Search results for: low head hydropower
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1018

Search results for: low head hydropower

358 Impact of Lined/Unlined Canal on Groundwater Recharge in the Lower Bhavani Basin, Tamilnadu, India

Authors: K. Mirudhula, R. Saravanan

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Bhavani basin is the fourth largest Sub Basin in the Cauvery basin. The entire command area of all three major canals that takes off from the Bhavani river falls within the Erode District i.e. Lower Bhavani Project (LBP), Kodiveri and Kalingarayan canals. The LBP canal is a major source of irrigation in Erode District. Many of these canals are unlined and leakage takes place from them. Thus the seepage from the canal helps in recharging the wells in the area, enabling to get adequate water supply for the crops when water was not released from Bhavanisagar Dam. In this study, the groundwater recharge is determined by groundwater flow modeling using Visual MODFLOW model. For this purpose, three major natural sources of groundwater recharge are taken into consideration such as rainfall infiltration, canal seepage and return flow of irrigation. The model was run and ZONEBUDGET gives an idea about the amount of recharge from lined/unlined canal to the field. Unlined canal helps to recharge the groundwater about 20% more than the lined canal. The analysis reveals that the annual rainfall also has rapidly changed in this region. In the LBP canal Head reach meets their requirement with available quantity of water from the canal system. Tail end reach does not receive the required quantity of water because of seepage loss and conveyance loss. Hence the lined canal can be provided for full length of the main canal. Branch canals and minor distributaries are suggested to maintain the canals with unlined canal system.

Keywords: lower Bhavani basin, erode, groundwater flow modeling, irrigation practice, lined canal system

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357 Investigating the Effect of the Shape of the Side Supports of the Gates of the Gotvand Reservoir Dam (from the Peak Overflows) on the Narrowing Coefficients

Authors: M. Abbasi

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A spillway structure is used to pass excess water and floods from upstream or upstream to downstream or tributary. The spillway is considered one of the most key members of the dam, and the failure of many dams is attributed to the inefficiency of their spillway. Weirs should be selected as strong, reliable and high-performance structures, and weirs should be ready for use in all conditions and able to drain the flood so that we do not witness many casualties and financial losses when a flood occurs. The purpose of this study is to simulate the flow pattern passing over the peak spillway in order to optimize and adjust the height of the spillway walls. In this research, the effect of the shape of the side wings on the flow pattern over the peak spillways of the Gotvand reservoir dam was simulated and modelled using Flow3D software. In this research, side wings with rounded walls with six different approach angles were used. In addition, the different value of H/Hd was used to check the effect of the tank head. The results showed that with the constant H/Hd ratio and the increase of the approach angle of the side wing, the flow depth first decreases and then increases. These changes were the opposite regarding the depth average speed of the flow and the depth average concentration of the air entering the flow. At the same time, with the constant angle of approach of the side wing and with the increase of H/Hd ratio, the flow depth increases. In general, a correct understanding of the operation of overflows and a correct design can significantly reduce construction costs and solve flooding problems.

Keywords: effect of the shape, gotvand reservoir dam, narrowing coefficients, supports of the gates

Procedia PDF Downloads 67
356 Forensic Methods Used for the Verification of the Authenticity of Prints

Authors: Olivia Rybak-Karkosz

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This paper aims to present the results of scientific research on methods of forging art prints and their elements, such as signature or provenance and forensic science methods that might be used to verify their authenticity. In the last decades, the art market has observed significant interest in purchasing prints. They are considered an economical alternative to paintings and a considerable investment. However, the authenticity of an art print is difficult to establish as similar visual effects might be achieved with drawings or xerox. The latter is easy to make using a home printer. They are then offered on flea markets or internet auctions as genuine prints. This probable ease of forgery and, at the same time, the difficulty of distinguishing art print techniques were the main reasons why this research was undertaken. A lack of scientific methods dedicated to disclosing a forgery encouraged the author to verify the possibility of using forensic science's methods known and used in other fields of expertise. This research methodology consisted of completing representative forgery samples collected in selected museums based in Poland and a few in Germany and Austria. That allowed the author to present a typology of methods used to forge art prints. Given that one of the most famous graphic design examples is bills and securities, it seems only appropriate to propose in print verification the usage of methods of detecting counterfeit currency. These methods contain an examination of ink, paper, and watermarks. On prints, additionally, signatures and imprints of stamps, etc., are forged as well. So the examination should be completed with handwriting examination and forensic sphragistics. The paper contains a stipulation to conduct a complex analysis of authenticity with the participation of an art restorer, art historian, and forensic expert as head of this team.

