Search results for: lower and higher risk category
18254 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan
Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee
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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis
Procedia PDF Downloads 13018253 Efficacy of In-Situ Surgical vs. Needle Revision on Late Failed Trabeculectomy Blebs
Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like
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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision
Procedia PDF Downloads 8418252 Prevalence of SARS-CoV-2 Infection and Associated Risk Factors in Selected Health Facilities of Tigray, Ethiopia: Cross-Sectional Study Design, 2023
Authors: Weldegerima Gebremedhin Hagos
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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.Keywords: prevalence, SARS-CoV-2, infection, risk factors
Procedia PDF Downloads 5618251 An Ecological Systems Approach to Risk and Protective Factors of Sibling Conflict for Children in the United Kingdom
Authors: C. A. Bradley, D. Patsios, D. Berridge
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This paper presents evidence to better understand the risk and protective factors related to sibling conflict and the patterns of association between sibling conflict and negative adjustment outcomes by incorporating additional familial and societal factors within statistical models of risk and adjustment. It was conducted through the secondary analysis of a large representative cross-sectional dataset of children in the UK. The original study includes proxy interviews for young children and self-report interviews for adolescents. The study applies an ecological systems framework for the analyses. Hierarchical regression models assess risk and protective factors and adjustment outcomes associated with sibling conflict. Interactions reveal differential effect between contextual risk factors and the social context of influence. The general pattern of findings suggested that, although factors affecting likelihood of experiencing sibling conflict were often determined by child age, some remained consistent across childhood. These factors were often conditional on each other, reinforcing the importance of an ecological framework. Across both age-groups, sibling conflict was associated with siblings closer in age; male sibling groups; most advantaged socio-economic group; and exposure to community violence, such as witnessing violent assault or robbery. The study develops the evidence base on the influence of ethnicity and socio-economic group on sibling conflict by exploring interactions between social context. It also identifies key new areas of influence – such as family structure, disability, and community violence in exacerbating or reducing risk of conflict. The study found negative associations between sibling conflict and young children’s mental well-being and adolescents' mental well-being and anti-social behaviour, but also more context specific associations – such as sibling conflict moderating the negative impact of adversity and high risk experiences for young children such as parental violence toward the child.Keywords: adjustment, conflict, ecological systems, family systems, risk and protective factors, sibling
Procedia PDF Downloads 10718250 Injury Prevention among Construction Workers: A Case Study on Iranian Steel Bar Bending Workers
Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl
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Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method
Procedia PDF Downloads 31218249 Lecturers Attitudes towards the Use of Information and Communication Technology
Authors: Sujata Gupta Kedar, Fasiha Fayaz
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This paper presents various studies being carried out by various researchers globally on the attitude of lecturers towards the advent of information technology and e-learning. An effort has been made in this paper to study the various trends being presented by researchers and draw some general conclusions. These show the effect of the lecturer’s gender, age and educational background on their attitude towards the e-learning. Also the favorable attitude of teachers' towards using new technology in teaching will certainly make teachers use them in appropriate situations in teaching and thus measuring of teachers attitude towards using new technology in teaching is very much needed. The sample of 50 males and 50 females were studied from different colleges of Bangalore “Attitudes towards using new technology scale” by Dr. Rajasekar was used. It was seen that male and female had no significant difference in hardware and software use, whereas both had favorable attitude. And there was a significant difference at 1% level among female lecturers belonging to arts faculty. There is no significant difference between the gender and age, because higher the age lower the score is. Irrespective of teaching experience males had no significant difference, whereas females are significant at 1% level, which says that higher the teaching experience of lecturers less knowledge they have towards the use of ICT, as the younger generation is more expose to technology.Keywords: e-learning, ICT, attitudes, lecturers, communication technology
Procedia PDF Downloads 46418248 Investigation on Dry Sliding Wear for Laser Cladding of Stellite 6 Produced on a P91 Steel Substrate
