Search results for: CSR reports
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1783

Search results for: CSR reports

433 A Geo DataBase to Investigate the Maximum Distance Error in Quality of Life Studies

Authors: Paolino Di Felice

Abstract:

The background and significance of this study come from papers already appeared in the literature which measured the impact of public services (e.g., hospitals, schools, ...) on the citizens’ needs satisfaction (one of the dimensions of QOL studies) by calculating the distance between the place where they live and the location on the territory of the services. Those studies assume that the citizens' dwelling coincides with the centroid of the polygon that expresses the boundary of the administrative district, within the city, they belong to. Such an assumption “introduces a maximum measurement error equal to the greatest distance between the centroid and the border of the administrative district.”. The case study, this abstract reports about, investigates the implications descending from the adoption of such an approach but at geographical scales greater than the urban one, namely at the three levels of nesting of the Italian administrative units: the (20) regions, the (110) provinces, and the 8,094 municipalities. To carry out this study, it needs to be decided: a) how to store the huge amount of (spatial and descriptive) input data and b) how to process them. The latter aspect involves: b.1) the design of algorithms to investigate the geometry of the boundary of the Italian administrative units; b.2) their coding in a programming language; b.3) their execution and, eventually, b.4) archiving the results in a permanent support. The IT solution we implemented is centered around a (PostgreSQL/PostGIS) Geo DataBase structured in terms of three tables that fit well to the hierarchy of nesting of the Italian administrative units: municipality(id, name, provinceId, istatCode, regionId, geometry) province(id, name, regionId, geometry) region(id, name, geometry). The adoption of the DBMS technology allows us to implement the steps "a)" and "b)" easily. In particular, step "b)" is simplified dramatically by calling spatial operators and spatial built-in User Defined Functions within SQL queries against the Geo DB. The major findings coming from our experiments can be summarized as follows. The approximation that, on the average, descends from assimilating the residence of the citizens with the centroid of the administrative unit of reference is of few kilometers (4.9) at the municipalities level, while it becomes conspicuous at the other two levels (28.9 and 36.1, respectively). Therefore, studies such as those mentioned above can be extended up to the municipal level without affecting the correctness of the interpretation of the results, but not further. The IT framework implemented to carry out the experiments can be replicated for studies referring to the territory of other countries all over the world.

Keywords: quality of life, distance measurement error, Italian administrative units, spatial database

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432 Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

Abstract:

Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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431 Development, Characterization and Performance Evaluation of a Weak Cation Exchange Hydrogel Using Ultrasonic Technique

Authors: Mohamed H. Sorour, Hayam F. Shaalan, Heba A. Hani, Eman S. Sayed, Amany A. El-Mansoup

Abstract:

Heavy metals (HMs) present an increasing threat to aquatic and soil environment. Thus, techniques should be developed for the removal and/or recovery of those HMs from point sources in the generating industries. This paper reports our endeavors concerning the development of in-house developed weak cation exchange polyacrylate hydrogel kaolin composites for heavy metals removal. This type of composite enables desirable characteristics and functions including mechanical strength, bed porosity and cost advantages. This paper emphasizes the effect of varying crosslinker (methylenebis(acrylamide)) concentration. The prepared cation exchanger has been subjected to intensive characterization using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray fluorescence (XRF) and Brunauer Emmett and Teller (BET) method. Moreover, the performance was investigated using synthetic and real wastewater for an industrial complex east of Cairo. Simulated and real wastewater compositions addressed; Cr, Co, Ni, and Pb are in the range of (92-115), (91-103), (86-88) and (99-125), respectively. Adsorption experiments have been conducted in both batch and column modes. In general, batch tests revealed enhanced cation exchange capacities of 70, 72, 78.2 and 99.9 mg/g from single synthetic wastes while, removal efficiencies of 82.2, 86.4, 44.4 and 96% were obtained for Cr, Co, Ni and Pb, respectively from mixed synthetic wastes. It is concluded that the mixed synthetic and real wastewaters have lower adsorption capacities than single solutions. It is worth mentioned that Pb attained higher adsorption capacities with comparable results in all tested concentrations of synthetic and real wastewaters. Pilot scale experiments were also conducted for mixed synthetic waste in a fluidized bed column for 48 hour cycle time which revealed 86.4%, 58.5%, 66.8% and 96.9% removal efficiency for Cr, Co, Ni, and Pb, respectively with maximum regeneration was also conducted using saline and acid regenerants. Maximum regeneration efficiencies for the column studies higher than the batch ones about by about 30% to 60%. Studies are currently under way to enhance the regeneration efficiency to enable successful scaling up of the adsorption column.

Keywords: polyacrylate hydrogel kaolin, ultrasonic irradiation, heavy metals, adsorption and regeneration

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430 The Relationship Between Weight Gain, Cyclicality of Diabetologic Education and the Experienced Stress: A Study Involving Pregnant Women

Authors: Agnieszka Rolinska, Marta Makara-Studzinska

Abstract:

Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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429 Development of Stretchable Woven Fabrics with Auxetic Behaviour