Keywords: art forgery, examination of an artwork, handwriting analysis, prints

Procedia PDF Downloads 129
355 Behavioral and Electroantennographic Responses of the Tea Shot Hole Borer, Euwallacea fornicatus, Eichhoff (Scolytidae: Coleoptera) to Volatiles Compounds of Montanoa bipinnatifida (Compositae: Asteraceae) and Development of a Kairomone Trap

Authors: Sachin Paul James, Selvasundaram Rajagopal, Muraleedharan Nair, Babu Azariah

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The shot hole borer (SHB), Euwallacea fornicatus (= Xyleborus fornicatus) (Scolytidae: Coleoptera) is one of the major pests of tea in southern India and Sri Lanka. The partially dried cut stem of a jungle plant, Montanoa bipinnatifida (C.Koch) (Compositae: Asteraceae) reported to attract shot hole borer beetles in the field. Collection, isolation, identification and quantification of the emitted volatiles from the partially dried cut stems of M. bipinnatifida using dynamic head space and GC-MS revealed the presence of seven compounds viz. α- pinene, β- phellandrene, β - pinene, D- limonene, trans-caryophyllene, iso- caryophyllene and germacrene– D. Behavioural bioassays using electroantennogram (EAG) and wind tunnel proved that, among these identified compounds only α - pinene, trans-caryophyllene, β – phellandrene and germacrene-D evoked significant behavioral response and maximum response was obtained to a specific blend of these four compounds @ 10:1:0.1:3. Field trapping experiments of this blend conducted in the SHB infested field using multiple funnel traps further proved the efficiency of the blend with a mean trap catch of 176.7 ± 13.1 beetles. Mass trapping studies in the field helped to develop a kairomone trap for the management of SHB in the tea fields of southern India.

Keywords: electroantennogram, kairomone trap, Montanoa bipinnatifida, tea shot hole borer

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354 Investigating the Effect of the Psychoactive Substances Act 2016 on the Incidence of Adverse Medical Events in Her Majesty’s Prison (HMP) Leeds

Authors: Hayley Boal, Chloe Bromley, John Fairfield

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Novel Psychoactive Substances (NPS) are synthetic compounds designed to reproduce effects of illicit drugs. Cheap, potent, and readily available on UK highstreets from so-called ‘head shops’, in recent years their use has surged and with it have emerged side effects including seizures, aggression, palpitations, coma, and death. Rapid development of new substances has vastly outpaced pre-existing drug legislation but the Psychoactive Substances Act 2016 rendered all but tobacco, alcohol, and amyl nitrates, illegal. Drug use has long been rife within prisons, but the absence of a reliable screening tool alongside the availability of NPS makes them ideal for prison use. Here we examine the occurrence of NPS-related adverse side effects within HMP Leeds, comparing May-September of 2015 and 2017 using daily reports distributed amongst prison staff summarising medical and behavioural incidents of the previous day. There was a statistically-significant rise of over 200% in the use of NPS between 2015 and 2017: 0.562 and 1.149 incidents per day respectively. In 2017, 38.46% incidents required ambulances, fallen from 51.02% in 2015. Although the most common descriptions in both years were ‘seizure’ and ‘unresponsive’, by 2017 ‘inhalation by staff’ had emerged. Patterns of NPS consumption mirrored the prison regime, peaking when cell doors opened, and prisoners could socialise. Despite limited data, the Psychoactive Substances Act has clearly been an insufficient deterrent to the prison population; more must be done to understand and address substance misuse in prison. NPS remains a significant risk to prisoners’ health and wellbeing.

Keywords: legislation, novel psychoactive substances, prison, spice

Procedia PDF Downloads 189
353 From Liquid to Solid: Advanced Characterization of Glass Applying Oscillatory Rheometry

Authors: Christopher Giehl, Anja Allabar, Daniela Ehgartner

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Rotational rheometry is standard practice for the viscosity measurement of molten glass, neglecting the viscoelastic properties of this material, especially at temperatures approaching the glass transition. Oscillatory rheometry serves as a powerful toolbox for glass melt characterization beyond viscosity measurements. Heating and cooling rates and the time-dependent visco-elastic behavior influence the temperature where materials undergo the glass transition. This study presents quantitative thermo-mechanical visco-elasticity measurements on three samples in the Na-K-Al-Si-O system. The measurements were performed with a Furnace Rheometer System combined with an air-bearing DSR 502 measuring head (Anton Paar) and a Pt90Rh10 measuring geometry. Temperature ramps were conducted in rotation and oscillation, and the (complex) viscosity values were compared to calculated viscosity values based on sample composition. Furthermore, temperature ramps with different frequencies were conducted, also revealing the frequency-dependence of the shear loss modulus G’’ and the shear storage modulus G’. Here, lower oscillatory frequency results in lower glass transition temperature, as defined by the G’-G’’ crossover point. This contribution demonstrates that oscillatory rheometry serves as a powerful toolbox beyond viscosity measurements, as it considers the visco-elasticity of glass melts quantifying viscous and elastic moduli. Further, it offers a strong definition of Tg beyond the 10^12 Pas concept, which cannot be utilized with rotational viscometry data.

