Search results for: post WWII period

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

Procedia PDF Downloads 180

Authors: Miriam Colleran, Barbara Sheehy-Skeffington

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Background: To explore if there are unique features in the palliative care needs of patients with intellectual disability that may impact on planning for resource and service provision for them. Aim: The purpose of this practice review is to assess the indications for, numbers of and outcomes of care for adults with intellectual disabilities referred to a specialist palliative care service over a twoyear period. Service utilization aspects considered included the frequency of home visits by a specialist palliative care doctor or clinical nurse specialist and the number of hospice admissions that occurred for the patients. Method: A retrospective review was carried out of persons 18 years and older with intellectual disabilities referred to a specialist palliative care service over a 5-year period from 30.11.3018 to 29.11.2023. A manual review was carried out of the register using key terms, namely, known residential care and community dwelling places of service providers for persons with intellectual disabilities in the area and registered diagnoses in addition to the patients known to the clinicians who had intellectual disabilities. Results: 25 referrals were made to the specialist palliative care service of 23 persons with intellectual disabilities during that time. However, this may be an underestimate. 15 women and 8 men were referred with an age range of 19 to 86 years of age. The majority had a diagnosis of Down’s syndrome or Trisomy 21. 5 patients referred did not have home visits from the specialist palliative care team. A range of 2 to 48 phone calls per person occurred by the specialist palliative care team regarding this cohort of patients. The outcomes for the patients included discharge and death. The majority of patients that died, did so in the community. One person however died in hospital. Another person died in a hospice out of area. Conclusion: Providing specialist palliative care for adults with intellectual disabilities is an important element of palliative care. The dominance of the community as the place of death for these patients and the limited number of patients dying in either hospice or hospital are noteworthy. Further research is necessary and education to inform, support, and empower specialist palliative care professionals in optimizing palliative and end-of-life care for persons with intellectual disabilities and to inform service development and provision.

Keywords: about intellectual disability, palliative care

Procedia PDF Downloads 70

Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

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Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

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Authors: Salim H. Al Salmani, Kevin Tansey, Mohammed S. Ozigis

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The study of the growth of built-up areas and settlement expansion is a major exercise that city managers seek to undertake to establish previous and current developmental trends. This is to ensure that there is an equal match of settlement expansion needs to the appropriate levels of services and infrastructure required. This research aims at demonstrating the potential of satellite image processing technique, harnessing the utility of single feature probability-object based image analysis technique in assessing the urban growth dynamics of the Muscat Governorate in Oman for the period 1990, 2002 and 2013. This need is fueled by the continuous expansion of the Muscat Governorate beyond predicted levels of infrastructural provision. Landsat Images of the years 1990, 2002 and 2013 were downloaded and preprocessed to forestall appropriate radiometric and geometric standards. A novel approach of probability filtering of the target feature segment was implemented to derive the spatial extent of the final Built-Up Area of the Muscat governorate for the three years period. This however proved to be a useful technique as high accuracy assessment results of 55%, 70%, and 71% were recorded for the Urban Landcover of 1990, 2002 and 2013 respectively. Furthermore, the Normalized Differential Built – Up Index for the various images were derived and used to consolidate the results of the SFP-OBIA through a linear regression model and visual comparison. The result obtained showed various hotspots where urbanization have sporadically taken place. Specifically, settlement in the districts (Wilayat) of AL-Amarat, Muscat, and Qurayyat experienced tremendous change between 1990 and 2002, while the districts (Wilayat) of AL-Seeb, Bawshar, and Muttrah experienced more sporadic changes between 2002 and 2013.

Keywords: urban growth, single feature probability, object based image analysis, landcover change

Procedia PDF Downloads 274

Authors: Agnieszka A. Malinowska, R. Hejmanowski

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A number of European cities are strongly affected by ground movements caused by anthropogenic activities or post-anthropogenic metamorphosis. Those are mainly water pumping, current mining operation, the collapse of post-mining underground voids or mining-induced earthquakes. These activities lead to large and small-scale ground displacements and a ground ruptures. The ground movements occurring in urban areas could considerably affect stability and safety of structures and infrastructures. The complexity of the ground deformation phenomenon in relation to the structures and infrastructures vulnerability leads to considerable constraints in assessing the threat of those objects. However, the increase of access to the free software and satellite data could pave the way for developing new methods and strategies for environmental risk mitigation and management. Open source geographical information systems (OS GIS), may support data integration, management, and risk analysis. Lately, developed methods based on fuzzy logic and experts methods for buildings and infrastructure damage risk assessment could be integrated into OS GIS. Those methods were verified base on back analysis proving their accuracy. Moreover, those methods could be supported by ground displacement observation. Based on freely available data from European Space Agency and free software, ground deformation could be estimated. The main innovation presented in the paper is the application of open source software (OS GIS) for integration developed models and assessment of the threat of urban areas. Those approaches will be reinforced by analysis of ground movement based on free satellite data. Those data would support the verification of ground movement prediction models. Moreover, satellite data will enable our mapping of ground deformation in urbanized areas. Developed models and methods have been implemented in one of the urban areas hazarded by underground mining activity. Vulnerability maps supported by satellite ground movement observation would mitigate the hazards of land displacements in urban areas close to mines.