Authors: Alain Kusmoko, Druce Dunne, Huijun Li
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Stellite 6 was deposited by laser cladding on a chromium bearing substrate (P91) with energy inputs of 1 kW (P91-1) and 1.8 kW (P91-1.8). The chemical compositions and microstructures of these coatings were characterized by atomic absorption spectroscopy, optical microscopy and scanning electron microscopy. The microhardness of the coatings was measured and the wear mechanism of the coatings was assessed using a pin-on-plate (reciprocating) wear testing machine. The results showed less cracking and pore development for Stellite 6 coatings applied to the P91 steel substrate with the lower heat input (P91-1). Further, the Stellite coating for P91-1 was significantly harder than that obtained for P91-1.8. The wear test results indicated that the weight loss for P91-1 was much lower than for P91-1.8. It is concluded that the lower hardness of the coating for P91-1.8, together with the softer underlying substrate structure, markedly reduced the wear resistance of the Stellite 6 coating.Keywords: friction and wear, laser cladding, P91 steel, Stellite 6 coating
Procedia PDF Downloads 44118247 Chloride Transport in Ultra High Performance Concrete
Authors: Radka Pernicova
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Chloride resistance in Ultra High Performance Concrete (UHPC) is determined in this paper. This work deals with the one dimension chloride transport, which can be potentially dangerous particularly for the durability of concrete structures. Risk of reinforcement corrosion due to exposure to the concrete surface to direct the action of chloride ions (mainly in the form de-icing salts or groundwater) is dangerously increases. The measured data are investigated depending on the depth of penetration of chloride ions into the concrete structure. Comparative measurements with normal strength concrete are done as well. The experimental results showed that UHCP have improved resistance of chlorides penetration than NSC and also chloride diffusion depth is significantly lower in UHCP.Keywords: chloride, one dimensional diffusion, transport, salinity, UHPC
Procedia PDF Downloads 43518246 Public Health Impact and Risk Factors Associated with Uterine Leiomyomata(UL) Among Women in Imo State
Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.
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Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP
Procedia PDF Downloads 16118245 Flood Hazard and Risk Mapping to Assess Ice-Jam Flood Mitigation Measures
Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell
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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk
Procedia PDF Downloads 18518244 Cytotoxicity and Genotoxicity of Glyphosate and Its Two Impurities in Human Peripheral Blood Mononuclear Cells
Authors: Marta Kwiatkowska, Paweł Jarosiewicz, Bożena Bukowska
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Glyphosate (N-phosphonomethylglycine) is a non-selected broad spectrum ingredient in the herbicide (Roundup) used for over 35 years for the protection of agricultural and horticultural crops. Glyphosate was believed to be environmentally friendly but recently, a large body of evidence has revealed that glyphosate can negatively affect on environment and humans. It has been found that glyphosate is present in the soil and groundwater. It can also enter human body which results in its occurrence in blood in low concentrations of 73.6 ± 28.2 ng/ml. Research conducted for potential genotoxicity and cytotoxicity can be an important element in determining the toxic effect of glyphosate. Due to regulation of European Parliament 1107/2009 it is important to assess genotoxicity and cytotoxicity not only for the parent substance but also its impurities, which are formed at different stages of production of major substance – glyphosate. Moreover verifying, which of these compounds are more toxic is required. Understanding of the molecular pathways of action is extremely important in the context of the environmental risk assessment. In 2002, the European Union has decided that glyphosate is not genotoxic. Unfortunately, recently performed studies around the world achieved results which contest decision taken by the committee of the European Union. World Health Organization (WHO) in March 2015 has decided to change the classification of glyphosate to category 2A, which means that the compound is considered to "probably carcinogenic to humans". This category relates to compounds for which there is limited evidence of carcinogenicity to humans and sufficient evidence of carcinogenicity on experimental animals. That is why we have investigated genotoxicity and cytotoxicity effects of the most commonly used pesticide: glyphosate and its impurities: N-(phosphonomethyl)iminodiacetic acid (PMIDA) and bis-(phosphonomethyl)amine on human peripheral blood mononuclear cells (PBMCs), mostly lymphocytes. DNA damage (analysis of DNA strand-breaks) using the single cell gel electrophoresis (comet assay) and ATP level were assessed. Cells were incubated with glyphosate and its impurities: PMIDA and bis-(phosphonomethyl)amine at concentrations from 0.01 to 10 mM for 24 hours. Evaluating genotoxicity using the comet assay showed a concentration-dependent increase in DNA damage for all compounds studied. ATP level was decreased to zero as a result of using the highest concentration of two investigated impurities, like bis-(phosphonomethyl)amine and PMIDA. Changes were observed using the highest concentration at which a person can be exposed as a result of acute intoxication. Our survey leads to a conclusion that the investigated compounds exhibited genotoxic and cytotoxic potential but only in high concentrations, to which people are not exposed environmentally. Acknowledgments: This work was supported by the Polish National Science Centre (Contract-2013/11/N/NZ7/00371), MSc Marta Kwiatkowska, project manager.Keywords: cell viability, DNA damage, glyphosate, impurities, peripheral blood mononuclear cells