Keywords: frequency dependent glass transition, Na-K-Al-Si-O glass melts, oscillatory rheometry, visco-elasticity

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352 The Effect of Fibre Orientation on the Mechanical Behaviour of Skeletal Muscle: A Finite Element Study

Authors: Christobel Gondwe, Yongtao Lu, Claudia Mazzà, Xinshan Li

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Skeletal muscle plays an important role in the human body system and function by generating voluntary forces and facilitating body motion. However, The mechanical properties and behaviour of skeletal muscle are still not comprehensively known yet. As such, various robust engineering techniques have been applied to better elucidate the mechanical behaviour of skeletal muscle. It is considered that muscle mechanics are highly governed by the architecture of the fibre orientations. Therefore, the aim of this study was to investigate the effect of different fibre orientations on the mechanical behaviour of skeletal muscle.In this study, a continuum mechanics approach–finite element (FE) analysis was applied to the left bicep femoris long head to determine the contractile mechanism of the muscle using Hill’s three-element model. The geometry of the muscle was segmented from the magnetic resonance images. The muscle was modelled as a quasi-incompressible hyperelastic (Mooney-Rivlin) material. Two types of fibre orientations were implemented: one with the idealised fibre arrangement, i.e. parallel single-direction fibres going from the muscle origin to insertion sites, and the other with curved fibre arrangement which is aligned with the muscle shape.The second fibre arrangement was implemented through the finite element method; non-uniform rational B-spline (FEM-NURBs) technique by means of user material (UMAT) subroutines. The stress-strain behaviour of the muscle was investigated under idealised exercise conditions, and will be further analysed under physiological conditions. The results of the two different FE models have been outputted and qualitatively compared.

Keywords: FEM-NURBS, finite element analysis, Mooney-Rivlin hyperelastic, muscle architecture

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351 Quantification of Hydrogen Sulfide and Methyl Mercaptan in Air Samples from a Waste Management Facilities

Authors: R. F. Vieira, S. A. Figueiredo, O. M. Freitas, V. F. Domingues, C. Delerue-Matos

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The presence of sulphur compounds like hydrogen sulphide and mercaptans is one of the reasons for waste-water treatment and waste management being associated with odour emissions. In this context having a quantifying method for these compounds helps in the optimization of treatment with the goal of their elimination, namely biofiltration processes. The aim of this study was the development of a method for quantification of odorous gases in waste treatment plants air samples. A method based on head space solid phase microextraction (HS-SPME) coupled with gas chromatography - flame photometric detector (GC-FPD) was used to analyse H2S and Metil Mercaptan (MM). The extraction was carried out with a 75-μm Carboxen-polydimethylsiloxane fiber coating at 22 ºC for 20 min, and analysed by a GC 2010 Plus A from Shimadzu with a sulphur filter detector: splitless mode (0.3 min), the column temperature program was from 60 ºC, increased by 15 ºC/min to 100 ºC (2 min). The injector temperature was held at 250 ºC, and the detector at 260 ºC. For calibration curve a gas diluter equipment (digital Hovagas G2 - Multi Component Gas Mixer) was used to do the standards. This unit had two input connections, one for a stream of the dilute gas and another for a stream of nitrogen and an output connected to a glass bulb. A 40 ppm H2S and a 50 ppm MM cylinders were used. The equipment was programmed to the selected concentration, and it automatically carried out the dilution to the glass bulb. The mixture was left flowing through the glass bulb for 5 min and then the extremities were closed. This method allowed the calibration between 1-20 ppm for H2S and 0.02-0.1 ppm and 1-3.5 ppm for MM. Several quantifications of air samples from inlet and outlet of a biofilter operating in a waste management facility in the north of Portugal allowed the evaluation the biofilters performance.

Keywords: biofiltration, hydrogen sulphide, mercaptans, quantification

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350 Effect of Miconazole Nitrate on Immunological Response and Its Preventive Efficacy in Labeo rohita Fingerlings against Oomycetes Saprolegnia parasitica

Authors: Mukta Singh, Ratan Kumar Saha, Himadri Saha, Paramveer Singh

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The present study evaluated the effect of sub-lethal doses of antifungal drug miconazole nitrate (MCZ) on immunological responses including immune-related gene expression and its role as a prophylactic drug against S. parasitica in Labeo rohita fingerlings. Fish were fed with sub lethal doses of MCZ i.e., T1- 6.30 mg MCZ kgBW⁻¹, T2- 12.61 mg MCZ kgBW⁻¹ and T3- 25.22 mg MCZ kgBW⁻¹ and sampling was done at different time intervals for 240 h. Immunological parameters viz. lysozyme activity, oxygen radical production and plasma anti-protease activity showed significant enhancement (p < 0.05) in fish fed with T2 and T3 doses. Significant reduction in plasma protein content was observed in all the dietary groups as compared to control. Expression of immune-relevant genes like TLR-22 and β2-M showed significantly higher expression at six h and 24 h of sampling in both liver and head-kidney. However, these genes showed a down-regulation after 120 h of sampling in both the tissues. Preventive efficacy study showed that single dose of MCZ provides protection against oomycetes up to the fourth day of infection. Significantly higher mortality was observed in control diet-fed fish as compared to fish fed with MCZ medicated diet. Thus, from the study, it can be concluded that the MCZ can act as a potent antifungal agent for preventing oomycetes infection as well as to enhance the immune response.

