Search results for: school food safety management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18090

Search results for: school food safety management

1710 Study on the Stages of Knowledge Flow in Central Libraries of Tehran Universities by the Pattern of American Productivity & Quality Center

Authors: Amir Reza Asnafi, Ehsan Tajabadi, Mohsen Hajizeinolabedini

Abstract:

The purpose of this study is to identify the concept of knowledge flow in central libraries of Tehran universities in by the pattern of American Productivity & Quality Center (APQC). The present study is an applied and descriptive survey in terms of its purpose and the methodology used. In this study, APQC framework was used for data collection. The study population is managers and supervisors of central libraries’ departments of public universities of Tehran belonging to the Ministry of Science, Research and Technology. These libraries include: Central Libraries of Al-Zahra University, Amir Kabir, Tarbiat Modarres, Tehran, Khajeh Nasir Toosi University of Technology, Shahed, Sharif, Shahid Beheshti, Allameh Tabataba'i University, Iran University of Science and Technology. Due to the limited number of members of the community, sampling was not performed and the census was conducted instead. The study of knowledge flow in central libraries of public universities in Tehran showed that in seven dimensions of knowledge flow of APQC, these libraries are far from desirable level and to achieve the ideal point, many activities in the field of knowledge flow need to be made, therefore suggestions were made in this study to reach the desired level. One Sample t Test in this research showed that these libraries are at a poor level in terms of these factors: in the dimensions of creation, identification and use of knowledge at a medium level and in the aspects of knowledge acquisition, review, sharing and access and also Manova test or Multivariable Analyze of Variance proved that there was no significant difference between the dimensions of knowledge flow between these libraries and the status of the knowledge flow in these libraries is at the same level as well. Except for the knowledge creation aspect that is slightly different in this regard that was mentioned before.

Keywords: knowledge flow, knowledge management, APQC, Tehran’s academic university libraries

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1709 Implementation of Gender Policy in the Georgian National Defence: Key Issues and Challenges

Authors: Vephkhvia Grigalashvili

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The defense of Georgia is every citizen’s duty. The present article reviews the principles and standards of gender policy in the Georgian national defense sector. In addition, it looks at mechanisms for ensuring gender equality, going through the relevant Georgian legislation. Furthermore, this work aims to conduct a comparative analysis of defense models of Georgia, Finland, and the Baltic States in order to identify core institutional challenges. The study produced the following findings:(a) The national defense planning is based on the Total Defense approach, which implies a wide involvement of the country`s population in state defense. (b) This political act does not specify gender equality aspects of the Total Defense strategy; (c) According to the Constitution of Georgia, irrespective of gender factors, every citizen of Georgia is legally obliged to participate in state security activities. However, the state has an authority (power of choice) to decide which gender group (male or/and female citizen) must fulfill above mentioned their constitutional commitment. For instance, completion of compulsory military and reserve military services is a male citizen’s duty, whereas professional military service is equally accessible to both genders. The study concludes that effective implementation of the Total Defense concept largely depends on how Georgia uses its capabilities and human resources. Based on the statistical fact that more than 50% of the country’s population are women, Georgia has to elaborate on relevant institutional mechanisms for implementation of gender equality in the national defense organization. In this regard, it would be advisable: (i) to give the legal opportunity to women to serve in compulsory military service, and (ii) to develop labor reserve service as a part of the anti-crisis management system of Georgia.

Keywords: gender in defense organisation, gender mechanisms, gender in defense policy, gender policy

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1708 Biopolitical Border Imagery during the European Migrant Crisis: A Comparative Discourse Analysis between Mediterranean Europe and the Balkans

Authors: Mira Kaneva

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The ongoing migration crisis polemic opens up the debate to the ambivalent essence of borders due to both the legality and legitimacy of the displacement of vast masses of people across the European continent. In neoliberal terms, migration is seen as an economic opportunity, or, on the opposite, as a social disparity; in realist terms, it is regarded as a security threat that calls for mobilization; from a critical standpoint, it is a matter of discourse on democratic governance. This paper sets the objective of analyzing borders through the Foucauldian prism of biopolitics. It aims at defining the specifics of the management of the human body by producing both the irregular migrant as a subject (but prevalently as an object in the discourse) and the political subjectivity by exercising state power in repressive practices, including hate speech. The study relies on the conceptual framework of Bigo, Agamben, Huysmans, among others, and applies the methodology of qualitative comparative analysis between the cases of borders (fences, enclaves, camps and other forms of abnormal spatiality) in Italy, Spain, Greece, the Republic of Macedonia, Serbia and Bulgaria. The paper thus tries to throw light on these cross- and intra-regional contexts that share certain similarities and differences. It tries to argue that the governmentality of the masses of refugees and economic immigrants through the speech acts of their exclusion leads to a temporary populist backlash; a tentative finding is that the status-quo in terms of social and economic measures remains relatively balanced, whereas, values such as freedom, openness, and tolerance are consecutively marginalized.

