Search results for: industrial wastewater treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2428

Search results for: industrial wastewater treatment

1438 Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems

Authors: Amal E. Shehata, Manal E. Fareed

Abstract:

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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1437 Assessment of Groundwater Quality in Karakulam Grama Panchayath in Thiruvananthapuram, Kerala State, South India

Authors: D. S. Jaya, G. P. Deepthi

Abstract:

Groundwater is vital to the livelihoods and health of the majority of the people, since it provides almost the entire water resource for domestic, agricultural and industrial uses. Groundwater quality comprises the physical, chemical and bacteriological qualities. The present investigation was carried out to determine the physicochemical and bacteriological quality of the ground water sources in the residential areas of Karakulam Grama Panchayath in Thiruvananthapuram district, Kerala state in India. Karakulam is located in the eastern suburbs of Thiruvananthapuram city. The major drinking water source of the residents in the study area is wells. The present study aims to assess the portability and irrigational suitability of groundwater in the study area. The water samples were collected from randomly selected dug wells and bore wells in the study area during post monsoon and pre monsoon seasons of the year 2014 after a preliminary field survey. The physical, chemical and bacteriological parameters of the water samples were analyzed following standard procedures. The concentration of heavy metals (Cd, Pb and Mn) in the acid digested water samples were determined by using an Atomic Absorption Spectrophotometer. The results showed that the pH of well water samples ranged from acidic to alkaline level. In majority of well water samples (>54 %) the iron and magnesium content were found high in both the seasons studied, and the values were above the permissible limits of WHO drinking water quality standards. Bacteriological analyses showed that 63% of the wells were contaminated with total coliforms in both the seasons studied. Irrigational suitability of groundwater was assessed by determining the chemical indices like Sodium Percentage (%Na), Sodium Adsorption Ratio (SAR), Residual Sodium Carbonate (RSC), Permeability Index (PI), and the results indicate that the well water in the study area are good for irrigation purposes. Therefore, the study reveals the degradation of drinking water quality groundwater sources in Karakulam Grama Panchayath in Thiruvananthapuram District, Keralain terms of its chemical and bacteriological characteristics, and is not potable without proper treatment. In the study, more than 1/3rdof the well water samples tested were positive for total coliforms, and the bacterial contamination may pose threat to public health. The study recommends the need for periodic well water quality monitoring in the study area and to conduct awareness programs among the residents.

Keywords: Bacteriological, groundwater, irrigational suitability, physicochemical, potability.

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1436 Inheritance Growth: a Biology Inspired Method to Build Structures in P2P

Authors: Panchalee Sukjit, Herwig Unger

Abstract:

IT infrastructures are becoming more and more difficult. Therefore, in the first industrial IT systems, the P2P paradigm has replaced the traditional client server and methods of self-organization are gaining more and more importance. From the past it is known that especially regular structures like grids may significantly improve the system behavior and performance. This contribution introduces a new algorithm based on a biologic analogue, which may provide the growth of several regular structures on top of anarchic grown P2P- or social network structures.

Keywords: P2P, Pattern generation, Grid, Social network, Inheritance, Reproduction

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1435 In situ Real-Time Multivariate Analysis of Methanolysis Monitoring of Sunflower Oil Using FTIR

Authors: Pascal Mwenge, Tumisang Seodigeng

Abstract:

The combination of world population and the third industrial revolution led to high demand for fuels. On the other hand, the decrease of global fossil 8fuels deposits and the environmental air pollution caused by these fuels has compounded the challenges the world faces due to its need for energy. Therefore, new forms of environmentally friendly and renewable fuels such as biodiesel are needed. The primary analytical techniques for methanolysis yield monitoring have been chromatography and spectroscopy, these methods have been proven reliable but are more demanding, costly and do not provide real-time monitoring. In this work, the in situ monitoring of biodiesel from sunflower oil using FTIR (Fourier Transform Infrared) has been studied; the study was performed using EasyMax Mettler Toledo reactor equipped with a DiComp (Diamond) probe. The quantitative monitoring of methanolysis was performed by building a quantitative model with multivariate calibration using iC Quant module from iC IR 7.0 software. 15 samples of known concentrations were used for the modelling which were taken in duplicate for model calibration and cross-validation, data were pre-processed using mean centering and variance scale, spectrum math square root and solvent subtraction. These pre-processing methods improved the performance indexes from 7.98 to 0.0096, 11.2 to 3.41, 6.32 to 2.72, 0.9416 to 0.9999, RMSEC, RMSECV, RMSEP and R2Cum, respectively. The R2 value of 1 (training), 0.9918 (test), 0.9946 (cross-validation) indicated the fitness of the model built. The model was tested against univariate model; small discrepancies were observed at low concentration due to unmodelled intermediates but were quite close at concentrations above 18%. The software eliminated the complexity of the Partial Least Square (PLS) chemometrics. It was concluded that the model obtained could be used to monitor methanol of sunflower oil at industrial and lab scale.

Keywords: Biodiesel, calibration, chemometrics, FTIR, methanolysis, multivariate analysis, transesterification.

