Search results for: Clinical documents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 659

Search results for: Clinical documents

539 Development and Validation of the Response to Stressful Situations Scale in the General Population

Authors: C. Barreto Carvalho, C. da Motta, M. Sousa, J. Cabral, A. L. Carvalho, E. B. Peixoto

Abstract:

The aim of the current study was to develop and validate a Response to Stressful Situations Scale (RSSS) for the Portuguese population. This scale assesses the degree of stress experienced in scenarios that can constitute positive, negative and more neutral stressors, and also describes the physiological, emotional and behavioral reactions to those events according to their intensity. These scenarios include typical stressor scenarios relevant to patients with schizophrenia, which are currently absent from most scales, assessing specific risks that these stressors may bring on subjects, which may prove useful in non-clinical and clinical populations (i.e. Patients with mood or anxiety disorders, schizophrenia). Results from Principal Components Analysis and Confirmatory Factor Analysis of two adult samples from general population allowed to confirm a three-factor model with good fit indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI = 0.914, RMSEA = 0.055, P(rmsea ≤0.005) = .096; PCFI = .781. Further data analysis of the scale revealed that RSSS is an adequate assessment tool of stress response in adults to be used in further research and clinical settings, with good psychometric characteristics, adequate divergent and convergent validity, good temporal stability and high internal consistency.

Keywords: Assessment, stress events, stress response, stress vulnerability.

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538 A New Version of Annotation Method with a XML-based Knowledge Base

Authors: Mohammad Yasrebi, Somayeh Khosravi

Abstract:

Machine-understandable data when strongly interlinked constitutes the basis for the SemanticWeb. Annotating web documents is one of the major techniques for creating metadata on the Web. Annotating websitexs defines the containing data in a form which is suitable for interpretation by machines. In this paper, we present a better and improved approach than previous [1] to annotate the texts of the websites depends on the knowledge base.

Keywords: Knowledge base, ontology, semantic annotation, XML.

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537 The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Authors: Feng-Chuan Pan, Fang-Yue Liu

Abstract:

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: hypertension, joint care management network, cardiovascular diseases, metabolic syndrome.

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536 Design of Stainless Steel Implant for Fractured Distal Femur

Authors: Abhishek Soni, Bhagat Singh

Abstract:

Perfect restoration of fractured distal femur has been a challenging task for the medical practitioners. In the present study, model of a fractured bone has been created using the scan data of the damaged bone. Thereafter, customized implant of Stainless Steel (SS-316L) for this fractured femur bone is modeled using the reverse engineering approach. Clinical set-up is prepared by assembling all the models together. Stress and deformation analysis of this clinical set-up has been performed in order to check the load bearing capacity and intactness of the joint. From this analysis, it has been inferred that the stresses and deformation developed due to the static load of the person is within the permissible limits.

Keywords: Biomechanical evaluations, customized implant, reverse engineering, stainless steel alloy.

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535 The PARADIGMA Approach for Cooperative Work in the Medical Domain

Authors: Antonio Di Leva, Carla Reyneri, Michele Sonnessa

Abstract:

PARADIGMA (PARticipative Approach to DIsease Global Management) is a pilot project which aims to develop and demonstrate an Internet based reference framework to share scientific resources and findings in the treatment of major diseases. PARADIGMA defines and disseminates a common methodology and optimised protocols (Clinical Pathways) to support service functions directed to patients and individuals on matters like prevention, posthospitalisation support and awareness. PARADIGMA will provide a platform of information services - user oriented and optimised against social, cultural and technological constraints - supporting the Health Care Global System of the Euro-Mediterranean Community in a continuous improvement process.

Keywords: Decision Support Systems, Ontology, Healt Care, Clinical Pathway

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534 Oral Examination: An Important Adjunct to the Diagnosis of Dermatological Disorders

Authors: Sanjay Saraf

Abstract:

The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their   importance in   early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: Vesiculobullous lesions, Desquamative gingivitis, Nikolsky’s sign, Erythema.

