Search results for: tender documentation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 405

Search results for: tender documentation

255 TeleEmergency Medicine: Transforming Acute Care through Virtual Technology

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

Procedia PDF Downloads 48
254 Documentation of Traditional Knowledge on Wild Medicinal Plants of Egypt

Authors: Nahla S. Abdel-Azim, Khaled A. Shams, Elsayed A. Omer, Mahmoud M. Sakr

Abstract:

Medicinal plants play a significant role in the health care system in Egypt. Knowledge developed over the years by people is mostly unrecorded and orally passes on from one generation to the next. This knowledge is facing the danger of becoming extinct. Therefore there is an urgent need to document the medicinal and aromatic plants associated with traditional knowledge. The Egyptian Encyclopedia of wild medicinal plants (EEWMP) is the first attempt to collect most of the basic elements of the medicinal plant resources of Egypt and their traditional uses. It includes scientific data on about 500 medicinal plants in the form of monographs. Each monograph contains all available information and scientific data on the selected species including the following: names, description, distribution, parts used, habitat, conservational status, active or major chemical constituents, folk medicinal uses and heritage resources, pharmacological and biological activities, authentication, pharmaceutical products, and cultivation. The DNA bar-coding is also included (when available). A brief Arabic summary is given for every monograph. This work revealed the diversity in plant parts used in the treatment of different ailments. In addition, the traditional knowledge gathered can be considered a good starting point for effective in situ and ex-situ conservation of endangered plant species.

Keywords: encyclopedia, medicinal plant, traditional medicine, wild flora

Procedia PDF Downloads 168
253 Role of Geomatics in Architectural and Cultural Conservation

Authors: Shweta Lall

Abstract:

The intent of this paper is to demonstrate the role of computerized auxiliary science in advancing the desired and necessary alliance of historians, surveyors, topographers, and analysts of architectural conservation and management. The digital era practice of recording architectural and cultural heritage in view of its preservation, dissemination, and planning developments are discussed in this paper. Geomatics include practices like remote sensing, photogrammetry, surveying, Geographic Information System (GIS), laser scanning technology, etc. These all resources help in architectural and conservation applications which will be identified through various case studies analysed in this paper. The standardised outcomes and the methodologies using relevant case studies are listed and described. The main component of geomatics methodology adapted in conservation is data acquisition, processing, and presentation. Geomatics is used in a wide range of activities involved in architectural and cultural heritage – damage and risk assessment analysis, documentation, 3-D model construction, virtual reconstruction, spatial and structural decision – making analysis and monitoring. This paper will project the summary answers of the capabilities and limitations of the geomatics field in architectural and cultural conservation. Policy-makers, urban planners, architects, and conservationist not only need answers to these questions but also need to practice them in a predictable, transparent, spatially explicit and inexpensive manner.

Keywords: architectural and cultural conservation, geomatics, GIS, remote sensing

Procedia PDF Downloads 116
252 Carbonate Crusts in Jordan: Records of Groundwater Flow, Carbon Fluxes, Tectonic Movement and Climate Change

Authors: Nizar Abu-Jaber

Abstract:

Late Pleistocene and Holocene carbonate crusts in the south of Jordan were studied using a combination of field documentation, petrography, geochemical and isotopic techniques. These surficial crusts and vein deposits appear to have formed as a result of interaction between near-surface groundwater, surficial soil and sediments and rising carbon dioxide. Rising mantle CO2 dissolves in the water to create carbonic acid, which in turn dissolves the calcite in the soil in the sediments. When the pH rises later due to degassing, the carbonate crusts are left in the places where the water was flowing in veins, channels and interfaces between high and low permeability materials. The crusts have the potential for being important records of natural and human agencies on the landscape of the area. They reflect the isotopic composition of the waters in which they precipitated in, and also contain isotopic information about the aeolian calcium fluxes affecting the area (using strontium isotopes). Moreover, changing stream valley base levels can be identified and measured, which can help quantify the rates of tectonic movement. Finally, human activities such and channel construction and terrace building can be identified and traced temporally and spatially using these deposits.

