Search results for: use case specification

Authors: Andrew D. Henshaw

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The research examines the influence of familial and kinship based leadership on the resilience of politically violent organizations. Organizations of this type frequently fight in the same conflicts though are called 'terrorist' or 'insurgent' depending on political foci of the time, and thus different approaches are used to combat them. The research considers them correlated phenomena with significant overlap and identifies strengths and vulnerabilities in resilience processes. The research employs paired case studies to examine resilience in organizations under significant external pressure, and achieves this by measuring three variables. 1: Organizational robustness in terms of leadership and governance. 2. Bounce-back response efficiency to external pressures and adaptation to endogenous and exogenous shock. 3. Perpetuity of operational and attack capability, and political legitimacy. The research makes three hypotheses. First, familial/kinship leadership groups have a significant effect on organizational resilience in terms of informal operations. Second, non-familial/kinship organizations suffer in terms of heightened security transaction costs and social economics surrounding recruitment, retention, and replacement. Third, resilience in non-familial organizations likely stems from critical external supports like state sponsorship or powerful patrons, rather than organic resilience dynamics. The case studies pair familial organizations with non-familial organizations. Set 1: The Haqqani Network (HQN) - Pair: Lashkar-e-Toiba (LeT). Set 2: Jemaah Islamiyah (JI) - Pair: The Abu Sayyaf Group (ASG). Case studies were selected based on three requirements, being: contrasting governance types, exposure to significant external pressures and, geographical similarity. The case study sets were examined over 24 months following periods of significantly heightened operational activities. This enabled empirical measurement of the variables as substantial external pressures came into force. The rationale for the research is obvious. Nearly all organizations have some nexus of familial interconnectedness. Examining familial leadership networks does not provide further understanding of how terrorism and insurgency originate, however, the central focus of the research does address how they persist. The sparse attention to this in existing literature presents an unexplored yet important area of security studies. Furthermore, social capital in familial systems is largely automatic and organic, given at birth or through kinship. It reduces security vetting cost for recruits, fighters and supporters which lowers liabilities and entry costs, while raising organizational efficiency and exit costs. Better understanding of these process is needed to exploit strengths into weaknesses. Outcomes and implications of the research have critical relevance to future operational policy development. Increased clarity of internal trust dynamics, social capital and power flows are essential to fracturing and manipulating kinship nexus. This is highly valuable to external pressure mechanisms such as counter-terrorism, counterinsurgency, and strategic intelligence methods to penetrate, manipulate, degrade or destroy the resilience of politically violent organizations.

Keywords: Counterinsurgency (COIN), counter-terrorism, familial influence, insurgency, intelligence, kinship, resilience, terrorism

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Authors: Saeed Yazdani, Sima Mohamadi Amidabadi, Amir Mohamadi Nejad, Farahnaz Nekoofar

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As a result of uncertainty and doubts about the quantity of agricultural products, greater significance has been attached to risk management in the agricultural sector. Normally, farmers seek to minimize risks, and crop diversity has always been a means to reduce risk. The study at hand seeks to explore the long-term impact of crop diversity on income risk reduction. The timeframe of the study is 1998 to 2018. Initially, the Herfindahl index was used to estimate crop diversity in different periods, and next, the Hodrick-Prescott filter was applied to estimate income risk both in nominal and real terms. Finally, using the Vector Error Correction Model (VECM), the long-term impact of crop diversity on two modes of risk for the farmer's income has been estimated. Given the long-term pattern’s results, it is evident that in the long-run, crop diversity can reduce income fluctuations in two nominal and real terms. Moreover, results showed that in case the fluctuation shock affects the agricultural income in the short run, to balance out the shock in nominal and real terms, 4 and 3 cycles are needed respectively. In other words, in each cycle, 25% and 33% of the shock impact can be removed, respectively. Thus, as the results of the error correction coefficient showed, policies need to be put in place to prevent income shocks. In case of a shock, they need to be balanced out in a four-year period, taking inflation into account, and in a three-year period irrespective of the inflation and reparative policies such as insurance services should be developed.