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533 Trends in Use of Millings in Pavement Maintenance

Authors: Rafiqul Tarefder, Mohiuddin Ahmad, Mohammad Hossain

Abstract:

While millings materials from old pavement surface can be an important component of cost effective maintenance operation, their use in maintenance projects are not uniform and well documented. This study documents the different maintenance practices followed by four transportation districts of New Mexico Department of Transportation (NMDOT) in an attempt to find whether millings are being used in maintenance projects by those districts. Based on existing literature, a questionnaire was developed related to six common maintenance practices. NMDOT district personal were interviewed face to face to discuss and get answers to that questionnaire. It revealed that NMDOT districts mainly use chip seal and patching. Other maintenance procedures such as sand seal, scrub seal, slurry seal, and thin overlay have limited use. Two out of four participating districts do not have any documents on chip sealing; rather they employ the experiences of the chip seal crew. All districts use polymer modified high float emulsion (HFE100P) for chip seal with an application rate ranging from 0.4 to 0.56 gallons per square yard. Chip application rate varies from 15 to 40 lb/ square yard. State wide, the thickness of chip seal varies from 3/8'' to 1'' and life varies from 3 to 10 years. NMDOT districts mainly use three type of patching: pothole, dig-out and blade patch. Pothole patches are used for small potholes and during emergency, dig-out patches are used for all type of potholes sometimes after pothole patching, and blade patch is used when a significant portion of the pavement is damaged. Pothole patches last as low as three days whereas, blade patch lasts as long as 3 years. It was observed that all participating districts use millings in maintenance projects.

Keywords: Chip seal, sand seal, scrub seal, slurry seal, overlay, patching, millings.

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532 Towards Medical Device Maintenance Workflow Monitoring

Authors: Beatriz López, Joaquim Meléndez, Heiko Wissel, Henning Haase, Kathleen Laatz, Oliver S. Grosser

Abstract:

Concerning the inpatient care the present situation is characterized by intense charges of medical technology into the clinical daily routine and an ever stronger integration of special techniques into the clinical workflow. Medical technology is by now an integral part of health care according to consisting general accepted standards. Purchase and operation thereby represent an important economic position and both are subject of everyday optimisation attempts. For this purpose by now exists a huge number of tools which conduce more likely to a complexness of the problem by a comprehensive implementation. In this paper the advantages of an integrative information-workflow on the life-cycle-management in the region of medical technology are shown.

Keywords: Medical equipment maintenance, maintenanceworkflow, medical equipment management, optimisation ofworkflow.

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531 Tourism Policy Challenges in Post-Soviet Georgia

Authors: Merab Khokhobaia

Abstract:

Within the framework of this research, the regulatory documents, which are in force in relation to this industry, were analyzed. The main attention is turned to their modernization and necessity of their compliance with European standards. It is a current issue to direct the efforts of state policy on support of business by implementing infrastructural projects, as well as by development of human resources, which may be possible by supporting the relevant higher and vocational studying-educational programs.

Keywords: Regional Development, Tourism Industry, Tourism Policy, Transition.

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530 Lexical Based Method for Opinion Detection on Tripadvisor Collection

Authors: Faiza Belbachir, Thibault Schienhinski

Abstract:

The massive development of online social networks allows users to post and share their opinions on various topics. With this huge volume of opinion, it is interesting to extract and interpret these information for different domains, e.g., product and service benchmarking, politic, system of recommendation. This is why opinion detection is one of the most important research tasks. It consists on differentiating between opinion data and factual data. The difficulty of this task is to determine an approach which returns opinionated document. Generally, there are two approaches used for opinion detection i.e. Lexical based approaches and Machine Learning based approaches. In Lexical based approaches, a dictionary of sentimental words is used, words are associated with weights. The opinion score of document is derived by the occurrence of words from this dictionary. In Machine learning approaches, usually a classifier is trained using a set of annotated document containing sentiment, and features such as n-grams of words, part-of-speech tags, and logical forms. Majority of these works are based on documents text to determine opinion score but dont take into account if these texts are really correct. Thus, it is interesting to exploit other information to improve opinion detection. In our work, we will develop a new way to consider the opinion score. We introduce the notion of trust score. We determine opinionated documents but also if these opinions are really trustable information in relation with topics. For that we use lexical SentiWordNet to calculate opinion and trust scores, we compute different features about users like (numbers of their comments, numbers of their useful comments, Average useful review). After that, we combine opinion score and trust score to obtain a final score. We applied our method to detect trust opinions in TRIPADVISOR collection. Our experimental results report that the combination between opinion score and trust score improves opinion detection.

Keywords: Tripadvisor, Opinion detection, SentiWordNet, trust score.

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529 An Semantic Algorithm for Text Categoritation

Authors: Xu Zhao

Abstract:

Text categorization techniques are widely used to many Information Retrieval (IR) applications. In this paper, we proposed a simple but efficient method that can automatically find the relationship between any pair of terms and documents, also an indexing matrix is established for text categorization. We call this method Indexing Matrix Categorization Machine (IMCM). Several experiments are conducted to show the efficiency and robust of our algorithm.

Keywords: Text categorization, Sub-space learning, Latent Semantic Space

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528 Comparisons of Fine Motor Functions in Subjects with Parkinson’s Disease and Essential Tremor

Authors: Nan-Ying Yu, Shao-Hsia Chang

Abstract:

This study explores the clinical features of neurodegenerative disease patients with tremor. We study the motor impairments in patients with Parkinson’s disease (PD) and essential tremor (ET). Since uncertainty exists on whether Parkinson's disease (PD) and essential tremor (ET) patients have similar degree of impairment during motor tasks, this study based on the self-developed computerized handwriting movement analysis to characterize motor functions of these two impairments. The recruited subjects were diagnosed and confirmed one of neurodegenerative diseases. They were undergone general clinical evaluations by physicians in the first year. We recruited 8 participants with PD and 10 with ET. Additional 12 participants without any neuromuscular dysfunction were recruited as control group. This study used fine motor control of penmanship on digital tablet for sensorimotor function tests. The movement speed in PD/ET group is found significant slower than subjects in normal control group. In movement intensity and speed, the result found subject with ET has similar clinical feature with PD subjects. The ET group shows smaller and slower movements than control group but not to the same extent as PD group. The results of this study contribute to the early screening and detection of diseases and the evaluation of disease progression.

Keywords: Parkinson’s disease, essential tremor, motor function, fine motor movement, computerized handwriting evaluation.

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527 Evaluation of the Microscopic-Observation Drug-Susceptibility Assay Drugs Concentration for Detection of Multidrug-Resistant Tuberculosis

Authors: Anita, Sari Septiani Tangke, Rusdina Bte Ladju, Nasrum Massi

Abstract:

New diagnostic tools are urgently needed to interrupt the transmission of tuberculosis and multidrug-resistant tuberculosis. The microscopic-observation drug-susceptibility (MODS) assay is a rapid, accurate and simple liquid culture method to detect multidrug-resistant tuberculosis (MDR-TB). MODS were evaluated to determine a lower and same concentration of isoniazid and rifampin for detection of MDR-TB. Direct drug-susceptibility testing was performed with the use of the MODS assay. Drug-sensitive control strains were tested daily. The drug concentrations that used for both isoniazid and rifampin were at the same concentration: 0.16, 0.08 and 0.04μg per milliliter. We tested 56 M. tuberculosis clinical isolates and the control strains M. tuberculosis H37RV. All concentration showed same result. Of 53 M. tuberculosis clinical isolates, 14 were MDR-TB, 38 were susceptible with isoniazid and rifampin, 1 was resistant with isoniazid only. Drug-susceptibility testing was performed with the use of the proportion method using Mycobacteria Growth Indicator Tube (MGIT) system as reference. The result of MODS assay using lower concentration was significance (P<0.001) compare with the reference methods.

