Search results for: risk management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13956

Search results for: risk management

2466 Woodcast is Ecologically Sound and Tolerated by a Majority of Patients

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

Abstract:

NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studies are shortcoming on individual patient experience. The aim of this study was to assess the patient’s satisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. For all patients managed with woodcast in our unit, we undertook a structured questionnaire that included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score and the pain numerical score at the time of injury and six weeks after. 30 patients were initially managed with woodcast. 80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Paris casting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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2465 Nurses' Knowledge and Attitudes about Clinical Governance

Authors: Sedigheh Salemi, Mahnaz Sanjari, Maryam Aalaa, Mohammad Mirzabeigi

Abstract:

Clinical governance is the framework within which the health service provider is required to ongoing accountability and improvement of the quality of their services. This cross-sectional study was conducted in 661 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 24 questions in which 4 questions focused on clinical governance defining from the nurses' perspective. The reliability was evaluated by Cronbach's alpha (α=0/83). Statistical analyzes were performed, using SPSS version 16. Approximately 40% of nurses correctly answered that clinical governance is not "system of punishment and rewards for the staff". The most nurses believed that "clinical efficacy" is one of the main components of clinical governance. A few of nurses correctly responded that "Evidence Based Practice" and "management" is not part of clinical governance. The small number of nurses correctly answered that the "maintenance of patient records" and "to recognize the adverse effects" is not the role of nurse in clinical governance. Most "do not know" answer was to the "maintenance of patient records". The most nurses unanimously believed that the implementation of clinical governance led to "promoting the quality of care". About a third of nurses correctly stated that the implementation of clinical governance will not lead to "an increase in salaries and benefits of the medical team". As a member of the health team, nurses are responsible in terms of participation in quality improvement and it is necessary to create an environment in which clinical care will flourish and serve to preserve the high standards.

Keywords: clinical governance, nurses, salary, health team

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2464 Color-Based Emotion Regulation Model: An Affective E-Learning Environment

Authors: Sabahat Nadeem, Farman Ali Khan

Abstract:

Emotions are considered as a vital factor affecting the process of information handling, level of attention, memory capacity and decision making. Latest e-Learning systems are therefore taking into consideration the effective state of learners to make the learning process more effective and enjoyable. One such use of user’s affective information is in the systems that tend to regulate users’ emotions to a state optimally desirable for learning. So for, this objective has been tried to be achieved with the help of teaching strategies, background music, guided imagery, video clips and odors. Nevertheless, we know that colors can affect human emotions. Relationship between color and emotions has a strong influence on how we perceive our environment. Similarly, the colors of the interface can also affect the user positively as well as negatively. This affective behavior of color and its use as emotion regulation agent is not yet exploited. Therefore, this research proposes a Color-based Emotion Regulation Model (CERM), a new framework that can automatically adapt its colors according to user’s emotional state and her personality type and can help in producing a desirable emotional effect, aiming at providing an unobtrusive emotional support to the users of e-learning environment. The evaluation of CERM is carried out by comparing it with classical non-adaptive, static colored learning management system. Results indicate that colors of the interface, when carefully selected has significant positive impact on learner’s emotions.

Keywords: effective learning, e-learning, emotion regulation, emotional design

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2463 Analysis of Brain Activities due to Differences in Running Shoe Properties

Authors: Kei Okubo, Yosuke Kurihara, Takashi Kaburagi, Kajiro Watanabe

Abstract:

Many of the ever-growing elderly population require exercise, such as running, for health management. One important element of a runner’s training is the choice of shoes for exercise; shoes are important because they provide the interface between the feet and road. When we purchase shoes, we may instinctively choose a pair after trying on many different pairs of shoes. Selecting the shoes instinctively may work, but it does not guarantee a suitable fit for running activities. Therefore, if we could select suitable shoes for each runner from the viewpoint of brain activities, it would be helpful for validating shoe selection. In this paper, we describe how brain activities show different characteristics during particular task, corresponding to different properties of shoes. Using five subjects, we performed a verification experiment, applying weight, softness, and flexibility as shoe properties. In order to affect the shoe property’s differences to the brain, subjects run for ten min. Before and after running, subjects conducted a paced auditory serial addition task (PASAT) as the particular task; and the subjects’ brain activities during the PASAT are evaluated based on oxyhemoglobin and deoxyhemoglobin relative concentration changes, measured by near-infrared spectroscopy (NIRS). When the brain works actively, oxihemoglobin and deoxyhemoglobin concentration drastically changes; therefore, we calculate the maximum values of concentration changes. In order to normalize relative concentration changes after running, the maximum value are divided by before running maximum value as evaluation parameters. The classification of the groups of shoes is expressed on a self-organizing map (SOM). As a result, deoxyhemoglobin can make clusters for two of the three types of shoes.

