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Sample records for critical etiological factor

  1. A critical review of food-associated factors proposed in the etiology of feline hyperthyroidism.

    Science.gov (United States)

    van Hoek, Ingrid; Hesta, Myriam; Biourge, Vincent

    2015-10-01

    Since the first description of feline hyperthyroidism (HT) in 1979, several studies have been undertaken to define the etiology of the disease. Epidemiologic studies, after investigating non-food- and food-associated factors, suggest a multifactorial etiology. However, in the absence of prospective cohort studies that can confirm a cause-and-effect relationship between HT and associated risk factors, no causative factor for HT has been identified to date. Feline HT resembles toxic nodular goiter in humans, with autonomously functioning upregulated iodide uptake systems. Contribution of the diet to HT development remains controversial. The purpose of this paper is to review critically the reported food-associated risk factors for HT. © ISFM and AAFP 2014.

  2. Etiological factors of psoas abscesses

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    Mehmet Nuri Bodakçi

    2014-03-01

    Full Text Available Objective: Psoas abscess (PA is a rare infection disease, which is difficult to diagnose. In the present study, we aimed to evaluate etiological factors and treatment results of patients with PA. Methods: Files of 20 patients who were diagnosed as PA between December 2006 and January 2013, were retrospectively analyzed. Patient’s whose data were entirely reached and diagnosed by Ultrasonography and/or Computed Tomography as an exact PA were included to the study. Results: The mean age of the 20 patients was 48.8 (range 17-82 year, and 6 of them were female and remaining were male. Psoas abscess were on the right side in 12 patients (60%, on the left side in seven patients (35%, and bilateral in one (5%. According to data records four patients had Diabetes Mellitus (20%, two had Hypertension (10%, one had cerebrovascular disease (5%, one had tuberculosis (5%, one had hyperthyroidism (5%, one had mental retardation (5%, and one had paraplegia (5%. Six case (30% were diagnosed as a primary psoas abscess (pPA, sPA and remaining (n=14, %70 were diagnosed as secondary. Percutaneous drainage was performed to 13 patients (65% and exploration was performed to three patients (15% as a treatment modality. Remaining four patients (20% were followed by medical treatment. Conclusion: Psoas abscess is rare and have variable and non-specific clinical characteristic, which may lead to difficulty in diagnosis. In developed and developing countries, it has been reported that the most common causes of sPA are Pott's disease, and Crohn's disease, also it should be taken into account that open surgery and urinary tract stone disease can receive a significant portion of the etiological factors. J Clin Exp Invest 2014; 5 (1: 59-63

  3. ETIOLOGICAL FACTORS FOR VOCAL FOLD POLYP FORMATION

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    DAŠA GLUVAJIĆ

    2016-05-01

    Full Text Available Background: Vocal fold polyp is one of the most common causes for hoarseness. Many different etiological factors contribute to vocal fold polyp formation. The aim of the study was to find out whether the etiological factors for polyp formation have changed in the last 30 years.Methods: Eighty-one patients with unilateral vocal fold polyp were included in the study. A control group was composed of 50 volunteers without voice problems who matched the patients by age and gender. The data about etiological factors and the findings of phoniatric examination were obtained from the patients' medical documentation and from the questionnaires for the control group. The incidence of etiological factors was compared between the two groups. The program SPSS, Version 18 was used for statistical analysis.Results: The most frequent etiological factors were occupational voice load, GER, allergy and smoking. In 79% of patients 2 – 6 contemporary acting risk factors were found. Occupational voice load (p=0,018 and GER (p=0,004 were significantly more frequent in the patients than in the controls. The other factors did not significantly influence the polyp formation.Conclusions: There are several factors involved simultaneously in the formation of vocal fold polyps both nowadays and 30 years ago. Some of the most common factors remain the same (voice load, smoking, others are new (GER, allergy, which is probably due to the different lifestyle and working conditions than 30 years ago. Occupational voice load and GER were significantly more frequently present in the patients with polyp than in the control group. Regarding the given results it is important to instruct workers with professional vocal load about etiological factors for vocal fold polyp formation.

