Search results for: delayed primary closure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4903

Search results for: delayed primary closure

4453 Chronically Ill Patient Satisfaction: An Indicator of Quality of Service Provided at Primary Health Care Settings in Alexandria

Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

Abstract:

Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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4452 WT1 Exprassion in Malignant Surface Epithelial Ovarian Tumors

Authors: Mahmoodreza Tahamtan

Abstract:

Background: Malignant surface epithelial ovarian tumors (SEOT) account for approximately 90% of primary ovarian cancer. Wilms tumor gene (WT1) product was defined as a tumor suppressor gene, but today it is considered capable of performing oncogenic functions. There seems to be differences in WT1 expression patterns among SEOT subtypes. We evaluate the immunohistochemical expression of WT1 protein among different histologic subtypes of SEOT. Materials and Methods: Immunohistochemistry for WT1 was done on 35 serous cystadenocarcinomas, 9 borderline serous tumors, 3 mucinous cystadenocarcinomas, 10 borderline mucinous tumors, 7 endometrioid ovarian carcinomas, 3 clear cell carcinomas, 1 malignant Brenner tumor, 2 metastatic adenocarcinomas, and 6 endometrial adenocarcinomas. A tumor was considered negative if < 1% of tumor cells were stained.Positive reactions were graded as follows:1+,1%-24%; 2+,25%-49%; 3+,50%-74%; 4+,75%-100%. Results: Of the 35 cases of ovarian serous cystadenocarcinoma, 30(85.7%) were diffusely positive (3+,4+),4 showed reactivity of < 50% of the tumor cells (1+,2+), and one were negative. All 9 borderline serous tumors showed immunoreactivity with WT1. All the mucinous tumors(n:13), endometrioid carcinomas (n: 7), clear cell carcinomas (n: 3), metastatic adenocarcinomas (n: 2) and primary endometrial carcinomas (n:6) were negative. The single malignant Brenner tumor showed a positive reaction for WT1(4+) Conclusion: WT1 is a good marker to distinguish primary ovarian serous carcinomas from other surface epithelial tumors (especially endometrioid subtype) and metastatic carcinomas (especially endometrial serous carcinoma), other than malignant mesothelioma. We cannot rely to the degree of expression inorder to separate high grade borderline serous tumors from low grade ones.

Keywords: WT1, ovary, epithelial tumors, malignant

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4451 Decreased Non-Communicable Disease by Surveillance, Control, Prevention Systems, and Community Engagement Process in Phayao, Thailand

Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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4450 Technology and Terror

Authors: Janet D. Fish

Abstract:

This paper will analyze how advanced information technology communications platform’s such as you tube, twitter, Facebook, and websites are being used in marketing cultural diversity on a global scale. The scope of this topic will encompass the use of marketing terror as a tool of educational understanding, accepting, and incorporating other ethnic groups into extremist Islamic cultural practices with an end goal of cultural assimilation. This paper will examine the impacts of various influences, such as globalism and technology on common public values and cultural diversity. Additionally, multiculturalism in public administration settings will be examined across cultures. Communications are a primary focus of review for this paper, the purpose of this review is to see how different technological platforms are currently being used as major tools of influence within the public sector. Technology and terror must become a primary concern for new public administrators in a modern world. While its existence is acknowledged, boundaries of legal recourse are currently few. Public administrators must understand the depth and reach of the future consequences of an unchecked process in the realm of technology and terror on a global scale.

