Search results for: solid waste management practices
1459 Comparing the Contribution of General Vocabulary Knowledge and Academic Vocabulary Knowledge to Learners' Academic Achievement
Authors: Reem Alsager, James Milton
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Coxhead’s (2000) Academic Word List (AWL) believed to be essential for students pursuing higher education and helps differentiate English for Academic Purposes (EAP) from General English as a course of study, and it is thought to be important for comprehending English academic texts. It has been described that AWL is an infrequent, discrete set of vocabulary items unreachable from general language. On the other hand, it has been known for a period of time that general vocabulary knowledge is a good predictor of academic achievement. This study, however, is an attempt to measure and compare the contribution of academic knowledge and general vocabulary knowledge to learners’ GPA and examine what knowledge is a better predictor of academic achievement and investigate whether AWL as a specialised list of infrequent words relates to the frequency effect. The participants were comprised of 44 international postgraduate students in Swansea University, all from the School of Management, following the taught MSc (Master of Science). The study employed the Academic Vocabulary Size Test (AVST) and the XK_Lex vocabulary size test. The findings indicate that AWL is a list based on word frequency rather than a discrete and unique word list and that the AWL performs the same function as general vocabulary, with tests of each found to measure largely the same quality of knowledge. The findings also suggest that the contribution that AWL knowledge provides for academic success is not sufficient and that general vocabulary knowledge is better in predicting academic achievement. Furthermore, the contribution that academic knowledge added above the contribution of general vocabulary knowledge when combined is really small and noteworthy. This study’s results are in line with the argument and suggest that it is the development of general vocabulary size is an essential quality for academic success and acquiring the words of the AWL will form part of this process. The AWL by itself does not provide sufficient coverage, and is probably not specialised enough, for knowledge of this list to influence this general process. It can be concluded that AWL as an academic word list epitomizes only a fraction of words that are actually needed for academic success in English and that knowledge of academic vocabulary combined with general vocabulary knowledge above the most frequent 3000 words is what matters most to ultimate academic success.Keywords: academic achievement, academic vocabulary, general vocabulary, vocabulary size
Procedia PDF Downloads 2181458 Nine Year Trend Analysis of Malaria in Kahsay Abera General Hospital Humera Town: Western Tigrai, Northern Ethiopia: A Retrospective Study
Authors: Getachew Belay, Getachew Kahsu, Brhane Berhe, Kebede Tesfay, Fitsum Mardu, Nigus Shishay, Hadush Negash, Aster Tsegaye
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Background: Malaria kills million people around the world, and it is still a serious public health problem in Ethiopia. Over the past years, the disease has been consistently reported as leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study assessed malaria trend in Humera Town Kahsay Abera Hospital Tigrai region, Northern Ethiopia. Method: A Health facility retrospective cross sectional study was conducted in Kahsay Abera General Hospital from January 2011 to December 2019. Data of Malaria cases were reviewed from Health Management Information System with the help of experts in the office. The nine year data were extracted and analyzed using Excel by excluding those which lack demographic data. Result: A total of 36,604 smear positive malaria cases were confirmed in last nine years in the study area. Plasmodim falcifarum was the most prevalent reported species. Higher number of malaria cases were reported during October season.Males were more infected by the disese (63.1%) than females and males aged 15 years and above were the most iffected ones. The percentage proportion of P.falcifarum and P.vivax were 61.6% to 38.4%, respectively. There was a decreasing trend over the nine years following the peak in 2013. Conclusion: Malaria smear positivity, with highest cases being recorded in October, was declined over the nine years after peaking in 2013. Males aged 15 years and above were more affected, and P falciparum was the predominat species. Strengtheing the prevention and control activities is warranted in the study area.Keywords: trend, malaria, kahsay abera general hospital, tigray, ethiopia
Procedia PDF Downloads 901457 The Impact of Undocumented Migration on Human Security in Northern Nigeria
Authors: Targba Aondowase
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Undocumented migration along Nigeria’s boarder with Cameroon, Chad and Niger is a key issue in tackling the human security challenges in the region as the security situation cannot be contained without proper boarder control. The paper adopts migration systems theory which asserts that migration alters the social, cultural, economic, and institutional conditions at both the sending and receiving ends to explain the influence of unregistered migrants on institutional changes as it affects the security situation in Northern Nigeria. It was found that undocumented migration is majorly influenced by poverty, illegal trade, wars and asylum. The study also discovers that Nigerian boarders are porous with over 250 footpaths that link directly to Cameroon, Chad and Niger, making the proliferation of small arms and light weapons a transnational organized crime in the region. These porous borders are unmanned by security operatives with limited government presence in the boarder communities. The study also found that undocumented immigrants are easily integrated into the northern communities due to common religious beliefs and race where they carry out normal and civic functions without obstruction. The paper concluded that the level of undocumented migration in Northern Nigeria is high due to unmanned and porous borders. The paper therefore recommended that the security agencies should be strengthened through adequate funding, innovative technology, sound policies and proficient processes that will help protect the country’s borders. The National Populations Commission and the National Identity Management Commission should be strengthened to have a good data base of the country’s citizens and there should be international cooperation between the neighbouring countries to tackle illegal migration and illegal trade along the borders. The findings and recommendations of this paper will serve as a guide towards curtailing the impact of undocumented migration on human security in Northern Nigeria.Keywords: human security, impact, migration, undocumented