Authors: Adeel Zulifqar, Hong Hu

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Auxetic fabrics are a special kind of textile materials which possess negative Poisson’s ratio. Opposite to most of the conventional fabrics, auxetic fabrics get bigger in the transversal direction when stretched or get smaller when compressed. Auxetic fabrics are superior to conventional fabrics because of their counterintuitive properties, such as enhanced porosity under the extension, excellent formability to a curved surface and high energy absorption ability. Up till today, auxetic fabrics have been produced based on two approaches. The first approach involves using auxetic fibre or yarn and weaving technology to fabricate auxetic fabrics. The other method to fabricate the auxetic fabrics is by using non-auxetic yarns. This method has gained extraordinary curiosity of researcher in recent years. This method is based on realizing auxetic geometries into the fabric structure. In the woven fabric structure auxetic geometries can be realized by creating a differential shrinkage phenomenon into the fabric structural unit cell. This phenomenon can be created by using loose and tight weave combinations within the unit cell of interlacement pattern along with elastic and non-elastic yarns. Upon relaxation, the unit cell of interlacement pattern acquires a non-uniform shrinkage profile due to different shrinkage properties of loose and tight weaves in designed pattern, and the auxetic geometry is realized. The development of uni-stretch auxetic woven fabrics and bi-stretch auxetic woven fabrics by using this method has already been reported. This study reports the development of another kind of bi-stretch auxetic woven fabric. The fabric is first designed by transforming the auxetic geometry into interlacement pattern and then fabricated, using the available conventional weaving technology and non-auxetic elastic and non-elastic yarns. The tensile tests confirmed that the developed bi-stretch auxetic woven fabrics exhibit negative Poisson’s ratio over a wide range of tensile strain. Therefore, it can be concluded that the auxetic geometry can be realized into the woven fabric structure by creating the phenomenon of differential shrinkage and bi-stretch woven fabrics made of non-auxetic yarns having auxetic behavior and stretchability are possible can be obtained. Acknowledgement: This work was supported by the Research Grants Council of Hong Kong Special Administrative Region Government (grant number 15205514).

Keywords: auxetic, differential shrinkage, negative Poisson's ratio, weaving, stretchable

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428 Influence of Long-Term Variability in Atmospheric Parameters on Ocean State over the Head Bay of Bengal

Authors: Anindita Patra, Prasad K. Bhaskaran

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The atmosphere-ocean is a dynamically linked system that influences the exchange of energy, mass, and gas at the air-sea interface. The exchange of energy takes place in the form of sensible heat, latent heat, and momentum commonly referred to as fluxes along the atmosphere-ocean boundary. The large scale features such as El Nino and Southern Oscillation (ENSO) is a classic example on the interaction mechanism that occurs along the air-sea interface that deals with the inter-annual variability of the Earth’s Climate System. Most importantly the ocean and atmosphere as a coupled system acts in tandem thereby maintaining the energy balance of the climate system, a manifestation of the coupled air-sea interaction process. The present work is an attempt to understand the long-term variability in atmospheric parameters (from surface to upper levels) and investigate their role in influencing the surface ocean variables. More specifically the influence of atmospheric circulation and its variability influencing the mean Sea Level Pressure (SLP) has been explored. The study reports on a critical examination of both ocean-atmosphere parameters during a monsoon season over the head Bay of Bengal region. A trend analysis has been carried out for several atmospheric parameters such as the air temperature, geo-potential height, and omega (vertical velocity) for different vertical levels in the atmosphere (from surface to the troposphere) covering a period from 1992 to 2012. The Reanalysis 2 dataset from the National Centers for Environmental Prediction-Department of Energy (NCEP-DOE) was used in this study. The study signifies that the variability in air temperature and omega corroborates with the variation noticed in geo-potential height. Further, the study advocates that for the lower atmosphere the geo-potential heights depict a typical east-west contrast exhibiting a zonal dipole behavior over the study domain. In addition, the study clearly brings to light that the variations over different levels in the atmosphere plays a pivotal role in supporting the observed dipole pattern as clearly evidenced from the trends in SLP, associated surface wind speed and significant wave height over the study domain.

Keywords: air temperature, geopotential height, head Bay of Bengal, long-term variability, NCEP reanalysis 2, omega, wind-waves

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427 The Non-Motor Symptoms of Filipino Patients with Parkinson’s Disease

Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

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426 Men’s Attendance in Labour and Birth Room: A Choice and Coercion in Childbirth

Authors: A/Prof Marjan Khajehei

Abstract:

In the last century, the role of fathers in the birth has changed exponentially. Before the 1970s, the principal view was that birth was a female business and not a man’s place. Changing cultural and professional attitudes around the emotional bond between a man and a woman, family structure and the more proactive involved role of men in the family have encouraged fathers’ attendance at birth. There is evidence that fathers’ support can make birthing less traumatic for some women and can make couples closer. This has made some clinicians to believe the fathers should be more involved throughout the birth process. Some clinicians even go further and ask the fathers to watch the medical procedures, such as inserting vaginal speculum, forceps or vacuum, episiotomy and stitches. Although birth can unfold like a beautiful picture captured by birth photographers, with fathers massaging women’s backs by candle light and the miraculous moment of birth, it can be overshadowed by less attractive images of cervical mucous, emptying bowels and the invasive medical procedures. What happens in the birth room and the fathers’ reaction to the graphic experience of birthing can be unpredictable. Despite the fact that most men are absolutely thrilled to be in the delivery room, for some men, a very intimate body part can become completely desexualised, and they can experience psychological and sexual scarring. They see someone they cherish dramatically sliced open and can then associate their partners with a disturbing scene, and it can dramatically affect their relationships. While most women want the expectant fathers by their side for this life-changing event, not all of them may be happy for their partners to watch the perineum to be cut or stitched or when large blades of forceps are inserted inside the vagina. Anecdotal reports have shown that consent is not sought from the labouring women as to whether they want their partners to watch these procedures. The majority of research1, 2, 3 focuses on men’s and women’s retrospective attitudes towards their birth experience. However, the effect of witnessing invasive procedures during childbirth on a man's attraction to his partner, while she is most vulnerable, and also an increased risk of post-traumatic stress disorder in fathers have not been widely investigated. There is a lack of sufficient research investigating whether women need to be asked for their consent before inviting their partners to closely watch medical procedures during childbirth. Future research is required to provide a basis for better awareness and involve the consumers to understanding the men’s and women’s experience and their expectations for labour and birth.