Keywords: brain activities, NIRS, PASAT, running shoes

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2462 The BETA Module in Action: An Empirical Study on Enhancing Entrepreneurial Skills through Kearney's and Bloom's Guiding Principles

Authors: Yen Yen Tan, Lynn Lam, Cynthia Lam, Angela Koh, Edwin Seng

Abstract:

Entrepreneurial education plays a crucial role in nurturing future innovators and change-makers. Over time, significant progress has been made in refining instructional approaches to develop the necessary skills among learners effectively. Two highly valuable frameworks, Kearney's "4 Principles of Entrepreneurial Pedagogy" and Bloom's "Three Domains of Learning," serve as guiding principles in entrepreneurial education. Kearney's principles align with experiential and student-centric learning, which are crucial for cultivating an entrepreneurial mindset. The potential synergies between these frameworks hold great promise for enhancing entrepreneurial acumen among students. However, despite this potential, their integration remains largely unexplored. This study aims to bridge this gap by building upon the Business Essentials through Action (BETA) module and investigating its contributions to nurturing the entrepreneurial mindset. This study employs a quasi-experimental mixed-methods approach, combining quantitative and qualitative elements to ensure comprehensive and insightful data. A cohort of 235 students participated, with 118 enrolled in the BETA module and 117 in a traditional curriculum. Their Personal Entrepreneurial Competencies (PECs) were assessed before admission (pre-Y1) and one year into the course (post-Y1) using a comprehensive 55-item PEC questionnaire, enabling measurement of critical traits such as opportunity-seeking, persistence, and risk-taking. Rigorous computations of individual entrepreneurial competencies and overall PEC scores were performed, including a correction factor to mitigate potential self-assessment bias. The orchestration of Kearney's principles and Bloom's domains within the BETA module necessitates a granular examination. Here, qualitative revelations surface, courtesy of structured interviews aligned with contemporary research methodologies. These interviews act as a portal, ushering us into the transformative journey undertaken by students. Meanwhile, the study pivots to explore the BETA module's influence on students' entrepreneurial competencies from the vantage point of faculty members. A symphony of insights emanates from intimate focus group discussions featuring six dedicated lecturers, who share their perceptions, experiences, and reflective narratives, illuminating the profound impact of pedagogical practices embedded within the BETA module. Preliminary findings from ongoing data analysis indicate promising results, showcasing a substantial improvement in entrepreneurial skills among students participating in the BETA module. This study promises not only to elevate students' entrepreneurial competencies but also to illuminate the broader canvas of applicability for Kearney's principles and Bloom's domains. The dynamic interplay of quantitative analyses, proffering precise competency metrics, and qualitative revelations, delving into the nuanced narratives of transformative journeys, engenders a holistic understanding of this educational endeavour. Through a rigorous quasi-experimental mixed-methods approach, this research aims to establish the BETA module's effectiveness in fostering entrepreneurial acumen among students at Singapore Polytechnic, thereby contributing valuable insights to the broader discourse on educational methodologies.

Keywords: entrepreneurial education, experiential learning, pedagogical frameworks, innovative competencies

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2461 Spirituality in Education (Enhance the Human Mind Competencies)

Authors: Kshama Sharma

Abstract:

Education is one of the most powerful tools to transform the world into a just, sustainable, and more peaceful place for existing lives across the globe. However, its recent objective approach focused on materialistic, factual, and existing knowledge, has a constraint of human experiences that is limited to certain dimensions only. And leads to a materialistic world which is deprived of spiritual approaches and makes it less compassionate, and more grades oriented. To make it more comprehensive, education should explore the subjective approaches towards spiritualism to connect lives with the greater self and consciousness of cosmic intelligence. This approach will bring a major shift in the orientation of pedagogical processes, assessment strategies, and administrative management of the present education system. Spirituality often related to the religious aspect of human civilization and development, however, when universal consciousness /cosmic intelligence (which is often claimed as dark energy) and the human mind competencies works in coherence and coordination then the efficiency of human mind reaches to a different dimension and achieve extraordinary level of human understanding. Quantitative analysis of the existing secondary data from the different agencies working in the field of meditation had been analyzed to conclude its implications on human mind and further how it can effectively use in education to bring the desired and expected results. Any kind of meditation practice affects the cognitive, mental, physical, emotional, and conscious state of mind. If aligned with the teaching and learning methodology will lead to conscious learner and peaceful world.

Keywords: spirituality, cosmic intelligence, consciousness, mind competencies

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2460 Deep Learning-Based Object Detection on Low Quality Images: A Case Study of Real-Time Traffic Monitoring

Authors: Jean-Francois Rajotte, Martin Sotir, Frank Gouineau

Abstract:

The installation and management of traffic monitoring devices can be costly from both a financial and resource point of view. It is therefore important to take advantage of in-place infrastructures to extract the most information. Here we show how low-quality urban road traffic images from cameras already available in many cities (such as Montreal, Vancouver, and Toronto) can be used to estimate traffic flow. To this end, we use a pre-trained neural network, developed for object detection, to count vehicles within images. We then compare the results with human annotations gathered through crowdsourcing campaigns. We use this comparison to assess performance and calibrate the neural network annotations. As a use case, we consider six months of continuous monitoring over hundreds of cameras installed in the city of Montreal. We compare the results with city-provided manual traffic counting performed in similar conditions at the same location. The good performance of our system allows us to consider applications which can monitor the traffic conditions in near real-time, making the counting usable for traffic-related services. Furthermore, the resulting annotations pave the way for building a historical vehicle counting dataset to be used for analysing the impact of road traffic on many city-related issues, such as urban planning, security, and pollution.

