Search results for: event injuries

Authors: Sachil Kumar, Anoop Kumar Verma, Wahid Ali, Uma Shankar Singh

Abstract:

Globally approximately 55.3 million people die each year. In the India there were 95 lakh annual deaths in 2013. The number of deaths resulted from homicides, suicides and unintentional injuries in the same period was about 5.7 lakh. The ever-increasing crime rate necessitated the development of methods for determining time since death. An erroneous time of death window can lead investigators down the wrong path or possibly focus a case on an innocent suspect. In this regard a research was carried out by analyzing the temperature dependent degradation of a Cardiac Troponin-T protein (cTnT) in the myocardium postmortem as a marker for time since death. Cardiac tissue samples were collected from (n=6) medico-legal autopsies, (in the Department of Forensic Medicine and Toxicology, King George’s Medical University, Lucknow India) after informed consent from the relatives and studied post-mortem degradation by incubation of the cardiac tissue at room temperature (20±2 OC), 12 0C, 25 0C and 37 0C for different time periods ((~5, 26, 50, 84, 132, 157, 180, 205, and 230 hours). The cases included were the subjects of road traffic accidents (RTA) without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc. The data shows a distinct temporal profile corresponding to the degradation of cTnT by proteases found in cardiac muscle. The disappearance of intact cTnT and the appearance of lower molecular weight bands are easily observed. Western blot data clearly showed the intact protein at 42 kDa, two major (27 kDa, 10kDa) fragments, two additional minor fragments (32 kDa) and formation of low molecular weight fragments as time increases. At 12 0C the intensity of band (intact cTnT) decreased steadily as compared to RT, 25 0C and 37 0C. Overall, both PMI and temperature had a statistically significant effect where the greatest amount of protein breakdown was observed within the first 38 h and at the highest temperature, 37 0C. The combination of high temperature (37 0C) and long Postmortem interval (105.15 hrs) had the most drastic effect on the breakdown of cTnT. If the percent intact cTnT is calculated from the total area integrated within a Western blot lane, then the percent intact cTnT shows a pseudo-first order relationship when plotted against the log of the time postmortem. These plots show a good coefficient of correlation of r = 0.95 (p=0.003) for the regression of the human heart at different temperature conditions. The data presented demonstrates that this technique can provide an extended time range during which Postmortem interval can be more accurately estimated.

Keywords: degradation, postmortem interval, proteolysis, temperature, troponin

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Authors: Ramalan Musa Yerima

Abstract:

The paper titled “loading by number” explained a strategy developed recently by Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably leads to the reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly, deliver goods on time or they pushed themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommend that if a strategy called loading by number is integrated with other multiple safety measures such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is design to ensure that the sequence of departure of drivers from motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively towards ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transportation

Procedia PDF Downloads 47

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

Abstract:

Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

Procedia PDF Downloads 55

Authors: Ramalan Musa Yerima

Abstract:

The paper titled “Loading by number” explained a strategy developed recently by the Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably lead to a reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with a focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose an effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly and deliver goods on time, or they push themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommends that if a strategy called loading by number is integrated with other multiple safety measures, such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is designed to ensure that the sequence of departure of drivers from the motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively toward ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transport

Procedia PDF Downloads 50

Authors: Pawel Kiper, Alfonc Baba, Mahmoud Alhelou, Giorgia Pregnolato, Michela Agostini, Andrea Turolla

Abstract:

Impairment of cervical spine mobility is often related to pain triggered by musculoskeletal disorders or direct traumatic injuries of the spine. To date, these disorders are assessed with goniometers and inclinometers, which are the most popular devices used in clinical settings. Nevertheless, these technologies usually allow measurement of no more than two-dimensional range of motion (ROM) quotes in static conditions. Conversely, the wide use of motion tracking systems able to measure 3 to 6 degrees of freedom dynamically, while performing standard ROM assessment, are limited due to technical complexities in preparing the setup and high costs. Thus, motion tracking systems are primarily used in research. These systems are an integral part of virtual reality (VR) technologies, which can be used for measuring spine mobility. To our knowledge, the accuracy of VR measure has not yet been studied within virtual environments. Thus, the aim of this study was to test the reliability of a protocol for the assessment of sensorimotor function of the cervical spine in a population of healthy subjects and to compare whether using immersive or non-immersive VR for visualization affects the performance. Both VR assessments consisted of the same five exercises and random sequence determined which of the environments (i.e. immersive or non-immersive) was used as first assessment. Subjects were asked to perform head rotation (right and left), flexion, extension and lateral flexion (right and left side bending). Each movement was executed five times. Moreover, the participants were invited to perform head reaching movements i.e. head movements toward 8 targets placed along a circular perimeter each 45°, visualized one-by-one in random order. Finally, head repositioning movement was obtained by head movement toward the same 8 targets as for reaching and following reposition to the start point. Thus, each participant performed 46 tasks during assessment. Main measures were: ROM of rotation, flexion, extension, lateral flexion and complete kinematics of the cervical spine (i.e. number of completed targets, time of execution (seconds), spatial length (cm), angle distance (°), jerk). Thirty-five healthy participants (i.e. 14 males and 21 females, mean age 28.4±6.47) were recruited for the cervical spine assessment with immersive and non-immersive VR environments. Comparison analysis demonstrated that: head right rotation (p=0.027), extension (p=0.047), flexion (p=0.000), time (p=0.001), spatial length (p=0.004), jerk target (p=0.032), trajectory repositioning (p=0.003), and jerk target repositioning (p=0.007) were significantly better in immersive than non-immersive VR. A regression model showed that assessment in immersive VR was influenced by height, trajectory repositioning (p<0.05), and handedness (p<0.05), whereas in non-immersive VR performance was influenced by height, jerk target (p=0.002), head extension, jerk target repositioning (p=0.002), and by age, head flex/ext, trajectory repositioning, and weight (p=0.040). The results of this study showed higher accuracy of cervical spine assessment when executed in immersive VR. The assessment of ROM and kinematics of the cervical spine can be affected by independent and dependent variables in both immersive and non-immersive VR settings.