Keywords: birth, childbirth, father, labour, men, women

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425 Process Modeling in an Aeronautics Context

Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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424 A Systematic Review: Prevalence and Risk Factors of Low Back Pain among Waste Collection Workers

Authors: Benedicta Asante, Brenna Bath, Olugbenga Adebayo, Catherine Trask

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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, reports of injuries and fatal accidents in the industry demand notice particularly common and debilitating musculoskeletal disorders such as low back pain (LBP). WCWs are likely exposed to diverse work-related hazards that could contribute to LBP. However, to our knowledge there has never been a systematic review or other synthesis of LBP findings within this workforce. The aim of this systematic review was to determine the prevalence and risk factors of LBP among WCWs. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back pain’ and ‘waste collection workers’. Articles were screened at title, abstract, and full-text stages by two reviewers. Data were extracted on study design, sampling strategy, socio-demographic, geographical region, and exposure definition, definition of LBP, risk factors, response rate, statistical techniques, and LBP prevalence. Risk of bias (ROB) was assessed based on Hoy Damien’s ROB scale. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; thirteen full-text articles met the study criteria at the full-text stage. Seven articles (54%) reported prevalence within 12 months of LBP between 42-82% among WCW. The major risk factors for LBP among WCW included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Summary data and syntheses of findings was presented in trend-lines and tables to establish the several prevalence periods based on age and region distribution. Public health implications: LBP is a major occupational hazard among WCWs. In light of these risks and future growth in this industry, further research should focus on more detail ergonomic exposure assessment and LBP prevention efforts.

Keywords: low back pain, scavenger, waste collection workers, waste pickers

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423 The Silent Tuberculosis: A Case Study to Highlight Awareness of a Global Health Disease and Difficulties in Diagnosis

Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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422 The Descending Genicular Artery Perforator Free Flap as a Reliable Flap: Literature Review

Authors: Doran C. Kalmin

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The descending genicular artery (DGA) perforator free flap provides an alternative to free flap reconstruction based on a review of the literature detailing both anatomical and clinical studies. The descending genicular artery (DGA) supplies skin, muscle, tendon, and bone located around the medial aspect of the knee that has been used in several pioneering reports in reconstructing defects located in various areas throughout the body. After the success of the medial femoral condyle flap in early studies, a small number of studies have been published detailing the use of the DGA in free flap reconstruction. Despite early success in the use of the DGA flap, acceptance within the Plastic and Reconstructive Surgical community has been limited due primarily to anatomical variations of the pedicle. This literature review is aimed at detailing the progression of the DGA perforator free flap and its variations as an alternative and reliable free flap for reconstruction of composite defects with an exploration into both anatomical and clinical studies. A literature review was undertaken, and the progression of the DGA flap is explored from the early review by Acland et al. pioneering the saphenous free flap to exploring modern changes and studies of the anatomy of the DGA. An extensive review of the literature was undertaken that details the anatomy and its variations, approaches to harvesting the flap, the advantages, and disadvantages of the DGA perforator free flap as well as flap outcomes. There are 15 published clinical series of DGA perforator free flaps that incorporate cutaneous, osteoperiosteal, cartilage, osteocutaneous, osteoperiosteal and muscle, osteoperiosteal and subcutaneous and tendocutatenous. The commonest indication for using a DGA free flap was for non-union of bone, particularly that of the scaphoid whereby the medial femoral condyle could be used. In the case series, a success rate of over 90% was established, showing that these early studies have had good success with a wide range of tissue transfers. The greatest limitation is the anatomical variation of the DGA and therefore, the challenges associated with raising the flap. Despite the variation in anatomy and around 10-15% absence of the DGA, the saphenous artery can be used as well as the superior medial genicular artery if the vascular bone is required as part of the flap. Despite only a handful of anatomical and clinical studies describing the DGA perforator free flap, it ultimately provides a reliable flap that can include a variety of composite structure used for reconstruction in almost any area throughout the body. Although it has limitations, it provides a reliable option for free flap reconstruction that can routinely be performed as a single-stage procedure.

Keywords: anatomical study, clinical study, descending genicular artery, literature review, perforator free flap reconstruction

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421 Green-Synthesized β-Cyclodextrin Membranes for Humidity Sensors

Authors: Zeineb Baatout, Safa Teka, Nejmeddine Jaballah, Nawfel Sakly, Xiaonan Sun, Mustapha Majdoub