  4. ETIOLOGICAL FACTORS OF CHRONIC GASTRITIS IN CHILDREN

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    G.V. Volynets

    2006-01-01

    Full Text Available In the article the data on the study of the etiological factors of various types of chronic gastritis in children are presented. Based on revealing of the auto antibodies to parietal gastric cells in 40,0% of children autoimmune gastritis (a type gastritis is diagnosed. Helicobacterr pylori infection is revealed in 44,8% of children. In 27,6% of children type c gastritis is diagnosed. Autoimmune gastritis in children has been linked to the active phase of chronic epsteinbbarr virus infection. the etiological factors of nonautoimmune gastritis are Helicobacter pylori infection (type b gastritis and multiple duodenogastric refluxes (type c gastritis.Key words: children, chronic gastritis, etiological factors, autoimmune gastritis, nonautoimmune gastritis, active phase of chronic Epstein-Barr virus infection, Helicobacter pylori infection.

  5. Testicular cancer - epidemiology, etiology and risk factors

    International Nuclear Information System (INIS)

    Ondrusova, M.; Ondrus, D.

    2012-01-01

    Testicular cancer is a rare malignancy, that affects 1-2 % of male population. Trends of testicular cancer mortality are stable for a long period of time, even that incidence shows a rapid growth. This paper deals with national trends in testicular cancer incidence and mortality in Slovakia from 1968 to 2007 by using the join-point regression analysis to propose potential changes in health care. The authors noted a statistically significant increase in the values of incidence and improvement in mortality after 1975. Paper also deals with the etiology and risk factors of this malignancy. (author)

  6. A etiological factors in mechanical intestinal obstruction

    International Nuclear Information System (INIS)

    Asad, S.; Khan, H.; Khan, I.A.; Ghaffar, S.; Rehman, Z.U.

    2012-01-01

    Background: Intestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The most frequent causes of intestinal obstruction are postoperative adhesions and hernias, which cause extrinsic compression of the intestine. Less frequently, tumours or strictures of the bowel can cause intrinsic blockage. Objective of the study was to find out the various a etiological factors of mechanical intestinal obstruction and to evaluate the morbidity and mortality in adult patients presenting to Surgical 'A' unit of Ayub teaching hospital with mechanical intestinal obstruction. Methods: This cross-sectional study was conducted from March 2009 to September, 2009. All patients presenting with intestinal obstruction and were above the age of 12 years were included in the study. Patients with non-mechanical obstruction were excluded from the study and those who responded to conservative measures were also excluded. Results: A total of 36 patients with age ranging from 12 to 80 years (Mean age 37.72+-19.74 years) and male to female ratio of 1.77:1, were treated for mechanical intestinal obstruction. The most common cause for mechanical intestinal obstruction was adhesions (36.1%). Intestinal tuberculosis was the second most common cause (19.4%), while hernias and sigmoid volvulus affected 13.9% patients each. Malignancies were found in 5.6% cases. Conclusion: Adhesions and Tuberculosis are the leading causes of mechanical intestinal obstruction in Pakistan. Although some patients can be treated conservatively, a substantial portion requires immediate surgical intervention. (author)

  7. Spoken language outcomes after hemispherectomy: factoring in etiology.

    Science.gov (United States)

    Curtiss, S; de Bode, S; Mathern, G W

    2001-12-01

    We analyzed postsurgery linguistic outcomes of 43 hemispherectomy patients operated on at UCLA. We rated spoken language (Spoken Language Rank, SLR) on a scale from 0 (no language) to 6 (mature grammar) and examined the effects of side of resection/damage, age at surgery/seizure onset, seizure control postsurgery, and etiology on language development. Etiology was defined as developmental (cortical dysplasia and prenatal stroke) and acquired pathology (Rasmussen's encephalitis and postnatal stroke). We found that clinical variables were predictive of language outcomes only when they were considered within distinct etiology groups. Specifically, children with developmental etiologies had lower SLRs than those with acquired pathologies (p =.0006); age factors correlated positively with higher SLRs only for children with acquired etiologies (p =.0006); right-sided resections led to higher SLRs only for the acquired group (p =.0008); and postsurgery seizure control correlated positively with SLR only for those with developmental etiologies (p =.0047). We argue that the variables considered are not independent predictors of spoken language outcome posthemispherectomy but should be viewed instead as characteristics of etiology. Copyright 2001 Elsevier Science.

