Search results for: realist review

Authors: Khalid Javed

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This study examines a feature of the budget process called the tax expenditure budget. The tax expenditure concept relies heavily on a normative notion that shielding certain. Taxpayer income from taxation deprives government of its rightful revenues. This view is inconsistent with the proposition that income belongs to the taxpayers and that tax liability is determined through the democratic process, not through arbitrary, bureaucratic Assumptions. Furthermore, the methodology of the tax expenditure budget is problematic as its expansive tax base treats the multiple taxation of saving as the norm. By using an expansive view of income as the underlying assumption of the tax expenditure concept, this viewpoint institutionalizes a particular bias into the decision-making process.

Keywords: revenue, expenditure, tax budget, propostion

Procedia PDF Downloads 288

Authors: Salman Abdul Majeed, Vidur Solanki, Ruqiya Shama Tareen

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BACKGROUND: The COVID-19 pandemic has affected the way of living as we have known for all strata of society. While disease containment measures imposed by governmental agencies have been instrumental in controlling the spread of the virus, it has had profound collateral impacts on all populations. However, the disruption caused in the lives of one segment of population has been far more damaging than most others: the emotional wellbeing of our child and adolescent populations. This impact was even more pronounced in children who already suffered from neurodevelopmental or psychiatric disorders. In particular, school closures have not only led to profound social isolation, but also negative impacts on normal developmental opportunities and interruptions in mental health services obtained through school systems. It is too soon to understand the full impacts of quarantine, isolation, stress of social detachment and fear of pandemic, but we have started to see the devastating impact on C&A already. This review intends to shed light on the current understanding of psychiatric wellbeing of C&A during COVID-19 pandemic. METHOD: Literature search utilizing key words COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, and mental health of children, disease containment measures was carried out. Over 200 articles were identified, out of which 81 articles were included in this review article. RESULTS: The disruption caused by COVID-19 in the lives of C&A is much more damaging and its impact is far reaching. The C&A ED visits for possible suicide attempts have jumped to 22.3% in 2020 and 39.1% during 2021. One study utilizing T1-weighted structural images, computed the thickness of cortical and subcortical structures including amygdala, hippocampus, and nucleus accumbens. The Peri-COVID group showed reduced cortical and subcortical thickness and more advanced brain aging compared to pre pandemic studies. CONCLUSION: Mental health resources for C&A remain under funded, neglected, and inaccessible to population that needs it most. Children with ongoing mental health disorders were impacted worst, along with those with predisposed biopsychosocial risk factors.

Keywords: COVID-19 and children, quarantine and children, social isolation, Loneliness, pandemic stress and children, disease containment measures, mental health of children

Procedia PDF Downloads 71

Authors: B. A. Alwahaby

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Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

Procedia PDF Downloads 117

Authors: Masimuddin Mohd Khaled

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This paper subsidizes to the discussion of Six Sigma in the Aerospace Industry. The main aim of this report is to study the literature review of Six Sigma emphasizing on the aerospace industry. The implementation of Six Sigma stages are studied and how the improvement cycle ‘Define, Measure, Analyze, Improve, and Control cycle’ (DMAIC) and the design process is ‘Define, Measure, Analyze, Design, and Verify Cycle’ (DMADV) is used. The focus is also done by studying how the implementation of Six Sigma on an aerospace company has brought a positive effect to the company.

Keywords: six sigma, DMAIC, DMADV, aerospace

Procedia PDF Downloads 361

Authors: Ali Heyder Alatas, D. Xin, L. Nai Ming

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An oil spill emergency can vary in size and complexity, subject to factors such as volume and characteristics of spilled oil, incident location, impacted sensitivities and resources required. A major incident typically involves numerous stakeholders; these include the responsible party, response organisations, government authorities across multiple jurisdictions, local communities, and a spectrum of technical experts. An incident management team will encounter numerous challenges. Factors such as limited access to location, adverse weather, poor communication, and lack of pre-identified resources can impede a response; delays caused by an inefficient response can exacerbate impacts caused to the wider environment, socio-economic and cultural resources. It is essential that all parties work based on defined roles, responsibilities and authority, and ensure the availability of sufficient resources. To promote steadfast coordination and overcome the challenges highlighted, an Incident Management System (IMS) offers an essential tool for oil spill response. It provides clarity in command and control, improves communication and coordination, facilitates the cooperation between stakeholders, and integrates resources committed. Following the preceding discussion, a comprehensive review of existing literature serves to illustrate the application of IMS in oil spill response to overcome common challenges faced in a major-scaled incident. With a primary audience comprising practitioners in mind, this study will discuss key principles of incident management which enables an effective response, along with pitfalls and challenges, particularly, the tension between government and industry; case studies will be used to frame learning and issues consolidated from previous research, and provide the context to link practice with theory. It will also feature the industry approach to incident management which was further crystallized as part of a review by the Joint Industry Project (JIP) established in the wake of the Macondo well control incident. The authors posit that a common IMS which can be adopted across the industry not only enhances response capacity towards a major oil spill incident but is essential to the global preparedness effort.

