downloads 1045139 Barrier Membrane Influence Histology of Guided Bone Regenerations: A Systematic Review and Meta-Analysis
Authors: Laura Canagueral-Pellice, Antonio Munar-Frau, Adaia Valls-Ontanon, Joao Carames, Federico Hernandez-Alfaro, Jordi Caballe-Serrano
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Objective: Guided bone regeneration (GBR) aims to replace the missing bone with a new structure to achieve long-term stability of rehabilitations. The aim of the present systematic review and meta-analysis is to determine the effect of barrier membranes on histological outcomes after GBR procedures. Moreover, the effect of the grafting material and tissue gain were analyzed. Materials & methods: Two independent reviewers performed an electronic search in Pubmed and Scopus, identifying all eligible publications up to March 2020. Only randomized controlled trials (RCTs) assessing a histological analysis of augmented areas were included. Results: A total of 6 publications were included for the present systematic review. A total of 110 biopsied sites were analysed; 10 corresponded to vertical bone augmentation procedures, whereas 100 analysed horizontal regeneration procedures. A mean tissue gain of 3 ± 1.48mm was obtained for horizontal defects. Histological assessment of new bone formation, residual particle and sub-epithelial connective tissue (SCT) was reported. The four main barrier membranes used were natural collagen membranes, e-PTFE, polylactic resorbable membranes and acellular dermal matrix membranes (AMDG). The analysis demonstrated that resorbable membranes result in higher values of new bone formation and lower values of residual particles and SCT. Xenograft resulted in lower new bone formation compared to allograft; however, no statistically significant differences were observed regarding residual particle and SCT. Overall, regeneration procedures adding autogenous bone, plasma derivate or growth factors achieved in general greater new bone formation and tissue gain. Conclusions: There is limited evidence favoring the effect of a certain type of barrier membrane in GBR. Data needs to be evaluated carefully; however, resorbable membranes are correlated with greater new bone formation values, especially when combined with allograft materials and/or the addition of autogenous bone, platelet reach plasma (PRP) or growth factors in the regeneration area. More studies assessing the histological outcomes of different GBR protocols and procedures testing different biomaterials are needed to maximize the clinical and histological outcomes in bone regeneration science.Keywords: barrier membrane, graft material, guided bone regeneration, implant surgery, histology
Procedia PDF Downloads 1505138 Legal Interpretation of the Transplanted Law
Authors: Wahyu Kurniawan
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Indonesia developed the legal system radically since 1999. Several laws have been established and mostly the result of transplantation. Laws were made general but legal problems have been growing. In the legal enforcement, the judges have authority to interpret the laws. Authority and freedom are the source of corruption by the courts in Indonesia. Therefore, it should be built the conceptual framework to interpret the transplanted laws as the legal basis in deciding the cases. This article describes legal development based on interpretation of transplanted law in Indonesia by using the Indonesian Supervisory Commission for Business Competition (KPPU) decisions between 2000 and 2010 as the object of the research. The study was using law as a system theory and theories of legal interpretation especially the static and dynamic interpretations. The research showed that the KPPU interpreted the concept that exists in the Competition Law by using static and dynamic interpretation. Static interpretation was used to interpret the legal concepts based on two grounds, minute of meeting during law making process and the definitions that have been recognized in the Indonesian legal system. Dynamic interpretation was used when the KPPU developing the definition of the legal concepts. The general purpose of the law and the theories of the basis of the law were the conceptual framework in using dynamic interpretation. There are two recommendations in this article. Firstly, interpreting the laws by the judges should be based on the correct conceptual framework. Secondly, the technique of interpreting the laws would be the method of controlling the judges.Keywords: legal interpretation, legal transplant, competition law, KPPU
Procedia PDF Downloads 3415137 The Role of Counselling Psychology on Expatriate Adjustment in East Asia: A Systematic Review
Authors: Panagiotis Platanitis
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Purpose: This research paper seeks to review the empirical studies in the field of expatriate adjustment in East Asia in order to produce a thematic understanding of the current adjustment challenges, thus enabling practitioners to enrich their knowledge. Background: Learning to live, work, and function in a country and culture vastly different from that of one’s upbringing can pose some unique challenges in terms of adaptation and adjustment. This has led to a growing body of research about the adjustment of expatriate workers. Adjustment itself has been posited as a three-dimensional construct; work adjustment, interaction adjustment and general or cultural adjustment. Methodology: This qualitative systematic review has been conducted on all identified peer-reviewed empirical studies related to expatriate adjustment in East Asia. Five electronic databases (PsychInfo, Emerald, Scopus, EBSCO and JSTOR) were searched to December 2015. Out of 625 identified records, thorough evaluation for eligibility resulted in 15 relevant studies being subjected to data analysis. The quality of the identified research was assessed according to the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. The data were analysed by means of thematic synthesis for systematic reviews of qualitative research. Findings: Data analysis revealed five key themes. The themes developed were: (1) personality traits (2) types of adjustment, (3) language, (4) culture and (5) coping strategies. Types of adjustment included subthemes such as: Interaction, general, work, psychological, sociocultural and cross-cultural adjustment. Conclusion: The present review supported previous literature on the different themes of adjustment and it takes the focus from work and general adjustment to the psychological challenges and it introduces the psychological adjustment. It also gives a different perspective about the use of cross-cultural training and the coping strategies expatriates use when they are abroad. This review helps counselling psychologists to understand the importance of a multicultural approach when working with expatriates and also to be aware of what expatriates might face when working and living in East Asia.Keywords: adjustment, counselling psychology, East Asia, expatriates