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Currently, the economic interests linked to the development of bio-based materials make biomass one of the most interesting areas for science development. We are interested in the β-cyclodextrin (β-CD), one of the popular bio-sourced macromolecule, produced from the starch via enzymatic conversion. It is a cyclic oligosaccharide formed by the association of seven glucose units. It presents a rigid conical and amphiphilic structure with hydrophilic exterior, allowing it to be water-soluble. It has also a hydrophobic interior enabling the formation of inclusion complexes, which support its application for the elaboration of electrochemical and optical sensors. Nevertheless, the solubility of β-CD in water makes its use as sensitive layer limit and difficult due to their instability in aqueous media. To overcome this limitation, we chose to precede by modification of the hydroxyl groups to obtain hydrophobic derivatives which lead to water-stable sensing layers. Hence, a series of benzylated β-CDs were synthesized in basic aqueous media in one pot. This work reports the synthesis of a new family of substituted amphiphilic β-CDs using a green methodology. The obtained β-CDs showed different degree of substitution (DS) between 0.85 and 2.03. These organic macromolecular materials were soluble in common organic volatile solvents, and their structures were investigated by NMR, FT-IR and MALDI-TOF spectroscopies. Thermal analysis showed a correlation between the thermal properties of these derivatives and the benzylation degree. The surface properties of the thin films based on the benzylated β-CDs were characterized by contact angle measurements and atomic force microscopy (AFM). These organic materials were investigated as sensitive layers, deposited on quartz crystal microbalance (QCM) gravimetric transducer, for humidity sensor at room temperature. The results showed that the performances of the prepared sensors are greatly influenced by the benzylation degree of β-CD. The partially modified β-CD (DS=1) shows linear response with best sensitivity, good reproducibility, low hysteresis, fast response time (15s) and recovery time (17s) at higher relative humidity levels (RH) between 11% and 98% in room temperature.

Keywords: β-cyclodextrin, green synthesis, humidity sensor, quartz crystal microbalance

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420 The Dismantling of the Santa Ana Riverbed Homeless Encampment: A Case Study

Authors: Shasta Bula

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This research provides the first case study of the Santa Ana riverbed homeless encampment. It contributes valuable information about the little-studied factors contributing to the formation and dismantling of transient homeless encampments. According to the author’s best knowledge, this is the discussion of three reoccurring characteristics of homeless camps: camps form a self-governing system, camps are viewed by the community as unsavory places, and the campers are viewed as being unable or unwilling to participate in normal society. Three theories are proposed as explanations for these characteristics: the social capital theory as a reason for homeless campers to develop a system of self-government, the aesthetics theory as rationale for camps being viewed as unsavory places, and the theory of vulnerable and inevitable inequality as a reason why campers are seen as being unable or unwilling to participate in normal society. Three hypotheses are introduced to assess these theories: The encampment was created because it provided inhabitants a sense of safety and autonomy. It was dismantled due to its highly visible location and lack of adherence to the Orange County consumption and leisure aesthetic. Most homeless people from this encampment relocated approximately thirty miles east to Riverside County to avoid harassment by police. An extensive review of interviews with camp inhabitants revealed that fifty-one percent resided in the camp because it gave them a sense of safety and autonomy. An examination of Anaheim city council meeting meetings showed that thirty-eight percent of complaints were related to aesthetic concerns. Analysis of population reports from the U.S. Department of Housing and Urban Development indicated that there was a notable increase in homelessness in Orange County the year after the camp was dismantled. These results reflect that the social capital theory is an applicable explanation for the homeless being drawn to set up camp as a collective. The aesthetics theory can be used to explain why a third of residents complained about the encampment. Camp residents did not move East to Riverside after the camp was dismantled. Further investigation into the enforcement of anti-camping ordinances needs to be conducted to evaluate if policing contributed to the vulnerability of the homeless.

Keywords: poverty, social relations, transformation of urban settlements, urban anthropology

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419 Fabric-Reinforced Cementitious Matrix (FRCM)-Repaired Corroded Reinforced Concrete (RC) Beams under Monotonic and Fatigue Loads

Authors: Mohammed Elghazy, Ahmed El Refai, Usama Ebead, Antonio Nanni

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Rehabilitating corrosion-damaged reinforced concrete (RC) structures has been accomplished using various techniques such as steel plating, external post-tensioning, and external bonding of fiber reinforced polymer (FRP) composites. This paper reports on the use of an innovative technique to strengthen corrosion-damaged RC structures using fabric-reinforced cementitious matrix (FRCM) composites. FRCM consists of dry-fiber fabric embedded in cement-based matrix. Twelve large-scale RC beams were constructed and tested in flexural monotonic and fatigue loads. Prior to testing, ten specimens were subjected to accelerated corrosion process for 140 days leading to an average mass loss in the tensile steel bars of 18.8 %. Corrosion was restricted to the main reinforcement located in the middle third of the beam span. Eight corroded specimens were repaired and strengthened while two virgin and two corroded-unrepaired/unstrengthened beams were used as benchmarks for comparison purpose. The test parameters included the FRCM materials (Carbon-FRCM, PBO-FRCM), the number of FRCM plies, the strengthening scheme, and the type of loading (monotonic and fatigue). The effects of the pervious parameters on the flexural response, the mode of failure, and the fatigue life were reported. Test results showed that corrosion reduced the yield and ultimate strength of the beams. The corroded-unrepaired specimen failed to meet the provisions of the ACI-318 code for crack width criteria. The use of FRCM significantly increased the ultimate strength of the corroded specimen by 21% and 65% more than that of the corroded-unrepaired specimen. Corrosion significantly decreased the fatigue life of the corroded-unrepaired beam by 77% of that of the virgin beam. The fatigue life of the FRCM repaired-corroded beams increased to 1.5 to 3.8 times that of the corroded-unrepaired beam but was lower than that of the virgin specimen. The specimens repaired with U-wrapped PBO-FRCM strips showed higher fatigue life than those repaired with the end-anchored bottom strips having similar number of PBO-FRCM-layers. PBO-FRCM was more effective than Carbon-FRCM in restoring the fatigue life of the corroded specimens.