Keywords: command and control, incident management system, oil spill response, response organisation

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Authors: Mehrnoosh Askarizadeh

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The increasing variations of the business world correspond with a high diversity of theoretical perspectives used in project management research. This diversity is reflected by a variety of influencing factors, which have been the subject of empirical studies. This article aims to systemize the different streams of research on the basis of a literature review and at developing a research framework influencing factors. We will identify fundamental elements of a project management theory. The framework consists of three dimensions: design, context, and goal. Its purpose is to support the combination of different perspectives and the development of strategies for further research.

Keywords: project, goal, project management, influencing factors

Procedia PDF Downloads 539

Authors: K. Akherfi, H. Harroud

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Cloud Computing (CC) and Mobile Cloud Computing (MCC) have advanced rapidly the last few years. Today, MCC undergoes fast improvement and progress in terms of hardware (memory, embedded sensors, power consumption, touch screen, etc.) software (more and more sophisticated mobile applications) and transmission (higher data transmission rates achieved with different technologies such as 3Gs). This paper presents a review on the concept of CC and MCC. Then, it discusses what has been done regarding middleware in CC and MCC. Later, it shows the architecture of our proposed middleware along with its functionalities which will be provided to mobile clients in order to overcome the well-known problems (such as low battery power, slow CPU speed and, little memory etc.).

Keywords: context-aware, cloud computing, middleware, mobile cloud computing

Procedia PDF Downloads 446

Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

Procedia PDF Downloads 385

Authors: Gokhan Egilmez, Erika Hatfield, Julie Turner

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In this study, we investigated the impacts of service-learning integration on an undergraduate level business analytics course from multiple perspectives, including academic proficiency, community awareness, engagement, social responsibility, and reflection. We assessed the impact of the service-learning experience by using a survey developed primarily based on the literature review and secondarily on an ad hoc group of researchers. Then, we implemented the survey in two sections, where one of the sections was a control group. We compared the results of the empirical survey visually and statistically.

Keywords: business analytics, service learning, experiential education, statistical analysis, survey research

Procedia PDF Downloads 105

Authors: Harsh Shah

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Spirituality and happiness are two very important aspects of human life. After defining happiness, an attempt has been made in this paper to review research on the relationship between happiness and spirituality, and then to experimentally study their correlation among students aged between 18-24 years. The relation was assessed in 200 students from IIT Kharagpur, who rated their own spirituality, and happiness using the Daily Spiritual Experience Scale (DSES) developed by Underwood, and the Subjective Happiness Scale (SHS) developed by Lyubomirsky and Lepper, respectively. Students who were more spiritual in general, were happier as well, and the Pearson Correlation Coefficient method gave a high positive correlation between happiness and spirituality.

Keywords: happiness, spirituality, youth, correlation, depression, religion

Procedia PDF Downloads 384

Authors: Aliakbar Alijarahi, Ali Khaleghi, Azadehe Afrasiyabi

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One of the emerging technologies in the field of education that can be effectively profitable, called augmented reality, where the combination of real world and virtual images in real time produces new concepts that can facilitate learning. The paper, providing an introduction to the general concept of augmented reality, aims at surveying its capabitities in different areas, with an emphasis on Education, It seems quite necessary to have comparative study on virtual/e-learning and augmented reality and conclude their differences in education methods. As an review article, the paper is composed, instead of producing new concepts, to sum-up and analayze accomplished works related to the subject.

Keywords: augmented reality, education, virtual learning, e-learning

Procedia PDF Downloads 335

Authors: Devatha Kalyan Kumar, Aravindraj D., Sadathulla A.