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1434 A Literature Review on the Effect of Industrial Clusters and the Absorptive Capacity on Innovation

Authors: Enrique Claver Cortés, Bartolomé Marco Lajara, Eduardo Sánchez García, Pedro Seva Larrosa, Encarnación Manresa Marhuenda, Lorena Ruiz Fernández, Esther Poveda Pareja

Abstract:

In recent decades, the analysis of the effects of clustering as an essential factor for the development of innovations and the competitiveness of enterprises has raised great interest in different areas. Nowadays, companies have access to almost all tangible and intangible resources located and/or developed in any country in the world. However, despite the obvious advantages that this situation entails for companies, their geographical location has shown itself, increasingly clearly, to be a fundamental factor that positively influences their innovative performance and competitiveness. Industrial clusters could represent a unique level of analysis, positioned between the individual company and the industry, which makes them an ideal unit of analysis to determine the effects derived from company membership of a cluster. Also, the absorptive capacity (hereinafter 'AC') can mediate the process of innovation development by companies located in a cluster. The transformation and exploitation of knowledge could have a mediating effect between knowledge acquisition and innovative performance. The main objective of this work is to determine the key factors that affect the degree of generation and use of knowledge from the environment by companies and, consequently, their innovative performance and competitiveness. The elements analyzed are the companies' membership of a cluster and the AC. To this end, 30 most relevant papers published on this subject in the "Web of Science" database have been reviewed. Our findings show that, within a cluster, the knowledge coming from the companies' environment can significantly influence their innovative performance and competitiveness, although in this relationship, the degree of access and exploitation of the companies to this knowledge plays a fundamental role, which depends on a series of elements both internal and external to the company.

Keywords: Absorptive capacity, clusters, innovation, knowledge.

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1433 In vitro Studies of Mucoadhesiveness and Release of Nicotinamide Oral Gels Prepared from Bioadhesive Polymers

Authors: Sarunyoo Songkro, Naranut Rajatasereekul, Nipapat Cheewasrirungrueng

Abstract:

The aim of the present study was to evaluate the mucoadhesion and the release of nicotinamide gel formulations using in vitro methods. An agar plate technique was used to investigate the adhesiveness of the gels whereas a diffusion apparatus was employed to determine the release of nicotinamide from the gels. In this respect, 10% w/w nicotinamide gels containing bioadhesive polymers: Carbopol 934P (0.5-2% w/w), hydroxypropylmethyl cellulose (HPMC) (4-10% w/w), sodium carboxymethyl cellulose (SCMC) (4-6% w/w) and methylcellulose 4000 (MC) (3-5% w/w) were prepared. The gel formulations had pH values in the range of 7.14 - 8.17, which were considered appropriate to oral mucosa application. In general, the rank order of pH values appeared to be SCMC > MC4000 > HPMC > Carbopol 934P. Types and concentrations of polymers used somewhat affected the adhesiveness. It was found that anionic polymers (Carbopol 934 and SCMC) adhered more firmly to the agar plate than the neutral polymers (HPMC and MC 4000). The formulation containing 0.5% Carbopol 934P (F1) showed the highest release rate. With the exception of the formulation F1, the neutral polymers tended to give higher relate rates than the anionic polymers. For oral tissue treatment, the optimum has to be balanced between the residence time (adhesiveness) of the formulations and the release rate of the drug. The formulations containing the anionic polymers: Carbopol 934P or SCMC possessed suitable physical properties (appearance, pH and viscosity). In addition, for anionic polymer formulations, justifiable mucoadhesive properties and reasonable release rates of nicotinamide were achieved. Accordingly, these gel formulations may be applied for the treatment of oral mucosal lesions.

Keywords: Nicotinamide, bioadhesive polymer, mucoadhesiveness, release rate, gel.

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1432 A Fuzzy MCDM Approach for Health-Care Waste Management

Authors: Mehtap Dursun, E. Ertugrul Karsak, Melis Almula Karadayi

Abstract:

The management of the health-care wastes is one of the most important problems in Istanbul, a city with more than 12 million inhabitants, as it is in most of the developing countries. Negligence in appropriate treatment and final disposal of the healthcare wastes can lead to adverse impacts to public health and to the environment. This paper employs a fuzzy multi-criteria group decision making approach, which is based on the principles of fusion of fuzzy information, 2-tuple linguistic representation model, and technique for order preference by similarity to ideal solution (TOPSIS), to evaluate health-care waste (HCW) treatment alternatives for Istanbul. The evaluation criteria are determined employing nominal group technique (NGT), which is a method of systematically developing a consensus of group opinion. The employed method is apt to manage information assessed using multigranularity linguistic information in a decision making problem with multiple information sources. The decision making framework employs ordered weighted averaging (OWA) operator that encompasses several operators as the aggregation operator since it can implement different aggregation rules by changing the order weights. The aggregation process is based on the unification of information by means of fuzzy sets on a basic linguistic term set (BLTS). Then, the unified information is transformed into linguistic 2-tuples in a way to rectify the problem of loss information of other fuzzy linguistic approaches.

Keywords: Group decision making, health care waste management, multi-criteria decision making, OWA, TOPSIS, 2-tuple linguistic representation

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1431 Developments for ''Virtual'' Monitoring and Process Simulation of the Cryogenic Pilot Plant

Authors: Carmen Maria Moraru, Iuliana Stefan, Ovidiu Balteanu, Ciprian Bucur, Liviu Stefan, Anisia Bornea, Ioan Stefanescu

Abstract:

The implementation of the new software and hardware-s technologies for tritium processing nuclear plants, and especially those with an experimental character or of new technology developments shows a coefficient of complexity due to issues raised by the implementation of the performing instrumentation and equipment into a unitary monitoring system of the nuclear technological process of tritium removal. Keeping the system-s flexibility is a demand of the nuclear experimental plants for which the change of configuration, process and parameters is something usual. The big amount of data that needs to be processed stored and accessed for real time simulation and optimization demands the achievement of the virtual technologic platform where the data acquiring, control and analysis systems of the technological process can be integrated with a developed technological monitoring system. Thus, integrated computing and monitoring systems needed for the supervising of the technological process will be executed, to be continued with the execution of optimization system, by choosing new and performed methods corresponding to the technological processes within the tritium removal processing nuclear plants. The developing software applications is executed with the support of the program packages dedicated to industrial processes and they will include acquisition and monitoring sub-modules, named “virtually" as well as the storage sub-module of the process data later required for the software of optimization and simulation of the technological process for tritium removal. The system plays and important role in the environment protection and durable development through new technologies, that is – the reduction of and fight against industrial accidents in the case of tritium processing nuclear plants. Research for monitoring optimisation of nuclear processes is also a major driving force for economic and social development.

