Search results for: assessment of interactions
Commenced in January 2007
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Edition: International
Paper Count: 1804

Search results for: assessment of interactions

94 Changing Patterns of Colorectal Cancer in Hail Region

Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

Abstract:

Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: Colorectal cancer, Hail Region, changing pattern, distal shift.

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93 Chemotherapy Safety Protocol for Oncology Nurses: It's Effect on Their Protective Measures Practices

Authors: Magda M. Mohsen, Manal E. Fareed

Abstract:

Background: Widespread use of chemotherapeutic drugs in the treatment of cancer has lead to higher health hazards among employee who handle and administer such drugs, so nurses should know how to protect themselves, their patients and their work environment against toxic effects of chemotherapy. Aim of this study was carried out to examine the effect of chemotherapy safety protocol for oncology nurses on their protective measure practices. Design: A quasi experimental research design was utilized. Setting: The study was carried out in oncology department of Menoufia university hospital and Tanta oncology treatment center. Sample: A convenience sample of forty five nurses in Tanta oncology treatment center and eighteen nurses in Menoufiya oncology department. Tools: 1. an interviewing questionnaire that covering sociodemographic data, assessment of unit and nurses' knowledge about chemotherapy. II: Obeservational check list to assess nurses' actual practices of handling and adminestration of chemotherapy. A base line data were assessed before implementing Chemotherapy Safety protocol, then Chemotherapy Safety protocol was implemented, and after 2 monthes they were assessed again. Results: reveled that 88.9% of study group I and 55.6% of study group II improved to good total knowledge scores after educating on the safety protocol, also 95.6% of study group I and 88.9% of study group II had good total practice score after educating on the safety protocol. Moreover less than half of group I (44.4%) reported that heavy workload is the most barriers for them, while the majority of group II (94.4%) had many barriers for adhering to the safety protocol such as they didn’t know the protocol, the heavy work load and inadequate equipment. Conclusions: Safety protocol for Oncology Nurses seemed to have positive effect on improving nurses' knowledge and practice. Recommendation: chemotherapy safety protocol should be instituted for all oncology nurses who are working in any oncology unit and/ or center to enhance compliance, and this protocol should be done at frequent intervals.

Keywords: Chemotherapy Safety protocol, Effect, protective measure practice.

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92 Wind Energy Resources Assessment and Micrositting on Different Areas of Libya: The Case Study in Darnah

Authors: F. Ahwide, Y. Bouker, K. Hatem

Abstract:

This paper presents long term wind data analysis in terms of annual and diurnal variations at different areas of Libya. The data of the wind speed and direction are taken each ten minutes for a period, at least two years, are used in the analysis. ‘WindPRO’ software and Excel workbook were used for the wind statistics and energy calculations. As for Darnah, average speeds are 10m, 20m and 40m and 6.57 m/s, 7.18 m/s, and 8.09 m/s, respectively. Highest wind speeds are observed at SSW, followed by S, WNW and NW sectors. Lowest wind speeds are observed between N and E sectors. Most frequent wind directions are NW and NNW. Hence, wind turbines can be installed against these directions. The most powerful sector is NW (31.3% of total expected wind energy), followed by 17.9% SSW, 11.5% NNW and 8.2% WNW

In Excel workbook, an estimation of annual energy yield at position of Derna, Al-Maqrun, Tarhuna and Al-Asaaba meteorological mast has been done, considering a generic wind turbine of 1.65 MW. (mtORRES, TWT 82-1.65MW) in position of meteorological mast. Three other turbines have been tested and a reduction of 18% over the net AEP. At 80m, the estimation of energy yield for Derna, Al- Maqrun, Tarhuna and Asaaba is 6.78 GWh or 3390 equivalent hours, 5.80 GWh or 2900 equivalent hours, 4.91 GWh or 2454 equivalent hours and 5.08 GWh or 2541 equivalent hours respectively. It seems a fair value in the context of a possible development of a wind energy project in the areas, considering a value of 2400 equivalent hours as an approximate limit to consider a wind warm economically profitable. Furthermore, an estimation of annual energy yield at positions of Misalatha, Azizyah and Goterria meteorological mast has been done, considering a generic wind turbine of 2 MW. We found that, at 80 m the estimation of energy yield is 3.12 GWh or 1557 equivalent hours, 4.47 GWh or 2235 equivalent hours and 4.07GWh or 2033 respectively.

It seems a very poor value in the context of possible development of a wind energy project in the areas, considering a value of 2400 equivalent hours as an approximate limit to consider a wind warm economically profitable. Anyway, more data and a detailed wind farm study would be necessary to draw conclusions.

Keywords: Wind turbines, wind data, energy yield, micrositting.

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91 Dynamic Balance, Pain and Functional Performance in Cruciate Retaining, Posterior Stabilized and Uni-Compartmental Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m2 for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-8th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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90 Lead and Cadmium Spatial Pattern and Risk Assessment around Coal Mine in Hyrcanian Forest, North Iran