Keywords: risk, long-term model, Herfindahl index, time series model, vector error correction model

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Authors: Dino Carpentras, Alejandro Dinkelberg, Michael Quayle

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Within agent-based modeling, opinion dynamics is the field that focuses on modeling people's opinions. In this prolific field, most of the literature is dedicated to the exploration of the two 'degrees of freedom' and how they impact the model’s properties (e.g., the average final opinion, the number of final clusters, etc.). These degrees of freedom are (1) the interaction rule, which determines how agents update their own opinion, and (2) the network topology, which defines the possible interaction among agents. In this work, we show that the third degree of freedom exists. This can be used to change a model's output up to 100% of its initial value or to transform two models (both from the literature) into each other. Since opinion dynamics models are representations of the real world, it is fundamental to understand how people’s opinions can be measured. Even for abstract models (i.e., not intended for the fitting of real-world data), it is important to understand if the way of numerically representing opinions is unique; and, if this is not the case, how the model dynamics would change by using different representations. The process of measuring opinions is non-trivial as it requires transforming real-world opinion (e.g., supporting most of the liberal ideals) to a number. Such a process is usually not discussed in opinion dynamics literature, but it has been intensively studied in a subfield of psychology called psychometrics. In psychometrics, opinion scales can be converted into each other, similarly to how meters can be converted to feet. Indeed, psychometrics routinely uses both linear and non-linear transformations of opinion scales. Here, we analyze how this transformation affects opinion dynamics models. We analyze this effect by using mathematical modeling and then validating our analysis with agent-based simulations. Firstly, we study the case of perfect scales. In this way, we show that scale transformations affect the model’s dynamics up to a qualitative level. This means that if two researchers use the same opinion dynamics model and even the same dataset, they could make totally different predictions just because they followed different renormalization processes. A similar situation appears if two different scales are used to measure opinions even on the same population. This effect may be as strong as providing an uncertainty of 100% on the simulation’s output (i.e., all results are possible). Still, by using perfect scales, we show that scales transformations can be used to perfectly transform one model to another. We test this using two models from the standard literature. Finally, we test the effect of scale transformation in the case of finite precision using a 7-points Likert scale. In this way, we show how a relatively small-scale transformation introduces both changes at the qualitative level (i.e., the most shared opinion at the end of the simulation) and in the number of opinion clusters. Thus, scale transformation appears to be a third degree of freedom of opinion dynamics models. This result deeply impacts both theoretical research on models' properties and on the application of models on real-world data.

Keywords: degrees of freedom, empirical validation, opinion scale, opinion dynamics

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Authors: E. V. Fakhrutdinova, K. R. Maksimova, P. B. Chursin

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At the present stage of the society progress the health care is an integral part of both the economic system and social, while in the second case the medicine is a major component of a number of basic and necessary social programs. Since the foundation of the health system are highly qualified health professionals, it is logical proposition that increase of doctor`s professionalism improves the effectiveness of the system as a whole. Professionalism of the doctor is a collection of many components, essential role played by such personal-psychological factors as honesty, willingness and desire to help people, and motivation. A number of researchers consider motivation as an expression of basic human needs that have passed through the “filter” which is a worldview and values learned in the process of socialization by the individual, to commit certain actions designed to achieve the expected result. From this point of view a number of researchers propose the following classification of highly skilled employee’s needs: 1. the need for confirmation the competence (setting goals that meet the professionalism and receipt of positive emotions in their decision), 2. The need for independence (the ability to make their own choices in contentious situations arising in the process carry out specialist functions), 3. The need for ownership (in the case of health care workers, to the profession and accordingly, high in the eyes of the public status of the doctor). Nevertheless, it is important to understand that in a market economy a significant motivator for physicians (both legal and natural persons) is to maximize its own profits. In the case of health professionals duality motivational structure creates an additional contrast, as in the public mind the image of the ideal physician; usually a altruistically minded person thinking is not primarily about their own benefit, and to assist others. In this context, the question of the real motivation of health workers deserves special attention. The survey conducted by the American researcher Harrison Terni for the magazine "Med Tech" in 2010 revealed the opinion of more than 200 medical students starting courses, and the primary motivation in a profession choice is "desire to help people", only 15% said that they want become a doctor, "to earn a lot". From the point of view of most of the classical theories of motivation this trend can be called positive, as intangible incentives are more effective. However, it is likely that over time the opinion of the respondents may change in the direction of mercantile motives. Thus, it is logical to assume that well-designed system of motivation of doctor`s labor should be based on motivational foundations laid during training in higher education.