Keywords: Balkans, biopolitical borders, cross- and intra-regional discourse analysis, irregular migration, Mediterranean Europe, securitization vs. humanitarianism

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1707 Teaching and Doing Research in Higher Education Settings: An Exploratory Study of Vietnamese Overseas-Trained Returnees

Authors: Bao Trang Thi Nguyen, Stephen Moore

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A large number of Vietnamese lecturers leave their home institutions every year to pursue an education in Australia and in other countries and most of whom return home to careers back in the Vietnamese work context. However, to the authors’ best knowledge, there is little empirical knowledge about these Vietnamese returnees. Much less is about how these overseas-trained returnees continue doing research while taking a lecturing role, though research has recently received growing heightened attention in Vietnamese Higher Education institutions and returnees are an important source of human resources. The research is mixed-methods in nature with questionnaires and interviews as the main instruments of data collection. Seven-six Vietnamese returnees working from a broad range of disciplines from different higher education institutions in central Vietnam completed a questionnaire on their perceived constraints and affordances in teaching and continuing doing research upon return from their overseas education. Twenty-five of these returnees took part in a subsequent in-depth interview which lasted from 30 minutes to an hour, which further seeks understanding of their lived individual experiences and stories. The overall results show that time constraint, heavy teaching loads, and varied administrative and familial roles are among inhibiting factors. However, these factors were more constraining for some returnees more than others. Their motivations to do research varied, from passion to work pressure and self-perceived responsibilities. Above all, these were mediated by personal, institutional and disciplinary contexts. The paper argues for a nuanced understanding of returnee academics’ life as complex and layered with the multiple identities they associated themselves with and the differing trajectories they embarked on as to what they perceived important as a university lecturer. Implications for Higher Education management and administration and professional development are addressed.

Keywords: Vietnamese overseas-trained returnees, higher education, teaching, doing research, constraints, affordances

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1706 Clinical Outcomes After Radiological Management of Varicoceles

Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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1705 Community Assemblages of Reef Fishes in Marine Sanctuary and Non-Marine Sanctuary Areas in Sogod Bay, Southern Leyte, Philippines

Authors: Homer Hermes De Dios, Dewoowoogen Baclayon

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The community assemblages of reef fishes was conducted in ten marine sanctuaries and ten non-marine sanctuary areas in Sogod Bay, Southern Leyte, Philippines from 2014-2015. A total of 223 species belonging to 39 families of reef fishes in Sogod Bay were recorded. Family Pomacentridae (e.g. damsel fishes) has the highest number of species (42), followed by Labridae or wrasses (27), Chaetodonthidae or butterfly fish (22), Scaridae or parrotfishes (17), and Acanthuridae (surgeonfishes) and Pomacanthidae (angelfishes) both with 10 species. Two of the recorded fish species were included in the IUCN Red List, wherein one is near threatened (Chlorurus bowersi) and the other is endangered species (Cheilinus undulatus). The mean total fish biomass (target + indicator + major or other fish) in MPA was significantly higher (13,468 g/500m2 or equivalent to 26.94 mt/km2) than Non-MPA with 7,408 g/500m2 or 15,216mt/km2 in Non-MPA. The mean total fish biomass in MPAs in Sogod Bay can be categorized as high (21-40 mt/km2) with minimal fishing and medium or slightly moderately fished (11-20 mt/km2) in Non-MPAs. The mean (±SE) biomass of target fishes was significantly higher in MPA than Non-MPA and differ significantly across two depths. The target fish biomass was significantly higher in Limasawa Marine Sanctuary (13,569 g/500m2) followed by Lungsodaan Marine Sanctuary in Padre Burgos (11,884 g/500m2) and the lowest was found in San Isidro (735 g/500m2). The mean total fish density (target + indicator + major or other fish) did not differ between Marine Protected area (607.912 fishes/500m2 or 1215.824 fishes/1000m2) and 525.937 fishes/500m2 in non-Marine Protected Area and can be categorized as moderate (667-2267mt/km2). The mean density of target fishes was significantly (p=0.022) higher in deeper areas (12-15m) than in shallow areas but did not differ significantly between MPAs and Non-MPA. No significant difference of the biomass and density for indicator and other fishes in MPAs and Non-MPAs.

Keywords: abundance, density, species richness, target fish, coral reef management

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1704 Studies on Climatic and Soil Site Suitability of Major Grapes-Growing Soils of Eastern and Southern Dry Zones of Karnataka

Authors: Harsha B. R., Anil Kumar K. S.

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Climate and soils are the two most dynamic entities among the factors affecting growth and grapes productivity. Studying of prevailing climate over the years in a region provides sufficient information related to management practices to be carried out in vineyards. Evaluating the suitability of vineyard soils under different climatic conditions serves as the yardstick to analyse the performance of grapevines. This study was formulated to study the climate and evaluate the site-suitability of soils in vineyards of southern Karnataka, which has registered its superiority in the quality production of wine. Ten soil profiles were excavated for suitability evaluation of soils, and six taluks were studied for climatic analysis. In almost all the regions studied, recharge starts at the end of the May or June months, peaking in either September or October months. Soil Starts drying from mid of December months in the taluks studied. Bangalore North (Rajanukunte) soils were highly suited for grapes cultivation with no or slight limitations. Bangalore North (GKVK Farm) was moderately suited with slight to moderate limitations of slope and available nitrogen content. Moderate suitability was observed in the rest of the profiles studied in Eastern dry zone soils with the slight to moderate limitations of either organic carbon or available nitrogen or both in the Eastern dry zone. Magadi (Southern dry zone) soils were moderately suitable with slight to moderate limitations of graveliness, available nitrogen, organic carbon, and exchangeable sodium percentage. Sustainable performance of vineyards in terms of yield can be achieved in these taluks by managing the constraints existing in soils.