Keywords: virtual reality, cervical spine, motion analysis, range of motion, measurement validity

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Authors: Ryotaro Ishikawa

Abstract:

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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Authors: Maggie Hui

Abstract:

Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Risk managers are responsible for managing risk, i.e. adopting strategies with the intention to minimize loss and maximize gains in spite of uncertainty. Which risk strategy to use often depends on the frequency of an event (i.e. probability) and the severity of its outcomes (i.e. impact). This is basically the way translation/localization project managers handle risk management. Although risk management could involve both positive and negative impacts, impact seems to be always negative in professional translators’ management models, e.g. how many days of project time are lost or how many clients are lost. However, for analysis of translation performance, the impact should be possibly positive (e.g. increased readability of the translation) or negative (e.g. loss of source-text information). In other words, the straight business model of risk management is not directly applicable to the study of risk management in the rendition process. This research aims to explore trainee translators’ risk managing while translating in a simulated setting that involves translator-client relations. A two-cycle experiment involving two roles, the translator and the simulated client, was carried out with a class of translation students to test the effects of the main variable of peer-group interaction. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) there is a wide gap between the translator’s internal risk management and their external presentation of risk; and (c) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence.

Keywords: risk management, role-playing simulation, translation pedagogy, translator-client relations

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Authors: Teresa Kupczyk, Selçuk Mustafa Özcan, Joanna Kubicka

Abstract:

The paper presents results of specialist literature analysis concerning learning outcomes and student satisfaction as a factor of the necessary change in the Polish higher education system. The objective of the empirical research was to determine students’ assessment of learning outcomes, satisfaction of their expectations, as well as their satisfaction with lectures and practical classes held in the traditional form, e-learning and video-conference. The assessment concerned effectiveness of time spent at classes, usefulness of the delivered knowledge, instructors’ preparation and teaching skills, application of tools, studies curriculum, its adaptation to students’ needs and labour market, as well as studying conditions. Self-assessment of learning outcomes was confronted with assessment by lecturers. The indirect objective of the research was also to identify how students assessed their activity and commitment in acquisition of knowledge and their discipline in achieving education goals. It was analysed how the studies held affected the students’ willingness to improve their skills and assessment of their perspectives at the labour market. To capture the changes underway, the research was held at the beginning, during and after completion of the studies. The study group included 86 students of two editions of full-time studies majoring in Management and specialising in “Mega-event organisation”. The studies were held within the EU-funded project entitled “Responding to challenges of new markets – innovative managerial education”. The results obtained were analysed statistically. Average results and standard deviations were calculated. In order to describe differences between the studied variables present during the process of studies, as well as considering the respondents’ gender, t-Student test for independent samples was performed with the IBM SPSS Statistics 21.0 software package. Correlations between variables were identified by calculation of Pearson and Spearman correlation coefficients. Research results suggest necessity to introduce some changes in the teaching system applied at Polish higher education institutions, not only considering the obtained outcomes, but also impact on students’ willingness to improve their qualifications constantly, improved self-assessment among students and their opportunities at the labour market.

Keywords: higher education, learning outcomes, students, change

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Authors: N. Uaphongsathorn, C. Worawong, S. Thaewpia

Abstract:

Background and significance: The population is aging in Thai society, the elderly dependent is at great risk of various functional, psychological, and socio-economic problems as well as less access to health care. They may require long term care at home to maximize their functional abilities and activities of daily living and to improve their quality of life during their own age. Therefore, there is a need to develop a home-based long term care to meet the long term care needs of elders dependent. Methods: The research purpose was to develop long term care model among the elderly dependent in Chaiyaphum province in Northeast region of Thailand. Action Research which is composing of planning, action, observation, and reflection phases was used. Research was carried out for 12 months in all sub-districts of 6 districts in Chaiyaphum province. Participants (N = 1,010) participating in the processes of model development were comprised of 3 groups: a) a total of 110 health care professionals, b) a total of 600 health volunteers and family caregivers and c) a total of 300 the elderly dependent with chronically medical illnesses or disabilities. Descriptive statistics and content analysis were used to analyze data. Findings: Results have shown that the most common health problems among elders dependent with physical disabilities to function independently were cardiovascular disease, dementia, and traffic injuries. The development of home-based long term care model among elders dependent in Chaiyaphum province was composed of six key steps. They are: a) initiating policies supporting formal and informal caregivers for the elder dependent in all sub-districts, b) building network and multidisciplinary team, c) developing 3-day care manager training program and 3-day care provider training program d) training case managers and care providers for the elderly dependent through team and action learning, e) assessing, planning and providing care based on care individual’s needs of the elderly dependent, and f) sharing experiences for good practice and innovation for long term care at homes in district urban and rural areas. Among all care managers and care providers, the satisfaction level for training programs was high with a mean score of 3.98 out of 5. The elders dependent and family caregivers addressed that long term care at home could contribute to improving life’s daily activities, family relationship, health status, and quality of life. Family caregivers and volunteers have feeling a sense of personal satisfaction and experiencing providing meaningful care and support for elders dependent. Conclusion: In conclusion, a home-based long term care is important to Thai elders dependent. Care managers and care providers play a large role and responsibility to provide appropriate care to meet the elders’ needs in both urban and rural areas in Thai society. Further research could be rigorously studied with a larger group of populations in similar socio-economic and cultural contexts.

