Search results for: inpatient leave
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 500

Search results for: inpatient leave

290 Strengthening Deradicalizing Islamist Extremism in Indonesia: A Victim-Centred Approach

Authors: Milda Istiqomah

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Deradicalization program has long been the subject of investigation. There is a steadily growing interest in examining the results on how Islamist terrorists agree to abandon violence and leave radicalism; however, it is argued that de-radicalization program on terrorism in many countries is still questionable for its effectiveness. This article aims to provide an overview of the deradicalization program specifically related to the victim-centred approach conducted by the Indonesian government and investigates critical issues surrounding the analysis of their effectiveness and outcomes. This research employs several case studies of a victim-centred approach conducted by the Indonesian Witness and Victim Protection Agency as well as the Indonesian Counter-terrorism Agency. This paper argues that the victim-centred approach to de-radicalize former terrorist prisoners faces several implemental challenges; however, the initiative may offer promise for future successful de-radicalization program. Furthermore, until more data surrounding the efficacy of this initiative available, the victim-centred approach may also constitute a significant and essential component of disengagement, de-radicalisation, and reintegration of terrorist prisoners. In conclusion, this paper suggests that further empirical research concerning prevention policies and disengagement interventions related to victim-centred approach need to be explored to give more inputs to the Indonesian government to achieve the effectiveness of de-radicalization program.

Keywords: terrorism, victim-centred approach, de-radicalization, Islamist extremism

Procedia PDF Downloads 288
289 Efficiency of Grover’s Search Algorithm Implemented on Open Quantum System in the Presence of Drive-Induced Dissipation

Authors: Nilanjana Chanda, Rangeet Bhattacharyya

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Grover’s search algorithm is the fastest possible quantum mechanical algorithm to search a certain element from an unstructured set of data of N items. The algorithm can determine the desired result in only O(√N) steps. It has been demonstrated theoretically and experimentally on two-qubit systems long ago. In this work, we investigate the fidelity of Grover’s search algorithm by implementing it on an open quantum system. In particular, we study with what accuracy one can estimate that the algorithm would deliver the searched state. In reality, every system has some influence on its environment. We include the environmental effects on the system dynamics by using a recently reported fluctuation-regulated quantum master equation (FRQME). We consider that the environment experiences thermal fluctuations, which leave its signature in the second-order term of the master equation through its appearance as a regulator. The FRQME indicates that in addition to the regular relaxation due to system-environment coupling, the applied drive also causes dissipation in the system dynamics. As a result, the fidelity is found to depend on both the drive-induced dissipative terms and the relaxation terms, and we find that there exists a competition between them, leading to an optimum drive amplitude for which the fidelity becomes maximum. For efficient implementation of the search algorithm, precise knowledge of this optimum drive amplitude is essential.

Keywords: dissipation, fidelity, quantum master equation, relaxation, system-environment coupling

Procedia PDF Downloads 73
288 COVID-19 and Heart Failure Outcomes: Readmission Insights from the 2020 United States National Readmission Database

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

Procedia PDF Downloads 49
287 The Role of Employee Incentives in Financing from Customers

Authors: Mengyu Lu, Yongsheng Guo

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This study investigates how employee incentives affect employee performance in financing from customers. This study followed a grounded theory approach where data were collected through 29 interviews. Main themes and categories were identified through the coding processes. This study found that casual conditions, including financial barriers, informal finance, business location, customer base and customer relationship, influenced the adoption of customer finance in the case of SMEs. The SMEs build and maintain long-term relationships with customers through personal communications. The SMEs engage and motivate employees in customer communications and business financing strategy through financial incentives programs, including bonuses, salary rises, rewards and non-financial incentives, including training opportunities, extra holiday leave, and flexible working hours. Employee performance was measured through financing contribution and job contribution. As a consequence, customers will be well served by employees and get a better customer experience. SMEs can get benefits such as employee engagement, employee satisfaction and sustainable financing sources. This study gets in sight of employee incentives in improving employee performance in customer finance and makes implications to human capital theories. Suggestions are provided to the decision-makers in businesses as incentive programs improve employee performance that, eventually contributes to overall business performance.