Procedia PDF Downloads 2655136 Conformal Invariance and F(R,T) Gravity
Authors: P. Y. Tsyba, O. V. Razina, E. Güdekli, R. Myrzakulov
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In this paper, we consider the equation of motion for the F(R,T) gravity on their property of conformal invariance. It is shown that in the general case such a theory is not conformally invariant. Special cases for the functions v and u, in which the properties of the theory can appear, were studied.Keywords: conformal invariance, gravity, space-time, metric
Procedia PDF Downloads 6605135 Estimating Age In Deceased Persons From The North Indian Population Using Ossification Of The Sternoclavicular Joint
Authors: Balaji Devanathan, Gokul G, Raveena Divya, Abhishek Yadav, Sudhir K.Gupta
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Background: Age estimation is a common problem in administrative settings, medico legal cases, and among athletes competing in different sports. Age estimation is a problem in medico legal problems that arise in hospitals when there has been a criminal abortion, when consenting to surgery or a general physical examination, when there has been infanticide, impotence, sterility, etc. Medical imaging progress has benefited forensic anthropology in various ways, most notably in the area of determining bone age. An efficient method for researching the epiphyseal union and other differences in the body's bones and joints is multi-slice computed tomography. There isn't a significant database on Indians available. So to obtain an Indian based database author has performed this original study. Methodologies: The appearance and fusion of ossification centre of sternoclavicular joint is evaluated, and grades were assigned accordingly. Using MSCT scans, we examined the relationship between the age of the deceased and alterations in the sternoclavicular joint during the appearance and union in 500 instances, 327 men and 173 females, in the age range of 0 to 25 years. Results: According to our research in both the male and female groups, the ossification centre for the medial end of the clavicle first appeared between the ages of 18.5 and 17.1 respectively. The age range of the partial union was 20.4 and 20.2 years old. The earliest age of complete fusion was 23 years for males and 22 years for females. For fusion of their sternebrae into one, age range is 11–24 years for females and 17–24 years. The fusion of the third and fourth sternebrae was completed by 11 years. The fusions of the first and second and second and third sternebrae occur by the age of 17 years. Furthermore, correlation and reliability were carried out which yielded significant results. Conclusion: With numerous exceptions, the projected values are consistent with a large number of the previously developed age charts. These variations may be caused by the ethnic or regional heterogeneity in the ossification pattern among the population under study. The pattern of bone maturation did not significantly differ between the sexes, according to the study. The study's age range was 0 to 25 years, and for obvious reasons, the majority of the occurrences occurred in the last five years, or between 20 and 25 years of age. This resulted in a comparatively smaller study population for the 12–18 age group, where age estimate is crucial because of current legal requirements. It will require specialized PMCT research in this age range to produce population standard charts for age estimate. The medial end of the clavicle is one of several ossification foci that are being thoroughly investigated since they are challenging to assess with a traditional X-ray examination. Combining the two has been shown to be a valid result when it comes to raising the age beyond eighteen.Keywords: age estimation, sternoclavicular joint, medial clavicle, computed tomography
Procedia PDF Downloads 445134 Electromyographic Analysis of Biceps Brachii during Golf Swing and Review of Its Impact on Return to Play Following Tendon Surgery
Authors: Amin Masoumiganjgah, Luke Salmon, Julianne Burnton, Fahimeh Bagheri, Gavin Lenton, S. L. Ezekial Tan
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Introduction: The incidence of proximal biceps tenodesis and acute distal biceps repair is increasing, and rehabilitation protocols following both are variable. Golf is a popular sport within Australia, and the Gold Coast has become a Mecca for golfers, with more courses per capita than anywhere else in the world. Currently, there are no clear guidelines regarding return to golf play following biceps procedures. The aim of this study was to determine biceps brachii activation during the golf swing through electromyographic analysis, and subsequently, aid in rehabilitation guidelines and return to golf following tenodesis and repair. Methods: Subjects were amateur golfers with no previous upper limb surgery. Surface electromyography (EMG) and high-speed video recording were used to analyse activation of the left and right biceps brachii and the anterior deltoid during the golf swing. Each participant’s maximum voluntary contraction (MVC) was recorded, and they were then required to hit a golf ball aiming for specific distances of 2, 50, 100 and 150 metres at a driving range. Noraxon myoResearch and Matlab were used for data analysis. Mean % MVC was calculated for leading and trailing arms during the full swing and its’ 4 phases: back-swing, acceleration, early follow-through and late follow-through. Results: 12 golfers (2 female and 10 male), participated in the study. Median age was 27 (25 – 38), with all being right handed. Over all distances, the mean activation of the short and long head of biceps brachii was < 10% through the full swing. When breaking down the 50, 100 and 150m swing into phases, mean MVC activation was lowest in backswing (5.1%), followed by acceleration (9.7%), early follow-through (9.2%), and late follow-through (21.4%). There was more variation and slightly higher activation in the right biceps (trailing arm) in backswing, acceleration, and early follow-through; with higher activation in the leading arm in late follow-through (25.4% leading, 17.3% trailing). 