Keywords: inclusionism, exclusionism, technology, terror

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4449 Role of the Midwifery Trained Registered Nurse in Postnatal Units at Tertiary Care Hospitals in the Western Province of Sri Lanka: A Postal Survey

Authors: Sunethra Jayathilake, Vathsala Jayasuriya-Illesinghe, Kerstin Samarasinghe, Himani Molligoda, Rasika Perera

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In Sri Lanka, postnatal care in the state hospitals is provided by different professional categories: Midwifery trained registered nurses (MTRNs), Registered Nurses (RNs) who do not have midwifery training, doctors and midwives. Even though four professional categories provide postnatal care to mothers and newborn babies, they are not aware of their own tasks and responsibilities in postnatal care. Particularly MTRN’s role in the postnatal unit is unclear. The current study aimed to identify nurses’ (both MTRN and RNs) perception on MTRN’s tasks and responsibilities in postnatal care. This is a descriptive cross sectional study using postal survey. All nurses who were currently working in postnatal units at five selected tertiary care hospitals in the Western Province at that time were invited to participate in the study. Accordingly, the pre evaluated self-administered questionnaire was sent to 201 nurses (53 MTRNs and 148 RNs) in the study setting. The number of valid return questionnaire was 166; response rate was 83%. Respondents rated the responsibility of four professional categories: MTRN, RN, doctor and midwife whether they are 'primarily responsible', 'responsible in absence' and 'not responsible', for each of 15 postnatal (PN) tasks which were previously identified from focus group discussions with care providers during the first phase of the study. Data were analyzed using SPSS version 20; descriptive statistics were calculated. Out of the 15 PN tasks, 13 were identified as MTRNs’ primary responsibilities by 71%-93% of respondents. The respondents also considered six (6) tasks out of 15 as primary responsibility of both MTRN and RN, seven (7) tasks as primary responsibility of MTRN, RN and doctor and the remaining two (2) tasks were identified as the primary responsibility of MTRN, RN and midwife. All 15 PN tasks overlapped with other professional categories. Overlapping tasks may create role confusion leading to conflicts among professional categories which affect the quality of care they provide, eventually, threaten the safety of the client. It is recommended that an official job description for each care provider is needed to recognize their own professional boundaries for ensuring safe, quality care delivery in Sri Lanka.

Keywords: overlapping, postnatal, responsibilities, tasks

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4448 Developing an Active Leisure Wear Range: A Dilemma for Khanna Enterprises

Authors: Jagriti Mishra, Vasundhara Chaudhary

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Introduction: The case highlights various issues and challenges faced by Khanna Enterprises while conceptualizing and execution of launching Active Leisure wear in the domestic market, where different steps involved in the range planning and production have been elaborated. Although Khanna Enterprises was an established company which dealt in the production of knitted and woven garments, they took the risk of launching a new concept- Active Leisure wear for Millennials. Methodology: It is based on primary and secondary research where data collection has been done through survey, in-depth interviews and various reports, forecasts, and journals. Findings: The research through primary and secondary data and execution of active leisure wear substantiated the acceptance, not only by the millennials but also by the generation X. There was a demand of bigger sizes as well as more muted colours. Conclusion: The sales data paved the way for future product development in tune with the strengths of Khanna Enterprises.

Keywords: millennials, range planning, production, active leisure wear

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4447 Consensus Problem of High-Order Multi-Agent Systems under Predictor-Based Algorithm

Authors: Cheng-Lin Liu, Fei Liu

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For the multi-agent systems with agent's dynamics described by high-order integrator, and usual consensus algorithm composed of the state coordination control parts is proposed. Under communication delay, consensus algorithm in asynchronously-coupled form just can make the agents achieve a stationary consensus, and sufficient consensus condition is obtained based on frequency-domain analysis. To recover the original consensus state of the high-order agents without communication delay, besides, a predictor-based consensus algorithm is constructed via multiplying the delayed neighboring agents' states by a delay-related compensation part, and sufficient consensus condition is also obtained. Simulation illustrates the correctness of the results.

Keywords: high-order dynamic agents, communication delay, consensus, predictor-based algorithm

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4446 Utilization of Learning Resources in Enhancing the Teaching of Science and Technology Courses in Post Primary Institutions in Nigeria

Authors: Isah Mohammed Patizhiko

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This paper aimed at discussing the important role learning resources play in enhancing the teaching and learning of science and technology courses in post primary institution in Nigeria. The paper highlighted the importance learning resources contributed to the effective understanding of the learners. The use of learning resources in the teaching of these courses will encourage teachers to be more exploratory and the learners to have more understanding. In this paper, different range of learning resources particularly common learning resources (learning resources not design primarily for education purposes) to enrich their teaching. The paper also highlighted how ordinary resource can be turned into an educational resource. Recommendations were proffered in the sourcing of learning resources ie from the market, library, institutions, museums, and dump refuse and concluded that good demonstration on the use of resources will engage the learner’s interest and will develop higher level of conceptual understanding in the learning area.