Authors: Mahsa Tavakoli, Seyed Mohammad Hojjati, Yahya Kooch

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In this study, the effect of coal mining activities on lead and cadmium concentrations and distribution in soil was investigated in Hyrcanian forest, North Iran. 16 plots (20×20 m2) were established by systematic-randomly (60×60 m2) in an area of 4 ha (200×200 m2-mine entrance placed at center). An area adjacent to the mine was not affected by the mining activity; considered as the controlled area. In order to investigate soil lead and cadmium concentration, one sample was taken from the 0-10 cm in each plot. To study the spatial pattern of soil properties and lead and cadmium concentrations in the mining area, an area of 80×80m2 (the mine as the center) was considered and 80 soil samples were systematic-randomly taken (10 m intervals). Geostatistical analysis was performed via Kriging method and GS+ software (version 5.1). In order to estimate the impact of coal mining activities on soil quality, pollution index was measured. Lead and cadmium concentrations were significantly higher in mine area (Pb: 10.97±0.30, Cd: 184.47±6.26 mg.kg-1) in comparison to control area (Pb: 9.42±0.17, Cd: 131.71±15.77 mg.kg-1). The mean values of the PI index indicate that Pb (1.16) and Cd (1.77) presented slightly polluted. Results of the NIPI index showed that Pb (1.44) and Cd (2.52) presented slight pollution and moderate pollution respectively. Results of variography and kriging method showed that it is possible to prepare interpolation maps of lead and cadmium around the mining areas in Hyrcanian forest. According to results of pollution and risk assessments, forest soil was contaminated by heavy metals (lead and cadmium); therefore, using reclamation and remediation techniques in these areas is necessary.

Keywords: Traditional coal mining, heavy metals, pollution indicators, geostatistics, caspian forest.

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89 Impact Assessment of Credit Policy and Medical Credit Facility (MCF) on Nigerian Private Sector Health Market: Evidence from Eight Nigerian States

Authors: Chimaobi V. Okolo, Kenneth A. Okpala, Johnbull S. Ogboi

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A teeming set of doctors that graduated from various universities within and outside Nigeria with the hope of practicing in the country, has their hope shattered because of poor financing, lack of medical equipments and a very weak healthcare systems. Such hydra headed challenges, allows room for quackery which increasingly contributes to the cause of mortality in Nigeria. With a view of reversing the challenges of healthcare delivery and financing in Nigeria, African Health Market for Equity (AHME), a project funded by the Bill and Melinda Gates foundation [With contribution from Department For International Development (DFID)] and currently implemented in three African Countries (Nigeria, Kenya and Ghana) over a Five (5) year period supports the healthcare sector via Medical credit fund (MCF). The study examines the impact of credit policy and medical credit funding on Nigerian health market. Ordinary least square analysis, correlation and granger causality tests were employed to measure the extent to which the Nigerian healthcare market has been influenced. Medical credit fund significantly and positively influenced average monthly turnover of private healthcare providers and Commercial bank’s lending rate had a weak relationship with access to credit/approved loans (13.46%). The programme has so far made 13.91% progress, which is very poor, considering the minimum targeted private health care providers (437.6) and expected number of loan approvals (180.4) for the two years. Medical credit policy in Nigeria should be revised to include private healthcare providers in rural area for more positive impact and increased returns. Good brand advert and sensitization of the programme to stakeholders and health pressure group, and an extension of the programme beyond five years is necessary to better address the issues raised in the study.

Keywords: Credit, health market, medical credit facility, policy.

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88 Risk Assessment of Trace Element Pollution in Gymea Bay, NSW, Australia

Authors: Yasir M. Alyazichi, Brian G. Jones, Errol McLean, Hamd N. Altalyan, Ali K. M. Al-Nasrawi

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The main purpose of this study is to assess the sediment quality and potential ecological risk in marine sediments in Gymea Bay located in south Sydney, Australia. A total of 32 surface sediment samples were collected from the bay. Current track trajectories and velocities have also been measured in the bay. The resultant trace elements were compared with the adverse biological effect values Effect Range Low (ERL) and Effect Range Median (ERM) classifications. The results indicate that the average values of chromium, arsenic, copper, zinc, and lead in surface sediments all reveal low pollution levels and are below ERL and ERM values. The highest concentrations of trace elements were found close to discharge points and in the inner bay, and were linked with high percentages of clay minerals, pyrite and organic matter, which can play a significant role in trapping and accumulating these elements. The lowest concentrations of trace elements were found to be on the shoreline of the bay, which contained high percentages of sand fractions. It is postulated that the fine particles and trace elements are disturbed by currents and tides, then transported and deposited in deeper areas. The current track velocities recorded in Gymea Bay had the capability to transport fine particles and trace element pollution within the bay. As a result, hydrodynamic measurements were able to provide useful information and to help explain the distribution of sedimentary particles and geochemical properties. This may lead to knowledge transfer to other bay systems, including those in remote areas. These activities can be conducted at a low cost, and are therefore also transferrable to developing countries. The advent of portable instruments to measure trace elements in the field has also contributed to the development of these lower cost and easily applied methodologies available for use in remote locations and low-cost economies.

Keywords: Current track velocities, Gymea Bay, surface sediments, trace elements.

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87 An Approach for Ensuring Data Flow in Freight Delivery and Management Systems

Authors: Aurelija Burinskienė, Dalė Dzemydienė, Arūnas Miliauskas

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This research aims at developing the approach for more effective freight delivery and transportation process management. The road congestions and the identification of causes are important, as well as the context information recognition and management. The measure of many parameters during the transportation period and proper control of driver work became the problem. The number of vehicles per time unit passing at a given time and point for drivers can be evaluated in some situations. The collection of data is mainly used to establish new trips. The flow of the data is more complex in urban areas. Herein, the movement of freight is reported in detail, including the information on street level. When traffic density is extremely high in congestion cases, and the traffic speed is incredibly low, data transmission reaches the peak. Different data sets are generated, which depend on the type of freight delivery network. There are three types of networks: long-distance delivery networks, last-mile delivery networks and mode-based delivery networks; the last one includes different modes, in particular, railways and other networks. When freight delivery is switched from one type of the above-stated network to another, more data could be included for reporting purposes and vice versa. In this case, a significant amount of these data is used for control operations, and the problem requires an integrated methodological approach. The paper presents an approach for providing e-services for drivers by including the assessment of the multi-component infrastructure needed for delivery of freights following the network type. The construction of such a methodology is required to evaluate data flow conditions and overloads, and to minimize the time gaps in data reporting. The results obtained show the possibilities of the proposing methodological approach to support the management and decision-making processes with functionality of incorporating networking specifics, by helping to minimize the overloads in data reporting.