2m putts resulted in low MVC values (3.1% ) with little variation across swing phases. There was considerable individual variation in results – one tense subject averaged 11.0% biceps MVC through the 2m putting stroke and others recorded peak mean MVC biceps activations of 68.9% at 50m, 101.3% at 100m, and 111.3% at 150m. Discussion: Previous studies have investigated the role of rotator cuff, spine, and hip muscles during the golf swing however, to our knowledge, this is the first study that investigates the activation of biceps brachii. Many rehabilitation programs following a biceps tenodesis or repair allow active range against gravity and restrict strengthening exercises until 6 weeks, and this does not appear to be associated with any adverse outcome. Previous studies demonstrate a range of < 10% MVC is similar to the unloaded biceps brachii during walking(1), active elbow flexion with the hand positioned either in pronation or supination will produce MVC < 20% throughout range(2) and elbow flexion with a 4kg dumbbell can produce mean MVC’s of around 40%(3). Our study demonstrates that increasing activation is associated with the leading arm, increasing shot distance and the late follow-through phase. Although the cohort mean MVC of the biceps brachii is <10% through the full swing, variability is high and biceps activation reach peak mean MVC’s of over 100% in different swing phases for some individuals. Given these EMG values, caution is advised when advising patients post biceps procedures to return to long distance golf shots, particularly when the leading arm is involved. Even though it would appear that putting would be as safe as having an unloaded hand out of a sling following biceps procedures, the variability of activation patterns across different golfers would lead us to caution against accelerated golf rehabilitation in those who may be particularly tense golfers. The 50m short iron shot was too long to consider as a chip shot and more work can be done in this area to determine the safety of chipping.Keywords: electromyographic analysis, biceps brachii rupture, golf swing, tendon surgery
Procedia PDF Downloads 795133 Effects of in silico (Virtual Lab) And in vitro (inside the Classroom) Labs in the Academic Performance of Senior High School Students in General Biology
Authors: Mark Archei O. Javier
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The Fourth Industrial Revolution (FIR) is a major industrial era characterized by the fusion of technologies that is blurring the lines between the physical, digital, and biological spheres. Since this era teaches us how to thrive in the fast-paced developing world, it is important to be able to adapt. With this, there is a need to make learning and teaching in the bioscience laboratory more challenging and engaging. The goal of the research is to find out if using in silico and in vitro laboratory activities compared to the conventional conduct laboratory activities would have positive impacts on the academic performance of the learners. The potential contribution of the research is that it would improve the teachers’ methods in delivering the content to the students when it comes to topics that need laboratory activities. This study will develop a method by which teachers can provide learning materials to the students. A one-tailed t-Test for independent samples was used to determine the significant difference in the pre- and post-test scores of students. The tests of hypotheses were done at a 0.05 level of significance. Based on the results of the study, the gain scores of the experimental group are greater than the gain scores of the control group. This implies that using in silico and in vitro labs for the experimental group is more effective than the conventional method of doing laboratory activities.Keywords: academic performance, general biology, in silico laboratory, in vivo laboratory, virtual laboratory
Procedia PDF Downloads 1885132 Design and Development of Motorized Placer for Balloon Uterine Stents in Gynecology
Authors: Metehan Mutlu, Meltem Elitas
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This study aims to provide an automated method for placing the balloon uterine stents after hysteroscopy adhesiolysis. Currently, there are no automatized tools to place the balloon uterine stent; therefore, surgeons into the endometrial cavity manually fit it. However, it is very hard to pass the balloon stent through the cervical canal, which is roughly 10mm after the surgery. Our method aims to provide an effective and practical way of placing the stent, by automating the procedure through our designed device. Furthermore, our device does the required tasks fast compared to traditional methods, reduces the narcosis time, and decreases the bacterial contamination risks.Keywords: balloon uterine stent, endometrial cavity, hysteroscopy, motorized-tool
Procedia PDF Downloads 2755131 An Investigation of the Barriers to E-Business Implementation in Small and Medium-Sized Enterprises
Authors: Jeffrey Chang, Barun Dasgupta
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E-business technologies, whereby business transactions are conducted remotely using the Internet, present unique opportunities and challenges for business. E-business technologies are applicable to a wide range of organizations and small and medium-sized enterprises (SMEs) are no exception. There is an established body of literature about e-business, looking at definitions, concepts, benefits and challenges. In general, however, the research focus has been on larger organizations, not SMEs. In an attempt to redress the balance of research, this paper looks at e-business technologies specifically from a small business perspective. It seeks to identify the possible barriers that SMEs might face when considering adoption of the e-business concept and practice as part of their business process change initiatives and implementation. To facilitate analysis of these barriers a conceptual framework has been developed which outlines the key conceptual and practical challenges of e-business implementation in SMEs. This is developed following a literature survey comprised of three categories: characteristics of SMEs, issues of IS/IT use in SMEs and general e-business adoption and implementation issues. The framework is then empirically assessed against 7 SMEs who have yet to implement e-business or whose e-business efforts have been unsatisfactory. Conclusions from the case studies can be used to verify the framework, and set parameters for further larger scale empirical investigation.Keywords: business process change, disruptive technologies, electronic business (e-Business), electronic commerce (e-Commerce), ICT adoption, small and medium sized enterprises (SMEs)