Procedia PDF Downloads 3341456 Enforcement against Illegal Logging: Issues and Challenges
Authors: Muhammad Nur Haniff Mohd Noor, Rokiah Kadir, Suriyani Muhamad
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Sustainable forest management and forest protection can be hampered by illegal logging. Illegal logging is not uncommon in many wood-producing countries. Hence, law enforcement, especially in timber-producing countries, is crucial in ensuring compliance with forestry related regulations, as well as confirming that all parties obey the rules and regulations prescribed by the authorities. However, enforcement officers are encountering various challenges and difficulties which have undermined the enforcement capacity and efficiency. The appropriate policy responses for these issues are important to resolve the problems in the long term and empowering enforcement capacity to meet future challenges of forest law enforcement. This paper is written according to extensive review of the articles and publications by The International Criminal Police Organization (INTERPOL), The International Tropical Timber Organization (ITTO), Chatham House and The Food and Agriculture Organization of the United Nations (FAO). Subsequently, various books and journal articles are reviewed to gain further insight towards enforcement issues and challenges. This paper identifies several issues which consist of (1) insufficient enforcement capacity and resources (2) lack of coordination between various enforcement agencies, (3) corruption in the government and private sectors and (4) unclear legal frameworks related to the forestry sector. Next, this paper discusses appropriate policy responses to address each enforcement challenges according to various publications. This includes specific reports concerning forest law enforcement published by international forestry-related organizations. Therefore, lack of resources, inadequate synchronization between agencies, corruption, and legal issues present challenges to enforcement officers in their daily routines. Recommendations regarding proper policy responses to overcome the issues are of great importance in assisting forest authorities in prioritizing their resources appropriately.Keywords: corruption, enforcement challenges, enforcement capacity, forest law enforcement, insufficient agency coordination, legislative ambiguity
Procedia PDF Downloads 1861455 Risk in the South African Sectional Title Industry: An Assurance Perspective
Authors: Leandi Steenkamp
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The sectional title industry has been a part of the property landscape in South Africa for almost half a century, and plays a significant role in addressing the housing problem in the country. Stakeholders such as owners and investors in sectional title property are in most cases not directly involved in the management thereof, and place reliance on the audited annual financial statements of bodies corporate for decision-making purposes. Although the industry seems to be highly regulated, the legislation regarding accounting and auditing of sectional title is vague and ambiguous. Furthermore, there are no industry-specific auditing and accounting standards to guide accounting and auditing practitioners in performing their work and industry financial benchmarks are not readily available. In addition, financial pressure on sectional title schemes is often very high due to the fact that some owners exercise unrealistic pressure to keep monthly levies as low as possible. All these factors have an impact on the business risk as well as audit risk of bodies corporate. Very little academic research has been undertaken on the sectional title industry in South Africa from an accounting and auditing perspective. The aim of this paper is threefold: Firstly, to discuss the findings of a literature review on uncertainties, ambiguity and confusing aspects in current legislation regarding the audit of a sectional title property that may cause or increase audit and business risk. Secondly, empirical findings of risk-related aspects from the results of interviews with three groups of body corporate role-players will be discussed. The role-players were body corporate trustee chairpersons, body corporate managing agents and accounting and auditing practitioners of bodies corporate. Specific reference will be made to business risk and audit risk. Thirdly, practical recommendations will be made on possibilities of closing the audit expectation gap, and further research opportunities in this regard will be discussed.Keywords: assurance, audit, audit risk, body corporate, corporate governance, sectional title
Procedia PDF Downloads 2661454 Rural Sanitation in India: Special Context in the State of Odisa
Authors: Monalisha Ghosh, Asit Mohanty
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The lack of sanitation increases living costs, decreases spend on education and nutrition, lowers income earning potential, and threatens safety and welfare. This is especially true for rural India. Only 32% of rural households have their own toilets and that less than half of Indian households have a toilet at home. Of the estimated billion people in the world who defecate in the open, more than half reside in rural India. It is empirically established that poor sanitation leads to high infant mortality rate and low income generation in rural India. In India, 1,600 children die every day before reaching their fifth birthday and 24% of girls drop out of school as the lack of basic sanitation. Above all, lack of sanitation is not a symptom of poverty but a major contributing factor. According to census 2011, 67.3% of the rural households in the country still did not have access to sanitation facilities. India’s sanitation deficit leads to losses worth roughly 6% of its gross domestic product (GDP) according to World Bank estimates by raising the disease burden in the country. The dropout rate for girl child is thirty percent in schools in rural areas because of lack of sanitation facilities for girl students. The productivity loss per skilled labors during a year is calculated at Rs.44, 160 in Odisha. The performance of the state of Odisha has not been satisfactory in improving sanitation facilities. The biggest challenge is triggering behavior change in vast section of rural population regarding need to use toilets. Another major challenge is funding and implementation for improvement of sanitation facility. In an environment of constrained economic resources, Public Private Partnership in form of performance based management or maintenance contract will be all the more relevant to improve the sanitation status in rural sector.Keywords: rural sanitation, infant mortality rate, income, granger causality, pooled OLS method test public private partnership