Keywords: enhance, learning, resources, science and technology, teaching

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4445 The Legal Framework for Solid Waste Disposal and Management in Kwara State, Nigeria

Authors: Alabi Odunayo Mayowa, Ajayi Oluwasola Felix

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Solid waste such as “garbage” “trash” “refuse” “slug” and “rubbish” is disposed off or is required to be disposed off in accordance with national law. The study relies on primary and secondary sources of information. The primary sources include the Constitution, statutes and subsidiary legislation. The secondary sources of information include books, journals, conference proceedings, newspapers, magazines and internet materials. The information obtained from these sources is subjected to content and contextual analysis. The study examines the Kwara State Environmental Protection Agency Law, 1992 and other laws on waste disposal and management in Kwara State, Nigeria. The study also examines the regulations and the agency i.e. the Kwara State Environmental Protection Agency created by the law with a view to determine the inadequacies in the law.

Keywords: solid waste, waste disposal, waste management, domestic waste

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4444 Estimation and Removal of Chlorophenolic Compounds from Paper Mill Waste Water by Electrochemical Treatment

Authors: R. Sharma, S. Kumar, C. Sharma

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A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

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4443 Litho-Structural Variations and Gold Mineralization around Wonaka Schist Belt, North West Nigeria

Authors: Umar Sambo Umar, Ahmad Isah Haruna, Abubakar Sadik Maigari, Muhammad Bello Abubakar

Abstract:

Schist belts in Nigeria occur prominently west of longitude 80 E and sporadic to the east, they are upper Proterozioc low-medium grade deformed metasediments and metavolcanics that were intruded by Pan-African granitoids. The Wonaka schist belt, though reportedly distinctive in composition and metamorphism, is the least understood; the host for primary gold were not defined, structures which may control primary enrichment have not been delineated. The aim of this work is to determine the relationship between litho-structures and the gold around Wonaka schist belt through geological field mapping, petrographic studies and structural data analysis via ArcGis 10.2, Surfer 11.0 and Stereopro 2.0. The results show that the major rock types are mica schist and migmatites, muscovites detected during microstructural analysis suggests low-grade metamorphism in the metapelites. The shear zones identified were trending North Northeast – South Southwest (NNE-SSW), fractures trend mostly Northeast-Southwest (NE-SW) perpendicular to planes of gneissic foliations, these conform to the late Pan-African deformational episode. Pegmatite lodes, net self-cross cutting quartz veins as well as the quartz stringers hosted by both migmatites and schist are delineated as targets for primary gold mineralization, while major confluences of the streams serve as zones for secondary (placer) gold targets since the streams are dendritic and intermittent.

Keywords: gold mineralization, Nigeria, migmatites, Wonaka schist belt

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4442 The Epigenetic Background Depended Treatment Planning for Glioblastoma Multiforme

Authors: Rasime Kalkan, Emine Ikbal Atli, Ali Arslantaş, Muhsin Özdemir, Sevilhan Artan

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Glioblastoma (WHO grade IV), is the malignant form of brain tumor, the genetic background of the GBM is highly variable. The tumor mass of a GBM is multilayered and every tumor layer shows distinct characteristics with a different cell population. The treatment planning of GBM should be focused on the tumor genetic characteristics. We screened primary glioblastoma multiforme (GBM) in a population-based study for MGMT and RARβ methylation and IDH1 mutation correlated them with clinical data and treatment. There was no correlation between MGMT-promoter methylation and overall survival. The overall survival time of the patients with methylated RARβ was statically (OS;p<0,05) significance between the patients who were treated with chemotherapy and radiotherapy. Here we showed the status of IDH1 gene associatied with younger age. We demonstrated that the together with MGMT gene the RARβ gene should be used as a potantial treatment decision marker for GBMs.

