Search results for: limitation of medical personnel
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4563

Search results for: limitation of medical personnel

3573 Effectiveness of Interactive Integrated Tutorial in Teaching Medical Subjects to Dental Students: A Pilot Study

Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

Abstract:

It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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3572 Evaluating the Effect of Splitting Wind Farms on Power Output

Authors: Nazanin Naderi, Milton Smith

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Since worldwide demand for renewable energy is increasing rapidly because of the climate problem and the limitation of fossil fuels, technologies of alternative energy sources have been developed and the electric power network now includes renewable energy resources such as wind energy. Because of the huge advantages that wind energy has, like reduction in natural gas use, price pressure, emissions of greenhouse gases and other atmospheric pollutants, electric sector water consumption and many other contributions to the nation’s economy like job creation it has got too much attention these days from different parts of the world especially in the United States which is trying to provide 20% of the nation’s energy from wind by 2030. This study is trying to evaluate the effect of splitting wind farms on power output. We are trying to find if we can get more output by installing wind turbines in different sites rather than installing all wind turbines in one site. Five potential sites in Texas have been selected as a case study and two years wind data has been gathered for these sites. Wind data are analyzed and effect of correlation between sites on power output has been evaluated. Standard deviation and autocorrelation effect has also been considered for this study. The paper has been organized as follows: After the introduction the second section gives a brief overview of wind analysis. The third section addresses the case study and evaluates correlation between sites, auto correlation of sites and standard deviation of power output. In section four we describe the results.

Keywords: auto correlation, correlation between sites, splitting wind farms, power output, standard deviation

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3571 Harmonic Assessment and Mitigation in Medical Diagonesis Equipment

Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

Abstract:

Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

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3570 A Framework Factors Influencing Accounting Information Systems Adoption Success

Authors: Manirath Wongsim

Abstract:

AIS plays an important role in business management, strategic and can provide assistance in all phases of decision making. Thus, many organisations needs to be seen as well adopting AIS, which is critical to a company in order to organise, manage and operate process in all sections. In order to implement AIS successfully, it is important to understand the underlying factors that influence the AIS adoption. Therefore, this research intends to study this perspective of factors influence and impact on AIS adoption’s success. The model has been designed to illustrate factors influences in AIS adoption. It also attempts to identify the critical success factors that organisations should focus on, to ensure the adoption on accounting process. This framework will be developed from case studies by collecting qualitative and quantitative data. Case study and survey methodology were adopted for this research. Case studies in two Thai- organisations were carried out. The results of the two main case studies suggested 9 factors that may have impact on in AIS adoption. Survey instrument was developed based on the findings from case studies. Two large-scale surveys were sent to selected members of Thailand Accountant, and Thailand Computer Society to further develop and test the research framework. The top three critical factors for ensuring AIS adoption were: top management commitment, steering committees, and Technical capability of AIS personnel. That is, it is now clear which factors impact in AIS adoption, and which of those factors are critical success factors for ensuring AIS adoption successes

Keywords: accounting information system, accounting information systems adoption, and inflecting AIS adoption

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3569 Nonlinear Analysis in Investigating the Complexity of Neurophysiological Data during Reflex Behavior

Authors: Juliana A. Knocikova

Abstract:

Methods of nonlinear signal analysis are based on finding that random behavior can arise in deterministic nonlinear systems with a few degrees of freedom. Considering the dynamical systems, entropy is usually understood as a rate of information production. Changes in temporal dynamics of physiological data are indicating evolving of system in time, thus a level of new signal pattern generation. During last decades, many algorithms were introduced to assess some patterns of physiological responses to external stimulus. However, the reflex responses are usually characterized by short periods of time. This characteristic represents a great limitation for usual methods of nonlinear analysis. To solve the problems of short recordings, parameter of approximate entropy has been introduced as a measure of system complexity. Low value of this parameter is reflecting regularity and predictability in analyzed time series. On the other side, increasing of this parameter means unpredictability and a random behavior, hence a higher system complexity. Reduced neurophysiological data complexity has been observed repeatedly when analyzing electroneurogram and electromyogram activities during defence reflex responses. Quantitative phrenic neurogram changes are also obvious during severe hypoxia, as well as during airway reflex episodes. Concluding, the approximate entropy parameter serves as a convenient tool for analysis of reflex behavior characterized by short lasting time series.