Procedia PDF Downloads 5365130 A Comparative Study to Evaluate Changes in Intraocular Pressure with Thiopentone Sodium and Etomidate in Patients Undergoing Surgery for Traumatic Brain Injury
Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur
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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.Keywords: etomidate, intraocular pressure, thiopentone, traumatic
Procedia PDF Downloads 1245129 The Mediating Effect of Taxpayers’ Compliance on Internal Business Process-Tax Revenue Relationship: A Case Study at the Directorate General of Taxation in Indonesia
Authors: Efrizal, Ferdiansyah, Noorlailie Soewarno, Bambang Tjahjadi
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Tax revenue plays an important role in the State Budget of the Government of Indonesia (GOI). The GOI keeps raising tax revenue portion of the Budget from year to year. The low tax ratio of 11 percent in Indonesia shows a big opportunity to collect taxes in the future. The Directorate General of Taxation (DGT) is the institution mandated by the Law to collect tax revenue. This is a case study using quantitative and qualitative approaches. This study introduces contingent factors of taxpayers’ compliance as the mediating variable and internal business process as the independent variable. This study aims to empirically test the contingency theory, especially the mediating effect of taxpayers’ compliance on internal business process-tax revenue relationship. Internal business processes of the DGT include servicing, counseling, expanding, supervising, inspecting, and enforcing. The secondary data of 31 regional offices representing 293 tax offices in Indonesia was collected and analyzed using Partial Least Square. The result showed the following: (1) internal business process affected tax revenue; (2) taxpayers’ compliance did not mediate internal business processes - tax revenue relationship, and (3) taxpayers’ compliance affected tax revenue. In-depth interviews revealed that the DGT needs to make more innovations in business processes in the future.Keywords: innovations, internal business process, taxpayers’ compliance, tax revenue
Procedia PDF Downloads 3555128 The Psychological Significance of Cultural and Religious Values Among the Arab Population
Authors: Michel Mikhail
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Introduction: Values, which are the guiding principles and beliefs of our lives, have an influence on one’s psychological health. This study aims to investigate how Schwartz’s four higher-order values (conservation, openness to change, self-transcendence, and self-enhancement) and religious values influence psychological health among the Arab population. Methods: A total of 1,023 respondents from nine Arab countries aged 18 to 71 filled out an online survey with measures of the following constructs: Schwartz’s four higher-order values (Portrait Value Questionnaire-21), religious values (Sahin’s Index of Islamic Moral Values), and general psychological health (General Health Questionnaire-28). Results: Two models of multiple regression were conducted to investigate the relationships between values and psychological health. Higher conservation, self-enhancement, and religious values were significantly associated with better psychological health, with conservation losing significance after adding religious values to the model. All of Schwartz’s four values were found to have a significant relationship with religious values. More self-enhancement and conservation values were associated with higher identification of religious values, and the opposite was true for the other two values. Conclusion: The findings challenged existing assumptions that conservation values relate negatively to psychological health. This finding could be explained by the congruence of conservation values and the Arab culture. The most powerful relationships were those of self-enhancement and religious values, both of which were positively associated with psychological health. As such, therapists should be aware to reconsider biases against religious or conservation values and rather pay attention to their potential positive influence over one’s psychological health.Keywords: counseling psychology, counseling and cultural values, counseling and religious values, psychotherapy and Arab values
Procedia PDF Downloads 465127 Optimization of Spatial Light Modulator to Generate Aberration Free Optical Traps
Authors: Deepak K. Gupta, T. R. Ravindran
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Holographic Optical Tweezers (HOTs) in general use iterative algorithms such as weighted Gerchberg-Saxton (WGS) to generate multiple traps, which produce traps with 99% uniformity theoretically. But in experiments, it is the phase response of the spatial light modulator (SLM) which ultimately determines the efficiency, uniformity, and quality of the trap spots. In general, SLMs show a nonlinear phase response behavior, and they may even have asymmetric phase modulation depth before and after π. This affects the resolution with which the gray levels are addressed before and after π, leading to a degraded trap performance. We present a method to optimize the SLM for a linear phase response behavior along with a symmetric phase modulation depth around π. Further, we optimize the SLM for its varying phase response over different spatial regions by optimizing the brightness/contrast and gamma of the hologram in different subsections. We show the effect of the optimization on an array of trap spots resulting in improved efficiency and uniformity. We also calculate the spot sharpness metric and trap performance metric and show a tightly focused spot with reduced aberration. The trap performance is compared by calculating the trap stiffness of a trapped particle in a given trap spot before and after aberration correction. The trap stiffness is found to improve by 200% after the optimization.Keywords: spatial light modulator, optical trapping, aberration, phase modulation
Procedia PDF Downloads 1845126 Being Your Own First Responder: A Training to Identify and Respond to Mental Health
Authors: Joe Voshall, Leigha Shoup