Keywords: Monitoring system, process simulation.

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1430 Identification of Flexographic-printed Newspapers with NIR Spectral Imaging

Authors: Raimund Leitner, Susanne Rosskopf

Abstract:

Near-infrared (NIR) spectroscopy is a widely used method for material identification for laboratory and industrial applications. While standard spectrometers only allow measurements at one sampling point at a time, NIR Spectral Imaging techniques can measure, in real-time, both the size and shape of an object as well as identify the material the object is made of. The online classification and sorting of recovered paper with NIR Spectral Imaging (SI) is used with success in the paper recycling industry throughout Europe. Recently, the globalisation of the recycling material streams caused that water-based flexographic-printed newspapers mainly from UK and Italy appear also in central Europe. These flexo-printed newspapers are not sufficiently de-inkable with the standard de-inking process originally developed for offset-printed paper. This de-inking process removes the ink from recovered paper and is the fundamental processing step to produce high-quality paper from recovered paper. Thus, the flexo-printed newspapers are a growing problem for the recycling industry as they reduce the quality of the produced paper if their amount exceeds a certain limit within the recovered paper material. This paper presents the results of a research project for the development of an automated entry inspection system for recovered paper that was jointly conducted by CTR AG (Austria) and PTS Papiertechnische Stiftung (Germany). Within the project an NIR SI prototype for the identification of flexo-printed newspaper has been developed. The prototype can identify and sort out flexoprinted newspapers in real-time and achieves a detection accuracy for flexo-printed newspaper of over 95%. NIR SI, the technology the prototype is based on, allows the development of inspection systems for incoming goods in a paper production facility as well as industrial sorting systems for recovered paper in the recycling industry in the near future.

Keywords: spectral imaging, imaging spectroscopy, NIR, waterbasedflexographic, flexo-printed, recovered paper, real-time classification.

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1429 A Development of English Pronunciation Using Principles of Phonetics for English Major Students at Loei Rajabhat University

Authors: Pongthep Bunrueng

Abstract:

This action research accentuates the outcome of a development in English pronunciation, using principles of phonetics for English major students at Loei Rajabhat University. The research is split into 5 separate modules: 1) Organs of Speech and How to Produce Sounds, 2) Monopthongs, 3) Diphthongs, 4) Consonant sounds, and 5) Suprasegmental Features. Each module followed a 4 step action research process, 1) Planning, 2) Acting, 3) Observing, and 4) Reflecting. The research targeted 2nd year students who were majoring in English Education at Loei Rajabhat University during the academic year of 2011. A mixed methodology employing both quantitative and qualitative research was used, which put theory into action, taking segmental features up to suprasegmental features. Multiple tools were employed which included the following documents: pre-test and post-test papers, evaluation and assessment papers, group work assessment forms, a presentation grading form, an observation of participants form and a participant self-reflection form.

All 5 modules for the target group showed that results from the post-tests were higher than those of the pre-tests, with 0.01 statistical significance. All target groups attained results ranging from low to moderate and from moderate to high performance. The participants who attained low to moderate results had to re-sit the second round. During the first development stage, participants attended classes with group participation, in which they addressed planning through mutual co-operation and sharing of responsibility. Analytic induction of strong points for this operation illustrated that learner cognition, comprehension, application, and group practices were all present whereas the participants with weak results could be attributed to biological differences, differences in life and learning, or individual differences in responsiveness and self-discipline.

Participants who were required to be re-treated in Spiral 2 received the same treatment again. Results of tests from the 5 modules after the 2nd treatment were that the participants attained higher scores than those attained in the pre-test. Their assessment and development stages also showed improved results. They showed greater confidence at participating in activities, produced higher quality work, and correctly followed instructions for each activity. Analytic induction of strong and weak points for this operation remains the same as for Spiral 1, though there were improvements to problems which existed prior to undertaking the second treatment.

Keywords: Action research, English pronunciation, phonetics, segmental features, suprasegmental features.

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1428 Efficiency of Wood Vinegar Mixed with Some Plants Extract against the Housefly (Musca domestica L.)

Authors: U. Pangnakorn, S. Kanlaya

Abstract:

The efficiency of wood vinegar mixed with each individual of three plants extract such as: citronella grass (Cymbopogon nardus), neem seed (Azadirachta indica A. Juss), and yam bean seed (Pachyrhizus erosus Urb.) were tested against the second instar larvae of housefly (Musca domestica L.). Steam distillation was used for extraction of the citronella grass while neem and yam bean were simple extracted by fermentation with ethyl alcohol. Toxicity test was evaluated in laboratory based on two methods of larvicidal bioassay: topical application method (contact poison) and feeding method (stomach poison). Larval mortality was observed daily and larval survivability was recorded until the survived larvae developed to pupae and adults. The study resulted that treatment of wood vinegar mixed with citronella grass showed the highest larval mortality by topical application method (50.0%) and by feeding method (80.0%). However, treatment of mixed wood vinegar and neem seed showed the longest pupal duration to 25 day and 32 days for topical application method and feeding method respectively. Additional, larval duration on treated M. domestica larvae was extended to 13 days for topical application method and 11 days for feeding method. Thus, the feeding method gave higher efficiency compared with the topical application method.