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Big data are now rapidly expanding in all engineering and science and many other domains. The potential of large or massive data is undoubtedly significant, make sense to require new ways of thinking and learning techniques to address the various big data challenges. Machine learning is continuously unleashing its power in a wide range of applications. In this paper, the latest advances and advancements in the researches on machine learning for big data processing. First, the machine learning techniques methods in recent studies, such as deep learning, representation learning, transfer learning, active learning and distributed and parallel learning. Then focus on the challenges and possible solutions of machine learning for big data.

Keywords: active learning, big data, deep learning, machine learning

Procedia PDF Downloads 437

Authors: Saima Ali, Pathamanathan Rajeev, Imteaz A. Monzur

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In this paper, a brief review of the corrosion mechanism in buried pipe and modes of failure is provided together with the available corrosion models. Moreover, the sensitivity analysis is performed to understand the influence of corrosion model parameters on the remaining life estimation. Further, the probabilistic analysis is performed to propagate the uncertainty in the corrosion model on the estimation of the renaming life of the pipe. Finally, the comparison among the corrosion models on the basis of the remaining life estimation will be provided to improve the renewal plan.

Keywords: corrosion, pit depth, sensitivity analysis, exposure period

Procedia PDF Downloads 522

Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

Procedia PDF Downloads 52

Authors: Rhea Khosla, Victoria Tzortziou-Brown

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Introduction: Adolescent SRH has been neglected since the start of the millennium. Adolescents comprise 16% of the global population, with the largest proportion living in Asia (650 million). By late adolescence, individuals in these regions are likely to become sexually active, and thus they must understand their SRH rights. Many lack knowledge of SRH, using unreliable sources for such information. Sex education is necessary to standardize and inform sexual knowledge, which empowers adolescents to make informed SRH decisions. School is an appropriate environment for this, however, SRH education requires effective policy to enforce. Nonetheless, this issue remains of low political priority in Asia and Africa. Current literature on sex education policy in schools in these regions is scarce and tends to have broad aims. Thus, a scoping review was necessary. Methods: Literature searches were conducted in February 2023 using six databases, including grey literature databases (PubMed, Scopus, Embase, Web of Science, Google Scholar, Global Index Medicus), returning a total of 1537 unique articles. After screening titles, abstracts and full text, 17 articles remained. References of included articles were additionally searched, producing a further 7 articles, which then underwent thematic analysis Results: Most countries in Africa and Asia did not have studies on this topic. Studies derived data from interviews with key stakeholders and quantitative methods quantified questionnaire responses. Barriers were: policy/curriculum issues, societal opinions, teaching discomfort, and lack of educator training. Limitations were insufficient timing, inconsistent implementation, insufficient hours dedicated to teaching, education received late into schooling, and discrepancies between teachers, schools, and students about whether policies were being implemented. Discussion: Based on the existing limited evidence, a cultural shift to reduce stigma seems necessary, alongside teacher and student involvement in policy formulation with effective implementation monitoring and educator training.

Keywords: adolescent, Africa, Asia, education, sexual and reproductive health, policy

Procedia PDF Downloads 42

Authors: Sani Mohammed Adam

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This work seeks to review the security challenges facing Nigeria and explore the relevance of laws and policies in tackling the menace. The work looks at the adequacy of available legislations and the functionality of relevant institutions such as the Armed Forces, the Nigeria Police Force, the State Security Service, the Defence Intelligence Agency and the Nigerian Intelligence Agency etc. Comparisons would be made with other jurisdictions, such as inter alia, the Homeland Security in the USA and Counter Terrorism Laws of the United Kingdom. Recommendations would be made on how to strengthen both institutions and laws to curtail the growth of Terrorism in Nigeria.

Keywords: legislations, Nigeria, security, terrorism

Procedia PDF Downloads 673

Authors: Monika Nuffer, Wesley Nuffer

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The problem of obesity is one that continues to be faced in the United States health care system and across the developing world. Prescription medications are available, but are often very expensive with minimal insurance coverage. The over-the-counter diet aid industry is a robust one, selling billions of dollars in products every year. It is important for clinicians to understand the myriad of different nutritional supplements marketed for obesity, and to weigh the evidence behind these products. This manuscript outlines the most commonly used nutritional supplements currently marketed for weight loss, reviewing the evidence with a focus on the efficacy and safety of these products.