Procedia PDF Downloads 48218243 Maternal and Neonatal Outcomes in Women Undergoing Bariatric Surgery: A Systematic Review and Meta-Analysis
Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides
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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight
Procedia PDF Downloads 40718242 Prevalence and the Results of the Czech Nationwide Survey and Personality Traits of Adolescence Playing Computer Games
Authors: Jaroslava Sucha, Martin Dolejs, Helena Pipova, Panajotis Cakirpaloglu
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The paper introduces the research project which is focused on evaluating the level of pathological relation towards computer or video games playing (including any games played by using a screen such as a mobile or a tablet). The study involves representative sample of the Czech adolescents between ages 11 and 19. This poster presents the psychometric indicators of the new psychologic assessment method (mean, standard deviation, reliability, validity) which will be able to detect an acceptable level of games’ playing and at the same time will detect and describe the level of gaming which might be potentially risky. The prevalence of risky computer game playing at Czech adolescents in age 11 to 19 will be mentioned. The research study also aims to describe the personality profile of the problematic players with respect to the digital games. The research area will encompass risky behaviour, aggression, the level of self-esteem, impulsivity, anxiety and depression. The contribution will introduce a new test method for the assessment of pathological playing computer games. The research will give the first screening information of playing computer games in the Czech Republic by adolescents between 11-19 years. The results clarify what relationship exists between playing computer games and selected personality characteristics (it will describe personality of the gamer, who is in the category of ‘pathological playing computer games’).Keywords: adolescence, computer games, personality traits, risk behaviour
Procedia PDF Downloads 23918241 Investigation on the Performance of Biodiesel and Natural Gas-Fuelled Diesel Engines for Shipboard Application
Authors: Kelvin Datonye Bob-Manuel
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The shipping industry has begun to seriously look at ways of reducing fossil fuel consumption so that current reserves can last longer and operate their ships in a more environmentally friendly way. The concept of Green Shipping or Sustainable Shipping with the use of alternative fuels is now becoming an important issue for ship owners, shipping lines and ship builders globally. This paper provides a critical review of the performance of biodiesel and natural gas-fuelled diesel engines for shipboard application. The emission reduction technique included the use of either neat or emulsified rapeseed methyl ester (RME) for pilot ignition and the emission of NOx, CO2 and SOx were measured at engine speed range of 500 - 1500 r/min. The NOx concentrations were compared with the regulated IMO MARPOL73/78, Annex VI, Tiers I, II, III and United States Environmental Protection Agency (US-EPA) standard. All NOx emissions met Tier I and II levels and the EPA standard for the minimum specification of category 1 engines at higher speed but none met the MARPOL Tier III limit which is for designated Emission Control Areas (ECAs). No trace of soot and SOx emission were observed.Keywords: dual-fuel, biodiesel, natural gas, NOx, SOx, MARPOL 73/78 Annex VI. USEPA Tier 3, EURO V &VI
Procedia PDF Downloads 41718240 PrEP and Risk: Challenges for an Emerging Sanitary Pact
Authors: Roberto Rubem Silva-Brandao, Aurea Maria Zollner Ianni
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This article discusses the use and the incorporation of Pre-exposure Prophylaxis for HIV (PrEP) within a risk society context. Considering contemporary social theoreticians, we discuss implications of biotechnological uses for health enhancement. Firstly, we explore examples of biological manipulation and its consequences of use on given ecological dynamics, particularly taking into account other Sexually Transmitted Infections. In addition, we discuss how HIV resistance cases occurred with people on PrEP and its possible consequences on population-based interventions. Moreover, we present recent studies that analyze biological modifications on bodies of those who are on consistent use of PrEP, and how these body modifications are addressed on common practices of Public Health. Secondly, we present our theoretical references, which are intended to the analysis that situates our contemporary society in the reflexive stage of modernization. We discuss limits of biological use by individuals and how this can fabric feelings of freedom and autonomy within the individualization process and health. Finally, we argue that biotechnological uses on health, specifically on Public Health, tackling the risk aspects of its application, shows that another sanitary pact is needed.Keywords: PrEP, public health, social sciences, risk society