Keywords: Housefly (Musca domestica L.), neem seed (Azadirachta indica), citronella grass (Cymbopogon nardus) yam bean seed (Pachyrhizus erosus), mortality.

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1427 Bioprophylaxis of Saprolegniasis in Incubated Clarias gariepinus Eggs Using Pyocyanin Extracted from Pseudomonas aeruginosa

Authors: G. A. Oladosu, P. O. Ogbodogbo, C. I. Makinde, M. O. Tijani, O. A. Adegboyega

Abstract:

Saprolegniasis is a major pathogenic infection that contributes significantly to poor hatching rates in incubated fish eggs in the African catfish hatchery in Nigeria. Malachite green, known to be very effective against this condition, has been banned because it is carcinogenic. There is therefore the need for other effective, yet safer method of controlling saprolegniasis in incubated fish eggs. A total of 50 ml crude, chloroform extract of pyocyanin from which solvent was removed to attain 30 ml, having a concentration of 12.16 ug/ml was produced from 700 ml broth culture of Pseudomonas aeruginosa isolated from a previous study. In vitro susceptibility of the fungus was investigated by exposing fungal infected eggs to two different time-concentration ratios of pyocyanin; 0.275 ug/ml and 2.75 ug/ml for 1 and 24 h, and 5 mg/L malachite green as positive control while normal saline was the control. Efficacy of pyocyanin was evaluated using the degree of mycelial growth inhibition in the different treatments. Fertilized Clarias gariepinus eggs (between 45 to 64 eggs) were then incubated in 20 ml of medium containing the similar concentrations of pyocyanin and malachite green, with freshwater as control for 24 hours. Hatching rates of the incubated eggs were observed. Three samples of un-hatched eggs were taken from each medium and observed for the presence of fungal pathogens using microscopy. Another batch of three samples of un-hatched eggs from each treatment was also inoculated on Sabourand dextrose agar (SDA) using Egg-Agar Transfer technique to observe for fungal growth. Mycelial growth was inhibited in fungal infected eggs treated with 2.75 ug/ml for 24 h and the 5 mg/L malachite green for both 1 h and 24 h. The mortality rate was 100% in fertilized C. gariepinus eggs exposed for 24 h to 0.275 and 2.75 ug/ml of pyocyanin. The mortality rate was least in the malachite green followed by the control treatment. Embryonic development was observed to be arrested in the eggs treated with the two pyocyanin concentrations as they maintain their color but showed no development beyond the gastrula stage, whereas viable eggs in the control and malachite green treatments developed fully into healthy hatchlings. Furthermore, microscopy of the un-hatched eggs revealed the presence of a protozoan ciliate; Colpidium sp. (Tetrahymenidae), as well as a pathogenic fungus; Saprolegnia sp. in the control, but not in the malachite green and pyocyanin treatments. Growth of Saprolegnia sp. was also observed in SDA culture of un-hatched eggs from the control, but not from pyocyanin and malachite green treated eggs. Pyocyanin treatment of incubated eggs of Clarias gariepinus effectively prevented fungal infection in the eggs, but also arrested the development of the embryo. Therefore, crude chloroform extract of pyocyanin from Pseudomonas aeruginosa cannot be used in the control of Saprolegniasis in incubated Clarias gariepinus eggs at the concentration and duration tested in this study.

Keywords: African catfish, bioprophylaxis, embryo, saprolegniasis.

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1426 Development of a Telemedical Network Supporting an Automated Flow Cytometric Analysis for the Clinical Follow-up of Leukaemia

Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

Abstract:

In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: Data security, flow cytometry, leukaemia, telematics platform, telemedicine.

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1425 Numerical Treatment of Matrix Differential Models Using Matrix Splines

Authors: Kholod M. Abualnaja

Abstract:

This paper consider the solution of the matrix differential models using quadratic, cubic, quartic, and quintic splines. Also using the Taylor’s and Picard’s matrix methods, one illustrative example is included.

Keywords: Matrix Splines, Cubic Splines, Quartic Splines.

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1424 Stabilization of Transition Metal Chromite Nanoparticles in Silica Matrix

Authors: Jiri Plocek, Petr Holec, Simona Kubickova, Barbara Pacakova, Irena Matulkova, Alice Mantlikova, Ivan Nemec, Daniel Niznansky, Jana Vejpravova

Abstract:

This article presents summary on preparation and characterization of zinc, copper, cadmium and cobalt chromite nanocrystals, embedded in an amorphous silica matrix. The ZnCr2O4/SiO2, CuCr2O4/SiO2, CdCr2O4/SiO2 and CoCr2O4/SiO2 nanocomposites were prepared by a conventional sol-gel method under acid catalysis. Final heat treatment of the samples was carried out at temperatures in the range of 900−1200 ◦C to adjust the phase composition and the crystallite size, respectively. The resulting samples were characterized by Powder X-ray diffraction (PXRD), High Resolution Transmission Electron Microscopy (HRTEM), Raman/FTIR spectroscopy and magnetic measurements. Formation of the spinel phase was confirmed in all samples. The average size of the nanocrystals was determined from the PXRD data and by direct particle size observation on HRTEM; both results were correlated. The mean particle size (reviewed by HRTEM) was in the range from ∼4 to 46 nm. The results showed that the sol-gel method can be effectively used for preparation of the spinel chromite nanoparticles embedded in the silica matrix and the particle size is driven by the type of the cation A2+ in the spinel structure and the temperature of the final heat treatment. Magnetic properties of the nanocrystals were found to be just moderately modified in comparison to the bulk phases.