Keywords: corrosion, concrete, fabric-reinforced cementitious matrix (FRCM), fatigue, flexure, repair

Procedia PDF Downloads 296
418 Human Rabies Survivors in India: Epidemiological, Immunological and Virological Studies

Authors: Madhusudana S. N., Reeta Mani, Ashwini S. Satishchandra P., Netravati, Udhani V., Fiaz A., Karande S.

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Rabies is an acute encephalitis which is considered 100% fatal despite occasional reports of survivors. However, in recent times more cases of human rabies survivors are being reported. In the last 5 years, there are six laboratories confirmed human rabies survivors in India alone. All cases were children below 15 years and all contracted the disease by dog bites. All of them also had received the full or partial course of rabies vaccination and 4 out of 6 had also received rabies immunoglobulin. All cases were treated in intensive care units in hospitals at Bangalore, Mumbai, Chandigarh, Lucknow and Goa. We report here the results of immunological and virological studies conducted at our laboratory on these patients. The clinical samples that were obtained from these patients were Serum, CSF, nuchal skin biopsy and saliva. Serum and CSF samples were subjected to standard RFFIT for estimation of rabies neutralizing antibodies. Skin biopsy, CSF and saliva were processed by TaqMan real-time PCR for detection of viral RNA. CSF, saliva and skin homogenates were also processed for virus isolation by inoculation of suckling mice. The PBMCs isolated from fresh blood was subjected to ELISPOT assay to determine the type of immune response (Th1/Th2). Both CSF and serum were also investigated for selected cytokines by Luminex assay. The level of antibodies to virus G protein and N protein were determined by ELISA. All survivors had very high titers of RVNA in serum and CSF 100 fold higher than non-survivors and vaccine controls. A five-fold rise in titer could be demonstrated in 4 out of 6 patients. All survivors had a significant increase in antibodies to G protein in both CSF and serum when compared to non-survivors. There was a profound and robust Th1 response in all survivors indicating that interferon gamma could play an important factor in virus clearance. We could isolate viral RNA in only one patient four years after he had developed symptoms. The partial N gene sequencing revealed 99% homology to species I strain prevalent in India. Levels of selected cytokines in CSF and serum did not reveal any difference between survivors and non-survivors. To conclude, survival from rabies is mediated by virus-specific immune responses of the host and clearance of rabies virus from CNS may involve the participation of both Th2 and Th1 immune responses.

Keywords: rabies, rabies treatment, rabies survivors, immune reponse in rabies encephalitis

Procedia PDF Downloads 330
417 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

Procedia PDF Downloads 103
416 Cross-Tier Collaboration between Preservice and Inservice Language Teachers in Designing Online Video-Based Pragmatic Assessment

Authors: Mei-Hui Liu

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This paper reports the progression of language teachers’ learning to assess students’ speech act performance via online videos in a cross-tier professional growth community. This yearlong research project collected multiple data sources from several stakeholders, including 12 preservice and 4 inservice English as a foreign language (EFL) teachers, 4 English professionals, and 82 high school students. Data sources included surveys, (focus group) interviews, online reflection journals, online video-based assessment items/scores, and artifacts related to teacher professional learning. The major findings depicted the effectiveness of this proposed learning module on language teacher development in pragmatic assessment as well as its impact on student learning experience. All these teachers appreciated this professional learning experience which enhanced their knowledge in assessing students’ pragmalinguistic and sociopragmatic performance in an English speech act (i.e., making refusals). They learned how to design online video-based assessment items by attending to specific linguistic structures, semantic formula, and sociocultural issues. They further became aware of how to sharpen pragmatic instructional skills in the near future after putting theories into online assessment and related classroom practices. Additionally, data analysis revealed students’ achievement in and satisfaction with the designed online assessment. Yet, during the professional learning process most participating teachers encountered challenges in reaching a consensus on selecting appropriate video clips from available sources to present the sociocultural values in English-speaking refusal contexts. Also included was to construct test items which could testify the influence of interlanguage transfer on students’ pragmatic performance in various conversational scenarios. With pedagogical implications and research suggestions, this study adds to the increasing amount of research into integrating preservice and inservice EFL teacher education in pragmatic assessment and relevant instruction. Acknowledgment: This research project is sponsored by the Ministry of Science and Technology in the Republic of China under the grant number of MOST 106-2410-H-029-038.

Keywords: cross-tier professional development, inservice EFL teachers, pragmatic assessment, preservice EFL teachers, student learning experience

Procedia PDF Downloads 259
415 A Versatile Standing Cum Sitting Device for Rehabilitation and Standing Aid for Paraplegic Patients

Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj

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The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.

Keywords: paraplegic, rehabilitation, spinal cord injury, standing frame

Procedia PDF Downloads 200
414 An Investigation of the Determinants of Discount Rate Manipulation in Swedish and Finnish Listed Companies