  8. Role of psychosocial factors in the etiology of bruxism

    NARCIS (Netherlands)

    Manfredini, D.; Lobbezoo, F.

    2009-01-01

    AIMS: To summarize literature data about the role of psychosocial factors in the etiology of bruxism. METHODS: A systematic search in the National Library of Medicine's PubMed Database was performed to identify all peer-reviewed papers in the English literature dealing with the bruxism-psychosocial

  9. Evaluation of etiologic and prognostic factors in neonatal convulsions.

    Science.gov (United States)

    Yıldız, Edibe Pembegul; Tatlı, Burak; Ekici, Barış; Eraslan, Emine; Aydınlı, Nur; Calışkan, Mine; Ozmen, Meral

    2012-09-01

    This study evaluated etiologic and risk factors affecting long-term prognoses of neurologic outcomes in newborns with neonatal seizures. We enrolled patients at chronologic ages of 23-44 months, referred to the Department of Pediatric Neurology, Istanbul Medical Faculty, from January 1, 2007-December 31, 2009, after manifesting seizures in their first postnatal 28 days. Of 112 newborns, 41 were female, 71 were male, 33 were preterm, and 79 were full-term. Perinatal asphyxia (28.6%) and intracranial hemorrhage (17%) were the most common causes of neonatal seizures. Cerebral palsy developed in 27.6% of patients during follow-up. The incidence of epilepsy was 35.7%. Almost 50% of patients manifested developmental delay in one or more areas. Global developmental delay was the most common (50.8%) neurologic disorder. The correlation between gestational age or birth weight and adverse outcomes was nonsignificant. Etiology, Apgar score, need for resuscitation at birth, background electroencephalogram, neonatal status epilepticus, cranial imaging findings, type/duration of antiepileptic treatment, and response to acute treatment were all strong prognostic factors in neurologic outcomes. Neonatal seizures pose a threat of neurologic sequelae for preterm and full-term infants. Although the number of recognized etiologic factors in neonatal seizures has increased because of improvements in neonatology and diagnostic methods, perinatal asphyxia remains the most common factor. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Factors involved in the etiology of temporomandibular disorders - a literature review.

    Science.gov (United States)

    Chisnoiu, Andrea Maria; Picos, Alina Monica; Popa, Sever; Chisnoiu, Petre Daniel; Lascu, Liana; Picos, Andrei; Chisnoiu, Radu

    2015-01-01

    This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered. The etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms.

  11. Prevalence, etiological factors and the treatment of infant exogenous obesity

    OpenAIRE

    Edio Luiz Petroski; Ludmila Dalben Soares

    2003-01-01

    In the last few years, there has been considerable interest in the effects of excessive weight gain during childhood, due to the fact that the development of fat tissue in this period is a determinant of adult body composition. The objective of this study was to investigate the prevalence of infant obesity, to identify possible etiological factors, and to highlight treatments that have been used to reduce and/or prevent child obesity. Results have shown that obesity has increased more than an...

  12. YEASTS AS A POSSIBLE ETIOLOGICAL FACTOR OF AUTISM

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    Mila SELAKOVIKJ

    2000-12-01

    Full Text Available Yeasts have to be considered as an etiological factor of autism. Urine testing by professor W. Shaw’s method is being done in all major laboratories in the USA. Tests for proving the existence of unidentified diseases with a fault in metabolism, lack of vitamins and the existence of abnormal metabolites cateholamine, dopamine, and serotonine can be done. The existence of 62 substances can be tested for time being, and according to that, adequate treatment can be undertaken.