Procedia PDF Downloads 4191453 Analysis of the Factors of Local Acceptance of Wind Power Generation Facilities
Authors: Hyunjoo Park, Taehyun Kim, Taehyun Kim
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The government that declared 'de-nuclearization' pushes up renewable energy policies such as solar power and wind power as an alternative to nuclear power generation. However, local residents who are concerned about the development and natural disasters have been hit by opposition, and related businesses around the country are experiencing difficulties. There is also a voice saying that installing a large wind power generator will cause landslides, low frequencies and noise, which will have a bad influence. Renewal is only a harmful and disgusting facility for the residents. In this way, it is expected that extreme social conflicts will occur in the decision making process related to the locally unwanted land-use (LULU). The government's efforts to solve this problem have been steadily progressing, but the systematic methodology for bringing in active participation and opinion gathering of the residents has not yet been established except for the simple opinion poll or referendum. Therefore, it is time to identify the factors that concern the local residents about the wind power generation facilities, and to find ways to make policy decision-making possible. In this study, we analyze the perception of people about offshore and onshore wind power facilities through questionnaires or interviews, and examine quantitative and qualitative precedent studies to analyze them. In addition, the study evaluates what factors affect the local acceptance of wind power facilities. As a result of the factor analysis of the questionnaire items, factors affecting the residents' acceptance of the wind power facility were extracted from four factors such as environmental, economic, risk, social, and management factor. The study also found that the influence of the determinants of local acceptance on the regional acceptability differs according to the demographic characteristics such as gender and income level. This study will contribute to minimizing the conflict on the installation of wind power facilities through communication among the local residents.Keywords: factor analysis, local acceptance, locally unwanted land-use, LULU, wind power generation facilities
Procedia PDF Downloads 1531452 Effect of Inoculation with Consortia of Plant-Growth Promoting Bacteria on Biomass Production of the Halophyte Salicornia ramosissima
Authors: Maria João Ferreira, Natalia Sierra-Garcia, Javier Cremades, Carla António, Ana M. Rodrigues, Helena Silva, Ângela Cunha
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Salicornia ramosissima, a halophyte that grows naturally in coastal areas of the northern hemisphere, is often considered the most promising halophyte candidate for extensive crop cultivation and saline agriculture practices. The expanding interest in this plant surpasses its use as gourmet food and includes their potential application as a source of bioactive compounds for the pharmaceutical industry. Despite growing well in saline soils, sustainable and ecologically friendly techniques to enhance crop production and the nutritional value of this plant are still needed. The root microbiome of S. ramosissima proved to be a source of taxonomically diverse plant growth-promoting bacteria (PGPB). Halotolerant strains of Bacillus, Salinicola, Pseudomonas, and Brevibacterium, among other genera, exhibit a broad spectrum of plant-growth promotion traits [e.g., 3-indole acetic acid (IAA), 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase, siderophores, phosphate solubilization, Nitrogen fixation] and express a wide range of extracellular enzyme activities. In this work, three plant growth-promoting bacteria strains (Brevibacterium casei EB3, Pseudomonas oryzihabitans RL18, and Bacillus aryabhattai SP20) isolated from the rhizosphere and the endosphere of S. ramosissima roots from different saltmarshes along the Portuguese coast were inoculated in S. ramosissima seeds. Plants germinated from inoculated seeds were grown for three months in pots filled with a mixture of perlite and estuarine sediment (1:1) in greenhouse conditions and later transferred to a growth chamber, where they were maintained two months with controlled photoperiod, temperature, and humidity. Pots were placed on trays containing the irrigation solution (Hoagland’s solution 20% added with 10‰ marine salt). Before reaching the flowering stage, plants were collected, and the fresh and dry weight of aerial parts was determined. Non-inoculated seeds were used as a negative control. Selected dried stems from the most promising treatments were later analyzed by GC-TOF-MS for primary metabolite composition. The efficiency of inoculation and persistence of the inoculum was assessed by Next Generation Sequencing. Inoculations with single strain EB3 and co-inoculations with EB3+RL18 and EB3+RL18+SP20 (All treatment) resulted in significantly higher biomass production (fresh and dry weight) compared to non-inoculated plants. Considering fresh weight alone, inoculation with isolates SP20 and RL18 also caused a significant positive effect. Combined inoculation with the consortia SP20+EB3 or SP20+RL18 did not significantly improve biomass production. The analysis of the profile of primary metabolites will provide clues on the mechanisms by which the growth-enhancement effect