Keywords: antifungal, immune gene, immunological, miconazole nitrate, prophylactic

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349 The Importance of Erythrocyte Parameters in Obese Children

Authors: Orkide Donma, M. Metin Donma, Burcin Nalbantoglu, Birol Topcu, Feti Tulubas, Murat Aydin, Tuba Gokkus, Ahmet Gurel

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Increasing prevalence of childhood obesity has increased the interest in early and late indicators of gaining weight. Cell blood counts may be indicators of proinflammatory states. The aim was to evaluate associations of hematological parameters, including Hematocrit (HTC), hemoglobin, blood cell counts, and their indices with the degree of obesity in pediatric population. A total of 249; -139 morbidly obese (MO), 82 healthy Normal Weight (NW) and 28 Overweight (OW) children were included into the scope of the study. WHO BMI-for age percentiles were used to form age- and sex-matched groups. Informed consent forms and the Ethics Committee approval were obtained. Anthropometric measurements were performed. Hematological parameters were determined. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. Significant differences (p=0.000) between waist-to-hip ratios and head-to-neck ratios (hnrs) of MO and NW children were detected. A significant difference between hnrs of OW and MO children (p=0.000) was observed. Red cell Distribution Width (RDW) was higher in OW children than NW group (p=0.030). Such finding couldn’t be detected between MO and NW groups. Increased RDW was prominent in OW children. The decrease in Mean Corpuscular Hemoglobin Concentration (MCHC) values in MO children was sharper than the values in OW children (p=0.006 vs p=0.042) compared to those in NW group. Statistically higher HTC levels were observed between MO-NW (p=0.014), but none between OW-NW. Though the cause-effect relationship between obesity and erythrocyte indices still needs further investigation, alterations in RDW, HTC, MCHC during obesity may be of significance in the early life.

Keywords: anthropometry, children, erythrocytes, obesity

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348 Upconversion Nanomaterials for Applications in Life Sciences and Medicine

Authors: Yong Zhang

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Light has proven to be useful in a wide range of biomedical applications such as fluorescence imaging, photoacoustic imaging, optogenetics, photodynamic therapy, photothermal therapy, and light controlled drug/gene delivery. Taking photodynamic therapy (PDT) as an example, PDT has been proven clinically effective in early lung cancer, bladder cancer, head, and neck cancer and is the primary treatment for skin cancer as well. However, clinical use of PDT is severely constrained by the low penetration depth of visible light through thick tissue, limiting its use to target regions only a few millimeters deep. One way to enhance the range is to use invisible near-infrared (NIR) light within the optical window (700–1100nm) for biological tissues, extending the depth up to 1cm with no observable damage to the intervening tissue. We have demonstrated use of NIR-to-visible upconversion fluorescent nanoparticles (UCNPs), emitting visible fluorescence when excited by a NIR light at 980nm, as a nanotransducer for PDT to convert deep tissue-penetrating NIR light to visible light suitable for activating photosensitizers. The unique optical properties of UCNPs enable the upconversion wavelength to be tuned and matched to the activation absorption wavelength of the photosensitizer. At depths beyond 1cm, however, tissue remains inaccessible to light even within the NIR window, and this critical depth limitation renders existing phototherapy ineffective against most deep-seated cancers. We have demonstrated some new treatment modalities for deep-seated cancers based on UCNP hydrogel implants and miniaturized, wirelessly powered optoelectronic devices for light delivery to deep tissues.

Keywords: upconversion, fluorescent, nanoparticle, bioimaging, photodynamic therapy

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347 Photophysics and Rotational Relaxation Dynamics of 6-Methoxyquinoline Fluorophore in Cationic Alkyltrimethylammonium Bromide Micelles

Authors: Tej Varma Y, Debi D. Pant

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Photophysics and rotational dynamics of the fluorescent probe, 6-methoxyquinoline (6MQ) with cationic surfactant, alkyltrimethylammonium bromide (nTAB) micelle solutions have been investigated (n = 12, 14 and 16). Absorption and emission peaks of the dye have been observed to shift at concentrations around critical micellar concentration (cmc) of nTAB compared to that of bulk solutions suggesting probe is in a lower polar environment. The probe senses changes in polarity (ET (30)) brought about by variation of surfactant chain length concentration and is invariably solubilized in the aqueous interface or palisade layer. The order of change in polarity observed was DTAB > CTAB > TTAB. The binding constant study shows that the probe binds strongest with TTAB (is of the order TTAB > CTAB > DTAB) due to deeper penetration into the micelle. The anisotropy decay for the probe in all the nTAB micelles studied have been rationalized based on a two-step model consisting of fast-restricted rotation of the probe and slow lateral diffusion of the probe in the micelle that is coupled to the overall rotation of the micelle. Fluorescence lifetime measurements of probe in the cationic micelles demonstrate the close proximity of the 6MQ to the Br - counterions. The fluorescence lifetimes of TTAB and DTAB are much shorter than in CTAB. These results indicate that 6MQ resides to a substantial degree in the head group region of the micelles. All the changes observed in the steady state fluorescence, microenvironment, fluorescence lifetimes, fluorescence anisotropy, and other calculations are in agreement with each other suggesting binding of the cationic surfactant with the neutral dye molecule.