Keywords: anthropogenic change, carbonate crusts, environmental change, Jordan

Procedia PDF Downloads 255
251 Simulation Tools for Training in the Case of Energy Sector Crisis

Authors: H. Malachova, A. Oulehlova, D. Rezac

Abstract:

Crisis preparedness training is the best possible strategy for identifying weak points, understanding vulnerability, and finding possible strategies for mitigation of blackout consequences. Training represents an effective tool for developing abilities and skills to cope with crisis situations. This article builds on the results of the research carried out in the field of preparation, realization, process, and impacts of training on subjects of energy sector critical infrastructure as a part of crisis preparedness. The research has revealed that the subjects of energy sector critical infrastructure have not realized training and therefore are not prepared for the restoration of the energy supply and black start after blackout regardless of the fact that most subjects state blackout and subsequent black start as key dangers. Training, together with mutual communication and processed crisis documentation, represent a basis for successful solutions for dealing with emergency situations. This text presents the suggested model of SIMEX simulator as a tool which supports managing crisis situations, containing training environment. Training models, possibilities of constructive simulation making use of non-aggregated as well as aggregated entities and tools of communication channels of individual simulator nodes have been introduced by the article.

Keywords: communication, energetic critical infrastructure, training, simulation

Procedia PDF Downloads 355
250 A Study to Examine the Use of Traditional Agricultural Practices to Fight the Effects of Climate Change

Authors: Rushva Parihar, Anushka Barua

Abstract:

The negative repercussions of a warming planet are already visible, with biodiversity loss, water scarcity, and extreme weather events becoming ever so frequent. The agriculture sector is perhaps the most impacted, and modern agriculture has failed to defend farmers from the effects of climate change. This, coupled with the added pressure of higher demands for food production caused due to population growth, has only compounded the impact. Traditional agricultural practices that are routed in indigenous knowledge have long safeguarded the delicate balance of the ecosystem through sustainable production techniques. This paper uses secondary data to explore these traditional processes (like Beejamrita, Jeevamrita, sheep penning, earthen bunding, and others) from around the world that have been developed over centuries and focuses on how they can be used to tackle contemporary issues arising from climate change (such as nutrient and water loss, soil degradation, increased incidences of pests). Finally, the resulting framework has been applied to the context of Indian agriculture as a means to combat climate change and improve food security, all while encouraging documentation and transfer of local knowledge as a shared resource among farmers.

Keywords: sustainable food systems, traditional agricultural practices, climate smart agriculture, climate change, indigenous knowledge

Procedia PDF Downloads 96
249 The Procedural Sedation Checklist Manifesto, Emergency Department, Jersey General Hospital

Authors: Jerome Dalphinis, Vishal Patel

Abstract:

The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

Procedia PDF Downloads 90
248 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report

Authors: Zainab Elazab, Azhar Aziz

Abstract:

Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

Procedia PDF Downloads 274
247 Comparison and Description of Enhanced Department-Based Arc Flash Safety Assessment with Substation-Based Arc Flash Safety Assessment for the Improvement of Work Place Safety

Authors: Md. Abid Khan

Abstract:

Arc Flash safety assessment is a critical component for continuous improvement of any company’s safe electrical arc flash standard (SEAFS). The standard requires periodic internal or external audits to verify compliance and assess implementation. Assessments will identify strengths and opportunities for improvement, and serve as the basis for corrective actions. An arc flash safety assessment is comprised of a review of any existing safe electrical arc flash standard documentation (e.g., such as work procedures or other supporting documents), onsite interviews, and observations (e.g., facility inspections and work task observations). Substation-based arc flash assessment is very popular as it is more specific for each substation. The enhanced department-based arc flash safety assessment will shift focus to more effective hazard control measures and emphasis will be placed on highlighting inherently unsafe equipment to support resolution actions by facility management, rather than relying on lessor effective control methods in the hierarchy of controls currently deployed at a number of facilities.

Keywords: assessment, remote racking device (RRD), key performance indicator (KPI), personal protective equipment (PPE), operation & maintenance (O&M), safety management system (SMS), safe electrical arc flash standard (SEAFS)

Procedia PDF Downloads 50
246 The Evolution of the Human Brain from the Hind Brain to the Fore Brain: Dialectics from the African Perspective in Understanding Stunted Development in Science and Technology

Authors: Philemon Wokoma Iyagba, Obey Onenee Christie

Abstract:

From the hindbrain, which is responsible for motor activities, to the forebrain, responsible for processing information related to complex cognitive activities, the human brain has continued to evolve over the years. This evolution- has been progressive, leading to advancements in science and technology. However, the development of science and technology in Africa, where ancient civilization arguably began, has been retrogressive. Dialectics was done by dissecting different opinions on the reason behind the stunted development of science and technology in Africa. The researchers proposed that the inability to sustain the technological advancements made by early Africans is due to poor or lack of replicability of the African knowledge-based system, almost no or poor documentation of adopted procedures and the approval-seeking mentality that cheaply paved the way for westernization which also led to the adulteration of the African way of life and education without making room for incorporating her identity and proper alignment of her rich cultural heritage in education and her enormous achievements before and during the middle age. This article discussed conceptual issues, with its positions based on established facts, the discussion was based on relevant literature and recommendations were made accordingly.