Keywords: Chromite, Fourier transform infrared spectroscopy, agnetic properties, nanocomposites, Raman spectroscopy, Rietveld refinement, sol-gel method, spinel.

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1423 Addressing Global Trauma: Somatic Interventions in PTSD Treatment and Clinician Burnout Prevention

Authors: Nina Kaufmans

Abstract:

Traditional treatments for post-traumatic stress disorder (PTSD) that rely primarily on oral narratives are partially insufficient to prevent PTSD symptoms from recurrence. As a result of the global COVID-19 pandemic, war conflicts, and economic crises, a rising proportion of users of mental health services express somatically based distress in addition to their existing mental health symptoms. Furthermore, the rapid increase in demand for mental health services has resulted in substantial burnout among mental health professionals, which may further impact the quality of services provided and the sustainability of professional life-work balance. This article examines the implications of current developments and challenges in mental health services demand and subsequent responses, as well as the effects of those responses on mental health professionals. The article examines the neurobiological mechanisms underlying traumatic experiences, then discusses the premises for "bottom-up," or somatically oriented, psychotherapy approaches, and concludes with suggestions for clinical skills and interventions to be used by practitioners who work with clients diagnosed with PTSD. In addition, we examine how somatically based psychotherapy interventions performed in sessions might reduce clinician burnout and improve their well-being. We examine how incorporating somatically based therapies into counseling will boost the efficacy of mental health recovery and maintain remission while providing mental health practitioners with chances for self-care.

Keywords: Somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment.

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1422 Mutation Analysis of the ATP7B Gene in 43 Vietnamese Wilson’s Disease Patients

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

Abstract:

Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease.

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1421 Effectiveness of Biopesticide against Insects Pest and Its Quality of Pomelo (Citrus maxima Merr.)

Authors: U. Pangnakorn, S. Chuenchooklin

Abstract:

Effect of biopesticide from wood vinegar and extracted substances from 3 medicinal plants such as: non taai yak (Stemona tuberosa Lour), boraphet (Tinospora crispa Mier) and derris (Derris elliptica Roxb) were tested on the age five years of pomelo. The selected pomelo was carried out for insects’ pest control and its quality. The experimental site was located at farmer’s orchard in Phichit Province, Thailand. This study was undertaken during the drought season (December to March). The extracted from plants and wood vinegar were evaluated in 6 treatments: 1) water as control; 2) wood vinegar; 3) S. tuberosa Lour; 4) T. crispa Mier; 5) D. elliptica Roxb; 6) mixed (wood vinegar + S. tuberosa Lour + T. crispa Mier + D. elliptica Roxb). The experiment was RCB with 6 treatments and 3 replications per treatment. The results showed that T. crispa Mier was the highest effectiveness for reduction population of thrips (Scirtothrips dorsalis Hood) and citrus leaf miner (Phyllocnistis citrella Stainton) at 14.10 and 15.37 respectively, followed by treatment of mixed, D. elliptica Roxb, S. tuberosa Lour and wood vinegar with significance different. Additionally, T. crispa Mier promoted the high quality of harvested pomelo in term of thickness of skin at 12.45 mm and S. tuberosa Lour gave the high quality of the pomelo in term of firmness (276.5 kg/cm2) and brix (11.0%).

Keywords: Wood vinegar, Medicinal plants, Pomelo (Citrus maxima Merr.), Thrips (Scirtothrips dorsalis Hood), Citrus leaf miner (Phyllocnistis citrella Stainton).

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1420 Overall Function and Symptom Impact of Self-Applied Myofascial Release in Adult Patients with Fibromyalgia: A Seven-Week Pilot Study

Authors: Domenica Tambasco, Riina Bray

Abstract:

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in various musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recognized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two physiotherapists knowledgeable in this physical treatment modality. The main outcome measure was an overall impact score for function and symptoms based on the validated assessment tool for fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre- and post-intervention. Both descriptive and analytical methods were applied and reported. We analyzed results using a paired t-test to determine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Our pilot study showed that SMR appeared to be a safe and effective intervention for our fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an randomized control trial (RCT) are recommended.

Keywords: Fibromyalgia, myofascial release, fibromyalgia impact questionnaire, fibromyalgia assessment status.