Keywords: RARβ, primary glioblastoma multiforme, methylation, MGMT

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4441 Transformation Strategies of the Nigerian Textile and Clothing Industries: The Integration of China Clothing Sector Model

Authors: Adetoun Adedotun Amubode

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Nigeria's Textile Industry was the second largest in Africa after Egypt, with above 250 vibrant factories and over 50 percent capacity utilization contributing to foreign exchange earnings and employment generation. Currently, multifaceted challenges such as epileptic power supply, inconsistent government policies, growing digitalization, smuggling of foreign textiles, insecurity and the inability of the local industries to compete with foreign products, especially Chinese textile, has created a hostile environment for the sector. This led to the closure of most of the textile industries. China's textile industry has experienced institutional change and industrial restructuring, having 30% of the world's market share. This paper examined the strategies adopted by China in transforming her textile and clothing industries and designed a model for the integration of these strategies to improve the competitive strength and growth of the Nigerian textile and clothing industries in a dynamic and changing market. The paper concludes that institutional support, regional production, export-oriented policy, value-added and branding cultivation, technological upgrading and enterprise resource planning be integrated into the Nigerian clothing and textile industries.

Keywords: clothing, industry, integration, Nigerian, textile, transformation.

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4440 Changing Governance and the Role of People's Involvement in Municipal Solid Waste Management: Study of Two Municipal Corporations in Kerala

Authors: Prathibha Ganesan

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This paper discusses discontents of inhabitants in the landfills and its culmination into resistance against centralised waste disposal during the last three decades in Kerala. The study is based on a sample survey of 175 households located in the landfill sites and city limits of two Municipal Corporations viz. Thrissur and Cochin. The study found that waste is dumped in the periphery of the urban area where economically and socially vulnerable people are densely populated. Moreover, landfill sites are unscientifically managed to cause severe socio-economic and health issues to the local people, finally leading to their mobilisation and persistent struggle. The struggles often culminate in the closure of landfills or forced relocation or abandonment of the region by the community. The study concluded that persistent people’s struggles compel the local state to either find alternatives to centralised solid waste management system or use political power to subsume the local resistance. The persistence of the struggles determined the type waste governance adopted by the local governments.

Keywords: solid waste management, municipal corporation, resistance movements, urban, Kerala

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4439 A Qualitative Study Investigating the Relationship Between External Context and the Mechanism of Change for the Implementation of Goal-oriented Primary Care

Authors: Ine Huybrechts, Anja Declercq, Emily Verté, Peter Raeymaeckers, Sibyl Anthierens

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Goal-oriented care is a concept gaining increased interest as an approach to go towards more coordinated and integrated primary care. It places patients’ personal life goals at the core of health care support, hereby shifting the focus from “what’s the matter with this patient” to “what matters to this patient.” In Flanders/Belgium, various primary care providers, health and social care organizations and governmental bodies have picked up this concept and have initiated actions to facilitate this approach. The implementation of goal-oriented care not only happens on the micro-level, but it also requires efforts on the meso- and macro-level. Within implementation research, there is a growing recognition that the context in which an intervention takes place strongly relates to its implementation outcomes. However, when investigating contextual variables, the external context and its impact on implementation processes is often overlooked. This study aims to explore how we can better identify and understand the external context and how it relates to the mechanism of change within the implementation process of goal-oriented care in Flanders/Belgium. Results can be used to support and guide initiatives to introduce innovative approaches such as goal-oriented care inside an organization or in the broader primary care landscape. We have conducted qualitative research, performing in-depth interviews with n=23 respondents who have affinity with the implementation of goal-oriented care within their professional function. This lead to in-depth insights from a wide range of actors, with meso-level and/or macro-level perspectives on the implementation of goal-oriented care. This means that we have interviewed actors that are not only involved with initiatives to implement goal-oriented care, but also actors that actively give form to the external context in which goal-oriented care is implemented. Data were collected using a semi-structured interview guide, audio recorded, and analyzed first inductively and then deductively using various theories and concepts that derive from organizational research. Our preliminary findings suggest t Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care. hat organizational theories can help understand the mechanism of change of implementation processes with a macro-level perspective. Institutional theories, contingency theories, resources dependency theories and others can expose the mechanism of change for an innovation such as goal-oriented care. Our findings can contribute to further define actions needed for sustainable implementation of goal-oriented primary care. It gives insights in the dynamics between contextual variables and implementation efforts, hereby indicating towards those contextual variables that can be further shaped to facilitate the implementation of an innovation such as goal-oriented care.

