Search results for: protocol of care

Authors: Özlem Canbolat, Sevgisun Kapucu

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The aim of this study was to determine the effect of a computer-assisted glycemic surveillance protocol on nursing workload in intensive care unit. The study is completed in an Education and Research Hospital in Ankara with the attendance of volunteered 19 nurse who had been worked in reanimation unit. Nurses used the written protocol and computer-assisted glycemic surveillance protocol for glycemic follow-up approach of the intensive care patients. Nurses used the written protocol first in the glycemic follow-up of the patient, then used the computer-assisted protocol. (Nurses used the written protocol first, then the computer-assisted protocol in the glycemic follow-up of the patient). Less time was spent in glycemic control with computerized protocol than written protocol and this difference is statistically significant (p < 0.001). It was determined that the computerized protocol application was completed in about 10 seconds (25% shorter) than the written protocol implementation. The computer-assisted glycemic surveillance protocol was found to be more easy and appropriate by nurses and the satisfaction level of the users was higher than with written protocol. While 79% of the nurses find it confusing to implement the written protocol, 79% were satisfied with the use of computerized protocol.

Keywords: computer-assisted protocol, glycemic control, insulin infusion protocol, intensive care, nursing workload

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Authors: Mohd Said Nurumal, Sarah Sheikh Abdul Karim

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Information regarding out of hospital cardiac arrest incidence include outcome in Malaysia is limited and fragmented. This study aims to identify incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by the pre-hospital personnel in regards managing cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining the qualitative and quantitative study design was used. The 285 pre-hospital care data sheet of out of hospital cardiac arrest during the year of 2011 were examined by using checklists for identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. For the incidence based on the overall out of hospital cardiac arrest cases that occurred in 2011 (n=285), the survival rates were 16.8%. For adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. The qualitative information provided insight about the issues related to out of hospital cardiac arrest in every aspect. All the relevant qualitative data were merged into few categories relating issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. One of the essential elements in the out of hospital cardiac arrest handling by pre-hospital care is to ensure increase of survival rates and excellent outcomes by adhering to given protocols based on international standard benchmarks. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support and also to tackle all the issues highlighted in qualitative results.

Keywords: pre-hospital care, out of hospital cardiac arrest, incidence, protocol, mixed method research

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Tao Feng, Fei Xing, Ye Lu, Jun Li Fang

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NDN is a kind of future Internet architecture. Due to the NDN design introduces four privacy challenges,Many research institutions began to care about the privacy issues of naming data network(NDN).In this paper, we are in view of the major NDN’s privacy issues to investigate privacy protection,then put forwards more effectively anonymous transfer policy for NDN.Firstly,based on mutual anonymity communication for MP2P networks,we propose NDN mutual anonymity protocol.Secondly,we add interest package authentication mechanism in the protocol and encrypt the coding coefficient, security of this protocol is improved by this way.Finally, we proof the proposed anonymous transfer protocol security and anonymity.

Keywords: NDN, mutual anonymity, anonymous routing, network coding, authentication mechanism

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Authors: Kondwani Magamba

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In the idealized Kish-Sethuraman (KS) protocol,messages are sent between Alice and Bob each using a secret personal key. This protocol is said to be perfectly secure because both Bob and Alice keep their keys undisclosed so that at all times the message is encrypted by at least one key, thus no information is leaked or shared. In this paper, we propose a realization of the KS protocol through the use of the Hill Cipher.

Keywords: Kish-Sethuraman Protocol, Hill Cipher, MDS Matrices, encryption

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Authors: Amira Zrelli, Tahar Ezzedine

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Routing protocol may enhance the lifetime of sensor network, it has a highly importance, especially in wireless sensor network (WSN). Therefore, routing protocol has a big effect in these networks, thus the choice of routing protocol must be studied before setting up our network. In this work, we implement the routing protocol collect tree protocol (CTP) which is one of the hierarchic protocols used in structural health monitoring (SHM). Therefore, to evaluate the performance of this protocol, we choice to work with Contiki system and Cooja simulator. By throughput and RSSI evaluation of each node, we will deduce about the utility of CTP in structural monitoring system.