Keywords: Transportation networks, freight delivery, data flow, monitoring, e-services.

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86 ELISA Based hTSH Assessment Using Two Sensitive and Specific Anti-hTSH Polyclonal Antibodies

Authors: Maysam Mard-Soltani, Mohamad Javad Rasaee, Saeed Khalili, Abdol Karim Sheikhi, Mehdi Hedayati

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Production of specific antibody responses against hTSH is a cumbersome process due to the high identity between the hTSH and the other members of the glycoprotein hormone family (FSH, LH and HCG) and the high identity between the human hTSH and host animals for antibody production. Therefore, two polyclonal antibodies were purified against two recombinant proteins. Four possible ELISA tests were designed based on these antibodies. These ELISA tests were checked against hTSH and other glycoprotein hormones, and their sensitivity and specificity were assessed. Bioinformatics tools were used to analyze the immunological properties. After the immunogen region selection from hTSH protein, c terminal of B hTSH was selected and applied. Two recombinant genes, with these cut pieces (first: two repeats of C terminal of B hTSH, second: tetanous toxin+B hTSH C terminal), were designed and sub-cloned into the pET32a expression vector. Standard methods were used for protein expression, purification, and verification. Thereafter, immunizations of the white New Zealand rabbits were performed and the serums of them were used for antibody titration, purification and characterization. Then, four ELISA tests based on two antibodies were employed to assess the hTSH and other glycoprotein hormones. The results of these assessments were compared with standard amounts. The obtained results indicated that the desired antigens were successfully designed, sub-cloned, expressed, confirmed and used for in vivo immunization. The raised antibodies were capable of specific and sensitive hTSH detection, while the cross reactivity with the other members of the glycoprotein hormone family was minimum. Among the four designed tests, the test in which the antibody against first protein was used as capture antibody, and the antibody against second protein was used as detector antibody did not show any hook effect up to 50 miu/l. Both proteins have the ability to induce highly sensitive and specific antibody responses against the hTSH. One of the antibody combinations of these antibodies has the highest sensitivity and specificity in hTSH detection.

Keywords: hTSH, bioinformatics, protein expression, cross reactivity.

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85 Grade and Maximum Tumor Dimension as Determinants of Lymphadenectomy in Patients with Endometrioid Endometrial Cancer (EEC)

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: Endometrial cancer, FIGO grade, lymphadenectomy, tumor size.

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84 A Real Time Set Up for Retrieval of Emotional States from Human Neural Responses

Authors: Rashima Mahajan, Dipali Bansal, Shweta Singh

Abstract:

Real time non-invasive Brain Computer Interfaces have a significant progressive role in restoring or maintaining a quality life for medically challenged people. This manuscript provides a comprehensive review of emerging research in the field of cognitive/affective computing in context of human neural responses. The perspectives of different emotion assessment modalities like face expressions, speech, text, gestures, and human physiological responses have also been discussed. Focus has been paid to explore the ability of EEG (Electroencephalogram) signals to portray thoughts, feelings, and unspoken words. An automated workflow-based protocol to design an EEG-based real time Brain Computer Interface system for analysis and classification of human emotions elicited by external audio/visual stimuli has been proposed. The front end hardware includes a cost effective and portable Emotiv EEG Neuroheadset unit, a personal computer and a set of external stimulators. Primary signal analysis and processing of real time acquired EEG shall be performed using MATLAB based advanced brain mapping toolbox EEGLab/BCILab. This shall be followed by the development of MATLAB based self-defined algorithm to capture and characterize temporal and spectral variations in EEG under emotional stimulations. The extracted hybrid feature set shall be used to classify emotional states using artificial intelligence tools like Artificial Neural Network. The final system would result in an inexpensive, portable and more intuitive Brain Computer Interface in real time scenario to control prosthetic devices by translating different brain states into operative control signals.

Keywords: Brain Computer Interface (BCI), Electroencephalogram (EEG), EEGLab, BCILab, Emotiv, Emotions, Interval features, Spectral features, Artificial Neural Network, Control applications.

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83 Rapid Monitoring of Earthquake Damages Using Optical and SAR Data

Authors: Saeid Gharechelou, Ryutaro Tateishi

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Earthquake is an inevitable catastrophic natural disaster. The damages of buildings and man-made structures, where most of the human activities occur are the major cause of casualties from earthquakes. A comparison of optical and SAR data is presented in the case of Kathmandu valley which was hardly shaken by 2015-Nepal Earthquake. Though many existing researchers have conducted optical data based estimated or suggested combined use of optical and SAR data for improved accuracy, however finding cloud-free optical images when urgently needed are not assured. Therefore, this research is specializd in developing SAR based technique with the target of rapid and accurate geospatial reporting. Should considers that limited time available in post-disaster situation offering quick computation exclusively based on two pairs of pre-seismic and co-seismic single look complex (SLC) images. The InSAR coherence pre-seismic, co-seismic and post-seismic was used to detect the change in damaged area. In addition, the ground truth data from field applied to optical data by random forest classification for detection of damaged area. The ground truth data collected in the field were used to assess the accuracy of supervised classification approach. Though a higher accuracy obtained from the optical data then integration by optical-SAR data. Limitation of cloud-free images when urgently needed for earthquak evevent are and is not assured, thus further research on improving the SAR based damage detection is suggested. Availability of very accurate damage information is expected for channelling the rescue and emergency operations. It is expected that the quick reporting of the post-disaster damage situation quantified by the rapid earthquake assessment should assist in channeling the rescue and emergency operations, and in informing the public about the scale of damage.