Authors: Fredrik Hartwig, Peter Lindberg

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In 2004, the International Accounting Standards Board (IASB) issued new accounting standards for impairment testing of goodwill. IFRS 3 Business Combinations and IAS 36 Impairment of Assets prohibited amortization of acquired goodwill and instead required companies to test goodwill for impairment annually or more often if necessary. The goodwill impairment test is based on management’s judgement and estimations, making the impairment-only-approach subjective and unreliable. Management can use the discretion opportunistically by managing goodwill impairments. The IASB’s remedy to the reliability problem has been to demand transparent financial reports. IAS 36 paragraph 134 requires detailed disclosures regarding the impairment test in order to make potentially unreasonable assumptions and estimations visible. The disclosure requirements should thus (in theory) make it more difficult for management to ‘choose’ assumptions and estimations that suit an agenda. Whether the requirement to disclose detailed disclosures regarding the impairment test leads to less opportunism is however an empirical question. This work analyses whether one of the required disclosures in IAS 36 paragraph 134, the reported discount rate, differs from an independently estimated risk-adjusted discount rate. Estimates of discount rates that are either lower or higher than the independently estimated discount rate are here defined as opportunism. In the former case - i.e. when the reported discount rate is lower - the objective may be to avoid profit reducing impairment charges. In the latter case - i.e. when the reported discount rate is higher - the objective may be to reduce profits or take ‘big baths’. This paper differs in one important respect from previous similar studies, the majority of which are based on purely descriptive statistics; we use multivariate regression analysis to analyze what factors affect deviations between disclosed discount rates and independently estimated discount rates. The sample consists of Swedish and Finnish listed companies. Swedish and Finnish listed companies are analysed since the accounting oversight bodies differ between the two countries. The results show that discount rate deviations in Swedish and Finnish listed companies are significantly related to accounting oversight, size and industry but not financial risk, business risk and goodwill intensity.

Keywords: discount rate, manipulation, goodwill impairment test, disclosures

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413 The Applicability of General Catholic Canon Law during the Ongoing Migration Crisis in Hungary

Authors: Lorand Ujhazi

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The vast majority of existing canonical studies about migration are focused on examining the general pastoral and legal regulations of the Catholic Church. The weakness of this approach is that it ignores a number of important factors; like the financial, legal and personal circumstances of a particular church or the canonical position of certain organizations which actually look after the immigrants. This paper is a case study, which analyses the current and historical migration related policies and activities of the Catholic Church in Hungary. To achieve this goal the study uses canon law, historical publications, various instructions and communications issued by church superiors, Hungarian and foreign media reports and the relevant Hungarian legislation. The paper first examines how the Hungarian Catholic Church assisted migrants like Armenians fleeing from the Ottoman Empire, Poles escaping during the Second World War, East German and Romanian citizens in the 1980s and refugees from the former Yugoslavia in the 1990s. These events underline the importance of past historical experience in the development of contemporary pastoral and humanitarian policy of the Catholic Church in Hungary. Then the paper turns to the events of the ongoing crisis by describing the unique challenges faced by churches in transit countries like Hungary. Then the research contrasts these findings with the typical responsibilities of churches in countries which are popular destinations for immigrants. The next part of the case study focuses on the changes to the pre-crisis legal and canonical framework which influenced the actions of hierarchical and charity organizations in Hungary. Afterwards, the paper illustrates the dangers of operating in an unclear legal environment, where some charitable activities of the church like a fundraising campaign may be interpreted as a national security risk by state authorities. Then the paper presents the reactions of Hungarian academics to the current migration crisis and finally it offers some proposals how to improve parts of Canon Law which govern immigration. The conclusion of the paper is that during the formulation of the central refugee policy of the Catholic Church decision makers must take into consideration the peculiar circumstances of its particular churches. This approach may prevent disharmony between the existing central regulations, the policy of the Vatican and the operations of the local church organizations.

Keywords: canon law, Catholic Church, civil law, Hungary, immigration, national security

Procedia PDF Downloads 308
412 Gilgel Gibe III: Dam-Induced Displacement in Ethiopia and Kenya

Authors: Jonny Beirne

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Hydropower developments have come to assume an important role within the Ethiopian government's overall development strategy for the country during the last ten years. The Gilgel Gibe III on the Omo river, due to become operational in September 2014, represents the most ambitious, and controversial, of these projects to date. Further aspects of the government's national development strategy include leasing vast areas of designated 'unused' land for large-scale commercial agricultural projects and 'voluntarily' villagizing scattered, semi-nomadic agro-pastoralist groups to centralized settlements so as to use land and water more efficiently and to better provide essential social services such as education and healthcare. The Lower Omo valley, along the Omo River, is one of the sites of this villagization programme as well as of these large-scale commercial agricultural projects which are made possible owing to the regulation of the river's flow by Gibe III. Though the Ethiopian government cite many positive aspects of these agricultural and hydropower developments there are still expected to be serious regional and transnational effects, including on migration flows, in an area already characterized by increasing climatic vulnerability with attendant population movements and conflicts over scarce resources. The following paper is an attempt to track actual and anticipated migration flows resulting from the construction of Gibe III in the immediate vicinity of the dam, downstream in the Lower Omo Valley and across the border in Kenya around Lake Turkana. In the case of those displaced in the Lower Omo Valley, this will be considered in view of the distinction between voluntary villagization and forced resettlement. The research presented is not primary-source material. Instead, it is drawn from the reports and assessments of the Ethiopian government, rights-based groups, and academic researchers as well as media articles. It is hoped that this will serve to draw greater attention to the issue and encourage further methodological research on the dynamics of dam constructions (and associated large-scale irrigation schemes) on migration flows and on the ultimate experience of displacement and resettlement for environmental migrants in the region.