  13. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

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    Kazim Duman

    2016-12-01

    Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232

  14. Role of psychosocial factors in the etiology of bruxism.

    Science.gov (United States)

    Manfredini, Daniele; Lobbezoo, Frank

    2009-01-01

    To summarize literature data about the role of psychosocial factors in the etiology of bruxism. A systematic search in the National Library of Medicine's PubMed Database was performed to identify all peer-reviewed papers in the English literature dealing with the bruxism-psychosocial factors relationship. All studies assessing the psychosocial traits of bruxers (by using questionnaires, interviews, and instrumental and laboratory exams) and reviews discussing the contribution of those factors to the etiology of bruxism were included in this review. A total of 45 relevant papers (including eight reviews) were retrieved with a search strategy combining the term "bruxism" with the words stress, anxiety, depression, psychosocial and psychological factors. The majority of data about the association between psychosocial disorders and bruxism came from studies adopting a clinical and/or self-report diagnosis of bruxism. These studies showed some association of bruxism with anxiety, stress sensitivity, depression and other personological characteristics, apparently in contrast with sleep laboratory investigations. A plausible hypothesis is that clinical studies are more suitable to detect awake bruxism (clenching type), while polysomnographic studies focused only on sleep bruxism (grinding type). Wake clenching seems to be associated with psychosocial factors and a number of psychopathological symptoms, while there is no evidence to relate sleep bruxism with psychosocial disorders. Future research should be directed toward the achievement of a better distinction between the two forms of bruxism in order to facilitate the design of experimental studies on this topic.

  15. Epiglottic cyst as an etiological factor of globus sensation.

    Science.gov (United States)

    Polat, Bahtiyar; Karahatay, Serdar; Gerek, Mustafa

    2015-09-01

    Globus is a subjective complaint that describes a sensation of a lump or a foreign body in the throat. Despite being a well-known and common clinical condition, the etiological factors have not been definitely elucidated yet. The study was set up to ascertain the relationship between epiglottic cysts and globus sensation. All patients undergoing investigation and treatments for globus sensation were included in the study. Patients with epiglottic cysts but no other possible causes of globus sensation were constituted the series of patients. Patients were asked to assess the levels of complaint before and after the carbon dioxide (CO2) laser excisions of the cysts. Epiglottic cysts were found in 10 (5.4%) of the 182 patients. Three of these 10 patients who had concomitant diseases or conditions that may cause globus sensation and one patient who refused the surgery were excluded from the study. All the remaining six patients reported relief of the globus sensation after the CO2 laser excisions of the cysts. Our results, obtained from this limited series, indicated that epiglottic cysts may be considered as one of the etiological factors of globus sensation.

  16. Most important etiologic factors in the development of genital prolapse

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    Mladenović-Segedi Ljiljana

    2010-01-01

    Full Text Available Introduction The incidence of genital prolapse depends on numerous factors. The contribution of race, gender and genetic factors is significant. However, additional factors of initiation, promotion and decomposition are necessary if a person with the genetic predisposition to genital prolapse begins to suffer from it. At least 50% of parous women are believed to suffer from genital prolapse of various degrees. Moreover, the prevalence of genital prolapse increases with age. The prevalence of genital prolapse is expected to be even higher in the future due to the extension of the lifespan of women worldwide. Objective The aim of this study was to determine the most common etiologic factors in the development of genital prolapse in the population of Serbia. Methods The study was conducted as prospective and included 50 women who underwent surgical treatment due to the problems caused by genital prolapse. Results Mean age of the women was 58.74 years. Twenty percent of the women had the menstrual cycle, while 80% were in menopause. Mean menopause period was 8.88 years. None of the women used hormone replacement therapy. Mean BMI was 27.395 kg/m2. Twenty-eight percent of the women were of normal weight, while 72% of the women were obese (42% were obese and 30% were severely obese. Ninety-eight percent of the women were parous, and mean parity was 2.08. Mean birth weight of neonates was 3682.77 g. Sixty-four percent of the women did physical labour and lifted heavy objects. Conclusion Vaginal childbirth is one of the most important initiating factors. The most significant promoting factor is obesity and heavy labour. Ageing and entering menopause are the most important factors of decomposition as well as the occurrence of clinical manifestations of the pelvic floor dysfunction. .

  17. Frequency of etiological factors leading to patent ductus arteriosus

    International Nuclear Information System (INIS)

    Waheed, I.; Shahbaz, A.