Keywords: motivation, quality of working life, health system, personal-psychological factors, motivational structure

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Authors: Mark Andrew Tu, Raymond Olazo, Cybele Abad

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Cryptococcosis is an invasive infection most commonly found in patients who are immuno compromised. However, patients with this infection usually present with meningitis and rarely pulmonary infection in isolation. We present a case of a Filipino HIV patient who developed cryptococcal pneumonia without meningitis.

Keywords: Cryptococcal Pneumonia, HIV, Filipino, immune system

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Authors: Md Rabiul Islam, Ben Wadham

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This paper describes how indigenous students face challenges with various school activities due to inadequate equity and diversity principles in mainstream primary schools in Bangladesh. This study focuses on indigenous students’ interactions with mainstream class teachers and students through teaching-learning activities at public primary schools. Ethnographic research methods guided data collection under a case study methodology in Chittagong Hill Tracts (CHTs) region where maximum indigenous peoples’ inhabitants. The participants (class teachers) shared information through in-depth interviews about their experiences in the four selecting schools. The authors also observed the effects of school activities by use of equity and diversity lens for indigenous students’ situations in those schools. The authors argue that the socio-economic situations of indigenous families are not supportive of the educational development of their children. Similarly, the Bangladesh government does not have enough initiative programs based on equity and diversity principles for fundamental education of indigenous children at rural schools level. Besides this, the conventional teaching system cannot improve the diversification among the students in classrooms. The principles of equity and diversity are not well embedded in professional development of teachers, and using teaching materials in classrooms. The findings suggest that implementing equitable education; there are needed to arrange teachers’ education with equitable knowledge and introducing diversified teaching materials, and implementing teaching through students centered activities that promote the diversification among the multicultural students.

Keywords: case study research, chittagong hill tracts, equity and diversity, Indigenous children

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Authors: Maria Inês Pinho

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Recent literature on issues of Cultural Management (also called Strategic Management for cultural organizations) systematically seeks for models that allow such equipment to adapt to the constant change that occurs in contemporary societies. In the last decade, the world, and in particular Europe has experienced a serious financial problem that has triggered defensive mechanisms, both in the direction of promoting the balance of public accounts and in the sense of the anonymous loss of the democratic and cultural values of each nation. If in the first case emerged the Troika that led to strong cuts in funding for Culture, deeply affecting those organizations; in the second case, the commonplace citizen is seen fighting for the non-closure of cultural equipment. Despite this, the cultural manager argues that there is no single formula capable of solving the need to adapt to change. In another way, it is up to this agent to know the existing scientific models and to adapt them in the best way to the reality of the institution he coordinates. These actions, as a rule, are concerned with the best performance vis-à-vis external audiences or with the financial sustainability of cultural organizations. They forget, therefore, that all this mechanics cannot function without its internal public, without its Human Resources. The employees of the cultural organization must then have an entrepreneurial posture - must be intrapreneurial. This paper intends to break this form of action and lead the cultural manager to understand that his role should be in the sense of creating value for society, through a good organizational performance. This is only possible with a posture of strategic entrepreneurship. In other words, with a link between: Cultural Management, Cultural Entrepreneurship and Cultural Intrapreneurship. In order to prove this assumption, the case study methodology was used with the symbol of the European Capital of Culture (Casa da Música) as well as qualitative and quantitative techniques. The qualitative techniques included the procedure of in-depth interviews to managers, founders and patrons and focus groups to public with and without experience in managing cultural facilities. The quantitative techniques involved the application of a questionnaire to middle management and employees of Casa da Música. After the triangulation of the data, it was proved that contemporary management of cultural organizations must implement among its practices, the concept of Strategic Entrepreneurship and its variables. Also, the topics which characterize the Cultural Intrapreneurship notion (job satisfaction, the quality in organizational performance, the leadership and the employee engagement and autonomy) emerged. The findings show then that to be sustainable, a cultural organization should meet the concerns of both external and internal forum. In other words, it should have an attitude of citizenship to the communities, visible on a social responsibility and a participatory management, only possible with the implementation of the concept of Strategic Entrepreneurship and its variable of Cultural Intrapreneurship.