Keywords: SMEs, financing from customers, employee incentives, performance-based measurement

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286 The Use of Neuter in Oedipus Lines to Refer to Antigone in Phoenissae of Seneca

Authors: Cíntia Martins Sanches

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In the first part of Phoenissae of Seneca, Antigone is a guide to Oedipus, and they leave Thebes: he is blind searching for death (inflicting the punishment himself wished on the killer of Laius, ie exile and death); she is trying to convince him to give up such punishment and bring him back to Thebes. Concerning Oedipus lines, we observed a high frequency of Latin neuter in the treatment the protagonist gave to his daughter Antigone. We considered in this study that such frequency may be related to the sanctification of the daughter, who is seen by him as an enlightened being and without defects, free of the human condition (which takes on the existence of failures by essence). This study, thus, puts forward an analysis of the passages the said feature is present, relating them to the effect of meaning found in each occurrence. As part of a doctorate, this study investigates the stylistic idiom of Seneca in the Oedipus and Phoenissae tragedies, aiming at translating both tragedies expressively. The concept of stylistic idiom concerns the stylistic affinity required for a translation to be equivalent to the source text. In this wise, this study inquires into how the Latin text is organized poetically, pointing out the expressive features frequently appearing in both dramas. The method we used is based on the Semiotics theory — observing how connotation, ie a language use in which prevails the poetic function, naturally polysemous, acts to achieve each expressive effect.

Keywords: antigone, neuter, Oedipus, Phoenissae, Seneca

Procedia PDF Downloads 261
285 Return to Bowel Function after Right versus Extended Right Hemicolectomy: A Retrospective Review

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

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Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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284 Women Presentation and Roles in Arab-Israeli Female Filmmakers Movies

Authors: Mariam Farah

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With the beginning of the 21 century, female Arab directors entered the industry of cinema in Israel. Before their entrance, the Palestinian cinema, directed in Israel and in other places in the world, was defined as political-masculine cinema. The recent research wonders if the entrance of female directors to the Arab-Israeli cinema brings a new, feminist and un- common discourse, just like female directors movies in other cultures. The research also examines which gendered, social and political identities or statements do the Arab female directors reveal in their works, and what do they say about their real life? In order to get answers to the previous questions, the paper conducts a narrative comparative research between movies that was directed by female and male Arab-Israeli directors. The narrative research examines specific categories in each movie such as: main topic, women role, women appearance and women characteristics. The findings show that a new discourse replaces the political-masculine traditional discourse in the Palestinian cinema. Female Arab directors in Israel leave aside the main theme in Palestinian movies: the Israeli-Palestinian conflict, and replace it with new themes related to women lives and reality. Women in female directors movies are presented within non-traditional, empowering, and feminist identities: independent, strong, and active women.

Keywords: feminism, gender, women presentation, women roles

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283 Policies and Practice of Refugee Education from Malaysian Perspective: Preliminary Findings

Authors: A. H. A. Hamid, N. A. Zainuddin, M. Y. M. Nor

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Millions of child refugees leave their countries in the hope of better and safer lives particularly in the aspect of education. However, the education access for the child refugees is strongly depending on the policies made by the federal and local governments. Malaysia, in particular, is a country which does not have a specific educational policy that is inclusive of child refugees. Hence, this study explores the feasibility of possible educational policy that specifically caters the needs of child refugees in Malaysia. These are preliminary findings of a case study which involved thirty-five postgraduate students in a local university who undertook Educational Policy coursework and five teachers in a refugee community centre in Kuala Lumpur, Malaysia. Interviews were recorded, transcribed and thematically analysed in relation to issues highlighted in the refugee education literature. The findings showed that most of the informants felt there is an urgent need of a systematic intervention put in place by the local government to cater to the needs of equal education access to the child refugees. A further large scale study is needed in the near future by integrating different perspectives of relevant stakeholders for an effective, efficient and sustainable policy formulation and implementation related to child refugees in Malaysia. The findings may be of interests to the educators, the ministry of education, state education office, district education office, teachers, parents and surrounding communities for their awareness about the needs of refugee education and the feasibility of educational policy for child refugees in the country.