Procedia PDF Downloads 39218239 Fuzzy Inference System for Risk Assessment Evaluation of Wheat Flour Product Manufacturing Systems
Authors: Yas Barzegaar, Atrin Barzegar
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The aim of this research is to develop an intelligent system to analyze the risk level of wheat flour product manufacturing system. The model consists of five Fuzzy Inference Systems in two different layers to analyse the risk of a wheat flour product manufacturing system. The first layer of the model consists of four Fuzzy Inference Systems with three criteria. The output of each one of the Physical, Chemical, Biological and Environmental Failures will be the input of the final manufacturing systems. The proposed model based on Mamdani Fuzzy Inference Systems gives a performance ranking of wheat flour products manufacturing systems. The first step is obtaining data to identify the failure modes from expert’s opinions. The second step is the fuzzification process to convert crisp input to a fuzzy set., then the IF-then fuzzy rule applied through inference engine, and in the final step, the defuzzification process is applied to convert the fuzzy output into real numbers.Keywords: failure modes, fuzzy rules, fuzzy inference system, risk assessment
Procedia PDF Downloads 10218238 Enabling Service Innovation in Higher Education Institutions by Means of Leveraging Knowledge Management Practices
Authors: Mulalo Mushaisano
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It has been revealed in the existing literature that specific knowledge management practices can be implemented and utilized in organizations to enable sustaining service innovation. This kind of innovation is of crucial importance in service environments such as institutions of higher education because it allows the delivery of enhanced services which are designed to add value and deliver better services to clients. However, there is a widespread lack of the necessary implementation of essential knowledge practices in higher education institutions owing to a variety of internal challenges and barriers. The primary objective of the study was to identify the essential knowledge management practices required for the enablement of service innovation. The main outcome was the development of a framework of knowledge management practice which can be applied in institutions of higher education to achieve service innovation. The study will address the gap in where existing literature mostly explored the aforementioned processes in the context of commercial and corporate organizations and not in the higher education environment.Keywords: higher education, innovation, knowledge management, service innovation
Procedia PDF Downloads 14318237 Quality of Life of Health Professionals during the COVID-19 Pandemic
Authors: Elucir Gir, Myllena Nilce de Freitas Surmano, Laelson Rochelle Milanês Sousa, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira E Silva, Renata Karina Reis
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Objective: To analyze the factors associated with the worsening of the quality of life of health professionals in the Southeast region of Brazil during the COVID-19 pandemic and its associated factors. Method: Analytical cross-sectional study carried out with health professionals from the southeastern region of Brazil. Data collection took place through an online survey with a form stored on the Survey Monkey platform. Bivariate analysis was used, and the chi-square test was adopted, followed by the multiple binary logistic regression model based on the stepwise method. Results: 3,493 health professionals participated in the study. Factors associated with worsening quality of life were: Professional Category (Nursing assistant) [OR 1.851 (95%CI 1.035-3.311) p= 0.038]; types of people who provided care (people in general) [OR 1.445 (95%CI 1.072-1.945) p=0.015]; Supply of good quality PPE by the institution where he works (no) [OR 1.595 (CI 95% 1.144-2.223) p= 0.006] and Supply of good quality PPE by the institution where he works (in part) [OR 1.563 (CI 95% 1.257-1.943) p < 0.001]. Conclusion: The factors associated with the worsening of the quality of life of health professionals during the COVID-19 pandemic were: Professional Category (Nursing assistant); types of people who provided assistance (people in general); Supply of sufficient PPE by the institution where you work (no) and Supply of good quality PPE by the institution where you work (in part). Future studies should investigate to what extent QoL can be improved based on modifiable factors.Keywords: COVID-19, quality of life, health professionals, respiratory infections
Procedia PDF Downloads 9118236 Effect of Testing Device Calibration on Liquid Limit Assessment
Authors: M. O. Bayram, H. B. Gencdal, N. O. Fercan, B. Basbug
