Search results for: trauma informed practices
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5621

Search results for: trauma informed practices

5411 Absence of Secured Bathing Spaces and Its Effect on Women: An Exploratory Qualitative Study of Rural Odisha, India

Authors: Minaj Ranjita Singh, Meghna Mukherjee, Abhijeet Jadhav

Abstract:

This is an exploratory qualitative study with an objective to understand the bathing practices followed by rural women and its consequences. Access to safe bathing spaces in rural India is a neglected issue due to which women are affected in various ways. Today, government policies are largely focused towards the building of toilets, but no importance has been given to the construction of bathrooms. Both qualitative and quantitative data were collected using in-depth interviews and focused group discussions with rural women in six villages of Odisha, India. The study was approved by an Institutional Research and Ethics Committee, and informed consent was taken from participants. For most of the participants, the access to water, bathing space and toilet was compromised posing various challenges in their daily lives. Women's daily schedule, hygiene practices, dignity, and health are greatly affected due to this lack. Since bathing in the open has been an ancient practice, the community's perception is benign towards the hardship of women. Lack of exposure to concealed bathing, necessary funds, and competing priorities are some of the household level factors which never let them think about having bathrooms and the lack of water supply, proper drainage system, subsidy or financial support are the governance and policy related factors which prevent their access to secured bathing spaces.

Keywords: bathrooms, dignity, exploratory, rural, qualitative, women's health, women

Procedia PDF Downloads 169
5410 MLOps Scaling Machine Learning Lifecycle in an Industrial Setting

Authors: Yizhen Zhao, Adam S. Z. Belloum, Goncalo Maia Da Costa, Zhiming Zhao

Abstract:

Machine learning has evolved from an area of academic research to a real-word applied field. This change comes with challenges, gaps and differences exist between common practices in academic environments and the ones in production environments. Following continuous integration, development and delivery practices in software engineering, similar trends have happened in machine learning (ML) systems, called MLOps. In this paper we propose a framework that helps to streamline and introduce best practices that facilitate the ML lifecycle in an industrial setting. This framework can be used as a template that can be customized to implement various machine learning experiment. The proposed framework is modular and can be recomposed to be adapted to various use cases (e.g. data versioning, remote training on cloud). The framework inherits practices from DevOps and introduces other practices that are unique to the machine learning system (e.g.data versioning). Our MLOps practices automate the entire machine learning lifecycle, bridge the gap between development and operation.

Keywords: cloud computing, continuous development, data versioning, DevOps, industrial setting, MLOps

Procedia PDF Downloads 251
5409 The Diurnal and Seasonal Relationships of Pedestrian Injuries Secondary to Motor Vehicles in Young People

Authors: Amina Akhtar, Rory O'Connor

Abstract:

Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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5408 Flow as a Positive Intervention for Post-Traumatic Stress Disorder

Authors: Sonal Khosla

Abstract:

A research is proposed in the present paper to explore the role of flow in coping with traumatic experiences and attaining post-traumatic growth. A grounded theory research is proposed to be carried by analyzing memoirs of people who have been through trauma. A pilot study was carried out on two memoirs of women who were held captive for over ten years and were sexually assaulted repeatedly. The role of flow in their coping experiences was explored by analyzing the books. Some of the flow activities that were used by them were- drawing and daydreaming. Their narratives show the evidence for flow as having cathartic and healing effects on them. Applicability of the findings can take two forms: 1. Flow can be applied as a preventive technique to help the people who are going through trauma, 2. Flow can be adopted into a positive intervention to help people suffering from PTSD.

Keywords: flow, positive intervention, PTSD, PTG

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5407 Bridging the Gap between Obstetric and Colorectal Services after Obstetric Anal Sphincter Injuries

Authors: Shachi Joshi

Abstract:

Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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5406 Sustainability in Community-Based Forestry Management: A Case from Nepal

Authors: Tanka Nath Dahal

Abstract:

Community-based forestry is seen as a promising instrument for sustainable forest management (SFM) through the purposeful involvement of local communities. Globally, forest area managed by local communities is on the rise. However, transferring management responsibilities to forest users alone cannot guarantee the sustainability of forest management. A monitoring tool, that allows the local communities to track the progress of forest management towards the goal of sustainability, is essential. A case study, including six forest user groups (FUGs), two from each three community-based forestry models—community forestry (CF), buffer zone community forestry (BZCF), and collaborative forest management (CFM) representing three different physiographic regions, was conducted in Nepal. The study explores which community-based forest management model (CF, BZCF or CFM) is doing well in terms of sustainable forest management. The study assesses the overall performance of the three models towards SFM using locally developed criteria (four), indicators (26) and verifiers (60). This paper attempts to quantify the sustainability of the models using sustainability index for individual criteria (SIIC), and overall sustainability index (OSI). In addition, rating to the criteria and scoring of the verifiers by the FUGs were done. Among the four criteria, the FUGs ascribed the highest weightage to institutional framework and governance criterion; followed by economic and social benefits, forest management practices, and extent of forest resources. Similarly, the SIIC was found to be the highest for the institutional framework and governance criterion. The average values of OSI for CFM, CF, and BZCF were 0.48, 0.51 and 0.60 respectively; suggesting that buffer zone community forestry is the more sustainable model among the three. The study also suggested that the SIIC and OSI help local communities to quantify the overall progress of their forestry practices towards sustainability. The indices provided a clear picture of forest management practices to indicate the direction where they are heading in terms of sustainability; and informed the users on issues to pay attention to enhancing the sustainability of their forests.

Keywords: community forestry, collaborative management, overall sustainability, sustainability index for individual criteria

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5405 Web 2.0 Enabling Knowledge-Sharing Practices among Students of IIUM: An Exploration of the Determinants

Authors: Shuaibu Hassan Usman, Ishaq Oyebisi Oyefolahan

Abstract:

This study was aimed to explore the latent factors in the web 2.0 enabled knowledge sharing practices instrument. Seven latent factors were identified through a factor analysis with orthogonal rotation and interpreted based on simple structure convergence, item loadings, and analytical statistics. The number of factors retains was based on the analysis of Kaiser Normalization criteria and Scree plot. The reliability tests revealed a satisfactory reliability scores on each of the seven latent factors of the web 2.0 enabled knowledge sharing practices. Limitation, conclusion, and future work of this study were also discussed.

Keywords: factor analysis, latent factors, knowledge sharing practices, students, web 2.0 enabled

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5404 Supporting Embedded Medical Software Development with MDevSPICE® and Agile Practices

Authors: Surafel Demissie, Frank Keenan, Fergal McCaffery

Abstract:

Emerging medical devices are highly relying on embedded software that runs on the specific platform in real time. The development of embedded software is different from ordinary software development due to the hardware-software dependency. MDevSPICE® has been developed to provide guidance to support such development. To increase the flexibility of this framework agile practices have been introduced. This paper outlines the challenges for embedded medical device software development and the structure of MDevSPICE® and suggests a suitable combination of agile practices that will help to add flexibility and address corresponding challenges of embedded medical device software development.

Keywords: agile practices, challenges, embedded software, MDevSPICE®, medical device

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5403 Effect of Project Control Practices on the Performance of Building Construction Companies in Uganda: A Case Study of Kampala City

Authors: Tukundane Hillary

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This research paper analytically evaluates the project control practice levels used by the building construction companies within Kampala, Uganda. The research also assesses the outcome of project control practices on the productivity of the companies. The research was performed to ascertain the current control practices among 160 respondents from various construction companies registered with the Uganda Registration Services Bureau. This research used amalgamation from multiple literature to obtain the variables. The research adopts 34 standard control practices from four vital project control duties: planning, monitoring, analyzing, and reporting. These project control tasks were organized using mean response ratings grounded on their relevance to the construction companies. Results showed that evaluating performance with the use of curves (4.32), timely access to information and encouragement (4.55), report representation using quantitative tools 4.75, and cost value comparison application during analysis (4.76) were rated least among the control practices. On the other hand, the top project control practices included formulation of the project schedule (8.88), Project feasibility validation (8.86), Budgeting for each activity (8.84), Key project route definition (8.81), Team awareness of the budget (8.77), Setting realistic targets for projects (8.50) and Consultation from subcontractors (8.74). From the results obtained by the sample respondents specified, it can be concluded that planning is the most vital project control task practiced in the building construction industry in Uganda. In addition, this research ascertained a substantial relationship between project control practices and the performance of building construction companies. Accordingly, this research recommends that project control practices be effectively observed by both contracting and consulting companies to enhance their overall performance and governance.