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1419 Statistical Approach to Identify Stress and Biases Impairing Decision-Making in High-Risk Industry

Authors: Ph. Fauquet-Alekhine

Abstract:

Decision-making occurs several times an hour when working in high risk industry and an erroneous choice might have undesirable outcomes for people and the environment surrounding the industrial plant. Industrial decisions are very often made in a context of acute stress. Time pressure is a crucial stressor leading decision makers sometimes to boost up the decision-making process and if it is not possible then shift to the simplest strategy. We thus found it interesting to update the characterization of the stress factors impairing decision-making at Chinon Nuclear Power Plant (France) in order to optimize decision making contexts and/or associated processes. The investigation was based on the analysis of reports addressing safety events over the last 3 years. Among 93 reports, those explicitly addressing decision-making issues were identified. Characterization of each event was undertaken in terms of three criteria: stressors, biases impairing decision making and weaknesses of the decision-making process. The statistical analysis showed that biases were distributed over 10 possibilities among which the hypothesis confirmation bias was clearly salient. No significant correlation was found between criteria. The analysis indicated that the main stressor was time pressure and highlights an unexpected form of stressor: the trust asymmetry principle of the expert. The analysis led to the conclusion that this stressor impaired decision-making from a psychological angle rather than from a physiological angle: it induces defensive bias of self-esteem, self-protection associated with a bias of confirmation. This leads to the hypothesis that this stressor can intervene in some cases without being detected, and to the hypothesis that other stressors of the same kind might occur without being detected too. Further investigations addressing these hypotheses are considered. The analysis also led to the conclusion that dealing with these issues implied i) decision-making methods being well known to the workers and automated and ii) the decision-making tools being well known and strictly applied. Training was thus adjusted.

Keywords: Bias, expert, high risk industry, stress.

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1418 Oral Cancer Screening Intentions of Residents in Eastern Taiwan

Authors: Chi-Shan Chen, Mao-Chou Hsu, Feng-Chuan Pan

Abstract:

The incidence of oral cancer in Taiwan increased year by year. It replaced the nasopharyngeal as the top incurrence among head and neck cancers since 1994. Early examination and earlier identification for earlier treatment is the most effective medical treatment for these cancers. Although the government fully subsidized the expenses with tremendous promotion program for oral cancer screening, the citizen-s participation remained low. Purpose of this study is to understand the factors affecting the citizens- behavior intensions of taking an oral cancer screening. Based on the Theory of Planned Behavior, this study adopted four distinctive variables in explaining the captioned behavior intentions.700 questionnaires were dispatched with 500 valid responses or 71.4% returned by the citizens with an age 30 or above from the eastern counties of Taiwan. Test results has shown that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening varied from some demographic factors to another. The study proofed that attitude toward, subjective norms of, and perceived behavioral control over the oral cancer screening had positive impacts on the corresponding behavior intention. The test concluded that the theory of planned behavior was appropriate as a theoretical framework in explaining the influencing factors of intentions of taking oral cancer screening. This study suggested the healthcare professional should provide high accessibility of screening services other than just delivering knowledge on oral cancer to promote the citizens- intentions of taking the captioned screening. This research also provided a practical implication to the healthcare professionals when formulating and implementing promotion instruments for lifting the screening rate of oral cancer.

Keywords: Theory of planned behavior, oral cancer, cancer screening

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1417 Dental Ethics versus Malpractice, as Phenomenon with a Growing Trend

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Dealing with emerging cases of dental malpractice with justifications that stem from the clear rules of dental ethics is a phenomenon with an increasing trend in today's dental practice. Dentists should clearly understand how far the limit of malpractice goes, with or without minimal or major consequences, for the affected patient, which can be justified as a complication of dental treatment, in support of the rules of dental ethics in the dental office. Indeed, malpractice can occur in cases of lack of professionalism, but it can also come as a consequence of anatomical and physiological limitations in the implementation of the dental protocols, predetermined and indicated by the patient in the paragraph of the treatment plan in his personal card. Let this article serve as a short communication between readers and interested parties about the problems that dental malpractice can bring to the community. Malpractice should not be seen only as a professional wrong approach, but also as a phenomenon that can occur during dental practice. The aim of this article is presentation of the latest data published in the literature about malpractice. The combination of keywords is done in such a way with the aim to give the necessary space for collecting the right information in the networks of publications about this field, always first from the point of view of the dentist and not from that of the lawyer or jurist. From the findings included in this article, it was noticed that the diversity of approaches towards the phenomenon depends on the different countries based on the legal basis that these countries have. There is a lack of or a small number of articles that touch on this topic, and these articles are presented with a limited amount of data on the same topic. Dental malpractice should not be hidden under the guise of various dental complications that we justify with the strict rules of ethics for patients treated in the dental chair. The individual experience of dental malpractice must be published with the aim of serving as a source of experience for future generations of dentists.

Keywords: Dental ethics, malpractice, professional protocol, random deviation, dental tourism.

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1416 The Effects of Organic or Inorganic Zinc and Microbial Phytase, Alone or in Combination, on the Performance, Biochemical Parameters and Nutrient Utilization of Broilers Fed a Diet Low in Available Phosphorus

Authors: Mustafa Midilli, Mustafa Salman, Omer Hakan Muglali, Tülay Ögretmen, Sena Cenesiz, Neslihan Ormanci

Abstract:

This study examined the effects of zinc (Zn) from different sources and microbial phytase on the broiler performance, biochemical parameters and digestibility of nutrients when they were added to broiler diets containing low available phosphorus. A total of 875, 1-day-old male broilers of the Ross 308 strain were randomly separated into two control groups (positive and negative) and five treatment groups each containing 125 birds; each group was divided into 5 replicates of 25 birds. The positive control (PC) group was fed a diet containing adequate concentration (0.45%) of available phosphorus due to mineral premix (except zinc) and feeds. The negative control (NC) group was fed a basal diet including low concentration (0.30%) of available phosphorus due to mineral premix (except zinc) and feeds. The basal diet was supplemented with 0.30% phosphorus and 500 FTU phytase (PH); 0.30% phosphorus and organic zinc (OZ; 75mg/kg of Zn from Zn-proteinate); 0.30% phosphorus and inorganic zinc (IZ; 75 mg/kg of Zn from ZnSO4); 0.30% phosphorus, organic zinc and 500 FTU phytase (OZ + PH); and 0.30% phosphorus, inorganic zinc and 500 FTU phytase (IZ + PH) in the treatment groups 1, 2, 3, 4 and 5, respectively. The lowest value for mean body weight was in the negative control group on a diet containing low available phosphorus. The use of supplementation with organic and inorganic zinc alone or in combination with microbial phytase significantly (P<0.05) increased the digestibility of Zn in the male broilers. Supplementation of those diets with OZ + PH or IZ + PH was very effective for increasing the body weight, body weight gain and the feed conversion ratio. In conclusion, the effects on broilers of diets with low phosphorus levels may be overcome by the addition of inorganic or organic zinc compounds in combination with microbial phytase.