Keywords: forebrain, hindbrain, dialectics from African perspective, development in science and technology

Procedia PDF Downloads 41
245 Challenges for Implementing Standards Compliant with Iso/Iec 17025, for Narcotics and DNA Laboratory’s

Authors: Blerim Olluri

Abstract:

A forensic science laboratory in Kosovo has never been organized at the level of most modern forensic science laboratories. This was made possible after the war of 1999 with the help and support from the United States. The United States Government/ICITAP provided 9.5 million dollars to support this project, this support have greatly benefitted law enforcement in Kosovo. With the establishment of Operative Procedures of Work and the law for Kosovo Agency of Forensic, the accreditation with ISO/IEC 17025 of the KAF labs it becomes mandatory. Since 2012 Laboratory’s DNA/Serology and Narcotics has begun reviewing and harmonizing their procedures according to ISO/IEC 17025. The focus of this work was to create quality manuals, procedures, work instructions, quality documentation and quality records. Furthermore, during this time is done the validation of work methods from scientific qualified personnel of KAF, without any help from other foreign agencies or accreditation body.In October 2014 we had the first evaluation based on ISO 17025 standards. According to the initial report of this assessment we have non conformity in test and Calibration methods method’s, and accommodation and environmental conditions. We identified several issues that are of extreme importance to KAF. One the most important issue is to create a professional group with experts of KAF, which will work in all the obligations, requested from ISO/IEC 17025. As conclusions that we earn in this path of accreditation, are that laboratory’s need to take corrective action, and all nonconformance’s must be addressed and corrective action taken before accreditation can be granted.

Keywords: accreditation, assessment, narcotics, DNA

Procedia PDF Downloads 344
244 An Analysis of the Effect of Sharia Financing and Work Relation Founding towards Non-Performing Financing in Islamic Banks in Indonesia

Authors: Muhammad Bahrul Ilmi

Abstract:

The purpose of this research is to analyze the influence of Islamic financing and work relation founding simultaneously and partially towards non-performing financing in Islamic banks. This research was regression quantitative field research, and had been done in Muammalat Indonesia Bank and Islamic Danamon Bank in 3 months. The populations of this research were 15 account officers of Muammalat Indonesia Bank and Islamic Danamon Bank in Surakarta, Indonesia. The techniques of collecting data used in this research were documentation, questionnaire, literary study and interview. Regression analysis result shows that Islamic financing and work relation founding simultaneously has positive and significant effect towards non performing financing of two Islamic Banks. It is obtained with probability value 0.003 which is less than 0.05 and F value 9.584. The analysis result of Islamic financing regression towards non performing financing shows the significant effect. It is supported by double linear regression analysis with probability value 0.001 which is less than 0.05. The regression analysis of work relation founding effect towards non-performing financing shows insignificant effect. This is shown in the double linear regression analysis with probability value 0.161 which is bigger than 0.05.

Keywords: Syariah financing, work relation founding, non-performing financing (NPF), Islamic Bank

Procedia PDF Downloads 404
243 Dual Role of Women and Its Influence on Farmers’ Household Income and Consumption Pattern: Study of Informal Women Workers in the District Mandalle, Pangkep, South Sulawesi Province

Authors: Ida Rosada, Nurliani

Abstract:

Today, the number of women who seek additional income to help her husband is increasing. They do that in order to be able to express themselves in the midst of the family and society. Nonetheless, housewives are in charge of managing family’s income and prepare food for the family. The objective of this research is 1) to analyze the effect of the dual role of women to household income and 2) to analyze the effect of the dual role to consumption patterns. The study used a qualitative approach, data collection techniques are through observation, interviews, and documentation on farming households. The data was analysed qualitative descriptively. The results found that: 1) The revenue contribution of women who play double role in the informal sector amounted to 34.07% (less than 50%). 2) The main reason that the respondents worked in the informal sector is to be able to send their children to school (34%) and to improve household economy condition (28%). 3) After earning additional income, respondents said that they can contribute to increase the family’s income and to cover the family shortage (82%); 4) Respondents’ opinion to changes in food consumption after performing the dual role is the ability to purchase and provide the desired food (44%) and changing patterns of consumption per day (30%).