Keywords: fuzzy logic, open source geographic information science (OS GIS), risk assessment on urbanized areas, satellite interferometry (InSAR)

Procedia PDF Downloads 159

Authors: Hala Shaari, Nuredin Ahmed

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Teaching computer programming is recognized to be difficult and a real challenge. The biggest problem faced by novice programmers is their lack of understanding of basic programming concepts. A visualized learning tool was developed and used by volunteered first-year students for two semesters. The purposes of this paper are firstly, to emphasize factors which directly affect the performance of our students negatively. Secondly, to examine whether the proposed tool would improve their performance and learning progression. The results of adopting this tool were conducted using a pre-survey and post-survey questionnaire. As a result, students who used the learning tool showed better performance in their programming subject.

Keywords: factors, novice, programming, visualization

Procedia PDF Downloads 363

Authors: Paul W. Murray

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This research explores the relationship between leadership style and continuous improvement (CI) teams. CI teams have several features that are not always found in other types of teams, including multi-functional members, short time period for performance, positive and actionable results, and exposure to senior leadership. There is not only one best style of leadership for these teams. Instead, it is important to select the best leadership style for the situation. The leader must have the flexibility to change styles and the skill to use the chosen style effectively in order to ensure the team’s success.

Keywords: leadership style, lean manufacturing, teams, cross-functional

Procedia PDF Downloads 372

Authors: Muhammad Rizwan Tariq, Muhammad Issa Khan, Zulfiqar Ahmad, Muhammad Adnan Nasir, Muhammad Sameem Javed, Sheraz Ahmed

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Functional foods may be a good tool that can be simply utilized in reducing community health expenses. Regular consumption of rabbit meat can offer patrons with bioactive components because the manipulation in rabbit feed is much successful to raise the levels of conjugated linoleic acid, ecosapentaenoic acid, decosahexaenoic acid, polyunsaturated fatty acids, selenium, tocopherol etc. and to reduce the ω-3/ω-6 ratio which is performing a major role in curing of cardiovascular and several other diseases. In comparison to the meats of other species, rabbit meat has higher amounts of protein with essential amino acids, especially in the muscles and low cholesterol contents that also have elevated digestibility. The present study was carried out to develop the functional rabbit meat by modifying feed ingredient of rabbit diet. Thirty-day old rabbits were fed with feeds containing 2 % and 4 % oat. The feeding trial was carried out for eight weeks. Rabbits were divided into three different groups and reared for the period of two months. T0 rabbits were considered control group while T1 rabbits were reared on 4% oat, and T2 were on 2% oat in the feed. At the end of the 8 weeks, the rabbits were slaughtered. Results presented in this study concluded that 4 % oat seed supplementation enhanced n-3 PUFA in meat. It was observed that oat seed supplementation also reduced fat percentage in the meat. Utilization of oat in the feed of rabbits significantly affected the pH, protein, fat, textural and concentration of polyunsaturated fatty acids. A study trial was conducted in order to examine the impact of functional meat on the blood lipid profile of human subjects. They were given rabbit meat in comparison to the chicken meat for the period of one month. The cholesterol, triglycerides and low density lipoprotein were found to be lower in blood serum of human subject group treated with 4 % oat meat.

Keywords: functional food, functional rabbit meat, meat quality, rabbit

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Authors: Marios Loucas, Rafael Loucas, Oliver Muensterer

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Aim of the Study: Over the last two years, there has been a substantial rise of refugees entering Germany, of which approximately one-third are underage. Little is known about the general state of health such as nutrition, dental status and post-traumatic stress disorder among underage refugees. Our study assesses the general health status of underage refugees based on a large sample cohort. Methods: After ethics board approval, we used a structured questionnaire to collect demographic information and health-related elements in 3 large refugee accommodation centers, focusing on nutritional and dental status, as well as symptoms of posttraumatic stress disorder. Main results: A total of 461 minor refugees were included. The majority were boys (54.5%), average age was 8 years. Out of the 8 recorded countries of origin, most children came from Syria (33.6%), followed by Afghanistan (23.2%). Of the participants, 50.3% reported DSM-5 criteria of Posttraumatic stress disorder and presented mental health-related problems. The most frequently reported mental abnormalities were concentration disturbances (15.2%), sleep disorders (6.9%), unclear headaches (5.4%). The majority of the participants showed an unfavorable nutritional and dental status. According to the family, the majority of the children rarely eat healthy foods such as fruits, vegetables and fish. However, the majority of these children (over 90%) consume a large quantity of sugary foods and sweetened drinks such as soft drinks and confectionery at least daily. Caries was found in 63% of the minor children included in the study. A large proportion (47%) reported never brushing their teeth. According to the family, 78.3% of refugee children have never been evaluated by a dentist in Germany. The remainder visited a dentist mainly because of unbearable toothache. Conclusions: Minor refugees have specific psychological, nutritional and dental problems that must be considered in order to ensure appropriate medical care. Posttraumatic stress disorder is mainly caused by physical and emotional trauma suffered either during the flight or in the refugee camp in Germany. These data call for widespread screening of psychological, dental and nutritional problems in underage refugees. Dental care of this cohort is completely inadequate. Nutritional programs should focus on educating the families and providing the means to obtain healthy foods for these children.

