Search results for: balanced budget rule

Authors: Rahmadanih, Sitti Bulkis, A. Amrullah, R. M. Rukka, N. M. Viantika

Abstract:

Food security is still a global issue, including in Indonesia. In South Sulawesi, this issue also occurs in members of farmer groups/women farmer groups. This study aims to (1) describe the implementation of strengthening institutional model of Women Farmer Groups (WFG) and (2) analyzing the capacity building of WFG members in order to develop food security after the implementations on institutional model. The research was conducted in Bulukumba and Luwu Utara District, South Sulawesi, Indonesia. The research was designed with qualitative and quantitative (mixed) method. Qualitative data were collected through in-depth interview and Focus Group Discussion (FGD); while quantitative data collected through a household survey of WGF members. Two WGF were selected they are WFG in Bulukumba and WGF in Luwu Utara District. Both WGF has been selected as the case unit, which consisting of 60 households. Institutional strengthening model that been implemented is a combination model of (1) institutional support and (2) capacity development of WGF members. The model of institutional support aim is to develop food security could be achieved through facilitation on produce banana chips (initiate a business group formation) and preparation of institution rule (AD/ART). (2) The developing Model of WFG members capacity building are (a) technical training of banana chips producing process, also food and nutrition counseling as well as the utilization of the yard, (b) processing of food products from their yards. Food and nutrition knowledge of WFG members was increased about 30% - 60% and accompanied by the development of households’ food security by 6.7% - 10.0%.; when compared to last year percentage.

Keywords: food security, institutional strengthening, model implementation, women farmer group

Procedia PDF Downloads 158

Authors: Prachi Chavda

Abstract:

The world, as of today, is smaller than it was for those who lived few decades ago. Internet, media and telecommunications have impacted the world like never before. Culture is the pillar upon which a society mushrooms. A culture develops with human creativity over the years and also by the exchange and intermixing of ideas and way of life across different civilizations and we can say that one of the influencing medium of exchange and intermixing of these ideas is cinema. Cinema has been the wonderful as well as important medium of communication since it has been emerged. Change is the thumb rule of life and so have been Indian cinema. As society has evolved from time to time so has the stories of Indian Cinema and its characters, hence it directly effects to the Indian culture as cinema has been very strong mediator for information exchange. The paper tries to discuss deeply how Indian cinema (reel life) and Indian culture (real life) has been influencing each other that results into a constant modification in both. Moreover, the research tries to deal with the issue with some examples that as a outcome how movies impact the Indian culture positively and negatively on culture. Therefore, it spreads the wave of change in cultural settings of society. The paper also tries to light the psychology of youth of India. Today, children and youth greatly admire the ostentatious materialistic display of outfits and style of the actors in the movies. Also, the movies bearing romanticism and showcasing disputatious issues like pre-marital sex, live-in relationship, homo-sexuality etc. though without highlighting them extensively have indeed inspired the commoners. Pros and cons always exist. Such revelation of issues certainly give a spark in the minds of those who are in their formative years and the effect of which is seen with the passage of time Thus, we can say that emergence of cinema as a strong tool of social change as well as culture as a triggering factor for transformation in cinema. As, a finding we can say that culture and cinema of India are influencing factors for each other. Cinema and culture are two sides of a coin, where both are responsible for evolution of each other.

Keywords: cinema, culture, influence, transformation

Procedia PDF Downloads 382

Authors: Najia Zulfiqar

Abstract:

Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

Procedia PDF Downloads 55

Authors: Shuk Ting Kinnia Yau

Abstract:

As China has become more and more influential in the global and geo-political arena, mutual understanding between Japan and China has also become a topic of paramount importance. There have always been tensions between the two countries, but unfortunately, each country tends to blame the other for fanning emotions. This research will investigate portrayals of China and the Chinese people in Japanese media such as newspapers, TV news, TV drama, and cinema over this period, focusing on media sources that have particularly wide viewership or readership. By doing so, it attempts to detect any general trends in the positive or negative character of such portrayals and to see if they correlate with the results of surveys of attitudes among the general population. To the degree that correlations may be found, the question arises as to whether the media portrayals are a reflection of societal attitudes towards the Chinese, on one hand, or may be playing a role in promoting such attitudes, on the other. The relationship here is, without doubt, more complex than a simple one-way relationship of cause and effect, but indications of some direction of causality may be suggested by trends in one occurring before or after the other. Evidence will also be sought of possible longer-term trends in media portrayals of China and the Chinese people in Japan during the post-2012 period, i.e., Abe Shinzo’s second term as prime minister, in comparison to earlier periods. Perceptions of Japan’s view of China and the Chinese, both inside and outside the scholarly world, tend to be oversimplified and are often incomprehensive. This research calls attention to the role played by the media in promoting or de-promoting Sino-Japanese relations. By analyzing the nature and background of images of China and the Chinese people presented in the Japanese media, especially under the new Abe Regime, this research seeks to promote a more balanced and comprehensive understanding of attitudes in Japanese society towards its gigantic neighbor. Scholars have seen the increasingly fragile Sino-Japanese relationship as inseparable from the real-world political conflicts that have become more frequent in recent years and have sought to draw a correlation between the two. The influence of the media, however, remains a mostly under-explored domain in the academic world. Against this background, this research aims to provide an enriched scholarly understanding of Japan’s perception of China by investigating to what extent such perception can be seen to be affected by subjective or selective forms of presentation of China found in the Japanese media, or vice versa.