Keywords: dual role, the informal sector, consumption patterns, household income

Procedia PDF Downloads 241
242 Forensic Necropsy-Importance in Wildlife Conservation

Authors: G. V. Sai Soumya, Kalpesh Solanki, Sumit K. Choudhary

Abstract:

Necropsy is another term used for an autopsy, which is known as death examination in the case of animals. It is a complete standardized procedure involving dissection, observation, interpretation, and documentation. Government Bodies like National Tiger Conservation Authority (NTCA) have given standard operating procedures for commencing the necropsies. Necropsies are rarely performed as compared to autopsies performed on human bodies. There are no databases which maintain the count of autopsies in wildlife, but the research in this area has shown a very small number of necropsies. Long back, wildlife forensics came into existence but is coming into light nowadays as there is an increase in wildlife crime cases, including the smuggling of trophies, pooching, and many more. Physical examination in cases of animals is not sufficient to yield fruitful information, and thus postmortem examination plays an important role. Postmortem examination helps in the determination of time since death, cause of death, manner of death, factors affecting the case under investigation, and thus decreases the amount of time required in solving cases. Increasing the rate of necropsies will help forensic veterinary pathologists to build standardized provision and confidence within them, which will ultimately yield a higher success rate in solving wildlife crime cases.

Keywords: necropsy, wildlife crime, postmortem examination, forensic application

Procedia PDF Downloads 106
241 The Philippine Collegian and the Catalyst's Journalistic Presentation of the UP and PUP: A Content Analysis

Authors: Diana Mariz Catangay, Irish-Ann Montano, Frances Janine Suyat

Abstract:

As an active pedestal for student’s interaction with both issues happening inside the school and out; may it be political, societal, international, or other current events, a school paper should at least meet the standard of providing a representation of the school’s morals and values and help the institution uplift its image. The researchers seek to ascertain how the two student publications from the Philippines’ two prime state universities, the University of the Philippines’ Philippine Collegian, and the Polytechnic University of the Philippines’ the Catalyst, presents iii their school through balanced journalism and objective documentation. The objectives include determining the number of school-related articles published versus those articles that are concerned outside the school’s jurisdiction, analyzing the insight it provides on the image of the university, assessing the similarities and/or differences between the two publications, and, finally, coming up with the conclusion of how the two newspapers uses their medium to present their respective schools. The research used the quantitative method of research in order to further analyze the articles that will serve as bases in coming up with the right conclusion based on the objectives of the study. Coding sheets and coding guides are utilized for the chosen research method. The gathered findings will then be interpreted as fitting to the goal of the research.

Keywords: content analysis, journalistic presentation, student publications, state universities

Procedia PDF Downloads 157
240 Does One Size Fit All: Immigrant Youths, Bullying and Peer-Aggression

Authors: Shila Khayambashi

Abstract:

For the past few decades, Western researchers studied different youth issues, such as bullying, peer-aggression, depression, self-harm, and suicide, in a formulated and standardized manner. These researchers have grounded their studies upon a series of introduced characteristics and traits, which pragmatically defined the action of the individuals involved in these activities (Olweus, 1994). The phenomena of bullying and peer-aggression have touched the lives of many immigrant youths, as well. However, in the case of these immigrant young adults, the Police investigated, and later dismissed, the victims’ involvement in drugs and gangs’ activities, instead of questioning the possibility of the peer-aggression. This paper argues that neither government officials nor school personnel has ever investigated any cyber-documentation which would clarify these youth’s untimely deaths or search for any indication of peer-aggression at school. Through my ongoing research, I will problematize the Eurocentric definition of bullying and its limitations. I question the assumed universality of these definitions’ characteristics and their lack of minority representation. This research questions explicitly the positionality of the displaced youth within the promised multiculturality of Canada. I will ask: Does one size fit all, considering the bio-psycho-socio-economic differences between the Eastern and the Western worlds? More importantly, how does the epidemy of the communicative devices, like smartphones, and communicative apps, like Twitter and Snapchats, facilitate or hinder peer-aggression for the displaced youths?