Keywords: child refugees, educational policy, inclusive education, Malaysia

Procedia PDF Downloads 117
282 Reconstructed Phase Space Features for Estimating Post Traumatic Stress Disorder

Authors: Andre Wittenborn, Jarek Krajewski

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Trauma-related sadness in speech can alter the voice in several ways. The generation of non-linear aerodynamic phenomena within the vocal tract is crucial when analyzing trauma-influenced speech production. They include non-laminar flow and formation of jets rather than well-behaved laminar flow aspects. Especially state-space reconstruction methods based on chaotic dynamics and fractal theory have been suggested to describe these aerodynamic turbulence-related phenomena of the speech production system. To extract the non-linear properties of the speech signal, we used the time delay embedding method to reconstruct from a scalar time series (reconstructed phase space, RPS). This approach results in the extraction of 7238 Features per .wav file (N= 47, 32 m, 15 f). The speech material was prompted by telling about autobiographical related sadness-inducing experiences (sampling rate 16 kHz, 8-bit resolution). After combining these features in a support vector machine based machine learning approach (leave-one-sample out validation), we achieved a correlation of r = .41 with the well-established, self-report ground truth measure (RATS) of post-traumatic stress disorder (PTSD).

Keywords: non-linear dynamics features, post traumatic stress disorder, reconstructed phase space, support vector machine

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281 Medical/Surgical Skills Day Improves Nurse Competence and Satisfaction

Authors: Betsy Hannam

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Background: Staff nurses felt overwhelmed to learn new skills or complete competencies during their shift. Med/Surg units need to provide dedicated, uninterrupted time to complete training and mandatory competencies and practice skills. Purpose: To improve nurse satisfaction and competence by creating a Skills Day with uninterrupted time to complete competencies, brush up on skills, and evaluate skills learned through pre- and post-tests. Methods: The USL and CNL interviewed nurses to obtain input regarding skills needing reinforcement and included mandatory competencies relevant to Med/Surg to create the Skills Day agenda. Content experts from multiple disciplines were invited to educate staff to help address knowledge gaps. To increase attendance, multiple class days were offered. Results: 2018 Skills Day was held for an inpatient unit with 95% participation (n=35 out of 37RNs). The average pretest score, comprised of content questions from topics discussed, was 57%, and post test scoresaveraged 80%. 94% of test scores improved or remained the same. RNs were given an evaluation at the end of the day, where100% of staff noted Skills Day as beneficial, and 97% requested to repeat next year. Another Med/Surg unit asked to join Skills Day in 2019. In 2019, with 89% participation (n=57 out 64 RNs), the average pretest score was 68%, and the average post test score was 85%. 97% of scores improved or remained the same. 98% reported the class as beneficial, and 96% requested to repeat next year. Skills Day 2020-2022 on hold due to COVID. Looking forward to Skills Day 2023. Conclusion: Skills Day allows nurses to maintain competencies and improve knowledge in areas of interest without the stress of a patient assignment. Having unit leaders organize Skills Day, with the involvement of content experts from multiple disciplines, showed to be a successful and innovative team approach to support professional development.

Keywords: education, competency, skills day, medical/surgical

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280 Conformation Prediction of Human Plasmin and Docking on Gold Nanoparticle

Authors: Wen-Shyong Tzou, Chih-Ching Huang, Chin-Hwa Hu, Ying-Tsang Lo, Tun-Wen Pai, Chia-Yin Chiang, Chung-Hao Li, Hong-Jyuan Jian

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Plasmin plays an important role in the human circulatory system owing to its catalytic ability of fibrinolysis. The immediate injection of plasmin in patients of strokes has intrigued many scientists to design vectors that can transport plasmin to the desired location in human body. Here we predict the structure of human plasmin and investigate the interaction of plasmin with the gold-nanoparticle. Because the crystal structure of plasminogen has been solved, we deleted N-terminal domain (Pan-apple domain) of plasminogen and generate a mimic of the active form of this enzyme (plasmin). We conducted a simulated annealing process on plasmin and discovered a very large conformation occurs. Kringle domains 1, 4 and 5 had been observed to leave its original location relative to the main body of the enzyme and the original doughnut shape of this enzyme has been transformed to a V-shaped by opening its two arms. This observation of conformational change is consistent with the experimental results of neutron scattering and centrifugation. We subsequently docked the plasmin on the simulated gold surface to predict their interaction. The V-shaped plasmin could utilize its Kringle domain and catalytic domain to contact the gold surface. Our findings not only reveal the flexibility of plasmin structure but also provide a guide for the design of a plasmin-gold nanoparticle.