Keywords: approximate entropy, neurophysiological data, nonlinear dynamics, reflex

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3568 BEATRICE: A Low-Cost Manipulator Arm for an Educational Planetary Rover

Authors: T. Pakulski, L. Kryza, A. Linossier

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The BEar Articulated TeleRobotic Inspection and Clasping Extremity is a lightweight, 5 DoF robotic manipulator for the Berlin Educational Assistant Rover (BEAR). BEAR is one of the educational planetary rovers developed under the Space Rover projects at the Chair of Space Technology of the Technische Universität Berlin. The projects serve to conduct research and train engineers by developing rovers for competitions like the European Rover Challenge and the DLR SpaceBot Cup. BEATRICE is the result of a cost-driven design process to deliver a simple but capable platform for a variety of competition tasks: object grasping and manipulation, inspection, instrument wielding and more. The manipulator’s simple mechatronic design, based on a combination of servomotors and stepper motors with planetary gearboxes, also makes it a practical tool for developing embedded control systems. The platform’s initial implementation relies on tele-operated control but is fully instrumented for future autonomous functionality. This paper describes BEATRICE’s development from its preliminary link model to its structural and mechatronic design, embedded control and AI and T. In parallel, it examines the influence of budget constraints and high personnel turnover commonly associated with student teams on the manipulator’s design. Finally, it comments on the utility of robot design projects for educating future engineers.

Keywords: education, low-cost, manipulator, robotics, rover

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3567 Adapting an Accurate Reverse-time Migration Method to USCT Imaging

Authors: Brayden Mi

Abstract:

Reverse time migration has been widely used in the Petroleum exploration industry to reveal subsurface images and to detect rock and fluid properties since the early 1980s. The seismic technology involves the construction of a velocity model through interpretive model construction, seismic tomography, or full waveform inversion, and the application of the reverse-time propagation of acquired seismic data and the original wavelet used in the acquisition. The methodology has matured from 2D, simple media to present-day to handle full 3D imaging challenges in extremely complex geological conditions. Conventional Ultrasound computed tomography (USCT) utilize travel-time-inversion to reconstruct the velocity structure of an organ. With the velocity structure, USCT data can be migrated with the “bend-ray” method, also known as migration. Its seismic application counterpart is called Kirchhoff depth migration, in which the source of reflective energy is traced by ray-tracing and summed to produce a subsurface image. It is well known that ray-tracing-based migration has severe limitations in strongly heterogeneous media and irregular acquisition geometries. Reverse time migration (RTM), on the other hand, fully accounts for the wave phenomena, including multiple arrives and turning rays due to complex velocity structure. It has the capability to fully reconstruct the image detectable in its acquisition aperture. The RTM algorithms typically require a rather accurate velocity model and demand high computing powers, and may not be applicable to real-time imaging as normally required in day-to-day medical operations. However, with the improvement of computing technology, such a computational bottleneck may not present a challenge in the near future. The present-day (RTM) algorithms are typically implemented from a flat datum for the seismic industry. It can be modified to accommodate any acquisition geometry and aperture, as long as sufficient illumination is provided. Such flexibility of RTM can be conveniently implemented for the application in USCT imaging if the spatial coordinates of the transmitters and receivers are known and enough data is collected to provide full illumination. This paper proposes an implementation of a full 3D RTM algorithm for USCT imaging to produce an accurate 3D acoustic image based on the Phase-shift-plus-interpolation (PSPI) method for wavefield extrapolation. In this method, each acquired data set (shot) is propagated back in time, and a known ultrasound wavelet is propagated forward in time, with PSPI wavefield extrapolation and a piece-wise constant velocity model of the organ (breast). The imaging condition is then applied to produce a partial image. Although each image is subject to the limitation of its own illumination aperture, the stack of multiple partial images will produce a full image of the organ, with a much-reduced noise level if compared with individual partial images.