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In 2022, the Ohio Peace Officer Training Council and the Attorney General required officers to complete a minimum of 24 hours of continued professional training for the year. Much of the training was based on Mental Health or similarly related topics. This includes Officer Wellness and Officer Mental Health. It is becoming clearer that the stigma of Officer / First Responder Mental Health is a topic that is becoming more prevalently faced. To assist officers and first responders in facing mental health issues, we are developing new training. This training will aid in recognizing mental health-related issues in officers/first responders and citizens, as well as further using the same information to better respond and interact with one another and the public. In general, society has many varying views of mental health, much of which is largely over-sensationalized by television, movies, and other forms of entertainment. There has also been a stigma in law enforcement / first responders related to mental health and being weak as a result of on-the-job-related trauma-induced struggles. It is our hope this new training will assist officers and first responders in not only positively facing and addressing their mental health but using their own experience and education to recognize signs and symptoms of mental health within individuals in the community. Further, we hope that through this recognition, officers and first responders can use their experiences and more in-depth understanding to better interact within the field and with the public. Through recognition and better understanding of mental health issues and more positive interaction with the public, additional achievements are likely to result. This includes in the removal of bias and stigma for everyone.Keywords: law enforcement, mental health, officer related mental health, trauma
Procedia PDF Downloads 1625125 Milk Curd Obstruction as a Mimic of Necrotising Enterocolitis (NEC)
Authors: Sofia Baldelli, Aman More
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Milk curd obstruction is commonly reported as being misdiagnosed for NEC, and they predominantly mimic each other in clinical presentation, including abdominal distension, vomiting, constipation, feeding intolerance and frank or occult blood PR. Using the case of a pre-term neonate misdiagnosed with necrotising enterocolitis when in fact, they had milk curd obstruction, we compare the two diagnoses and why they are hard to differentiate, the risk factors for clinicians to consider and the different management options. The main diagnostic tool for these conditions remains the plain radiograph and here we present the original radiograph of the neonate and discuss the classical radiological features of both diagnoses. We conclude that further imaging techniques such as ultrasound might be used to improve diagnosis when X-ray is inconclusive.Keywords: milk curd obstruction, Necrotising Enterocolitis, radiology, pediatric surgery
Procedia PDF Downloads 1065124 Analysis of Global Social Responsibilities of Social Studies Pre-Service Teachers Based on Several Variables
Authors: Zafer Cakmak, Birol Bulut, Cengiz Taskiran
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Technological advances, the world becoming smaller and increasing world population increase our interdependence with individuals that we maybe never meet face to face. It is impossible for the modern individuals to escape global developments and their impact. Furthermore, it is very unlikely for the global societies to turn back from the path they are in. These effects of globalization in fact encumber the humankind at a certain extend. We succumb to these responsibilities for we desire a better future, a habitable world and a more peaceful life. In the present study, global responsibility levels of the participants were measured and the significance of global reactions that individuals have to develop on global issues was reinterpreted under the light of the existing literature. The study was conducted with general survey model, one of the survey methodologies General survey models are surveys conducted on the whole universe or a group, sample or sampling taken from the universe to arrive at a conclusion about the universe, which includes a high number of elements. The study was conducted with data obtained from 350 pre-service teachers attending 2016 spring semester to determine 'Global Social Responsibility' levels of social studies pre-service teachers based on several variables. Collected data were analyzed using SPSS 21.0 software. T-test and ANOVA were utilized in the data analysis.Keywords: social studies, globalization, global social responsibility, education
Procedia PDF Downloads 3895123 Analysis of the Treatment Hemorrhagic Stroke in Multidisciplinary City Hospital №1 Nur-Sultan
Authors: M. G. Talasbayen, N. N. Dyussenbayev, Y. D. Kali, R. A. Zholbarysov, Y. N. Duissenbayev, I. Z. Mammadinova, S. M. Nuradilov
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Background. Hemorrhagic stroke is an acute cerebrovascular accident resulting from rupture of a cerebral vessel or increased permeability of the wall and imbibition of blood into the brain parenchyma. Arterial hypertension is a common cause of hemorrhagic stroke. Male gender and age over 55 years is a risk factor for intracerebral hemorrhage. Treatment of intracerebral hemorrhage is aimed at the primary pathophysiological link: the relief of coagulopathy and the control of arterial hypertension. Early surgical treatment can limit cerebral compression; prevent toxic effects of blood to the brain parenchyma. Despite progress in the development of neuroimaging data, the use of minimally invasive techniques, and navigation system, mortality from intracerebral hemorrhage remains high. Materials and methods. The study included 78 patients (62.82% male and 37.18% female) with a verified diagnosis of hemorrhagic stroke in the period from 2019 to 2021. The age of patients ranged from 25 to 80 years, the average age was 54.66±11.9 years. Demographic, brain CT data (localization, volume of hematomas), methods of treatment, and disease outcome were analyzed. Results. The retrospective analyze demonstrate that 78.2% of all patients underwent surgical treatment: decompressive craniectomy in 37.7%, craniotomy with hematoma evacuation in 29.5%, and hematoma draining in 24.59% cases. The study of the proportion of deaths, depending on the volume of intracerebral hemorrhage, shows that the number of deaths was higher in the group with a hematoma volume of more than 60 ml. Evaluation of the relationship between the time before surgery and mortality demonstrates that the most favorable outcome is observed during surgical treatment in the interval from 3 to 24 hours. Mortality depending on age did not reveal a significant difference between age groups. An analysis of the impact of the surgery type on mortality reveals that decompressive craniectomy with or without hematoma evacuation led to an unfavorable outcome in 73.9% of cases, while craniotomy with hematoma evacuation and drainage led to mortality only in 28.82% cases. Conclusion. Even though the multimodal approaches, the development of surgical techniques and equipment, and the selection of optimal conservative therapy, the question of determining the tactics of managing and treating hemorrhagic strokes is still controversial. Nevertheless, our experience shows that surgical intervention within 24 hours from the moment of admission and craniotomy with hematoma evacuation improves the prognosis of treatment outcomes.Keywords: hemorragic stroke, Intracerebral hemorrhage, surgical treatment, stroke mortality