Keywords: Abe Shinzo, China, Japan, media

Procedia PDF Downloads 295

Authors: Junaid Asimiyu Mohammed, Olakunle Docas Tosin

Abstract:

The housing environment in many developing countries is fraught with risks that have potential negative impacts on the lives of the residents. The study examined the risk factors in residential areas of two neighborhoods in Bosso Local Government Areas of Minna in Nigeria with a view to determining the level of their potential impacts. A sample of 378 households was drawn from the estimated population of 22,751 household heads. The questionnaire and direct observation were used as instruments for data collection. The data collected were analyzed using the Relative Importance Index (RII) rule to determine the level of the potential impact of the risk factors while ArcGIS was used for mapping the spatial distribution of the risks. The study established that the housing environment of Angwan Biri and El-Waziri areas of Bosso is poor and vulnerable as 26% of the houses were not habitable and 57% were only fairly habitable. The risks of epidemics, building collapse and rainstorms were evident in the area as 53% of the houses had poor ventilation; 20% of residents had no access to toilets; 47% practiced open waste dumping; 46% of the houses had cracked walls while 52% of the roofs were weak and sagging. The results of the analysis of the potential impact of the risk factors indicate a RII score of 0.528 for building collapse, 0.758 for rainstorms and 0.830 for epidemics, indicating a moderate to very high level of potential impacts. The mean RII score of 0.639 shows a significant potential impact of the risk factors. The study recommends the implementation of sanitation measures, provision of basic urban facilities and neighborhood revitalization through housing infrastructure retrofitting as measures to mitigate the risks of disasters and improve the living conditions of the residents of the study area.

Keywords: assessment, risk, residential, Nigeria

Procedia PDF Downloads 33

Authors: Olga Biedova, Victoria Steblovskaya, Kai Wallbaum

Abstract:

In the current capital market environment, investors constantly face the challenge of finding a successful and stable investment mechanism. Highly volatile equity markets and extremely low bond returns bring about the demand for sophisticated yet reliable risk management strategies. Investors are looking for risk management solutions to efficiently protect their investments. This study compares a classic Constant Proportion Portfolio Insurance (CPPI) strategy to a Volatility Target portfolio insurance (VTPI). VTPI is an extension of the well-known Option Based Portfolio Insurance (OBPI) to the case where an embedded option is linked not to a pure risky asset such as e.g., S&P 500, but to a Volatility Target (VolTarget) portfolio. VolTarget strategy is a recently emerged rule-based dynamic asset allocation mechanism where the portfolio’s volatility is kept under control. As a result, a typical VTPI strategy allows higher participation rates in the market due to reduced embedded option prices. In addition, controlled volatility levels eliminate the volatility spread in option pricing, one of the frequently cited reasons for OBPI strategy fall behind CPPI. The strategies are compared within the framework of the stochastic dominance theory based on numerical simulations, rather than on the restrictive assumption of the Black-Scholes type dynamics of the underlying asset. An extended comparative quantitative analysis of performances of the above investment strategies in various market scenarios and within a range of input parameter values is presented.

Keywords: CPPI, portfolio insurance, stochastic dominance, volatility target

Procedia PDF Downloads 147

Authors: Lucas Berrini

Abstract:

Academic libraries have always struggled with engaging with students and faculty. Striking the balance between what the community needs and what the library can afford has also been a point of contention for libraries. As academia begins to return to a new normal after COVID, library staff are rethinking how remind patrons that the library is open and ready for business. NC Wesleyan, a small liberal arts school in eastern North Carolina, decided to be proactive and reach out to the academic community. After shutting down in 2020 for COVID, the campus library saw a marked decrease in in-person attendance. For a small school whose operational budget was tied directly to tuition payments, it was imperative for the library to remind faculty and staff that they were open for business. At the beginning of the Summer 2022 term and continuing into the fall, the reference team created a marketing plan using email, physical meetings, and virtual events targeted at students and faculty as well as community members who utilized the facilities prior to COVID. The email blasts were gentle reminders that the building was open and available for use The target audiences were the community at large. Several of the emails contained reminders of previous events in the library that were student centered. The next phase of the email campaign centers on reminding the community about the libraries physical and electronic resources, including the makerspace lab. Language will indicate that student voices are needed, and a QR code is included for students to leave feedback as to what they want to see in the library. The final phase of the email blasts were faculty focused and invited them to connect with library reference staff for an in-person consultation on their research needs. While this phase is ongoing, the response has been positive, and staff are compiling data in hopes of working with administration to implement some of the requested services and materials. These email blasts will be followed up by in-person meetings with faculty and students who responded to the QR codes. This research is ongoing. This type of targeted outreach is new for Wesleyan. It is the hope of the library that by the end of Fall 2022, there will be a plan in place to address the needs and concerns of the students and faculty. Furthermore, the staff hopes to create a new sense of community for the students and staff of the university.