Keywords: photophysics, chain length, ntaB, micelles

Procedia PDF Downloads 637
346 Impact of Mucormycosis Infection In Limb Salvage for Trauma Patients

Authors: Katie-Beth Webster

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Mucormycosis is a rare opportunistic fungal infection that, if left untreated, can cause large scale tissue necrosis and death. There are a number of cases of this in the literature, most commonly in the head and neck region arising from sinuses. It is also usually found in immunocompromised patient subgroups. This study reviewed a number of cases of mucormycosis in previously fit and healthy young trauma patients to assess predisposing factors for infection and adequacy of current treatment paradigms. These trauma patients likely contracted the fungal infection from the soil at the site of the incident. Despite early washout and debridement of the wounds at the scene of the injury and on arrival in hospital, both these patients contracted mucormycosis. It was suspected that inadequate early debridement of soil contaminated limbs was one of the major factors that can lead to catastrophic tissue necrosis. In both cases, this resulted in the patients having a higher level of amputation than would have initially been required based on the level of their injury. This was secondary to cutaneous and soft tissue necrosis secondary to the fungal infiltration leading to osteomyelitis and systemic sepsis. In the literature, it appears diagnosis is often protracted in this condition secondary to inadequate early treatment and long processing times for fungal cultures. If fungal cultures were sent at the time of first assessment and adequate debridements are performed aggressively early, it could lead to these critically unwell trauma patients receiving appropriate antifungal and surgical treatment earlier in their episode of care. This is likely to improve long term outcomes for these patients.

Keywords: mucormycosis, plastic surgery, osteomyelitis, trauma

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345 Acute Kidney Injury in Severe Trauma Patients: Clinical Presentation and Risk Factor Analysis

Authors: Inkyong Yi

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Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

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344 Outcome Analysis of Surgical and Nonsurgical Treatment on Indicated Operative Chronic Subdural Hematoma: Serial Case in Cipto Mangunkusumo Hospital Indonesia

Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli

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Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.

Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome

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343 Retrospective Analysis of Facial Skin Cancer Patients Treated in the Department of Oral and Maxillofacial Surgery Kiel

Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

Procedia PDF Downloads 106
342 Isolation and Characterization of Actinophages Infecting Streptomyces scabies in Egypt

Authors: D. Zahran, M. AlKhazindar, M. Khalil, E. T. A. Sayed

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Streptomyces scabies is a pathogenic actinomycete that infects potato crop causing severe production losses. Actinophages affect the composition and diversity of the bacterial population, thereby, can be used as a biological control. Samples of actinomycetes and phages were collected from different cultivated soils including farms of Faculty of Science, Faculty of Agriculture and different locations in Giza, Egypt. Actinomycetes were identified by using biochemical, morphological tests and molecular studies using 16S rRNA sequencing. Two specific phages (E1 and E2) against Streptomyces scabies and other hosts were isolated. Phages were identified using dilution end point (DEP), longevity in vitro (LIV), thermal inactivation point (TIP), host range and electron microscopy. PhageE1 was characterized by 10-8 (DEP),180 days(LIV), 95°C(TIP), narrow host range and electron microscopy showed ahead (59.9 nm) and neck (10.4nm). On the other hand phageE2 had 10-20 (DEP),180 days(LIV), 90°C(TIP), and the size of head was (67.2 nm) and tail (114nm). Antiviral activity was also studied using different chemicals (NaCL, KCL, CaCL2, BaCL2, CoCL2, AgNO3, ALCL3and HgCL2) with different concentrations and different plant extracts with different concentrations (star anise, tea, tillia, peppermint, ginger, cumin, chamomile, turmeric cinnamon, marjoram and black cumin). Both Phage E1and phage E2 were vulnerable to (cumin, ginger, chamomile, guavas leaves and star anise) but resistant to (Tillie, marjoram, fennelflower seeds, peppermint, and cinnamon).

Keywords: potato scab, actinophages, biological control, electron microscopy, TIP, DEP, LIV, antiviral activity

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341 Perceptions of Students toward ODL Services Quality in Facilitating Their Study: Experience of Universitas Terbuka in Managing ODL in Cultural Diversity Areas

Authors: Ribut Alam Malau, Durri Andriani, C. B. Supartomo

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Universitas Terbuka (UT) as a higher education institution implements open and distance education is responsible to provide higher education to all Indonesian citizen wherever they live, including those reside in cultural diversity aras. Operate from Jakarta Head Office and 37 regional centers (ROs), UT is accustomed to the challenge. UT-Kupang and UT-Ambon which oversee East Nusa Tenggara and Maluku have successfully provided quality educational services for students. The two ROs have provided educational facilities which could assist the students to cope with their study in spite of the diversity situations. In order to analyze the effectiveness of the facilities provided, questionnaires focusing on tutorial services were sent to 90 students in the two ROs asking them to assess the facilities which best fulfills students’ needs in terms of their culture diversity. The results showed that UT-Kupang and UT-Ambon have successful in providing education for students in their areas as reflected in more than 80% of respondents aware of the facilities concerning tutorial service except for tutorial mechanism where only 34,5% of respondents aware of. However, despite lower rate of awareness in tutorial mechanism, majority of respondent 90.8% of respondents registered in tutorials and 95.4% will register in tutorials next semester. The majority of respondents showed appreciation for the ROs efforts to provide tutorials on weekdays which could accommodate their beliefs. In addition, conducting tutorials in all islands also perceived highly since students did not have to commute between islands. Efforts done by UT-Kupang and UT-Ambon have proven to be appreciated by students.