Keywords: children, nutrition, posttraumatic stress disorder, refugee

Procedia PDF Downloads 172

Authors: Rasmila Kawan, Sanjay Juvekar, Sandeep Salvi, Gufran Beig, Rainer Sauerborn

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Background: Indoor air pollution especially from the use of biomass fuels, remains a potentially large global health threat. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, most seriously affecting women and young children. Objectives: The main aim of this study was to measure and compare the lung function of the women exposed in the biomass fuels and LPG fuels and relate it to the indoor emission measured using a structured questionnaire, spirometer and filter based low volume samplers respectively. Methodology: This cross-sectional comparative study was conducted among the women (aged > 18 years) living in rural villages of Pune district who were not diagnosed of chronic pulmonary diseases or any other respiratory diseases and using biomass fuels or LPG for cooking for a minimum period of 5 years or more. Data collection was done from April to June 2017 in dry season. Spirometer was performed using the portable, battery-operated ultrasound Easy One spirometer (Spiro bank II, NDD Medical Technologies, Zurich, Switzerland) to determine the lung function over Forced expiratory volume. The primary outcome variable was forced expiratory volume in 1 second (FEV1). Secondary outcome was chronic obstruction pulmonary disease (post bronchodilator FEV1/ Forced Vital Capacity (FVC) < 70%) as defined by the Global Initiative for Obstructive Lung Disease. Potential confounders such as age, height, weight, smoking history, occupation, educational status were considered. Results: Preliminary results showed that the lung function of the women using Biomass fuels (FEV1/FVC = 85% ± 5.13) had comparatively reduced lung function than the LPG users (FEV1/FVC = 86.40% ± 5.32). The mean PM 2.5 mass concentration in the biomass user’s kitchen was 274.34 ± 314.90 and 85.04 ± 97.82 in the LPG user’s kitchen. Black carbon amount was found higher in the biomass users (black carbon = 46.71 ± 46.59 µg/m³) than LPG users (black carbon=11.08 ± 22.97 µg/m³). Most of the houses used separate kitchen. Almost all the houses that used the clean fuel like LPG had minimum amount of the particulate matter 2.5 which might be due to the background pollution and cross ventilation from the houses using biomass fuels. Conclusions: Therefore, there is an urgent need to adopt various strategies to improve indoor air quality. There is a lacking of current state of climate active pollutants emission from different stove designs and identify major deficiencies that need to be tackled. Moreover, the advancement in research tools, measuring technique in particular, is critical for researchers in developing countries to improve their capability to study the emissions for addressing the growing climate change and public health concerns.

Keywords: black carbon, biomass fuels, indoor air pollution, lung function, particulate matter

Procedia PDF Downloads 174

Authors: Krisztina Bohacs, Klaudia Markus

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To author’s best knowledge we are in absence of studies on cognitive program evaluation and we are certainly short of programs that prove to have high effect sizes with strong retention results. The purpose of our study was to investigate the effectiveness of a comprehensive cognitive training program, namely BrainRx. This cognitive rehabilitation program target and remediate seven core cognitive skills and related systems of sub-skills through repeated engagement in game-like mental procedures delivered one-on-one by a clinician, supplemented by digital training. A larger sample of children with learning disability were given pretest and post-test cognitive assessments. The experimental group completed a twenty-week cognitive training program in a BrainRx center. A matched control group received another twenty-week intervention with Feuerstein’s Instrumental Enrichment programs. A second matched control group did not receive training. As for pre- and post-test, we used a general intelligence test to assess IQ and a computer-based test battery for assessing cognition across the lifespan. Multiple regression analyses indicated that the experimental BrainRx treatment group had statistically significant higher outcomes in attention, working memory, processing speed, logic and reasoning, auditory processing, visual processing and long-term memory compared to the non-treatment control group with very large effect sizes. With the exception of logic and reasoning, the BrainRx treatment group realized significantly greater gains in six of the above given seven cognitive measures compared to the Feuerstein control group. Our one-year retention measures showed that all the cognitive training gains were above ninety percent with the greatest retention skills in visual processing, auditory processing, logic, and reasoning. The BrainRx program may be an effective tool to establish long-term cognitive changes in case of students with learning disabilities. Recommendations are made for treatment centers and special education institutions on the cognitive training of students with special needs. The importance of our study is that targeted, systematic, progressively loaded and intensive brain training approach may significantly change learning disabilities.