Keywords: academic, education, libraries, outreach

Procedia PDF Downloads 72

Authors: Dewan Hasin Mahtab, Farzana Sadia

Abstract:

At present, wastewater treatment has become essential to maintain a constant supply of safe water as well as to protect the environment. Due to overpopulation and overconsumption, the water quality from various surface water sources is degrading every day. Being one of the megacities in the world, Dhaka City, is going through rapid industrialization and urbanization. The effluents from these industries and factories are mostly discharged directly into the rivers without any treatment. As such, the quality of water of Buriganga is being afflicted with a noisome problem of pollution. The water of the Buriganga River has become detrimental to humans, animals, and the environment. It has become crucial to conserve the environment so that we can save both ourselves and the environment. The first step towards it should be analyzing the wastewater to decide the further steps of the treatment process. Increased population and increased consumption both contribute to water pollution. Mohammadpur is a developing area of Dhaka City, and Kamrangirchar is one of the largest slum areas in Dhaka City. The total study area is 6.13 sq. Km of Dhaka city with a population of 4,73,310 people. Of them, 86.47% had their own latrine, 47% were directly connected to the drain, 55% had septic tanks, and 70.09% of them cleaned their septic tank once a year. The pH, Dissolved Oxygen, Chemical Oxygen Demand, Biochemical Oxygen Demand, Total Dissolved Solid, Total Suspended and total coliforms of wastewater from two samples of both Mohammadpur and Kamrangirchar was analyzed. The DO level from the water bodies of Kamrangirchar was found very low, making the water bodies inhabitable for aquatic plants and animals. The BOD and COD level was extremely high from samples collected from Mohammadpur. The total coliforms count was found too high during the wet season, making it a potential health concern in the wet season in these two areas.

Keywords: Dhaka, environmental conservation rule, sanitation, wastewater

Procedia PDF Downloads 111

Authors: Nihal Atif Salim

Abstract:

To improve the quality of life in cities, a variety of interventions are used. Noise is a substantial and important sort of pollution that has a negative impact on the urban environment and human health. According to the complaint survey, it ranks second among environmental contamination complaints (conducted by EEAA in 2019). The most significant source of noise in the city is traffic noise. In order to improve the sound urban environment, many physical techniques are applied. In the local area, noise barriers are considered as one of the most appropriate physical techniques along existing traffic routes. Alexandria is Egypt's second-largest city after Cairo. It is located along the Mediterranean Sea, and El- Gish Road is one of the city's main arteries. It impacts the waterfront promenade that extends along with the city by a high level of traffic noise. The purpose of this paper is to clarify the design considerations for the most appropriate noise barrier type along with the promenade, with the goal of improving the Quality of Life (QOL) and the sonic urban environment specifically. The proposed methodology focuses on how noise affects human perception and the environment. Then it delves into the various physical noise control approaches. After that, the paper discusses sustainable design decisions making. Finally, look into the importance of incorporating sustainability into design decisions making. Three stages will be followed in the case study. The first stage involves doing a site inspection and using specific sound measurement equipment (a noise level meter) to measure the noise level along the promenade at many sites, and the findings will be shown on a noise map. The second step is to inquire about the site's user experience. The third step is to investigate the various types of noise barriers and their effects on QOL along existing routes in order to select the most appropriate type. The goal of this research is to evaluate the suitable design of noise barriers that fulfill environmental and social perceptions while maintaining a balanced approach to the noise issue in order to improve QOL along existing roadways in the local area.

Keywords: noise pollution, sonic urban environment, traffic noise, noise barrier, acoustic sustainability, noise reduction techniques

Procedia PDF Downloads 120

Authors: Stephen M. Magu

Abstract:

The 9/11 and Christmas bombing attacks in the United States are mostly associated with the inability of intelligence agencies to connect dots based on intelligence that was already available. The 1998, 2002, 2013 and several 2014 terrorist attacks in Kenya, on the other hand, are probably driven by a completely different dynamic: the invisible hand of corruption. The World Bank and Transparency International annually compute the Worldwide Governance Indicators and the Corruption Perception Index respectively. What perhaps is not adequately captured in the corruption metrics is the impact of corruption on terrorism. The World Bank data includes variables such as the control of corruption, (estimates of) government effectiveness, political stability and absence of violence/terrorism, regulatory quality, rule of law and voice and accountability. TI's CPI does not include measures related to terrorism, but it is plausible that there is an expectation of some terrorism impact arising from corruption. This paper, by examining the incidence, frequency and total number of terrorist attacks that have occurred especially since 1990, and further examining the specific cases of Kenya and Nigeria, argues that in addition to having major effects on governance, corruption has an even more frightening impact: that of facilitating and/or violating security mechanisms to the extent that foreign nationals can easily obtain identification that enables them to perpetuate major events, targeting powerful countries' interests in countries with weak corruption-fighting mechanisms. The paper aims to model interactions that demonstrate the cost/benefit analysis and agents' rational calculations as being non-rational calculations, given the ultimate impact. It argues that eradication of corruption is not just a matter of a better business environment, but that it is implicit in national security, and that for anti-corruption crusaders, this is an argument more potent than the economic cost / cost of doing business argument.

Keywords: corruption, global south, identification, passports, terrorism

Procedia PDF Downloads 407

Authors: Nathalie Elia, Samer Aouad, Jane Estephane, Christophe Poupin, Bilal Nsouli, Edmond Abi Aad

Abstract:

Carbon dioxide is one of the main contributors to greenhouse effect and hence to climate change. As a result, the methanation reaction CO2(g) + 4H2(g) →CH4(g) + 2H2O (ΔH°298 = -165 kJ/mol), also known as Sabatier reaction, has received great interest as a process for the valorization of the greenhouse gas CO2 into methane which is a hydrogen-carrier gas. The methanation of CO2 is an exothermic reaction favored at low temperature and high pressure. However, this reaction requires a high energy input to activate the very stable CO2 molecule, and exhibits serious kinetic limitations. Consequently, the development of active and stable catalysts is essential to overcome these difficulties. Catalytic methanation of CO2 has been studied using catalysts containing Rh, Pd, Ru, Co and Ni on various supports. Among them, the Ni-based catalysts have been extensively investigated under various conditions for their comparable methanation activity with highly improved cost-efficiency. The addition of promoters are common strategies to increase the performance and stability of Ni catalysts. In this work, a small amount of Ru was used as a promoter for Ni catalysts supported on ceria and tested in the CO2 methanation reaction. The nickel loading was 5 wt. % and ruthenium loading is 0.5wt. %. The catalysts were prepared by successive impregnation method using Ni(NO3)2.6H2O and Ru(NO)(NO3)3 as precursors. The calcined support was impregnated with Ni(NO3)2.6H2O, dried, calcined at 600°C for 4h, and afterward, was impregnated with Ru(NO)(NO3)3. The resulting solid was dried and calcined at 600°C for 4 h. Supported monometallic catalysts were prepared likewise. The prepared solids Ru(0.5%)/CeO2, Ni(5%)/CeO2 and Ru(0.5%)-Ni(5%)/CeO2 were then reduced prior to the catalytic test under a flow of 50% H2/Ar (50 ml/min) for 4h at 500°C. Finally, their catalytic performances were evaluated in the CO2 methanation reaction, in the temperature range of 100–350°C by using a gaseous mixture of CO2 (10%) and H2 (40%) in Ar balanced at a total flow rate of 100 mL/min. The effect of pressure on the CO2 methanation was studied by varying the pressure between 1 and 10 bar. The various catalysts showed negligible CO2 conversion at temperatures lower than 250°C. The conversion of CO2 increases with increasing reaction temperature. The addition of Ru as promoter to Ni/CeO2 improved the CO2 methanation. It was shown that the CO2 conversion increases from 15 to 70% at 350°C and 1 bar. The effect of pressure on CO2 conversion was also studied. Increasing the pressure from 1 to 5 bar increases the CO2 conversion from 70% to 87%, while increasing the pressure from 5 to 10 bar increases the CO2 conversion from 87% to 91%. Ru–Ni catalysts showed excellent catalytic performance in the methanation of carbon dioxide with respect to Ni catalysts. Therefore the addition of Ru onto Ni catalysts improved remarkably the catalytic activity of Ni catalysts. It was also found that the pressure plays an important role in improving the CO2 methanation.

Keywords: CO2, methanation, nickel, ruthenium

Procedia PDF Downloads 199

Authors: R. Edward Minchin Jr.

Abstract:

The U.S. Federal Highway Administration (FHWA) Every Day Counts Program (EDC) has resulted in state DOTs putting evermore emphasis on speeding up the delivery of highway and bridge construction projects for use by the driving public. This has resulted in an increase in the use of alternative construction delivery systems such as design-build (D-B), construction manager at-risk (CMR) or construction manager/general contractor (CM/GC), and adding alternative technical concepts (ATCs) to traditional design-bid-build (DBB) contracts. ATCs have exhibited great potential for delivering substantial benefits like cost savings, increased constructability, and quicker project delivery. Previous research has found that knowledge of project constructability was lacking in state Department of Transportation (DOT) planning, programming, and environmental staffs. Many agencies have therefore relied on a set of ‘acceptable’ design solutions over the years of working with their local resource agencies. The result is that the permitting process for several government agencies has become increasingly restrictive with the result that the DOTs and their industry partners lose the ability to innovate after a permit is approved. The intent of this paper is to report on the research team’s progress in this ongoing effort furnish the United States government with a uniform set of guidelines for the application of constructability reviews during all phases of project development and delivery. The research uses surveys and interviews to determine which states have implemented formal programs to ensure that the constructor is furnished with a set of contract documents that affords said constructor with the best possible opportunity to successfully construct the project with the highest quality standards, within the contract duration and without exceeding the construction budget. Once these states are identified, workshops are held all over the nation, resulting in the team learning the best current practices and giving the team the ability to recommend new practices that will improve the process. The plan is for the FHWA to encourage or require state DOTs to use these practices on all federally funded highway and bridge construction projects. The project deliverable is a Guidebook for FHWA to use in disseminating the recommended practices to the states.

Keywords: alternative construction delivery, alternative technical concepts, constructability, construction design plans

Procedia PDF Downloads 191

Authors: A. van Staden, M. M. Coetzee

Abstract:

Despite numerous efforts to increase the literacy level of South African learners, for example, through the implementation of educational policies such as the Revised National Curriculum statement, advocating mother-tongue instruction (during a child's formative years), in reality, the majority of South African children are still being educated in a second language (in most cases English). Moreover, despite the fact that a significant percentage of our country's budget is spent on the education sector and that both policy makers and educationalists have emphasized the importance of learning English in this globalized world, the poor overall academic performance and English literacy level of a large number of school leavers are still a major concern. As we move forward in an attempt to comprehend the nuances of English language and literacy development in our country, it is imperative to explore both extrinsic and intrinsic factors that contribute or impede the effective development of English as a second language. In the present study, the researchers set out to investigate how intrinsic factors such as motivation and self-concept contribute to or affect English language learning amongst high school learners in South Africa. Emanating from the above the main research question that guided this research is the following: Is there a significant relationship between high school learners' self-concept, motivation, and English second language performances? In order to investigate this hypothesis, this study utilized quantitative research methodology to investigate the interplay of self-concept and motivation in English language learning. For this purpose, we sampled 201 high school learners from various schools in South Africa. Methods of data gathering inter alia included the following: A biographical questionnaire; the Academic Motivational Scale and the Piers-Harris Self-Concept Scale. Pearson Product Moment Correlation Analyses yielded significant correlations between L2 learners' motivation and their English language proficiency, including demonstrating positive correlations between L2 learners' self-concept and their achievements in English. Accordingly, researchers have argued that the learning context, in which students learn English as a second language, has a crucial influence on students' motivational levels. This emphasizes the important role the teacher has to play in creating learning environments that will enhance L2 learners' motivation and improve their self-concepts.

