Search results for: risk management

Authors: Samereh Abdoli, Amit Vora, Anusha Vora

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Background: Diabetes burnout is one of the most common contributors to decreased quality of life, poor psychosocial well-being, and increased morbidity, mortality and diabetes cost. While the term diabetes burnout is widely accepted particularly in type 1 diabetes (T1D), the state of the science on diabetes burnout is lacking a systematic approach to overcome diabetes burnout. Objective: The study aimed to explore the strategies to overcome burnout by integrating the voices of individuals with T1D. Methods: In this study, we applied a descriptive qualitative design using YouTube videos produced by individuals with T1D. Seven YouTube videos (Austria= 1, U.S=6) with the highest rate of views which met the inclusion criteria were analyzed using a qualitative content analysis approach. Results: Participants verbalized overcoming diabetes burnout as a 'difficult hole to climb out of' which make them empowered. Themes that describes their strategies to overcome burnout in T1D, in general, include; 'make plan and take action', 'start with small steps', 'ask for help', 'get engage in diabetes community' and 'do not be perfect'. Future Work: These findings can begin the examination of different strategies to overcome diabetes burnout, which may change the course of action for diabetes care and management to improve quality of diabetes care and quality of life.

Keywords: diabetes burnout, type 1 diabetes, qualitative research, YouTube videos

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

Procedia PDF Downloads 99

Authors: Godwin A. Otogo, Sansanee Wangvoralak, Graham J. Pierce, Lee C. Hastie, Beth Scott

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The squid Loligo forbesii is suspected to be an important species in marine food webs, as it can strongly impact its prey and be impacted upon by predation, competition, fishing and/or climate variability. To quantify these impacts in the food web, the measurement of its trophic position and ecological role within well-studied ecosystems is essential. An Ecopath model was balanced and run for the Moray Firth ecosystem and was used to investigate the significance of this squid’s trophic roles. The network analysis routine included in Ecopath with Ecosim (EwE) was used to estimate trophic interaction, system indicators (health condition and developmental stage) and food web features. Results indicated that within the Moray Firth squid occupy a top trophic position in the food web and also a major prey item for many other species. Results from Omnivory Index (OI) showed that squid is a generalized feeder transferring energy across wide trophic levels and is more important as a predator than that as a prey in the Moray Firth ecosystem. The results highlight the importance of taking squid into account in the management of Europe’s living marine resources.

Keywords: Squid, Loligo forbesii, Ecopath, Moray Firth, Trophic level

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Authors: Elisa Bertagna

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A frame analysis of the work done by various energy multinational companies concerning diversity issues and gender equality is presented. Documents of four multinational companies - two from Finland and two from Italy - have been studied. The array of companies’ documents includes data from their websites, policies and so on. The Finnish and Italian contexts have been chosen as a sample of North and South Europe, of 'advanced' and 'less advanced'. The aim of the analysis is to understand if and how human resource and diversity management in Finnish and Italian multinational energy companies communicate their activity towards the employees. Attention is given on how employees are reacting in their role and on the consequences of its social positioning. The findings of this essay are crucially important. They show how the companies in object tend to focus on the HR and DM positive actions towards female employees’ struggles since the industry is characterized by multinationals with male-dominated employees. In this way, other categories, which are also depicted as sensitive such as young and elderly people or foreigners, do not receive the same amount of attention. Consequently, power hierarchies can be found: 'women' as a social category are given more importance and space in the companies’ data than others. Consequently, the present work analysis reflects on possible struggles that such companies might be facing concerning gender biases and further diverse issues.