A lower and same concentration of isoniazid and rifampin can be used to detect MDR-TB. Operational cost and application can be more efficient and easier in resource-limited environments. However, additional studies evaluating the MODS using lower and same concentration of isoniazid and rifampin must be conducted with a larger number of clinical isolates.

Keywords: Isoniazid, MODS assay, MDR-TB, Rifampin.

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526 Indications and Characteristics of Clinical Application of Periodontal Suturing

Authors: Saimir Heta, Ilma Robo, Vera Ostreni, Glorja Demika, Sonila Kapaj

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Suturing, as a procedure of joining the lips of the lembo or wound, is important at the beginning of the healing process. This procedure helps to pass the healing process from the procedure per secundam to the stages of healing per primam, thus logically reducing the healing time of the wound. The purpose of this article is to publish some data on the clinical characteristics of periodontal suturing, presenting the advantages and disadvantages of different types of suture threads. The article is a mini-review type of articles selected from the application of keywords on the PubMed page. The number of articles extracted from this article publication page is in accordance with the 10-year publication time limit. The element that remains in the individual selection of the dentist applying the suture is the selection of the suture material. At a moment when some types of sutures are offered for use, some elements should be considered in the selection of the suture depending on the constituent material, the cross-section of the suture elements, and whether it collects bacteria in the "pits" created by the material. The presence of bacteria is a source of infection and possible delay in the healing of the sutured wound. The marketing of suture types offers a variety of materials, from which the selection of the most suitable suture type for specific application cases is a personal indication of the dental surgeon based on professional experiences and knowledge in this field.

Keywords: Suture, suture material, types of sutures, clinical application.

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525 Periodontal Disease or Cement Disease? New Frontier in the Treatment of Periodontal Disease in Dogs

Authors: C. Gallottini, W. Di Mari, A. Amaddeo, K. Barbaro, A. Dolci, G. Dolci, L. Gallottini, G. Barraco, S. Eramo

Abstract:

A group of 10 dogs (group A) with Periodontal Disease in the third stage, were subjected to regenerative therapy of periodontal tissues, by use of nano hydroxy apatite (NHA). These animals induced by general anesthesia, where treated by ultrasonic scaling, root planning, and at the end by a mucogingival flap in which it was applied NHA. The flap was closed and sutured with simple steps. Another group of 10 dogs (group B), control group, was treated only by scaling and root planning. No patient was subjected to antibiotic therapy. After three months, a check was made by inspection of the oral cavity, radiography and bone biopsy at the alveolar level. Group A showed a total restitutio ad integrum of the periodontal structures, and in group B still mild gingivitis in 70% of cases and 30% of the state remains unchanged. Numerous experimental studies both in animals and humans have documented that the grafts of porous hydroxyapatite are rapidly invaded by fibrovascular tissue which is subsequently converted into mature lamellar bone tissue by activating osteoblast. Since we acted on the removal of necrotic cementum and rehabilitating the root tissue by polishing without intervention in the ligament but only on anatomical functional interface of cement-blasts, we can connect the positive evolution of the clinical-only component of the cement that could represent this perspective, the only reason that Periodontal Disease become a Cement Disease, while all other clinical elements as nothing more than a clinical pathological accompanying.

Keywords: Nanoidroxiaphatite, Parodontal Disease, Rigenerative Therapy.