Keywords: traffic monitoring, deep learning, image annotation, vehicles, roads, artificial intelligence, real-time systems

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2459 The OverStitch and OverStitch SX Endoscopic Suturing System in Bariatric Surgery, Closing Perforations and Fistulas and Revision Procedures

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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2458 Unity in Diversity: Exploring the Psychological Processes and Mechanisms of the Sense of Community for the Chinese Nation in Ethnic Inter-embedded Communities

Authors: Jiamin Chen, Liping Yang

Abstract:

In 2007, sociologist Putnam proposed a pessimistic forecast in the United States' "Social Capital Community Benchmark Survey," suggesting that "ethnic diversity would challenge social unity and undermine social cohesion." If this pessimistic assumption were proven true, it would indicate a risk of division in diverse societies. China, with 56 ethnic groups, is a multi-ethnic country. On May 26, 2014, General Secretary Xi Jinping proposed "building ethnically inter-embedded communities to promote deeper development in interactions, exchanges, and integration among ethnic groups." Researchers unanimously agree that ethnic inter-embedded communities can serve as practical arenas and pathways for solidifying the sense of the Chinese national community However, there is no research providing evidence that ethnic inter-embedded communities can foster the sense of the Chinese national community, and the influencing factors remain unclear. This study adopts a constructivist grounded theory research approach. Convenience sampling and snowball sampling were used in the study. Data were collected in three communities in Kunming City. Twelve individuals were eventually interviewed, and the transcribed interviews totaled 187,000 words. The research has obtained ethical approval from the Ethics Committee of Nanjing Normal University (NNU202310030). The research analyzed the data and constructed theories, employing strategies such as coding, constant comparison, and theoretical sampling. The study found that: firstly, ethnic inter-embedded communities exhibit characteristics of diversity, including ethnic diversity, cultural diversity, and linguistic diversity. Diversity has positive functions, including increased opportunities for contact, promoting self-expansion, and increasing happiness; negative functions of diversity include highlighting ethnic differences, causing ethnic conflicts, and reminding of ethnic boundaries. Secondly, individuals typically engage in interactions within the community using active embedding and passive embedding strategies. Active embedding strategies include maintaining openness, focusing on similarities, and pro-diversity beliefs, which can increase external group identification, intergroup relational identity, and promote ethnic integration. Individuals using passive embedding strategies tend to focus on ethnic stereotypes, perceive stigmatization of their own ethnic group, and adopt an authoritarian-oriented approach to interactions, leading to a perception of more identity threats and ultimately rejecting ethnic integration. Thirdly, the commonality of the Chinese nation is reflected in the 56 ethnic groups as an "identity community" and "interest community," and both active and passive embedding paths affect individual understanding of the commonality of the Chinese nation. Finally, community work and environment can influence the embedding process. The research constructed a social psychological process and mechanism model for solidifying sense of the Chinese national community in ethnic inter-embedded communities. Based on this theoretical model, future research can conduct more micro-level psychological mechanism tests and intervention studies to enhance Chinese national cohesion.

Keywords: diversity, sense of the chinese national community, ethnic inter-embedded communities, ethnic group

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2457 Pattern of Substance Use: Study in a De-Addiction Clinic

Authors: Mohammad Muntasir Maruf, Muhammad Zillur Rahman Khan, Nasim Jahan, Md. Waziul Alam Chowdhury, Satparkash, Md. Nozrul Islam

Abstract:

Background: Substance use disorders have become a major public health problem in Bangladesh. Objectives: The present study was designed to assess the pattern of substance use and factors related to it among the hospitalized patients. Methods: This was a cross-sectional study. All the patients who were admitted in a private drug de-addiction clinic in the capital city (Dhaka) of Bangladesh during 1 July-31 December, 2013 and diagnosed as a case of substance use disorder by applying Structured Clinical Interview for DSM- Clinician Version were enrolled in the study. Data were collected through face to face interview by a semi-structured questionnaire and the information was complemented by the case-notes. Study subjects were 105 in number. Data analysis was performed using Statistical Package for Social Sciences (SPSS). Results: Most (90.5%) of the respondents were male. The mean age of the respondents was 28.8 (± 8.0) years. Majority (91.4%) were poly-substance users. Most (27.6%) respondents used 3 types of substances. Smoking or inhalation was the route used by most (90.5%) respondents. More than three-fourth (81%) of the respondents used nicotine. Among the other substances, majority (79%) used opiates group, followed by cannabinoids group (55.2%) and alcohol (41%). Curiosity, peer pressure and to have enjoyment or fun were identified as the common reasons for initiating substance use. Conclusions: A high proportion of poly-substance use was found. The study findings would help in management and prevention strategy of substance use in Bangladesh.