Keywords: goal-oriented care, implementation processes, organizational theories, person-centered care, implementation research

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4438 An Energy Detection-Based Algorithm for Cooperative Spectrum Sensing in Rayleigh Fading Channel

Authors: H. Bakhshi, E. Khayyamian

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Cognitive radios have been recognized as one of the most promising technologies dealing with the scarcity of the radio spectrum. In cognitive radio systems, secondary users are allowed to utilize the frequency bands of primary users when the bands are idle. Hence, how to accurately detect the idle frequency bands has attracted many researchers’ interest. Detection performance is sensitive toward noise power and gain fluctuation. Since signal to noise ratio (SNR) between primary user and secondary users are not the same and change over the time, SNR and noise power estimation is essential. In this paper, we present a cooperative spectrum sensing algorithm using SNR estimation to improve detection performance in the real situation.

Keywords: cognitive radio, cooperative spectrum sensing, energy detection, SNR estimation, spectrum sensing, rayleigh fading channel

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4437 The Effect of Irgafos 168 in the Thermostabilization of High Density Polyethylene

Authors: Mahdi Almaky

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The thermostabilization of High Density Polyethylene (HDPE) is realized through the action of primary antioxidant such as phenolic antioxidants and secondary antioxidants as aryl phosphates. The efficiency of two secondary antioxidants, commercially named Irgafos 168 and Weston 399, was investigated using different physical, mechanical, spectroscopic, and calorimetric methods. The effect of both antioxidants on the processing stability and long term stability of HDPE produced in Ras Lanuf oil and gas processing Company were measured and compared. The combination of Irgafos 168 with Irganox 1010, as used in smaller concentration, results in a synergetic effect against thermo-oxidation and protect better than the combination of Weston 399 with Irganox 1010 against the colour change at processing temperature and during long term oxidation process.

Keywords: thermostabilization, high density polyethylene, primary antioxidant, phenolic antioxidant, Irgafos 168, Irganox 1010, Weston 399

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4436 Comparative Analysis of Patent Protection between Health System and Enterprises in Shanghai, China

Authors: Na Li, Yunwei Zhang, Yuhong Niu

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The study discussed the patent protections of health system and enterprises in Shanghai. The comparisons of technical distribution and scopes of patent protections between Shanghai health system and enterprises were used by the methods of IPC classification, co-words analysis and visual social network. Results reflected a decreasing order within IPC A61 area, namely A61B, A61K, A61M, and A61F. A61B required to be further investigated. The highest authorized patents A61B17 of A61B of IPC A61 area was found. Within A61B17, fracture fixation, ligament reconstruction, cardiac surgery, and biopsy detection were regarded as common concerned fields by Shanghai health system and enterprises. However, compared with cardiac closure which Shanghai enterprises paid attention to, Shanghai health system was more inclined to blockages and hemostatic tools. The results also revealed that the scopes of patent protections of Shanghai enterprises were relatively centralized. Shanghai enterprises had a series of comprehensive strategies for protecting core patents. In contrast, Shanghai health system was considered to be lack of strategic patent protections for core patents.