Keywords: energy, diversity, gender, multinationals, power hierarchies

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Authors: Sebastião Milton Pinheiro da Silva, Michele Barbosa da Rocha, Ana Lúcia Fernandes Campos, Miquéias Rildo de Souza Silva

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Water is an essential natural resource for life on Earth. Rivers, lakes, lagoons and dams are the main sources of water storage for human consumption. The costs of extracting and using these water sources are lower than those of exploiting groundwater on transition zones to semi-arid terrains. However, the volume of surface water has decreased over time, with the depletion of first-order drainage and the disappearance of springs, phenomena which are easily observed in the field. Climate change worsens water scarcity, compromising supply and hydric security for rural populations. To minimize the expected impacts, producing and storing water through watershed management planning requires detailed cartographic information on the relief and topography, and updated data on the stage and intensity of catchment basin environmental degradation problems. The cartography available of the Brazilian northeastern territory dates to the 70s, with topographic maps, printed, at a scale of 1:100,000 which does not meet the requirements to execute this project. Exceptionally, there are topographic maps at scales of 1:50,000 and 1:25,000 of some coastal regions in northeastern Brazil. Still, due to scale limitations and outdatedness, they are products of little utility for mapping low-order watersheds drainage and springs. Remote sensing data and geographic information systems can contribute to guiding the process of mapping and environmental recovery by integrating detailed relief and topographic data besides social and other environmental information in the Guajiru River Basin, located on the east coast of Rio Grande do Norte, on the Northeast region of Brazil. This study aimed to recognize and map catchment basin, springs and low-order drainage features along estimating morphometric parameters. Alos PALSAR and Copernicus DEM digital elevation models were evaluated and provided regional drainage features and the watersheds limits extracted with Terraview/Terrahidro 5.0 software. CBERS 4A satellite images with 2 m spatial resolution, processed with ESA SNAP Toolbox, allowed generating land use land cover map of Guajiru River. A Mappir Survey 3 multiespectral camera onboard of a DJI Phantom 4, a Mavic 2 Pro PPK Drone and an X91 GNSS receiver to collect the precised position of selected points were employed to detail mapping. Satellite images enabled a first knowledge approach of watershed areas on a more regional scale, yet very current, and drone images were essential in mapping details of catchment basins. The drone multispectral image mosaics, the digital elevation model, the contour lines and geomorphometric parameters were generated using OpenDroneMap/ODM and QGis softwares. The drone images generated facilitated the location, understanding and mapping of watersheds, recharge areas and first-order ephemeral watercourses on an adequate scale and will be used in the following project’s phases: watershed management planning, recovery and environmental protection of Rio's springs Guajiru. Environmental degradation is being analyzed from the perspective of the availability and quality of surface water supply.

Keywords: imaging, relief, UAV, water

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Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

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The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

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Authors: Bangkit Adhi Nugraha, Bambang Suripto

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On September 2016 Bank Indonesia (BI) release regulation no.18/18/PBI/2016 that permit bank clients for using the FX option call spread USD/IDR. Basically, this product is a combination between clients buy FX call option (pay premium) and sell FX call option (receive premium) to protect against currency depreciation while also capping the potential upside with cheap premium cost. BI classifies this product as a structured product. The structured product is combination at least two financial instruments, either derivative or non-derivative instruments. The call spread is the first structured product against IDR permitted by BI since 2009 as response the demand increase from Indonesia firms on FX hedging through derivative for protecting market risk their foreign currency asset or liability. The composition of hedging products on Indonesian FX market increase from 35% on 2015 to 40% on 2016, the majority on swap product (FX forward, FX swap, cross currency swap). Swap is formulated by interest rate difference of the two currency pairs. The cost of swap product is 7% for USD/IDR with one year USD/IDR volatility 13%. That cost level makes swap products seem expensive for hedging buyers. Because call spread cost (around 1.5-3%) cheaper than swap, the most Indonesian firms are using NDF FX call spread USD/IDR on offshore with outstanding amount around 10 billion USD. The cheaper cost of call spread is the main advantage for hedging buyers. The problem arises because BI regulation requires the call spread buyer doing the dynamic hedging. That means, if call spread buyer choose strike price 1 and strike price 2 and volatility USD/IDR exchange rate surpass strike price 2, then the call spread buyer must buy another call spread with strike price 1’ (strike price 1’ = strike price 2) and strike price 2’ (strike price 2’ > strike price 1‘). It could make the premium cost of call spread doubled or even more and dismiss the purpose of hedging buyer to find the cheapest hedging cost. It is very crucial for the buyer to choose best optimum strike price before entering into the transaction. To help hedging buyer find the optimum strike price and avoid expensive multiple premium cost, we observe ten years 2005-2015 historical data of USD/IDR volatility to be compared with the price movement of the call spread USD/IDR using Garman–Kohlhagen Model (as a common formula on FX option pricing). We use statistical tools to analysis data correlation, understand nature of call spread price movement over ten years, and determine factors affecting price movement. We select some range of strike price and tenor and calculate the probability of dynamic hedging to occur and how much it’s cost. We found USD/IDR currency pairs is too uncertain and make dynamic hedging riskier and more expensive. We validated this result using one year data and shown small RMS. The study result could be used to understand nature of FX call spread and determine optimum strike price for hedging plan.