Keywords: Bullying , Immigrant youths, Peer aggression, Minority population

Procedia PDF Downloads 110
239 The Role of High-Intensity Focused Ultrasound (HIFU) in the Treatment of Fibroadenomas: A Systematic Review

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

Abstract:

Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

Procedia PDF Downloads 183
238 Descriptive Study of Adverse Drug Reactions in a Paediatric Hospital in Mongolia from 2015 to 2019

Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

Abstract:

Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

Procedia PDF Downloads 86
237 Application of the Total Least Squares Estimation Method for an Aircraft Aerodynamic Model Identification

Authors: Zaouche Mohamed, Amini Mohamed, Foughali Khaled, Aitkaid Souhila, Bouchiha Nihad Sarah

Abstract:

The aerodynamic coefficients are important in the evaluation of an aircraft performance and stability-control characteristics. These coefficients also can be used in the automatic flight control systems and mathematical model of flight simulator. The study of the aerodynamic aspect of flying systems is a reserved domain and inaccessible for the developers. Doing tests in a wind tunnel to extract aerodynamic forces and moments requires a specific and expensive means. Besides, the glaring lack of published documentation in this field of study makes the aerodynamic coefficients determination complicated. This work is devoted to the identification of an aerodynamic model, by using an aircraft in virtual simulated environment. We deal with the identification of the system, we present an environment framework based on Software In the Loop (SIL) methodology and we use MicrosoftTM Flight Simulator (FS-2004) as the environment for plane simulation. We propose The Total Least Squares Estimation technique (TLSE) to identify the aerodynamic parameters, which are unknown, variable, classified and used in the expression of the piloting law. In this paper, we define each aerodynamic coefficient as the mean of its numerical values. All other variations are considered as modeling uncertainties that will be compensated by the robustness of the piloting control.

Keywords: aircraft aerodynamic model, total least squares estimation, piloting the aircraft, robust control, Microsoft Flight Simulator, MQ-1 predator

Procedia PDF Downloads 241
236 The Folksongs of Jharkhand: An Intangible Cultural Heritage of Tribal India

Authors: Walter Beck

Abstract:

Jharkhand is newly constituted 28th State in the eastern part of India which is known for the oldest settlement of the indigenous people. In the State of Jharkhand in which broadly three language family are found namely, Austric, Dravidian, and Indo-European. Ex-Mundari, kharia, Ho Santali come from the Austric Language family. Kurukh, Malto under Dravidian language family and Nagpuri Khorta etc. under Indo-European language family. There are 32 Indigenous Communities identified as Scheduled Tribe in the State of Jharkhand. Santhal, Munda, Kahria, Ho and Oraons are some of the major Tribe of the Jharkhand state. Jharkhand has a Rich Cultural heritage which includes Folk art, folklore, Folk Dance, Folk Music, Folk Songs for which diversity can been seen from place to place, season to season and all traditional Culture and practices. The languages as well as the songs are vulnerable to dominant culture and hence needed to be protected. The collection and documentation of these songs in their natural setting adds significant contribution to the conservation and propagation of the cultural elements. This paper reflects to bring out the Originality of the Collected Songs from remote areas of the plateau of Sothern Jharkhand as a rich intangible Cultural heritage of the Country. The research was done through participatory observation. In this research project more than 100 songs which were never documented before.

Keywords: cultural heritage, India, indigenous people, songs, languages

Procedia PDF Downloads 178
235 The Construction of Knowledge and Social Wisdom on Local Community in the Process of Disaster Management

Authors: Oman Sukmana

Abstract:

Geographically, Indonesia appears to be disaster-prone areas, whether for natural, nonnatural (man-made), or social disasters. This study aimed to construct the knowledge and social wisdom on the local community in the process of disaster management after the eruption of Mt. Kelud. This study, moreover, encompassed two major concerns: (1) the construction of knowledge and social wisdom on the local community in the process of disaster management after the eruption of Mt. Kelud; (2) the conceptual framework of disaster management on the basis of knowledge and social wisdom on the local community. The study was conducted by means of qualitative approach. The data were analyzed by using the qualitative-descriptive technique. The data collection techniques used in this study were in-depth interview, focus group discussion, observation, and documentation. It was conducted at Pandansari Village, Sub-district Ngantang, District Malang as the most at risk area of Mt. Kelud’s eruption. The purposive sampling was applied ad hoc to select the respondents including: the apparatus of Pandansari Village, the local figures of Pandansari Village, the Chief and Boards of the Forum of Disaster Risk Reduction (FPRB), the Head of Malang Regional Disaster Management Agency, and other agencies. The findings of this study showed that the local community has already possessed the adequate knowledge and social wisdom to overcome the disaster. Through the social wisdom, the local community could predict the potential eruption.