Keywords: docking, gold nanoparticle, molecular simulation, plasmin

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279 Antibacterial Evaluation, in Silico ADME and QSAR Studies of Some Benzimidazole Derivatives

Authors: Strahinja Kovačević, Lidija Jevrić, Miloš Kuzmanović, Sanja Podunavac-Kuzmanović

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In this paper, various derivatives of benzimidazole have been evaluated against Gram-negative bacteria Escherichia coli. For all investigated compounds the minimum inhibitory concentration (MIC) was determined. Quantitative structure-activity relationships (QSAR) attempts to find consistent relationships between the variations in the values of molecular properties and the biological activity for a series of compounds so that these rules can be used to evaluate new chemical entities. The correlation between MIC and some absorption, distribution, metabolism and excretion (ADME) parameters was investigated, and the mathematical models for predicting the antibacterial activity of this class of compounds were developed. The quality of the multiple linear regression (MLR) models was validated by the leave-one-out (LOO) technique, as well as by the calculation of the statistical parameters for the developed models and the results are discussed on the basis of the statistical data. The results of this study indicate that ADME parameters have a significant effect on the antibacterial activity of this class of compounds. Principal component analysis (PCA) and agglomerative hierarchical clustering algorithms (HCA) confirmed that the investigated molecules can be classified into groups on the basis of the ADME parameters: Madin-Darby Canine Kidney cell permeability (MDCK), Plasma protein binding (PPB%), human intestinal absorption (HIA%) and human colon carcinoma cell permeability (Caco-2).

Keywords: benzimidazoles, QSAR, ADME, in silico

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278 Impact of COVID-19 on Radiology Training in Australia and New Zealand

Authors: Preet Gill, Danus Ravindran

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These The COVID-19 pandemic resulted in widespread implications for medical specialist training programs worldwide, including radiology. The objective of this study was to investigate the impact of COVID-19 on the Australian and New Zealand radiology trainee experience and well-being, as well as to compare the Australasian experience with that reported by other countries. An anonymised electronic online questionnaire was disseminated to all training members of the Royal Australian and New Zealand College of Radiologists who were radiology trainees during the 2020 – 2022 clinical years. Trainees were questioned about their experience from the beginning of the COVID-19 pandemic in Australasia (March 2020) to the time of survey completion. Participation was voluntary. Questions assessed the impact of the pandemic across multiple domains, including workload (inpatient/outpatient & individual modality volume), teaching, supervision, external learning opportunities, redeployment and trainee wellbeing. Survey responses were collated and compared with other peer reviewed publications. Answer options were primarily in categorical format (nominal and ordinal subtypes, as appropriate). An opportunity to provide free text answers to a minority of questions was provided. While our results mirror that of other countries, which demonstrated reduced case exposure and increased remote teaching and supervision, responses showed variation in the methods utilised by training sites during the height of the pandemic. A significant number of trainees were affected by examination cancellations/postponements and had subspecialty training rotations postponed. The majority of trainees felt that the pandemic had a negative effect on their training. In conclusion, the COVID-19 pandemic has had a significant impact on radiology trainees across Australia and New Zealand. The present study has highlighted the extent of these effects, with most aspects of training impacted. Opportunities exist to utilise this information to create robust workplace strategies to mitigate these negative effects should the need arise in the future.

Keywords: COVID-19, radiology, training, pandemic

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277 Exploration of Bullying Perceptions in Adolescents in Sekolah Menengah Kejuruan Negeri 1 Manado