Keywords: cognitive rehabilitation training, cognitive skills, learning disability, permanent structural cognitive changes

Procedia PDF Downloads 202

Authors: Jianlun Zhang, Christine Lim

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Local food is one of the most attractive elements to tourists. The role of local cuisine in destination branding is very important because it is the distinctive identity that helps tourists remember the destination. The objectives of this study are: (1) Test the direct relation between the cognitive image of destination food and tourists’ intention to eat local food. (2) Examine the mediating effect of tourists’ desire to try destination food on the relationship between the cognitive image of local food and tourists’ intention to eat destination food. (3) Study the moderating effect of tourists’ perceived difficulties in finding local food on the relationship between tourists’ desire to try destination food and tourists’ intention to eat local food. To achieve the goals of this study, Macanese cuisine is selected as the destination food. Macau is located in Southeastern China and is a former colonial city of Portugal. The taste and texture of Macanese cuisine are unique because it is a fusion of cuisine from many countries and regions of mainland China. As people travel to seek authentically exotic experience, it is important to investigate if the food image of Macau leaves a good impression on tourists and motivate them to try local cuisine. A total of 449 Chinese tourists were involved in this study. To analyze the data collected, partial least square-structural equation modelling (PLS-SEM) technique is employed. Results suggest that the cognitive image of Macanese cuisine has a direct effect on tourists’ intention to eat Macanese cuisine. Tourists’ desire to try Macanese cuisine mediates the cognitive image-intention relationship. Tourists’ perceived difficulty of finding Macanese cuisine moderates the desire-intention relationship. The lower tourists’ perceived difficulty in finding Macanese cuisine is, the stronger the desire-intention relationship it will be. There are several practical implications of this study. First, the government tourism website can develop an authentic storyline about the evolvement of local cuisine, which provides an opportunity for tourists to taste the history of the destination and create a novel experience for them. Second, the government should consider the development of food events, restaurants, and hawker businesses. Third, to lower tourists’ perceived difficulty in finding local cuisine, there should be locations of restaurants and hawker stalls with clear instructions for finding them on the websites of the government tourism office, popular tourism sites, and public transportation stations in the destination. Fourth, in the post-COVID-19 era, travel risk will be a major concern for tourists. Therefore, when promoting local food, the government tourism website should post images that show food safety and hygiene.

Keywords: cognitive image of destination food, desire to try destination food, intention to eat food in the destination, perceived difficulties of finding local cuisine, PLS-SEM

Procedia PDF Downloads 189

Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

Procedia PDF Downloads 103

Authors: Esra Zengin, Sinan Akkar

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Reliable and accurate prediction of nonlinear structural response requires specification of appropriate earthquake ground motions to be used in nonlinear time history analysis. The current research has mainly focused on selection and manipulation of real earthquake records that can be seen as the most critical step in the performance based seismic design and assessment of the structures. Utilizing amplitude scaled ground motions that matches with the target spectra is commonly used technique for the estimation of nonlinear structural response. Representative ground motion ensembles are selected to match target spectrum such as scenario-based spectrum derived from ground motion prediction equations, Uniform Hazard Spectrum (UHS), Conditional Mean Spectrum (CMS) or Conditional Spectrum (CS). Different sets of criteria exist among those developed methodologies to select and scale ground motions with the objective of obtaining robust estimation of the structural performance. This study presents ground motion selection and scaling procedure that considers the spectral variability at target demand with the level of ground motion dispersion. The proposed methodology provides a set of ground motions whose response spectra match target median and corresponding variance within a specified period interval. The efficient and simple algorithm is used to assemble the ground motion sets. The scaling stage is based on the minimization of the error between scaled median and the target spectra where the dispersion of the earthquake shaking is preserved along the period interval. The impact of the spectral variability on nonlinear response distribution is investigated at the level of inelastic single degree of freedom systems. In order to see the effect of different selection and scaling methodologies on fragility curve estimations, results are compared with those obtained by CMS-based scaling methodology. The variability in fragility curves due to the consideration of dispersion in ground motion selection process is also examined.

Keywords: ground motion selection, scaling, uncertainty, fragility curve

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Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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Authors: Mohamed Basheer Abdul Atti Hassan

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This research paper will follow the main outlines of the Italian colonization in Libya in a historical geopolitical approach; before we reach the contemporary map. In this study, we are also concerned with following the chain's links, not as drama in time, but as a strategy in place, so that it draws to us a map of power and the distribution of political formations throughout this period within and around Libya. From the sum of these variable distributions and successive balances, we can come up with the basic principles that determined the Italian history in Libya and formed its political entity, which is a compass of guidance and an indication of the future.

Keywords: conflict, Mediterranean, colonization, political history

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Authors: Turkan Harmanbasi, Zeliha Busra Eryigit

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The Anatolian Seljuk State was established in Anatolia by the Seljuks and continued its existence between the 11th and 14th centuries. Iznik was the first capital of Anatolian Seljuks. With the conquest of Konya in 1086, this place was declared as the capital. The Anatolian Seljuk State, with its numerous cultural elements, has produced valuable and permanent works for more than two centuries. Most of the important and monumental works were built in Konya. Anatolian Seljuk Art that makes unique; the technique in his works is the difference in material and style. It has gained an important place in Islamic architecture with this feature. In this period, rich embellishment programs emerged with the use of geometrical ornaments, floral motifs and calligraphy belts. In the Anatolian Seljuks, decoration was mainly applied with façade, crown gates, doors, windows, mihrab, mimbar, cover, transition elements and minarets; built with stone, brick and wooden materials. The minarets are located adjacent to the mosques or outside, as a high place that can be reached by stairs, which is made to invite people to worship and to announce this to people. They are architectural elements that have always been important in Islamic architecture with their compositions, construction techniques and ornaments. In different countries where Islam has spread, it has gained different appearances with the influence of local traditions. In the Seljuk art, minarets have become indispensable architectural elements of mosques and masjids. Stone and brick are generally used as a material in the minarets, and in some examples it can be seen that the tile was accompanied by the material. Ornamental motifs are formed by bringing these materials side by side vertically or horizontally. The scope of this study, the decoration details of the minarets built during the Anatolian Seljuk period will be examined. As a study area, samples from various Anatolian cities, especially Konya, were selected. Aim of studying the decoration of the Anatolian Seljuk minaret can shed some light on one of the most important aspects of the Islamic architecture in Anatolia and the development of the minaret in the Islamic World.