Keywords: cost value, project control, cost control, time control, project performance, control practices

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5402 C-Spine Imaging in a Non-trauma Centre: Compliance with NEXUS Criteria Audit

Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

Abstract:

The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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5401 Impact Assessment of Lean Practices on Social Sustainability Indicators: An Approach Using ISM Method

Authors: Aline F. Marcon, Eduardo F. da Silva, Marina Bouzon

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The impact of lean management on environmental sustainability is the research line that receives the most attention from academicians. Therefore, the social dimension of sustainable development has so far received less attention. This paper aims to evaluate the impact of intra-plant lean manufacturing practices on social sustainability indicators extracted from the Global Reporting Initiative (GRI) parameters. The method is two-phased, including MCDM approach to uncover the most relevant practices regarding social performance and Interpretive Structural Modeling (ISM) method to reveal the structural relationship among lean practices. Professionals from the academic and industrial fields answered the questionnaires. From the results of this paper, it is possible to verify that practices such as “Safety Improvement Programs”, “Total Quality Management” and “Cross-functional Workforce” are the ones which have the most positive influence on the set of GRI social indicators.

Keywords: indicators, ISM, lean, social, sustainability

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5400 An Adaptive Application of Emotionally Focused Couple Therapy with Trans and Nonbinary Couples

Authors: Reihaneh Mahdavishahri, Dumayi Gutierrez

Abstract:

Emotionally focused couple therapy (EFCT) is one of the most effective and evidence-based approaches to couple therapy. Yet, literature is scarce of its effective application with trans and non-binary couples. It is estimated that 1.4 million trans adults live in the United Stated, with about 40% of these individuals experiencing serious psychological distress within the past month. Trans and nonbinary adults are significantly likely to experience discrimination, harassment, family rejection, and relationship challenges throughout the course of their lives. As systemic therapists, applying an informed lens when working with trans and nonbinary couples can contribute to providing effective mental health care to these individuals. This paper aims to provide a comprehensive, intersectional, and culturally informed application of EFCT with trans and nonbinary couples. We will address the current literature on applications of EFCT with diverse couples, EFCT’s strengths and limitations on cultural humility, and the gaps within current systems of care for trans and nonbinary couples. We will then provide an adaptive application of EFCT to help trans, and nonbinary couples recover from potential attachment injuries in their relationships, intersecting gender minority stressors, and achieve healing and restoration in their interpersonal dynamics.

Keywords: attachment, culturally informed care, emotionally focused couple therapy, trans and nonbinary couples

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5399 Nature of HR Practices in the Micro Informal Enterprises: Case Study of Pakistan

Authors: Aamar Ilyas

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Value of firm does not only depend upon its financial and material resources rather human resource is also a significant contributor in success of organizations by achieving competitive advantage. Human resource is an important asset so it is the main responsibility of employers to get the best use of this resource. Hence, this paper will explore the human resource practices used by entrepreneurs in the informal economy in Lahore, the provincial capital of Punjab, Pakistan. In this study three major sectors are randomly selected. Snowball sampling technique was applied to collect data. Survey was conducted through interviews of 45 respondents working in the informal sector. The results show that informal sector in Pakistan is not using any formal human resource practices as done by formal enterprises. Findings suggest that there should be the implementation of the human resource practices that help the firm to increase its productivity and ensure the betterment of the employees. The main limitation of the study was short time period to cater all sectors of informal economy of Pakistan which limits the extent of its generalizability. The rationale behind this study is to uncover the facts regarding management practices of human capital in the informal sector.