Keywords: elderly people, care manager, care provider, long term care

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Authors: Aymen Arfaoui, Abdelkader Soumaya

Abstract:

The Messalla-Ressas-Bou Kornine (MRB) and Hammamet Korbous (HK) major trending North-South fault zones provide a good opportunity to show the effects of the Eocene compressive phase in northern Tunisia. They acted as paleogeographical boundaries during the Mesozoic and belonged to a significant strike-slip corridor called the «North-South Axis,» extending from the Saharan platform at the South to the Gulf of Tunis at the North. Our study area is situated in a relay zone between two significant strike-slip faults (HK and MRB), separating the Atlas domain from the Pelagian Block. We used a multidisciplinary approach, including fieldwork, stress inversion, and geophysical profiles, to argue the shortening event that affected the study region. The MRB and HK contractional duplex is a privileged area for a local stress field and stress nucleation. The stress inversion of fault slip data reveals an Eocene compression with NW-SE trending SHmax, reactivating most of the ancient Mesozoic normal faults in the region. This shortening phase is represented in the MRB belt by an angular unconformity between the Upper Eocene over various Cretaceous strata. The stress inversion data reveal a compressive tectonic with an average NW-SE trending Shmax. The major N-S faults are reactivated under this shortening as sinistral oblique faults. The orientation of SHmax deviates from NW-SE to E-W near the preexisting deep faults of MRB and HK. This E-W stress direction generated the emerging overlap of Ressas-Messella and blind thrust faults in the Cretaceous deposits. The connection of the sub-meridian reverse faults in depth creates "flower structures" under an E-W local compressive stress. In addition, we detected a reorientation of the SHmax into an N-S direction in the central part of the MRB - HK contractional duplex, creating E-W reverse faults and overlapping zones. Finally, the Eocene compression constituted the first major tectonic phase which inverted the Mesozoic preexisting extensive fault system in Northern Tunisia.

Keywords: Tunisia, eocene compression, tectonic stress field, Bou Kornine-Ressas-Messella

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Authors: Seema Paul, John Mango Magero, Prosun Bhattacharya, Zahra Kalantari, Steve W. Lyon

Abstract:

The purpose of this review paper is to develop an understanding of lake hydrodynamics and the potential climate impact on the Lake Victoria (LV) catchment scale. This paper briefly discusses the main problems of lake hydrodynamics and its’ solutions that are related to quality assessment and climate effect. An empirical methodology in modeling and mapping have considered for understanding lake hydrodynamic and visualizing the long-term observational daily, monthly, and yearly mean dataset results by using geographical information system (GIS) and Comsol techniques. Data were obtained for the whole lake and five different meteorological stations, and several geoprocessing tools with spatial analysis are considered to produce results. The linear regression analyses were developed to build climate scenarios and a linear trend on lake rainfall data for a long period. A potential evapotranspiration rate has been described by the MODIS and the Thornthwaite method. The rainfall effect on lake water level observed by Partial Differential Equations (PDE), and water quality has manifested by a few nutrients parameters. The study revealed monthly and yearly rainfall varies with monthly and yearly maximum and minimum temperatures, and the rainfall is high during cool years and the temperature is high associated with below and average rainfall patterns. Rising temperatures are likely to accelerate evapotranspiration rates and more evapotranspiration is likely to lead to more rainfall, drought is more correlated with temperature and cloud is more correlated with rainfall. There is a trend in lake rainfall and long-time rainfall on the lake water surface has affected the lake level. The onshore and offshore have been concentrated by initial literature nutrients data. The study recommended that further studies should consider fully lake bathymetry development with flow analysis and its’ water balance, hydro-meteorological processes, solute transport, wind hydrodynamics, pollution and eutrophication these are crucial for lake water quality, climate impact assessment, and water sustainability.