Keywords: FX call spread USD/IDR, USD/IDR volatility statistical analysis, Garman–Kohlhagen Model on FX Option USD/IDR, Bank Indonesia Regulation no.18/18/PBI/2016

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Authors: Tina Naser Torabi

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Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Kavita Goel, Donald Winchester

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In a world of information overload and work complexities, academics often struggle to create an online instructional environment enabling efficient and effective student learning. Research has established that students’ learning styles are different, some learn faster when taught using audio and visual methods. Attributes like prior knowledge and mental effort affect their learning. ‘Cognitive load theory’, opines learners have limited processing capacity. Cognitive load depends on the learner’s prior knowledge, the complexity of content and tasks, and instructional environment. Hence, the proper allocation of cognitive resources is critical for students’ learning. Consequently, a lecturer needs to understand the limits and strengths of the human learning processes, various learning styles of students, and accommodate these requirements while designing online assessments. As acknowledged in the cognitive load theory literature, visual and auditory explanations of worked examples potentially lead to a reduction of cognitive load (effort) and increased facilitation of learning when compared to conventional sequential text problem solving. This will help learner to utilize both subcomponents of their working memory. Instructional design changes were introduced at the case site for the delivery of the postgraduate business subjects. To make effective use of auditory and visual modalities, video recorded lectures, and key concept webinars were delivered to students. Videos were prepared to free up student limited working memory from irrelevant mental effort as all elements in a visual screening can be viewed simultaneously, processed quickly, and facilitates greater psychological processing efficiency. Most case study students in the postgraduate programs are adults, working full-time at higher management levels, and studying part-time. Their learning style and needs are different from other tertiary students. The purpose of the audio and visual interventions was to lower the students cognitive load and provide an online environment supportive to their efficient learning. These changes were expected to impact the student’s learning experience, their academic performance and retention favourably. This paper posits that these changes to instruction design facilitates students to integrate new knowledge into their long-term memory. A mixed methods case study methodology was used in this investigation. Primary data were collected from interviews and survey(s) of students and academics. Secondary data were collected from the organisation’s databases and reports. Some evidence was found that the academic performance of students does improve when new instructional design changes are introduced although not statistically significant. However, the overall grade distribution of student’s academic performance has changed and skewed higher which shows deeper understanding of the content. It was identified from feedback received from students that recorded webinars served as better learning aids than material with text alone, especially with more complex content. The recorded webinars on the subject content and assessments provides flexibility to students to access this material any time from repositories, many times, and this enhances students learning style. Visual and audio information enters student’s working memory more effectively. Also as each assessment included the application of the concepts, conceptual knowledge interacted with the pre-existing schema in the long-term memory and lowered student’s cognitive load.