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Liquid limit, which is used as a measure of soil strength, can be detected by Casagrande and fall-cone testing methods. The two methods majorly diverge from each other in terms of operator dependency. The Casagrande method that is applied according to ASTM D4318-17 standards may give misleading results, especially if the calibration process is not performed well. To reveal the effect of calibration for drop height and amount of soil paste placement in the Casagrande cup, a series of tests were carried out by multipoint method as it is specified in the ASTM standards. The tests include the combination of 6 mm, 8 mm, 10 mm, and 12 mm drop heights and under-filled, half-filled, and full-filled Casagrande cups by kaolinite samples. It was observed that during successive tests, the drop height of the cup deteriorated; hence the device was recalibrated before and after each test to provide the accuracy of the results. Besides, the tests by under-filled and full-filled samples for higher drop heights revealed lower liquid limit values than the lower drop heights revealed. For the half-filled samples, it was clearly seen that the liquid limit values didn’t change at all as the drop height increased, and this explains the function of standard specifications.Keywords: calibration, casagrande cup method, drop height, kaolinite, liquid limit, placing form
Procedia PDF Downloads 16018235 Temporal Variation of Surface Runoff and Interrill Erosion in Different Soil Textures of a Semi-arid Region, Iran
Authors: Ali Reza Vaezi, Naser Fakori Ivand, Fereshteh Azarifam
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Interrill erosion is the detachment and transfer of soil particles between the rills due to the impact of raindrops and the shear stress of shallow surface runoff. This erosion can be affected by some soil properties such as texture, amount of organic matter and stability of soil aggregates. Information on the temporal variation of interrill erosion during a rainfall event and the effect soil properties have on it can help in understanding the process of runoff production and soil loss between the rills in hillslopes. The importance of this study is especially grate in semi-arid regions, where the soil is weakly aggregated and vegetation cover is mostly poor. Therefore, this research was conducted to investigate the temporal variation of surface flow and interrill erosion and the effect of soil properties on it in some semi-arid soils. A field experiment was done in eight different soil textures under simulated rainfalls with uniform intensity. A total of twenty four plots were installed for eight study soils with three replicates in the form of a random complete block design along the land. The plots were 1.2 m (length) × 1 m (width) in dimensions which designed with a distance of 3 m from each other across the slope. Then, soil samples were purred into the plots. The plots were surrounded by a galvanized sheet, and runoff and soil erosion equipment were placed at their outlets. Rainfall simulation experiments were done using a designed portable simulator with an intensity of 60 mm per hour for 60 minutes. A plastic cover was used around the rainfall simulator frame to prevent the impact of the wind on the free fall of water drops. Runoff production and soil loss were measured during 1 hour time with 5-min intervals. In order to study soil properties, such as particle size distribution, aggregate stability, bulk density, ESP and Ks were determined in the laboratory. Correlation and regression analysis was done to determine the effect of soil properties on runoff and interrill erosion. Results indicated that the study soils have lower booth organic matter content and aggregate stability. The soils, except for coarse textured textures, are calcareous and with relatively higher exchangeable sodium percentages (ESP). Runoff production and soil loss didn’t occur in sand, which was associated with higher infiltration and drainage rates. In other study soils, interrill erosion occurred simultaneously with the generation of runoff. A strong relationship was found between interrill erosion and surface runoff (R2 = 0.75, p< 0.01). The correlation analysis showed that surface runoff was significantly affected by some soil properties consisting of sand, silt, clay, bulk density, gravel, hydraulic conductivity (Ks), lime (calcium carbonate), and ESP. The soils with lower Ks such as fine-textured soils, produced higher surface runoff and more interrill erosion. In the soils, Surface runoff production temporally increased during rainfall and finally reached a peak after about 25-35 min. Time to peak was very short (30 min) in fine-textured soils, especially clay, which was related to their lower infiltration rate.Keywords: erosion plot, rainfall simulator, soil properties, surface flow
Procedia PDF Downloads 6718234 Fabrication of Hollow Germanium Spheres by Dropping Method
Authors: Kunal D. Bhagat, Truong V. Vu, John C. Wells, Hideyuki Takakura, Yu Kawano, Fumio Ogawa
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Hollow germanium alloy quasi-spheres of diameters 1 to 2 mm with a relatively smooth inner and outer surface have been produced. The germanium was first melted at around 1273 K and then exuded from a coaxial nozzle into an inert atmosphere by argon gas supplied to the inner nozzle. The falling spheres were cooled by water spray and collected in a bucket. The spheres had a horn type of structure on the outer surface, which might be caused by volume expansion induced by the density difference between solid and gas phase. The frequency of the sphere formation was determined from the videos to be about 133 Hz. The outer diameter varied in the range of 1.3 to 1.8 mm with a wall thickness in the range of 0.2 to 0.5 mm. Solid silicon spheres are used for spherical silicon solar cells (S₃CS), which have various attractive features. Hollow S₃CS promise substantially higher energy conversion efficiency if their wall thickness can be kept to 0.1–0.2 mm and the inner surface can be passivated. Our production of hollow germanium spheres is a significant step towards the production of hollow S₃CS with, we hope, higher efficiency and lower material cost than solid S₃CS.Keywords: hollow spheres, semiconductor, compound jet, dropping method