Keywords: climatic analysis, dry zone, water recharge, growing period, suitability, sustainability

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1703 Water Management Scheme: Panacea to Development Using Nigeria’s University of Ibadan Water Supply Scheme as a Case Study

Authors: Sunday Olufemi Adesogan

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The supply of potable water at least is a very important index in national development. Water tariffs depend on the treatment cost which carries the highest percentage of the total operation cost in any water supply scheme. In order to keep water tariffs as low as possible, treatment costs have to be minimized. The University of Ibadan, Nigeria, water supply scheme consists of a treatment plant with three distribution stations (Amina way, Kurumi and Lander) and two raw water supply sources (Awba dam and Eleyele dam). An operational study of the scheme was carried out to ascertain the efficiency of the supply of potable water on the campus to justify the need for water supply schemes in tertiary institutions. The study involved regular collection, processing and analysis of periodic operational data. Data collected include supply reading (water production on daily basis) and consumers metered reading for a period of 22 months (October 2013 - July 2015), and also collected, were the operating hours of both plants and human beings. Applying the required mathematical equations, total loss was determined for the distribution system, which was translated into monetary terms. Adequacies of the operational functions were also determined. The study revealed that water supply scheme is justified in tertiary institutions. It was also found that approximately 10.7 million Nigerian naira (N) is lost to leakages during the 22-month study period; the system’s storage capacity is no longer adequate, especially for peak water production. The capacity of the system as a whole is insufficient for the present university population and that the existing water supply system is not being operated in an optimal manner especially due to personnel, power and system ageing constraints.

Keywords: development, panacea, supply, water

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1702 Tritium Activities in Romania, Potential Support for Development of ITER Project

Authors: Gheorghe Ionita, Sebastian Brad, Ioan Stefanescu

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In any fusion device, tritium plays a key role both as a fuel component and, due to its radioactivity and easy incorporation, as tritiated water (HTO). As for the ITER project, to reduce the constant potential of tritium emission, there will be implemented a Water Detritiation System (WDS) and an Isotopic Separation System (ISS). In the same time, during operation of fission CANDU reactors, the tritium content increases in the heavy water used as moderator and cooling agent (due to neutron activation) and it has to be reduced, too. In Romania, at the National Institute for Cryogenics and Isotopic Technologies (ICIT Rm-Valcea), there is an Experimental Pilot Plant for Tritium Removal (Exp. TRF), with the aim of providing technical data on the design and operation of an industrial plant for heavy water depreciation of CANDU reactors from Cernavoda NPP. The selected technology is based on the catalyzed isotopic exchange process between deuterium and liquid water (LPCE) combined with the cryogenic distillation process (CD). This paper presents an updated review of activities in the field carried out in Romania after the year 2000 and in particular those related to the development and operation of Tritium Removal Experimental Pilot Plant. It is also presented a comparison between the experimental pilot plant and industrial plant to be implemented at Cernavoda NPP. The similarities between the experimental pilot plant from ICIT Rm-Valcea and water depreciation and isotopic separation systems from ITER are also presented and discussed. Many aspects or 'opened issues' relating to WDS and ISS could be checked and clarified by a special research program, developed within ExpTRF. By these achievements and results, ICIT Rm - Valcea has proved its expertise and capability concerning tritium management therefore its competence may be used within ITER project.

Keywords: ITER project, heavy water detritiation, tritium removal, isotopic exchange

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1701 Enhancing Higher Education Teaching and Learning Processes: Examining How Lecturer Evaluation Make a Difference

Authors: Daniel Asiamah Ameyaw

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This research attempts to investigate how lecturer evaluation makes a difference in enhancing higher education teaching and learning processes. The research questions to guide this research work states first as, “What are the perspectives on the difference made by evaluating academic teachers in order to enhance higher education teaching and learning processes?” and second, “What are the implications of the findings for Policy and Practice?” Data for this research was collected mainly through interviewing and partly documents review. Data analysis was conducted under the framework of grounded theory. The findings showed that for individual lecturer level, lecturer evaluation provides a continuous improvement of teaching strategies, and serves as source of data for research on teaching. At the individual student level, it enhances students learning process; serving as source of information for course selection by students; and by making students feel recognised in the educational process. At the institutional level, it noted that lecturer evaluation is useful in personnel and management decision making; it assures stakeholders of quality teaching and learning by setting up standards for lecturers; and it enables institutions to identify skill requirement and needs as a basis for organising workshops. Lecturer evaluation is useful at national level in terms of guaranteeing the competencies of graduates who then provide the needed manpower requirement of the nation. Besides, it mentioned that resource allocation to higher educational institution is based largely on quality of the programmes being run by the institution. The researcher concluded, that the findings have implications for policy and practice, therefore, higher education managers are expected to ensure that policy is implemented as planned by policy-makers so that the objectives can successfully be achieved.

Keywords: academic quality, higher education, lecturer evaluation, teaching and learning processes

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1700 Analysis of Relationship between Social Media Conversation and Mainstream Coverage to Mobilize Social Movement

Authors: Sakulsri Srisaracam

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Social media has become an important source of information for the public and the media profession. Some social issues raised on social media are picked up by journalists to report on other platforms. This relationship between social media and mainstream media can sometimes drive public debate or stimulate social movements. The question to examine is in what situations can social media conversations raise awareness and stimulate change on public issues. This study addresses the communication patterns of social media conversations driving covert issues into mainstream media and leading to social advocacy movements. In methodological terms, the study findings are based on a content analysis of Facebook, Twitter, news websites and television media reports on three different case studies – saving Bryde’s whale, protests against a government proposal to downsize the Office of Knowledge Management and Development in Thailand, and a dengue fever campaign. These case studies were chosen because they represent issues that most members of the public do not pay much attention to but social media conversations stimulated public debate and calls to action. This study found: 1) Collective social media conversations can stimulate public debate and encourage change at three levels – awareness, public debate, and action of policy and social change. The level depends on the communication patterns of online users and media coverage. 2) Patterns of communication have to be designed to combine social media conversations, online opinion leaders, mainstream media coverage and call to both online and offline action to motivate social change. Thus, this result suggests that social media is a powerful platform for collective communication and setting the agenda on public issues for mainstream media. However, for social change to succeed, social media should be used to mobilize online movements to move offline too.