Keywords: Bangladesh, de-addiction clinic, poly-substance users, substance use disorder

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2456 Assessment of Forest Resource Exploitation in the Rural Communities of District Jhelum

Authors: Rubab Zafar Kahlon, Ibtisam Butt

Abstract:

Forest resources are deteriorating and experiencing decline around the globe due to unsustainable use and over exploitation. The present study was an attempt to determine the relationship between human activities, forest resource utilization, extraction methods and practices of forest resource exploitation in the district Jhelum of Pakistan. For this purpose, primary sources of data were used which were collected from 8 villages through structured questionnaire and tabulated in Microsoft Excel 365 and SPSS 22 was used for multiple linear regression analysis. The results revealed that farming, wood cutting, animal husbandry and agro-forestry were the major occupations in the study area. Most commonly used resources included timber 26%, fuelwood 25% and fodder 19%. Methods used for resource extraction included gathering 49%, plucking 34% trapping 11% and cutting 6%. Population growth, increased demand of fuelwood and land conversion were the main reasons behind forest degradation. Results for multiple linear regression revealed that Forest based activities, sources of energy production, methods used for wood harvesting and resource extraction and use of fuelwood for energy production contributed significantly towards extensive forest resource exploitation with p value <0.5 within the study area. The study suggests that effective measures should be taken by forest department to control the unsustainable use of forest resources by stringent management interventions and awareness campaigns in Jhelum district.

Keywords: forest resource, biodiversity, expliotation, human activities

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2455 Correlation between Clinical Measurements of Static Foot Posture in Young Adults

Authors: Phornchanok Motantasut, Torkamol Hunsawong, Lugkana Mato, Wanida Donpunha

Abstract:

Identifying abnormal foot posture is important for prescribing appropriate management in patients with lower limb disorders and chronic non-specific low back pain. The normalized navicular height truncated (NNHt) and the foot posture index-6 (FPI-6) have been recommended as the common, simple, valid, and reliable static measures for clinical application. The NNHt is a single plane measure while the FPI-6 is a triple plane measure. At present, there is inadequate information about the correlation between the NNHt and the FPI-6 for categorizing foot posture that leads to a difficulty of choosing the appropriate assessment. Therefore, the present study aimed to determine the correlation between the NNHt and the FPI-6 measures in adult participants with asymptomatic feet. Methods: A cross-sectional descriptive study was conducted in 47 asymptomatic individuals (23 males and 24 females) aged 28.89 ± 7.67 years with body mass index 21.73 ± 1.76 kg/m². The right foot was measured twice by the experienced rater using the NNHt and the FPI-6. A sequence of the measures was randomly arranged for each participant with a 10-minute rest between the tests. The Pearson’s correlation coefficient (r) was used to determine the relationship between the measures. Results: The mean NNHt score was 0.23 ± 0.04 (ranged from 0.15 to 0.36) and the mean FPI-6 score was 4.42 ± 4.36 (ranged from -6 to +11). The Pearson’s correlation coefficient among the NNHt score and the FPI-6 score was -0.872 (p < 0.01). Conclusion: The present finding demonstrates the strong correlation between the NNHt and FPI-6 in adult feet and implies that both measures could be substituted for each other in identifying foot posture.

Keywords: foot posture index, foot type, measurement of foot posture, navicular height

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2454 Thermal Management of Ground Heat Exchangers Applied in High Power LED

Authors: Yuan-Ching Chiang, Chien-Yeh Hsu, Chen Chih-Hao, Sih-Li Chen

Abstract:

The p-n junction temperature of LEDs directly influences their operating life and luminous efficiency. An excessively high p-n junction temperature minimizes the output flux of LEDs, decreasing their brightness and influencing the photon wavelength; consequently, the operating life of LEDs decreases and their luminous output changes. The maximum limit of the p-n junction temperature of LEDs is approximately 120 °C. The purpose of this research was to devise an approach for dissipating heat generated in a confined space when LEDs operate at low temperatures to reduce light decay. The cooling mode of existing commercial LED lights can be divided into natural- and forced convection cooling. In natural convection cooling, the volume of LED encapsulants must be increased by adding more fins to increase the cooling area. However, this causes difficulties in achieving efficient LED lighting at high power. Compared with forced convection cooling, heat transfer through water convection is associated with a higher heat transfer coefficient per unit area; therefore, we dissipated heat by using a closed loop water cooling system. Nevertheless, cooling water exposed to air can be easily influenced by environmental factors. Thus, we incorporated a ground heat exchanger into the water cooling system to minimize the influence of air on cooling water and then observed the relationship between the amounts of heat dissipated through the ground and LED efficiency.

Keywords: helical ground heat exchanger, high power LED, ground source cooling system, heat dissipation

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2453 Measuring Greenhouse Gas Exchange from Paddy Field Using Eddy Covariance Method in Mekong Delta, Vietnam

Authors: Vu H. N. Khue, Marian Pavelka, Georg Jocher, Jiří Dušek, Le T. Son, Bui T. An, Ho Q. Bang, Pham Q. Huong

Abstract:

Agriculture is an important economic sector of Vietnam, the most popular of which is wet rice cultivation. These activities are also known as the main contributor to the national greenhouse gas. In order to understand more about greenhouse gas exchange in these activities and to investigate the factors influencing carbon cycling and sequestration in these types of ecosystems, since 2019, the first eddy covariance station has been installed in a paddy field in Long An province, Mekong Delta. The station was equipped with state-of-the-art equipment for CO₂ and CH₄ gas exchange and micrometeorology measurements. In this study, data from the station was processed following the ICOS recommendations (Integrated Carbon Observation System) standards for CO₂, while CH₄ was manually processed and gap-filled using a random forest model from methane-gapfill-ml, a machine learning package, as there is no standard method for CH₄ flux gap-filling yet. Finally, the carbon equivalent (Ce) balance based on CO₂ and CH₄ fluxes was estimated. The results show that in 2020, even though a new water management practice - alternate wetting and drying - was applied to reduce methane emissions, the paddy field released 928 g Cₑ.m⁻².yr⁻¹, and in 2021, it was reduced to 707 g Cₑ.m⁻².yr⁻¹. On a provincial level, rice cultivation activities in Long An, with a total area of 498,293 ha, released 4.6 million tons of Cₑ in 2020 and 3.5 million tons of Cₑ in 2021.

Keywords: eddy covariance, greenhouse gas, methane, rice cultivation, Mekong Delta

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2452 Community Based Heritage Tourism in the Old City of Nazareth

Authors: Alon Gelbman, Daniel Laven

Abstract:

The paper focuses on a case study of a small-scale heritage tourism venture that seeks to influence tourism development in Nazareth’s old city. This is an exploratory case study that uses qualitative research methods including extensive participant observation and in-depth interviews with the venture’s senior management group and selected employees. Study findings indicate a model of the relationship between community-based tourism development, heritage, and peace-building in a city that has experienced a wide range of cross-cultural conflicts. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict.

Keywords: cultural heritage tourism, tourism and peace, community-based tourism, sustainable tourism, cross-cultural conflict, Nazareth historic city

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2451 Assessment of the Remains in Historic Urban Area Based on Spatial Prototype: Case Study on Jingmen City, China

Authors: Guangtong Xu, Yi He

Abstract:

Like most historic and cultural cities in China, the historic urban area of Jingmen city is facing a typical spatial problem of fragmentation and fuzzification. This study focuses on exploring a method for evaluating the existing values of historic urban area based on spatial prototype, a concept introduced into urban morphology from 'Archetype' in architectural typology. As the spatial elements and built-up relationship of historic city, spatial prototype has habitual structural characteristics and formal modulus. It is the inherent logic and order rules behind the scattered historic environment, providing a clue to understand the spatial characteristics and a basis for guiding the construction and conservation in historic urban areas. Three criteria, the resolution of historical elements, the completeness of historical structure and the renewal potential of associated land, were selected to construct the integrated assessment system. These three dimensions are linked to the spatial prototype and its constituent elements, as well as the transformation relationship in ancient and present day. The results showed that historic urban areas have changed from a holistic city to different existing types dominated by their historic structure elements. It is necessary to improve the pertinence of planning strategies and develop diversified management measures in the conservation scope of historic urban area. Moreover, a constructive-conservation strategy should be put forward to enhance the integrity of historic urban area based on the trace of spatial prototype and evaluation results.

Keywords: constructive conservation, existing value, historic urban area, spatial prototype

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2450 RE:SOUNDING a 2000-Year-Old Vietnamese Dong Son Bronze Drum; Artist-Led Collaborations outside the Museum to Challenge the Impasse of Repatriating and Rematriating Cultural Instruments

Authors: H. A. J. Nguyen, V. A. Pham

Abstract:

RE:SOUNDING is an ongoing research project and artwork seeking to return the sound and knowledge of Dong Son bronze drums back to contemporary musicians. Colonial collections of ethnographic instruments are problematic in how they commit acts of conceptual, cultural, and acoustic silencing. The collection (or more honestly), the plagiarism, and pillaging of these instruments have systemically separated them from living and breathing cultures. This includes diasporic communities, who have come to resettle in close proximity - but still have little access - to the museums and galleries that display their cultural objects. Despite recent attempts to 'open up' and 'recognise' the tensions and violence of these ethnographic collections, many museums continue to structurally organize and reproduce knowledge with the same procedural distance and limitations of imperial condescension. Impatient with the slowness of these museums, our diaspora led collaborations participated in the opaque economy of the auction market to gain access and begin the process of digitally recording and archiving the actual sounds of the ancient Dong Son drum. This self-directed, self-initiated artwork not only acoustically reinvigorated an ancient instrument but redistributed these sonic materials back to contemporary musicians, composers, and their diasporic communities throughout Vietnam, South East Asia, and Australia. Our methodologies not only highlight the persistent inflexibility of museum infrastructures but demand that museums refrain from their paternalistic practice of risk-averse ownership, to seriously engage with new technologies and political formations that require all public institutions to be held accountable for the ethical and intellectual viability of their colonial collections. The integrated and practical resolve of diasporic artists and their communities are more than capable of working with new technologies to reclaim and reinvigorate what is culturally and spiritually theirs. The motivation to rematriate – as opposed to merely repatriate – the acoustic legacies of these instruments to contemporary musicians and artists is a new model for decolonial and restorative practices. Exposing the inadequacies of western scholarship that continues to treat these instruments as discreet, disembodied, and detached artifacts, these collaborative strategies have thus far produced a wealth of new knowledge – new to the west perhaps – but not that new to these, our own communities. This includes the little-acknowledged fact that the Dong Son drum were political instruments of war and technology, rather than their simplistic description in the museum and western academia as agrarian instruments of fertility and harvest. Through the collective and continued sharing of knowledge and sound materials produced from this research, these drums are gaining a contemporary relevance beyond the cultural silencing of the museum display cabinet. Acknowledgement: We acknowledge the Wurundjeri and Boon Wurrung of the Kulin Nation and the Gadigal of the Eora Nation where we began this project. We pay our respects to the Peoples, Lands, Traditional Custodians, Practices, and Creator Ancestors of these Great Nations, as well as those First Nations peoples throughout Australia, Vietnam, and Indonesia, where this research continues, and upon whose stolen lands and waterways were never ceded.