Keywords: HR practices, informal economy, working condition, recruitment, training, employee motivation, welfare

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5398 A Concept Analysis of Control over Nursing Practice

Authors: Oznur Ispir, S. Duygulu

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Health institutions are the places where fast and efficient decisions are required and mistakes and uncertainties are not tolerated due to the urgency of the services provided within the body of these institutions. Thus, in those institutions where patient care services are targeted to be provided quality and safety, the nurses attending the decisions, creating the solutions for problems, taking initiative and bearing the responsibility of results in brief having the control over practices are needed. Control over nursing practices is defined as affecting the employment and work environment at the unit level of the institution, perceived freedom for organizing and evaluating nursing practices, the ability to make independent decisions about patient care and accountability for the results of such decisions. This study scrutinizes the concept of control over nursing practices (organizational autonomy), which is frequently confused with other concepts (autonomy) in the literature, by reviewing the literature and making suggestions to improve nurses’ control over nursing practices.

Keywords: control over nursing practice, nurse, nursing, organizational autonomy

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5397 The Psychological Impact of War Trauma on Refugees

Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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5396 Community Strengths and Indigenous Resilience as Drivers for Health Reform Change

Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

Abstract:

Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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5395 Exhaust Gas Cleaning Systems on Board Ships and Impact on Crews’ Health: A Feasibility Study Protocol

Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous

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Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.

Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures

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5394 Traumatic Brachiocephalic Artery Pseudoaneurysm

Authors: Sally Shepherd, Jessica Wong, David Read

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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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5393 ‘A Ghost of One’s Own’: Spectral Intrusions and Trauma in the Poetry of Joanna Baillie and Anne Bannerman

Authors: Elli Karampela

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In Specters of Marx (1993), Jacques Derrida refers to the ghost as an Other presence that occupies the space of the self and emanates from there, haunting in its shadowy pastness and threatening/striving to break free. In times of change, ghosts both reflect the dissolution of set principles and voice traumas of the past that create a sense of fear and instability. This paper observes the way female ghosts create connections with the living in the poetry of Joanna Baillie and Anne Bannerman, both integral, albeit under-researched in different ways, writers of the English Romantic period working in the aftermath of the French Revolution. Especially at the beginning of the nineteenth century, when ghost narratives were devoured by readers and enjoyed as stories that re-awakened sensation in times of revolution, there was at the same time fear of intrusion by terror’s unruly forces that threatened to turn the readers restless. The ghost was particularly dangerous because it was associated with memory and the intrusion of past trauma in the here and now. As will be seen, both Baillie and Bannerman explore the idea of the female ghost’s ‘return’ (a Freudian term that will be approached) which breaks both time and space boundaries to raise the suppressed female voice, threaten stability, and correct wrongs. As a result, the varied manifestations of female ghosts render Baillie and Bannerman active in the contemporary discourse about human rights and the reclamation of the agency.

Keywords: poetry, romanticism, spectrality, trauma, women

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5392 Identification of Stakeholders and Practices of Inclusive Education

Authors: Luis Javier Serrano-Tamayo

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This paper focuses on the recent interest in the concept of inclusion from multiple areas of social sciences, but particularly from the academic studies on what do scholars mean when they refer to inclusive education. Therefore, this paper has been based on a three-year systematic review of near two hundred peer-reviewed documents in the last two decades. The results illustrate some of the use, misuse, and abuse of inclusive education as well as shed some light on the identification of the different stakeholders involved in the dynamic concept of inclusive education and their suggested practices.

Keywords: inclusion, inclusive education, inclusive practices, education stakeholders

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5391 Socioeconomic Factors Associated with the Knowledge, Attitude, and Practices of Oil Palm Smallholders toward Ganoderma Disease

Authors: K. Assis, B. Bonaventure, A. Abdul Rahim, H. Affendy, A. Mohammad Amizi

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Oil palm smallholders are considered as a very important producer of oil palm in Malaysia. They are categorized into two, which are organized smallholder and independent smallholder. In this study, there were 1000 oil palms smallholders have been interviewed by using a structured questionnaire. The main objective of the survey is to identify the relationship between socioeconomic characteristics of smallholders with their knowledge, attitude, and practices toward Ganoderma disease. The locations of study include Peninsular Malaysia and Sabah. There were three important aspects studied, namely knowledge of Ganoderma disease, attitude towards the disease as well as the practices in managing the disease. Cluster analysis, factor analysis, and binary logistic regression were used to analyze the data collected. The findings of the study should provide a baseline data which can be used by the relevant agencies to conduct programs or to formulate a suitable development plan to improve the knowledge, attitude and practices of oil palm smallholders in managing Ganoderma disease.