Keywords: Anatolian Seljuk, decoration, Islamic architecture, minaret, ornament

Procedia PDF Downloads 134

Authors: Petra Suchovska

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The spirit of post-modernity remains chaotic and obscure. Geopolitical rivalries raging at the more extreme levels and the ability of intellectual community to explain the entropy of global affairs has been diminishing. The Western-led idea of globalisation imposed upon the world does not seem to bring the bright future for human progress anymore, and its architects lose much of global control, as the strong non-western cultural entities develop new forms of post-modern establishments. The overall growing cultural misunderstanding and mistrust are expressions of political impotence to deal with the inner contradictions within the contemporary phenomenon (capitalism, economic globalisation) that embrace global society. The drivers and effects of global restructuring must be understood in the context of systems and principles reflecting on true complexity of society. The purpose of this paper is to set out some ideas about how cybernetics can contribute to understanding international system structure and analyse possible world futures. “IS Cybernetics” would apply to system thinking and cybernetic principles in IR in order to analyse and handle the complexity of social phenomena from global perspective. “IS cybernetics” would be, for now, the subfield of IR, concerned with applying theories and methodologies from cybernetics and system sciences by offering concepts and tools for addressing problems holistically. It would bring order to the complex relations between disciplines that IR touches upon. One of its tasks would be to map, measure, tackle and find the principles of dynamics and structure of social forces that influence human behaviour and consequently cause political, technological and economic structural reordering, forming and reforming the international system. “IS cyberneticists” task would be to understand the control mechanisms that govern the operation of international society (and the sub-systems in their interconnection) and only then suggest better ways operate these mechanisms on sublevels as cultural, political, technological, religious and other. “IS cybernetics” would also strive to capture the mechanism of social-structural changes in time, which would open space for syntheses between IR and historical sociology. With the cybernetic distinction between first order studies of observed systems and the second order study of observing systems, IS cybernetics would also provide a unifying epistemological and methodological, conceptual framework for multilateralism and multiple modernities theory.

Keywords: cybernetics, historical sociology, international system, systems theory

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Authors: Yu Chen, Xiaoguang Yang, Lin Lin

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Traffic engineering construction is an important infrastructure for economic and social development. In the process of construction and operation, the ability to make a correct evaluation of the project's environmental impact appears to be crucial to the rational operation of existing transportation projects, the correct development of transportation engineering construction and the adoption of corresponding measures to scientifically carry out environmental protection work. Most of the existing research work on ecological and environmental impact assessment is limited to individual aspects of the environment and less to the overall evaluation of the environmental system; in terms of research conclusions, there are more qualitative analyses from the technical and policy levels, and there is a lack of quantitative research results and quantitative and operable evaluation models. In this paper, a comprehensive analysis of the ecological and environmental impacts of transportation construction projects is conducted, and factors such as the accessibility of data and the reliability of calculation results are comprehensively considered to extract indicators that can reflect the essence and characteristics. The qualitative evaluation indicators were screened using the expert review method, the qualitative indicators were measured using the fuzzy statistics method, the quantitative indicators were screened using the principal component analysis method, and the quantitative indicators were measured by both literature search and calculation. An environmental impact evaluation index system with the general objective layer, sub-objective layer and indicator layer was established, dividing the environmental impact of the transportation construction project into two periods: the construction period and the operation period. On the basis of the evaluation index system, the index weights are determined using the hierarchical analysis method, and the individual indicators to be evaluated are dimensionless, eliminating the influence of the original background and meaning of the indicators. Finally, the thesis uses the above research results, combined with the actual engineering practice, to verify the correctness and operability of the evaluation method.

Keywords: transportation construction projects, ecological and environmental impact, analysis and evaluation, indicator evaluation system

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Authors: Sung Ho Oh

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The advanced traffic lights, the system of traffic information collection and provision, the CCTVs for traffic control, and the traffic information center were installed in Asuncion, capital of Paraguay. After pre-post comparison of the installation, significant changes were found. Even though the traffic volumes were increased, travel speed was higher, so that travel time from origin to destination was decreased. the saving values for travel time, gas cost, and environmental cost are about 47 million US dollars per year. Satisfaction survey results for the installation were presented with statistical significance analysis.