Authors: Madjid Nancy, Rakinaung Natalia, Lumowa Fresy

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Background: Bullying becomes one of the problems that concern the world of education, especially in adolescents, which has a negative impact on learning achievement, psychology, and physical health. The psychological impact is shame, depression, distress, fear, sadness, and anxiety, so that if prolonged leave can lead to depression in the victim. While the impact on physical health in the form of bruises on the hit area, blisters, swelling and in more severe cases will lead to death. Objectives: This study aims to explore the perception of bullying in adolescent students Sekolah Menengah Kejuruan (SMK) Negeri 1 Manado and the people associated with that adolescent students. Methods: This research uses descriptive qualitative research design and using thematic analysis, and supported by Urie Bronfenbrenner Ecological Framework. The data collection that will be used is by in-depth interview. Sampling using purposive sampling and snowball techniques. This research was conducted at SMK Negeri 1 Manado. Result: From the analysis obtained three themes with the categories: 1) the perception of bullying with categories are: Understanding of Bullying and The Impact of Bullying, 2) the originator of bullying with categories are: Fulfillment of Youth Development Tasks and Needs, Peers Influence, and Family Communication; 3) the effort to handle bullying with categories are: the Individual Coping and Teacher Role. Conclusion: This research get three themes, those are perception of bullying, bullying’s originator and the effort of handling bullying.

Keywords: adolscent, students, bullying, perception

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276 An Investigation of Sentiment and Themes from Twitter for Brexit in 2016

Authors: Anas Alsuhaibani

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Observing debate and discussion over social media has been found to be a promising tool to investigate different types of opinion. On 23 June 2016, Brexit voters in the UK decided to depart from the EU, with 51.9% voting to leave. On Twitter, there had been a massive debate in this context, and the hashtag Brexit was allocated as number six of the most tweeted hashtags across the globe in 2016. The study aimed to investigate the sentiment and themes expressed in a sample of tweets during a political event (Brexit) in 2016. A sentiment and thematic analysis was conducted on 1304 randomly selected tweets tagged with the hashtag Brexit in Twitter for the period from 10 June 2016 to 7 July 2016. The data were coded manually into two code frames, sentiment and thematic, and the reliability of coding was assessed for both codes. The sentiment analysis of the selected sample found that 45.63% of tweets conveyed negative emotions while there were only 10.43% conveyed positive emotions. It also surprisingly resulted that 29.37% were factual tweets, where the tweeter expressed no sentiment and the tweet conveyed a fact. For the thematic analysis, the economic theme dominated by 23.41%, and almost half of its discussion was related to business within the UK and the UK and global stock markets. The study reported that the current UK government and relation to campaign themes were the most negative themes. Both sentiment and thematic analyses found that tweets with more than one opinion or theme were rare, 8.29% and 6.13%, respectively.

Keywords: Brexit, political opinion mining, social media, twitter

Procedia PDF Downloads 171
275 Isolating Refugees in Mountains: The Case of the Austrian Border Regime

Authors: Deike Janssen

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In the scenery of the Tyrolean mountains, at an altitude of 1300 meters, stands a building. Residents and activists call it a prison. However, it is not a prison -according to authorities, it is a 'Return Counseling Facility' where migrants and refugees should be "motivated" to return "voluntary" to their countries of origin. This paper argues that the geographical location of the camp functions as a site of exclusion, isolation, and coercion where no one can decide “voluntary” to return, but where people are brought to despair to leave Austria. Through a qualitative case study, this paper documents the heavy impact of offshore detention on the mental, physical and social state of the residents and a variety of human rights problems in the centre. Different developments at the Return Counselling Facility and the law that back up the centre uncover a worrying dynamic that deliberately accepts human rights problems in order to enforce borders, a policy that disregards humanitarian, legal, and ethical stands in order to deport people at all hazards. It, therefore, can be seen as a creative and ultimate exercise of state power, which uses isolated locations to control migration. While the analysis revises the micro and macro implications of the facility and, therefore, the legal and political facets, it also sheds light on the role of the civil society, which tries to increase through constant and collective efforts the human rights efforts of the government.

Keywords: deportation, human rights, migration, refugee detention, voluntary return

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274 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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273 Assessment of Adsorption Properties of Neem Leaves Wastes for the Removal of Congo Red and Methyl Orange