Keywords: cultural entrepreneurship, cultural intrapreneurship, cultural organizations, strategic management

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Authors: Mitchell Stanton

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Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

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Irrigation management transfer has been taken as the important policy instrument for effective irrigation resource management in many developing countries. The change in governance of the irrigation schemes for its day-to-day operation and maintenance has been centered in recent Nepalese irrigation policies also. However, both farmer- and agency-managed irrigation schemes in Nepal are performing well below than expected. This study tries to link the present concerns of poor performance of both forms of schemes with the institutions for its operation and management. Two types of surveys, management and farm surveys; were conducted as a case study in the command area of Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmer-managed) of Chitwan District. The farm survey from head, middle and tail regions of both schemes revealed that unequal water distribution exists in these regions in both schemes with greater percentage of farmers experiencing this situation in agency managed scheme. In both schemes, the cost recovery rate was very low, even below five percent in Lift System indicating poor operation and maintenance of the schemes. Also, the institution on practice in both schemes is unable to create any incentives for farmers’ willingness to pay as well as for its economical use in the farm. Thus, outcomes from the study showed that only the management transfer programs may not achieve the goal of efficient irrigation resource management. This may suggest water professionals to rethink about the irrigation policies for refining institutional framework irrespective of the governance of schemes for improved cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, irrigation management transfer, willingness to pay

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Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

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Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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Authors: Mohamed Zellagui, Heba Ahmed Hassan

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This paper proposes a new approach for the calculation of short-circuit parameters in the presence of Pulse Width Modulated based Series Compensator (PWMSC). PWMSC is a newly Flexible Alternating Current Transmission System (FACTS) device that can modulate the impedance of a transmission line through applying a variation to the duty cycle (D) of a train of pulses with fixed frequency. This results in an improvement of the system performance as it provides virtual compensation of distribution line impedance by injecting controllable apparent reactance in series with the distribution line. This controllable reactance can operate in both capacitive and inductive modes and this makes PWMSC highly effective in controlling the power flow and increasing system stability in the system. The purpose of this work is to study the impact of fault resistance (RF) which varies between 0 to 30 Ω on the fault current calculations in case of a ground fault and a fixed fault location. The case study is for a medium voltage (MV) Algerian distribution line which is compensated by PWMSC in the 30 kV Algerian distribution power network. The analysis is based on symmetrical components method which involves the calculations of symmetrical components of currents and voltages, without and with PWMSC in both cases of maximum and minimum duty cycle value for capacitive and inductive modes. The paper presents simulation results which are verified by the theoretical analysis.

Keywords: pulse width modulated series compensator (pwmsc), duty cycle, distribution line, short-circuit calculations, ground fault, symmetrical components method

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Authors: Galuh Pramesti

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In Indonesia, the rise of the middle class and consumer purchasing power has created a trend of shifting the traditional into a modern retail market. Development of the creative economy as an impact of the global economy has invaded the traditional market, due to low rents and minimum innovation, raising the issue of sustainability and urban resilience for survival of the traditional market. The study aims to understand the current market conditions by examining the challenges, resiliency, and identify the relationship between the traditional market and creative market. Using a single-case study approach as the research methodology, Santa Market has been chosen as the case study. It is a pilot project of collaboration between a traditional market and creative economy in Jakarta, Indonesia. The research was conducted as a qualitative study through in-depth interviews with the market vendors and the market management, besides a desk-based study of the leasing data and spatial analysis. The findings indicate traffic fluctuation as the main challenge. It is related to the tenant’s presence, rental fluctuation, gentrification, infrastructure, and market competition. Thus, the findings on resilience show a different response for creative and traditional markets. The traditional market’s response remained stable with minimum innovation, whereas the creative market relies on technological development. Regarding the relationship, supply and demand have become the main relationship occurring in Santa Market. It is then developed into the context of society and regulation. The conclusion provides recommendations for more solid regulation to protect the market tenants from stakeholder interests that can disrupt market viability, and a critical discussion on the concept of collaboration between traditional and creative markets. There is also a suggestion for further study on relation with the surroundings, to create a holistic study on how the collaboration can work well in the traditional market.