of the inoculants operates in the plants. These results sustain promising prospects for the use of rhizospheric and endophytic PGPB as biofertilizers, reducing environmental impacts and operational costs of agrochemicals and contributing to the sustainability and cost-effectiveness of saline agriculture. Acknowledgments: This work was supported by project Rhizomis PTDC/BIA-MIC/29736/2017 financed by Fundação para a Ciência e Tecnologia (FCT) through the Regional Operational Program of the Center (02/SAICT/2017) with FEDER funds (European Regional Development Fund, FNR, and OE) and by FCT through CESAM (UIDP/50017/2020 + UIDB/50017/2020), LAQV-REQUIMTE (UIDB/50006/2020). We also acknowledge FCT/FSE for the financial support to Maria João Ferreira through a PhD grant (PD/BD/150363/2019). We are grateful to Horta dos Peixinhos for their help and support during sampling and seed collection. We also thank Glória Pinto for her collaboration providing us the use of the growth chambers during the final months of the experiment and Enrique Mateos-Naranjo and Jennifer Mesa-Marín of the Departamento de Biología Vegetal y Ecología, the University of Sevilla for their advice regarding the growth of salicornia plants in greenhouse conditions.Keywords: halophytes, PGPB, rhizosphere engineering, biofertilizers, primary metabolite profiling, plant inoculation, Salicornia ramosissima
Procedia PDF Downloads 1571451 Paper-Like and Battery Free Sensor Patches for Wound Monitoring
Authors: Xiaodi Su, Xin Ting Zheng, Laura Sutarlie, Nur Asinah binte Mohamed Salleh, Yong Yu
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Wound healing is a dynamic process with multiple phases. Rapid profiling and quantitative characterization of inflammation and infection remain challenging. We have developed paper-like battery-free multiplexed sensors for holistic wound assessment via quantitative detection of multiple inflammation and infection markers. In one of the designs, the sensor patch consists of a wax-printed paper panel with five colorimetric sensor channels arranged in a pattern resembling a five-petaled flower (denoted as a ‘Petal’ sensor). The five sensors are for temperature, pH, trimethylamine, uric acid, and moisture. The sensor patch is sandwiched between a top transparent silicone layer and a bottom adhesive wound contact layer. In the second design, a palm-like-shaped paper strip is fabricated by a paper-cutter printer (denoted as ‘Palm’ sensor). This sensor strip carries five sensor regions connected by a stem sampling entrance that enables rapid colorimetric detection of multiple bacteria metabolites (aldehyde, lactate, moisture, trimethylamine, tryptophan) from wound exudate. For both the “\’ Petal’ and ‘Palm’ sensors, color images can be captured by a mobile phone. According to the color changes, one can quantify the concentration of the biomarkers and then determine wound healing status and identify/quantify bacterial species in infected wounds. The ‘Petal’ and ‘Palm’ sensors are validated with in-situ animal and ex-situ skin wound models, respectively. These sensors have the potential for integration with wound dressing to allow early warning of adverse events without frequent removal of the plasters. Such in-situ and early detection of non-healing condition can trigger immediate clinical intervention to facilitate wound care management.Keywords: wound infection, colorimetric sensor, paper fluidic sensor, wound care
Procedia PDF Downloads 791450 From Acute Abdomen to Hormonal Crisis: Case Report on a Long-Delayed Sheehan's Syndrome Diagnosis
Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman
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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis
Procedia PDF Downloads 161449 Involvement of Community Pharmacists in Public Health Services in Asir Region, Saudi Arabia: A Cross-Sectional Study
Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool
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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.Keywords: community pharmacist, public health, Asir region, Saudi Arabia
Procedia PDF Downloads 1001448 The Clash between Environmental and Heritage Laws: An Australian Case Study
Authors: Andrew R. Beatty
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The exploitation of Australia’s vast mineral wealth is regulated by a matrix of planning, environment and heritage legislation, and despite the desire for a ‘balance’ between economic, environmental and heritage values, Aboriginal objects and places are often detrimentally impacted by mining approvals. The Australian experience is not novel. There are other cases of clashes between the rights of traditional landowners and businesses seeking to exploit mineral or other resources on or beneath those lands, including in the United States, Canada, and Brazil. How one reconciles the rights of traditional owners with those of resource companies is an ongoing legal problem of general interest. In Australia, planning and environmental approvals for resource projects are ordinarily issued by State or Territory governments. Federal legislation such as the Aboriginal and Torres Strait Islander Heritage Protection Act 1984 (Cth) is intended to act as a safety net when State or Territory legislation is incapable of protecting Indigenous objects or places in the context of approvals for resource projects. This paper will analyse the context and effectiveness of legislation enacted to protect Indigenous heritage in the planning process. In particular, the paper will analyse how the statutory objects of such legislation need to be weighed against the statutory objects of competing legislation designed to facilitate and control resource exploitation. Using a current claim in the Federal Court of Australia for the protection of a culturally significant landscape as a case study, this paper will examine the challenges faced in ascribing value to cultural heritage within the wider context of environmental and planning laws. Our findings will reveal that there is an inherent difficulty in defining and weighing competing economic, environmental and heritage considerations. An alternative framework will be proposed to guide regulators towards making decisions that result in better protection of Indigenous heritage in the context of resource management.Keywords: environmental law, heritage law, indigenous rights, mining