Keywords: Sentinel-1A data, Landsat-8, earthquake damage, InSAR, rapid monitoring, 2015-Nepal earthquake.

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82 Assessment of Path Loss Prediction Models for Wireless Propagation Channels at L-Band Frequency over Different Micro-Cellular Environments of Ekiti State, Southwestern Nigeria

Authors: C. I. Abiodun, S. O. Azi, J. S. Ojo, P. Akinyemi

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The design of accurate and reliable mobile communication systems depends majorly on the suitability of path loss prediction methods and the adaptability of the methods to various environments of interest. In this research, the results of the adaptability of radio channel behavior are presented based on practical measurements carried out in the 1800 MHz frequency band. The measurements are carried out in typical urban, suburban and rural environments in Ekiti State, Southwestern part of Nigeria. A total number of seven base stations of MTN GSM service located in the studied environments were monitored. Path loss and break point distances were deduced from the measured received signal strength (RSS) and a practical path loss model is proposed based on the deduced break point distances. The proposed two slope model, regression line and four existing path loss models were compared with the measured path loss values. The standard deviations of each model with respect to the measured path loss were estimated for each base station. The proposed model and regression line exhibited lowest standard deviations followed by the Cost231-Hata model when compared with the Erceg Ericsson and SUI models. Generally, the proposed two-slope model shows closest agreement with the measured values with a mean error values of 2 to 6 dB. These results show that, either the proposed two slope model or Cost 231-Hata model may be used to predict path loss values in mobile micro cell coverage in the well-considered environments. Information from this work will be useful for link design of microwave band wireless access systems in the region.

Keywords: Break-point distances, path loss models, path loss exponent, received signal strength.

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81 Neuropalliative Care in Patients with Progressive Neurological Disease in Czech Republic: Study Protocol

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

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

Keywords: Multidisciplinary approach, neuropalliative care, research, quality of life.

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80 Effects of Four Dietary Oils on Cholesterol and Fatty Acid Composition of Egg Yolk in Layers

Authors: A. F. Agboola, B. R. O. Omidiwura, A. Oyeyemi, E. A. Iyayi, A. S. Adelani

Abstract:

Dietary cholesterol has elicited the most public interest as it relates with coronary heart disease. Thus, humans have been paying more attention to health, thereby reducing consumption of cholesterol enriched food. Egg is considered as one of the major sources of human dietary cholesterol. However, an alternative way to reduce the potential cholesterolemic effect of eggs is to modify the fatty acid composition of the yolk. The effect of palm oil (PO), soybean oil (SO), sesame seed oil (SSO) and fish oil (FO) supplementation in the diets of layers on egg yolk fatty acid, cholesterol, egg production and egg quality parameters were evaluated in a 42-day feeding trial. One hundred and five Isa Brown laying hens of 34 weeks of age were randomly distributed into seven groups of five replicates and three birds per replicate in a completely randomized design. Seven corn-soybean basal diets (BD) were formulated: BD+No oil (T1), BD+1.5% PO (T2), BD+1.5% SO (T3), BD+1.5% SSO (T4), BD+1.5% FO (T5), BD+0.75% SO+0.75% FO (T6) and BD+0.75% SSO+0.75% FO (T7). Five eggs were randomly sampled at day 42 from each replicate to assay for the cholesterol, fatty acid profile of egg yolk and egg quality assessment. Results showed that there were no significant (P>0.05) differences observed in production performance, egg cholesterol and egg quality parameters except for yolk height, albumen height, yolk index, egg shape index, haugh unit, and yolk colour. There were no significant differences (P>0.05) observed in total cholesterol, high density lipoprotein and low density lipoprotein levels of egg yolk across the treatments. However, diets had effect (P<0.05) on TAG (triacylglycerol) and VLDL (very low density lipoprotein) of the egg yolk. The highest TAG (603.78 mg/dl) and VLDL values (120.76 mg/dl) were recorded in eggs of hens on T4 (1.5% sesame seed oil) and was similar to those on T3 (1.5% soybean oil), T5 (1.5% fish oil) and T6 (0.75% soybean oil + 0.75% fish oil). However, results revealed a significant (P<0.05) variations on eggs’ summation of polyunsaturated fatty acid (PUFA). In conclusion, it is suggested that dietary oils could be included in layers’ diets to produce designer eggs low in cholesterol and high in PUFA especially omega-3 fatty acids.

Keywords: Dietary oils, Egg cholesterol, Egg fatty acid profile, Egg quality parameters.

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79 A Coupled Model for Two-Phase Simulation of a Heavy Water Pressure Vessel Reactor