Keywords: archipelago, cultural diversity, ODL, service quality, Universitas Terbuka

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340 Knowledge, Attitudes, and Practices regarding Anthrax among Community Members, Health and Veterinary Workers in Maragua, Kenya

Authors: Isaiah Chacha, Samuel Arimi, Andrew Thaiya

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Background: This study was conducted to assess knowledge, attitudes and practices regarding anthrax in Maragua, Kenya to provide baseline information to design interventions. Methods: A cross sectional survey was conducted among head of households, health and veterinary workers in Maragua Sub-county in August and September 2014. Administered questionnaires were used to collect data from household members and a key informant interview held with health and veterinary workers. Multi stage sampling was used to obtain participants’ knowledge, attitudes and practices. Questions were scored and descriptively analyzed using Excel spreadsheet then exported to GenStat Discovery Edition 4. Results: A total of 293 community members were recruited in this study. The overall level of knowledge was 77.9% of all community members regarding cause, transmission, symptoms and prevention of the disease in both humans and animals. Majority of the participants (96.3%) had heard about anthrax. A total of 99 (33.8%) correspondents had seen a person with anthrax and 75.1% think that anthrax is a very serious disease in the area. Of the interviewed correspondents, 14.3% of them have had their animals (mostly cattle) suffer from anthrax while 15.7% had either suffered from anthrax or have had their family member who suffered from anthrax. Conclusion: The study findings indicate above average knowledge on cause, symptoms, transmission and prevention of anthrax among community members in humans and animals. Practices in this study were still risk among community members. Veterinary and Medical health planners should design anthrax awareness interventions as a team targeting to reach these communities and the public through barazas, radio, CHW and other communication channel on a regular basis.

Keywords: anthrax, attitudes, Kenya, knowledge, Maragua, practices

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339 Design and Synthesis of Some Oxadiazole Bearing Benzimidazole Derivatives as Potential Epidermal Growth Factor Receptor Inhibitors

Authors: Ismail Celik, Gulgun Ayhan Kilcigil, Berna Guven, Zumra Kara, Arzu Onay-Besikci

Abstract:

Epidermal Growth Factor Receptor is the cell-surface receptor of the ErbB (erythroblastic leukemia viral oncogene homologue receptors) family of tyrosine kinases. It plays a vital role in regulating the proliferation and differentiation of cells. However, a variety of mechanisms, such as EGFR expression, mutation, and ligand-dependent receptor dimerization, are associated with the development of various activated EGFR tumors. EGFR is highly expressed in most solid tumors, including breast, head and neck cancer, non-small cell lung cancer (NSCLC), renal, ovarian, and colon cancers. Thus, specific EGFR inhibition plays one of the key roles in cancer treatment. The compounds used in the treatment as tyrosine kinase inhibitors are known to contain the benzimidazole isosterium indole, pazopanib, and axitinibin indazole rings. In addition, benzimidazoles have been shown to exhibit protein kinase inhibitory activity in addition to their different biological activities.Based on these data, it was planned and synthesized of some oxadiazole bearing benzimidazole derivatives [N-cyclohexyl-5-((2-phenyl/substitutedphenyl-1H-benzo[d]imidazole-1-yl) methyl)-1,3,4-oxadiazole-2-amine]. EGFR kinase inhibitory efficiency of the synthesized compounds was determined by comparing them with a known kinase inhibitor erlotinib in vitro, and two of the compounds bearing phenyl (19a) and 3,4-dibenzyloxyphenyl (21a) ring exhibited significant activities.

Keywords: benzimidazole, EGFR kinase inhibitory, oxadiazole, synthesis

Procedia PDF Downloads 139
338 Factors Affecting of Musculoskeletal Disorders in Nurses from a Taiwan Hospital

Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

Procedia PDF Downloads 333
337 Effect of Synchronization Protocols on Serum Concentrations of Estrogen and Progesterone in Holstein Dairy Heifers

Authors: K. Shafiei, A. Pirestani, G. Ghalamkari, S. Safavipour

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Use of GnRH or its agonists to increase conception rates should be based on an understanding of GnRH-induced biological effects on the reproductive-endocrine system. This effect may occur through GnRH-stimulated LH surge stimulating production of progesterone by corpus luteum.the aim of this study was to compare the effects on reproductive efficiency of a luteolytic dose of a synthetic prostaglandin Cloprostenol Sodium versus ainjectable progesterone and Luliberin- A on Follicle estrogen and progesterone levels.In this study, we used45 head of holstein dairy heifersin the three treatments, with 15 replicates per treatment were performed in random groups. all the heifers before the projects is began in two steps injection 3 mL CloprostenolSodium with an interval of 11 days been synchronized and 10 days later, second injection of prostaglandin was conducted after that we started below protocol:Control group (daily sodium chloride serum injection 1 cc), Group B: Day Zero, intramuscular injection of 15 mg Luliberin- A + every other day injection of 3 cc progesterone + day 7, injection of Cloprostenol Sodium+ day 9, injection of 15 mg Luliberin- A.Group C: similar to Grop B + daily injection of progesterone after that blood samples was collected and centrifuged.plasma were analysed by ELISA.the analysis of this study uses SPSS data software package and compared between the mean and LS Means LSD test at 5% significance level was used.The results of this study shows that maximum of progesterone plasma levels were in the control gruop (P ≥ 0.05).Therefore, daily injection of progesterone inhibit the growth CL. the most estrogen levels in plasma were in Group C (P ≥ 0.05) thus it can be concluded, rise in endogenous estrogen concentrations normally stimulates the preovulatory LH release in heifers.