Keywords: attitude, Ganoderma, knowledge, oil palm, practices, smallholders

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5390 Understanding the Effect of Fall Armyworm and Integrated Pest Management Practices on the Farm Productivity and Food Security in Malawi

Authors: Innocent Pangapanga, Eric Mungatana

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Fall armyworm (FAW) (Spodoptera frugiperda), an invasive lepidopteran pest, has caused substantial yield loss since its first detection in September 2016, thereby threatening the farm productivity food security and poverty reduction initiatives in Malawi. Several stakeholders, including households, have adopted chemical pesticides to control FAW without accounting for its costs on welfare, health and the environment. Thus, this study has used panel data endogenous switching regression model to investigate the impact of FAW and the integrated pest management (IPM) –related practices on-farm productivity and food security. The study finds that FAW substantively reduces farm productivity by seven (7) percent and influences the adoption of IPM –related practices, namely, intercropping, mulching, and agroforestry, by 6 percent, ceteris paribus. Interestingly, multiple adoptions of the IPM -related practices noticeably increase farm productivity by 21 percent. After accounting for potential endogeneity through the endogenous switching regression model, the IPM practices further demonstrate tenfold more improvement on food security, implying the role of the IPM –related practices in containing the effect of FAW at the household level.

Keywords: hunger, invasive fall army worms, integrated pest management practices, farm productivity, endogenous switching regression

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5389 The Traditional Roles and Place of Indigenous Musical Practices in Contemporary African Society

Authors: Benjamin Obeghare Izu

Abstract:

In Africa, indigenous musical practices are the focal point in which most cultural practices revolve, and they are the conduit mainly used in transmitting Indigenous knowledge and values. They serve as a means of documenting, preserving, transmitting indigenous knowledge, and re-enacting their historical, social, and cultural affinity. Indigenous musical practices also serve as a repository for indigenous knowledge and artistic traditions. However, these indigenous musical practices and the resulting cultural ideals are confronted with substantial challenges in the twenty-first century from contemporary cultural influence. Additionally, indigenous musical practices' educational and cultural purposes have been impacted by the broad monetisation of the arts in contemporary society. They are seen as objects of entertainment. Some young people are today unaware of their cultural roots and are losing their cultural identity due to these influences and challenges. In order to help policymakers raise awareness of and encourage the use of indigenous knowledge and musical practices among African youth and scholars, this study is in response to the need to explore the components and functions of the indigenous knowledge system, values, and musical tradition in Africa. The study employed qualitative research methods, utilising interviews, participant observation, and conducting related literature as data collection methods. It examines the indigenous musical practices in the Oba of Benin Royal Igue festival among the Benin people in Edo state, Nigeria, and the Ovwuwve festival observed by the Abraka people in Delta state, Nigeria. The extent to which the indigenous musical practices convey and protect indigenous knowledge and cultural values are reflected in the musical practices of the cultural festivals. The study looks at how indigenous musical arts are related to one another and how that affects how indigenous knowledge is transmitted and preserved. It makes recommendations for how to increase the use of indigenous knowledge and values and their fusion with contemporary culture. The study contributes significantly to ethnomusicology by showing how African traditional music traditions support other facets of culture and how indigenous knowledge might be helpful in contemporary society.

Keywords: African musical practices, African music and dance, African society, indigenous musical practices

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5388 The Role of Risk Management Practices in the Relationship between Risks Factors and Construction Project Performance

Authors: Ali Abdullah Albezaghi

Abstract:

This article aims to introduce a conceptual framework that can facilitate investigations concerning the role of risk management practices in the relationship between construction risks and the construction project's performance. This article is structured based on the extant literature; it reviews theoretical perspectives, highlights the gaps, and illustrates the significance of developing a framework of suggested relationships. Despite growing interest in the role of risks in construction project performance, previous studies have paid little attention to investigating the moderating role of risk management practices on the risk-performance link. This has left researchers and construction project managers with minimal information to explain the conditions under which risk management practices can reduce the impact of project-related risks and improve performance. In this context, this article suggests a viable research model with propositions that assess risk-performance relationships and discusses the potential moderating effects on the domain relationship. This paper adds to the risk management literature by focusing on risk variables that directly impact performance. Further, it also considers the moderating role of risk management practices in such relationships.