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524 Comparison between Different Classifications of Periodontal Diseases and Their Advantages

Authors: Ilma Robo, Saimir Heta, Merilda Tarja, Sonila Kapaj, Eduart Kapaj, Geriona Lasku

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The classification of periodontal diseases has changed significantly in favor of simplifying the protocol of diagnosis and periodontal treatment. This review study aims to highlight the latest publications in the new periodontal disease classification, talking about the most significant differences versus the old classification with the tendency to express the advantages or disadvantages of clinical application. The aim of the study also includes the growing tendency to link the way of classification of periodontal diseases with predetermined protocols of periodontal treatment of the diagnoses included in the classification. The new classification of periodontal diseases is rather comprehensive in its subdivisions, as the disease is viewed in its entirety, with the biological dimensions of the disease, the degree of aggravation and progression of the disease, in relation to risk factors, predisposition to patient susceptibility and impact of periodontal disease to the general health status of the patient.

Keywords: Periodontal diseases, clinical application, periodontal treatment, oral diagnosis.

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523 Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology

Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

Abstract:

Background: To improve the delivery of paediatric healthcare in low resource settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (inadequate adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (SL eCCM app) as an exemplar. Results: A service blueprint is developed which illustrates how the SL eCCM app can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: Adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint.

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522 Extrapolation of Clinical Data from an Oral Glucose Tolerance Test Using a Support Vector Machine

Authors: Jianyin Lu, Masayoshi Seike, Wei Liu, Peihong Wu, Lihua Wang, Yihua Wu, Yasuhiro Naito, Hiromu Nakajima, Yasuhiro Kouchi

Abstract:

To extract the important physiological factors related to diabetes from an oral glucose tolerance test (OGTT) by mathematical modeling, highly informative but convenient protocols are required. Current models require a large number of samples and extended period of testing, which is not practical for daily use. The purpose of this study is to make model assessments possible even from a reduced number of samples taken over a relatively short period. For this purpose, test values were extrapolated using a support vector machine. A good correlation was found between reference and extrapolated values in evaluated 741 OGTTs. This result indicates that a reduction in the number of clinical test is possible through a computational approach.

Keywords: SVM regression, OGTT, diabetes, mathematical model

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521 Suicide Wrongful Death: Standard of Care Problems Involving the Inaccurate Discernment of Lethal Risk When Focusing on the Elicitation of Suicide Ideation

Authors: Bill D. Geis, Frederick Newman

Abstract:

Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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520 Patient-Specific Modeling Algorithm for Medical Data Based on AUC

Authors: Guilherme Ribeiro, Alexandre Oliveira, Antonio Ferreira, Shyam Visweswaran, Gregory Cooper

Abstract:

Patient-specific models are instance-based learning algorithms that take advantage of the particular features of the patient case at hand to predict an outcome. We introduce two patient-specific algorithms based on decision tree paradigm that use AUC as a metric to select an attribute. We apply the patient specific algorithms to predict outcomes in several datasets, including medical datasets. Compared to the patient-specific decision path (PSDP) entropy-based and CART methods, the AUC-based patient-specific decision path models performed equivalently on area under the ROC curve (AUC). Our results provide support for patient-specific methods being a promising approach for making clinical predictions.

Keywords: Approach instance-based, area Under the ROC Curve, Patient-specific Decision Path, clinical predictions.

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519 University Curriculum Policy Processes in Chile: A Case Study

Authors: Victoria C. Valdebenito

Abstract:

Located within the context of accelerating globalization in the 21st-century knowledge society, this paper focuses on one selected university in Chile at which radical curriculum policy changes have been taking place, diverging from the traditional curriculum in Chile at the undergraduate level as a section of a larger investigation. Using a ‘policy trajectory’ framework, and guided by the interpretivist approach to research, interview transcripts and institutional documents were analyzed in relation to the meso (university administration) and the micro (academics) level. Inside the case study, participants from the university administration and academic levels were selected both via snow-ball technique and purposive selection, thus they had different levels of seniority, with some participating actively in the curriculum reform processes. Guided by an interpretivist approach to research, documents and interview transcripts were analyzed to reveal major themes emerging from the data. A further ‘bigger picture’ analysis guided by critical theory was then undertaken, involving interrogation of underlying ideologies and how political and economic interests influence the cultural production of policy. The case-study university was selected because it represents a traditional and old case of university setting in the country, undergoing curriculum changes based on international trends such as the competency model and the liberal arts. Also, it is representative of a particular socioeconomic sector of the country. Access to the university was gained through email contact. Qualitative research methods were used, namely interviews and analysis of institutional documents. In all, 18 people were interviewed. The number was defined by when the saturation criterion was met. Semi-structured interview schedules were based on the four research questions about influences, policy texts, policy enactment and longer-term outcomes. Triangulation of information was used for the analysis. While there was no intention to generalize the specific findings of the case study, the results of the research were used as a focus for engagement with broader themes, often evident in global higher education policy developments. The research results were organized around major themes in three of the four contexts of the ‘policy trajectory’. Regarding the context of influences and the context of policy text production, themes relate to hegemony exercised by first world countries’ universities in the higher education field, its associated neoliberal ideology, with accountability and the discourse of continuous improvement, the local responses to those pressures, and the value of interdisciplinarity. Finally, regarding the context of policy practices and effects (enactment), themes emerged around the impacts of the curriculum changes on university staff, students, and resistance amongst academics. The research concluded with a few recommendations that potentially provide ‘food for thought’ beyond the localized settings of this study, as well as possibilities for further research.

Keywords: Curriculum, policy, higher education, global-local dynamics.

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518 Restructuring of XML Documents in the Form of Ontologies

Authors: Jamal Bakkas, Mohamed Bahaj, Abdellatif Soklabi

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The intense use of the web has made it a very changing environment, its content is in permanent evolution to adapt to the demands. The standards have accompanied this evolution by passing from standards that regroup data with their presentations without any structuring such as HTML, to standards that separate both and give more importance to the structural aspect of the content such as XML standard and its derivatives. Currently, with the appearance of the Semantic Web, ontologies become increasingly present on the web and standards that allow their representations as OWL and RDF/RDFS begin to gain momentum. This paper provided an automatic method that converts XML schema document to ontologies represented in OWL.

Keywords: XML Schema, OWL, RDB, Mapping, Ontology.

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517 The Effect of Relaxation Training on First Year Nursing Students Anxiety in Clinical Setting

Authors: S. Ahmadnejad, Z. Monjamed, M. Pakravannejad, A. Malekian

Abstract:

The investigating and assessing the effects of relaxation training on the levels of state anxiety concerning first year female nursing students at their initial experience in clinical setting. This research is a quasi experimental study that was carried out in nursing and midwifery faculty of Tehran university of medical sciences .The sample of research consists 60 first term female nursing students were selected through convenience and random sampling. 30 of them were the experimental group and 30 of them were in control group. The Instruments of data-collection has been a questionnaire which consists of 3 parts. The first part includes 10 questions about demographic characteristics .the second part includes 20 question about anxiety (test 'Spielberg' ). The 3rd part includes physiological indicators of anxiety (BP, P, R, body temperature). The statistical tests included t-test and  and fisher test, Data were analyzed by SPSS software.

Keywords: Anxiety, Nursing students, Relaxation

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516 The Impact of Web Based Education on Cancer Patients’ Clinical Outcomes

Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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515 Evaluation of Gingival Hyperplasia Caused by Medications

Authors: Ilma Robo, Saimir Heta, Greta Plaka, Vera Ostreni

Abstract:

Purpose: Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. The purpose of this paper is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. Materials and Methods: The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by vertical and horizontal evaluation according to the periodontal indexes. Results: Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity has been exposed at time period for more than 1 year and 1 month. According to the GOI, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. Conclusions: The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

Keywords: Drug gingival hyperplasia, horizontal growth index, vertical growth index.