Authors: Damian Ramajo, Santiago Corzo, Norberto Nigro

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A Multi-dimensional computational fluid dynamics (CFD) two-phase model was developed with the aim to simulate the in-core coolant circuit of a pressurized heavy water reactor (PHWR) of a commercial nuclear power plant (NPP). Due to the fact that this PHWR is a Reactor Pressure Vessel type (RPV), three-dimensional (3D) detailed modelling of the large reservoirs of the RPV (the upper and lower plenums and the downcomer) were coupled with an in-house finite volume one-dimensional (1D) code in order to model the 451 coolant channels housing the nuclear fuel. Regarding the 1D code, suitable empirical correlations for taking into account the in-channel distributed (friction losses) and concentrated (spacer grids, inlet and outlet throttles) pressure losses were used. A local power distribution at each one of the coolant channels was also taken into account. The heat transfer between the coolant and the surrounding moderator was accurately calculated using a two-dimensional theoretical model. The implementation of subcooled boiling and condensation models in the 1D code along with the use of functions for representing the thermal and dynamic properties of the coolant and moderator (heavy water) allow to have estimations of the in-core steam generation under nominal flow conditions for a generic fission power distribution. The in-core mass flow distribution results for steady state nominal conditions are in agreement with the expected from design, thus getting a first assessment of the coupled 1/3D model. Results for nominal condition were compared with those obtained with a previous 1/3D single-phase model getting more realistic temperature patterns, also allowing visualize low values of void fraction inside the upper plenum. It must be mentioned that the current results were obtained by imposing prescribed fission power functions from literature. Therefore, results are showed with the aim of point out the potentiality of the developed model.

Keywords: CFD, PHWR, Thermo-hydraulic, Two-phase flow.

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78 Assessment of Obesity Parameters in Terms of Metabolic Age above and below Chronological Age in Adults

Authors: Orkide Donma, Mustafa M. Donma

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Chronologic age (CA) of individuals is closely related to obesity and generally affects the magnitude of obesity parameters. On the other hand, close association between basal metabolic rate (BMR) and metabolic age (MA) is also a matter of concern. It is suggested that MA higher than CA is the indicator of the need to improve the metabolic rate. In this study, the aim was to assess some commonly used obesity parameters, such as obesity degree, visceral adiposity, BMR, BMR-to-weight ratio, in several groups with varying differences between MA and CA values. The study comprises adults, whose ages vary between 18 and 79 years. Four groups were constituted. Group 1, 2, 3 and 4 were composed of 55, 33, 76 and 47 adults, respectively. The individuals exhibiting -1, 0 and +1 for their MA-CA values were involved in Group 1, which was considered as the control group. Those, whose MA-CA values varying between -5 and -10 participated in Group 2. Those, whose MAs above their real ages were divided into two groups [Group 3 (MA-CA; from +5 to + 10) and Group 4 (MA-CA; from +11 to + 12)]. Body mass index (BMI) values were calculated. TANITA body composition monitor using bioelectrical impedance analysis technology was used to obtain values for obesity degree, visceral adiposity, BMR and BMR-to-weight ratio. The compiled data were evaluated statistically using a statistical package program; SPSS. Mean ± SD values were determined. Correlation analyses were performed. The statistical significance degree was accepted as p < 0.05. The increase in BMR was positively correlated with obesity degree. MAs and CAs of the groups were 39.9 ± 16.8 vs 39.9 ± 16.7 years for Group 1, 45.0 ± 15.3 vs 51.4 ± 15.7 years for Group 2, 47.2 ± 12.7 vs 40.0 ± 12.7 years for Group 3, and 53.6 ± 14.8 vs 42 ± 14.8 years for Group 4. BMI values of the groups were 24.3 ± 3.6 kg/m2, 23.2 ± 1.7 kg/m2, 30.3 ± 3.8 kg/m2, and 40.1 ± 5.1 kg/m2 for Group 1, 2, 3 and 4, respectively. Values obtained for BMR were 1599 ± 328 kcal in Group 1, 1463 ± 198 kcal in Group 2, 1652 ± 350 kcal in Group 3, and 1890 ± 360 kcal in Group 4. A correlation was observed between BMR and MA-CA values in Group 1. No correlation was detected in other groups. On the other hand, statistically significant correlations between MA-CA values and obesity degree, BMI as well as BMR/weight were found in Group 3 and in Group 4. It was concluded that upon consideration of these findings in terms of MA-CA values, BMR-to-weight ratio was found to be much more useful indicator of the severe increase in obesity development than BMR. Also, the lack of associations between MA and BMR as well as BMR-to-weight ratio emphasize the importance of consideration of MA-CA values rather than MA.

Keywords: Basal metabolic rate, chronologic age, metabolic age, obesity degree.

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77 The Importance of Changing the Traditional Mode of Higher Education in Bangladesh: Creating Huge Job Opportunities for Home and Abroad

Authors: M. M. Shahidul Hassan, Omiya Hassan

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Bangladesh has set its goal to reach upper middle-income country status by 2024. To attain this status, the country must satisfy the World Bank requirement of achieving minimum Gross National Income (GNI). Number of youth job seekers in the country is increasing. University graduates are looking for decent jobs. So, the vital issue of this country is to understand how the GNI and jobs can be increased. The objective of this paper is to address these issues and find ways to create more job opportunities for youths at home and abroad which will increase the country’s GNI. The paper studies proportion of different goods Bangladesh exported, and also the percentage of employment in different sectors. The data used here for the purpose of analysis have been collected from the available literature. These data are then plotted and analyzed. Through these studies, it is concluded that growth in sectors like agricultural, ready-made garments (RMG), jute industries and fisheries are declining and the business community is not interested in setting up capital-intensive industries. Under this situation, the country needs to explore other business opportunities for a higher economic growth rate. Knowledge can substitute the physical resource. Since the country consists of the large youth population, higher education will play a key role in economic development. It now needs graduates with higher-order skills with innovative quality. Such dispositions demand changes in a university’s curriculum, teaching and assessment method which will function young generations as active learners and creators. By bringing these changes in higher education, a knowledge-based society can be created. The application of such knowledge and creativity will then become the commodity of Bangladesh which will help to reach its goal as an upper middle-income country.

Keywords: Bangladesh, economic sectors, economic growth, higher education, knowledge-based economy, massifcation of higher education, teaching and learning, universities’ role in society.