Keywords: advanced transport management systems, effectiveness, Paraguay, traffic lights

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Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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Authors: Pablo González Álvarez, Anna Vinaixa Vergés, Paula Sol Ventura, Paula Fernández, Mercè Redorta, Gemma Ginovart Galiana, Maria Méndez Hernández

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Context: The use of music therapy is gaining popularity worldwide, and it has shown positive effects in neonatology. Hospital Germans Trias i Pujol has recently established a music therapy unit and initiated a project in their neonatal intensive care unit (NICU). Research Aim: The aim of this study is to measure the effect of a music therapy intervention in the NICU of Hospital Germans Trias i Pujol in Spain. Methodology: The study will be an observational analytical case-control study. All newborns admitted to the neonatology unit, both term and preterm, and their parents will be offered a session of music therapy. Data will be collected from families who receive at least two music therapy sessions. Maternal and paternal anxiety levels will be measured through a pre- and post-intervention test. Findings: The study aims to demonstrate the benefits and acceptance of music therapy by patients, parents, and healthcare workers in the neonatal unit. The findings are expected to show a reduction in maternal and paternal anxiety levels following the music therapy sessions. Theoretical Importance: This study contributes to the growing body of literature on the effectiveness of music therapy in neonatal care. It will provide evidence of the acceptance and potential benefits of music therapy in reducing anxiety levels in both parents and babies in the NICU setting. Data Collection: Data will be collected from families who receive at least two music therapy sessions. This will include pre- and post-intervention test results to measure anxiety levels. Analysis Procedures: The collected data will be analyzed using appropriate statistical methods to determine the impact of music therapy on reducing anxiety levels in parents. Questions Addressed: - What is the effect of music therapy on maternal anxiety levels? - What is the effect of music therapy on paternal anxiety levels? - What is the acceptability and perceived benefits of music therapy among patients and healthcare workers in the NICU? Conclusion: The study aims to provide evidence supporting the value of music therapy in the neonatal intensive care unit. It seeks to demonstrate the positive effect of music therapy on reducing anxiety levels among parents.

Keywords: neonatology, music therapy, neonatal intensive care unit, babies, parents

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Authors: Beth Vale

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Academic research has often neglected the city after dark. Surprisingly little consideration has been given to the every night life of cities: the spatial tactics and creative insurgencies of urban residents when night falls. The focus on ‘pleasure’ in the nocturnal city has often negated the subtle politics of night-time play, embedded in expressions of identity, attachment and resistance. This paper investigates Johannesburg nightclubs as sites of quotidian political labour, through which young people contest social space and their place in it, thereby contributing to the city’s effective and socio-political cartography. The tactical remodelling of the nocturnal city through nightclubbing traces lines of desire (material, emotional, sexual), affiliation, and fear. These in turn map onto young people’s expressions of their social and political identities, as well as their attempts at place-making in a ‘post-apartheid’ context. By examining the micro-politics of the cities' nightclubs, this paper speaks back to an earlier post-94 literature, which regularly characterised Johannesburg youth as superficial, individualist and idealistic. Similarly, some might position nightclubs as sites of frivolous consumption or liberatory permissiveness. Yet because nightclub spaces are racialised, classed and gendered, historically-signified and socially regulated, they are also profoundly political. Through ordinary encounters on the cities' dancefloors, young Jo’burgers are imagining, contesting and negotiating their socio-political identities and indeed their claims to the city. Meanwhile, the politics of this generation of youth, who are increasingly critical of the utopian post-apartheid city, are being increasingly inserted and coopted into night-time cultures. Data for this study was gathered through five months of ethnographic fieldwork in Johannesburg nightclubs, including over 120 hours of participant observation and in-depth interviews with organisers and partygoers. Interviewees recognised that parties, rather than being simple frivolity, are a cacophony of celebration, mourning, worship, rage, rebellion and attachment. Countering standard associations between partying and escapism, party planners, venue owners and nightclub audiences were infusing night-time infrastructures with the aesthetics of politics and protest. Not unlike parties, local political assemblies so often rely on music, dance, the occupation of space, and a heaving crowd. References to social movements, militancy and anti-establishment emerged in nightclub themes, dress codes and décor. Metaphors of fire crossed over between party and protest, both of which could be described as having ‘been lit’ or having ‘brought flames’. More so, young people’s articulations of the city’s night-time geography, and their place in it, reflected articulations of race, class and ideological affiliation. The location, entrance fees and stylistic choices of one’s chosen club destination demarcated who was welcome, while also signalling membership to a particular politics (whether progressive or materialistic, inclusive or elitist, mainstream or counter-culture). Because of their ability to divide and unite, aggravate and titillate, mask and reveal, club cultures might offer a mirror to the complex socialities of a generation of Jo’burg youth, as they inhabit, and bring into being, a contemporary South African city.

Keywords: affect, Johannesburg, nightclub, nocturnal city, politics

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Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev

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Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.

Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP

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Authors: F. Rarbi, D. Dzahini, W. Uhring

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In this paper, a dynamic and power efficient 8-bit and 100-MSPS Successive Approximation Register (SAR) Analog-to-Digital Converter (ADC) is presented. The circuit uses a non-differential capacitive Digital-to-Analog (DAC) architecture segmented by 2. The prototype is produced in a commercial 65-nm 1P7M CMOS technology with 1.2-V supply voltage. The size of the core ADC is 208.6 x 103.6 µm². The post-layout noise simulation results feature a SNR of 46.9 dB at Nyquist frequency, which means an effective number of bit (ENOB) of 7.5-b. The total power consumption of this SAR ADC is only 1.55 mW at 100-MSPS. It achieves then a figure of merit of 85.6 fJ/step.