Keywords: risk management practices, external risks, internal risks, project risks, project performance

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5387 An Interpretative Phenomenological Analysis of the Death Practices and Rituals of the Isneg People in Apayao

Authors: Ivy Angelique Malit, Marion Nicole Dela Vega, Marjorie Mae Mendoza

Abstract:

Death practices and rituals of the Philippines is rich with facts about our history mostly on our beliefs of the afterlife before the arrival of the western culture which is still being practiced by the indigenous people of the Philippines. The death practices and rituals are acts of showing the inner thoughts, and feelings towards the person who died. The meanings behind those practices and rituals become the reason why the indigenous people still treasure these death practices and rituals as a part of their culture. This study seeks to know the experiences of the death practices and rituals of one of the Indigenous groups in Apayao, the Isnegs and the meaning of those experiences. The researchers aimed to look at it on a psychological lens. In which the researchers aim (1) to know their experiences of their death practices from the perspective of their thoughts, feelings and actions, and (2) to seek the meaning behind their death rituals. The design used in the research is a qualitative design and Interpretative Phenomenological Analysis. The participants were gathered by using purposive sampling. The researchers gathered the data from a form of a semi-structured interview with guide questions. The researchers used Thematic Analysis to analyze the verbatim transcriptions from the interview. The experiences of death practices and rituals of the Isneg people have been presented in the aspects of their thoughts, feelings and behavior. The experiences were presented with 7 superordinate themes namely, (1) Refusal of Reality (2) Feelings of mixed emotions (3) Oblivious Acts of the participants (4) Conflict with self and culture (5) Negative thinking of the participants (6) Process of Acceptance (8) Act of Love. The make meaning behind the death practices and rituals of the Isneg people have been presented with 2 superordinate themes, (1) Act of Respect and (2) Act of Loyalty. The results of the research show that the experiences and meaning behind their death practices and burials were being based more by their own beliefs. In their culture, which has been passed through by their ancestors and becomes the foundation of their beliefs and their newly found religion which was introduced by the travelling missionaries. Doing those death practices and rituals is their way to show their affections, like respect and loyalty towards the person who died.

Keywords: death practices, interpretative phenomenological analysis, isneg people, rituals, theory of grieving

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5386 The Data-Driven Localized Wave Solution of the Fokas-Lenells Equation Using Physics-Informed Neural Network

Authors: Gautam Kumar Saharia, Sagardeep Talukdar, Riki Dutta, Sudipta Nandy

Abstract:

The physics-informed neural network (PINN) method opens up an approach for numerically solving nonlinear partial differential equations leveraging fast calculating speed and high precession of modern computing systems. We construct the PINN based on a strong universal approximation theorem and apply the initial-boundary value data and residual collocation points to weekly impose initial and boundary conditions to the neural network and choose the optimization algorithms adaptive moment estimation (ADAM) and Limited-memory Broyden-Fletcher-Golfard-Shanno (L-BFGS) algorithm to optimize learnable parameter of the neural network. Next, we improve the PINN with a weighted loss function to obtain both the bright and dark soliton solutions of the Fokas-Lenells equation (FLE). We find the proposed scheme of adjustable weight coefficients into PINN has a better convergence rate and generalizability than the basic PINN algorithm. We believe that the PINN approach to solve the partial differential equation appearing in nonlinear optics would be useful in studying various optical phenomena.