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514 Trunk and Gluteus-Medius Muscles’ Fatigability during Occupational Standing in Clinical Instructors with Low Back Pain

Authors: Eman A. Embaby, Amira A. A. Abdallah

Abstract:

Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs 29.07±2.4years, weight 63.6±7 vs 60±7.8kg, and height 162.73±4 vs 162.8±6cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, Fatigability, Gluteus-medius, LBP, Standing, Trunk.

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513 Concepts Extraction from Discharge Notes using Association Rule Mining

Authors: Basak Oguz Yolcular

Abstract:

A large amount of valuable information is available in plain text clinical reports. New techniques and technologies are applied to extract information from these reports. In this study, we developed a domain based software system to transform 600 Otorhinolaryngology discharge notes to a structured form for extracting clinical data from the discharge notes. In order to decrease the system process time discharge notes were transformed into a data table after preprocessing. Several word lists were constituted to identify common section in the discharge notes, including patient history, age, problems, and diagnosis etc. N-gram method was used for discovering terms co-Occurrences within each section. Using this method a dataset of concept candidates has been generated for the validation step, and then Predictive Apriori algorithm for Association Rule Mining (ARM) was applied to validate candidate concepts.

Keywords: association rule mining, otorhinolaryngology, predictive apriori, text mining

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512 The New Approach to Airport Emergency Plans

Authors: Jakub Kraus, Vladimír Plos, Peter Vittek

Abstract:

This article deals with a new approach to the airport emergency plans, which are the basic documents and manuals for dealing with events with impact on safety or security. The article describes the identified parts in which the current airport emergency plans do not fulfill their role and which should therefore be considered in the creation of corrective measures. All these issues have been identified at airports in the Czech Republic and confirmed at airports in neighboring countries.

Keywords: Airport emergency plan, aviation safety, aviation security, comprehensive management system.

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511 Industrial Production and Clinical Application of L-Asparaginase: A Chemotherapeutic Agent

Authors: Soni Yadav, Sitansu Kumar Verma, Jitendra Singh, Ajay Kumar

Abstract:

This article comprises detail information about L-asparaginase, encompassing topic such as various sources of L-asparaginase, mechanism and properties of L-asparaginase. Also describe the production, cultivation and purification of L-asparaginase along with information about the application of L-asparaginase. L-asparaginase catalyzes the conversion reaction to convert asparagine to aspartic acid and ammonia. Asparagine is a nutritional requirement for both normal and tumor cell. Present scenario has found that L-asparaginase has been found to be a best anti tumor or antileukemic agent. In the recent years this enzyme gained application in the field of clinical research pharmacologic and food industry. It has been characterized based on the enzyme assay principle hydrolyzing L-asparagine into L-aspartic acid and ammonia. It has been observed that eukaryotic microorganisms such as yeast and filamentous fungi have a potential for L-asparaginase production. L-asparaginase has been and is still one of the most lengthily studied therapeutic enzymes by scientist and researchers worldwide.

Keywords: L-asparaginase, antitumor, solid state fermentation, chemotherapeutic.

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510 HIV Treatment Planning on a case-by-CASE Basis

Authors: Marios M. Hadjiandreou, Raul Conejeros, Ian Wilson

Abstract:

This study presents a mathematical modeling approach to the planning of HIV therapies on an individual basis. The model replicates clinical data from typical-progressors to AIDS for all stages of the disease with good agreement. Clinical data from rapid-progressors and long-term non-progressors is also matched by estimation of immune system parameters only. The ability of the model to reproduce these phenomena validates the formulation, a fact which is exploited in the investigation of effective therapies. The therapy investigation suggests that, unlike continuous therapy, structured treatment interruptions (STIs) are able to control the increase in both the drug-sensitive and drug-resistant virus population and, hence, prevent the ultimate progression from HIV to AIDS. The optimization results further suggest that even patients characterised by the same progression type can respond very differently to the same treatment and that the latter should be designed on a case-by-case basis. Such a methodology is presented here.

Keywords: AIDS, chemotherapy, mathematical modeling, optimal control, progression.

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