Keywords: acoustic archaeology, decolonisation, museum collections, rematriation, repatriation, Dong Son, experimental music, digital recording

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2449 Antibiogram Profile of Antibacterial Multidrug Resistance in Democratic Republic of Congo: Situation in Bukavu City Hospitals

Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba

Abstract:

Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.

Keywords: multidrug resistance, bacteria, antibiogram, Bukavu

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2448 Unsteady Three-Dimensional Adaptive Spatial-Temporal Multi-Scale Direct Simulation Monte Carlo Solver to Simulate Rarefied Gas Flows in Micro/Nano Devices

Authors: Mirvat Shamseddine, Issam Lakkis

Abstract:

We present an efficient, three-dimensional parallel multi-scale Direct Simulation Monte Carlo (DSMC) algorithm for the simulation of unsteady rarefied gas flows in micro/nanosystems. The algorithm employs a novel spatiotemporal adaptivity scheme. The scheme performs a fully dynamic multi-level grid adaption based on the gradients of flow macro-parameters and an automatic temporal adaptation. The computational domain consists of a hierarchical octree-based Cartesian grid representation of the flow domain and a triangular mesh for the solid object surfaces. The hybrid mesh, combined with the spatiotemporal adaptivity scheme, allows for increased flexibility and efficient data management, rendering the framework suitable for efficient particle-tracing and dynamic grid refinement and coarsening. The parallel algorithm is optimized to run DSMC simulations of strongly unsteady, non-equilibrium flows over multiple cores. The presented method is validated by comparing with benchmark studies and then employed to improve the design of micro-scale hotwire thermal sensors in rarefied gas flows.

Keywords: DSMC, oct-tree hierarchical grid, ray tracing, spatial-temporal adaptivity scheme, unsteady rarefied gas flows

Procedia PDF Downloads 295
2447 Investing the Employees Higher Quitting Intention at the Call Centers of Pakistan: A Reality or a Myth: A Case Study of Pakistan Telecommunication Sector

Authors: Naheed Malik, Marisa Smith

Abstract:

This study has been undertaken as an attempt to explore the underlying reasons that cause higher employee turnover rates at the call centers of Pakistan. This research also aimed to examine the relationship among the job related variables such as job satisfaction, organizational commitment, supervisor support, self-esteem, organizational stressors (work overload, role ambiguity and work family conflict) and quitting inclination. A total of 340 call centers respondents filled the survey questionnaire. The data was analyzed through SPSS 19.0. Results reveal the significant relationship among the study variables and stress level contributing more towards employee penchant to leave the job. A significant amount of call centers employee have proclivity to quit from their jobs as soon as they would be able to find some other jobs with attractive compensation. The majority of the respondents were found to be unhappy and dissatisfied due to hectic schedule and imbalance between family and work. This research also highlighted the specific areas in which call centre management needs to emphasize deliberately that affect more sharply on employee leaving aptitude. This study also suggests some useful strategies for the well being of employees that can minimize their tendency of quitting and retention in the long run.

Keywords: call centers, stress, job satisfaction, organizational commitment, supervisor’s support, self esteem, employee turnover, employees’ intention to quit, customer service representative (CSRs)

Procedia PDF Downloads 276
2446 The Challenge of the Decarbonization of Shipping and Complex Imo Regulations

Authors: Saiyeed Jakaria Baksh Imran

Abstract:

The earth is being endangered by many of the climate related issues today. The most serious issue for the world today is the global warming. Increase in Greenhouse gas (GHG) emissions post-industrial revolution period is the prime reason for global warming. Shipping is the fifth largest GHG emitting sector worldwide. The key reason for this is because, over 90% of the world trade is conducted through ocean as the ocean alone covers 70% of the earth surface. While the countries continue to develop, trade and commerce continue to increase between them simultaneously. However, there is no sign of reduction in GHG emission from shipping because of many concerned issues. Firstly, there is technological barrier for which ships cannot just become environment friendly immediately. Secondly, there is no alternative fuel available as well. Thirdly, there is no proper mechanism to measure how much ships emit as emission from ships vary according to the size, engine type and loading capacity of ships. The International Maritime Organization (IMO) being the governing body of the international shipping has implemented MARPOL Annex VI. However, the policy alone is not enough unless there is a proper data available regarding ship emissions, which the IMO is yet to figure out. This paper will present a critical analysis of existing IMO policies such as the Energy Efficiency Design Index (EEDI), Ship Energy Efficiency Management Plan (SEEMP), Data Collection System (SEEMP) and the IMO’s Initial Strategy on Reduction of Greenhouse Gas emissions from shipping. Also, the challenges exist in implementing such policies have been presented in the paper.