Keywords: creative economy, market sustainability, traditional market, urban resilience

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Authors: Kamaran Fathulla

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Human creativity knows no bounds. More than a millennia ago humans have expressed their knowledge on cave walls and on clay artefacts. Using visuals such as diagrams and paintings have always provided us with a natural and intuitive medium for expressing such creativity. Making sense of human generated visualisation has been influenced by western scientific philosophies which are often reductionist in their nature. Theoretical frameworks such as those delivered by Peirce dominated our views of how to make sense of visualisation where a visual is seen as an emergent property of our thoughts. Others have reduced the richness of human-generated visuals to mere shapes drawn on a piece of paper or on a screen. This paper introduces an alternate framework where the centrality of human functioning is given explicit and richer consideration through the multi aspectual philosophical works of Herman Dooyeweerd. Dooyeweerd's framework of understanding reality was based on fifteen aspects of reality, each having a distinct core meaning. The totality of the aspects formed a ‘rainbow’ like spectrum of meaning. The thesis of this approach is that meaningful human functioning in most cases involves the diversity of all aspects working in synergy and harmony. Illustration of the foundations and applicability of this approach is underpinned in the case of humans use of diagramming for creative purposes, particularly within an educational context. Diagrams play an important role in education. Students and lecturers use diagrams as a powerful tool to aid their thinking. However, research into the role of diagrams used in education continues to reveal difficulties students encounter during both processes of interpretation and construction of diagrams. Their main problems shape up students difficulties with diagrams. The ever-increasing diversity of diagrams' types coupled with the fact that most real-world diagrams often contain a mix of these different types of diagrams such as boxes and lines, bar charts, surfaces, routes, shapes dotted around the drawing area, and so on with each type having its own distinct set of static and dynamic semantics. We argue that the persistence of these problems is grounded in our existing ways of understanding diagrams that are often reductionist in their underpinnings driven by a single perspective or formalism. In this paper, we demonstrate the limitations of these approaches in dealing with the three problems. Consequently, we propose, discuss, and demonstrate the potential of a nonreductionist framework for understanding diagrams based on Symbolic and Spatial Mappings (SySpM) underpinned by Dooyeweerd philosophy. The potential of the framework to account for the meaning of diagrams is demonstrated by applying it to a real-world case study physics diagram.

Keywords: SySpM, drawing style, mapping

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Authors: Raymond Ndhlovu, Jen Snowball

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It has long been known that the Cultural and Creative Industries (CCIs) have the potential to aid in physical, social and economic renewal and regeneration of towns and cities, hence their importance when dealing with regional development. The CCIs can act as a catalyst for activity and investment in an area because the ‘consumption’ of cultural activities will lead to the activities and use of other non-cultural activities, for example, hospitality development including restaurants and bars, as well as public transport. ‘Consumption’ of cultural activities also leads to employment creation, and diversification. However, CCIs tend to be clustered, especially around large cities. There is, moreover, a case for development of CCIs around smaller towns and cities, because they do not rely on high technology inputs, and long supply chains, and, their direct link to rural and isolated places makes them vital in regional development. However, there is currently little research on how to craft cultural policy for regions with smaller towns and cities. Using the Sarah Baartman District (SBDM) in South Africa as an example, this paper describes the process of developing cultural policy for a region that has potential, and existing, cultural clusters, but currently no one, coherent policy relating to CCI development. The SBDM was chosen as a case study because it has no large cities, but has some CCI clusters, and has identified them as potential drivers of local economic development. The process of developing cultural policy is discussed in stages: Identification of what resources are present; including human resources, soft and hard infrastructure; Identification of clusters; Analysis of CCI labour markets and ownership patterns; Opportunities and challenges from the point of view of CCIs and other key stakeholders; Alignment of regional policy aims with provincial and national policy objectives; and finally, design and implementation of a regional cultural policy.