Keywords: illumination, reverse time migration (RTM), ultrasound computed tomography (USCT), wavefield extrapolation

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3566 A Short Dermatoscopy Training Increases Diagnostic Performance in Medical Students

Authors: Magdalena Chrabąszcz, Teresa Wolniewicz, Cezary Maciejewski, Joanna Czuwara

Abstract:

BACKGROUND: Dermoscopy is a clinical tool known to improve the early detection of melanoma and other malignancies of the skin. Over the past few years melanoma has grown into a disease of socio-economic importance due to the increasing incidence and persistently high mortality rates. Early diagnosis remains the best method to reduce melanoma and non-melanoma skin cancer– related mortality and morbidity. Dermoscopy is a noninvasive technique that consists of viewing pigmented skin lesions through a hand-held lens. This simple procedure increases melanoma diagnostic accuracy by up to 35%. Dermoscopy is currently the standard for clinical differential diagnosis of cutaneous melanoma and for qualifying lesion for the excision biopsy. Like any clinical tool, training is required for effective use. The introduction of small and handy dermoscopes contributed significantly to the switch of dermatoscopy toward a first-level useful tool. Non-dermatologist physicians are well positioned for opportunistic melanoma detection; however, education in the skin cancer examination is limited during medical school and traditionally lecture-based. AIM: The aim of this randomized study was to determine whether the adjunct of dermoscopy to the standard fourth year medical curriculum improves the ability of medical students to distinguish between benign and malignant lesions and assess acceptability and satisfaction with the intervention. METHODS: We performed a prospective study in 2 cohorts of fourth-year medical students at Medical University of Warsaw. Groups having dermatology course, were randomly assigned to:  cohort A: with limited access to dermatoscopy from their teacher only – 1 dermatoscope for 15 people  Cohort B: with a full access to use dermatoscopy during their clinical classes:1 dermatoscope for 4 people available constantly plus 15-minute dermoscopy tutorial. Students in both study arms got an image-based test of 10 lesions to assess ability to differentiate benign from malignant lesions and postintervention survey collecting minimal background information, attitudes about the skin cancer examination and course satisfaction. RESULTS: The cohort B had higher scores than the cohort A in recognition of nonmelanocytic (P < 0.05) and melanocytic (P <0.05) lesions. Medical students who have a possibility to use dermatoscope by themselves have also a higher satisfaction rates after the dermatology course than the group with limited access to this diagnostic tool. Moreover according to our results they were more motivated to learn dermatoscopy and use it in their future everyday clinical practice. LIMITATIONS: There were limited participants. Further study of the application on clinical practice is still needed. CONCLUSION: Although the use of dermatoscope in dermatology as a specialty is widely accepted, sufficiently validated clinical tools for the examination of potentially malignant skin lesions are lacking in general practice. Introducing medical students to dermoscopy in their fourth year curricula of medical school may improve their ability to differentiate benign from malignant lesions. It can can also encourage students to use dermatoscopy in their future practice which can significantly improve early recognition of malignant lesions and thus decrease melanoma mortality.

Keywords: dermatoscopy, early detection of melanoma, medical education, skin cancer

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3565 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

Abstract:

The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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3564 Enhanced Boiling Heat Transfer Using Wettability Patterned Surfaces

Authors: Dong Il Shim, Geehong Choi, Donghwi Lee, Namkyu Lee, Hyung Hee Cho

Abstract:

Effective cooling technology is required to secure thermal stability in extreme heat generated systems such as integrated electronic devices and power generated systems. Pool boiling heat transfer is one of the powerful cooling mechanisms using phase change phenomena. Critical heat flux (CHF) and heat transfer coefficient (HTC) are main factors to evaluate the performance of boiling heat transfer. CHF is the limitation of boiling heat transfer before film boiling which occurs thermal failure. Surface wettability is an important surface characteristic of boiling heat transfer. A hydrophilic surface has higher CHF through effective working fluid supply to local hot spots. A hydrophobic surface promotes the onset of nucleate boiling (ONB) to enhance HTC. In this study, superbiphilic surfaces, which is combined with superhydrophillic and superhydrophobic, are applied on boiling experiments to maximize boiling performance. We conducted pool boiling heat transfer using DI water at a saturated temperature and recorded bubble dynamics using a high-speed camera with 2000 fps. As a result, superbiphilic patterned surfaces promote ONB and enhance both CHF and HTC. This study demonstrates the enhanced boiling performance using superbiphilic surfaces by effective nucleation and separation of liquid/vapor pathway. We expect that further enhancement of heat transfer could be achieved in future work using optimized patterned surfaces.

Keywords: boiling heat transfer, wettability, critical heat flux, heat transfer coefficient

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3563 Credible Autopsy Report for Investigators and Judiciary

Authors: Sudhir K. Gupta

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Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.