Keywords: CTP, WSN, SHM, routing protocol

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Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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Authors: Rajaa Filali, Mohamed Bouhdadi

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This paper presents an incremental formal development of the Wireless Transaction Protocol (WTP) in Event-B. WTP is part of the Wireless Application Protocol (WAP) architectures and provides a reliable request-response service. To model and verify the protocol, we use the formal technique Event-B which provides an accessible and rigorous development method. This interaction between modelling and proving reduces the complexity and helps to eliminate misunderstandings, inconsistencies, and specification gaps. As result, verification of WTP allows us to find some deficiencies in the current specification.

Keywords: event-B, wireless transaction protocol, proof obligation, refinement, Rodin, ProB

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Authors: Luvisa Kusuma, Panji Yudha Prakasa

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Cloud storage, as a subservice of infrastructure as a service (IaaS) in Cloud Computing, is the model of nerworked storage where data can be stored in server. In this paper, we propose a secure cloud storage system consisting of two main components; client as a user who uses the cloud storage service and server who provides the cloud storage service. In this system, we propose the protocol schemes to guarantee against security attacks in the data transmission. The protocols are login protocol, upload data protocol, download protocol, and push data protocol, which implement hybrid cryptographic mechanism based on data encryption before it is sent to the cloud, so cloud storage provider does not know the user's data and cannot analysis user’s data, because there is no correspondence between data and user.

Keywords: cloud storage, security, cryptographic protocol, artificial intelligence

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Ardavan Zamanpour, Somaieh Yassari

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ZigBee protocol network was developed in industries and MIT laboratory in 1997. ZigBee is a wireless networking technology by alliance ZigBee which is designed to low board and low data rate applications. It is a Protocol which connects between electrical devises with very low energy and cost. The first version of IEEE 802.15.4 which was formed ZigBee was based on 2.4GHZ MHZ 912MHZ 868 frequency band. The name of system is often reminded random directions that bees (BEES) traversing during pollination of products. Such as alloy of the ways in which information packets are traversed within the mesh network. This paper aims to study the performance and effectiveness of this protocol in wireless networks.

Keywords: ZigBee, protocol, wireless, networks

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

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The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Rajaa Filali, Mohamed Bouhdadi

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This paper presents an incremental development of the Dynamic Host Configuration Protocol (DHCP) in Event-B. DHCP is widely used communication protocol, which provides a standard mechanism to obtain configuration parameters. The specification is performed in a stepwise manner and verified through a series of refinements. The Event-B formal method uses the Rodin platform to modeling and verifying some properties of the protocol such as safety, liveness and deadlock freedom. To model and verify the protocol, we use the formal technique Event-B which provides an accessible and rigorous development method. This interaction between modelling and proving reduces the complexity and helps to eliminate misunderstandings, inconsistencies, and specification gaps.

Keywords: DHCP protocol, Event-B, refinement, proof obligation, Rodin

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Elisenda Camprecios, Alicia Macarrila, Montse Albiol, Neus Garriga Garriga

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The loss of a child during pregnancy, or shortly after birth, is not a common occurrence, but it is a prevalent fact in our society. When this loss happens, life and death walk together. The grief that parents experience following a perinatal loss is a devastating experience. Professionals are aware that the quality of care offered during this first period is crucial to support the families experiencing a perinatal loss and meet their needs. However, it is not always easy for the health care professionals to know what to say and what to do in these difficult circumstances. Given the complexity of the Health, painful process that a family must face when is affected by such loss, we believe that the creation of a protocol that pays special attention to the emotional needs of those couples can be a very valuable tool for the professionals. The short documentary named ‘When the illusion vanished’ was created as part of the material of this protocol, which focuses on the emotional needs of the families who have suffered a perinatal loss. This video is designed to see what impact has a perinatal death and to raise awareness among professionals working in this field. The methodology is based on interviews with couples who have experienced perinatal death and to professionals who accompany families suffering from perinatal loss. The use of sensitive and empathized words, being encouraged to express feelings, respect the time, appropriate training for the professionals are some of the issues reflected in this documentary. We believe that this video has contributed to help health care professionals to empathize and understand the need to be able to accompany these families with the appropriate care, respectful, empathetic attitude and professionalism so that they can start the path to a ‘healthy’ mourning.