Keywords: public issues, mainstream media, social media, social movement

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1699 Effectiveness of Computer Video Games on the Levels of Anxiety of Children Scheduled for Tooth Extraction

Authors: Marji Umil, Miane Karyle Urolaza, Ian Winston Dale Uy, John Charle Magne Valdez, Karen Elizabeth Valdez, Ervin Charles Valencia, Cheryleen Tan-Chua

Abstract:

Objective: Distraction techniques can be successful in reducing the anxiety of children during medical procedures. Dental procedures, in particular, are associated with dental anxiety which has been identified as a significant and common problem in children, however, only limited studies were conducted to address such problem. Thus, this study determined the effectiveness of computer video games on the levels of anxiety of children between 5-12 years old scheduled for tooth extraction. Methods: A pre-test post-test quasi-experimental study was conducted involving 30 randomly-assigned subjects, 15 in the experimental and 15 in the control. Subjects in the experimental group played computer video games for a maximum of 15 minutes, however, no intervention was done on the control. The modified Yale Pre-operative Anxiety Scale (m-YPAS) with a Cronbach’s alpha of 0.9 was used to assess anxiety at two different points: upon arrival in the clinic (pre-test anxiety) and 15 minutes after the first measurement (post-test anxiety). Paired t-test and ANCOVA were used to analyze the gathered data. Results: Results showed that there is a significant difference between the pre-test and post-test anxiety scores of the control group (p=0.0002) which indicates an increased anxiety. A significant difference was also noted between the pre-test and post-test anxiety scores of the experimental group (p=0.0002) which indicates decreased anxiety. Comparatively, the experimental group showed lower anxiety score (p=<0.0001) than the control. Conclusion: The use of computer video games is effective in reducing the pre-operative anxiety among children and can be an alternative non-pharmacological management in giving pre-operative care.

Keywords: play therapy, preoperative anxiety, tooth extraction, video games

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1698 Emotional Labour and Employee Performance Appraisal: The Missing Link in Some Hotels in South East Nigeria

Authors: Polycarp Igbojekwe

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The main objective of this study was to determine if emotional labour has become a criterion in performance appraisal, job description, selection, and training schemes in the hotel industry in Nigeria. Our main assumption was that majority of hotel organizations have not built emotional labour into their human resources management schemes. Data were gathered by the use of structured questionnaires designed in Likert format, and interviews. The focus group was managers of the selected hotels. Analyses revealed that majority of the hotels have not built emotional labour into their human resources schemes particularly in the 1, 2, and 3-star hotels. It was observed that service employees of 1, 2, and 3-star hotels have not been adequately trained to perform emotional labour; a critical factor in quality service delivery. Managers of 1, 2, and 3-star hotels have not given serious thought to emotional labour as a critical factor in quality service delivery. The study revealed that suitability of an individual’s characteristics is not being considered as a criterion for selection and performance appraisal for service employees. The implication of this is that, person-job-fit is not seriously considered. It was observed that there has been a disconnect between required emotional competency, its recognition, evaluation, and training. Based on the findings of this study, it is concluded that selection, training, job description and performance appraisal instruments in use in hotels in Nigeria are inadequate. Human resource implications of the findings in this study are presented. It is recommended that hotel organizations should re-design and plan the emotional content and context of their human resources practices to reflect the emotional demands of front line jobs in the hotel industry and the crucial role emotional labour plays during service encounters.

Keywords: emotional labour, employee selection, job description, performance appraisal, person-job-fit, employee compensation

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1697 Factors Affecting M-Government Deployment and Adoption

Authors: Saif Obaid Alkaabi, Nabil Ayad

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Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The implementation of advances depends on the utilization of the most innovative structures of data techniques, mainly in web dependent applications, to enhance the main functions of governments. These functions, in turn, have spread to mobile and wireless techniques, generating a new advanced direction called m-government. This paper discusses a selection of available m-government applications and several business modules and frameworks in various fields. Practically, the m-government models, techniques and methods have become the improved version of e-government. M-government offers the potential for applications which will work better, providing citizens with services utilizing mobile communication and data models incorporating several government entities. Developing countries can benefit greatly from this innovation due to the fact that a large percentage of their population is young and can adapt to new technology and to the fact that mobile computing devices are more affordable. The use of models of mobile transactions encourages effective participation through the use of mobile portals by businesses, various organizations, and individual citizens. Although the application of m-government has great potential, it does have major limitations. The limitations include: the implementation of wireless networks and relative communications, the encouragement of mobile diffusion, the administration of complicated tasks concerning the protection of security (including the ability to offer privacy for information), and the management of the legal issues concerning mobile applications and the utilization of services.