Keywords: cognitive load theory, learning style, instructional environment, working memory

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Authors: L. Edirisinghe, Z. Jin, A. W. Wijeratne, R. Mudunkotuwa

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Empty container repositioning is a fundamental problem faced by the shipping industry. The virtual container yard is a novel strategy underpinning the container interchange between carriers that could substantially reduce this ever-increasing shipping cost. This paper evaluates the shipping industry perception of the virtual container yard using chi-square tests. It examines if the carriers perceive that the selected independent variables, namely culture, organization, decision, marketing, attitudes, legal, independent, complexity, and stakeholders of carriers, impact the efficiency and benefits of the virtual container yard. There are two major findings of the research. Firstly, carriers view that complexity, attitudes, and stakeholders may impact the effectiveness of container interchange and may influence the perceived benefits of the virtual container yard. Secondly, the three factors of legal, organization, and decision influence only the perceived benefits of the virtual container yard. Accordingly, the implementation of the virtual container yard will be influenced by six key factors, namely complexity, attitudes, stakeholders, legal, organization and decision. Since the virtual container yard could reduce overall shipping costs, it is vital to examine the carriers’ perception of this concept.

Keywords: virtual container yard, imbalance, management, inventory

Procedia PDF Downloads 190

Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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Authors: Eddy K. Mukadi

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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.

Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa

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Authors: Mrinal Saurabh Bhaskar, Rahul E Ravindranathan, Priyangana Borah

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Energy plays a key role and as a driving force for economic and social growth for any country. To manage the energy sources and its efficient utilization in different economic sectors, energy policy of a country is critical. The energy performance of a country is measured in Energy Intensity and India’s Energy Intensity due to several policies interventions has reduced from 0.53 toe/1000USD (2010) in the year 2000 to 0.38 toe/1000USD (2010) in the year 2014, which is about 28 per cent reduction. The Government of India has taken several initiates to manage their increasing energy demand and meet the climate change goals defined by them. The major policy milestones in India related to energy are (i) Enactment of Energy Conservation (EC) Act 2001 (ii) Establishment of Bureau of Energy Efficiency 2001 (iii) National Action Plan on Climate Change (iv) Launch of Demand Side Management schemes (v) Amendment of EC Act 2010 (vi) Launch of Perform Achieve and Trade scheme 2012. Through a critical review, this paper highlights the key energy policy interventions by India, its benefits and impact, challenges faced and efforts of the Government to overcome such challenges. Such take away would be helpful for other countries who are proposing to prepare or amend their energy policy for their different economic sectors.

Keywords: energy, efficiency, climate, policy

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Authors: Yolanda Ramírez, Ángel Tejada, Agustín Baidez

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In the higher education setting, there is a current trend in society toward greater openness and transparency. The economic, social and political changes that have occurred in recent years in public sector universities (particularly the New Public Management, the Bologna Process and the emergence of the “third mission”) call for a wider disclosure of value created by universities to support fundraising activities, to ensure accountability in the use of public funds and the outcomes of research and teaching, as well as close relationships with industries and territories. The paper has two purposes: 1) to explore the intellectual capital (IC) disclosure in Spanish universities through their websites, and 2) to identify university profiles. This study applies a content analysis to analyze the institutional websites of Spanish public universities and a cluster analysis. The analysis reveals that Spanish universities’ website content usually relates to human capital, while structural and relational capitals are less widely disclosed. Our research identifies three behavioral profiles of Spanish universities with regard to the online disclosure of IC (universities more proactive, universities less proactive and universities adopt a middle position in this regard. The results can serve as encouragement to university managers to enhance online IC disclosure to meet the information needs of university stakeholders.