Keywords: forced displacement, voluntary resettlement, migration, human rights, human security, land grabs, dams, commercial agriculture, pastoralism, ecosystem modification, natural resource conflict, livelihoods, development

Procedia PDF Downloads 381
411 Psychological Well-Being and Human Rights of Teenage Mothers Attending One Secondary School in the Eastern Cape, South Africa

Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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This paper reports on teenage motherhood and its adverse outcomes on the academic performance, emotional well-being and sexual relationships that adolescent females encounter. Drawing from Ryff’s six dimensions of psychological well-being and Bronfenbrenner’s ecological model which underpinned this study, teenage motherhood has been found to link with multiple factors such as poverty, negative self-esteem, substance abuse, cohabitation, intimate partner violence and ill-health. Furthermore, research indicates that in schools where educators fail to perform their duties as loco-parentis to motivate adolescent females learners who are mothers, absenteeism, poor academic performance and learned helplessness, are likely. The aim of this research was two-fold, namely; (i) to determine the impact of teenage motherhood on the psychological well-being of the teenage mothers and (ii) to investigate the policies which protect the human rights of teenage mothers attending secondary schools. In a qualitative study conducted in one secondary school, Fort Beaufort, Eastern Cape, South Africa, fifteen Xhosa-speaking teenage mothers, aged 15-18 years old, were interviewed. The sample was recruited by means of snow-ball sampling. To safeguard the human dignity of the respondents, informed consent, confidentiality, anonymity and privacy of the respondents were assured. For trustworthiness, this research ensured that credibility, neutrality, and transferability, are met. Following an axial and open coding of responses, five themes were identified; Health issues of teenage mothers, lack of support, violation of human rights, impaired sense of purpose in life and intimate partner-violence. From these findings, it is clear that teenage mothers lack resilience and are susceptible to contract sexually transmitted infections and HIV/AIDS because they are submissive and hopeless. Furthermore, owing to stigma that the teenage mothers' experience from family members, they resort to alcohol and drug abuse, and feel demotivated to bond with their babies. In conclusion, the recommendations are that the Health and Social Development departments collaborate to empower the psychological well-being of teenage mothers. Furthermore, school policies on discrimination should be enacted and consistently implemented.

Keywords: depression, discrimination, self-esteem, teenage mothers

Procedia PDF Downloads 273
410 Pregnancy and Birth Outcomes of Single versus Multiple Embryo Transfer in Gestational Surrogacy Arrangements: A Systematic Review

Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

Procedia PDF Downloads 404
409 Central Line Stock and Use Audit in Adult Patients: A Quality Improvement Project on Central Venous Catheter Standardisation Across Hospital Departments

Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

Procedia PDF Downloads 117
408 The Effect of Realizing Emotional Synchrony with Teachers or Peers on Children’s Linguistic Proficiency: The Case Study of Uji Elementary School

Authors: Reiko Yamamoto

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This paper reports on a joint research project in which a researcher in applied linguistics and elementary school teachers in Japan explored new ways to realize emotional synchrony in a classroom in childhood education. The primary purpose of this project was to develop a cross-curriculum of the first language (L1) and second language (L2) based on the concept of plurilingualism. This concept is common in Europe, and can-do statements are used in forming the standard of linguistic proficiency in any language; these are attributed to the action-oriented approach in the Common European Framework of Reference for Languages (CEFR). CEFR has a basic tenet of language education: improving communicative competence. Can-do statements are classified into five categories based on the tenet: reading, writing, listening, speaking/ interaction, and speaking/ speech. The first approach of this research was to specify the linguistic proficiency of the children, who are still developing their L1. Elementary school teachers brainstormed and specified the linguistic proficiency of the children as the competency needed to synchronize with others – teachers or peers – physically and mentally. The teachers formed original can-do statements in language proficiency on the basis of the idea that emotional synchrony leads to understanding others in communication. The research objectives are to determine the effect of language education based on the newly developed curriculum and can-do statements. The participants of the experiment were 72 third-graders in Uji Elementary School, Japan. For the experiment, 17 items were developed from the can-do statements formed by the teachers and divided into the same five categories as those of CEFR. A can-do checklist consisting of the items was created. The experiment consisted of three steps: first, the students evaluated themselves using the can-do checklist at the beginning of the school year. Second, one year of instruction was given to the students in Japanese and English classes (six periods a week). Third, the students evaluated themselves using the same can-do checklist at the end of the school year. The results of statistical analysis showed an enhancement of linguistic proficiency of the students. The average results of the post-check exceeded that of the pre-check in 12 out of the 17 items. Moreover, significant differences were shown in four items, three of which belonged to the same category: speaking/ interaction. It is concluded that children can get to understand others’ minds through physical and emotional synchrony. In particular, emotional synchrony is what teachers should aim at in childhood education.

Keywords: elementary school education, emotional synchrony, language proficiency, sympathy with others

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407 Development of a Journal over 20 Years: Citation Analysis

Authors: Byung Lee, Charles Perschau

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This study analyzes the development of a communication journal, the Journal of Advertising Education (JAE) over the past 20 years by examining citations of all research articles there. The purpose of a journal is to offer a stable and transparent forum for the presentation, scrutiny, and discussion of research in a targeted domain. This study asks whether JAE has fulfilled this purpose. The authors and readers who are involved in a journal need to have common research topics of their interest. In the case of the discipline of communication, scholars have a variety of backgrounds beyond communication itself since the social scientific study of communication is a relatively recent development, one that emerged after World War II, and the discipline has been heavily indebted to other social sciences, such as psychology, sociology, social psychology, and political science. When authors impart their findings and knowledge to others, their work is not done in isolation. They have to stand on previous studies, which are listed as sources in the bibliography. Since communication has heavily piggybacked on other disciplines, cited sources should be as diverse as the resources it taps into. This paper analyzes 4,244 articles that were cited by JAE articles in the past 36 issues. Since journal article authors reveal their intellectual linkage by using bibliographic citations, the analysis of citations in journal articles will reveal various networks of relationships among authors, journal types, and fields in an objective and quantitative manner. The study found that an easier access to information sources because of the development of electronic databases and the growing competition among scholars for publication seemed to influence authors to increase the number of articles cited even though some variations existed during the examined period. The types of articles cited have also changed. Authors have more often cited journal articles, periodicals (most of them available online), and web site sources, while decreased their dependence on books, conference papers, and reports. To provide a forum for discussion, a journal needs a common topic or theme. This can be realized when an author writes an article about a topic, and that article is cited and discussed in another article. Thus, the citation of articles in the same journal is vital for a journal to form a forum for discussion. JAE has gradually increased the citations of in-house articles with a few fluctuations over the years. The study also examines not only specific articles that are often cited, but also specific authors often cited. The analysis of citations in journal articles shows how JAE has developed into a full academic journal while offering a communal forum even though the speed of its formation is not as fast as desired probably because of its interdisciplinary nature.