Procedia PDF Downloads 20818233 Stability Bound of Ruin Probability in a Reduced Two-Dimensional Risk Model
Authors: Zina Benouaret, Djamil Aissani
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In this work, we introduce the qualitative and quantitative concept of the strong stability method in the risk process modeling two lines of business of the same insurance company or an insurance and re-insurance companies that divide between them both claims and premiums with a certain proportion. The approach proposed is based on the identification of the ruin probability associate to the model considered, with a stationary distribution of a Markov random process called a reversed process. Our objective, after clarifying the condition and the perturbation domain of parameters, is to obtain the stability inequality of the ruin probability which is applied to estimate the approximation error of a model with disturbance parameters by the considered model. In the stability bound obtained, all constants are explicitly written.Keywords: Markov chain, risk models, ruin probabilities, strong stability analysis
Procedia PDF Downloads 24918232 Comparison of Remifentanil EC50 for Facilitating I-Gel and Laryngeal Mask Airway Insertion with Propofol Anesthesia
Authors: Jong Yeop Kim, Jong Bum Choi, Hyun Jeong Kwak, Sook Young Lee
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Background: Each supraglottic airway requires different anesthetic depth because it has a specific structure and different compressive force in the oropharyngeal cavity. We designed the study to investigate remifentanil effect-site concentration (Ce) in 50% of patients (EC50) for successful insertion of i- gel, and to compare it with that for laryngeal mask airway (LMA) insertion during propofol target-controlled infusion (TCI). Methods: Forty-one female patients were randomized to the i-gel group (n=20) or the LMA group (n=21). Anesthesia induction was performed using propofol Ce of 5 μg/ml and the predetermined remifentanil Ce, and i-gel or LMA insertion was attempted 5 min later. The remifentanil Ce was estimated by modified Dixon's up-and-down method (initial concentration: 3.0 ng/ml, step size: 0.5 ng/ml). The patient’s response to device insertion was classified as either ‘success (no movement)’ or ‘failure (movement)’. Results: Using the Dixon’s up and down method, EC50 of remifentanil Ce for i-gel (1.58 ± 0.41 ng/ml) was significantly lower than that for LMA (2.25 ± 0.55 ng/ml) (p=0.038). Using isotonic regression, EC50 (83% CI) of remifentanil in the i-gel group [1.50 (1.37-1.80) ng/ml] was statistically lower than that in the LMA group [2.00 (1.82-2.34) ng/ml]. EC95 (95% CI) of remifentanil in the i-gel group [2.38 (1.48-2.50) ng/ml] was statistically lower than that in the LMA group [3.35 (2.58-3.48) ng/ml]. Conclusion: We found that EC50 of remifentanil Ce for i-gel insertion (1.58 ng/ml) was significantly lower than that for LMA insertion (2.25 ng/ml), in female patients during propofol TCI without neuromuscular blockade.Keywords: i-gel, laryngeal mask airway, propofol, remifentanil
Procedia PDF Downloads 38718231 The Perceptions of Students in Tourism and Hospitality in Relation to the Pursuit of Higher Degrees: A Case of Walter Sisulu University
Authors: Adelaide Rethabile Motshabi Pitso-Mbili
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Higher education institutions (HEIs) are under pressure in producing PhD graduates so that they can position themselves higher in terms of rankings. However, hospitality and tourism higher degree enrolment numbers are very low within South African universities. Furthermore, hospitality and tourism students choose these fields of study because they want to travel, be social, and have fun. Students in higher education are anxious about their future after studies as they are particularly worried about the job conditions in the hospitality and tourism sector, the remuneration, and the status perceptions of many jobs in the sector. Hence, there is a need for a continuous increase in the level of education with the formation of professional aptitudes and personnel quality. In order to understand the reasons for low enrolments, this study aims to explore the perceptions of the final year in tourism and hospitality diploma students towards enrolling for higher degree qualifications after their graduation. This paper utilised a quantitative research method, and data was gathered through questionnaires. In addition, the Linkert scale design was used for questionnaires. The questionnaires were distributed to 137 hospitality and tourism students who are on their exit level at Walter Sisulu University. SPSS was used to analyse data. The findings revealed that students do not wish to continue studying for higher degrees as they believe higher degrees are not important for the industry. Furthermore, families already have financial expectations as they think one qualification is enough. In addition, some students mentioned that they would love to study further, but lack of funding is a problem since NSFAS only funds the first qualification. Thus, it is recommended that students are made aware of the benefits and opportunities available after obtaining higher degrees.Keywords: hospitality and tourism education, higher degrees, higher education, student’s perceptions, hospitality and tourism sector