Keywords: Luliberin- A, Cloprostenol Sodium, estrogen, progesterone, dairy heifers

Procedia PDF Downloads 541
336 The Effect of Geographical Differentials of Epidemiological Transition on Health-Seeking Behavior in India

Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

Procedia PDF Downloads 183
335 The Impact of Food Inflation on Poverty: An Analysis of the Different Households in the Philippines

Authors: Kara Gianina D. Rosas, Jade Emily L. Tong

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This study assesses the vulnerability of households to food price shocks. Using the Philippines as a case study, the researchers aim to understand how such shocks can cause food insecurity in different types of households. This paper measures the impact of actual food price changes during the food crisis of 2006-2009 on poverty in relation to their spatial location. Households are classified as rural or urban and agricultural or non-agricultural. By treating food prices and consumption patterns as heterogeneous, this study differs from conventional poverty analysis as actual prices are used. Merging the Family, Income and Expenditure Survey (FIES) with the Consumer Price Index dataset (CPI), the researchers were able to determine the effects on poverty measures, specifically, headcount index, poverty gap, and poverty severity. The study finds that, without other interventions, food inflation would lead to a significant increase in the number of households that fall below the poverty threshold, except for households whose income is derived from agricultural activities. It also finds that much of the inflation during these years was fueled by the rise in staple food prices. Essentially, this paper aims to broaden the economic perspective of policymakers with regard to the heterogeneity of impacts of inflation through analyzing the deeper microeconomic levels of different subgroups. In hopes of finding a solution to lessen the inequality gap of poverty between the rural and urban poor, this paper aims to aid policymakers in creating projects targeted towards food insecurity.

Keywords: poverty, food inflation, agricultural households, non-agricultural households, net consumption ratio, urban poor, rural poor, head count index, poverty gap, poverty severity

Procedia PDF Downloads 246
334 Nalanda ‘School of Joy’: Teaching Learning Strategies and Support System, for Implementing Child-Friendly Education in Bangladesh

Authors: Sufia Ferdousi

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Child-friendly education (CFE) is very important for the children, especially the early year’s students, because it fosters the holistic development of a child. Teacher plays a key role in creating child-friendly education. This study intends to learn about child-friendly education in Bangladesh. The purpose of the study is to explore how CFE is being practiced in Bangladesh. The study attempted to fulfill the purpose through case study investigation. One school, named Nalanda, was selected for the study as it claims to run the school through CFE approach. The objective of the study was to identify, how this school is different from the other schools in Bangladesh, to explore overall teaching learning system like, curriculum, teaching strategies, assessments and to investigate the support system for Child Friendly Education provided to the teachers through training or mentoring. The nature of the case study was qualitative method to get maximum information from the students, parents, teachers and school authorities. The findings were based on 3 classroom observations, interviews with 1 teacher, 1 head teacher and 1 trainer, FGD with 10 students and 6 parents, were used to collect the data. It has been found that Nalanda is different than the other schools in Bangladesh in terms of, parents’ motivation about school curriculum, and sufficiency of teachers’ knowledge on joyful learning/child-friendly learning. The students took part in the extracurricular activities alongside the national curriculum. Teachers showed particular strength in the teaching learning strategies, using materials and assessment. And Nalanda gives strong support for teacher’s training. In conclusion, The Nalanda School in Dhaka was found appropriate for the requirements of Child-friendly education.

Keywords: child friendly education, overall teaching learning system, the requirements of child-friendly education, the alternative education approach

Procedia PDF Downloads 247
333 Effect of Prone Trunk Extension on Scapular and Thoracic Kinematics, and Activity during Scapular Posterior Tilting Exercise in Subjects with Round Shoulder Posture

Authors: A-Reum Shin, Heon-Seock Cynn, Ji-Hyun Lee, Da-Eun Kim

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Round shoulder posture (RSP) is a position of scapular protraction and elevation, which may appear as scapular winging, and humeral internal rotation. Flexed posture (FP) may also affect RSP because FP is characterized by hyperkyphosis, forward head posture, and height reduction. The aim of this study was to investigate the effect of scapular posterior tilting exercise with prone trunk extension on round shoulder posture, activities of lower trapezius and serratus anterior, flexed posture, and thoracic erector spinae activity in subjects with round shoulder posture. Fifteen subjects with round shoulder posture were recruited in this study. Activities of lower trapezius, serratus anterior and thoracic erector spinae were measured during both scapular posterior tilting exercise and scapular posterior tilting exercise with prone trunk extension using electromyography, and round shoulder posture and flexed posture were measured immediately after each exercises using caliper. When the prone trunk extension was applied, the round shoulder posture and flexed posture significantly decreased, activities of lower trapezius and thoracic erector spinae significantly increased (p < 0.05) compared with the scapular posterior tilting exercise alone. There was no significant difference in serratus anterior activity between two exercises. Thus, prone trunk extension could be effective method to improve round shoulder posture during scapular posterior tilting exercise in subjects with round shoulder posture.