Procedia PDF Downloads 1055122 Effect of Moisture Content Compaction in the Geometry Definition of Earth Dams
Authors: Julian B. García, Virginie Q. R. Pinto, André P. Assis
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This paper presents numerical flow and slope stability simulations in three typical sections of earth dams built in tropical regions, two homogeneous with different slope inclinations, and the other one heterogeneous with impermeable core. The geotechnical material parameters used in this work were obtained from a lab testing of physical characterization, compaction, consolidation, variable load permeability and saturated triaxial type CD for compacted soil samples with standard proctor energy at optimum moisture content (23%), optimum moisture content + 2% and optimum moisture content +5%. The objective is to analyze the general behavior of earth dams built in rainy regions where optimum moisture is exceeded. The factor of safety is satisfactory for the three sections compacted in all moisture content during the stages of operation and end of construction. On The other hand, the rapid drawdown condition is the critical phase for homogeneus dams configuration, the factor of safety obtained were unsatisfactory. In general, the heterogeneous dam behavior is more efficient due to the fact that the slopes are made up of gravel, which favors the dissipation of pore pressures during the rapid drawdown. For the critical phase, the slopes should have lower inclinations of the upstream and downstream slopes to guarantee stability, although it increases the costs.Keywords: earth dams, flow, moisture content, slope stability
Procedia PDF Downloads 1885121 The Development of User Behavior in Urban Regeneration Areas by Utilizing the Floating Population Data
Authors: Jung-Hun Cho, Tae-Heon Moon, Sun-Young Heo
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A lot of urban problems, caused by urbanization and industrialization, have occurred around the world. In particular, the creation of satellite towns, which was attributed to the explicit expansion of the city, has led to the traffic problems and the hollowization of old towns, raising the necessity of urban regeneration in old towns along with the aging of existing urban infrastructure. To select urban regeneration priority regions for the strategic execution of urban regeneration in Korea, the number of population, the number of businesses, and deterioration degree were chosen as standards. Existing standards had a limit in coping with solving urban problems fundamentally and rapidly changing reality. Therefore, it was necessary to add new indicators that can reflect the decline in relevant cities and conditions. In this regard, this study selected Busan Metropolitan City, Korea as the target area as a leading city, where urban regeneration such as an international port city has been activated like Yokohama, Japan. Prior to setting the urban regeneration priority region, the conditions of reality should be reflected because uniform and uncharacterized projects have been implemented without a quantitative analysis about population behavior within the region. For this reason, this study conducted a characterization analysis and type classification, based on the user behaviors by using representative floating population of the big data, which is a hot issue all over the society in recent days. The target areas were analyzed in this study. While 23 regions were classified as three types in existing Busan Metropolitan City urban regeneration priority region, 23 regions were classified as four types in existing Busan Metropolitan City urban regeneration priority region in terms of the type classification on the basis of user behaviors. Four types were classified as follows; type (Ⅰ) of young people - morning type, Type (Ⅱ) of the old and middle-aged- general type with sharp floating population, type (Ⅲ) of the old and middle aged-24hour-type, and type (Ⅳ) of the old and middle aged with less floating population. Characteristics were shown in each region of four types, and the study results of user behaviors were different from those of existing urban regeneration priority region. According to the results, in type (Ⅰ) young people were the majority around the existing old built-up area, where floating population at dawn is four times more than in other areas. In Type (Ⅱ), there were many old and middle-aged people around the existing built-up area and general neighborhoods, where the average floating population was more than in other areas due to commuting, while in type (Ⅲ), there was no change in the floating population throughout 24 hours, although there were many old and middle aged people in population around the existing general neighborhoods. Type (Ⅳ) includes existing economy-based type, central built-up area type, and general neighborhood type, where old and middle aged people were the majority as a general type of commuting with less floating population. Unlike existing urban regeneration priority region, these types were sub-divided according to types, and in this study, approach methods and basic orientations of urban regeneration were set to reflect the reality to a certain degree including the indicators of effective floating population to identify the dynamic activity of urban areas and existing regeneration priority areas in connection with urban regeneration projects by regions. Therefore, it is possible to make effective urban plans through offering the substantial ground by utilizing scientific and quantitative data. To induce more realistic and effective regeneration projects, the regeneration projects tailored to the present local conditions should be developed by reflecting the present conditions on the formulation of urban regeneration strategic plans.Keywords: floating population, big data, urban regeneration, urban regeneration priority region, type classification
Procedia PDF Downloads 2135120 Institutional Structures Shaping Female Representation in Politics in Pakistan
Authors: Neelum Maqsood