Keywords: cultural and creative industries, economic impact, intrinsic value, regional development

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Authors: Neda Zamani

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The present study aimed to investigate the effectiveness of training courses and their limitations using the CIPP model. The investigations were done on Isfahan Refinery as a case study. From a purpose point of view, the present paper is included among applied research and from a data gathering point of view, it is included among descriptive research of the field type survey. The population of the study included participants in training courses, their supervisors and experts of the training department. Probability-proportional-to-size (PPS) was used as the sampling method. The sample size for participants in training courses included 195 individuals, 30 supervisors and 11 individuals from the training experts’ group. To collect data, a questionnaire designed by the researcher and a semi-structured interview was used. The content validity of the data was confirmed by training management experts and the reliability was calculated through 0.92 Cronbach’s alpha. To analyze the data in descriptive statistics aspect (tables, frequency, frequency percentage and mean) were applied, and inferential statistics (Mann Whitney and Wilcoxon tests, Kruskal-Wallis test to determine the significance of the opinion of the groups) have been applied. Results of the study indicated that all groups, i.e., participants, supervisors and training experts, absolutely believe in the importance of training courses; however, participants in training courses regard content, teacher, atmosphere and facilities, training process, managing process and product as to be in a relatively appropriate level. The supervisors also regard output to be at a relatively appropriate level, but training experts regard content, teacher and managing processes as to be in an appropriate and higher than average level.

Keywords: training courses, limitations of training effectiveness, CIPP model, Isfahan oil refinery company

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Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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Authors: Rubens Duarte Coelho, Timóteo Herculino da Silva Barros, Jefferson de Olveira Costa

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Brazil has an electrical matrix of predominantly renewable origin, with emphasis on water sources, which account for 65.2%, biomass energy for 8.2%, wind for 6.8% and solar for 0.13% of the domestic supply. Among these sources, sugarcane cultivation stands out, aiming both at the production of bioethanol and biomass to supply “clean energy”. However, like all other crops, sugar cane demands a large volume of a natural resource that is increasingly “scarce” in quantity and quality: water. Adequate and strategic water management throughout the entire sugarcane cycle is of fundamental importance, and water productivity can be used to adjust irrigation planning and decision-making, increasing the productivity of stalks, bioethanol, biomass, and sugar. In this way, water productivity is a good indicator for analysis and decision-making considering the sustainability of cultivation, as it allows evaluation of the variation in the ratio between production and the amount of water used, suggesting values that maximize the use of this natural resource. In this context, studies that relate water demand, in this case, expressed by water productivity, with the energy production of this crop, in this case, expressed by the production of bioethanol, biomass and sugar, are fundamental to obtaining an efficient production of renewable energy, which aims at the rational use of natural resources, especially water. The objective of the present work was to evaluate the response of sugarcane varieties subjected to different water availability to obtain better sustainability in bioenergy production, presenting water productivity indices for Bioethanol, Sugar and Biomass. The variety that responded best was RB966928, with a bioethanol yield of 68.7 L Mg-1. Future research should focus on the water response under each of the sugarcane fractions in terms of their elemental composition so that the influence of water on the energy supply of this crop can be better understood.