Keywords: obesity, weight loss, herbal products, nutritional supplements

Procedia PDF Downloads 236

Authors: Francesca Maria Melucci, Marco Panettieri, Rocco Roma

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Cities are at the forefront of achieving the sustainable development goals set out in the Sustainable Development Goals of Agenda 2030. For these reasons, increasing attention has been given to the creation of resilient, sustainable, inclusive and green cities and finding solutions to these problems is one of the greatest challenges faced by researchers today. In particular urban green infrastructures, including green roofs, play a key role in tackling environmental, social and economic problems. The starting point was an extensive literature review on 1. research developments on the benefits (environmental, economic and social) and implications of green roofs; 2. sustainability assessment and applied methodologies; 3. specific indicators to measure impacts on urban sustainability. Through this review, the appropriate qualitative and quantitative characteristics that are part of the complex 'green roof' system were identified, as studies that holistically capture its multifunctional nature are still lacking. So, this paper aims to find a method to improve community participation in green roof initiatives and support local governance processes in developing efficient proposals to achieve better sustainability and resilience of cities. To this aim, the multidimensional indicator-based framework, presented by Tapia in 2021, has been tested for the first time in the case of a green roof in the city of Madrid. The framework's set of indicators was implemented with other indicators such as those of waste management and circularity (OECD Inventory of Circular Economy indicators) and sustainability performance. The specific indicators to be used in the case study were decided after a consultation phase with relevant stakeholders. Data on the community's willingness to participate in green roof implementation initiatives were collected through interviews and online surveys with a heterogeneous sample of citizens. The results of the application of the framework suggest how the different aspects of sustainability influence the choice of a green roof and provide input on the main mechanisms involved in citizens' willingness to participate in such initiatives.

Keywords: urban agriculture, green roof, urban sustainability, indicators, multi-criteria analysis

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Authors: Chrysi K. Nikoloutsou, Gianna Th. Siapati

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The pandemic limitations have altered architectural education as the discourse shifted towards virtual studios and blended learning. In addition, lockdown conditions and remote working have affected habitation. Adaptability is now a key factor. The architectural studio needs to adjust to these new terms both in education and in inhabitation. This paper will investigate the operation of an architectural studio in relation to how one experiences their house due to the pandemic, based on a literature review and qualitative research methods (interviews & workshops with students). Zenetos’ prophetic ideas of ‘Electronic Urbanism’ and ‘tele-activities’ are now more present than ever.

Keywords: architectural education, pandemic, residential design, studio pedagogy

Procedia PDF Downloads 100

Authors: Pieter De Vries, Renate Klaassen, Maria Ioannides

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This paper is about an explorative research into the use of emerging technologies for teaching and learning in higher engineering education. The assumption is that these technologies and applications, which are not yet widely adopted, will help to improve education and as such actively work on the ability to better deal with the mismatch of skills bothering our industries. Technologies such as 3D printing, the Internet of Things, Virtual Reality, and others, are in a dynamic state of development which makes it difficult to grasp the value for education. Also, the instruments in current educational research seem not appropriate to assess the value of such technologies. This explorative research aims to foster an approach to better deal with this new complexity. The need to find out is urgent, because these technologies will be dominantly present in the near future in all aspects of life, including education. The methodology used in this research comprised an inventory of emerging technologies and tools that potentially give way to innovation and are used or about to be used in technical universities. The inventory was based on both a literature review and a review of reports and web resources like blogs and others and included a series of interviews with stakeholders in engineering education and at representative industries. In addition, a number of small experiments were executed with the aim to analyze the requirements for the use of in this case Virtual Reality and the Internet of Things to better understanding the opportunities and limitations in the day-today learning environment. The major findings indicate that it is rather difficult to decide about the value of these technologies for education due to the dynamic state of change and therefor unpredictability and the lack of a coherent policy at the institutions. Most decisions are being made by teachers on an individual basis, who in their micro-environment are not equipped to select, test and ultimately decide about the use of these technologies. Most experiences are being made in the industry knowing that the skills to handle these technologies are in high demand. The industry though is worried about the inclination and the capability of education to help bridge the skills gap related to the emergence of new technologies. Due to the complexity, the diversity, the speed of development and the decay, education is challenged to develop an approach that can make these technologies work in an integrated fashion. For education to fully profit from the opportunities, these technologies offer it is eminent to develop a pro-active strategy and a sustainable approach to frame the emerging technologies development.

Keywords: emerging technologies, internet of things, pro-active strategy, virtual reality

Procedia PDF Downloads 188

Authors: François Chiocchio, Mahshid Gharibpour

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Regardless of the extent to which succession management is implemented in the private sector, it is still overlooked in the public sector. Traditional succession management is evolving providing a better alignment between business strategies and HR strategies. Succession management brings sustainable effectiveness for succession programs through career path development, knowledge and skill transfer, job retention, as well as high-potential candidates’ empowerment for upcoming vacancies. By way of a systematic literature review, we bring into focus strategic succession management in public organizations and discuss best ways of implementation. 