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This paper is a study of how institutional structures shape the policy-making activities of female legislators. The literature on this area indicates that if there is an institution created by men to secure elite interests, women will face constraints in legislative activities. This paper will analyze the institutional setting in Pakistan and document the conditions women face that both restrict or enable them from representing the general interests of other women. The main experimental design depends on the variation of international scrutiny that Pakistan faces in two different time periods that will be classified as high international scrutiny and low international scrutiny. A high international scrutiny period is one where Pakistan comes under the international lens because of a domestic event that has international ramifications, for example, in terms of gender equality. The argument is that women parliamentarians receive different treatment in periods of high international scrutiny. As Pakistan comes under scrutiny, women will be more active in their legislative activities than in low international scrutiny, as male parliamentarians will be less likely to influence or restrain women’s activities. Using this variation, the trends in memberships and support functions given to women in these two time periods will be studied. The second variation will comprise the analysis of male and female assignments, training, and funding on general seats across time, which will require data collection over this time of 12-15 years, including the years during the war when Pakistan was under high international scrutiny.Keywords: female representation, gender equality, democratic institutions, quota seats
Procedia PDF Downloads 845119 Inequality for Doubly Warped Product Manifolds
Authors: Morteza Faghfouri
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In this paper we establish a general inequality involving the Laplacian of the warping functions and the squared mean curvature of any doubly warped product isometrically immersed in a Riemannian manifold.Keywords: integral submanifolds, S-space forms, doubly warped product, inequality
Procedia PDF Downloads 2865118 Sustainability of Performing Venues Considering Urban Connectivity and Facility Utilization
Authors: Wei-Hwa Chiang, Wei-Ting Hsu, Yuan-Chi Liu, Cheng-Che Tsai
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A sustainable built environment aims for minimizing both regional and global environmental impact while maintaining a healthy living for individuals. Sustainability of performing venues has rarely been discussed when compared with residential, office, and other popular building types. Life-cycle carbon emission due to the high standard requirements in acoustics, stage engineering, HVAC, and building structure need to be carefully examined. This can be complicated by social-economic and cultural concerns in addition to technical excellence. This paper reported case-based study and statistics of performing venues regarding urban connectivity and spatial layouts in enhancing facility usage and promoting cultural vitality. Interviews conducted for a major venue at Taipei indicated high linkage with surrounding leisure activity and the need for quality pedestrian and additional spaces open to the general public. Statistics of venues with various size and function suggested the possibility and strategies limit the size and height of reception and foyer spaces, and to maximize their use when there are no performances. Design strategies are identified to increase visual contact or facility sharing between the artists and the audience or the general public in reducing facility size and promoting potential involvement in cultural activities.Keywords: sustainability, performing venue, design, operation
Procedia PDF Downloads 1215117 Soil Organic Carbon and Nutrients in Smallholding Land Uses in Southern Ethiopia
Authors: Mekdes Lulu
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This study assessed the soil organic C (SOC) and soil nutrients in smallholding home garden, woodlot, grazing land, and cropland at two soil depths and two sites in Wolaita Zone, southern Ethiopia. The results showed that soil properties were significantly influenced by land use. The home garden had significantly higher (p < 0.05) SOC and soil nutrients when compared to the cropland. When the home garden was compared to the woodlot and grazing land uses, it had significantly higher (p < 0.05) values except in SOC, total N (TN), cation exchange capacity (CEC), and exchangeable Ca. Cropland, in comparison with grazing land and woodlot, had a non-significant difference except TN. The SOC stock (0–40 cm) in the home garden, woodlot, grazing land and cropland was 79.5, 68.0, 65.0, and 58.1 Mg ha–1, respectively. Home garden significantly differed (p <0.05) in SOC only from cropland, and this was attributed not only to the relatively higher organic input in the home garden but also to the little organic matter input and frequently tillage of the cropland. The similar SOC among the home garden, woodlot and grazing lands may imply that the balance between inputs and outputs could be nearly similar for the land uses. Soil TN and CEC had a nearly similar pattern of difference as in SOC among the land uses because of their close relationship with SOC. In general, the land use influence on soil nutrients can be in the order: home garden > wood land » grazing land » cropland, with home garden showing the least difference from the woodlot and the greatest from the cropland. In the agroecosystem, in general, the influence of smallholding home garden on SOC and soil nutrient was marginally different from Eucalyptus woodlot and grazing lands but evidently different from cropland.Keywords: cropland, grazing land, home garden, soc stock, soil nutrients, woodlot
Procedia PDF Downloads 255116 Attitudes of University Students toward English Language Education Policy in Iraqi Kurdistan
Authors: Momen Yaseen M. Amin