Keywords: e-government, m-government, system dependability, system security, trust

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1696 Benefits of Occupational Therapy for Children with Intellectual Disabilities in the Aspects of Vocational Activities and Instrumental Activities of Daily Life

Authors: Shakhawath Hossain, Tazkia Tahsin

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Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.

Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL

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1695 An Attempt of Cost Analysis of Heart Failure Patients at Cardiology Department at Kasr Al Aini Hospitals: A Micro-Costing Study from Social Perspective

Authors: Eman Elsebaie, A. Sedrak, R. Ziada

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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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1694 Nectariferous Plant Genetic Resources for Apicultural Entrepreneurship in Nigeria: Prerequisite for Conservation, Sustainable Management and Policy

Authors: C. V. Nnamani, O. L. Adedeji

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The contemporary global economic meltdown has devastating effect on the Nigerian’s economy and its frantic search for alternative source of national revenue aside from oil and gas has become imperative for economic emancipation for Nigerians. Apicultural entrepreneurship could provide a source of livelihood if the basic knowledge of those plant genetic resources needed by bees is made available. A palynological evaluation of those palynotaxa which honey bees forage for pollen and nectar was carried out after standard acetolysis method. Results showed that the honey samples were highly diversified and rich in honey plants. A total of 9544.3 honey pollen, consisting of 39 honey plants belonging to 21 plant families and distributed within 38 genera were identified excluding 238 unidentified pollen grains. Data from the analysis equally revealed that Elaeis guineensis Jacq, Anacardium occidentale L, Diospyros mespiliformis Hochist xe ADC, Alchornea cordifolia Muell, Arg, Daniella oliveri (Rolfe) Hutch & Dalz, Irvingia wombolu Okafor ex Baill, Treculia africana Decne, Nauclea latifolia Smith and Crossopteryx febrifuga Afzil ex Benth were the predominant honey plants. It provided a guide to the optimal utilization of floral resources by honeybees in these regions, showing the opportunity and amazing potentials for apiculture entrepreneurship of these palytaxa. Most of these plants are rare, threatened and endangered. It calls for urgent conservation techniques and step by all players. Critical awareness creation to ensure farmers knowledge of these palynotaxa to ensure proper understanding and attendance boost from them as economic empowerment is needed.

Keywords: palynotaxa, acetolysis, enterprise, livelihood, Nigeria

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1693 High-Resolution Flood Hazard Mapping Using Two-Dimensional Hydrodynamic Model Anuga: Case Study of Jakarta, Indonesia

Authors: Hengki Eko Putra, Dennish Ari Putro, Tri Wahyu Hadi, Edi Riawan, Junnaedhi Dewa Gede, Aditia Rojali, Fariza Dian Prasetyo, Yudhistira Satya Pribadi, Dita Fatria Andarini, Mila Khaerunisa, Raditya Hanung Prakoswa

Abstract:

Catastrophe risk management can only be done if we are able to calculate the exposed risks. Jakarta is an important city economically, socially, and politically and in the same time exposed to severe floods. On the other hand, flood risk calculation is still very limited in the area. This study has calculated the risk of flooding for Jakarta using 2-Dimensional Model ANUGA. 2-Dimensional model ANUGA and 1-Dimensional Model HEC-RAS are used to calculate the risk of flooding from 13 major rivers in Jakarta. ANUGA can simulate physical and dynamical processes between the streamflow against river geometry and land cover to produce a 1-meter resolution inundation map. The value of streamflow as an input for the model obtained from hydrological analysis on rainfall data using hydrologic model HEC-HMS. The probabilistic streamflow derived from probabilistic rainfall using statistical distribution Log-Pearson III, Normal and Gumbel, through compatibility test using Chi Square and Smirnov-Kolmogorov. Flood event on 2007 is used as a comparison to evaluate the accuracy of model output. Property damage estimations were calculated based on flood depth for 1, 5, 10, 25, 50, and 100 years return period against housing value data from the BPS-Statistics Indonesia, Centre for Research and Development of Housing and Settlements, Ministry of Public Work Indonesia. The vulnerability factor was derived from flood insurance claim. Jakarta's flood loss estimation for the return period of 1, 5, 10, 25, 50, and 100 years, respectively are Rp 1.30 t; Rp 16.18 t; Rp 16.85 t; Rp 21.21 t; Rp 24.32 t; and Rp 24.67 t of the total value of building Rp 434.43 t.

Keywords: 2D hydrodynamic model, ANUGA, flood, flood modeling

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1692 Conservation Planning of Paris Polyphylla Smith, an Important Medicinal Herb of the Indian Himalayan Region Using Predictive Distribution Modelling

Authors: Mohd Tariq, Shyamal K. Nandi, Indra D. Bhatt

Abstract:

Paris polyphylla Smith (Family- Liliaceae; English name-Love apple: Local name- Satuwa) is an important folk medicinal herb of the Indian subcontinent, being a source of number of bioactive compounds for drug formulation. The rhizomes are widely used as antihelmintic, antispasmodic, digestive stomachic, expectorant and vermifuge, antimicrobial, anti-inflammatory, heart and vascular malady, anti-fertility and sedative. Keeping in view of this, the species is being constantly removed from nature for trade and various pharmaceuticals purpose, as a result, the availability of the species in its natural habitat is decreasing. In this context, it would be pertinent to conserve this species and reintroduce them in its natural habitat. Predictive distribution modelling of this species was performed in Western Himalayan Region. One such recent method is Ecological Niche Modelling, also popularly known as Species distribution modelling, which uses computer algorithms to generate predictive maps of species distributions in a geographic space by correlating the point distributional data with a set of environmental raster data. In case of P. polyphylla, and to understand its potential distribution zones and setting up of artificial introductions, or selecting conservation sites, and conservation and management of their native habitat. Among the different districts of Uttarakhand (28°05ˈ-31°25ˈ N and 77°45ˈ-81°45ˈ E) Uttarkashi, Rudraprayag, Chamoli, Pauri Garhwal and some parts of Bageshwar, 'Maximum Entropy' (Maxent) has predicted wider potential distribution of P. polyphylla Smith. Distribution of P. polyphylla is mainly governed by Precipitation of Driest Quarter and Mean Diurnal Range i.e., 27.08% and 18.99% respectively which indicates that humidity (27%) and average temperature (19°C) might be suitable for better growth of Paris polyphylla.

Keywords: biodiversity conservation, Indian Himalayan region, Paris polyphylla, predictive distribution modelling

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1691 Right Cerebellar Stroke with a Right Vertebral Artery Occlusion Following an Embolization of the Right Glomus Tympanicum Tumor

Authors: Naim Izet Kajtazi

Abstract:

Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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1690 Changes in the Quantity of Milk and the PH and Temperature of Rumen Content, after Surgical Treatment of Displaced Abomasum

Authors: Ramūnas Antanaitis, Robertas Stoškus, Mindaugas Televičius

Abstract:

The objective is to identify changes in the quantity of milk and the pH and the temperature of rumen content after omentopexia. The research was performed in a dairy farm with 550 cows on December 2014 – January 2015. The sample consisted of 10 cows. Left-sided displacement of the abomasums was diagnosed in 5 of them, which was treated by lateral omentopexia according to Dirksen; the rest 5 were used for control. Additional treatment was not applied. A special bolus for measuring pH and temperature was administered to the rumen of healthy cows and cows after the operation. The quantity of milk was registered with the help of herd management program Westfalia DP C21. All data were recorded ones a week in the period of four weeks. Statistically reliable difference in the quantity of milk (p<0.05) between the research groups was observed during the entire research. The major difference was recorded on Week 1 after the treatment (29.18 kg/d); on Week 4, the difference was 13.97 kg/d. During the entire research, rumen pH of Test group was lower than that of the Control group. Statistically reliable difference between the groups was identified on Week 1 (p<0.05). On the period mentioned, the pH of the rumen content of Test group was lower by 0.42 than that of the Control group. On Week 3, the difference increased up to 0.84. On Weeks 1, 2, and 3, statistically reliable (p<0.05) higher temperature was observed in the Test group. Major difference of temperature, 1.81 °C, was recorded on Week 1. On Week 4, the temperature of rumen in the Test group became equal to that of the Control group. After omentopexia treatment, the first four weeks showed the following results: statistically reliable difference in the quantity of milk remains the most obvious in Week 1 after the treatment; cows with left-sided displacement of abomasums were exposed to greater risk of acidosis; they indicated lower pH of rumen content; the first two weeks after omentopexia, rumen content has increased temperature, especially obvious in Week 1.

Keywords: Displacement of the abomasum, omentopexia, acidosis

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1689 Towards Sustainable Consumption: A Framework for Assessing Supplier's Commitment

Authors: O. O. Oguntoye

Abstract:

Product consumption constitutes an important consideration for sustainable development. Seeing how product consumption could be highly unsustainable, coupled with how existing policies on corporate responsibility do not particularly address the consumption aspect of product lifecycle, conducting this research became necessary. The research makes an attempt to provide a framework by which to gauge corporate responsibility of product suppliers in terms of their commitment towards the sustainable consumption of their products. Through an exploration of relevant literature, independently established ideas with which to assess a given product supplier were galvanised into a four-criterion framework. The criteria are: (1) Embeddedness of consumption as a factor in corporate sustainability policy, (2) Level of understanding of consumption behaviour, (3) Breadth of behaviour-influencing strategies adopted, and (4) Inclusiveness for all main dimensions of sustainability. This resulting framework was then applied in a case study involving a UK-based furniture supplier where interviews and content analysis of corporate documents were used as the mode for primary data collection. From the case study, it was found that the supplier had performed to different levels across the four themes of the assessment. Two major areas for improvement were however identified – one is for the furniture supplier to focus more proactively on understanding consumption behaviour and, two is for it to widen the scope of its current strategies for enhancing sustainable consumption of supplied furniture. As a generalisation, the framework presented here makes it possible for companies to reflect with a sense of guidance, how they have demonstrated commitment towards sustainable consumption through their values, culture, and operations. It also provides a foundation for developing standardized assessment which the current widely used frameworks such as the GRI, the Global Compact, and others do not cover. While these popularly used frameworks mainly focus on sustainability of companies within the production and supply chain management contexts (i.e. mostly ‘upstream’), the framework here provides an extension by bringing the ‘downstream’ or consumer bit into light.