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76 A Posterior Predictive Model-Based Control Chart for Monitoring Healthcare

Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: Average run length, Bernoulli CUSUM chart, beta binomial posterior predictive distribution, clinical indicator, health care organization, highest posterior density interval.

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75 Curriculum Development of Successful Intelligence Promoting for Nursing Students

Authors: Saranya Chularee, Tawa Chularee

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Successful intelligence (SI) is the integrated set of the ability needed to attain success in life, within individual-s sociocultural context. People are successfully intelligent by recognizing their strengths and weaknesses. They will find ways to strengthen their weakness and maintain their strength or even improve it. SI people can shape, select, and adapt to the environments by using balance of higher-ordered thinking abilities including; critical, creative, and applicative. Aims: The purposes of this study were to; 1) develop curriculum that promotes SI for nursing students, and 2) study the effectiveness of the curriculum development. Method: Research and Development was a method used for this study. The design was divided into two phases; 1) the curriculum development which composed of three steps (needs assessment, curriculum development and curriculum field trail), and 2) the curriculum implementation. In this phase, a pre-experimental research design (one group pretest-posttest design) was conducted. The sample composed of 49 sophomore nursing students of Boromarajonani College of Nursing, Surin, Thailand who enrolled in Nursing care of Health problem course I in 2011 academic year. Data were carefully collected using 4 instruments; 1) Modified essay questions test (MEQ) 2) Nursing Care Plan evaluation form 3) Group processing observation form (α = 0.74) and 4) Satisfied evaluation form of learning (α = 0.82). Data were analyzed using descriptive statistics and content analysis. Results: The results revealed that the sample had post-test average score of SI higher than pre-test average score (mean difference was 5.03, S.D. = 2.84). Fifty seven percentages of the sample passed the MEQ posttest at the criteria of 60 percentages. Students demonstrated the strategies of how to develop nursing care plan. Overall, students- satisfaction on teaching performance was at high level (mean = 4.35, S.D. = 0.46). Conclusion: This curriculum can promote the attribute of characteristic of SI person and was highly required to be continued.

Keywords: Curriculum Development, Nursing Education, Successful Intelligence, Thinking ability.

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74 Performance Analysis of Three Absorption Heat Pump Cycles, Full and Partial Loads Operations

Authors: B. Dehghan, T. Toppi, M. Aprile, M. Motta

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The environmental concerns related to global warming and ozone layer depletion along with the growing worldwide demand for heating and cooling have brought an increasing attention toward ecological and efficient Heating, Ventilation, and Air Conditioning (HVAC) systems. Furthermore, since space heating accounts for a considerable part of the European primary/final energy use, it has been identified as one of the sectors with the most challenging targets in energy use reduction. Heat pumps are commonly considered as a technology able to contribute to the achievement of the targets. Current research focuses on the full load operation and seasonal performance assessment of three gas-driven absorption heat pump cycles. To do this, investigations of the gas-driven air-source ammonia-water absorption heat pump systems for small-scale space heating applications are presented. For each of the presented cycles, both full-load under various temperature conditions and seasonal performances are predicted by means of numerical simulations. It has been considered that small capacity appliances are usually equipped with fixed geometry restrictors, meaning that the solution mass flow rate is driven by the pressure difference across the associated restrictor valve. Results show that gas utilization efficiency (GUE) of the cycles varies between 1.2 and 1.7 for both full and partial loads and vapor exchange (VX) cycle is found to achieve the highest efficiency. It is noticed that, for typical space heating applications, heat pumps operate over a wide range of capacities and thermal lifts. Thus, partially, the novelty introduced in the paper is the investigation based on a seasonal performance approach, following the method prescribed in a recent European standard (EN 12309). The overall result is a modest variation in the seasonal performance for analyzed cycles, from 1.427 (single-effect) to 1.493 (vapor-exchange).

Keywords: Absorption cycles, gas utilization efficiency, heat pump, seasonal performance, vapor exchange cycle.

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73 Demonstration of Land Use Changes Simulation Using Urban Climate Model

Authors: Barbara Vojvodikova, Katerina Jupova, Iva Ticha

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Cities in their historical evolution have always adapted their internal structure to the needs of society (for example protective city walls during classicism era lost their defense function, became unnecessary, were demolished and gave space for new features such as roads, museums or parks). Today it is necessary to modify the internal structure of the city in order to minimize the impact of climate changes on the environment of the population. This article discusses the results of the Urban Climate model owned by VITO, which was carried out as part of a project from the European Union's Horizon grant agreement No 730004 Pan-European Urban Climate Services Climate-Fit city. The use of the model was aimed at changes in land use and land cover in cities related to urban heat islands (UHI). The task of the application was to evaluate possible land use change scenarios in connection with city requirements and ideas. Two pilot areas in the Czech Republic were selected. One is Ostrava and the other Hodonín. The paper provides a demonstration of the application of the model for various possible future development scenarios. It contains an assessment of the suitability or inappropriateness of scenarios of future development depending on the temperature increase. Cities that are preparing to reconstruct the public space are interested in eliminating proposals that would lead to an increase in temperature stress as early as in the assignment phase. If they have evaluation on the unsuitability of some type of design, they can limit it into the proposal phases. Therefore, especially in the application of models on Local level - in 1 m spatial resolution, it was necessary to show which type of proposals would create a significant temperature island in its implementation. Such a type of proposal is considered unsuitable. The model shows that the building itself can create a shady place and thus contribute to the reduction of the UHI. If it sensitively approaches the protection of existing greenery, this new construction may not pose a significant problem. More massive interventions leading to the reduction of existing greenery create a new heat island space.