Keywords: citation, co-citation, the Journal of Advertising Education, development of a journal

Procedia PDF Downloads 155
406 Cyber Bullying, Online Risks and Parental Mediation: A Comparison between Adolescent Reports and Parent Perceptions in South Africa

Authors: Masa Popovac, Philip Fine

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Information and Communication Technologies (ICTs) have altered our social environments, and young people in particular have immersed themselves in the digital age. Despite countless benefits, younger ICT users are being exposed to various online risks such as contact with strangers, viewing of risky content, sending or receiving sexually themed images or comments (i.e. ‘sexting’) as well as cyber bullying. Parents may not be fully aware of the online spaces their children inhabit and often struggle to implement effective mediation strategies. This quantitative study explored (i) three types of online risks (contact risks, content risks and conduct risks), (ii) cyber bullying victimization and perpetration, and (iii) parental mediation among a sample of 689 South African adolescents aged between 12-17 years. Survey data was also collected for 227 of their parents relating to their perceptions of their child’s online experiences. A comparison between adolescent behaviors and parental perceptions was examined on the three variables in the study. Findings reveal various online risk taking behaviors. In terms of contact risks, 56% of adolescents reported having contact with at least one online stranger, with many meeting these strangers in person. Content risks included exposure to harmful information such as websites promoting extreme diets or self-harm as well as inappropriate content: 84% of adolescents had seen violent content and 75% had seen sexual content online. Almost 60% of adolescents engaged in conduct risks such as sexting. Eight online victimization behaviors were examined in the study and 79% of adolescents had at least one of these negative experiences, with a third (34%) defining this experience as cyber bullying. A strong connection between victimization and perpetration was found, with 63% of adolescents being both a victim and perpetrator. Very little parental mediation of ICT use was reported. Inferential statistics revealed that parents consistently underestimated their child’s online risk taking behaviors as well as their cyber bullying victimization and perpetration. Parents also overestimated mediation strategies in the home. The generational gap in the knowledge and use of ICTs is a barrier to effective parental mediation and online safety, since many negative online experiences by adolescents go undetected and can continue for extended periods of time thereby exacerbating the potential psychological and emotional distress. The study highlights the importance of including parents in online safety efforts.

Keywords: cyber bullying, online risk behaviors, parental mediation, South Africa

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405 A 10 Year Review of the Complications of Ingested and Aspirated Dentures

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

Procedia PDF Downloads 138
404 A Modified QuEChERS Method Using Activated Carbon Fibers as r-DSPE Sorbent for Sample Cleanup: Application to Pesticides Residues Analysis in Food Commodities Using GC-MS/MS

Authors: Anshuman Srivastava, Shiv Singh, Sheelendra Pratap Singh

Abstract:

A simple, sensitive and effective gas chromatography tandem mass spectrometry (GC-MS/MS) method was developed for simultaneous analysis of multi pesticide residues (organophosphate, organochlorines, synthetic pyrethroids and herbicides) in food commodities using phenolic resin based activated carbon fibers (ACFs) as reversed-dispersive solid phase extraction (r-DSPE) sorbent in modified QuEChERS (Quick Easy Cheap Effective Rugged Safe) method. The acetonitrile-based QuEChERS technique was used for the extraction of the analytes from food matrices followed by sample cleanup with ACFs instead of traditionally used primary secondary amine (PSA). Different physico-chemical characterization techniques such as Fourier transform infrared spectroscopy, scanning electron microscopy, X-ray diffraction and Brunauer-Emmet-Teller surface area analysis were employed to investigate the engineering and structural properties of ACFs. The recovery of pesticides and herbicides was tested at concentration levels of 0.02 and 0.2 mg/kg in different commodities such as cauliflower, cucumber, banana, apple, wheat and black gram. The recoveries of all twenty-six pesticides and herbicides were found in acceptable limit (70-120%) according to SANCO guideline with relative standard deviation value < 15%. The limit of detection and limit of quantification of the method was in the range of 0.38-3.69 ng/mL and 1.26 -12.19 ng/mL, respectively. In traditional QuEChERS method, PSA used as r-DSPE sorbent plays a vital role in sample clean-up process and demonstrates good recoveries for multiclass pesticides. This study reports that ACFs are better in terms of removal of co-extractives in comparison of PSA without compromising the recoveries of multi pesticides from food matrices. Further, ACF replaces the need of charcoal in addition to the PSA from traditional QuEChERS method which is used to remove pigments. The developed method will be cost effective because the ACFs are significantly cheaper than the PSA. So the proposed modified QuEChERS method is more robust, effective and has better sample cleanup efficiency for multiclass multi pesticide residues analysis in different food matrices such as vegetables, grains and fruits.

Keywords: QuEChERS, activated carbon fibers, primary secondary amine, pesticides, sample preparation, carbon nanomaterials

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