Keywords: universities, intellectual capital, disclosure, internet

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Authors: Jennifer Zelmer

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The debate regarding the morality, and therefore legality, of abortion has many social, political, and medical ramifications worldwide. In a developing country like Bolivia, carrying a pregnancy to delivery is incredibly risky. Given the very high maternal mortality rate in Bolivia, greater consideration has been given to the (de)criminalization of abortion – a contributing cause of maternal death. In the spring of 2017, the Bolivian government proposed to loosen restrictions on women’s access to receiving a safe abortion, which was met with harsh criticism from 'pro-vida' (pro-life) factions. Although the current Bolivian government Movimiento al Socialismo (Movement Toward Socialism) portrays an agenda of decolonization, or to seek a 'traditionally-modern' society, nevertheless, Bolivia still has one of the highest maternal mortality rates in the Americas, because of centuries of colonial and patriarchal order. Applying a feminist critique and using the abortion debate as the central point, this paper argues that the 'traditionally-modern' society Bolivia strives towards is a paradox, and in fact only contributes to the reciprocal process of the death of 'mother tongues' and the unnecessary death of women. This claim is supported by a critical analysis of historical texts about Spanish Colonialism in Bolivia; the linguistic reality of reproductive educational strategies, and the philosophical framework which the Bolivian government and its citizens implement. This analysis is demonstrated in the current state of women’s access to reproductive healthcare in Cochabamba, Bolivia based on recent fieldwork which included audits of clinics and hospitals, interviews, and participant observation. This paper has two major findings: 1) the language used by opponents of abortion in Bolivia is not consistent with the claim of being 'pro-life' but more accurately with being 'pro-potential'; 2) when the topic of reproductive health appears in Cochabamba, Bolivia, it is often found written in the Spanish language, and does not cater to the many indigenous communities that inhabit or visit this city. Finally, this paper considers the crucial role of public health documentation to better inform the abortion debate, as well as the necessity of expanding reproductive health information to more than text-based materials in Cochabamba. This may include more culturally appropriate messages and mediums that cater to the oral tradition of the indigenous communities, who historically and currently have some of the highest fertility rates. If the objective of one who opposes abortion is to save human lives, then preventing the death of women should equally be of paramount importance. But rather, the 'pro-life' movement in Bolivia is willing to risk the lives of to-be mothers, by judicial punishment or death, for the chance of a potential baby. Until abortion is fully legal, safe, and accessible, there will always be the vestiges of colonial and patriarchal order in Bolivia which only perpetuates the needless death of women.

Keywords: abortion, feminist theory, Quechua, reproductive health education

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Authors: Ferdağ Çulhan, Emine Gaye Çontay

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Geometric thinking levels created by Van Hiele are used to determine students' progress in geometric thinking. Many studies have been conducted on geometric thinking levels and they have taken their place in teaching curricula over time. It is thought that geometric thinking levels, which have become so important in teaching, can be examined in depth. In order to make an in-depth analysis, it was decided that the most appropriate management was discourse analysis. In this study, the focus is on examining the geometric thinking levels of 8th grade students from a discursive point of view. Sfard (2008)'s "Commognitive" theory will be used to conduct discursive analysis. The "Global Van Hiele Questionnaire" created by Patkin (2014) and translated into Turkish for this research will be used in the research. The "Global Van Hiele Questionnaire" contains questions from the sub-learning domain of triangles and quadrilaterals, circles and geometric objects. It has a wider scope than many "Van Hiele Questionnaires". “Global Van Hiele Questionnaire” will be applied to 8th grade students. Then, the geometric thinking levels of the students will be determined and interviews will be held with two students from each of the 1st, 2nd and 3rd levels. The interviews will be recorded and the students' discourses will be examined. By evaluating the relations between the students' geometric thinking levels and their discourses, it will be examined how much their discourse reflects their level of thinking. In this way, it is thought that students' geometric thinking processes can be better understood.

Keywords: mathematical discourses, commognitive framework, geometric thinking levels, van hiele

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Authors: Bifeng Zhu, Zhekai Wang, Chaoyang Sun, Bart Dewancker

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Under the tide of promoting sustainable development in the world, American universities that have been committed to sustainable practice and innovation, not only have its sustainable campus construction been in the forefront of the world, but also have developed STARS (The Sustainability Tracking, Assessment & Rating System), which is widely used in the world and highly recognized. At the same time, in the process of global sustainable campus construction, energy problem is often regarded as one of the most important sustainable aspects, even equivalent to the sustainability of campus. Therefore, the relationship between campus energy and sustainability is worth discussing. In this study, four American universities with the highest level evaluated by STARS are selected as examples to compare and analyze the campus energy consumption and the use of new energy, GHG emissions and the overall sustainability of the campus, in order to explore the relationship between campus energy and sustainable construction. It is found that the advantages of sustainable campus construction in the United States are mainly focused on the "software" of management, education, activities, etc. Although different energy-saving measures have been taken in campus energy, the construction results are quite different. Moreover, as an important aspect of sustainable campus, energy can not fully represent the sustainability of campus, but because of the various measures it takes, it can greatly promote the sustainable construction of the whole campus. These measures and construction experiences are worthy of summary and promotion, and have positive reference significance for other universities even communities around the world.