Keywords: motivation, self-concept, language learning, English second language learners (L2)

Procedia PDF Downloads 240

Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

Abstract:

Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

Procedia PDF Downloads 395

Authors: Sweeti, Anoop Kant Godiyal, Neha Singh, Sneh Anand, B. K. Panigrahi, Jayasree Santhosh

Abstract:

This work is about developing a tool for visualization and segmentation of Electroencephalograph (EEG) signals based on frequency domain features. Change in the frequency domain characteristics are correlated with change in mental state of the subject under study. Proposed algorithm provides a way to represent the change in the mental states using the different frequency band powers in form of segmented EEG signal. Many segmentation algorithms have been suggested in literature having application in brain computer interface, epilepsy and cognition studies that have been used for data classification. But the proposed method focusses mainly on the better presentation of signal and that’s why it could be a good utilization tool for clinician. Algorithm performs the basic filtering using band pass and notch filters in the range of 0.1-45 Hz. Advanced filtering is then performed by principal component analysis and wavelet transform based de-noising method. Frequency domain features are used for segmentation; considering the fact that the spectrum power of different frequency bands describes the mental state of the subject. Two sliding windows are further used for segmentation; one provides the time scale and other assigns the segmentation rule. The segmented data is displayed second by second successively with different color codes. Segment’s length can be selected as per need of the objective. Proposed algorithm has been tested on the EEG data set obtained from University of California in San Diego’s online data repository. Proposed tool gives a better visualization of the signal in form of segmented epochs of desired length representing the power spectrum variation in data. The algorithm is designed in such a way that it takes the data points with respect to the sampling frequency for each time frame and so it can be improved to use in real time visualization with desired epoch length.

Keywords: de-noising, multi-channel data, PCA, power spectra, segmentation

Procedia PDF Downloads 377

Authors: Lilian Bambirra De Assis, Patricia Albuquerque Gomes, Kamila Pagel De Oliveira, Deborah Oliveira Santos, Marcelo Esteves Chaves Campos

Abstract:

This paper aimed to analyze how performance management occurs in the context of the modernization of the federal public sector in Chile and Portugal. To do so, the study was based on a theoretical framework that covers the modernization of public administration to performance management, passing on people management. The work consisted of qualitative-descriptive research in which 16 semi-structured interviews were applied in the countries of study and documents and legislation were used referring to the subject. Performance management, as well as other people management subsystems, is criticized for using private sector management tools, based on a results-driven logic. From this point of view, it is understood that certain practices of the private sector, regarding the measurement of performance, can not be simply inserted in the scenario of the public administration. Beyond this criticism, performance management can contribute to the achievement of the strategic objectives of the countries and its focus is upward, a trend that can be verified through the manuals produced; by the interest of consultants and professional organizations, both public and private; and OECD (Organization for Economic Cooperation and Development) evaluations. In Portugal, public administration reform was implemented during the Constitutional Government (2005-2009) and had as its objective the restructuring of human resources management, with an emphasis on its integration with budget management, which is an inclination of the OECD, while in Chile HRM (Human Resource Management) practices are directed to ministries to a lesser extent than the OECD average. The central human resources management sector, for the most part, coordinates policy but is also responsible for other issues, including payment and classification systems. Chile makes less use of strategic Human Resource Management practices than the average of OECD countries, and its prominence lies in the decentralization of public bodies, which may grant autonomy, but fragments the implementation of policies and practices in that country since they are not adopted by all organs. Through the analysis, it was possible to identify that Chile and Portugal have practices and personnel management policies that make reference to performance management, which is similar to other OECD countries. The study countries also have limitations to implement performance management and the results indicate that there are still processes to be perfected, such as performance appraisal and compensation.

Keywords: management of people in the public sector, modernization of public administration, performance management in the public sector, HRM, OECD

Procedia PDF Downloads 131

Authors: Kofi Quartey, Kola Ijasan

Abstract:

Achieving densification around transit-oriented development projects has proven the most ideal way of facilitating urban sprawl whilst increasing the mobility of the majority of the urban populations, making parts of the city that were inaccessible, accessible. Johannesburg has undertaken TOD vision, which was initially called the corridors of freedom. The TOD, in line with the Sustainable Development Goal 11, seeks to establish inclusive, sustainable cities and, in line with the Joburg Growth Development Strategy, aims to create an equitable world-class African city. Equity and inclusivity should occur from the onset of planning and implementation of TOD projects through meaningful community participation. Stakeholder engagement literature from various disciplinary backgrounds has documented dissatisfaction of communities regarding the lack of meaningful participation in government-led development initiatives. The views of other project stakeholders such as project policy planners and project implementors and their challenges in undertaking community participation are, however, not taken into account in such instances, leaving room for a biased perspective. Document analysis was undertaken to determine what is expected of the Project stakeholders according to policy and whether they carried out their duties) seven interviews were also conducted with city entities and community representatives to determine their experiences and challenges with community participation in the various TOD projects attributed to the CoF vision. The findings of the study indicated that stakeholder engagement processes were best described as an ‘educative process’; where local communities were limited to being informed from the onset rather than having an active involvement in the planning processes. Most community members felt they were being informed and educated as to what was going to happen in spite of having their views and opinions collected – primarily due to project deadlines and budget constraints, as was confirmed by professional stakeholders. Some community members exhibited reluctance to change due to feelings of having projects being imposed on them, and the implications of the projects on their properties and lifestyles. It is recommended that community participation should remain a participatory and engaging process that creates an exchange of knowledge and understanding in the form of a dialogue between communities and project stakeholders until a consensus is reached.