Authors: Muhammad B. Ibrahim, Muhammad S. Sulaiman, Sadiq Sani

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Neem leaves were studied as plant wastes derived adsorbents for detoxification of Congo Red (CR) and Methyl Orange (MO) from aqueous solutions using batch adsorption technique. The objectives involved determining the effects of the basic adsorption parameters are namely, agitation time, adsorbent dosage, adsorbents particle size, adsorbate loading concentrations and initial pH, on the adsorption process as well as characterizing the adsorbents by determining their physicochemical properties, functional groups responsible for the adsorption process using Fourier Transform Infrared (FTIR) spectroscopy and surface morphology using scanning electron microscopy (SEM) coupled with energy dispersion X – ray spectroscopy (EDS). The adsorption behaviours of the materials were tested against Langmuir, Freundlich, etc. isotherm models. Percent adsorption increased with increase in agitation time (5 – 240 minutes), adsorbent dosage (100-500mg), initial concentration (100-300mg/L), and with decrease in particle size (≥75μm to ≤300μm) of the adsorbents. Both processes are dye pH-dependent, increasing or decreasing percent adsorption in acidic (2-6) or alkaline (8-12) range over the studied pH (2-12) range. From the experimental data the Langmuir’s separation factor (RL) suggests unfavourable adsorption for all processes, Freundlich constant (nF) indicates unfavourable process for CR and MO adsorption; while the mean free energy of adsorption

Keywords: adsorption, congo red, methyl orange, neem leave

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272 Can 3D Virtual Prototyping Conquers the Apparel Industry?

Authors: Evridiki Papachristou, Nikolaos Bilalis

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Imagine an apparel industry where fashion design does not begin with a paper-and-pen drawing which is then translated into pattern and later to a 3D model where the designer tries out different fabrics, colours and contrasts. Instead, imagine a fashion designer in the future who produces that initial fashion drawing in a three-dimensional space and won’t leave that environment until the product is done, communicating his/her ideas with the entire development team in true to life 3D. Three-dimensional (3D) technology - while well established in many other industrial sectors like automotive, aerospace, architecture and industrial design, has only just started to open up a whole range of new opportunities for apparel designers. The paper will discuss the process of 3D simulation technology enhanced by high quality visualization of data and its capability to ensure a massive competitiveness in the market. Secondly, it will underline the most frequent problems & challenges that occur in the process chain when various partners in the production of textiles and apparel are working together. Finally, it will offer a perspective of how the Virtual Prototyping Technology will make the global textile and apparel industry change to a level where designs will be visualized on a computer and various scenarios modeled without even having to produce a physical prototype. This state-of-the-art 3D technology has been described as transformative and“disruptive”comparing to the process of the way apparel companies develop their fashion products today. It provides the benefit of virtual sampling not only for quick testing of design ideas, but also reducing process steps and having more visibility.A so called“digital asset” that can be used for other purposes such as merchandising or marketing.

Keywords: 3D visualization, apparel, virtual prototyping, prototyping technology

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271 Montelukast Doesn’t Decrease the Risk of Cardiovascular Disease in Asthma Patients in Taiwan

Authors: Sheng Yu Chen, Shi-Heng Wang

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Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.

Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases

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270 Equal Right to Inherit: A South African Perspective

Authors: Rika van Zyl

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South Africa’s racial discrimination past has led to the drafting of the Constitution with the Bill of Rights for the people of South Africa. The Bill of Rights prohibits the state from unfairly discriminating directly or indirectly on certain grounds, one of which is race and another is gender. This has forced changes to the law of succession. The customary law rule of male primogeniture was abolished to ensure that women were not excluded from the intestate succession of the male head of the family in 2005. It was said that this rule cannot be reconciled with the notions of equality and human dignity contained in the Bill of Rights. The freedom of testation has further come under fire in South Africa, where it was found to be unfair discrimination and against public policy to exclude a specific gender (women) from inheriting in a private will. Although no one has the right to inherit in South Africa, any person with an interest can approach the court alleging that a right in the Bill of Rights has been infringed. A will that is found inconsistent with the South African Bill of Rights then cannot be enforced. Recent case law found that to leave out a specific gender (women) from a will, based entirely on the fact that they are of said specific gender, is in contravention of the Constitution and should, therefore, be declared invalid. It was said that the courts should take a transformative constitutional approach when equality rights are affected. Otherwise, the historical and insidious unequal distribution of wealth in South Africa will continue along the fault lines such as gender. This decision has opened the debate on the extent to which the state can interfere with the private autonomy of an individual who is deceased. Some of these arguments will be discussed, including the ambit of public policy in this regard.