Keywords: forensic doctor, professional credibility, investigation, expert opinion

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3562 A Goal-Oriented Approach for Supporting Input/Output Factor Determination in the Regulation of Brazilian Electricity Transmission

Authors: Bruno de Almeida Vilela, Heinz Ahn, Ana Lúcia Miranda Lopes, Marcelo Azevedo Costa

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Benchmarking public utilities such as transmission system operators (TSOs) is one of the main strategies employed by regulators in order to fix monopolistic companies’ revenues. Since 2007 the Brazilian regulator has been utilizing Data Envelopment Analysis (DEA) to benchmark TSOs. Despite the application of DEA to improve the transmission sector’s efficiency, some problems can be pointed out, such as the high price of electricity in Brazil; the limitation of the benchmarking only to operational expenses (OPEX); the absence of variables that represent the outcomes of the transmission service; and the presence of extremely low and high efficiencies. As an alternative to the current concept of benchmarking the Brazilian regulator uses, we propose a goal-oriented approach. Our proposal supports input/output selection by taking traditional organizational goals and measures as a basis for the selection of factors for benchmarking purposes. As the main advantage, it resolves the classical DEA problems of input/output selection, undesirable and dual-role factors. We also provide a demonstration of our goal-oriented concept regarding service quality. As a result, most TSOs’ efficiencies in Brazil might improve when considering quality as important in their efficiency estimation.

Keywords: decision making, goal-oriented benchmarking, input/output factor determination, TSO regulation

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3561 Use of a New Multiplex Quantitative Polymerase Chain Reaction Based Assay for Simultaneous Detection of Neisseria Meningitidis, Escherichia Coli K1, Streptococcus agalactiae, and Streptococcus pneumoniae

Authors: Nastaran Hemmati, Farhad Nikkhahi, Amir Javadi, Sahar Eskandarion, Seyed Mahmuod Amin Marashi

Abstract:

Neisseria meningitidis, Escherichia coli K, Streptococcus agalactiae, and Streptococcus pneumoniae cause 90% of bacterial meningitis. Almost all infected people die or have irreversible neurological complications. Therefore, it is essential to have a diagnostic kit with the ability to quickly detect these fatal infections. The project involved 212 patients from whom cerebrospinal fluid samples were obtained. After total genome extraction and performing multiplex quantitative polymerase chain reaction (qPCR), the presence or absence of each infectious factor was determined by comparing with standard strains. The specificity, sensitivity, positive predictive value, and negative predictive value calculated were 100%, 92.9%, 50%, and 100%, respectively. So, due to the high specificity and sensitivity of the designed primers, they can be used instead of bacterial culture that takes at least 24 to 48 hours. The remarkable benefit of this method is associated with the speed (up to 3 hours) at which the procedure could be completed. It is also worth noting that this method can reduce the personnel unintentional errors which may occur in the laboratory. On the other hand, as this method simultaneously identifies four common factors that cause bacterial meningitis, it could be used as an auxiliary method diagnostic technique in laboratories particularly in cases of emergency medicine.

Keywords: cerebrospinal fluid, meningitis, quantitative polymerase chain reaction, simultaneous detection, diagnosis testing

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3560 Effects of Dietary Synbiotics on Growth Performance, Antioxidant Capacity, Digestibility and Intestinal Health of Nile Tilapia (Oreochromis Niloticus)

Authors: Addise Kerebih Chekol

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Current aquaculture practice is sustainable, environment friendly and produces safe products to end users. However, the disease becomes a limitation to the above-mentioned aquaculture practices. Excessive use of antibiotics and chemotherapeutics is practiced in aquaculture health management. The implication of excessive use of antibiotics leads to increasing antibiotic resistance cases among pathogenic bacteria from aquaculture sites and seeping into the food chain. Last but not least, cost is another key determinant for the applicability of the product. In fact, animal feed is one of the main expenditures in aquaculture, which typically accounts for more than 60% of the total expenditure in a fish farm. The intricate production method and the extensive research needed to validate treatment efficacy require sufficient funding. Therefore, the production of cost-effective yet high-quality feed has been a primary agenda for the industry. Therefore, plant herbal could be promising supplements added to fortify the existing animal feed attributed to their multiple potentials in promoting growth, strengthening immunity, and increasing the resistance of animals towards diseases and stresses. Thus, alternative methods in aquaculture species health management should be applied instantly. So, the aim of this study is to determine the effects of dietary synbiotics on growth performance, immunity, and intestinal health of aquatic animals.