Keywords: Broiler, Performance, Phytase, Phosphorus, Zinc.

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1415 Productivity Effect of Urea Deep Placement Technology: An Empirical Analysis from Irrigation Rice Farmers in the Northern Region of Ghana

Authors: Shaibu Baanni Azumah, Ignatius Tindjina, Stella Obanyi, Tara N. Wood

Abstract:

This study examined the effect of Urea Deep Placement (UDP) technology on the output of irrigated rice farmers in the northern region of Ghana. Multi-stage sampling technique was used to select 142 rice farmers from the Golinga and Bontanga irrigation schemes, around Tamale. A treatment effect model was estimated at two stages; firstly, to determine the factors that influenced farmers’ decision to adopt the UDP technology and secondly, to determine the effect of the adoption of the UDP technology on the output of rice farmers. The significant variables that influenced rice farmers’ adoption of the UPD technology were sex of the farmer, land ownership, off-farm activity, extension service, farmer group participation and training. The results also revealed that farm size and the adoption of UDP technology significantly influenced the output of rice farmers in the northern region of Ghana. In addition to the potential of the technology to improve yields, it also presents an employment opportunity for women and youth, who are engaged in the deep placement of Urea Super Granules (USG), as well as in the transplantation of rice. It is recommended that the government of Ghana work closely with the IFDC to embed the UDP technology in the national agricultural programmes and policies. The study also recommends an effective collaboration between the government, through the Ministry of Food and Agriculture (MoFA) and the International Fertilizer Development Center (IFDC) to train agricultural extension agents on UDP technology in the rice producing areas of the country.

Keywords: Northern Ghana, output, irrigation rice farmers, treatment effect model, urea deep placement.

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1414 Dengue Disease Mapping with Standardized Morbidity Ratio and Poisson-gamma Model: An Analysis of Dengue Disease in Perak, Malaysia

Authors: N. A. Samat, S. H. Mohd Imam Ma’arof

Abstract:

Dengue disease is an infectious vector-borne viral disease that is commonly found in tropical and sub-tropical regions, especially in urban and semi-urban areas, around the world and including Malaysia. There is no currently available vaccine or chemotherapy for the prevention or treatment of dengue disease. Therefore prevention and treatment of the disease depend on vector surveillance and control measures. Disease risk mapping has been recognized as an important tool in the prevention and control strategies for diseases. The choice of statistical model used for relative risk estimation is important as a good model will subsequently produce a good disease risk map. Therefore, the aim of this study is to estimate the relative risk for dengue disease based initially on the most common statistic used in disease mapping called Standardized Morbidity Ratio (SMR) and one of the earliest applications of Bayesian methodology called Poisson-gamma model. This paper begins by providing a review of the SMR method, which we then apply to dengue data of Perak, Malaysia. We then fit an extension of the SMR method, which is the Poisson-gamma model. Both results are displayed and compared using graph, tables and maps. Results of the analysis shows that the latter method gives a better relative risk estimates compared with using the SMR. The Poisson-gamma model has been demonstrated can overcome the problem of SMR when there is no observed dengue cases in certain regions. However, covariate adjustment in this model is difficult and there is no possibility for allowing spatial correlation between risks in adjacent areas. The drawbacks of this model have motivated many researchers to propose other alternative methods for estimating the risk.

Keywords: Dengue disease, Disease mapping, Standardized Morbidity Ratio, Poisson-gamma model, Relative risk.

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1413 Olive Leaves Extract Restored the antioxidant Perturbations in Red Blood Cells Hemolysate in Streptozotocin Induced Diabetic Rats

Authors: Ismail I. Abo Ghanema, Kadry M. Sadek

Abstract:

Oxidative stress and overwhelming free radicals associated with diabetes mellitus are likely to be linked with development of certain complication such as retinopathy, nephropathy and neuropathy. Treatment of diabetic subjects with antioxidant may be of advantage in attenuating these complications. Olive leaf (Oleaeuropaea), has been endowed with many beneficial and health promoting properties mostly linked to its antioxidant activity. This study aimed to evaluate the significance of supplementation of Olive leaves extract (OLE) in reducing oxidative stress, hyperglycemia and hyperlipidemia in Sterptozotocin (STZ)- induced diabetic rats. After induction of diabetes, a significant rise in plasma glucose, lipid profiles except High density lipoproteincholestrol (HDLc), malondialdehyde (MDA) and significant decrease of plasma insulin, HDLc and Plasma reduced glutathione GSH as well as alteration in enzymatic antioxidants was observed in all diabetic animals. During treatment of diabetic rats with 0.5g/kg body weight of Olive leaves extract (OLE) the levels of plasma (MDA) ,(GSH), insulin, lipid profiles along with blood glucose and erythrocyte enzymatic antioxidant enzymes were significantly restored to establish values that were not different from normal control rats. Untreated diabetic rats on the other hand demonstrated persistent alterations in the oxidative stress marker (MDA), blood glucose, insulin, lipid profiles and the antioxidant parameters. These results demonstrate that OLE may be of advantage in inhibiting hyperglycemia, hyperlipidemia and oxidative stress induced by diabetes and suggest that administration of OLE may be helpful in the prevention or at least reduced of diabetic complications associated with oxidative stress.