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Despite widespread coverage of language policy in the literature, there has been scant research probing into English language education policy at tertiary levels in general and in the case of higher education context of Iraqi Kurdistan in particular. The present qualitative study investigated the results of a questionnaire on attitudes toward English language education policy in terms of attitudes toward the English language in general, the current English education policy, and the purposes for learning English among Kurdish EFL university students. Moreover, this study aimed to investigate this topic in light of the participants’ gender and major. To this end, an adapted version of Yang’s (2012) questionnaire was administered to university EFL students majoring in soft and hard sciences (N=300, male 34%, female 67%, four and two disciplines, respectively) at two-state and private universities in Iraqi Kurdistan. The findings revealed positive attitudes toward English as an international language in both soft and hard sciences. While strongly subscribing to the idea that all Iraqi Kurdish students should learn the English language and the courses to be offered in English as well as Kurdish, the majority of the participants expressed their readiness and enthusiasm to excel in English and considered such competency a significant academic accomplishment. However, a good number felt dissatisfied with the status quo of English education at their institutions. This paper provides some implications and recommendations for English education policies makers, administrators, and English language instructors at tertiary levels.Keywords: attitudes, language policy, English language education, Iraqi Kurdistan
Procedia PDF Downloads 1775115 Students’ Perception of Effort and Emotional Costs in Chemistry Courses
Authors: Guizella Rocabado, Cassidy Wilkes
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It is well known that chemistry is one of the most feared courses in college. Although many students enjoy learning about science, most of them perceive that chemistry is “too difficult”. These perceptions of chemistry result in many students not considering Science, Technology, Engineering, and Mathematics (STEM) majors because they require chemistry courses. Ultimately, these perceptions are also thought to be related to high attrition rates of students who begin STEM majors but do not persist. Students perceived costs of a chemistry class can be many, such as task effort, loss of valued alternatives, emotional, and others. These costs might be overcome by students’ interests and goals, yet the level of perceived costs might have a lasting impact on the students’ overall perception of chemistry and their desire to pursue chemistry and other STEM careers in the future. In this mixed methods study, we investigated task effort and emotional cost, as well as a mastery or performance goal orientation, and the impact these constructs may have on achievement in general chemistry classrooms. Utilizing cluster analysis as well as student interviews, we investigated students’ profiles of perceived cost and goal orientation as it relates to their final grades. Our results show that students who are well prepared for general chemistry, such as those who have taken chemistry in high school, display less negative perceived costs and thus believe they can master the material more fully. Other interesting results have also emerged from this research, which has the potential to have an impact on future instruction of these courses.Keywords: chemistry education, motivation, affect, perceived costs, goal orientations
Procedia PDF Downloads 885114 Domain-Specific Languages Evaluation: A Literature Review and Experience Report
Authors: Sofia Meacham
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In this abstract paper, the Domain-Specific Languages (DSL) evaluation will be presented based on existing literature and years of experience developing DSLs for several domains. The domains we worked on ranged from AI, business applications, and finances/accounting to health. In general, DSLs have been utilised in many domains to provide tailored and efficient solutions to address specific problems. Although they are a reputable method among highly technical circles and have also been used by non-technical experts with success, according to our knowledge, there isn’t a commonly accepted method for evaluating them. There are some methods that define criteria that are adaptations from the general software engineering quality criteria. Other literature focuses on the DSL usability aspect of evaluation and applies methods such as Human-Computer Interaction (HCI) and goal modeling. All these approaches are either hard to introduce, such as the goal modeling, or seem to ignore the domain-specific focus of the DSLs. From our experience, the DSLs have domain-specificity in their core, and consequently, the methods to evaluate them should also include domain-specific criteria in their core. The domain-specific criteria would require synergy between the domain experts and the DSL developers in the same way that DSLs cannot be developed without domain-experts involvement. Methods from agile and other software engineering practices, such as co-creation workshops, should be further emphasised and explored to facilitate this direction. Concluding, our latest experience and plans for DSLs evaluation will be presented and open for discussion.Keywords: domain-specific languages, DSL evaluation, DSL usability, DSL quality metrics
Procedia PDF Downloads 1015113 Exploring the Power of Words: Domesticating the Competence/Competency Concept in Ugandan Organisations
Authors: John C. Munene, Florence Nansubuga
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The study set out to examine a number of theories that have directly or indirectly implied that words are potent but that the potency depends on the context or practice in which they are utilised. The theories include the Freudian theory of Cathexis, which directly suggests that ambiguous events when named become potent as well as the word that is used to name them. We briefly examine Psychological differentiation, which submit that ambiguity is often a result of failure to distinguish figure from ground. The investigate Prospecting Theory, which suggests that in a situation when people have to make decisions, they have options to utilise intuition or reasoned judgment. It suggests that more often than not, the tendency is to utilise intuition especially when generic heuristics such as representativeness and similarity are available. That usage of these heuristics may depend on lack of a salience or accessibility of the situation due to ambiguity. We also examine Activity Theory, which proposes that meaning of words emerge directly and dialectically from the activities in which they are used. The paper argues that the power of words will depend on either or all of the theories mentioned above. To examine this general proposition we test the utilization of a generic competence framework in a local setting. The assumption is that generic frameworks are inherently ambiguous and lack the potency normally associated with the competence concept in the management of human resources. A number of case studies provide initial supporting evidence for the general proposition.Keywords: competence, meaning, operationalisation, power of words
Procedia PDF Downloads 411