Keywords: GHG, IMO, EEDI, SEEMP, DCS, greenhouse gas, decarbonization, shipping

Procedia PDF Downloads 67
2445 Applying Theory of Inventive Problem Solving to Develop Innovative Solutions: A Case Study

Authors: Y. H. Wang, C. C. Hsieh

Abstract:

Good service design can increase organization revenue and consumer satisfaction while reducing labor and time costs. The problems facing consumers in the original serve model for eyewear and optical industry includes the following issues: 1. Insufficient information on eyewear products 2. Passively dependent on recommendations, insufficient selection 3. Incomplete records on progression of vision conditions 4. Lack of complete customer records. This study investigates the case of Kobayashi Optical, applying the Theory of Inventive Problem Solving (TRIZ) to develop innovative solutions for eyewear and optical industry. Analysis results raise the following conclusions and management implications: In order to provide customers with improved professional information and recommendations, Kobayashi Optical is suggested to establish customer purchasing records. Overall service efficiency can be enhanced by applying data mining techniques to analyze past consumer preferences and purchase histories. Furthermore, Kobayashi Optical should continue to develop a 3D virtual trial service which can allow customers for easy browsing of different frame styles and colors. This 3D virtual trial service will save customer waiting times in during peak service times at stores.

Keywords: theory of inventive problem solving (TRIZ), service design, augmented reality (AR), eyewear and optical industry

Procedia PDF Downloads 274
2444 Extrapulmonary Gastrointestinal Small Cell Carcinoma: A Single Institute Experience of 14 Patients from a Low Middle Income Country

Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

Abstract:

Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

Procedia PDF Downloads 148
2443 A Review On Traditional Agroforestry Systems In Europe Revisited: Biodiversity, Ecosystem Services, And Future Perspectives

Authors: Thuy Hang Le

Abstract:

Traditional agroforestry systems are land-use practices still widespread in tropical and subtropical countries, while in Europe have significantly decreased due to land-use intensification, land abandonment, and urbanization. Nevertheless, scientific evidence reveals that traditional agroforestry systems significantly support biodiversity and ecosystem services and may positively contribute to socioeconomic rural regional development. We worked out a review that follows the PRISMA approach and compiled comprehensive information on traditional agroforestry systems in Europe. Based on the differentiation of different land-use systems, also considering the agricultural as well as forestry components, we compiled information regarding current distribution, management (agrodiversity), biodiversity and agrobiodiversity, ecosystem and landscape services, threats, and restoration initiatives. From a total of 3,304 studies that dealt with agroforestry systems in Europe, both “modern” (e.g., buffer strip) and “traditional” (e.g., meadow orchards), we filtered out 158 studies from 35 European countries which represent the basis for in-depth investigation. We found, for example, that the traditional pastoral agroforestry system in the Mediterranean region, the so-called Dehesa, can harbor up to 300 plant species as well as 238 bird species, of which 134 are breeding birds. With regard to carbon storage, the traditional orchard agroforestry system in Germany stocks ranged between 6.5 and 9.8 Mg C ha−1, showing significantly higher values compared to an intensively used grassland with around 3.4 to 6.7 Mg C ha−1. With the remarkably high benefit for biodiversity and ecosystem services provided, the important role and multifunctionality of traditional agroforestry systems in Europe should be acknowledged and promoted.

Keywords: biodiversity, ecosystem services, landscape services, traditional agroforestry systems

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2442 Gas Network Noncooperative Game

Authors: Teresa Azevedo PerdicoúLis, Paulo Lopes Dos Santos

Abstract:

The conceptualisation of the problem of network optimisation as a noncooperative game sets up a holistic interactive approach that brings together different network features (e.g., com-pressor stations, sources, and pipelines, in the gas context) where the optimisation objectives are different, and a single optimisation procedure becomes possible without having to feed results from diverse software packages into each other. A mathematical model of this type, where independent entities take action, offers the ideal modularity and subsequent problem decomposition in view to design a decentralised algorithm to optimise the operation and management of the network. In a game framework, compressor stations and sources are under-stood as players which communicate through network connectivity constraints–the pipeline model. That is, in a scheme similar to tatonnementˆ, the players appoint their best settings and then interact to check for network feasibility. The devolved degree of network unfeasibility informs the players about the ’quality’ of their settings, and this two-phase iterative scheme is repeated until a global optimum is obtained. Due to network transients, its optimisation needs to be assessed at different points of the control interval. For this reason, the proposed approach to optimisation has two stages: (i) the first stage computes along the period of optimisation in order to fulfil the requirement just mentioned; (ii) the second stage is initialised with the solution found by the problem computed at the first stage, and computes in the end of the period of optimisation to rectify the solution found at the first stage. The liability of the proposed scheme is proven correct on an abstract prototype and three example networks.