Keywords: corporate sustainability, design for sustainable consumption, extended producer responsibility, sustainable consumer behaviour

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1688 Neural Networks Based Prediction of Long Term Rainfall: Nine Pilot Study Zones over the Mediterranean Basin

Authors: Racha El Kadiri, Mohamed Sultan, Henrique Momm, Zachary Blair, Rachel Schultz, Tamer Al-Bayoumi

Abstract:

The Mediterranean Basin is a very diverse region of nationalities and climate zones, with a strong dependence on agricultural activities. Predicting long term (with a lead of 1 to 12 months) rainfall, and future droughts could contribute in a sustainable management of water resources and economical activities. In this study, an integrated approach was adopted to construct predictive tools with lead times of 0 to 12 months to forecast rainfall amounts over nine subzones of the Mediterranean Basin region. The following steps were conducted: (1) acquire, assess and intercorrelate temporal remote sensing-based rainfall products (e.g. The CPC Merged Analysis of Precipitation [CMAP]) throughout the investigation period (1979 to 2016), (2) acquire and assess monthly values for all of the climatic indices influencing the regional and global climatic patterns (e.g., Northern Atlantic Oscillation [NOI], Southern Oscillation Index [SOI], and Tropical North Atlantic Index [TNA]); (3) delineate homogenous climatic regions and select nine pilot study zones, (4) apply data mining methods (e.g. neural networks, principal component analyses) to extract relationships between the observed rainfall and the controlling factors (i.e. climatic indices with multiple lead-time periods) and (5) use the constructed predictive tools to forecast monthly rainfall and dry and wet periods. Preliminary results indicate that rainfall and dry/wet periods were successfully predicted with lead zones of 0 to 12 months using the adopted methodology, and that the approach is more accurately applicable in the southern Mediterranean region.

Keywords: rainfall, neural networks, climatic indices, Mediterranean

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1687 Comparison of Support Vector Machines and Artificial Neural Network Classifiers in Characterizing Threatened Tree Species Using Eight Bands of WorldView-2 Imagery in Dukuduku Landscape, South Africa

Authors: Galal Omer, Onisimo Mutanga, Elfatih M. Abdel-Rahman, Elhadi Adam

Abstract:

Threatened tree species (TTS) play a significant role in ecosystem functioning and services, land use dynamics, and other socio-economic aspects. Such aspects include ecological, economic, livelihood, security-based, and well-being benefits. The development of techniques for mapping and monitoring TTS is thus critical for understanding the functioning of ecosystems. The advent of advanced imaging systems and supervised learning algorithms has provided an opportunity to classify TTS over fragmenting landscape. Recently, vegetation maps have been produced using advanced imaging systems such as WorldView-2 (WV-2) and robust classification algorithms such as support vectors machines (SVM) and artificial neural network (ANN). However, delineation of TTS in a fragmenting landscape using high resolution imagery has widely remained elusive due to the complexity of the species structure and their distribution. Therefore, the objective of the current study was to examine the utility of the advanced WV-2 data for mapping TTS in the fragmenting Dukuduku indigenous forest of South Africa using SVM and ANN classification algorithms. The results showed the robustness of the two machine learning algorithms with an overall accuracy (OA) of 77.00% (total disagreement = 23.00%) for SVM and 75.00% (total disagreement = 25.00%) for ANN using all eight bands of WV-2 (8B). This study concludes that SVM and ANN classification algorithms with WV-2 8B have the potential to classify TTS in the Dukuduku indigenous forest. This study offers relatively accurate information that is important for forest managers to make informed decisions regarding management and conservation protocols of TTS.

Keywords: artificial neural network, threatened tree species, indigenous forest, support vector machines

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1686 Traumatic Osteoarthritis Induces Mechanical Hyperalgesia through IL-1β/TNF-α-Mediated Upregulation of the Sema4D Gene Expression

Authors: Hsiao-Chien Tsai, Yu-Pin Chen, Ruei-Ming Chen

Abstract:

Introduction: Osteoarthritis (OA) is characterized by joint destruction and causes chronic disability. One of the prominent symptoms is pain. Alleviating the pain is necessary and urgent for the therapy of OA patients. However, currently, understanding the mechanisms that drive OA-induced pain remains challenging, which hampers the optimistic management of pain in OA patients. Semaphorin 4D (Sema4D) participates in axon guidance pathway and bone remodeling, thus, may play a role in the regulation of pain in OA. In this study, we have established a rat model of OA to find out the mechanisms of OA-induced pain and to deliberate the roles of Sema4D. Methods: Behavioral changes and the pro-inflammatory cytokines (IL-1β, TNF-α, and IL-17) associated with pain were measured during the development of OA. Sema4D expression in cartilage and synovial membrane at 1, 4, and 12 weeks after inducing OA was analyzed. To assess if Sema4D is related to the neurogenesis in OA as an axon repellant, we analyzed the expression of PGP9.5 as well. Results: Synovitis and cartilage degradation were evident histologically during the development of OA. Mechanical hyperalgesia was most severe at week 1, then persisted thereafter. It was associated with stress coping strategies. Similar to the pain behavioral results, levels of IL-1β and TNF-α in synovial lavage fluid were significantly elevated in the OA group at weeks 1 and 4, respectively. Sema4D expression in cartilage and the synovial membrane was also enhanced in the OA group and was correlated with pain and pro-inflammatory cytokines. The marker of neurogenesis, PGP9.5, was also enhanced during the development of OA. Discussion: OA induced mechanical hyperalgesia, which might be through upregulating IL-1β/TNF-α-mediated Sema4D expressions. If anti-Sema4D treatment could reduce OA-induced mechanical hyperalgesia and prevent the subsequent progression of OA needs to be further investigated. Significance: OA can induce mechanical hyperalgesia through upregulation of IL-1β/TNF-α-mediated Sema4D and PGP9.5 expressions. And the upregulation of Sema4D may indicate the severity or active status of OA and OA-induced pain.