Keywords: climograph, climate scenarios, evapotranspiration, linear trend flow, rainfall event on LV, concentration

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

Abstract:

Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Naziema B. Jappie

Abstract:

Over the last 23 years leaders in government, political parties and universities have been spending much time on identifying and discussing various gaps in the system that impact systematically on students especially those from historically Black communities. Equity and access to higher education were two critical aspects that featured in achieving the transformation goals together with a funding model for those previously disadvantaged. Free education was not a feasible option for the government. Institutional leaders in higher education face many demands on their time and resources. Often, the time for crisis management planning or consideration of being proactive and preventative is not a standing agenda item. With many issues being priority in academia, people become complacent and think that crisis may not affect them or they will cross the bridge when they get to it. Historically South Africa has proven to be a country of militancy, strikes and protests in most industries, some leading to disastrous outcomes. Higher education was not different between October 2015 and late 2016 when the #Rhodes Must Fall which morphed into the # Fees Must Fall protest challenged the establishment, changed the social fabric of universities, bringing the sector to a standstill. Some institutional leaders and administrators were better at handling unexpected, high-consequence situations than others. At most crisis leadership is viewed as a situation more than a style of leadership which is usually characterized by crisis management. The objective of this paper is to show how institutions managed catastrophes of disastrous proportions, down through unexpected incidents of 2015/2016. The content draws on the vast past crisis management experience of the presenter and includes the occurrences of the recent protests giving an event timeline. Using responses from interviews with institutional leaders and administrators as well as students will ensure first-hand information on their experiences and the outcomes. Students have tasted the power of organized action and they demand immediate change, if not the revolt will continue. This paper will examine the approaches that guided institutional leaders and their crisis teams and sector crisis response. It will further expand on whether the solutions effectively changed governance in higher education or has it minimized the need for more protests. The conclusion will give an insight into the future of higher education in South Africa from a leadership perspective.

Keywords: crisis, governance, intervention, leadership, strategies, protests

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Authors: John K. Avor, Choong-Koo Chang

Abstract:

The transfer of electrical loads at power generation stations from Standby Auxiliary Transformer (SAT) to Unit Auxiliary Transformer (UAT) and vice versa is through a fast bus transfer scheme. Fast bus transfer is a time-critical application where the transfer process depends on various parameters, thus transfer schemes apply advance algorithms to ensure power supply reliability and continuity. In a nuclear power generation station, supply continuity is essential, especially for critical class 1E electrical loads. Bus transfers must, therefore, be executed accurately within 4 to 10 cycles in order to achieve safety system requirements. However, the main problem is that there are instances where transfer schemes scrambled due to inaccurate interpretation of key parameters; and consequently, have failed to transfer several critical loads from UAT to the SAT during main generator trip event. Although several techniques have been adopted to develop robust transfer schemes, a combination of Artificial Neural Network and Fuzzy Systems (Neuro-Fuzzy) has not been extensively used. In this paper, we apply the concept of Neuro-Fuzzy to determine plant operating mode and dynamic prediction of the appropriate bus transfer algorithm to be selected based on the first cycle of voltage information. The performance of Sequential Fast Transfer and Residual Bus Transfer schemes was evaluated through simulation and integration of the Neuro-Fuzzy system. The objective for adopting Neuro-Fuzzy approach in the bus transfer scheme is to utilize the signal validation capabilities of artificial neural network, specifically the back-propagation algorithm which is very accurate in learning completely new systems. This research presents a combined effect of artificial neural network and fuzzy systems to accurately interpret key bus transfer parameters such as magnitude of the residual voltage, decay time, and the associated phase angle of the residual voltage in order to determine the possibility of high speed bus transfer for a particular bus and the corresponding transfer algorithm. This demonstrates potential for general applicability to improve reliability of the auxiliary power distribution system. The performance of the scheme is implemented on APR1400 nuclear power plant auxiliary system.

Keywords: auxiliary power system, bus transfer scheme, fuzzy logic, neural networks, reliability

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Authors: Aleksandra Tomic

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According to reliable sources, 4% of all websites is devoted to pornographic material, yet these estimates are often reported to be much higher. The largest internet pornography streaming website reports 21.2 billion visits in 2015 only. Considering the ubiquity of online pornography and the frequency of use, it is necessary to examine its potential influence on the construal of the sexual act and the roles of participants. Apart from the verbal and physical interactions in the pornographic movies themselves, the language in the titles of movies has the power to frame the sexual intercourse. In this study, Critical Discourse Analysis and corpus linguistics approaches will be used to examine the way the sexual intercourse and the roles of the participants are ideologically construed and perpetuated in the Internet pornography discourse. To this end, the study will explore the association between the specific morphosyntactic aspects of the references to performers of both genders, the person and the thematic role, and the gender of referred performer in the corpus of online pornographic movie titles. Distinctive collexeme analysis will be conducted to uncover possible associations between for gender of the performer denoted by the linguistic expression, and the person and thematic role assigned to it in the titles of online pornography movies. Initial results of the chi-square procedure performed on a sample of 295 online pornography movie titles on the largest pornography streaming website ‘Pornhub’ yielded significant results. The use of the three person categories was not equally distributed between genders, X2 (2, N = 106) = 32.52, p < 0.001, with female performers being referred to in the third person in 71.7% of the instances, and speaking in the first person 20.8% of the time, whereas male performers spoke in the first person 68% of the time, and were referred to in the third person in 17% of the instances. Moreover, there was a gender disparity in the assignment of thematic roles, with linguistic expressions for women being assigned the Patient role and men the Agent role in 58.8% of the cases, whereas the roles were reversed in 41.2% of the instances, X2 (1, N = 262) = 8.07633, p < 0.005. The results are discussed in terms of the ideologies surrounding female and male sexuality in the pornography discourse. Potential patterns of power imbalance, objectification, and discrimination are highlighted. Finally, the evidence from psycholinguistic studies on the influence of the language structure on event construal is related to the results of the study.