Keywords: energy matrix, water use, water use efficiency, sustainability

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Authors: John Akinwumi Makinde

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Nigerian manufacturing industry, particularly the fast moving consumer producing firms play vital roles in Nigerian economy. This sector’s product acceptability is given very little attention along with social media advertising that communicate product information to audience across the globe need to be documented. Procter and Gamble Plc operate in Nigeria with appreciable number of fast moving consumer goods that service Nigerian economy. Social media advertising disposition of the company and product acceptability of the company deserve some elucidations. This study therefore examined the impact of social media advertising on product acceptability of FMCG in Nigerian manufacturing industry, using Procter and Gamble Plc as case study. The study employed the case study type of descriptive survey research design. The population consisted of 235 customers of G&P Plc, which were selected through random sampling method. A total of 235 copies of questionnaires titled 'Social Media Advertising and Product Acceptability (SMA-PA) Questionnaire' was administered and retrieved. Data generated were analysed using frequency distribution and regression analysis at 0.05 level. It was found that social media advertising positively and significantly motivated customers to buy product of P&G Plc (r =.147**, N= 235, p(.000) < .01). Findings also showed that social media advertising has significant impact on product acceptability of FCMG in P&G Plc (F(2,61)=22.250; R2=.629; P(.000) < .05). The study concluded that social media advertising is a determinant factor of consumer decision to accept fast moving consumer goods in Nigerian manufacturing industry. It is recommended that with the growing market of FMCG, there is need to educate the market with the product unique features, standard and quality on social media. Finally, Fast Moving Consumer Goods firms should deploy excellent marketing mix on social media.

Keywords: advertising, fast moving consumer goods, manufacturing industry, product acceptability, social media

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Authors: Antonis Skouloudis, Konstantinos Evangelinos, Walter Leal-Filho, Panagiotis Vouros, Ioannis Nikolaou

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Organizational resilience capacity to extreme weather events (EWEs) has sparked a growth in scholarly attention over the past decade as an essential aspect in business continuity management, with supporting evidence for this claim to suggest that it retains a key role in successful responses to adverse situations, crises and shocks. Small and medium-sized enterprises (SMEs) are more vulnerable to face floods compared to their larger counterparts, so they are disproportionately affected by such extreme weather events. The limited resources at their disposal, the lack of time and skills all conduce to inadequate preparedness to challenges posed by floods. SMEs tend to plan in the short-term, reacting to circumstances as they arise and focussing on their very survival. Likewise, they share less formalised structures and codified policies while they are most usually owner-managed, resulting in a command-and-control management culture. Such characteristics result in them having limited opportunities to recover from flooding and quickly turnaround their operation from a loss making to a profit making one. Scholars frame the capacity of business entities to be resilient upon an EWE disturbance (such as flash floods) as the rate of recovery and restoration of organizational performance to pre-disturbance conditions, the amount of disturbance (i.e. threshold level) a business can absorb before losing structural and/or functional components that will alter or cease operation, as well as the extent to which the organization maintains its function (i.e. impact resistance) before performance levels are driven to zero. Nevertheless, while it seems to be accepted as an essential trait of firms effectively transcending uncertain conditions, research deconstructing the enabling conditions and/or inhibitory factors of SMEs resilience capacity to natural hazards is still sparse, fragmentary and mostly fuelled by anecdotal evidence or normative assumptions. Focusing on the individual level of analysis, i.e. the individual enterprise and its endeavours to succeed, the emergent picture from this relatively new research strand delineates the specification of variables, conceptual relationships or dynamic boundaries of resilience capacity components in an attempt to provide prescriptions for policy-making as well as business management. This study will present the development of a flood resilience capacity index (FRCI) and its application to Greek SMEs. The proposed composite indicator pertains to cognitive, behavioral/managerial and contextual factors that influence an enterprise’s ability to shape effective responses to meet flood challenges. Through the proposed indicator-based approach, an analytical framework is set forth that will help standardize such assessments with the overarching aim of reducing the vulnerability of SMEs to flooding. This will be achieved by identifying major internal and external attributes explaining resilience capacity which is particularly important given the limited resources these enterprises have and that they tend to be primary sources of vulnerabilities in supply chain networks, generating Single Points of Failure (SPOF).

Keywords: Floods, Small & Medium-Sized enterprises, organizational resilience capacity, index development

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Authors: Sudha Puhal, Dr Rajmala Jaiswal

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Retropharyngeal abscess occurs most commonly in children following acute upper respiratory tract and ear infection. Airway management in retropharyngeal abscess is an anesthetic challenge due to distortion of airway anatomy and the possibility of spontaneous rupture of abscess leading to aspiration or stridor due to laryngeal edema.. In this report we present a case of retropharyngeal abscess in a child, which was drained under general anaesthesia successfully without any complications.