Keywords: synbiotics, probiotics, prebiotics, Nile Tilapia

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3559 A Holistic Analysis of the Emergency Call: From in Situ Negotiation to Policy Frameworks and Back

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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3558 Nanoparticles in Drug Delivery and Therapy of Alzeheimer's Disease

Authors: Nirupama Dixit, Anyaa Mittal, Neeru Sood

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Alzheimer’s disease (AD) is a progressive form of dementia, contributing to up to 70% of cases, mostly observed in elderly but is not restricted to old age. The pathophysiology of the disease is characterized by specific pathological changes in brain. The changes (i.e. accumulation of metal ions in brain, formation of extracellular β-amyloid (Aβ) peptide aggregates and tangle of hyper phosphorylated Tau protein inside neurons) damage the neuronal connections irreversibly. The current issues in improvement of life quality of Alzheimer's patient lies in the fact that the diagnosis is made at a late stage of the disease and the medications do not treat the basic causes of Alzheimer's. The targeted delivery of drug through the blood brain barrier (BBB) poses several limitations via traditional approaches for treatment. To overcome these drug delivery limitation, nanoparticles provide a promising solution. This review focuses on current strategies for efficient targeted drug delivery using nanoparticles and improving the quality of therapy provided to the patient. Nanoparticles can be used to encapsulate drug (which is generally hydrophobic) to ensure its passage to brain; they can be conjugated to metal ion chelators to reduce the metal load in neural tissue thus lowering the harmful effects of oxidative damage; can be conjugated with drug and monoclonal antibodies against BBB endogenous receptors. Finally this review covers how the nanoparticles can play a role in diagnosing the disease.

Keywords: Alzheimer's disease, β-amyloid plaques, blood brain barrier, metal chelators, nanoparticles

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3557 Marine Natural Products: A Rich Source of Medicine in Ayurveda, the Ancient Indian Medical Science

Authors: Ashok D. Satpute

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Ayurveda, the ancient Indian Medical system is practiced all over India and abroad, is rich in natural source of medicines, including marine products. The marine drugs which prominently used are pravala (coral), mukta (pearl), kapardika (cowry).Shukti (oyster shell), shankha (conch), agnijara (amber) etc. Except agnijara (amber) all are rich in calcium. Interestingly they are not used as supplements in calcium deficiency as done in conventional medical practice. They are used as medicines in the disease like fever, tuberculosis, bleeding disorders, eye problems, digestive complaints etc. Many scientific studies have shown their potent medicinal value. Each has its own properties and used therapeutically after subjecting them to various purificatory processes which are called shodhana in which several medicinal plants are used which also help in enhancing therapeutical activity. Then these purified marine products are subjected to marana (incineration) process and obtained in the form of Bhasma (a finest form of medicine). Agnijara, a derivative of whale is useful as aphrodisiac and prescribed in neuromuscular disorders and tetanus. The ancient scriptures written in Sanskrit language thousands of years back have rich information about all these natural marine products and their medicinal usage.

Keywords: Ayurveda, bhasma, marana, shodhana

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3556 Operation and Management System of New Ahmadi Hospital Facility

Authors: Abdulrahman H. Alrashidi

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Kuwait Oil Company provides health care services through Ahmadi hospital for oil sector employee and their families. Due to increasing number of entitled patients in Ahmadi hospital, the company starts health insurance option in 2010. In addition, a new Ahmadi hospital decided to build to accumulate all entitled patients. Operation and management of new Ahmadi hospital investigated in this research. In order to maintain the high quality of medical services and satisfaction rate among oil sector community and reducing the operation cost. Six operation and management options evaluated in order to implement in new Ahmadi hospital. Qualitative Risk assessment method used to investigate proposed options for operation and management of new Ahmadi hospital. Evaluation criteria consist of quality of medical services, operation cost and satisfaction rate among oil sector community. Results show that using the same operation and management system in existing Ahmadi hospital with new Ahmadi hospital will bring cost higher. This approach brings risk to KOC. Results from risk assessment show that partially operated new Ahmadi hospital is the best opportunity to meet the objectives of KOC’s medical group.