Keywords: co-words analysis, IPC classification, patent protection, technical distribution

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4435 Surgical Outcomes of Lung Cancer Surgery in Tasmania

Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar

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Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.

Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes

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4434 Thai Primary School Teachers’ Attitude and Preparedness to Teach Students with Autism in the General Education Classroom

Authors: Sunanta Klibthong

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Inclusive education services for students with Autism remains in its early developmental stages in Thailand. Despite many more children with autism are attending schools since the Thai government introduced the Education Provision for People with Disabilities Act in 2008, the services students with autism and their families receive are generally lacking. This quantitative study used Attitude and Preparedness to Teach Students with Autism Scale (APTSAS) to investigate 110 primary school teachers’ attitude and preparedness to teach students with autism in the general education classroom. Descriptive statistical analysis of the data found that student behaviour was the most significant factor in building teachers’ negative attitudes students with autism. The majority of teachers also indicated that their pre-service education did not prepare them to meet the learning needs of children with autism in particular, those who are non-verbal. The study is significant and provides direction for enhancing teacher education for inclusivity in Thailand.

Keywords: attitude, autism, teachers, Thailand

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4433 Simulation of the Performance of the Reforming of Methane in a Primary Reformer

Authors: A. Alkattib, M. Boumaza

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Steam reforming is industrially important as it is incorporated in several major chemical processes including the production of ammonia, methanol, hydrogen and ox alcohols. Due to the strongly endothermic nature of the process, a large amount of heat is supplied by fuel burning (commonly natural gas) in the furnace chamber. Reaction conversions, tube catalyst life, energy consumption and CO2 emission represent the principal factors affecting the performance of this unit and are directly influenced by the high operating temperatures and pressures. This study presents a simulation of the performance of the reforming of methane in a primary reformer, through a developed empirical relation which enables to investigate the effects of operating parameters such as the pressure, temperature, steam to carbon ratio on the production of hydrogen, as well as the fraction of non-converted methane. It appears from this analysis that the exit temperature Te, the operating pressure as well the steam to carbon ratio has an important effect on the reforming of methane.

Keywords: reforming, methane, performance, hydrogen, parameters

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4432 Ancelim: Health System Restoration Protocol for Cancer Patients

Authors: Mark Berry

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A number of studies have identified several factors involved in the malignant progression of cancer cells. The Primary modulator in driving inflammation to these transformed cells has been identified as the transcription factor known as nuclear factor-κB. This essential regulator of inflammation and the development of cancer, combined with a microenvironment of inflammation and signaling molecules, plays a major role in the malignant progression of cancer, and this progression is the result of the mutagenic predisposition of persistent substances that combat infection at tumor sites and other areas of chronic inflammation. Inflammation-induced tumors, and their inflammatory cells and regulators may be the primary source of metastasis of tumor cells through angiogenesis. Previous research on cytokines and chemokines, including their downstream targets, has been the focus of the cancer/inflammation connection. The identification of the biological mechanisms of other proteins vital to the inflammation cascade and their interactions are crucial to novel and effective therapeutic protocols for the treatment of inflammation-induced cancers. The Ancelim HSRP Protocol is just such a therapeutic intervention.

Keywords: ancelim, cancer, inflammation, tumor

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4431 Metastatic Polypoid Nodular Melanoma Management During The COVID-19 Pandemic

Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

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4430 Family Functionality in Mexican Children with Congenital and Non-Congenital Deafness

Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

Abstract:

A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: deafness, psychological support, family, adaptation to disability

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4429 Teaching Children about Their Brains: Evaluating the Role of Neuroscience Undergraduates in Primary School Education

Authors: Clea Southall

Abstract:

Many children leave primary school having formed preconceptions about their relationship with science. Thus, primary school represents a critical window for stimulating scientific interest in younger children. Engagement relies on the provision of hands-on activities coupled with an ability to capture a child’s innate curiosity. This requires children to perceive science topics as interesting and relevant to their everyday life. Teachers and pupils alike have suggested the school curriculum be tailored to help stimulate scientific interest. Young children are naturally inquisitive about the human body; the brain is one topic which frequently engages pupils, although it is not currently included in the UK primary curriculum. Teaching children about the brain could have wider societal impacts such as increasing knowledge of neurological disorders. However, many primary school teachers do not receive formal neuroscience training and may feel apprehensive about delivering lessons on the nervous system. This is exacerbated by a lack of educational neuroscience resources. One solution is for undergraduates to form partnerships with schools - delivering engaging lessons and supplementing teacher knowledge. The aim of this project was to evaluate the success of a short lesson on the brain delivered by an undergraduate neuroscientist to primary school pupils. Prior to entering schools, semi-structured online interviews were conducted with teachers to gain pedagogical advice and relevant websites were searched for neuroscience resources. Subsequently, a single lesson plan was created comprising of four hands-on activities. The activities were devised in a top-down manner, beginning with learning about the brain as an entity, before focusing on individual neurons. Students were asked to label a ‘brain map’ to assess prior knowledge of brain structure and function. They viewed animal brains and created ‘pipe-cleaner neurons’ which were later used to depict electrical transmission. The same session was delivered by an undergraduate student to 570 key stage 2 (KS2) pupils across five schools in Leeds, UK. Post-session surveys, designed for teachers and pupils respectively, were used to evaluate the session. Children in all year groups had relatively poor knowledge of brain structure and function at the beginning of the session. When asked to label four brain regions with their respective functions, older pupils labeled a mean of 1.5 (± 1.0) brain regions compared to 0.8 (± 0.96) for younger pupils (p=0.002). However, by the end of the session, 95% of pupils felt their knowledge of the brain had increased. Hands-on activities were rated most popular by pupils and were considered the most successful aspect of the session by teachers. Although only half the teachers were aware of neuroscience educational resources, nearly all (95%) felt they would have more confidence in teaching a similar session in the future. All teachers felt the session was engaging and that the content could be linked to the current curriculum. Thus, a short fifty-minute session can successfully enhance pupils’ knowledge of a new topic: the brain. Partnerships with an undergraduate student can provide an alternative method for supplementing teacher knowledge, increasing their confidence in delivering future lessons on the nervous system.

Keywords: education, neuroscience, primary school, undergraduate

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4428 The Lightener of Love: The World Peace Religion

Authors: Abdul Razzaq

Abstract:

It is known that every human society throughout the world and throughout history, the various religions and their theologies, ethics, and traditions influence everything in their life, shaping socio-economic and political ideas, attitudes and institutions. It is observed that religious teachings and traditions shape how people respond to each other in their daily social inter-course and interaction in the community at large. The majorities of us preserves and protect our own religious beliefs and traditions as generally they symbolize our essential identities, theologically, historically, culturally, socially, and even politically. Our religious faiths symbolize our dignity as persons and our very souls as communities and individuals. It thus goes without saying that in our multi-racial and multi-religious society, the only way for us to live in peace and harmony is for us to live in peaceful co-existence. It is important for us to recognize, understand, accept and respect each other regardless of our respective belief. The history of interfaith is as ancient as the religions since men and women when not at war with their neighbors have always made an effort to understand them (not least because understanding is a strategy for defense, but also because for as long as there is dialogue wars are delayed).

Keywords: Islam, religion, peace, society

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4427 The Lightener of Love - The World Peace

Authors: Abdul Razzaq

Abstract:

It is known that every human society throughout the world and throughout history, the various religions and their theologies, ethics, and traditions influence everything in their life, shaping socio-economic and political ideas, attitudes and institutions. It is observed that religious teachings and traditions shape how people respond to each other in their daily social inter-course and interaction in the community at large. The majorities of us preserves and protect our own religious beliefs and traditions as generally they symbolize our essential identities, theologically, historically, culturally, socially, and even politically. Our religious faiths symbolize our dignity as persons and our very souls as communities and individuals. It thus goes without saying that in our multi-racial and multi-religious society, the only way for us to live in peace and harmony is for us to live in peaceful co-existence. It is important for us to recognize, understand, accept and respect each other regardless of our respective belief. The history of interfaith is as ancient as the religions since men and women when not at war with their neighbors have always made an effort to understand them (not least because understanding is a strategy for defense, but also because for as long as there is dialogue wars are delayed).