Keywords: corpus linguistics, gender studies, pornography, thematic roles

Procedia PDF Downloads 176

Authors: Maryam Nazari

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COVID-19 is a respiratory disease triggered by the novel coronavirus, SARS-CoV-2, that has reached pandemic status today. Acute inflammation and immune cells infiltration into lung injuries result in multi-organ failure. The presence of other non-communicable diseases (NCDs) with systemic inflammation derived from COVID-19 may exacerbate the patient's situation and increase the risk for adverse effects and mortality. This pandemic is a novel situation and the scientific community at this time is looking for vaccines or drugs to treat the pathology. One of the biggest challenges is focused on reducing inflammation without compromising the correct immune response of the patient. In this regard, addressing the nutritional factors should not be overlooked not only as a matter of avoiding the presence of NCDs with severe infections but also as an adjunctive way to modulate the inflammatory status of the patients. Despite the pivotal role of nutrition in modifying immune response, due to the novelty of the COVID-19 disease, information about the effects of specific dietary agents is limited in this area. From the macronutrients point of view, protein deficiency (quantity or quality) has negative effects on the number of functional immunoglobulins and gut-associated lymphoid tissue (GALT). High biological value proteins or some amino acids like arginine and glutamine are well known for their ability to augment the immune system. Among lipids, fish oil has the ability to inactivate enveloped viruses, suppress pro-inflammatory prostaglandin production and block platelet-activating factors and their receptors. In addition, protectin D1, which is an Omega-3 PUFAs derivation, is a novel antiviral drug. So it seems that these fatty acids can reduce the severity and/or improve recovery of patients with COVID-19. Carbohydrates with lower glycemic index and fibers are associated with lower levels of inflammatory cytokines (CRP, TNF-α, and IL-6). Short-Chain Fatty acids not only exert a direct anti-inflammatory effect but also provide appropriate gut microbial, which is important in gastrointestinal issues related to COVID-19. From the micronutrients point of view, Vitamins A, C, D, E, iron, magnesium, zinc, selenium and copper play a vital role in the maintenance of immune function. Inadequate status in these nutrients may result in decreased resistance against COVID-19 infection. There are specific bioactive compounds in the diet that interact with the ACE2 receptor, which is the gateway for SARS and SARS-CoV-2, and thus controls the viral infection. Regarding this, the potential benefits of probiotics, resveratrol (a polyphenol found in grape), oleoylethanolamide (derived from oleic acid), and natural peroxisome proliferator-activated receptor γ agonists in foodstuffs (like curcumin, pomegranate, hot pepper) are suggested. Yet, it should be pointed out that most of these results have been reported in animal models and further human studies are needed to be verified.

Keywords: Covid-19, inflammation, nutrition, dietary agents

Procedia PDF Downloads 160

Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

Procedia PDF Downloads 138

Authors: Alexander N. Savostyanov, Tatyana A. Dolgorukova, Elena A. Esipenko, Mikhail S. Zaleshin, Margherita Malanchini, Anna V. Budakova, Alexander E. Saprygin, Yulia V. Kovas

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The present study compared spectral-power indexes and cortical topography of brain activity in a sample characterized by different levels of trait and mathematical anxiety. 52 healthy Russian-speakers (age 17-32; 30 males) participated in the study. Participants solved an error recognition task under 3 conditions: A lexical condition (simple sentences in Russian), and two numerical conditions (simple arithmetic and complicated algebraic problems). Trait and mathematical anxiety were measured using self-repot questionnaires. EEG activity was recorded simultaneously during task execution. Event-related spectral perturbations (ERSP) were used to analyze spectral-power changes in brain activity. Additionally, sLORETA was applied in order to localize the sources of brain activity. When exploring EEG activity recorded after tasks onset during lexical conditions, sLORETA revealed increased activation in frontal and left temporal cortical areas, mainly in the alpha/beta frequency ranges. When examining the EEG activity recorded after task onset during arithmetic and algebraic conditions, additional activation in delta/theta band in the right parietal cortex was observed. The ERSP plots reveled alpha/beta desynchronizations within a 500-3000 ms interval after task onset and slow-wave synchronization within an interval of 150-350 ms. Amplitudes of these intervals reflected the accuracy of error recognition, and were differently associated with the three (lexical, arithmetic and algebraic) conditions. The level of trait anxiety was positively correlated with the amplitude of alpha/beta desynchronization. The level of mathematical anxiety was negatively correlated with the amplitude of theta synchronization and of alpha/beta desynchronization. Overall, trait anxiety was related with an increase in brain activation during task execution, whereas mathematical anxiety was associated with increased inhibitory-related activity. We gratefully acknowledge the support from the №11.G34.31.0043 grant from the Government of the Russian Federation.