Keywords: Kuwait Oil Company, new Ahmadi hospital, operation and management, risk assessment

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3555 Assessing the Empowerment of Muslim Women in Malawi: A Case Study of the Muslim Women Organisation

Authors: Ulemu Maseko

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This research is a critical assessment of the empowerment of Muslim women in Malawi. The study assessed, evaluated, and analyzed how the Muslim Women Organization (MWO) has influenced gender equality and women empowerment in different Islamic communities. In analyzing the data collected for this research, the study has examined the following topics: The way MWO has interpreted Islamic women’s rights, the various stereotypes Muslim women face, and lastly, the factors contributing to the limitation of Muslim women’s rights in Malawi. Towards this analysis, the study revealed that women groups such as MWO are crucial in understanding Muslim women and the different dynamics related to their empowerment. Therefore, it is necessary to understand how Muslim women comprehend various Islamic sources and how they link religion to their position and participation in society. To achieve the scope of this study, relevant works of literature that best described Islam in Malawi, Muslim women groups, and women empowerment in Malawi were used, coupled with a qualitative research approach that involved interviews, focus group discussions, and participant observations. In addition, phenomenology and feminist theoretical frameworks were used to examine and analyze the findings. Based on the findings, it can be concluded that MWO is a significant body for gender equality and women empowerment initiatives in the Malawian Islamic community. Since its establishment in 1985 till the time of this study, MWO has been an imperative driving force towards an Islamic women’s discourse that uses Islamic teachings, faith, policies, and practices to justify the role of the Muslim woman in society. This has been enlightening for their platform and has given them more confidence to justify the empowerment of Muslim women and support different initiatives towards social change.

Keywords: Islam, women, empowerment, Malawi

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3554 The Roles of Non-Codified Traditional Medicine in a Suburban Village in Kerala, India

Authors: Sachi Matsuoka

Abstract:

This study aimed at implicating a current community health in South India focusing on a Vaidya, a non-codified traditional doctor, based on long-term field works. As the prevalence of colonic diseases is increasing in all over the world, it is needed to know the potential of non-codified medicines and how they can effectively take in a part in community health. Describing the people’s treatment seeking behaviours in a suburban village which is susceptible to modernization can give us a new insight for studying Indian medicines, that is included not only non-codified but also codified traditional ones, affected by global, national and local communities. Both qualitative and quantitative data were gathered via participatory fieldworks and open-ended interviews to a Vaidya and his 97 patients and 31 individuals who lived in a community near the Vaidya’s station. It was found that the community members seldom consulted the Vaidya while a number of patients outside the village (mainly from urban nearby area) daily visited the Vaidya. Thus, the role of the Vaidya as the community’ s primary health care provider had nearly disappeared. Nonetheless, the Vaidya was deeply respected as one of the community’ s leaders by its members because of the spiritual and financial support he provided to them. The reasons for choosing the Vaidya for the patients from urban area are characterized by several social factors of the patients such as their religious belief, seriousness, occupation and medical history. Meanwhile, not only the Vaidya but also other codified traditional medicines, e.g., Ayurveda, were less popular among the community members. It sounds paradoxical given that the traditional Indian medical system has been becoming popular as an alternative medicine in societies outside of India, such as in Europe. The community members who are less educated and engaged in religious activities in daily life preferred to allopathy, the biomedicine in Indian context. It is thus concluded that roles of non-codified medicine has changed depending on its cultural and social contexts, even though its medical system is not authorized by the government. Nowadays, traditional medical effectiveness is recognized as evidenced by scientific survey and the codified medical doctors treats diseases rather than people. However, this study implicated that people’s treatment seeking behaviors are likely based on the social context in which people live their lives even though evidenced based codified medicine is provided in their community.

Keywords: medical pluralism, non-codified medicine, south india, treatment-seeking behaviours

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3553 Healthcare Waste Management Practices in Bangladesh: A Case Study in Dhaka City, Bangladesh

Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

Abstract:

Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: awareness, disposal, Dhaka city, healthcare waste management, waste generation

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3552 Knowledge of Operation Rooms’ Staff toward Sources, Prevention and Control of Fires at Governmental Hospitals in Sana’a, Yemen

Authors: Abdulnasser Ahmed Haza’a, Marzoq Ali Odhah, Saddam Ahmed Al-Ahdal, Abdulfatah Saleh Al-Jaradi, Gamil Ghaleb Alrubaiee

Abstract:

Patient safety in hospitals is an essential professional indicator that should be noticed. The threat of fires is potentially the most dangerous risk that could harm patients and personnel. The aim of the study is to assess the knowledge of operating room (OR) staff toward prevention and control sources of fires. Between March 1 and March 30, 2022, data collection was done. A descriptive cross-sectional study was conducted. The sample of the study consisted of 89 OR staff from different governmental hospitals. Convenient sampling was applied to select the sample size. Official approvals were obtained from selected settings for start collection data. Data were collected using a close-ended questionnaire and tested for knowledge. This study was conducted in four governmental hospitals in Sana'a, Yemen. Most of the OR staff were male. Of these, 50.6% of them were operation technician professionals. More than two-thirds of OR staff have less than ten years of experience; 93% of OR staff had inadequate knowledge of sources of fires, and inadequate knowledge of them toward controls and prevention of fires (73%, 79.8%), respectively; 77.5% of OR staff had inadequate knowledge of prevention and control sources of fires. The study concluded that most of OR staff had inadequate knowledge of sources, controls, and prevention of fires, while 22.5% of them had adequate knowledge of prevention and control sources of fires. We recommended the implementation of training programs toward sources, controls, and prevention of fires or related workshops in their educational planning for OR staff of hospitals.

Keywords: knowledge, operation rooms staff, fires, prevention

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3551 A Case Study on the Value of Corporate Social Responsibility Systems

Authors: José M. Brotons, Manuel E. Sansalvador

Abstract:

The relationship between Corporate Social Responsibility (CSR) and financial performance (FP) is a subject of great interest that has not yet been resolved. In this work, we have developed a new and original tool to measure this relation. The tool quantifies the value contributed to companies that are committed to CSR. The theoretical model used is the fuzzy discounted cash flow method. Two assumptions have been considered, the first, the company has implemented the IQNet SR10 certification, and the second, the company has not implemented that certification. For the first one, the growth rate used for the time horizon is the rate maintained by the company after obtaining the IQNet SR10 certificate. For the second one, both, the growth rates company prior to the implementation of the certification, and the evolution of the sector will be taken into account. By using triangular fuzzy numbers, it is possible to deal adequately with each company’s forecasts as well as the information corresponding to the sector. Once the annual growth rate of the sales is obtained, the profit and loss accounts are generated from the annual estimate sales. For the remaining elements of this account, their regression with the nets sales has been considered. The difference between these two valuations, made in a fuzzy environment, allows obtaining the value of the IQNet SR10 certification. Although this study presents an innovative methodology to quantify the relation between CSR and FP, the authors are aware that only one company has been analyzed. This is precisely the main limitation of this study which in turn opens up an interesting line for future research: to broaden the sample of companies.

Keywords: corporate social responsibility, case study, financial performance, company valuation

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3550 Functions of Public Policy in Private International Law

Authors: Fedorova Elena

Abstract:

In this article, we draw a distinction between two important functions of public policy in private international law. The first function is widely recognized and relates to the prevention of application of foreign laws and enforcement of foreign court judgments whenever their effects are incompatible with the domestic legal system of the forum. This effectively protects sovereign rights of the forum state as it allows to resist against the undesirable effects of foreign law-making and law-enforcement policies. The second function is less obvious, but not less important. As the internal private legal relationships, international private relationships are usually governed by rules of public policy, to which the parties can not derogate by mutual agreement. Thefore, for international private law relations public policy has a different function than previously mentioned: in this case, the public policy acts as a defense against unacceptable effects of the party autonomy. Thus, this second function of public policy consists in the limitation of the party autonomy wich effects would be unacceptable for the local legal system. In the frame of this second function the author will analyse two types of public policy which can limit the party autonomy: « substantial » public policy (which regulates the substance of international legal relationship) and « conflictual » public policy (which regulates the party autonomy to choose the law applicable for the substance of relationship). The author provides an analysis of these functions of the public policy in the field of international contract law because of the important role of the principle of party autonomy for international contract relations.

Keywords: public policy, general theory of private international law, substantial public policy, conflictual public policy

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3549 Designing an Integrated Platform for Real-Time Recommendations Sharing among the Aged and People Living with Cancer

Authors: Adekunle O. Afolabi, Pekka Toivanen

Abstract:

The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: recommendation systems, Internet of Things, healthcare, homecare, real-time

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3548 Performance Evaluations of Lap Spliced Joint of Decked Bulb-Tee Type Modular Bridge

Authors: Sang-Yoon Lee, Jae-Joon Song

Abstract:

Precast decked bulb-tee girder or precast deck generally adopts in-situ connections of loop joints. Loop joint could be an effective method to connect precast concrete members where the width of joint is not wide sufficiently to allow the lap splice length of reinforcing bars. However, the regulation for the minimum bend diameter of looped rebar gives limitation not to reduce the thickness of precast concrete member; thus, in-situ connection adopting loop joint place a constraint on improving the structural efficiency of precast concrete member. Ultra high strength concrete (UHSC) is effective on reduce the development and lap splice length of reinforcing bar. In-situ connection with UHSC gives a merit to reduce connection width. This study intends to investigate the details of the longitudinal joint to be applied in the precast modular bridge using decked bulb-tee girder that has been recently developed in Korea. This paper presents the details applying UHSC and lap splices of straight reinforcement and results of tests. Several tests were performed on flexural specimens with longitudinal joints to verify the length of the lap splices and amount of transverse reinforcement, and to examine the flexural strength of the longitudinal joint.

Keywords: precast structure, decked bulb-tee girder, in-situ connection, UHSC, modular bridge

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3547 Technology in the Calculation of People Health Level: Design of a Computational Tool

Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

Abstract:

Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

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3546 Development of Management Model for Promoting Sustainable Tourism of Rajabhat Universities in Thailand

Authors: Weera Weerasophon

Abstract:

This research paper is to study the development of a management model for promoting sustainable tourism of Rajabhat universities in Thailand. Mixed Method Research is applied under the said topic. The researcher has developed a management model to promote sustainable tourism. The objectives of the research are 1) to study the readiness in management sustainable tourism of Rajabhat universities in Thailand 2) to develop a management model for promoting sustainable tourism of those universities. The process of this research is organized in two steps according to the objectives. The results of the research are as in the following: 1. Rajabhat universities have the readiness in management for promoting sustainable tourism. The universities can be developed to be sustainable tourist attraction under the admistrators who have vision and realize the importance of tourism, eager to promote sustainable tourism of the universities by specifying obvious policy plans and management. 2. The management model for promoting sustainable tourism of Rajabhat universities is consisted of the main following factors : 2.1 Master plan and policy, 2.2 Rajabhat universities organization management and personnel administration, 2.3 Assignment and authority, leadership, 2.4 Join network, 2.5 Assurance of quality and controlling, 2.6 Budget management, 2.7 Human Resources management, 2.8 Alliance and co-ordination, 2.9 Tool of marketing. There are also other communal factors for promoting sustainable tourism. They are: local communities, local communities, tourism activities, government and private sectors, communicative technology system, history, tourist attractive, art and culture, internal and external environment including local wisdom heritage. The management model for promoting sustainable tourism can be concluded from these main and communal factors mentioned above.

Keywords: tourism, sustainable tourism, management, Rajabhat University

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3545 The Missing Link in Holistic Health Care: Value-Based Medicine in Entrustable Professional Activities for Doctor-Patient Relationship

Authors: Ling-Lang Huang

Abstract:

Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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3544 A pH-Activatable Nanoparticle Self-Assembly Triggered by 7-Amino Actinomycin D Demonstrating Superior Tumor Fluorescence Imaging and Anticancer Performance

Authors: Han Xiao

Abstract:

The development of nanomedicines has recently achieved several breakthroughs in the field of cancer treatment; however, the biocompatibility and targeted burst release of these medications remain a limitation, which leads to serious side effects and significantly narrows the scope of their applications. The self-assembly of intermediate filament protein (IFP) peptides was triggered by a hydrophobic cation drug 7-amino actinomycin D (7-AAD) to synthesize pH-activatable nanoparticles (NPs) that could simultaneously locate tumors and produce antitumor effects. The designed IFP peptide included a target peptide (arginine–glycine–aspartate), a negatively charged region, and an α-helix sequence. It also possessed the ability to encapsulate 7-AAD molecules through the formation of hydrogen bonds and hydrophobic interactions by a one-step method. 7-AAD molecules with excellent near-infrared fluorescence properties could be target delivered into tumor cells by NPs and released immediately in the acidic environments of tumors and endosome/lysosomes, ultimately inducing cytotoxicity by arresting the tumor cell cycle with inserted DNA. It is noteworthy that the IFP/7-AAD NPs tail vein injection approach demonstrated not only high tumor-targeted imaging potential, but also strong antitumor therapeutic effects in vivo. The proposed strategy may be used in the delivery of cationic antitumor drugs for precise imaging and cancer therapy.

Keywords: 7-amino actinomycin D, intermediate filament protein, nanoparticle, tumor image

Procedia PDF Downloads 138