Keywords: neonatal loss, midwifery, perinatal bereavement, perinatal loss

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Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

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Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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Authors: Vikram Prabhu, Mohammad Shikh Bahaei

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This paper depicts the implementation of a new infallible technique to protect an Unmanned Aerial Vehicle from cyber-attacks. An Unmanned Aerial Vehicle (UAV) could be vulnerable to cyber-attacks because of jammers or eavesdroppers over the network which pose as a threat to the security of the UAV. In the field of network security, there are quite a few protocols which can be used to establish a secure connection between UAVs and their Operators. In this paper, we discuss how the Interlock Protocol could be implemented to foil the Man-in-the-Middle Attack. In this case, Wireshark has been used as the sniffer (man-in-the-middle). This paper also shows a comparison between the Interlock Protocol and the TCP Protocols using cryptcat and netcat and at the same time highlights why the Interlock Protocol is the most efficient security protocol to prevent eavesdropping over the communication channel.

Keywords: interlock protocol, Diffie-Hellman algorithm, unmanned aerial vehicles, control station, man-in-the-middle attack, Wireshark

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Authors: Kerem Ok, Cem Cevikbas, Vedat Coskun, Mohammed Alsadi, Busra Ozdenizci

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Un-keyed SIM cards do not contain the required security infrastructure to provide end-to-end encryption with Service Providers. Hence, new, emerging, or smart services those require end-to-end encryption between SIM card and a Service Provider is impossible. SIMSec key exchange protocol creates symmetric keys between SIM card and Service Provider. After a successful protocol execution, SIM card and Service Provider creates the symmetric keys and can perform end-to-end data encryption when required. In this paper, our aim is to analyze the SIMSec protocol’s security. According to the results, SIM card and Service Provider can generate keys securely using SIMSec protocol.

Keywords: End-to-end encryption, key exchange, SIM card, smart card

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Authors: Ahmadu Maidorawa, Kamalrulnizam Abu Bakar

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This paper proposed an Enhanced Connectivity Aware Routing (ECAR) protocol for Vehicular Ad hoc Network (VANET). The protocol uses a control broadcast to reduce the number of overhead packets needed in a route discovery process. It is also equipped with an alternative backup route that is used whenever a primary path to destination failed, which highly reduces the frequent launching and re-launching of the route discovery process that waste useful bandwidth and unnecessarily prolonging the average packet delay. NS2 simulation results show that the performance of ECAR protocol outperformed the original connectivity aware routing (CAR) protocol by reducing the average packet delay by 28%, control overheads by 27% and increased the packet delivery ratio by 22%.

Keywords: alternative path, primary path, protocol, routing, VANET, vehicular ad hoc networks

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Authors: Anu Malhotra

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An Ad-hoc network is one that is an autonomous, self configuring network made up of mobile nodes connected via wireless links. Ad-hoc networks often consist of nodes, mobile hosts (MH) or mobile stations (MS, also serving as routers) connected by wireless links. Different routing protocols are used for data transmission in between the nodes in an adhoc network. In this paper two protocols (OLSR and AODV) are analyzed on the basis of two parameters i.e. time delay and throughput with different data rates. On the basis of these analysis, we observed that with same data rate, AODV protocol is having more time delay than the OLSR protocol whereas throughput for the OLSR protocol is less compared to the AODV protocol.

Keywords: routing adhoc, mobile hosts, mobile stations, OLSR protocol, AODV protocol

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Authors: Dongwon Lee, Sunmyeng Kim

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Underwater acoustic networks (UANs) have become a very active research area in recent years. Compared with wireless networks, UANs are characterized by the limited bandwidth, long propagation delay and high channel dynamic in acoustic modems, which pose challenges to the design of medium access control (MAC) protocol. The characteristics severely affect network performance. In this paper, we study a MS-MAC (Multi-Sender MAC) protocol in order to improve network performance. The proposed protocol exploits temporal reuse by learning the propagation delays to neighboring nodes. A source node locally calculates the transmission schedules of its neighboring nodes and itself based on the propagation delays to avoid collisions. Performance evaluation is conducted using simulation, and confirms that the proposed protocol significantly outperforms the previous protocol in terms of throughput.