Keywords: knowledge, social and local wisdom, disaster management

Procedia PDF Downloads 345
234 Predicting Stack Overflow Accepted Answers Using Features and Models with Varying Degrees of Complexity

Authors: Osayande Pascal Omondiagbe, Sherlock a Licorish

Abstract:

Stack Overflow is a popular community question and answer portal which is used by practitioners to solve technology-related challenges during software development. Previous studies have shown that this forum is becoming a substitute for official software programming languages documentation. While tools have looked to aid developers by presenting interfaces to explore Stack Overflow, developers often face challenges searching through many possible answers to their questions, and this extends the development time. To this end, researchers have provided ways of predicting acceptable Stack Overflow answers by using various modeling techniques. However, less interest is dedicated to examining the performance and quality of typically used modeling methods, and especially in relation to models’ and features’ complexity. Such insights could be of practical significance to the many practitioners that use Stack Overflow. This study examines the performance and quality of various modeling methods that are used for predicting acceptable answers on Stack Overflow, drawn from 2014, 2015 and 2016. Our findings reveal significant differences in models’ performance and quality given the type of features and complexity of models used. Researchers examining classifiers’ performance and quality and features’ complexity may leverage these findings in selecting suitable techniques when developing prediction models.

Keywords: feature selection, modeling and prediction, neural network, random forest, stack overflow

Procedia PDF Downloads 109
233 The Effects of Mobile Phones in Mitigating Cultural Shock amongst Refugees: Case of South Africa

Authors: Sarah Vuningoma, Maria Rosa Lorini, Wallace Chigona

Abstract:

The potential of mobile phones is evident in their ability to address isolation and loneliness, support the improvement of interpersonal relations, and contribute to the facilitation of assimilation processes. Mobile phones can play a role in facilitating the integration of refugees into a new environment. This study aims to evaluate the impact of mobile phone use on helping refugees navigate the challenges posed by cultural differences in the host country. Semi-structured interviews were employed to collect data for the study, involving a sample size of 27 participants. Participants in the study were refugees based in South Africa, and thematic analysis was the chosen method for data analysis. The research highlights the numerous challenges faced by refugees in their host nation, including a lack of local cultural skills, the separation of family and friends from their countries of origin, hurdles in acquiring legal documentation, and the complexities of assimilating into the unfamiliar community. The use of mobile phones by refugees comes with several advantages, such as the advancement of language and cultural understanding, seamless integration into the host country, streamlined communication, and the exploration of diverse opportunities. Concurrently, mobile phones allow refugees in South Africa to manage the impact of culture shock.

Keywords: mobile phones, culture shock, refugees, South Africa

Procedia PDF Downloads 45
232 Enhancement Effect of Compound 4-Hydroxybenzoic Acid from Petung Bamboo (Dendrocalamus Asper) Shoots on α1β2γ2S of GABA (A) Receptor Expressed in Xenopus laevis Oocytes- Preliminary Study on Its Anti-Epileptic Potential

Authors: Muhammad Bilal, Amelia Jane Llyod, Habsah Mohamad, Jia Hui Wong, Abdul Aziz Mohamed Yusoff, Jafri Malin Abdullah, Jingli Zhang

Abstract:

Epilepsy is one of the major brain afflictions occurs with uncontrolled excitation of cortex; disturbed 50 million of world’s population. About 25 percent of patients subjected to adverse effects from antiepileptic drugs (AEDs) such as depression, nausea, tremors, gastrointestinal symptoms, osteoporosis, dizziness, weight change, drowsiness, fatigue are commonly observed indications; therefore, new drugs are required to cure epilepsy. GABA is principle inhibitory neurotransmitter, control excitation of the brain. Mutation or dysfunction of GABA receptor is one of the primary causes of epilepsy, which is confirmed from many acquired models of epilepsy like traumatic brain injury, kindling, and status epilepticus models of epilepsy. GABA receptor has 3 distinct types such as GABA (A), GABA (B), GABA(C).GABA (A) receptor has 20 different subunits, α1β2γ2 subunits composition of GABA (A) receptor is the most used combination of subunits for screening of compounds against epilepsy. We expressed α1β2γ2s subunits of GABA (A) Receptor in Xenopus leavis oocytes and examined the enhancement potential of 4-Hydroxybenzoic acid compound on GABA (A) receptor via two-electrode voltage clamp current recording technique. Bamboo shoots are the young, tender offspring of bamboo, which are usually harvested after a cultivating period of 2 weeks. Proteins, acids, fat, starch, carbohydrate, fatty acid, vitamin, dietary fiber, and minerals are the major constituent found systematically in bamboo shoots. These shoots reported to have anticancer, antiviral, antibacterial activity, also possess antioxidant properties due to the presence of phenolic compounds. Student t-test analysis suggested that 4- hydroxybenzoic acid positively allosteric GABA (A) receptor, increased normalized current amplitude to 1.0304±0.0464(p value 0.032) compared with vehicle. 4-Hydrobenzoic acid, a compound from Dendrocalamus Asper bamboo shoot gives new insights for future studies on bamboo shoots with motivation for extraction of more compounds to investigate their effects on human and rodents against epilepsy, insomnia, and anxiety.

Keywords: α1β2γ2S, antiepileptic, bamboo shoots, epilepsy GABA (A) receptor, two-microelectrode voltage clamp, xenopus laevis oocytes

Procedia PDF Downloads 371
231 Enhancing Entrepreneurial Skills, Vocational, and Technical Education in Nigeria Schools: The Challenges and Way Forward

Authors: Stella Chioma Nwizu, Emmanuel Nwangwu

Abstract:

Entrepreneurship, Vocational, and Technical education is an education that prepares one for effective adaptation to the world of work. It equally makes individuals self-reliant, self-sufficient and contributes to the development of society. It is, therefore, imperative that this type of education should be a priority in the development of any nation and should be given the utmost political support because of its importance and increasing demand on a global scale. This paper qualitatively explores three research questions on the policy status of Entrepreneurial, Vocational, and Technical Education (EVTE) in Nigeria, challenges hindering the enhancement of Entrepreneurial skills, Vocational and Technical Education in Nigeria, and strategies for the way forward. The major sources of data are secondary, interview and observation. Findings revealed the need to revise the policy of ETVE to meet the needs of the changing world of work. Challenges identified include corruption, inadequate funding, inadequate equipment, unqualified TVET Teachers/Instructors, poor documentation, policy implementation, poor conditions of service, and poor supervision of TVET programmes. Finally, the study identified policy revision, improvement in budgetary allocation, collaboration, sensitization, Public-Private Partnership, and training and retraining of instructors as the way forward toward the amelioration of the issues raised.

Keywords: entrepreneurship, entrepreneurial skills, vocational and technical education, technical and vocational education and training, VTE policy

Procedia PDF Downloads 32
230 Drowning: An Emergency Department Guideline

Authors: Thomas P. Jones

Abstract:

Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

Procedia PDF Downloads 184
229 Optimization of Technical and Technological Solutions for the Development of Offshore Hydrocarbon Fields in the Kaliningrad Region

Authors: Pavel Shcherban, Viktoria Ivanova, Alexander Neprokin, Vladislav Golovanov

Abstract:

Currently, LLC «Lukoil-Kaliningradmorneft» is implementing a comprehensive program for the development of offshore fields of the Kaliningrad region. This is largely associated with the depletion of the resource base of land in the region, as well as the positive results of geological investigation surrounding the Baltic Sea area and the data on the volume of hydrocarbon recovery from a single offshore field are working on the Kaliningrad region – D-6 «Kravtsovskoye».The article analyzes the main stages of the LLC «Lukoil-Kaliningradmorneft»’s development program for the development of the hydrocarbon resources of the region's shelf and suggests an optimization algorithm that allows managing a multi-criteria process of development of shelf deposits. The algorithm is formed on the basis of the problem of sequential decision making, which is a section of dynamic programming. Application of the algorithm during the consolidation of the initial data, the elaboration of project documentation, the further exploration and development of offshore fields will allow to optimize the complex of technical and technological solutions and increase the economic efficiency of the field development project implemented by LLC «Lukoil-Kaliningradmorneft».