Keywords: sustainable campus, energy consumption, STARS assessment, GHG emissions

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Authors: Danielle M. Barna, Kolbjørn Engeland, Thordis Thorarinsdottir, Chong-Yu Xu

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Design flood values give estimates of flood magnitude within a given return period and are essential to making adaptive decisions around land use planning, infrastructure design, and disaster mitigation. Often design flood values are needed at locations with insufficient data. Additionally, in hydrologic applications where flood retention is important (e.g., floodplain management and reservoir design), design flood values are required at different flood durations. A statistical approach to this problem is a development of a regression model for extremes where some of the parameters are dependent on flood duration in addition to being covariate-dependent. In hydrology, this is called a regional flood-duration-frequency (regional-QDF) model. Typically, the underlying statistical distribution is chosen to be the Generalized Extreme Value (GEV) distribution. However, as the support of the GEV distribution depends on both its parameters and the range of the data, special care must be taken with the development of the regional model. In particular, we find that the GEV is problematic when developing a GAMLSS-type analysis due to the difficulty of proposing a link function that is independent of the unknown parameters and the observed data. We discuss these challenges in the context of developing a regional QDF model for Norway.

Keywords: design flood values, bayesian statistics, regression modeling of extremes, extreme value analysis, GEV

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Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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Authors: Nyambayar Davaadorj, Ichiro Koshijima

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Safety or the state of being safe can be described as a condition of being not dangerous or not harmful. It is necessary for an individual to avoid dangerous situations every day. Also, an organization is subject to legal requirements for the health and safety of persons inside and around the immediate workplace, or who are exposed to the workplace activities. Although it might be difficult to keep a situation where complete safety is ensured, efforts must nonetheless be made to consider ways of removing any potential danger within an organization. In order to ensure a safe working environment, the capability of responding (i.e., resilience) to signals (i.e., information concerning events that could pose future problems that must be taken into account) that occur in and around corporations is necessary. The ability to evaluate this essential point is thus one way in which safety and security can be managed. This study focuses on OHSAS18001, an internationally applied standard for the construction and operation of occupational health and safety management systems, by using IDEF0 for Function Modeling (IDEF0) and the Resilience Matrix originally made by Bracco. Further, this study discusses a method for evaluating a manner in which Occupational Health and Safety Assessment Series (OHSAS) systematically functions within corporations. Based on the findings, this study clarifies the potential structural objection for corporations when implementing and operating the OHSAS standard.

Keywords: OHSAS18001, IDEF0, resilience engineering, safety culture

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Authors: Musyimi Mbathi

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Information regarding social, political, demographic, economic and other attributes of human settlement is important for decision makers at all levels of planning, as they have to grapple with dynamic environments often associated with settlements. At the local level, it is particularly important for both communities and urban managers to have accurate and reliable information regarding all planning attributes. Settlement mapping, in particular, informal settlements mapping in Kenya, has over the past few years been carried out using modern tools like Geographic information systems (GIS) and remote sensing for spatial data analysis and planning. GIS tools offer a platform for integration of spatial and non-spatial data as well as visualisation of the settlements. The capabilities offered by these tools have enabled communities to participate especially in the planning and management of new infrastructure as well as settlement upgrading. Land tenure based projects within informal settlements have also relied on GIS and related tools with considerable success. Additionally, the adoption of participatory approaches and use of geo-information tools helped to provide a basis for all inclusive planning thus promoting accountability, transparency, legitimacy, and other dimensions of governance within human settlement planning. The paper examines the context and application of geo-information tools for planning within low-income settlements of Kenya. A case study of Kiambiu settlement will be used to demonstrate how the tools have been applied for planning and decision-making purposes.