Keywords: flexed posture, prone trunk extension, round shoulder posture, scapular posterior tilting

Procedia PDF Downloads 213
332 Effect of Depth on Texture Features of Ultrasound Images

Authors: M. A. Alqahtani, D. P. Coleman, N. D. Pugh, L. D. M. Nokes

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In diagnostic ultrasound, the echo graphic B-scan texture is an important area of investigation since it can be analyzed to characterize the histological state of internal tissues. An important factor requiring consideration when evaluating ultrasonic tissue texture is the depth. The effect of attenuation with depth of ultrasound, the size of the region of interest, gain, and dynamic range are important variables to consider as they can influence the analysis of texture features. These sources of variability have to be considered carefully when evaluating image texture as different settings might influence the resultant image. The aim of this study is to investigate the effect of depth on the texture features in-vivo using a 3D ultrasound probe. The left leg medial head of the gastrocnemius muscle of 10 healthy subjects were scanned. Two regions A and B were defined at different depth within the gastrocnemius muscle boundary. The size of both ROI’s was 280*20 pixels and the distance between region A and B was kept constant at 5 mm. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The paired t –test was used to test the depth effect for the normally distributed data and the Wilcoxon–Mann-Whitney test was used for the non-normally distributed data. The gray level, variance, and run length matrix were significantly lowered when the depth increased. The other texture parameters showed similar values at different depth. All the texture parameters showed no significant difference between depths A and B (p > 0.05) except for gray level, variance and run length matrix (p < 0.05). This indicates that gray level, variance, and run length matrix are depth dependent.

Keywords: ultrasound image, texture parameters, computational biology, biomedical engineering

Procedia PDF Downloads 295
331 Neuroimaging Markers for Screening Former NFL Players at Risk for Developing Alzheimer's Disease / Dementia Later in Life

Authors: Vijaykumar M. Baragi, Ramtilak Gattu, Gabriela Trifan, John L. Woodard, K. Meyers, Tim S. Halstead, Eric Hipple, Ewart Mark Haacke, Randall R. Benson

Abstract:

NFL players, by virtue of their exposure to repetitive head injury, are at least twice as likely to develop Alzheimer's disease (AD) and dementia as the general population. Early recognition and intervention prior to onset of clinical symptoms could potentially avert/delay the long-term consequences of these diseases. Since AD is thought to have a long preclinical incubation period, the aim of the current research was to determine whether former NFL players, referred to a depression center, showed evidence of incipient dementia in their structural imaging prior to diagnosis of dementia. Thus, to identify neuroimaging markers of AD, against which former NFL players would be compared, we conducted a comprehensive volumetric analysis using a cohort of early stage AD patients (ADNI) to produce a set of brain regions demonstrating sensitivity to early AD pathology (i.e., the “AD fingerprint”). A cohort of 46 former NFL players’ brain MRIs were then interrogated using the AD fingerprint. Brain scans were done using a T1-weighted MPRAGE sequence. The Free Surfer image analysis suite (version 6.0) was used to obtain the volumetric and cortical thickness data. A total of 55 brain regions demonstrated significant atrophy or ex vacuo dilatation bilaterally in AD patients vs. healthy controls. Of the 46 former NFL players, 19 (41%) demonstrated a greater than expected number of atrophied/dilated AD regions when compared with age-matched controls, presumably reflecting AD pathology.

Keywords: alzheimers, neuroimaging biomarkers, traumatic brain injury, free surfer, ADNI

Procedia PDF Downloads 154
330 Design and Analysis of a Piezoelectric Linear Motor Based on Rigid Clamping

Authors: Chao Yi, Cunyue Lu, Lingwei Quan

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Piezoelectric linear motors have the characteristics of great electromagnetic compatibility, high positioning accuracy, compact structure and no deceleration mechanism, which make it promising to applicate in micro-miniature precision drive systems. However, most piezoelectric motors are employed by flexible clamping, which has insufficient rigidity and is difficult to use in rapid positioning. Another problem is that this clamping method seriously affects the vibration efficiency of the vibrating unit. In order to solve these problems, this paper proposes a piezoelectric stack linear motor based on double-end rigid clamping. First, a piezoelectric linear motor with a length of only 35.5 mm is designed. This motor is mainly composed of a motor stator, a driving foot, a ceramic friction strip, a linear guide, a pre-tightening mechanism and a base. This structure is much simpler and smaller than most similar motors, and it is easy to assemble as well as to realize precise control. In addition, the properties of piezoelectric stack are reviewed and in order to obtain the elliptic motion trajectory of the driving head, a driving scheme of the longitudinal-shear composite stack is innovatively proposed. Finally, impedance analysis and speed performance testing were performed on the piezoelectric linear motor prototype. The motor can measure speed up to 25.5 mm/s under the excitation of signal voltage of 120 V and frequency of 390 Hz. The result shows that the proposed piezoelectric stacked linear motor obtains great performance. It can run smoothly in a large speed range, which is suitable for various precision control in medical images, aerospace, precision machinery and many other fields.

Keywords: piezoelectric stack, linear motor, rigid clamping, elliptical trajectory

Procedia PDF Downloads 153
329 Palliative Performance Scale Differences between Patients Referred by Specialized Cancer Center and General Hospitals to the Palliative Care Center in Kuwait

Authors: Khalid Al Saleh, Najlaa AlSayed

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Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

Procedia PDF Downloads 305