Procedia PDF Downloads 951447 Whey Protein in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Zyrah Lou R. Samar, Genecarlo Liwanag
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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction
Procedia PDF Downloads 1061446 Liquidity Risk of Banks in Light of a Dominant Share of Foreign Capital in the Polish Banking Sector
Authors: Karolina Patora
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This article investigates liquidity risk management by banks, which has gained significant importance since the global financial crisis of 2008. The issue is of particular interest for countries like Poland, in which foreign capital plays a dominant role. Such an ownership structure poses certain risks to the local banking sector, which faces an increased probability of the withdrawal of funding or assets’ transfers abroad in case of a crisis. Both these factors can have a detrimental influence on the liquidity position of foreign-owned banks and hence negatively affect the financial stability of the whole banking sector. The aim of this study is to evaluate the impact of a dominating share of foreign investors in the Polish banking sector on the liquidity position of commercial banks. The study hypothesizes that the ownership structure of the Polish banking sector, in which there are banks predominantly controlled by foreign investors, does not pose a threat to the liquidity position of Polish banks. A supplementary research hypothesis is that the liquidity risk profile of foreign-owned banks differs from that of domestic banks. The sample consists of 14 foreign-owned banks and 5 domestic banks owned by local investors, which together constitute approximately 87% of the banking sector’s assets. The data covers the period of 2004–2014. The results of the regression models show no evidence of significant differences in terms of the dynamics of changes of the liquidity buffers between the foreign-owned and domestic banks, although the signs of the coefficients might suggest that the foreign-owned banks were decreasing the holdings of liquid assets at a slower pace over the examined period, compared to the domestic banks. However, no proof of the statistical significance of these findings has been found. The supplementary research hypothesis that the liquidity risk profile of foreign-controlled banks differs from that of domestic banks was rejected.Keywords: foreign-owned banks, liquidity position, liquidity risk, financial stability
Procedia PDF Downloads 2941445 Destruction of Coastal Wetlands in Harper City-Liberia: Setting Nature against the Future Society
Authors: Richard Adu Antwako
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Coastal wetland destruction and its consequences have recently taken the center stage of global discussions. This phenomenon is no gray area to humanity as coastal wetland-human interaction seems inevitably ingrained in the earliest civilizations, amidst the demanding use of its resources to meet their necessities. The severity of coastal wetland destruction parallels with growing civilizations, and it is against this backdrop that, this paper interrogated the causes of coastal wetland destruction in Harper City in Liberia, compared the degree of coastal wetland stressors to the non-equilibrium thermodynamic scale as well as suggested an integrated coastal zone management to address the problems. Literature complemented the primary data gleaned via global positioning system devices, field observation, questionnaire, and interviews. Multi-sampling techniques were used to generate data from the sand miners, institutional heads, fisherfolk, community-based groups, and other stakeholders. Non-equilibrium thermodynamic theory remains vibrant in discerning the ecological stability, and it would be employed to further understand the coastal wetland destruction in Harper City, Liberia and to measure the coastal wetland stresses-amplitude and elasticity. The non-equilibrium thermodynamics postulates that the coastal wetlands are capable of assimilating resources (inputs), as well as discharging products (outputs). However, the input-output relationship exceedingly stretches beyond the thresholds of the coastal wetlands, leading to coastal wetland disequilibrium. Findings revealed that the sand mining, mangrove removal, and crude dumping have transformed the coastal wetlands, resulting in water pollution, flooding, habitat loss and disfigured beaches in Harper City in Liberia. This paper demonstrates that the coastal wetlands are converted into developmental projects and agricultural fields, thus, endangering the future society against nature.Keywords: amplitude, crude dumping, elasticity, non-equilibrium thermodynamics, wetland destruction
Procedia PDF Downloads 1401444 HPSEC Application as a New Indicator of Nitrification Occurrence in Water Distribution Systems
Authors: Sina Moradi, Sanly Liu, Christopher W. K. Chow, John Van Leeuwen, David Cook, Mary Drikas, Soha Habibi, Rose Amal
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In recent years, chloramine has been widely used for both primary and secondary disinfection. However, a major concern with the use of chloramine as a secondary disinfectant is the decay of chloramine and nitrification occurrence. The management of chloramine decay and the prevention of nitrification are critical for water utilities managing chloraminated drinking water distribution systems. The detection and monitoring of nitrification episodes is usually carried out through measuring certain water quality parameters, which are commonly referred to as indicators of nitrification. The approach taken in this study was to collect water samples from different sites throughout a drinking water distribution systems, Tailem Bend – Keith (TBK) in South Australia, and analyse the samples by high performance size exclusion chromatography (HPSEC). We investigated potential association between the water qualities from HPSEC analysis with chloramine decay and/or nitrification occurrence. MATLAB 8.4 was used for data processing of HPSEC data and chloramine decay. An increase in the absorbance signal of HPSEC profiles at λ=230 nm between apparent molecular weights of 200 to 1000 Da was observed at sampling sites that experienced rapid chloramine decay and nitrification while its absorbance signal of HPSEC profiles at λ=254 nm decreased. An increase in absorbance at λ=230 nm and AMW < 500 Da was detected for Raukkan CT (R.C.T), a location that experienced nitrification and had significantly lower chloramine residual (<0.1 mg/L). This increase in absorbance was not detected in other sites that did not experience nitrification. Moreover, the UV absorbance at 254 nm of the HPSEC spectra was lower at R.C.T. than other sites. In this study, a chloramine residual index (C.R.I) was introduced as a new indicator of chloramine decay and nitrification occurrence, and is defined based on the ratio of area underneath the HPSEC spectra at two different wavelengths of 230 and 254 nm. The C.R.I index is able to indicate DS sites that experienced nitrification and rapid chloramine loss. This index could be useful for water treatment and distribution system managers to know if nitrification is occurring at a specific location in water distribution systems.Keywords: nitrification, HPSEC, chloramine decay, chloramine residual index