Keywords: informal settlements, GIS, governance, modern tools

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Authors: Ying Chen

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Conservation Agriculture in a sustainable way of farming, as it brings many benefits, such as preventing soil from erosion and degradation, improving soil health, conserving energy, and sequestrating carbon. However, adoption of conservation agriculture has been progressing slowly in some part of the world due to some challenges. Among them, seeding in heavy crop residue is challenging, especially in corn production systems. Weed control is also challenging in conservation agriculture. This research aimed to investigate some technologies that can address these challenges. For crop residue management, vertical tillage and vertical seeding have been studied in multiple research projects. Results showed that vertical tillage and seeding were able to deal with crop residue through cutting residue into small segments, which would not plug seeder in the sub-sequent seeding. Vertical tillage is a conservation tillage system, as it leaves more than 30% crop residue on soil surface while incorporating some residue into the shallow soil layer for fast residue decomposition. For weed control, mechanical weeding can reduce chemical inputs in crop production. A tine weeder was studied for weed control during the early growing season of several field crops (corn, soybean, flax, and pea). Detail results of these studies will be shared at the conference.

Keywords: tillage, seeding, mechanical weeding, crop residue

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Authors: Kwok Tak Kit

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The construction industry plays an important role in environmental and carbon emissions as it consumes a huge amount of natural resources and energy. Sustainable engineering involves the process of planning, design, procurement, construction and delivery in which the whole building and construction process resulting from building and construction can be effectively and sustainability managed to achieve the use of natural resources. Implementation of sustainable technology development and innovation, adoption of the advanced construction process and facilitate the facilities management to implement the energy and waste control more accurately and effectively. Study and research in the relationship of BIM and environment assessment tools lack a clear discussion. In this paper, we will focus on the synergy of BIM technology and sustainable engineering in the AEC industry and outline the key factors which enhance the use of advanced innovation, technology and method and define the role of stakeholders to achieve zero-carbon emission toward the Paris Agreement to limit global warming to well below 2ᵒC above pre-industrial levels. A case study of the adoption of Building Information Modeling (BIM) and environmental assessment tools in Hong Kong will be discussed in this paper.

Keywords: sustainability, sustainable engineering, BIM, LEED

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Authors: Oluwole Enoch Adeniran

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Peace studies and conflict resolution; though a relatively new discipline had attracted scholars from far and near. It had enhanced a purposeful training of mind of young adult among other categories of learners. It provides a platform through which university under-graduates and post-graduates students are exposed to the rudiments of peace building, peacemaking and peace keeping towards a successful conflict resolution. The paper historicizes peace education as most desirable in any human society that desired development. It aims at educating children and young adults in the dynamics of peaceful conflicts resolution at home, in school and communities (states) throughout the world for a purposeful technological development. It also aims at exposing students to the nature of conflict and how to manage and resolve conflicts in order to promote national unity for meaningful development. The paper argues that, for a state to record any meaningful socio-economic, political and technological development; a conducive and peaceful atmosphere must be put in place. This theoretical paper emerged in the context of historical specificities of conflict resolution from a general conceptual framework. It then concludes with suggestions on the modes of conflict prevention, conflict management and conflict resolution for an ideal technologically advanced society.

Keywords: history, education, peace, unity, technology and development

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Authors: Mohammad J. Mortazavi, Arvin Najafi, Pejman Mansouri

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Hemophilia A is simply described as deficiency of factor VIII(FVIII) and patients with this disorder have bleeding complications in different organs. By using the recombinant factor VIII in these patients, elective orthopedic surgeries have been done approximately in 40 last years. About 10-30 % of these patients have bleeding complications in their surgeries even by using recombinant factor VIII because of their inhibitor against FVIII molecule. Preoperative haemostatic management in these patients is challenging. We treated a 28-year-old male patient with hemophilia A with FVIII inhibitor which had been detected when he was14 years old (with the titer 54 Bethesda unit(BU)) scheduled for total knee arthroplasty (TKA). We use 90 µg/kg rFVIIa just before the surgery and every 2 hours during surgery. The patient did not have any significant hemorrhage during the surgery and after that. For the 2 days after surgery, the rFVIIa repeated every 2 hours as the same as preoperative dosage(90 µg/kg) and for another 2 days of postoperative admission it continued every 4 hours. After 4th day, the rFVIIa continued every 6 hours with the same dosage until the sixth day from the surgery, and finally the patient were discharged about two weeks after surgery. Seven days after the discharge, he came back for the follow up visit. On the follow up examination, the site of the surgery had neither infection hemarthroses signs.