Keywords: stakeholder engagement, transit oriented development, community participation, Johannesburg

Procedia PDF Downloads 104

Authors: Vincent Jones

Abstract:

The North African country of Libya is in crisis and is currently a humanitarian disaster. The current American ‘hands off’ foreign policy appear to have contributed to this crisis. The research upon which this paper is based focused on a qualitative analysis of migration to Libya and its history with slavery, current conditions that have contributed to the re-emergence of slavery, an analysis of available resources in the effected region, and an analysis of legal remedies pursuant to international law. In addition, a qualitative analysis of American foreign policy from the Reagan Administration through the current Trump administration has been a focus of analysis. The major findings of this research are: (1) Since the removal of Muammar Gadhafi, a move that the United States played a major role in achieving, the nation of Libya has been in free fall and the rule of law has all but disappeared. As a major port stop for refugees and migrants fleeing atrocities in sub-Saharan African states, Libya has become the gate way to European ports of asylum. The problem is these migrant refugees are unwanted, caught between rival and often ineffective governments, profiteers, and inaction from the international community. (2) The outlook for these refugees is bleak: the ineffective government of Libya is ill-equipped to handle the large influx, European refugee destination states like Italy and Greece are already overburdened by the Syrian refugee crisis and are reluctant to accept more refugees, leaving the powerful and armed Libyan militia in control of a situation that is ripe for exploitation. (3) The combined intervention of the international community, led by a newly committed and engaged American foreign policy. In conclusion, a new American foreign policy approach along with the active engagement of the United Nations, EU, and the African Union can effectively resolve this humanitarian crisis.

Keywords: slavery, Libya, migrants, slave auction

Procedia PDF Downloads 211

Authors: Pedro Esteban

Abstract:

Most installations nowadays are exposed to many power quality problems, and they also face numerous challenges to comply with grid code and energy efficiency requirements. The reason behind this is that they are not designed to support nonlinear, non-balanced, and variable loads and generators that make up a large percentage of modern electric power systems. These problems and challenges become especially critical when designing green buildings and smart cities. These problems and challenges are caused by equipment that can be typically found in these installations like variable speed drives (VSD), transformers, lighting, battery chargers, double-conversion UPS (uninterruptible power supply) systems, highly dynamic loads, single-phase loads, fossil fuel generators and renewable generation sources, to name a few. Moreover, events like capacitor switching (from existing capacitor banks or passive harmonic filters), auto-reclose operations of transmission and distribution lines, or the starting of large motors also contribute to these problems and challenges. Active power filters (APF) are one of the fastest-growing power electronics technologies for solving power quality problems and meeting grid code and energy efficiency requirements for a wide range of segments and applications. They are a high performance, flexible, compact, modular, and cost-effective type of power electronics solutions that provide an instantaneous and effective response in low or high voltage electric power systems. They enable longer equipment lifetime, higher process reliability, improved power system capacity and stability, and reduced energy losses, complying with most demanding power quality and energy efficiency standards and grid codes. There can be found several types of active power filters, including active harmonic filters (AHF), static var generators (SVG), active load balancers (ALB), hybrid var compensators (HVC), and low harmonic drives (LHD) nowadays. All these devices can be used in applications in Smart Cities bringing several technical and economic benefits.

Keywords: power quality improvement, energy efficiency, grid code compliance, green buildings, smart cities

Procedia PDF Downloads 95

Authors: Strahinja Kovačević, Sanja Podunavac-Kuzmanović, Lidija Jevrić, Cristina Prandi, Piermichele Kobauri

Abstract:

The present study is based on molecular modeling of a series of twelve 5-(4-substituent-phenoxy)-3-methylfuran-2(5H)-one derivatives which have potential of strigolactones mimics toward Striga hermonthica. The first step of the analysis included the calculation of molecular descriptors which numerically describe the structures of the analyzed compounds. The descriptors ALOGP (lipophilicity), AClogS (water solubility) and BBB (blood-brain barrier penetration), served as the input variables in multiple linear regression (MLR) modeling of germination activity toward S. hermonthica. Two MLR models were obtained. The first MLR model contains ALOGP and AClogS descriptors, while the second one is based on these two descriptors plus BBB descriptor. Despite the braking Topliss-Costello rule in the second MLR model, it has much better statistical and cross-validation characteristics than the first one. The ALOGP and AClogS descriptors are often very suitable predictors of the biological activity of many compounds. They are very important descriptors of the biological behavior and availability of a compound in any biological system (i.e. the ability to pass through the cell membranes). BBB descriptor defines the ability of a molecule to pass through the blood-brain barrier. Besides the lipophilicity of a compound, this descriptor carries the information of the molecular bulkiness (its value strongly depends on molecular bulkiness). According to the obtained results of MLR modeling, these three descriptors are considered as very good predictors of germination activity of the analyzed compounds toward S. hermonthica seeds. This article is based upon work from COST Action (FA1206), supported by COST (European Cooperation in Science and Technology).