Keywords: Diabetes mellitus, olive leaves, oxidative stress, red blood cells

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1412 Combined Sewer Overflow forecasting with Feed-forward Back-propagation Artificial Neural Network

Authors: Achela K. Fernando, Xiujuan Zhang, Peter F. Kinley

Abstract:

A feed-forward, back-propagation Artificial Neural Network (ANN) model has been used to forecast the occurrences of wastewater overflows in a combined sewerage reticulation system. This approach was tested to evaluate its applicability as a method alternative to the common practice of developing a complete conceptual, mathematical hydrological-hydraulic model for the sewerage system to enable such forecasts. The ANN approach obviates the need for a-priori understanding and representation of the underlying hydrological hydraulic phenomena in mathematical terms but enables learning the characteristics of a sewer overflow from the historical data. The performance of the standard feed-forward, back-propagation of error algorithm was enhanced by a modified data normalizing technique that enabled the ANN model to extrapolate into the territory that was unseen by the training data. The algorithm and the data normalizing method are presented along with the ANN model output results that indicate a good accuracy in the forecasted sewer overflow rates. However, it was revealed that the accurate forecasting of the overflow rates are heavily dependent on the availability of a real-time flow monitoring at the overflow structure to provide antecedent flow rate data. The ability of the ANN to forecast the overflow rates without the antecedent flow rates (as is the case with traditional conceptual reticulation models) was found to be quite poor.

Keywords: Artificial Neural Networks, Back-propagationlearning, Combined sewer overflows, Forecasting.

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1411 Basic Business-Forces behind the Surviving and Sustainable Organizations: The Case of Medium Scale Contractors in South Africa

Authors: Iruka C. Anugwo, Winston M. Shakantu

Abstract:

The objective of this study is to uncover the basic business-forces that necessitated the survival and sustainable performance of the medium scale contractors in the South African construction market. This study is essential as it set to contribute towards long-term strategic solutions for combating the incessant failure of start-ups construction organizations within South African. The study used a qualitative research methodology; as the most appropriate approach to elicit and understand, and uncover the phenomena that are basic business-forces for the active contractors in the market. The study also adopted a phenomenological study approach; and in-depth interviews were conducted with 20 medium scale contractors in Port Elizabeth, South Africa, between months of August to October 2015. This allowed for an in-depth understanding of the critical and basic business-forces that influenced their survival and performance beyond the first five years of business operation. Findings of the study showed that for potential contractors (startups), to survival in the competitive business environment such as construction industry, they must possess the basic business-forces. These forces are educational knowledge in construction and business management related disciplines, adequate industrial experiences, competencies and capabilities to delivery excellent services and products as well as embracing the spirit of entrepreneurship. Convincingly, it can be concluded that the strategic approach to minimize the endless failure of startups construction businesses; the potential construction contractors must endeavoring to access and acquire the basic educationally knowledge, training and qualification; need to acquire industrial experiences in collaboration with required competencies, capabilities and entrepreneurship acumen. Without these basic business-forces as been discovered in this study, the majority of the contractors gaining entrance in the market will find it difficult to develop and grow a competitive and sustainable construction organization in South Africa.

Keywords: Basic business-forces, medium scale contractors, South Africa, sustainable organisations.

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1410 Electronics Thermal Management Driven Design of an IP65-Rated Motor Inverter

Authors: Sachin Kamble, Raghothama Anekal, Shivakumar Bhavi

Abstract:

Thermal management of electronic components packaged inside an IP65 rated enclosure is of prime importance in industrial applications. Electrical enclosure protects the multiple board configurations such as inverter, power, controller board components, busbars, and various power dissipating components from harsh environments. Industrial environments often experience relatively warm ambient conditions, and the electronic components housed in the enclosure dissipate heat, due to which the enclosures and the components require thermal management as well as reduction of internal ambient temperatures. Design of Experiments based thermal simulation approach with MOSFET arrangement, Heat sink design, Enclosure Volume, Copper and Aluminum Spreader, Power density, and Printed Circuit Board (PCB) type were considered to optimize air temperature inside the IP65 enclosure to ensure conducive operating temperature for controller board and electronic components through the different modes of heat transfer viz. conduction, natural convection and radiation using Ansys ICEPAK. MOSFET’s with the parallel arrangement, IP65 enclosure molded heat sink with rectangular fins on both enclosures, specific enclosure volume to satisfy the power density, Copper spreader to conduct heat to the enclosure, optimized power density value and selecting Aluminum clad PCB which improves the heat transfer were the contributors towards achieving a conducive operating temperature inside the IP-65 rated Motor Inverter enclosure. A reduction of 52 ℃ was achieved in internal ambient temperature inside the IP65 enclosure between baseline and final design parameters, which met the operative temperature requirements of the electronic components inside the IP-65 rated Motor Inverter.

Keywords: Ansys ICEPAK, Aluminum Clad PCB, IP 65 enclosure, motor inverter, thermal simulation.

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1409 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

Abstract:

This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: Awareness, knowledge, osteoporosis, practices.

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