Keywords: hemophilia, factor VIII inhibitor, total knee replacement, rFVIIa

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Authors: Jim Shi, Jasmine Chang, Nesreen El-Rayes

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The world has been experiencing a steadily increasing trend in both the production and consumption of plastic. The global consumer revolution should not have been possible without plastic, thanks to its salient feature of inexpensiveness and durability. But, as a two-edged sword, its durable quality has returned to haunt and even jeopardized us. That exacerbating the plastic crisis has attracted various global initiatives and actions. Simultaneously, firms are eager to adopt new technology as they witness and perceive more potential and merit of Industry 4.0 technologies. For example, Blockchain technology (BCT) is drawing the attention of numerous stakeholders because of its wide range of outstanding features that promise to enhance supply chain operations. However, from a research perspective, most of the literature addresses the plastic crisis from either environmental or social perspectives. In contrast, analysis from the data science perspective and technology is relatively scarce. To this end, this study aims to fill this gap and cover the plastic crisis from a holistic view of environmental, social, technological, and business perspectives. In particular, we propose a mathematical model to examine the inclusion of BCT to enhance and improve the efficiency on the upstream and the downstream sides of the plastic value, where the whole value chain is coordinated systematically, and its interoperability can be optimized. Consequently, the Environmental, Social, and Governance (ESG) goal and Circular Economics (CE) sustainability can be maximized.

Keywords: blockchain technology, plastic, circular economy, sustainability

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Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

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Authors: P. Jayashree, S. Rajkumar

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With social networks and smart devices generating a multitude of data, effective data management is the need of the hour for networks and cloud applications. Some applications need effective storage while some other applications need effective communication over networks and data reduction comes as a handy solution to meet out both requirements. Most of the data compression techniques are based on data statistics and may result in either lossy or lossless data reductions. Though lossy reductions produce better compression ratios compared to lossless methods, many applications require data accuracy and miniature details to be preserved. A variety of data compression algorithms does exist in the literature for different forms of data like text, image, and multimedia data. In the proposed work, a generic progressive compression algorithm, based on probabilistic encoding, called PEINS is projected as an enhancement over irrational number stored coding technique to cater to storage issues of increasing data volumes as a cost effective solution, which also offers data security as a secondary outcome to some extent. The proposed work reveals cost effectiveness in terms of better compression ratio with no deterioration in compression time.

Keywords: compression ratio, generic compression, irrational number storage, probabilistic encoding

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Authors: Rachel Gugu Mkhasibe

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Incorporation of technology as a pedagogy has many benefits. For instance, improvement of pedagogy, increased information access, increased cooperation, and collaboration. However, as good as it may be, this integration of technology as a pedagogy has not been widely adopted in most historically Black higher education institutions especially those in developing countries. For example, the socioeconomic background of students in historically black universities, the weak financial support available from these universities, as well as a large population of students struggle to access the recommended modern physical resources such as iPads, laptops, mobile phones, to name a few. This contributes to an increase in the increase of educational inequalities. The qualitative research approach was utilized in this work to gather detailed data about the obstacles created by the integration of technology as a pedagogy. Interviews were conducted to generate data from 20 academics from 10 Leve two students from one of the historically disadvantaged higher education Institutions in South Africa. The findings revealed that although both students and academics had overwhelming support of the integration of technology as a pedagogy in their institution, the environment which they found themselves in compromise the incorporation of technology as a pedagogy. Therefore, this paper recommends that Department of Higher Education and University Management should intervene and budget for technology to be provided in all the institutions of higher education regardless of where the institutions are situated.

Keywords: collaboration, integration, pedagogy, technology

Procedia PDF Downloads 78