Keywords: traumatic osteoarthritis, mechanical hyperalgesia, Sema4D, inflammatory cytokines

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1685 Adjustments of Mechanical and Hydraulic Properties of Wood Formed under Environmental Stresses

Authors: B. Niez, B. Moulia, J. Dlouha, E. Badel

Abstract:

Trees adjust their development to the environmental conditions they experience. Storms events of last decades showed that acclimation of trees to mechanical stresses due to wind is a very important process that allows the trees to sustain for long years. In the future, trees will experience new wind patterns, namely, more often strong winds and fewer daily moderate winds. Moreover, these patterns will go along with drought periods that may interact with the capacity of trees to adjust their growth to mechanical stresses due to wind. It is necessary to understand the mechanisms of wood functional acclimations to environmental conditions in order to predict their behaviour and in order to give foresters and breeders the relevant tools to adapt their forest management. This work aims to study how trees adjust the mechanical and hydraulic functions of their wood to environmental stresses and how this acclimation may be beneficial for the tree to resist to future stresses. In this work, young poplars were grown under controlled climatic conditions that include permanent environmental stress (daily mechanical stress of the stem by bending and/or hydric stress). Then, the properties of wood formed under these stressed conditions were characterized. First, hydraulic conductivity and sensibility to cavitation were measured at the tissue level in order to evaluate the changes in water transport capacity. Secondly, bending tests and Charpy impact tests were carried out at the millimetric scale to locally measure mechanical parameters such as elastic modulus, elastic limit or rupture energy. These experimental data allow evaluating the impacts of mechanical and water stress on the wood material. At the stem level, they will be merged in an integrative model in order to evaluate the beneficial aspect of wood acclimation for trees.

Keywords: acclimation, environmental stresses, hydraulics, mechanics, wood

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1684 Prevalence of Mycobacterium Tuberculosis Infection and Rifampicin Resistance among Presumptive Tuberculosis Cases Visiting Tuberculosis Clinic of Adare General Hospital, Southern Ethiopia

Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

Abstract:

Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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1683 Patient Perspectives on the Role of Orthopedic Nurse Practitioners: A Cross-Sectional Study

Authors: Merav Ben Natan, May Revach, Or Sade, Yaniv Yonay, Yaron Berkovich

Abstract:

Background: The inclusion of nurse practitioners (NPs) specializing in orthopedics holds promise for enhancing the quality of care for orthopedic patients. Understanding patients’ perspectives on this role is crucial for evaluating the feasibility and acceptance of integrating NPs into orthopedic settings. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic NPs and examines potential associations between patients’ willingness to engage with NPs, their familiarity with the NP role, perceptions of nursing, and satisfaction with orthopedic nursing care. Methods: This cross-sectional study involved patients admitted to an orthopedic department at a central Israeli hospital between January and February 2023. Data was collected using a validated questionnaire consisting of five sections, reviewed by content experts. Statistical analyses were conducted using SPSS and included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression. Results: Participants in the study showed a moderate willingness to receive treatment from orthopedic NPs, with more than two-thirds expressing strong openness. Patients were generally receptive to NPs performing various clinical tasks, though there was less enthusiasm for NPs’ involvement in medication management and preoperative evaluations. Positive attitudes towards nurses and familiarity with the NP role were significant predictors of patient receptiveness to NP treatment. Conclusion: Patient acceptance of orthopedic NPs varies across different aspects of care. While there is a general willingness to receive care from NPs, these nuanced preferences must be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions of the NP role play crucial roles in shaping patients’ willingness to engage with NPs.

Keywords: orthopedic nurse practitioners, patient receptiveness, perceptions of nursing, clinical tasks

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1682 Organization of the Purchasing Function for Innovation

Authors: Jasna Prester, Ivana Rašić Bakarić, Božidar Matijević

Abstract:

Various prominent scholars and substantial practitioner-oriented literature on innovation orientation have shown positive effects on firm performance. There is a myriad of factors that influence and enhance innovation but it has been found in the literature that new product innovations accounted for an average of 14 percent of sales revenues for all firms. If there is one thing that has changed in innovation management during the last decade, it is the growing reliance on external partners. As a consequence, a new task for purchasing arises, as firms need to understand which suppliers actually do have high potential contributing to the innovativeness of the firm and which do not. Purchasing function in an organization is extremely important as it deals on an average of 50% or more of a firm's expenditures. In the nineties the purchasing department was largely seen as a transaction-oriented, clerical function but today purchasing integration provides a formal interface mechanism between purchasing and other firm functions that services other functions within the company. Purchasing function has to be organized differently to enable firm innovation potential. However, innovations are inherently risky. There are behavioral risk (that some partner will take advantage of the other party), technological risk in terms of complexity of products and processes of manufacturing and incoming materials and finally market risks, which in fact judge the value of the innovation. These risks are investigated in this work since it has been found in the literature that the higher the technological risk, higher will be the centralization of the purchasing function as an interface with other supply chain members. Most researches on organization of purchasing function were done by case study analysis of innovative firms. This work actually tends to prove or discard results found in the literature based on case study method. A large data set of 1493 companies, from 25 countries collected in the GMRG 4 survey served as a basis for analysis.

Keywords: purchasing function organization, innovation, technological risk, GMRG 4 survey

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1681 A Rare Form of Rapidly Progressive Parkinsonism Associated with Dementia

Authors: Murat Emre, Zeynep Tufekcioglu

Abstract:

Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.

Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism

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