Keywords: Islam, interfaith, Sects, world, piece

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4426 Systems Strengthening for Sustainable Family Planning Service Provision in Uganda

Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

Abstract:

Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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4425 Consideration of Failed Fuel Detector Location through Computational Flow Dynamics Analysis on Primary Cooling System Flow with Two Outlets

Authors: Sanghoon Bae, Hanju Cha

Abstract:

Failed fuel detector (FFD) in research reactor is a very crucial instrument to detect the anomaly from failed fuels in the early stage around primary cooling system (PCS) outlet prior to the decay tank. FFD is considered as a mandatory sensor to ensure the integrity of fuel assemblies and mitigate the consequence from a failed fuel accident. For the effective function of FFD, the location of them should be determined by contemplating the effect from coolant flow around two outlets. For this, the analysis on computational flow dynamics (CFD) should be first performed how the coolant outlet flow including radioactive materials from failed fuels are mixed and discharged through the outlet plenum within certain seconds. The analysis result shows that the outlet flow is well mixed regardless of the position of failed fuel and ultimately illustrates the effect of detector location.

Keywords: computational flow dynamics (CFD), failed fuel detector (FFD), fresh fuel assembly (FFA), spent fuel assembly (SFA)

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4424 Assessment of Agricultural Intervention on Ecosystem Services in the Central-South Zone of Chile

Authors: Steven Hidalgo, Patricio Neumann

Abstract:

The growth of societies has increased the consumption of raw materials and food obtained from nature. This has influenced the services offered by ecosystems to humans, mainly supply and regulation services. One of the indicators used to evaluate these services is Net Primary Productivity (NPP), which is understood as the energy stored in the form of biomass by primary organisms through the process of photosynthesis and respiration. The variation of NPP by defined area produces changes in the properties of terrestrial and aquatic ecosystems, which alter factors such as biodiversity, nutrient cycling, carbon storage and water quality. The analysis of NPP to evaluate variations in ecosystem services includes harvested NPP (understood as provisioning services), which is the raw material from agricultural systems used by humans as a source of energy and food, and the remaining NPP (expressed as a regulating service) or the amount of biomass that remains in ecosystems after the harvesting process, which is mainly related to factors such as biodiversity. Given that agriculture is a fundamental pillar of Chile's integral development, the purpose of this study is to evaluate provisioning and regulating ecosystem services in the agricultural sector, specifically in cereal production, in the communes of the central-southern regions of Chile through a conceptual framework based on the quantification of the fraction of Human Appropriation of Net Primary Productivity (HANPP) and the fraction remaining in the ecosystems (NPP remaining). A total of 161 communes were analyzed in the regions of O'Higgins, Maule, Ñuble, Bio-Bío, La Araucanía and Los Lagos, which are characterized by having the largest areas planted with cereals. It was observed that the region of La Araucanía produces the greatest amount of dry matter, understood as provisioning service, where Victoria is the commune with the highest cereal production in the country. In addition, the maximum value of HANPP was in the O'Higgins region, highlighting the communes of Coltauco, Quinta de Tilcoco, Placilla and Rengo. On the other hand, the communes of Futrono, Pinto, Lago Ranco and Pemuco, whose cereal production was important during the study, had the highest values of remaining NPP as a regulating service. Finally, an inverse correlation was observed between the provisioning and regulating ecosystem services, i.e., the higher the cereal or dry matter production in a defined area, the lower the net primary production remaining in the ecosystems. Based on this study, future research will focus on the evaluation of ecosystem services associated with other crops, such as forestry plantations, whose activity is an important part of the country's productive sector.

Keywords: provisioning services, regulating services, net primary productivity, agriculture

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