Procedia PDF Downloads 2981443 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014
Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez
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Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia
Procedia PDF Downloads 5121442 Analyzing the Impact of the COVID-19 Pandemic on Clinicians’ Perceptions of Resuscitation and Escalation Decision-Making Processes: Cross-Sectional Survey of Hospital Clinicians in the United Kingdom
Authors: Michelle Hartanto, Risheka Suthantirakumar
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Introduction Staff redeployment, increased numbers of acutely unwell patients requiring resuscitation decision-making conversations, visiting restrictions, and varying guidance regarding resuscitation for patients with COVID-19 disrupted clinicians’ management of resuscitation and escalation decision-making processes. While it was generally accepted that the COVID-19 pandemic disturbed numerous aspects of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process in the United Kingdom, a process which establishes a patient’s CPR status and treatment escalation plans, the impact of the pandemic on clinicians’ attitudes towards these resuscitation and decision-making conversations was unknown. This was the first study to examine the impact of the COVID-19 pandemic on clinicians’ knowledge, skills, and attitudes towards the ReSPECT process. Methods A cross-sectional survey of clinicians at one acute teaching hospital in the UK was conducted. A questionnaire with a defined five-point Likert scale was distributed and clinicians were asked to recall their pre-pandemic views on ReSPECT and report their current views at the time of survey distribution (May 2020, end of the first COVID-19 wave in the UK). Responses were received from 171 clinicians, and self-reported views before and during the pandemic were compared. Results Clinicians reported they found managing ReSPECT conversations more challenging during the pandemic, especially when conducted over the telephone with relatives, and they experienced an increase in negative emotions before, during, and after conducting ReSPECT conversations. Our findings identified that due to the pandemic there was now a need for clinicians to receive training and support in conducting resuscitation and escalation decision-making conversations over the telephone with relatives and managing these processes.Keywords: cardiopulmonary resuscitation, COVID-19 pandemic, DNACPR discussion, education, recommended summary plan for emergency care and treatment, resuscitation order
Procedia PDF Downloads 1001441 Exploring Relationship of National Talent Retention and National Value Proposition
Authors: Dzul Fahmi Md. Nordin, Rosmini Omar
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This conceptual paper aims to explore the concept of National Talent Retention for a nation by extending the works on Talent Retention in organizations to the scope of nations. The objective of this paper is to explore the relationship of National Talent Retention as the dependent variable with the three explored value propositions namely Firm Value Proposition, Higher Education and Training Value Proposition and National Attractiveness Value Proposition as the independent variables. Life Satisfaction is introduced in this study as a moderating variable to explore possibilities of Life Satisfaction as a mediator for the relationship between National Value Proposition and National Talent Retention. Theories such as Migration, Value Propositions, Life Satisfaction, Human Resource Management and Resource Based View are referred to in order to understand and explore the concept of National Talent Retention. Malaysia is chosen as the background of this study since Malaysia represents a developing nation with progressive economic, education and national policy which presents an interesting background for this exploratory paper. Surprisingly, Malaysia is still facing the phenomenon of Brain Drain which if not handled properly will hinder its Vision 2020 to progress a fully developed nation by year 2020. Mixed methodology analysis is proposed in this paper to include both qualitative face-to-face interview as well as quantitative survey questionnaire to study on the value proposition factors explored. Target respondents are strictly confined to Malaysia’s local high skilled talents either residing in Malaysia or migrated abroad since this paper is mainly interested to study on the concept of National Talent Retention and how successful Malaysia is projecting its value propositions from the perception of high skilled talent Malaysians. It is hoped that this paper could contribute towards understanding National Talent Retention concept where, the model could be replicated to identify influential factors specific to other nations.Keywords: national talent retention, national value proposition, life satisfaction, high skilled talents
Procedia PDF Downloads 4011440 Occupational Health and Well-Being of Healthcare Workers at Tertiary Care Hospitals in Lahore, Pakistan: A Comparison of Public and Private Sector
Authors: Mehwish Sarfaraz Ahmad
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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits
Procedia PDF Downloads 661439 By Removing High-Performance Aerobic Scope Phenotypes, Capture Fisheries May Reduce the Resilience of Fished Populations to Thermal Variability and Compromise Their Persistence into the Anthropocene.