Keywords: acoustic channel, MAC, temporal reuse, UAN

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Authors: Eun-Jun Yoon

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Deniable authentication protocol is a new security authentication mechanism which can enable a receiver to identify the true source of a given message, but not to prove the identity of the sender to a third party. In 2013, Kar proposed a secure ID-based deniable authentication protocol whose security is based on computational infeasibility of solving Elliptic Curve Diffie-Hellman Problem (ECDHP). Kar claimed that the proposed protocol achieves properties of deniable authentication, mutual authentication, and message confidentiality. However, this paper points out that Kar's protocol still suffers from sender spoofing attack and message modification attack unlike its claims.

Keywords: deniable authentication, elliptic curve cryptography, Diffie-Hellman problem, cryptanalysis

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Authors: Jaouadi Ikram, Machhout Mohsen

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The development of a quantum key distribution (QKD) system on a field-programmable gate array (FPGA) platform is the subject of this paper. A quantum cryptographic protocol is designed based on the properties of quantum information and the characteristics of FPGAs. The proposed protocol performs key extraction, reconciliation, error correction, and privacy amplification tasks to generate a perfectly secret final key. We modeled the presence of the spy in our system with a strategy to reveal some of the exchanged information without being noticed. Using an FPGA card with a 100 MHz clock frequency, we have demonstrated the evolution of the error rate as well as the amounts of mutual information (between the two interlocutors and that of the spy) passing from one step to another in the key generation process.

Keywords: QKD, BB84, protocol, cryptography, FPGA, key, security, communication

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Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

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Authors: Sara Sahraoui

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This research studied the effect of Alzheimer's disease (AD) on language information processing in subjects with Alzheimer’s disease (AD) who were bilingual (French and dialectical Arabic). The results show a disorder of certain semantic aspects of their mother tongue (L1). On the other hand, grammatical levels appeared to be relatively unaffected in oral speech in L1 but were disturbed in the second language (L2). In consequence, we constructed a cognitive-language stimulation protocol for bilingual patients (PSCLAB) to respond to this disorder. The efficacy of this protocol in terms of rehabilitation was assessed in 30 such patients through discourse analysis carried out before and after initiating the protocol. The results show that cognitive/language training using the PSCLAB appears to improve the language behaviour of bilingual patients with AD. However, this survey study aims to verify the satisfaction of patients’ relatives with the results of cognitive language training by PSCLAB. We developed a brief instrument to measure the satisfaction of family members. The results report that the patient's relatives are satisfied with the results of cognitive training by PSCLAB.

Keywords: satisfaction, Alzheimer's disease, rehabilitation, levels language

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Authors: Navneet Kaur, Amarpreet Singh

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In Vehicular Adhoc Networks, Data Dissemination is a challenging task. There are number of techniques, types and protocols available for disseminating the data but in order to preserve limited bandwidth and to disseminate maximum data over networks makes it more challenging. There are broadcasting, multicasting and geocasting based protocols. Multicasting based protocols are found to be best for conserving the bandwidth. One such protocol named BEAM exists that improves the performance of Vehicular Adhoc Networks by reducing the number of in-network message transactions and thereby efficiently utilizing the bandwidth during an emergency situation. But this protocol may result in multicar chain collision as there was no V2V communication. So, this paper proposes a new protocol named Enhanced Bandwidth Efficient Cluster Based Multicasting Protocol (EBECM) that will overcome the limitations of existing BEAM protocol. And Simulation results will show the improved performance of EBECM in terms of Routing overhead, throughput and PDR when compared with BEAM protocol.

Keywords: BEAM, data dissemination, emergency situation, vehicular adhoc network

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: cancer, complementary and alternative medicine , ozone therapy, palliative care, PEMF therapy

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Authors: Agnes J. Otjen, Sarah Keller

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A Montana university has used applied consumer research in experiential learning with non-profit clients for over a decade. Through trial and error, a successful protocol has been established from problem statement through formative research to integrated marketing campaign execution. In this paper, we describe the protocol and its applications. Analysis was completed to determine the effectiveness of the campaigns and the results of how pre- and post-consumer research mark societal change because of media.

Keywords: consumer, research, marketing, communications

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