Keywords: deep learning, optical soliton, physics informed neural network, partial differential equation

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5385 Serum Granulocyte Colony Stimulating Factor is a Potent Stimulator of Hematopoeitic Progenitor Cells Mobilization in Trauma Hemorrhagic Shock

Authors: Manoj Kumar, Sujata Mohanty, D. N. Rao, Arul Selvi, Sanjeev K. Bhoi

Abstract:

Background: Hematopoietic progenitor cells (HPC) mobilized from bone marrow to peripheral blood has been observed in severe trauma and hemorrhagic shock patients. Granulocyte-colony stimulating factor (G-CSF) is a potent stimulator that mobilized HPC from bone marrow to peripheral blood. Objective: Our aim of the study was to investigate the serum G-CSF levels and correlate with HPC and outcome. Methods: Peripheral blood sample from 50 hemorrhagic shock patients was collected on arrival for determination of G-CSF and peripheral blood HPC (PBHPC) and compared with healthy control (n=15). Determination of serum levels of G-CSF by sandwich ELISA and PBHPC by Sysmex XE-2100. Data were categorized by age, sex, Injury Severity Score (ISS), and laboratory data was prospectively collected. Data are expressed as mean±SD and median (min, max). Results: Significantly increased the serum level of G-CSF (264.8 vs. 79.1 pg/ml) and peripheral blood HPC (0.1 vs. 0.01 %) in the T/HS patients when compared with control group. Conclusions: Our studies suggest serum G-CSF elevated in T/HS patients. The elevated in G-CSF was also associated with mobilization of HPC from BM to peripheral blood HPC. Increased the levels of G-CSF in T/HS may play a significant role in the alteration of the hematopoietic compartment.

Keywords: granulocyte colony stimulating factor, G-CSF, hematopoietic progenitor cells, HPC, trauma hemorrhagic shock, T/HS, outcome

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5384 The Applications of Four Fingers Theory: The Proof of 66 Acupoints under the Human Elbow and Knee

Authors: Chih-I. Tsai, Yu-Chien. Lin

Abstract:

Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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5383 Identification and Origins of Multiple Personality: A Criterion from Wiggins

Authors: Brittany L. Kang

Abstract:

One familiar theory of the origin of multiple personalities focuses on how symptoms of trauma or abuse are central causes, as seen in paradigmatic examples of the condition. The theory states that multiple personalities constitute a congenital condition, as babies all exhibit multiplicity, and that generally alters only remain separated due to trauma. In more typical cases, the alters converge and become a single identity; only in cases of trauma, according to this account, do the alters remain separated. This theory is misleading in many aspects, the most prominent being that not all multiple personality patients are victims of child abuse or trauma, nor are all cases of multiple personality observed in early childhood. The use of this criterion also causes clinical problems, including an inability to identify multiple personalities through the variety of symptoms and traits seen across observed cases. These issues present a need for revision in the currently applied criterion in order to separate the notion of child abuse and to be able to better understand the origins of multiple personalities itself. Identifying multiplicity through the application of identity theories will improve the current criterion, offering a bridge between identifying existing cases and understanding their origins. We begin by applying arguments from Wiggins, who held that each personality within a multiple was not a whole individual, but rather characters who switch off. Wiggins’ theory is supported by observational evidence of how such characters are differentiated. Alters of older ages are seen to require different prescription lens, in addition to having different handwriting. The alters may also display drastically varying styles of clothing, preferences in food, their gender, sexuality, religious beliefs and more. The definitions of terms such as 'personality' or 'persons' also become more distinguished, leading to greater understanding of who is exactly able to be classified as a patient of multiple personalities. While a more common meaning of personality is a designation of specific characteristics which account for the entirety of a person, this paper argues from Wiggins’ theory that each 'personality' is in fact only partial. Clarification of the concept in question will allow for more successful future clinical applications.

Keywords: identification, multiple personalities, origin, Wiggins' theory

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5382 Developing a Total Quality Management Model Using Structural Equation Modeling for Indonesian Healthcare Industry

Authors: Jonny, T. Yuri M. Zagloel

Abstract:

This paper is made to present an Indonesian Healthcare model. Currently, there are nine TQM (Total Quality Management) practices in healthcare industry. However, these practices are not integrated yet. Therefore, this paper aims to integrate these practices as a model by using Structural Equation Modeling (SEM). After administering about 210 questionnaires to various stakeholders of this industry, a LISREL program was used to evaluate the model's fitness. The result confirmed that the model is fit because the p-value was about 0.45 or above required 0.05. This has signified that previously mentioned of nine TQM practices are able to be integrated as an Indonesian healthcare model.

Keywords: healthcare, total quality management (TQM), structural equation modeling (SEM), linear structural relations (LISREL)

Procedia PDF Downloads 279