Keywords: offshore fields of hydrocarbons of the Baltic Sea, development of offshore oil and gas fields, optimization of the field development scheme, solution of multicriteria tasks in oil and gas complex, quality management in oil and gas complex

Procedia PDF Downloads 174
228 A Discourse on the Rhythmic Pattern Employed in Yoruba Sakara Music of Nigeria

Authors: Oludare Olupemi Ezekiel

Abstract:

This research examines the rhythmic structure of Sakara music by tracing its roots and analyzing the various rhythmic patterns of this neo-traditional genre, as well as the contributions of the major exponents and contemporary practitioners, using these as a model for understanding and establishing African rhythms. Biography of the major exponents and contemporary practitioners, interviews and participant observational methods were used to elicit information. Samples of the genre which were chosen at random were transcribed, notated and analyzed for academic use and documentation. The research affirmed that rhythms such as the Hemiola, Cross-rhythm, Clave or Bell rhythm, Percussive, Speech and Melodic rhythm and other relevant rhythmic theories were prevalent and applicable to Sakara music, while making important contributions to musical scholarship through its analysis of the music. The analysis and discussions carried out in the research pointed towards a conclusion that the Yoruba musicians are guided by some preconceptions and sound musical considerations in making their rhythmic patterns, used as compositional techniques and not mere incidental occurrence. These rhythmic patterns, with its consequential socio-cultural connotations, enhance musical values and national identity in Nigeria. The study concludes by recommending that musicologists need to carry out more research into this and other neo-traditional genres in order to advance the globalisation of African music.

Keywords: compositional techniques, globalisation, identity, neo-traditional, rhythmic theory, Sakara music

Procedia PDF Downloads 417
227 Enhancing Children’s English Vocabulary Acquisition through Digital Storytelling at Happy Kids Kindergarten, Palembang, Indonesia

Authors: Gaya Tridinanti

Abstract:

Enhanching English vocabulary in early childhood is the main problem often faced by teachers. Thus, the purpose of this study was to determine the enhancement of children’s English vocabulary acquisition by using digital storytelling. This type of research was an action research. It consisted of a series of four activities done in repeated cycles: planning, implementation, observation, and reflection. The subject of the study consisted of 30 students of B group (5-6 years old) attending Happy Kids Kindergarten Palembang, Indonesia. This research was conducted in three cycles. The methods used for data collection were observation and documentation. Descriptive qualitative and quantitative methods were also used to analyse the data. The research showed that the digital storytelling learning activities could enhance the children’s English vocabulary acquisition. It is based on the data in which the enhancement in pre-cycle was 37% and 51% in Cycle I. In Cycle II it was 71% and in Cycle III it was 89.3%. The results showed an enhancement of about 14% from the pre-cycle to Cycle I, 20% from Cycle I to Cycle II, and enhancement of about 18.3% from Cycle II to Cycle III. The conclusion of this study suggests that digital storytelling learning method could enhance the English vocabulary acquisition of B group children at the Happy Kids Kindergarten Palembang. Therefore, digital storytelling can be considered as an alternative to improve English language learning in the classroom.

Keywords: acquisition, enhancing, digital storytelling, English vocabulary

Procedia PDF Downloads 237
226 Protection of Human Rights in Polish Centres for Foreigners – in the Context of the European Human Rights System

Authors: Oktawia Braniewicz

Abstract:

The phenomenon of emigration and migration increasingly affects Poland's borders as well. For this reason, it is necessary to examine the level of protection of Human Rights in Polish Centres for Foreigners. The field study covered 11 centers for Foreigners in the provinces Kujawsko-Pomorskie Region, Lubelskie Region, Lodzkie Region, Mazowieckie Region and Podlaskie Region. Photographic documentation of living and social conditions, conversations with center employees and refugees allow to show a comprehensive picture of the situation prevailing in Centres for Foreigners. The object of reflection will be, in particular, the standards resulting from art. 8 and 13 of the Convention for the Protection of Human Rights and Fundamental Freedoms and article 2 of Protocol No. 1 to the Convention for the Protection of Human Rights and Fundamental Freedoms. The degree of realization of the right to education and the right to respect for family and private life will be shown. Issues related to learning the Polish language, access to a professional translator and psychological help will also be approximated. Learning Polish is not obligatory, which causes problems with assimilation and integration with other members of the new community. In centers for foreigners, there are no translators - a translator from an external company is rented if necessary. The waiting time for an interpreter makes the refugees feel anxious, unable to communicate with the employees of the centers (this is a situation in which the refugees do not know either English, Polish or Russian). Psychologist's help is available on designated days of the week. There is no separate specialist in child psychology, which is a serious problem.

Keywords: human rights, Polish centres, foreigners, fundamental freedoms

Procedia PDF Downloads 105