Keywords: Heat islands, land use, urban climate model.

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72 Reliability Levels of Reinforced Concrete Bridges Obtained by Mixing Approaches

Authors: Adrián D. García-Soto, Alejandro Hernández-Martínez, Jesús G. Valdés-Vázquez, Reyna A. Vizguerra-Alvarez

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Reinforced concrete bridges designed by code are intended to achieve target reliability levels adequate for the geographical environment where the code is applicable. Several methods can be used to estimate such reliability levels. Many of them require the establishment of an explicit limit state function (LSF). When such LSF is not available as a close-form expression, the simulation techniques are often employed. The simulation methods are computing intensive and time consuming. Note that if the reliability of real bridges designed by code is of interest, numerical schemes, the finite element method (FEM) or computational mechanics could be required. In these cases, it can be quite difficult (or impossible) to establish a close-form of the LSF, and the simulation techniques may be necessary to compute reliability levels. To overcome the need for a large number of simulations when no explicit LSF is available, the point estimate method (PEM) could be considered as an alternative. It has the advantage that only the probabilistic moments of the random variables are required. However, in the PEM, fitting of the resulting moments of the LSF to a probability density function (PDF) is needed. In the present study, a very simple alternative which allows the assessment of the reliability levels when no explicit LSF is available and without the need of extensive simulations is employed. The alternative includes the use of the PEM, and its applicability is shown by assessing reliability levels of reinforced concrete bridges in Mexico when a numerical scheme is required. Comparisons with results by using the Monte Carlo simulation (MCS) technique are included. To overcome the problem of approximating the probabilistic moments from the PEM to a PDF, a well-known distribution is employed. The approach mixes the PEM and other classic reliability method (first order reliability method, FORM). The results in the present study are in good agreement whit those computed with the MCS. Therefore, the alternative of mixing the reliability methods is a very valuable option to determine reliability levels when no close form of the LSF is available, or if numerical schemes, the FEM or computational mechanics are employed.

Keywords: Structural reliability, reinforced concrete bridges, mixing approaches, point estimate method, Monte Carlo simulation.

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71 An Introduction to the Concept of Environmental Audit: Indian Context

Authors: Pradip Kumar Das

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Phenomenal growth of population and industry exploits the environment in varied ways. Consequently, the greenhouse effect and other allied problems are threatening mankind the world over. Protection and up gradation of environment have, therefore, become the prime necessity all of mankind for the sustainable development of environment. People in humbler walks of life including the corporate citizens have become aware of the impacts of environmental pollution. Governments of various nations have entered the picture with laws and regulations to correct and cure the effects of present and past violations of environmental practices and to obstruct future violations of good environmental disciplines. In this perspective, environmental audit directs verification and validation to ensure that the various environmental laws are complied with and adequate care has been taken towards environmental protection and preservation. The discipline of environmental audit has experienced expressive development throughout the world. It examines the positive and negative effects of the activities of an enterprise on environment and provides an in-depth study of the company processes any growth in realizing long-term strategic goals. Environmental audit helps corporations assess its achievement, correct deficiencies and reduce risk to the health and improving safety. Environmental audit being a strong management tool should be administered by industry for its own self-assessment. Developed countries all over the globe have gone ahead in environment quantification; but unfortunately, there is a lack of awareness about pollution and environmental hazards among the common people in India. In the light of this situation, the conceptual analysis of this study is concerned with the rationale of environmental audit on the industry and the society as a whole and highlights the emerging dimensions in the auditing theory and practices. A modest attempt has been made to throw light on the recent development in environmental audit in developing nations like India and the problems associated with the implementation of environmental audit. The conceptual study also reflects that despite different obstacles, environmental audit is becoming an increasing aspect within the corporate sectors in India and lastly, conclusions along with suggestions have been offered to improve the current scenario.

Keywords: Environmental audit, environmental hazards, environmental laws, environmental protection, environmental preservation.

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70 Comparison of Multivariate Adaptive Regression Splines and Random Forest Regression in Predicting Forced Expiratory Volume in One Second

Authors: P. V. Pramila, V. Mahesh

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Pulmonary Function Tests are important non-invasive diagnostic tests to assess respiratory impairments and provides quantifiable measures of lung function. Spirometry is the most frequently used measure of lung function and plays an essential role in the diagnosis and management of pulmonary diseases. However, the test requires considerable patient effort and cooperation, markedly related to the age of patients resulting in incomplete data sets. This paper presents, a nonlinear model built using Multivariate adaptive regression splines and Random forest regression model to predict the missing spirometric features. Random forest based feature selection is used to enhance both the generalization capability and the model interpretability. In the present study, flow-volume data are recorded for N= 198 subjects. The ranked order of feature importance index calculated by the random forests model shows that the spirometric features FVC, FEF25, PEF, FEF25-75, FEF50 and the demographic parameter height are the important descriptors. A comparison of performance assessment of both models prove that, the prediction ability of MARS with the `top two ranked features namely the FVC and FEF25 is higher, yielding a model fit of R2= 0.96 and R2= 0.99 for normal and abnormal subjects. The Root Mean Square Error analysis of the RF model and the MARS model also shows that the latter is capable of predicting the missing values of FEV1 with a notably lower error value of 0.0191 (normal subjects) and 0.0106 (abnormal subjects) with the aforementioned input features. It is concluded that combining feature selection with a prediction model provides a minimum subset of predominant features to train the model, as well as yielding better prediction performance. This analysis can assist clinicians with a intelligence support system in the medical diagnosis and improvement of clinical care.

Keywords: FEV1, Multivariate Adaptive Regression Splines Pulmonary Function Test, Random Forest.