Authors: Lauren A. Bailey, Amber R. Childs, Nicola C. James, Murray I. Duncan, Alexander Winkler, Warren M. Potts
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For the persistence of fished populations in the Anthropocene, it is critical to predict how fished populations will respond to the coupled threats of exploitation and climate change for adaptive management. The resilience of fished populations will depend on their capacity for physiological plasticity and acclimatization in response to environmental shifts. However, there is evidence for the selection of physiological traits by capture fisheries. Hence, fish populations may have a limited scope for the rapid expansion of their tolerance ranges or physiological adaptation under fishing pressures. To determine the physiological vulnerability of fished populations in the Anthropocene, the metabolic performance was compared between a fished and spatially protected Chrysoblephus laticeps population in response to thermal variability. Individual aerobic scope phenotypes were quantified using intermittent flow respirometry by comparing changes in energy expenditure of each individual at ecologically relevant temperatures, mimicking variability experienced as a result of upwelling and downwelling events. The proportion of high and low-performance individuals were compared between the fished and spatially protected population. The fished population had limited aerobic scope phenotype diversity and fewer high-performance phenotypes, resulting in a significantly lower aerobic scope curve across low (10 °C) and high (24 °C) thermal treatments. The performance of fished populations may be compromised with predicted future increases in cold upwelling events. This requires the conservation of the physiologically fittest individuals in spatially protected areas, which can recruit into nearby fished areas, as a climate resilience tool.Keywords: climate change, fish physiology, metabolic shifts, over-fishing, respirometry
Procedia PDF Downloads 1271438 Rational Allocation of Resources in Water Infrastructure Development Projects
Authors: M. Macchiaroli, V. Pellecchia, L. Dolores
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Within any European and world model of management of the integrated water service (in Italy only since 2012 is regulated by a national Authority, that is ARERA), a significant part is covered by the development of assets in terms of hydraulic networks and wastewater collection networks, including all their relative building works. The process of selecting the investments to be made starts from the preventive analysis of critical issues (water losses, unserved areas, low service standards, etc.) who occur in the managed territory of the Operator. Through the Program of Interventions (Provision by ARERA n. 580/2019/R/idr), the Operator provides to program the projects that can meet the emerged needs to determine the improvement of the water service levels. This phase (analyzed and solved by the author with a work published in 2019) involves the use of evaluation techniques (cost-benefit analysis, multi-criteria, and multi-objective techniques, neural networks, etc.) useful in selecting the most appropriate design answers to the different criticalities. However, at this point, the problem of establishing the time priorities between the various works deemed necessary remains open. That is, it is necessary to hierarchize the investments. In this decision-making moment, the interests of the private Operator are often opposed, which favors investments capable of generating high profitability, compared to those of the public controller (ARERA), which favors investments in greater social impact. In support of the concertation between these two actors, the protocol set out in the research has been developed, based on the AHP and capable of borrowing from the programmatic documents an orientation path for the settlement of the conflict. The protocol is applied to a case study of the Campania Region in Italy and has been professionally applied in the shared decision process between the manager and the local Authority.Keywords: analytic hierarchy process, decision making, economic evaluation of projects, integrated water service
Procedia PDF Downloads 1211437 Cultural Regeneration and Social Impacts of Industrial Heritage Transformation: The Case of Westergasfabriek Cultural Park, Netherland
Authors: Hsin Hua He
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The purpose of this study is to strengthen the social cohesion of the local community by injecting the cultural and creative concept into the industrial heritage transformation. The paradigms of industrial heritage research tend to explore from the perspective of space analysis, which concerned less about the cultural regeneration and the development of local culture. The paradigms of cultural quarter research use to from the perspective of creative economy and urban planning, concerned less about the social impacts and the interaction between residents and industrial sites. This research combines these two research areas of industrial heritage and cultural quarter, and focus on the social and cultural aspects. The transformation from the industrial heritage into a cultural park not only enhances the cultural capital and the quality of residents’ lives, but also preserves the unique local values. Internally it shapes the local identity, while externally establishes the image of the city. This paper uses Westergasfabriek Cultural Park in Amsterdam as the case study, through literature analysis, field work, and depth interview to explore how the cultural regeneration transforms industrial heritage. In terms of the planners’ and residents’ point of view adopt the theory of community participation, social capital, and sense of place to analyze the social impact of the industrial heritage transformation. The research finding is through cultural regeneration policies like holding cultural activities, building up public space, social network and public-private partnership, and adopting adaptive reuse to fulfil the people’s need and desire and reach the social cohesion. Finally, the study will examine the transformation of Taiwan's industrial heritage into cultural and creative quarters. The results are expected to use the operating experience of the Amsterdam cases and provide directions for Taiwan’s industrial heritage management to meet the cultural, social, economic symbiosis.Keywords: cultural regeneration, community participation, social capital, sense of place, industrial heritage transformation
Procedia PDF Downloads 5031436 Visitor's Perception toward Boating in Silver River, Florida
Authors: Hoda Manafian, Stephen Holland