Keywords: anxiety, EEG, lexical and numerical error-recognition tasks, alpha/beta desynchronization

Procedia PDF Downloads 518

Authors: Faiz N. K. Yusufi, Aquil Ahmed, Jamal Ahmad

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Predicting the risk of diabetic retinopathy (DR) in Indian type 2 diabetes patients is immensely necessary. India, being the second largest country after China in terms of a number of diabetic patients, to the best of our knowledge not a single risk score for complications has ever been investigated. Diabetic retinopathy is a serious complication and is the topmost reason for visual impairment across countries. Any type or form of DR has been taken as the event of interest, be it mild, back, grade I, II, III, and IV DR. A sample was determined and randomly collected from the Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N.M.C., A.M.U., Aligarh, India. Collected variables include patients data such as sex, age, height, weight, body mass index (BMI), blood sugar fasting (BSF), post prandial sugar (PP), glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), systolic blood pressure (SBP), smoking, alcohol habits, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), physical activity, duration of diabetes, diet control, history of antihypertensive drug treatment, family history of diabetes, waist circumference, hip circumference, medications, central obesity and history of DR. Cox proportional hazard regression is used to design risk scores for the prediction of retinopathy. Model calibration and discrimination are assessed from Hosmer Lemeshow and area under receiver operating characteristic curve (ROC). Overfitting and underfitting of the model are checked by applying regularization techniques and best method is selected between ridge, lasso and elastic net regression. Optimal cut off point is chosen by Youden’s index. Five-year probability of DR is predicted by both survival function, and Markov chain two state model and the better technique is concluded. The risk scores developed can be applied by doctors and patients themselves for self evaluation. Furthermore, the five-year probabilities can be applied as well to forecast and maintain the condition of patients. This provides immense benefit in real application of DR prediction in T2DM.

Keywords: Cox proportional hazard regression, diabetic retinopathy, ROC curve, type 2 diabetes mellitus

Procedia PDF Downloads 170

Authors: Munirajulu M, Srikanth Modem

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A large cricket stadium with the capacity to accommodate several thousands of spectators has the seating arena consisting of a two-tier arrangement with an upper and a lower bowl and an intermediate concourse podium level for pedestrian movement to access the bowls. The uniqueness of the stadium is that spectators can have an unobstructed view from all around the podium towards the field of play. Upper and lower bowls are connected by stairs. The stairs landing is a precast slab supported by cantilevered steel beams. These steel beams are fixed to precast columns supporting the stadium structure. The stair slabs are precast concrete supported on a landing slab and cantilevered steel beams. During an event of a fire at podium level between two staircases, fire resistance of steel beams is very critical to life safety. If the steel beam loses its strength due to lack of fire resistance, it will be weak in supporting stair slabs and may lead to a hazard in evacuating occupants from the upper bowl to the lower bowl. In this study, to ascertain fire rating and life safety, a performance-based design using CFD analysis is used to evaluate the steel beams' fire resistance. A fire size of 3.5 MW (convective heat output of fire) with a wind speed of 2.57 m/s is considered for fire and smoke simulation. CFD results show that the smoke temperature near the staircase/ around the staircase does not exceed 1500 C for the fire duration considered. The surface temperature of cantilevered steel beams is found to be less than or equal to 1500 C. Since this temperature is much less than the critical failure temperature of steel (5200 C), it is concluded that the design of structural steel supports on the staircase is adequate and does not need additional fire protection such as fire-resistant coating. CFD analysis provided an engineering basis for the performance-based design of steel structural elements and an opportunity to optimize fire protection requirements. Thus, performance-based design using CFD modeling and simulation of fire and smoke is an innovative way to evaluate fire rating requirements, ascertain life safety and optimize the design with regard to fire protection on structural steel elements.

Keywords: fire resistance, life safety, performance-based design, CFD analysis

Procedia PDF Downloads 179

Authors: A/Prof Marjan Khajehei

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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

Procedia PDF Downloads 117

Authors: Dimitra Riza

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This paper examines different ways of exploring a city by using smart phones' applications while walking, and the way this new attitude will change our perception of the urban environment. By referring to various examples of such applications we will consider options and possibilities that open up with new technologies, their advantages and disadvantages, as well as ways of experiencing and interpreting the urban environment. The widespread use of smart phones gave access to information, maps, knowledge, etc. at all times and places. The city tourism marketing takes advantage of this event and promotes the city's attractions through technology. Mobile mediated walking tours, provide new possibilities and modify the way we used to explore cities, for instance by giving directions proper to find easily destinations, by displaying our exact location on the map, by creating our own tours through picking points of interest and interconnecting them to create a route. These apps act as interactive ones, as they filter the user's interests, movements, etc. Discovering a city on foot and visiting interesting sites and landmarks, became very easy, and has been revolutionized through the help of navigational and other applications. In contrast to the re-invention of the city as suggested by the Baudelaire's Flâneur in the 19th century, or to the construction of situations by the Situationists in 60s, the new technological means do not allow people to "get lost", as these follow and record our moves. In the case of strolling or drifting around the city, the option of "getting lost" is desired, as the goal is not the "wayfinding" or the destination, but it is the experience of walking itself. Getting lost is not always about dislocation, but it is about getting a feeling, free of the urban environment while experiencing it. So, on the one hand, walking is considered to be a physical and embodied experience, as the observer becomes an actor and participates with all his senses in the city activities. On the other hand, the use of a screen turns out to become a disembodied experience of the urban environment, as we perceive it in a fragmented and distanced way. Relations with the city are similar to Alberti’s isolated viewer, detached from any urban stage. The smartphone, even if we are present, acts as a mediator: we interact directly with it and indirectly with the environment. Contrary to the Flaneur and to the Situationists, who discovered the city with their own bodies, today the body itself is being detached from that experience. While contemporary cities turn out to become more walkable, the new technological applications tend to open out all possibilities in order to explore them by suggesting multiple routes. Exploration becomes easier, but Perception changes.