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69 Long-Term Follow-up of Dynamic Balance, Pain and Functional Performance in Cruciate Retaining and Posterior Stabilized Total Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi, Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks preand post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months postoperatively in groups I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months postoperatively in groups I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Long-Term.

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68 Malpractice, Even in Conditions of Compliance with the Rules of Dental Ethics

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

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: Dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments.

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67 Stakeholder Analysis: Who are the Key Actorsin Establishing and Developing Thai Independent Consumer Organizations?

Authors: P. Ondee, S. Pannarunothai

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In Thailand, both the 1997 and the current 2007 Thai Constitutions have mentioned the establishment of independent organizations as a new mechanism to play a key role in proposing policy recommendations to national decision-makers in the interest of collective consumers. Over the last ten years, no independent organizations have yet been set up. Evidently, nobody could point out who should be key players in establishing provincial independent consumer bodies. The purpose of this study was to find definitive stakeholders in establishing and developing independent consumer bodies in a Thai context. This was a cross-sectional study between August and September 2007, using a postal questionnaire with telephone follow-up. The questionnaire was designed and used to obtain multiple stakeholder assessment of three key attributes (power, interest and influence). Study population was 153 stakeholders associated with policy decision-making, formulation and implementation processes of civil-based consumer protection in pilot provinces. The population covered key representatives from five sectors (academics, government officers, business traders, mass media and consumer networks) who participated in the deliberative forums at 10 provinces. A 49.7% response rate was achieved. Data were analyzed, comparing means of three stakeholder attributes and classification of stakeholder typology. The results showed that the provincial health officers were the definitive stakeholders as they had legal power, influence and interest in establishing and sustaining the independent consumer bodies. However, only a few key representatives of the provincial health officers expressed their own paradigm on the civil-based consumer protection. Most provincial health officers put their own standpoint of building civic participation at only a plan-implementation level. For effective policy implementation by the independent consumer bodies, the Thai government should provide budgetary support for the operation of the provincial health officers with their paradigm shift as well as their own clarified standpoint on corporate governance.

Keywords: Civic participation, civil society, consumerprotection, independent organization, policy decision-making, stakeholder analysis.

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66 Preparation and in vivo Assessment of Nystatin-Loaded Solid Lipid Nanoparticles for Topical Delivery against Cutaneous Candidiasis

Authors: Rawia M. Khalil, Ahmed A. Abd El Rahman, Mahfouz A. Kassem, Mohamed S. El Ridi, Mona M. Abou Samra, Ghada E. A. Awad, Soheir S. Mansy

Abstract:

Solid lipid nanoparticles (SLNs) have gained great attention for the topical treatment of skin associated fungal infection as they facilitate the skin penetration of loaded drugs. Our work deals with the preparation of nystatin loaded solid lipid nanoparticles (NystSLNs) using the hot homogenization and ultrasonication method. The prepared NystSLNs were characterized in terms of entrapment efficiency, particle size, zeta potential, transmission electron microscopy, differential scanning calorimetry, rheological behavior and in vitro drug release. A stability study for 6 months was performed. A microbiological study was conducted in male rats infected with Candida albicans, by counting the colonies and examining the histopathological changes induced on the skin of infected rats. The results showed that SLNs dispersions are spherical in shape with particle size ranging from 83.26±11.33 to 955.04±1.09 nm. The entrapment efficiencies are ranging from 19.73±1.21 to 72.46±0.66% with zeta potential ranging from -18.9 to -38.8 mV and shear-thinning rheological Behavior. The stability studies done for 6 months showed that nystatin (Nyst) is a good candidate for topical SLN formulations. A least number of colony forming unit/ ml (cfu/ml) was recorded for the selected NystSLN compared to the drug solution and the commercial Nystatin® cream present in the market. It can be fulfilled from this work that SLNs provide a good skin targeting effect and may represent promising carrier for topical delivery of Nyst offering the sustained release and maintaining the localized effect, resulting in an effective treatment of cutaneous fungal infection.

Keywords: Candida infections, Hot homogenization, Nystatin, Solid lipid nanoparticles, Stability, Topical delivery.

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65 Designing for Sustainable Public Housing from Property Management and Financial Feasibility Perspectives

Authors: Kung-Jen Tu

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Many public housing properties developed by local governments in Taiwan in the 1980s have deteriorated severely as these rental apartment buildings aged. The lack of building maintainability considerations during project design phase as well as insufficient maintenance funds have made it difficult and costly for local governments to maintain and keep public housing properties in good shape. In order to assist the local governments in achieving and delivering sustainable public housing, this paper intends to present a developed design evaluation method to be used to evaluate the presented design schemes from property management and financial feasibility perspectives during project design phase of public housing projects. The design evaluation results, i.e. the property management and financial implications of presented design schemes that could occur later during the building operation and maintenance phase, will be reported to the client (the government) and design schemes revised consequently. It is proposed that the design evaluation be performed from two main perspectives: (1) Operation and property management perspective: Three criteria such as spatial appropriateness, people and vehicle circulation and control, property management working spaces are used to evaluate the ‘operation and PM effectiveness’ of a design scheme. (2) Financial feasibility perspective: Four types of financial analyses are performed to assess the long term financial feasibility of a presented design scheme, such as operational and rental income analysis, management fund analysis, regular operational and property management service expense analysis, capital expense analysis. The ongoing Chung-Li Public Housing Project developed by the Taoyuan City Government will be used as a case to demonstrate how the presented design evaluation method is implemented. The results of property management assessment as well as the annual operational and capital expenses of a proposed design scheme are presented.

Keywords: Design evaluation method, management fund, operational and capital expenses, rental apartment buildings.

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