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Silver Springs are one of Florida's first tourist attractions. They are one of the largest artesian spring formations in the world, producing nearly 550 million gallons of crystal-clear water daily that is one of the most popular sites for water-based leisure activities. As part of managing the use of a state park, the state is interested in establishing a baseline count of number of boating users to compare this to the quality of the natural resources and environment in the park. Understanding the status of the environmental resources and also the human recreational experience is the main objective of the project. Two main goals of current study are 1) to identify the distribution of different types of watercrafts (kayak, canoe, motor boat, Jet Ski, paddleboard and pontoon). 2) To document the level of real crowdedness in the river during different seasons, months, and hours of each day based on the reliable information gained from camera versus self-reported method by tourists themselves in the past studies (the innovative achievement of this study). In line with these objectives, on-site surveys and also boat counting using a time-lapse camera at the Riverside launch was done during 12 months of 2015. 700 on-site surveys were conducted at three watercraft boat ramp sites (Rays Wayside, Riverside launch area, Ft. King Waterway) of recreational users. We used Virtualdub and ImageJ software for counting boats for meeting the first and second goals, since this two software can report even the hour of presence of watercraft in the water in addition to the number of users and the type of watercraft. The most crowded hours were between 9-11AM from February to May and kayak was the most popular watercraft. The findings of this research can make a good foundation for better management in this state park in future.Keywords: eco-tourism, Florida state, visitors' perception, water-based recreation
Procedia PDF Downloads 2431435 Challenges and Success Factors in Introducing Information Systems for Students' Online Registration
Authors: Stanley Fore, Sharon Chipeperekwa
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The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.Keywords: online registration, information systems, University of Technology, end-users
Procedia PDF Downloads 2581434 Understanding Team Member Autonomy and Team Collaboration: A Qualitative Study
Authors: Ayşen Bakioğlu, Gökçen Seyra Çakır
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This study aims to explore how research assistants who work in project teams experience team member autonomy and how they reconcile team member autonomy with team collaboration. The study utilizes snowball sampling. 20 research assistants who work the faculties of education in Marmara University and Yıldız Technical University have been interviewed. The analysis of data involves a content analysis MAXQDAPlus 11 which is a qualitative data analysis software is used as the data analysis tool. According to the findings of this study, emerging themes include team norm formation, team coordination management, the role of individual tasks in team collaboration, leadership distribution. According to the findings, interviewees experience team norm formation process in terms of processes, which pertain to task fulfillment, and processes, which pertain to the regulation of team dynamics. Team norm formation process instills a sense of responsibility amongst individual team members. Apart from that, the interviewees’ responses indicate that the realization of the obligation to work in a team contributes to the team norm formation process. The participants indicate that individual expectations are taken into consideration during the coordination of the team. The supervisor of the project team also has a crucial role in maintaining team collaboration. Coordination problems arise when an individual team member does not relate his/her academic field with the research topic of the project team. The findings indicate that the leadership distribution in the project teams involves two leadership processes: leadership distribution which is based on the processes that focus on individual team members and leadership distribution which is based on the processes that focus on team interaction. Apart from that, individual tasks serve as a facilitator of collaboration amongst team members. Interviewees also indicate that individual tasks also facilitate the expression of individuality.Keywords: project teams in higher education, research assistant teams, team collaboration, team member autonomy
Procedia PDF Downloads 3591433 Soil Quality State and Trends in New Zealand’s Largest City after Fifteen Years
Authors: Fiona Curran-Cournane
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Soil quality monitoring is a science-based soil management tool that assesses soil ecosystem health. A soil monitoring program in Auckland, New Zealand’s largest city, extends from 1995 to the present. The objective of this study was to firstly determine changes in soil parameters (basic soil properties and heavy metals) that were assessed from rural land in 1995-2000 and repeated in 2008-2012. The second objective was to determine differences in soil parameters across various land uses including native bush, rural (horticulture, pasture and plantation forestry) and urban land uses using soil data collected in more recent years (2009-2013). Across rural land, mean concentrations of Olsen P had significantly increased in the second sampling period and was identified as the indicator of most concern, followed by soil macroporosity, particularly for horticultural and pastoral land. Mean concentrations of Cd were also greatest for pastoral and horticultural land and a positive correlation existed between these two parameters, which highlights the importance of analysing basic soil parameters in conjunction with heavy metals. In contrast, mean concentrations of As, Cr, Pb, Ni and Zn were greatest for urban sites. Native bush sites had the lowest concentrations of heavy metals and were used to calculate a ‘pollution index’ (PI). The mean PI was classified as high (PI > 3) for Cd and Ni and moderate for Pb, Zn, Cr, Cu, As, and Hg, indicating high levels of heavy metal pollution across both rural and urban soils. From a land use perspective, the mean ‘integrated pollution index’ was highest for urban sites at 2.9 followed by pasture, horticulture and plantation forests at 2.7, 2.6, and 0.9, respectively. It is recommended that soil sampling continues over time because a longer spanning record will allow further identification of where soil problems exist and where resources need to be targeted in the future. Findings from this study will also inform policy and science direction in regional councils.Keywords: heavy metals, pollution index, rural and urban land use, soil quality
Procedia PDF Downloads 3751432 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India
Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar
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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.Keywords: HIV, children, India, disclosure
Procedia PDF Downloads 6321431 Tibial Hemimelia Type VIIa: A Case Report
Authors: M. Medrano, M. D. M. S., L. Younes, M. D.
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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity
Procedia PDF Downloads 1581430 Pathological Disparities in Patients Diagnosed with Prostate Imaging Reporting and Data System 3 Lesions: A Retrospective Study in a High-Volume Academic Center
Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari
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Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery
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