Keywords: body, experience, mobile apps, walking

Procedia PDF Downloads 399

Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

Procedia PDF Downloads 234

Authors: Rahul Bishnoi

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Theatre, as Ann Ubersfld calls it, is a paradox. At once, it is both a literary work and a physical representation. Theatre as a text is eternal, reproducible, and identical while as a performance, theatre is momentary and never identical to the previous performances. In this dual existence of theatre, who is the author? Is the author the playwright who writes the dramatic text, or the director who orchestrates the performance, or the actor who embodies the text? From the poststructuralist lens of Barthes, the author is dead. Barthes’ argument of discrete temporality, i.e. the author is the before, and the text is the after, does not hold true for theatre. A published literary work is written, edited, printed, distributed and then gets consumed by the reader. On the other hand, theatrical production is immediate; an actor performs and the audience witnesses it instantaneously. Time, so to speak, does not separate the author, the text, and the reader anymore. The question of authorship gets further complicated in Augusto Boal’s “Theatre of the Oppressed” movement where the audience is a direct participant like the actors in the performance. In this research, through an experimental performance, the duality of theatre is explored with the authorship discourse. And the conventional definition of authorship is subjected to additional complexity by erasing the distinction between an actor and the audience. The design/methodology of the experimental performance is as follows: The audience will be asked to produce a text under an anonymous virtual alias. The text, as it is being produced, will be read and performed by the actor. The audience who are also collectively “authoring” the text, will watch this performance and write further until everyone has contributed with one input each. The cycle of writing, reading, performing, witnessing, and writing will continue until the end. The intention is to create a dynamic system of writing/reading with the embodiment of the text through the actor. The actor is giving up the power to the audience to write the spoken word, stage instruction and direction while still keeping the agency of interpreting that input and performing in the chosen manner. This rapid conversation between the actor and the audience also creates a conversion of authorship. The main conclusion of this study is a perspective on the nature of dynamic authorship of theatre containing a critical enquiry of the collaboratively produced text, an individually performed act, and a collectively witnessed event. Using practice as a methodology, this paper contests the poststructuralist notion of the author as merely a ‘scriptor’ and breaks it further by involving the audience in the authorship as well.

Keywords: practice based research, performance studies, post-humanism, Avant-garde art, theatre

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Authors: Matt Stichter

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Moral development requires learning from one’s failures, but that turnsout to be especially challenging when dealing with moral failures. The distress prompted by moral failure can cause responses ofdefensiveness or disengagement rather than attempts to make amends and work on self-change. The most potentially distressing response to moral failure is a shame. However, there appears to be two different senses of “shame” that are conflated in the literature, depending on whether the failure is appraised as the result of a global and unalterable self-defect, or a local and alterable self-defect. One of these forms of shame does prompt self-improvement in response to moral failure. This occurs if one views the failure as indicating only a specific (local) defect in one’s identity, where that’s something repairable, rather than asanoverall(orglobal)defectinyouridentity that can’t be fixed. So, if the whole of one’s identity as a morally good person isn’t being called into question, but only a part, then that is something one could work on to improve. Shame, in this sense, provides motivation for self-improvement to fix this part oftheselfinthe long run, and this would be important for moral development. One factor that looks to affect these different self-attributions in the wake of moral failure can be found in mindset theory, as reactions to moral failure in these two forms of shame are similar to how those with a fixed or growth mindset of their own abilities, such as intelligence, react to failure. People fall along a continuum with respect to how they view abilities – it is more of a fixed entity that you cannot do much to change, or it is malleable such that you can train to improve it. These two mindsets, ‘fixed’ versus ‘growth’, have different consequences for how we react to failure – a fixed mindset leads to maladaptive responses because of feelings of helplessness to do better; whereas a growth mindset leads to adaptive responses where a person puts forth effort to learn how to act better the next time. Here we can see the parallels between a fixed mindset of one’s own (im)morality, as the way people respond to shame when viewed as indicating a global and unalterable self-defect parallels the reactions people have to failure when they have a fixed mindset. In addition, it looks like there may be a similar structure to pride. Pride is, like shame, a self-conscious emotion that arises from internal attributions about the self as being the cause of some event. There are also paradoxical results from research on pride, where pride was found to motivate pro-social behavior in some cases but aggression in other cases. Research suggests that there may be two forms of pride, authentic and hubristic, that are also connected to different self-attributions, depending on whether one is feeling proud about a particular (local) aspect of the self versus feeling proud about the whole of oneself (global).

Keywords: emotion, mindset, moral development, moral psychology, pride, shame, self-regulation

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Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak

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Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.

Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity

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Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

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Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

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Authors: Mohamed Aljarallah, Mohamed Nurullah, George Saridakis