Keywords: chemometrics, germination activity, molecular modeling, QSAR analysis, strigolactones

Procedia PDF Downloads 265

Authors: Daral Maesincee, Jompol Thongpaen

Abstract:

Thus far, most of the decisions made within the walls of Thai higher education (HE) institutions have primarily been supply-oriented. With the current supply-driven, itemized HE financing systems, the nation is struggling to systemically produce high-quality manpower that serves the market’s needs, often resulting in education mismatches and unemployment – particularly in science, technology, and innovation (STI)-related fields. With the COVID-19 pandemic challenges widening the education inequality (accessibility and quality) gap, HE becomes even more unobtainable for underprivileged students, permanently leaving some out of the system. Therefore, Thai HE needs a new financing system that produces the “right people” for the “right occupations” through the “right ways,” regardless of their socioeconomic backgrounds, and encourages the creation of non-degree courses to tackle these ongoing challenges. The “Demand-Side Financing for Thai Higher Education” policy aims to do so by offering a new paradigm of HE resource allocation via two main mechanisms: i) standardized formula-based unit-cost subsidizations that is specific to each study field and ii) student loan programs that respond to the “demand signals” from the labor market and the students, that are in line with the country’s priorities. Through in-dept reviews, extensive studies, and consultations with various experts, education committees, and related agencies, i) the method of demand signal analysis is identified, ii) the unit-cost of each student in the sample study fields is approximated, iii) the method of budget analysis is formulated, iv) the interagency workflows are established, and v) a supporting information database is created to suggest the number of graduates each HE institution can potentially produce, the study fields and skillsets that are needed by the labor market, the employers’ satisfaction with the graduates, and each study field’s employment rates. By responding to the needs of all stakeholders, this policy is expected to steer Thai HE toward producing more STI-related manpower in order to uplift Thai people’s quality of life and enhance the nation’s global competitiveness. This policy is currently in the process of being considered by the National Education Transformation Committee and the Higher Education Commission.

Keywords: demand-side financing, higher education resource, human capital, higher education

Procedia PDF Downloads 183

Authors: Asinguza P. Allan

Abstract:

The Advocacy for Better Health aims to equip citizens with enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target for Uganda to transform into a middle income country will be achieved if investment is made in keeping the population healthy and productive. Citizen participation as an important foundation for change has been emphasized to gather data through participatory rural appraisal and inform evidence-based advocacy for recruitment and motivation of human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, health worker to population ratio in Uganda remains at 0.25/1,000 which is far below the World Health Organization (WHO) threshold of 2.3/1,000. Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1,000 and Maternal Mortality Ratio of 320/100,000. Government has committed to increase staffing to 80% by 2018 (10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. On the other hand, the better health advocacy debate has been elevated with need to increase health sector budget allocations from 8% to 10%. The project has learnt that building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce Neonatal Mortality Rate and Maternal Mortality Ratio. The project has learnt that interface meeting between duty bearers and the community allows for immediate feedback and the process is a strong instrument for empowerment. It facilitates monitoring and performance evaluation of services, projects and government administrative units (like district assemblies) by the community members themselves. This, in turn, makes the human resources in health to be accountable, transparent and responsive to communities where they work. This, in turn, promotes human resource performance.

Keywords: advocacy, empowerment, evidence, human resources

Procedia PDF Downloads 198

Authors: Victoria H. Hamilton

Abstract:

Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

Procedia PDF Downloads 22

Authors: M. Kolotylo, H. Zheng, R. Parente, R. Dahiya

Abstract:

Large number of organizations, frequently motivated by budget and cost cuts, outsource their Information Technology (IT) positions every year. Although the objective of reduction in financial obligations is often not accomplished, many buyer companies still manage to benefit from outsourcing projects. Knowledge Transfer (KT), being one of the major processes that take place during IT outsourcing partnership, may exert a strong impact on the performance of the parties involved, particularly that of the buyer. Research, however, lacks strong conceptual basis for the possible benefits that KT from supplier may bring to the buyer; and for the mechanisms that may be adopted by the buyer to maximize such benefit. This paper aims to fill this gap by proposing a conceptual framework of organizational learning and development of dynamic capabilities enabled by KT from the supplier to the buyer. The study examines buyer-supplier relationships in the context of IT outsourcing transactions, and theorizes how KT from the supplier to the buyer helps the performance of the buyer. It warrants that more research is carried out in order to explicate and provide evidence regarding the role that KT plays in strategic improvements for the buyer. The paper proposes to take up a two-fold approach to the research: conceptual development that utilizes logical argumentation and interpretive historical research, as well as a qualitative case study which aims to capture and understand the complex processes involved. Thus, the study provides a comprehensive visualization of the dynamics of the conditions under which participation in IT outsourcing partnership might be of benefit to the buyer company. The framework demonstrates the mechanisms involved in buyer’s achievement of strategic alignment through organizational learning enabled by KT from the supplier. It highlights that organizational learning involves a balance between exploitation of assets and exploration of new possibilities, and further notes that the dynamic capabilities mediate the effect of organizational learning on firm performance. The paper explicates in what ways managers can leverage outsourcing projects to execute strategy, which would enable their organization achieve better performance. The study concludes that organizational learning enables the firm to develop IT capabilities of strategic planning, IT integration, and IT relationships in the outsourcing context, and that IT capabilities developed through the organizational learning would help the firm in achieving strategic alignment.