Keywords: equality, discrimination, succession, public policy

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269 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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268 The Trauma Suffered by Left behind Children and Its Impact on Their Emotional Development: A Pilot Study with Brazilian Immigrants in the United States

Authors: Liliane Clark

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Immigrating to a different country may imply having to handle many difficult exertions. There is a particular issue that has to be endured by some immigrants: the children they had to leave behind. It is a phenomenon that occurs with certain frequency. Surprisingly, despite the fact that immigration in the United States is such a large proceeding, there is not much research about the topic in America exploring the trauma of the abandonment caused by this separation and its consequences on the mental health of those children. The term “left behind children” is usually applied to children who were left behind by their parents in their original nation under the care of a noteworthy relative, frequently the grandparents, when they moved to another country. This preliminary research, which is a partial study projected for a doctoral thesis, investigated whether the trauma of abandonment experienced by ten left behind children had affected their emotional development. The Strengths and Difficulties Questionnaire (SDQ) and a brief interview were utilized to assess the information. The SDQ explored scales such as emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behavior. In this pilot study, the results indicated that all these issues had some sort of significant correlation between them. During the interviews, the participants or their parents identified a range of symptoms: anxiety disorder, eating disorders, panic attacks, psychotic-like experiences, drug use and depression. Hence, it seems that there is a connection between the trauma of abandonment suffered due to the separation and the children’s consequent symptomatic behavior. Further studies are indeed necessary to validate the initial results of this investigation.

Keywords: abandonment, parent migration, psychological problems, trauma

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267 Identifying the Source of Stress and Coping Strategies of Undergraduate Occupational Therapy Students' of BHPI in Bangladesh

Authors: Md. Toufiq Hasan

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This research set out to explore the source of stress and coping strategies of undergraduate Occupational Therapy students’ of Bangladesh Health Professions Institute (BHPI) in Bangladesh. For that reason, a quantitative and prospective type survey has been conducted by the researcher with 27 student participants of BHPI Occupational Therapy department whose stress scores were ≥40 according to Zung’s self-rating depression scale. Data was collected by using Bengali and English joined questionnaire of Inventory of College Students’ Recent Life Experience and Ways of Coping Scale. The researcher followed ‘Comprehensive sampling’ procedure to study the entire group of population. From the in-depth analysis to data found some source of stress and coping strategies of the students’. Stress was found significantly more in 2nd year students rather than other years. Female students were more vulnerable for stress rather than male. The age ranges 18-20 years of students are more vulnerable for stress. The main sources of stresses are found that, a lot of responsibilities and too many things to do at once and not enough time to meet their obligation or duties. The important coping strategies are found that, they criticized or lectured their selves, tried not to burn their bridges, but leave things open somewhat and inspired to do something creative. Findings of the study highlighted the need for teachers-students interactive relationship for better academic performance. The study also discloses some important recommendations for the students and teachers. At last the findings of the study will help the Occupational Therapy students and teachers of BHPI.

Keywords: BHPI undergraduate occupational therapy students, stress, source of stress, coping strategies

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266 Developing Medical Leaders: A Realistic Evaluation Study for Improving Patient Safety and Maximising Medical Engagement

Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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265 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital

Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

Abstract:

SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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264 Understanding Europe’s Role in the Area of Liberty, Security, and Justice as an International Actor

Authors: Barrere Sarah

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The area of liberty, security, and justice within the European Union is still a work in progress. No one can deny that the EU struggles between a monistic and a dualist approach. The aim of our essay is to first review how the European law is perceived by the rest of the international scene. It will then discuss two main mechanisms at play: the interpretation of larger international treaties and the penal mechanisms of European law. Finally, it will help us understand the role of a penal Europe on the international scene with concrete examples. Special attention will be paid to cases that deal with fundamental rights as they represent an interesting case study in Europe and in the rest of the World. It could illustrate the aforementioned duality currently present in the Union’s interpretation of international public law. On the other hand, it will explore some specific European penal mechanism through mutual recognition and the European arrest warrant in the transnational criminality frame. Concerning the interpretation of the treaties, it will first, underline the ambiguity and the general nature of some treaties that leave the EU exposed to tension and misunderstanding then it will review the validity of an EU act (whether or not it is compatible with the rules of International law). Finally, it will focus on the most complete manifestation of liberty, security and justice through the principle of mutual recognition. Used initially in commercial matters, it has become “the cornerstone” of European construction. It will see how it is applied in judicial decisions (its main event and achieving success is via the European arrest warrant) and how European member states have managed to develop this cooperation.