Keywords: succession management, strategic succession management, public organization, succession management model

Procedia PDF Downloads 352

Authors: Sherif O. Zain Elabideen, Ahmed A. Helal, Ibrahim F. El-Arabawy

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Due to the drastic increase of the wind turbines installed capacity; the grid codes are increasing the restrictions aiming to treat the wind turbines like other conventional sources sooner. In this paper, an intensive review has been presented for different techniques used to add low voltage ride through capability to Doubly Fed Induction Generator (DFIG) wind turbine. A system model with 1.5 MW DFIG wind turbine is constructed and simulated using MATLAB/SIMULINK to explore the effectiveness of the reviewed techniques.

Keywords: DFIG, grid side converters, low voltage ride through, wind turbine

Procedia PDF Downloads 420

Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

Procedia PDF Downloads 141

Authors: Abdullah Alhomidan

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This study is conducted to identify the main factors affecting accuracy of pretender cost estimate in building construction projects in Saudi Arabia from owners’ perspective. 44 factors affecting pretender cost estimate were identified through literature review and discussion with some construction experts. The results show that the top important factors affecting pretender cost estimate accuracy are: level of competitors in the tendering, material price changes, communications with suppliers, communications with client, and estimating method used.

Keywords: cost estimate, accuracy, pretender, estimating, bid estimate

Procedia PDF Downloads 553

Authors: O. J. Olaniran, P. E. D. Love, D. J. Edwards, O. Olatunji, J. Matthews

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Cost overruns are a persistent problem in oil and gas megaprojects. Whilst the extant literature is filled with studies on incidents and causes of cost overruns, underlying theories to explain their emergence in oil and gas megaprojects are few. Yet, a way to contain the syndrome of cost overruns is to understand the bases of ‘how and why’ they occur. Such knowledge will also help to develop pragmatic techniques for better overall management of oil and gas megaprojects. The aim of this paper is to explain the development of cost overruns in hydrocarbon megaprojects through the perspective of chaos theory. The underlying principles of chaos theory and its implications for cost overruns are examined and practical recommendations proposed. In addition, directions for future research in this fertile area provided.

Keywords: chaos theory, oil and gas, cost overruns, megaprojects

Procedia PDF Downloads 556

Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

Procedia PDF Downloads 277

Authors: Hsiao Hsun Yuan

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Internal marketing was proposed in 1970s. The theory of the concept has continually changed over the past forty years. This study discussed the following themes: the definition and implication of internal marketing, the progress of its development, and the evolution of its theoretical model. Moreover, the study systematically organized the strategies of the internal marketing theory adopted on enterprise and how they were put into practice. It also compared the empirical studies focusing on how the existent theories influenced the important variables of internal marketing. The results of this study are expected to serve as references for future exploration of the boundary and studies aiming at how internal marketing is applied to different types of enterprises.

Keywords: corporate responsibility, employee organizational performance, internal marketing, internal customer

Procedia PDF Downloads 350

Authors: Clive L. Morley

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Gravity models and panel data modelling of tourism flows are receiving renewed attention, after decades of general neglect. Such models have quite different underpinnings from conventional demand models derived from micro-economic theory. They operate at a different level of data and with different theoretical bases. These differences have important consequences for the interpretation of the results and their policy and managerial implications. This review compares and contrasts the two model forms, clarifying the distinguishing features and the estimation requirements of each. In general, gravity models are not recommended for use to address specific management and marketing purposes.

Keywords: gravity models, micro-economics, demand models, marketing

Procedia PDF Downloads 435

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

Abstract:

Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

Procedia PDF Downloads 75

Authors: Fatima Al-Aswadi, Chan Yong

Abstract:

With the large volume of unstructured data that increases day by day on the web, the motivation of representing the knowledge in this data in the machine processable form is increased. Ontology is one of the major cornerstones of representing the information in a more meaningful way on the semantic Web. The goal of Ontology learning from text is to elicit and represent domain knowledge in the machine readable form. This paper aims to give a follow-up review on the ontology learning systems from text and some of their defects. Furthermore, it discusses how far the ontology learning process will enhance in the future.

Keywords: concept discovery, deep learning, ontology learning, semantic relation, semantic web

Procedia PDF Downloads 514