Keywords: connectivity matrix, gas network optimisation, large-scale, noncooperative game, system decomposition

Procedia PDF Downloads 144
2441 Global Evidence on the Seasonality of Enteric Infections, Malnutrition, and Livestock Ownership

Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

Abstract:

Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

Procedia PDF Downloads 117
2440 FEM Based Numerical Simulation and Analysis of a Landslide Triggered by the Fluctuations of Ground-Water Levels

Authors: Deepak Raj Bhat, Akihiko Wakai, Shigeru Ogita, Yorihiro Tanaka, Kazushige Hayashi, Shinro Abe

Abstract:

In this study, the newly developed finite element methods are used for numerical analysis ofa landslide triggered by the fluctuations of ground-water levels in different cases I-IV. In case I, the ground-water level is fixed in such a way that the overall factor of safety (Fs) would be greater or equal to 1 (i.e., stable condition). Then, the ground-water level is gradually increased up to 1.0 m for, making the overall factor of safety (Fs) less than one (i.e., stable or moving condition). Then, the newly developed finite element model is applied for numerical simulation of the slope for each case. Based on the numerical analysis results of each Cases I-IV, the details of the deformation pattern and shear strain pattern are compared to each other. Moreover, the change in mobilized shear strength and local factor of safety along the slip surface of the landslide for each case are discussed to understand the triggering behaviors of a landslide due to the increased in ground water level. It is expected that this study will help to better understand the role of groundwater fluctuation for triggering of a landslide or slope failure disasters, and it would be also helpful for the judgment of the countermeasure works for the prevention and mitigation of landslide and slope failure disasters in near future.

Keywords: finite element method, ground water fluctuations, constitutive model, landslides, long-term disaster management system

Procedia PDF Downloads 113
2439 Changing the Way South Africa Think about Parking Provision at Tertiary Institutions

Authors: M. C. Venter, G. Hitge, S. C. Krygsman, J. Thiart

Abstract:

For decades, South Africa has been planning transportation systems from a supply, rather than a demand side, perspective. In terms of parking, this relates to requiring the minimum parking provision that is enforced by city officials. Newer insight is starting to indicate that South Africa needs to re-think this philosophy in light of a new policy environment that desires a different outcome. Urban policies have shifted from reliance on the private car for access, to employing a wide range of alternative modes. Car dominated travel is influenced by various parameters, of which the availability and location of parking plays a significant role. The question is therefore, what is the right strategy to achieve the desired transport outcomes for SA. The focus of this paper is used to assess this issue with regard to parking provision, and specifically at a tertiary institution. A parking audit was conducted at the Stellenbosch campus of Stellenbosch University, monitoring occupancy at all 60 parking areas, every hour during business hours over a five-day period. The data from this survey was compared with the prescribed number of parking bays according to the Stellenbosch Municipality zoning scheme (requiring a minimum of 0.4 bays per student). The analysis shows that by providing 0.09 bays per student, the maximum total daily occupation of all the parking areas did not exceed an 80% occupation rate. It is concluded that the prevailing parking standards are not supportive of the new urban and transport policy environment, but that it is extremely conservative from a practical demand point of view.

Keywords: parking provision, parking requirements, travel behaviour, travel demand management

Procedia PDF Downloads 173
2438 Dopamine and Female Sexual Function: A Clinical and Biochemical Study

Authors: Azza Gaber Antar Farag, Eman Abd El Fatah Badr, Wesam Ahmed Tawfik Hasssan Abdel Aal, Mustafa Elsayed Elshaib

Abstract:

Background: Female Sexual Dysfunction (FSD) represents recurrent and persistent problems that distress women and/or strain their relationships with their partners. Dopamine can affect sexual function and interacts with ovarian hormones in the ventromedial area in the hypothalamus. Objective: To investigate the possible role of dopamine in FSD. Method: This prospective case-control study was carried on 100 women having FSD and 100 healthy volunteer females. They were recruited from the Al-Menoufia governorate. All included women were subjected to the questionnaire to assess their demographic and gynecological data as well as sexual function. They were investigated for serum levels of dopamine, estradiol, progesterone and DHEA hormones. Results: Dopamine serum levels were significantly lower in females having sexual dysfunction (6.68±4.14) than controls (57.97±26.26) (P>0.001). This decreased dopamine level was of a significant positive correlation with the arousal domain and significant negative correlation regarding the pain domain (r=-0.19, p=0.01). Also, estradiol serum levels were significantly lower (P>0.001), but progesterone and DHEA serum levels were significantly higher in the FSD group than controls (P>0.001). There was a significant negative correlation between dopamine and DHEA serum levels (r= -0.45, p <0.001). Conclusions: Decreased dopamine serum levels may have an active role in the pathophysiology of FSD, impacting mainly arousal and pain domains, and its targeting should be considered during FSD management.

Keywords: dopamine, estradiol, progesterone, DHEA, females sexual dysfunction

Procedia PDF Downloads 156
2437 Transperineal Repair Is Ideal for the Management of Rectocele with Faecal Incontinence

Authors: Tia Morosin, Marie Shella De Robles

Abstract:

Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

Procedia PDF Downloads 118