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This paper aims and objectives are to investigate how the structural change of the financial regulatory bodies affect the financial supervision and how the regulators can design such a structure with taking into account; the Central Bank, the conduct of business and the prudential regulators, it will also consider looking at the structure of the international regulatory bodies and what barriers are found. There will be five questions to be answered; should conduct of business and prudential regulation be separated? Should the financial supervision and financial stability be separated? Should the financial supervision be under the Central Bank? To what extent the politician should intervene in changing the regulatory and supervisory structure? What should be the regulatory and supervisory structure when there is financial conglomerate? Semi structure interview design will be applied. This research sample selection contains a collective of financial regulators and supervisors from the emerged and emerging countries. Moreover, financial regulators and supervisors must be at a senior level at their organisations. Additionally, senior financial regulators and supervisors would come from different authorities and from around the world. For instance, one of the participants comes from the International Bank Settlements, others come from European Central Bank, and an additional one will come from Hong Kong Monetary Authority and others. Such a variety aims to fulfil the aims and objectives of the research and cover the research questions. The analysis process starts with transcription of the interview, using Nvivo software for coding, applying thematic interview to generate the main themes. The major findings of the study are as follow. First, organisational structure changes quite frequently if the mandates are not clear. Second, measuring structural change is difficult, which makes the whole process unclear. Third, effective coordination and communication are what regulators looking for when they change the structure and that requires; openness, trust, and incentive. In addition to that, issues appear during the event of crisis tend to be the reason why the structure change. Also, the development of the market sometime causes a change in the regulatory structure. And, some structural change occurs simply because of the international trend, fashion, or other countries' experiences. Furthermore, when the top management change the structure tends to change. Moreover, the structure change due to the political change, or politicians try to show they are doing something. Finally, fear of being blamed can be a driver of structural change. In conclusion, this research aims to provide an insight from the senior regulators and supervisors from fifty different countries to have a clear understanding of why the regulatory structure keeps changing from time to time through a qualitative approach, namely, semi-structure interview.

Keywords: financial regulation bodies, financial regulatory structure, global financial regulation, financial crisis

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Authors: Inigo Beckett

Abstract:

In forensic investigations, it is often the case that the most potentially useful recorded evidence derives from coincidental imagery, recorded immediately before or during an incident, and that during the incident (e.g. a ‘failure’ or fire event), the evidence is changed or destroyed. To an image analysis expert involved in photogrammetric analysis for Civil or Criminal Proceedings, traditional computer vision methods involving calibrated cameras is often not appropriate because image metadata cannot be relied upon. This paper presents an approach for resolving this problem, considering in particular and by way of a case study, the angle of a simple ladder shown in a photograph. The UK Health and Safety Executive (HSE) guidance document published in 2014 (INDG455) advises that a leaning ladder should be erected at 75 degrees to the horizontal axis. Personal injury cases can arise in the construction industry because a ladder is too steep or too shallow. Ad-hoc photographs of such ladders in their incident position provide a basis for analysis of their angle. This paper presents a direct approach for ascertaining the position of the camera and the angle of the ladder simultaneously from the photograph(s) by way of a workflow that encompasses a novel application of projective geometry and matrix analysis. Mathematical analysis shows that for a given pixel ratio of directly measured collinear points (i.e. features that lie on the same line segment) from the 2D digital photograph with respect to a given viewing point, we can constrain the 3D camera position to a surface of a sphere in the scene. Depending on what we know about the ladder, we can enforce another independent constraint on the possible camera positions which enables us to constrain the possible positions even further. Experiments were conducted using synthetic and real-world data. The synthetic data modeled a vertical plane with a ladder on a horizontally flat plane resting against a vertical wall. The real-world data was captured using an Apple iPhone 13 Pro and 3D laser scan survey data whereby a ladder was placed in a known location and angle to the vertical axis. For each case, we calculated camera positions and the ladder angles using this method and cross-compared them against their respective ‘true’ values.

Keywords: image analysis, projective geometry, homography, photogrammetry, ladders, Forensics, Mathematical modeling, planar geometry, matrix analysis, collinear, cameras, photographs

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Authors: Ayala Amir

Abstract:

The paper presents interdisciplinary research which draws on the literary study and the cultural study of photography to explore a literary genre defined by nostalgia – the photographed book for children. This genre, which was popular in the second half of the 20th century, presents the romantic, nostalgic image of childhood created in the visual arts in the 18th century (as suggested by Ann Higonnet). At the same time, it capitalizes on the nostalgia inherent in the event of photography as formulated by Jennifer Green-Lewis: photography frames a moment in the present while transforming it into a past longed for in the future. Unlike Freudian melancholy, nostalgia is an effect that enables representation by acknowledging the loss and containing it in the very experience of the object. The representation and preservation of the lost object (nature, childhood, innocence) are in the center of the genre of children's photography books – a modern version of ancient pastoral. In it, the unique synergia of word and image results in a nostalgic image of childhood in an era already conquered by modernization. The nostalgic effect works both in the representation of space – an Edenic image of nature already shadowed by its demise, and of time – an image of childhood imbued by what Gill Bartholnyes calls the "looking backward aesthetics" – under the sign of loss. Little critical attention has been devoted to this genre with the exception of the work of Bettina Kümmerling-Meibauer, who noted the nostalgic effect of the well-known series of photography books by Astrid Lindgren and Anna Riwkin-Brick. This research aims to elaborate Kümmerling-Meibauer's approach using the theories of the study of photography, word-image studies, as well as current studies of childhood. The theoretical perspectives are implemented in the case study of photography books created in one of the most innovative social structures in our time – the Israeli Kibbutz. This communal way of life designed a society where children will experience their childhood in a parentless rural environment that will save them from the fate of the Oedipal fall. It is suggested that in documenting these children in a fictional format, photographers and writers, images and words cooperated in creating nostalgic works situated on the border between nature and culture, imagination and reality, utopia and its realization in history.

Keywords: nostalgia, photography , childhood, children's books, kibutz

Procedia PDF Downloads 130