Keywords: dynamic capabilities, it outsourcing, knowledge transfer, organizational learning, strategic alignment

Procedia PDF Downloads 413

Authors: David P. Horton, Gary Lynch-Wood

Abstract:

Western populations are aging, prone to various lifestyle health problems, and increasing their demand for health and social care services. This demand has created enormous fiscal and regulatory challenges. In response, government institutions have deployed strategies of behavior modification to encourage people to exercise greater personal responsibility over their health and care needs (i.e., welfare responsibilisation). Policy strategies are underpinned by the assumption that people if properly supported, will make better health and lifestyle selections. Not only does this absolve governments of the responsibility for meeting all health and care needs, but it also enables government institutions to assert fiscal control over welfare spending. Looking at the regulation of health and social care in the UK, the authors identify and outline a suite of regulatory tools that are designed to extract and manage the resources of health and social care services users and to encourage them to make (‘better’) use of these resources. This is important for our understanding of how health and social care regulation is responding to ongoing social and economic challenges. It is also important because there has been a failure to systematically examine the relevance of resources for regulation, which is surprising given that resources are crucial to how and whether regulation succeeds or fails. In particular, drawing from the regulatory welfare state concept, the authors analyse the key legal and regulatory changes and mechanisms that have been introduced since the 2008 financial crisis, focusing on critical measures such as the Health and Social Care Act and regulations introduced under the National Health Service Act. The authors show how three types of user resources (i.e., tangible, labor, and data) are being used to assert fiscal control and increase welfare responsibilisation. Amongst other things, the paper concludes that service users have become more than rule followers and targets of behavioral modification; rather, they are producers of resources that regulatory systems have come to rely on.

Keywords: health care, regulation, resources, social care

Procedia PDF Downloads 72

Authors: Lee Bih Ni, Zulfhikar Rabe, Nurul Asyikin Hassan

Abstract:

The Ministry of Education Malaysia dynamically and drastically made the subject of History mandatory to be in force in 2013. This is in recognition of the nation's heritage and treasures in maintaining true facts and information for future generations of the State. History reveals the civilization of a nation and the fact of national cultural heritage. Civilization needs to be preserved as a legacy of sovereign heritage. Today's generation is the catalyst for future heirs who will support the principle and direction of the country. In line with the National Education Philosophy that aims to shape the potential development of individuals holistically and uniquely in order to produce a balanced and harmonious student in terms of intellectual, spiritual, emotional and physical. Hence, understanding the importance of studying the history subject as a pillar of identity and the history of nationhood is to be a priority in the pursuit of knowledge and empowering the spirit of statehood that is nurtured through continuous learning at school. Judging from the aspect of teacher leadership role in integrating history in a combined way based on Teacher Education Philosophy. It empowers the teaching profession towards the teacher to support noble character. It also supports progressive and scientific views. Teachers are willing to uphold the State's aspirations and celebrate the country's cultural heritage. They guarantee individual development and maintain a united, democratic, progressive and disciplined society. Teacher's role as a change and leadership agent in education begins in the classroom through formal or informal educational processes. This situation is expanded in schools, communities and countries. The focus of this paper is on the role of teacher leadership influencing the effectiveness of teaching and learning history in the classroom environment. Leadership guides to teachers' perceptions on the role of teacher leadership, teaching leadership, and the teacher leadership role and effective teacher leadership role. Discussions give emphasis on aspects of factors affecting the classroom environment, forming the classroom agenda, effective classroom implementation methods, suitable climate for historical learning and teacher challenges in implicating the effectiveness of teaching and learning processes.

Keywords: teacher leadership, leadership lessons, effective classroom, effective teacher

Procedia PDF Downloads 263

Authors: Oljana Hoxhaj

Abstract:

The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

Procedia PDF Downloads 91

Authors: Sadaf Rafiq, Muhammad Waqas, Shakeel Ahmad Khan, Nisar Ahmad

Abstract:

Everyday life information seeking (ELIS) is considered as the mastery of life. It plays an important role in daily problem solving activities. Female students living in university hostels need variety of information to fulfil their everyday information needs. To find accurate and timely information is really challenging for females students who move from rural areas for educational purposes. These challenges involve culture differences, stress, financial issues, homesickness, diet needs and change in sleeping and eating habits. These complications create numerous problems for female students to adjust themselves in new and unfamiliar environment. Although the Internet has increased the ease of seeking everyday life information to survive successfully but there is still uncertainty to fully rely on the quality of information available on the web. Pakistan is an underdeveloped country where limited budget is allocated for educational institutions to enable them in developing well established hostels for their students. Female students who pursue for higher education has to stay at hostels for years to obtain education goals. It really becomes very difficult for them to spend life in hostels if they are not properly facilitated with relevant information sources to acquire everyday life information. The proposed study attempts to investigate the everyday life information seeking behavior of female students who are living in university and private hostels of Lahore. It investigates the various sources of information used by female students. It also identifies the problems faced by the female students in accessing everyday life information. The results of this study will be helpful for university management to understand their information need and provide required information sources which are essential for them to spend a comfortable, successful and peaceful life in hostels and achieve their educational goals. To achieve the objectives of the study, we will use quantitative research approach by using questionnaire as a data collection tool. The population of this study will be the university students living in public and private hostels of Lahore, Pakistan. This study will increase the understanding of everyday life information seeking behavior of female students living in hostels. Results of the study will be helpful for hostel administrations to better understand the students’ everyday life information needs and provide high quality of information services and living environment.

Keywords: everyday, information seeking, hostel, female

Procedia PDF Downloads 127

Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak

Abstract:

Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.

Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact

Procedia PDF Downloads 56

Authors: Liaquat Ali, Khurshid Natasha

Abstract:

Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

Procedia PDF Downloads 161