Keywords: abscess, airway, difficult, retropharyngeal

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Authors: Yu Guang

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“Case studies are the preferred strategy when ‘how’ or ‘why’ questions are being posed.” Therefore, the study is based on two cases: strategy performed in JingNan War and by NIKE. The two samples are chosen as they are of comparability. Data are gathered and PEST and SWOT are used as analysis models to examine their strategic employment in order that the answer to brilliant strategies in variety is found. The niche strategy has been used in the past and present, in the battle fields and business. The homogeneity among diversity is the skill of performing strategies.

Keywords: challenger, homogeneity, managing diversity, niche strategy

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

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This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: energy efficiency, energy retrofitting, hot arid, Saudi Arabia

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Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: Predrag Kavaric, Vladimir L. Jubic, Maxim Cadenovic

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The patient was transferred from his dentist to our tertiary medical institution. In anamnesis, we got information that his dental intervention was two years ago when he got dental implants but because of the coronavirus pandemic event, he didn’t finish the whole procedure. After two years, he decided that he will continue his work at his dentist, then his dentist noticed that there is no earlier inserted implant in the upper jaw on the right side. They do Panoramic X-ray and find that the implant is all in the maxillary sinus cavity. The flour of the maxilla was intact without any fistula on the place where the implant was inserted in the maxilla bone, After that initial diagnostic they sent the patient to maxillofacial surgery and otorhinolaryngology. We asked for a CT scan of paranasal sinuses, which confirmed the foreign body in the right maxillary sinus. The plan was that in general anesthesia we do FESS and try to find a foreign body in the maxillary sinus or in case of failure to do Caldwel Luc on that side. After preoperative preparation in GA, we do FESS. In inspection, we find small polyps and chronically changed mucosa of osteomeatal complex and right maxillary sinus. After removing polyps we did uncinectomy and medial maxillectomy. With Heuweiser Antrum grasping forceps after several attempts we managed to extract a foreign body from the bottom of the right maxillary sinus. On the first postoperative day we did detamponade, and then we discharge the patient from hospital. The Covid pandemic has contributed to the postponement of a large number of planned operations, which has resulted in various complications in the treatment of a number of patients. In this case, it happened that the implant was most likely rejected by the bone but in the direction of the maxillary sinus, which is not a common cause. On the other hand, the success was that less traumatic intervention was able to remove the foreign body from the maxillary sinus in which it was located. Since the sinus floor is free of bone defects, it can be continued relatively quickly with dental procedures.

Keywords: x-ray, surgery, maxillar sinus, complication, fees

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Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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Authors: Michał Lidner, Zbigniew SzcześNiak

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The ability to estimate blast load overpressure properly plays an important role in safety design of buildings. The issue of studying of blast loading on structural elements has been explored for many years. However, in many literature reports shock wave overpressure is estimated with simplified triangular or exponential distribution in time. This indicates some errors when comparing real and numerical reaction of elements. Nonetheless, it is possible to further improve setting similar to the real blast load overpressure function versus time. The paper presents a method of numerical analysis of the phenomenon of the air shock wave propagation. It uses Finite Volume Method and takes into account energy losses due to a heat transfer with respect to an adiabatic process rule. A system of three equations (conservation of mass, momentum and energy) describes the flow of a volume of gaseous medium in the area remote from building compartments, which can inhibit the movement of gas. For validation three cases of a shock wave flow were analyzed: a free field explosion, an explosion inside a steel insusceptible tube (the 1D case) and an explosion inside insusceptible cube (the 3D case). The results of numerical analysis were compared with the literature reports. Values of impulse, pressure, and its duration were studied. Finally, an overall good convergence of numerical results with experiments was achieved. Also the most important parameters were well reflected. Additionally analyses of dynamic response of one of considered structural element were made.

Keywords: adiabatic process, air shock wave, explosive, finite volume method

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Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

Procedia PDF Downloads 139

Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

Procedia PDF Downloads 182