Procedia PDF Downloads 11718230 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients
Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte
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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results: Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients.Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome
Procedia PDF Downloads 6618229 Surface Coatings of Boards Made from Alternative Materials
Authors: Stepan Hysek, Petra Gajdacova
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In recent years, alternative materials, such as annual plants or recycled and waste materials are becoming more and more popular input material for the production of composite materials. They can be used for the production of insulation boards, construction boards or furniture boards. Surface finishing of those boards is essential for utilization in furniture. However, some difficulties could occur during coating of boards from alternative materials; physical and chemical differences from conventional particleboards need to be considered. From the physical aspects, surface soundness and surface roughness mainly determine the quality of the surface. Since surface layers of boards from alternative materials have often lower density, these characteristics could be deteriorated and thus the production process needs to be optimized. Also, chemical reactions of board’s material with coating could be undesirable. The objective of this study is to evaluate the parameters affecting the surface quality of boards made form alternative materials and to find possibilities of the coating of these boards. In this study, boards of particles from rapeseed stems were produced using a laboratory press. Surface soundness, as representatives of mechanical properties and surface roughness, as representative of physical properties, were measured on boards from rapeseed stems. Results clearly indicated that produced boards had lower surface quality than commercially produced particle boards from wood. Therefore, higher thickness of surface coating on rapeseed based boards is needed.Keywords: coating, surface, annual plant, composites, particleboard
Procedia PDF Downloads 26518228 Comparison Study of Capital Protection Risk Management Strategies: Constant Proportion Portfolio Insurance versus Volatility Target Based Investment Strategy with a Guarantee
Authors: Olga Biedova, Victoria Steblovskaya, Kai Wallbaum
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In the current capital market environment, investors constantly face the challenge of finding a successful and stable investment mechanism. Highly volatile equity markets and extremely low bond returns bring about the demand for sophisticated yet reliable risk management strategies. Investors are looking for risk management solutions to efficiently protect their investments. This study compares a classic Constant Proportion Portfolio Insurance (CPPI) strategy to a Volatility Target portfolio insurance (VTPI). VTPI is an extension of the well-known Option Based Portfolio Insurance (OBPI) to the case where an embedded option is linked not to a pure risky asset such as e.g., S&P 500, but to a Volatility Target (VolTarget) portfolio. VolTarget strategy is a recently emerged rule-based dynamic asset allocation mechanism where the portfolio’s volatility is kept under control. As a result, a typical VTPI strategy allows higher participation rates in the market due to reduced embedded option prices. In addition, controlled volatility levels eliminate the volatility spread in option pricing, one of the frequently cited reasons for OBPI strategy fall behind CPPI. The strategies are compared within the framework of the stochastic dominance theory based on numerical simulations, rather than on the restrictive assumption of the Black-Scholes type dynamics of the underlying asset. An extended comparative quantitative analysis of performances of the above investment strategies in various market scenarios and within a range of input parameter values is presented.Keywords: CPPI, portfolio insurance, stochastic dominance, volatility target
Procedia PDF Downloads 16718227 The Impact of Total Dust (LGS) and Mineral Dust (PM 10) in Cardio Vascular and Respiratory System, in Albania: A Longitudinal Study
Authors: Canga Mimoza, Irene Malagnino, Giulia Malagnino, Vito Malagnino
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Aim: This study aims at evaluating the impact of total dust (LGS) and mineral dust (PM10), in the cardio vascular and respiratory systems. Also proving that these air polluters are the cause of several diseases, such as bronchopneumonia, pneumonia, bronchitis, angina pectoris and cardiac insufficiency. Material and Method: The study is concentrated in the cities of Fier and Vlora. This is a clinic-epidemiological study conducted during the time period 2014-2019. Some of the data of LGS and PM10 were obtained from the database of the Institute of Public Health. The formula to measure the mean value of LGS and PM10 is ∆X=X (mean)-Xᵢ. Results: Based on the calculations made, we noticed that: The mean value of LGS in the city of Fieri was 227,33, while the mean value of LGS in