Keywords: CMOS analog to digital converter, dynamic comparator, image sensor application, successive approximation register

Procedia PDF Downloads 418

Authors: Gabriela R. Silveira, Claudia S. Rocha, Lais S. Vitti, Jeane L. Borges, Helen B. Durgante

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Emerging adulthood occurs after adolescence in a period that maybe be marked by experimentation, identity reconfigurations, labor life demands, and insertion in the work environment, which tends to generate stress and emotional instability. Health promotion programs for the development of strengths and virtues, based on Positive Psychology, for emerging adults are sparse in Brazil. The aim of this study was to evaluate the preliminary effects of an online multi-component Positive Psychology program for the health promotion of emerging adults based on Cognitive Behavioural Therapy and Positive Psychology. The program included six online (synchronous) weekly group sessions of approximately two hours each and homework (asynchronous) activities. The themes worked were Values and self-care/Prudence, Optimism, Empathy, Gratitude, Forgiveness, and Meaning of life and work. This study presents data from a longitudinal, pre-experimental design with pre (T1) and post-test (T2) evaluation in the intervention group. 47 individuals aged between 19-30 years old participated, mean age of 24.53 years (SD=3.13), 37 females (78.7%). 42 (89.4%) self-defined as heterosexual, four (8.5%) as homosexual, and one (2.5%) as bisexual. 33 (70.2%) had incomplete higher education, four (8.5%) completed higher education, and seven (14.9%) had a graduate level of education. 27 participants worked (57.4%), out of which 25 were health workers (53.2%). 14 (29.8%) were caregivers, 27 (57.4%) had a spiritual belief, 36 (76.6%) had access to leisure, and 38 (80.9%) had perceived social support. The instruments used were a sociodemographic questionnaire, the 10-item Perceived Stress Scale, and the 12-item General Health Questionnaire. The program was advertised on social networks and interested participants filled out the Consent Form and the evaluation protocol at T1 and T2 via Google Docs form. The main research was approved (CEP n.1,899,368; 4,143,219; CAAE: 61997516.5.0000.5334) and complied with sanitary and Ethics criteria in research with human beings. Wilcoxon statistics revealed significant improvements in indicators of perceived stress between T1 (X=22.21, SD=6.79) and T2 (X=15.10, SD=5.82); (Z=-4.353; p=0.001) as well as depression and anxiety symptoms (T1:X=26.72, SD=8.84; T2: X=19.23, SD=4.68); (Z=-3.945, p=0.001) of the emerging adults after their participation in the programme. The programme has an innovative character not only for presenting an online Positive Psychology approach but also for being based on an intervention developed, evaluated, and manualized in Brazil. By focusing on emerging adults, this study contributes to advancing research on a relatively new field in developmental studies. As a limitation, this is a pre-experimental and pilot study, requiring an increase in sample size for greater statistical robustness, also qualitative data analysis is crucial for methodological complementarity. The importance of investing efforts to accompany this age group and provide advances in longitudinal research in the area of health promotion and disease prevention is highlighted.

Keywords: emerging adults, disease prevention, health promotion, online program

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Authors: Miao Li, Mengyuan Xu

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As a low-carbon travel mode, bicycling has drawn increasing political interest in the contemporary Chinese urban context, and the public sharing bikes have become the most popular ways of bike usage in China now. This research aims to explore the spatial-temporal relationship between sharing bike usage and different characteristics of the urban street built environment. In the research, street segments were used as the analytic unit of the street built environment defined by street intersections. The sharing bike usage data in the research include a total of 2.64 million samples that are the entire sharing bike distribution data recorded in two days in 2018 within a neighborhood of 185.4 hectares in the city of Wuhan, China. And these data are assigned to the 97 urban street segments in this area based on their geographic location. The built environment variables used in this research are categorized into three sections: 1) street design characteristics, such as street width, street greenery, types of bicycle lanes; 2) condition of other public transportation, such as the availability of metro station; 3) Street function characteristics that are described by the categories and density of the point of interest (POI) along the segments. Spatial Lag Models (SLM) were used in order to reveal the relationships of specific urban streets built environment characteristics and the likelihood of sharing bicycling usage in whole and different periods a day. The results show: 1) there is spatial autocorrelation among sharing bicycling usage of urban streets in case area in general, non-working day, working day and each period of a day, which presents a clustering pattern in the street space; 2) a statistically strong association between bike sharing usage and several different built environment characteristics such as POI density, types of bicycle lanes and street width; 3) the pattern that bike sharing usage is influenced by built environment characteristics depends on the period within a day. These findings could be useful for policymakers and urban designers to better understand the factors affecting bike sharing system and thus propose guidance and strategy for urban street planning and design in order to promote the use of sharing bikes.