Keywords: European penal law, international scene, liberty security and justice area, mutual recognition

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263 An Efficient Traceability Mechanism in the Audited Cloud Data Storage

Authors: Ramya P, Lino Abraham Varghese, S. Bose

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By cloud storage services, the data can be stored in the cloud, and can be shared across multiple users. Due to the unexpected hardware/software failures and human errors, which make the data stored in the cloud be lost or corrupted easily it affected the integrity of data in cloud. Some mechanisms have been designed to allow both data owners and public verifiers to efficiently audit cloud data integrity without retrieving the entire data from the cloud server. But public auditing on the integrity of shared data with the existing mechanisms will unavoidably reveal confidential information such as identity of the person, to public verifiers. Here a privacy-preserving mechanism is proposed to support public auditing on shared data stored in the cloud. It uses group signatures to compute verification metadata needed to audit the correctness of shared data. The identity of the signer on each block in shared data is kept confidential from public verifiers, who are easily verifying shared data integrity without retrieving the entire file. But on demand, the signer of the each block is reveal to the owner alone. Group private key is generated once by the owner in the static group, where as in the dynamic group, the group private key is change when the users revoke from the group. When the users leave from the group the already signed blocks are resigned by cloud service provider instead of owner is efficiently handled by efficient proxy re-signature scheme.

Keywords: data integrity, dynamic group, group signature, public auditing

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262 Partial Privatization, Control Rights of Large Shareholders and Privatized Shares Transfer: Evidence from Chinese State-Owned Listed Companies

Authors: Tingting Zhou

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The partial privatization of state-owned enterprises (SOEs) is a dynamic process. The main features of this process lie in not only gradual and sequential privatizations, but also privatized shares transfer. For partially privatized SOEs, the introduction of private sector ownership is not the end of the story because the previously introduced private owners may choose to leave the SOEs by transferring the privatized shares after privatization, a process that is called “privatized shares transfer”. This paper investigates the determinants of privatized shares transfer from the perspective of large shareholders’ control rights. The results captures the fact that the higher control rights of large shareholders lead to more privatized shares transfer. After exploring the impacts of excessive control rights, the results provide evidence supporting the idea that firms with excessive numbers of directors, senior managers or supervisors who also have positions in the largest controlling shareholder’s entity are more likely to transfer privatized shares owned by private owners. In addition, the largest shareholders’ ownership also plays a role in privatized shares transfer. This evidence suggests that the large shareholders’ control rights should be limited to an appropriate range during the process of privatization, thereby giving private shareholders more opportunity to participate in the operation of firms, strengthen the state and enhance the competitiveness of state capital.

Keywords: control rights of large shareholders, partial privatization, privatized shares transfer, state-owned listed companies

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261 Investing the Employees Higher Quitting Intention at the Call Centers of Pakistan: A Reality or a Myth: A Case Study of Pakistan Telecommunication Sector

Authors: Naheed Malik, Marisa Smith

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This study has been undertaken as an attempt to explore the underlying reasons that cause higher employee turnover rates at the call centers of Pakistan. This research also aimed to examine the relationship among the job related variables such as job satisfaction, organizational commitment, supervisor support, self-esteem, organizational stressors (work overload, role ambiguity and work family conflict) and quitting inclination. A total of 340 call centers respondents filled the survey questionnaire. The data was analyzed through SPSS 19.0. Results reveal the significant relationship among the study variables and stress level contributing more towards employee penchant to leave the job. A significant amount of call centers employee have proclivity to quit from their jobs as soon as they would be able to find some other jobs with attractive compensation. The majority of the respondents were found to be unhappy and dissatisfied due to hectic schedule and imbalance between family and work. This research also highlighted the specific areas in which call centre management needs to emphasize deliberately that affect more sharply on employee leaving aptitude. This study also suggests some useful strategies for the well being of employees that can minimize their tendency of quitting and retention in the long run.

Keywords: call centers, stress, job satisfaction, organizational commitment, supervisor’s support, self esteem, employee turnover, employees’ intention to quit, customer service representative (CSRs)

Procedia PDF Downloads 250