the city of Vlora was 177,4. Whereas, the mean value of PM10 in the city of Fieri was 105.5 and the mean value of PM10 in the city of Vlore was 77.5. According to, our statistics the values of LGS were 1.2 times higher in Fier than in Vlora and the PM10 values were 1.36 times higher in Fier than in Vlora. Based on the data, in the city of Fier, the incidence of the bronchopneumonia was 56.53 sick patients/1000 inhabitants, but in Vlora, it was 22 sick patients/1000 inhabitants, so the number of the sick patients was 2.5 times higher in the city of Fieri compared with Vlora city, (P=0.001). The number of the patients with bronchitis, in the city of Fier, was 18 patients/1000 inhabitants, whereas, in Vlora, it was 9 patients/1000 inhabitants, (P=0.005). Based on the data, 8 patients/1000 inhabitants in the city of Fier, suffered from the pneumonia disease, while in Vlora city, were 4 patients/1000 inhabitants, (P=0.005). Another disease taken in consideration was angina pectoris. This study can claim that in the city of Fier, 9.5 patients/1000 inhabitants suffered from this disease, while in Vlora city, were only 4 patients /1000 inhabitants, (P=0.001). Findings of the present study proved that 3.7 patients/1000 inhabitants in the city of Fieri, had cardiac insufficiency, whereas in the city of Vlora, were 1.8 patients/1000 inhabitants, (P=0.05). Conclusions: LGS and PM10 have an influential impact on the cardio vascular and respiratory system; that’s why their levels should be kept under control. The pollution levels are 1.2 and 1.4 times higher in Fier than in Vlora; also the incidences of the diseases are 2 times higher in Fier than in Vlora. Recommendations: In order to prevent the cardio vascular and respiratory diseases, we should avoid places where pollution is higher than the norm. This can be achieved by frequenting places where the air pollution is lower, such as parks, gardens, top floors, etc.Keywords: impact of total dust, LGS, mineral dust, PM 10, cardio vascular pathologies, respiratory disease
Procedia PDF Downloads 12818226 Expression of Stance in Lower- and Upper- Level Students’ Writing in Business Administration at English-Medium University in Burundi
Authors: Clement Ndoricimpa
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The expression of stance is highly expected in writing at tertiary level. Through a selection of linguistic and rhetorical elements, writers express commitment, critical distance and build a critically discerning reader in texts. Despite many studies on patterns of stance in students’ academic writing, little may not be known about how English as a Foreign Language students learns to build a critically discerning reader in their texts. Therefore, this study examines patterns of stance in essays written by students majoring in business administration at English-medium University in Burundi as part of classroom assignments. It draws on systemic functional linguistics to analyze qualitatively and quantitatively the data. The quantitative analysis is used to identify the differences in frequency of stance patterns in the essays. The results show a significant difference in the use of boosters by lower- and upper-level students. Lower-level students’ writing contains more boosters and many idiosyncratic sentence structures than do upper-level students’ writing, and upper-level students’ essays contain more hedging and few grammatical mistakes than do lower-level students’ essays. No significant difference in the use of attitude markers and concessive and contrastive expressions. Students in lower- and upper-level do not use attitude markers and disclaimer markers appropriately and accurately. These findings suggest that students should be taught the use of stance patterns in academic writing.Keywords: academic writing, metadiscourse, stance, student corpora
Procedia PDF Downloads 13718225 The Application of Article 111 of the Constitution of Bangladesh in the Criminal Justice System as a Sentencing Guideline
Authors: Sadiya S. Silvee
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Generally, the decision of the higher court is binding on its subordinate courts. As provided in Article 111 of the Constitution, 'the law declared by the Appellate Division (AD) shall be binding on the High Court Division (HCD) and the law declared by either division of the Supreme Court shall be binding on all courts subordinate to it.' This means the judicial discipline requires the HCD to follow the decision of the AD and that it is necessary for the lower tiers of courts to accept the decision of the higher tiers as a binding precedent. Analyzing the application of Article 111 of the Constitution in the criminal justice system as a sentencing guideline, the paper, by examining whether there is any consistency in decision between one HC Bench and another HC Bench, explores whether HCD can per incuriam its previous decision. In doing so, the Death Reference (DR) Cases are contemplated. Furthermore, the paper shall examine whether the Court of Session follows the decision of the HCD while using their discretion to make the choice between death and imprisonment for life under section 302 of PC. The paper argues due to the absence of any specific direction for sentencing and inconsistency in jurisprudence among the HCD; the subordinate courts are in a dilemma.Keywords: death reference, sentencing factor, sentencing guideline, criminal justice system and constitution
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