Keywords: big data, sharing bike usage, spatial statistics, urban street built environment

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Authors: Jeremy Ritchey

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Undocumented immigrants in the U.S. face many challenges when looking to progress in society, especially when pursuing post-secondary education. The majority of research done on state-level policy adoption pertaining to undocumented higher-education pursuits, specifically in-state resident tuition and financial aid eligibility policies, have framed the discussion on the potential and actual impacts which implementation can and has achieved. What is missing is a model to view the social, political and demographic landscapes upon which such policies (in their various forms) find a route to legislative enactment. This research looks to address this gap in the field by investigating the correlations and significant state-level variables which can be operationalized to construct a framework for adoption of these specific policies. In the process, analysis will show that past unexamined conceptualizations of how such policies come to fruition may be limited or contradictory when compared to available data. Circling on the principles of Policy Innovation and Policy Diffusion theory, this study looks to use variables collected via Michigan State University’s Correlates of State Policy Project, a collectively and ongoing compiled database project centered around annual variables (1900-2016) collected from all 50 states relevant to policy research. Using established variable groupings (demographic, political, social capital measurements, and educational system measurements) from the time period of 2000 to 2014 (2001 being when such policies began), one can see how this data correlates with the adoption of policies related to undocumented students and in-state college tuition. After regression analysis, the results will illuminate which variables appears significant and to what effect, as to help formulate a model upon which to explain when adoption appears to occur and when it does not. Early results have shown that traditionally held conceptions on conservative and liberal identities of the state, as they relate to the likelihood of such policies being adopted, did not fall in line with the collected data. Democratic and liberally identified states were, overall, less likely to adopt pro-undocumented higher education policies than Republican and conservatively identified states and vis versa. While further analysis is needed as to improve the model’s explanatory power, preliminary findings are showing promise in widening our understanding of policy adoption factors in this realm of policies compared to the gap of such knowledge in the publications of the field as it currently exists. The model also looks to serve as an important tool for policymakers in framing such potential policies in a way that is congruent with the relevant state-level determining factors while being sensitive to the most apparent sources of potential friction. While additional variable groups and individual variables will ultimately need to be added and controlled for, this research has already begun to demonstrate how shallow or unexamined reasoning behind policy adoption in the realm of this topic needs to be addressed or else the risk is erroneous conceptions leaking into the foundation of this growing and ever important field.

Keywords: policy adoption, in-state tuition, higher education, undocumented immigrants

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Authors: Emma Van Schie

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The purpose of this study is to use mixed methods research to create typologies of the performance of firms in the cotton-to-clothing value chain in Zimbabwe, and to use these typologies to achieve the objective of adding to the small pool of studies on Sub-Saharan African value chains performing in the context of economic liberalisation and achieving development. The uptake of economic liberalisation measures across Sub-Saharan Africa has led to the restructuring of many value chains. While this action has resulted in some African economies positively reintegrating into global commodity chains, it has also been deeply problematic for the development impacts of the majority of others. Over and above this, these nations have been placed at a disadvantage due to the fact that there is little scholarly and policy research on approaches for managing economic liberalisation and value chain development in the unique African context. As such, the central question facing these less successful cases is how they can integrate into the world economy whilst still fostering their development. This paper draws from quantitative questionnaires and qualitative interviews with 28 stakeholders in the cotton-to-clothing value chain in Zimbabwe. This paper examines the performance of firms in the value chain, and the subsequent local socio-economic development impacts that are affected by the revival of the cotton-to-clothing value chain following its collapse in the wake of Zimbabwe’s uptake of economic liberalisation measures. Firstly, the paper finds the relatively undocumented characteristics and structures of firms in the value chain in the post-economic liberalisation era. As well as this, it finds typologies of the status of firms as either being in operation, closed down, or being placed under judicial management and the common characteristics that these typologies hold. The key findings show how a mixture of macro and local level aspects, such as value chain governance and the management structure of a business, leads to the most successful typology that is able to add value to the chain in the context of economic liberalisation, and thus unlock its socioeconomic development potential. These typologies are used in making industry and policy recommendations on achieving this balance between the macro and the local level, as well as recommendations for further academic research for more typologies and models on the case of cotton value chains in Sub-Saharan Africa. In doing so, this study adds to the small collection of academic evidence and policy recommendations for the challenges that African nations face when trying to incorporate into global commodity chains in attempts to benefit from their associated socioeconomic development opportunities.

Keywords: cotton-to-clothing value chain, economic liberalisation, restructuring value chain, typologies of firms, value chain governance, Zimbabwe

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Authors: Elisangela Sobreira, Denise Teixeira

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Visceral leishmaniasis is a public health problem in Brazil, it is the main reservoir dog. In the period 2012-2016 78 diagnoses were performed in dogs suspected. Blood samples were collected from the cephalic vein obtaining serum used for the indirect immunofluorescence test and enzyme-linked immunosorbent assay, while it collected a drop of blood for the rapid chromatographic immunoassay. Obtained in 32 dogs positive. The test is important for the control of this disease and is used routinely in the Zoonoses Control Center.

Keywords: Brazil, dogs, Leismaniasis, Zoonoses center

Procedia PDF Downloads 261