    2013-01-01

    Background: Patent Ductus Arteriosus (PDA) is developing as major problem in our society. Many studies in Pakistan has been done to analyze the efficacy of surgical procedures but no one tried to find the frequency of factors leading to this problem. Objective: The purpose of this study was to find out the frequency of factors leading to patent ductus arteriosus in children presented at Punjab Institute of Cardiology. Method: A cross sectional study was conducted on 242 patients of PDA who already have been treated during the year 2006 - 2007. They were interviewed on their regular follow up visits. Their operative information was gathered from their files. Results: Mean age of children at time of treatment was 6.12 + 5.203 years. Out of 242 children, there were more female (62.8%) as compared to male (37.2%). In this study, 17.8% children inherited the disease from their close relatives and 105 (43.4%) mothers had some infectious problems during pregnancy. 103 (42.6%) mothers used antibiotics or other drugs during pregnancy. 11 (4.5%) children had Down syndrome. One hundred and thirty seven (56.61%) children had premature birth. Conclusion: Female gender, preterm birth, infection during pregnancy, mother's exposure to drugs and smoking, low birth weight may be etiological factors for development of PDA. (author)

  18. A systematic review of etiological and risk factors associated with bruxism.

    Science.gov (United States)

    Feu, Daniela; Catharino, Fernanda; Quintão, Catia Cardoso Abdo; Almeida, Marco Antonio de Oliveira

    2013-06-01

    The aim of the present work was to systematically review the literature and identify all peer-reviewed papers dealing with etiological and risk factors associated with bruxism. Data extraction was carried out according to the standard Cochrane systematic review methodology. The following databases were searched for randomized clinical trials (RCT), controlled clinical trials (CCT) or cohort studies: Cochrane Library, Medline, and Embase from 1980 to 2011. Unpublished literature was searched electronically using ClinicalTrials.gov. The primary outcome was bruxism etiology. Studies should have a standardized method to assess bruxism. Screening of eligible studies, assessment of the methodological quality and data extraction were conducted independently and in duplicate. Two reviewers inspected the references using the same search strategy and then applied the same inclusion criteria to the selected studies. They used criteria for methodological quality that was previously described in the Cochrane Handbook. Among the 1247 related articles that were critically assessed, one randomized clinical trial, one controlled clinical trial and seven longitudinal studies were included in the critical appraisal. Of these studies, five were selected, but reported different outcomes. There is convincing evidence that (sleep-related) bruxism can be induced by esophageal acidification and also that it has an important relationship with smoking in a dose-dependent manner. Disturbances in the central dopaminergic system are also implicated in the etiology of bruxism.

  19. [Analysis of etiological factors involved in noncarious cervical lesions].

    Science.gov (United States)

    Tomasik, Małgorzata

    2006-01-01

    The etiopathology of noncarious cervical lesions (NCCL) is multifactorial and still not fully understood. Tooth wear is defined as loss of dental hard tissue by a chemical or mechanical process that does not involve bacteria. This form of tooth surface loss includes attrition, abrasion, erosion, and abfraction. Noncarious cervical lesions represent loss of tooth structure at the cementoenamel junction. The purpose of this clinical study of NCCL was to analyze the etiology in relation to age and to identify the most important risk factors associated with cervical lesions, as well as patients and teeth more susceptible to NCCL with a focus on more effective treatment of this condition. The study group comprised 124 patients with NCCL, aged 15-75 years (mean = 44). A questionnaire was distributed addressing medical history--gastric disorders, dietary habits--consumption of acidic drinks, dental history, oral hygiene practices, and parafunctional habits. Clinical examination of tooth wear was performed on four tooth surfaces after air-drying. The distribution and severity of tooth wear was graded using the tooth wear index (TWI) calculated with a computer programme allowing for tooth characteristic to be determined for each decade of life. Depth of the cervical defect was measured with a periodontal probe. TWI was devised to reveal the extent of tooth surface wear irrespective of the cause. Raw scores were compared with the computer using predetermined threshold values which are set to distinguish between acceptable and unacceptable pathological levels of tooth wear for each decade of life and each tooth surface. Dentition status, oral hygiene, periodontal status, gingival recession, number of teeth and their mobility, oral symptoms of parafunction and relationship to lateral and protrusive tooth contact schemes was assessed and analyzed. Statistical analyses were performed with the Stata Statistical Software: release 5. The risk of NCCL formation was estimated with

  20. Prevalence, etiological factors and the treatment of infant exogenous obesity

    Directory of Open Access Journals (Sweden)

    Edio Luiz Petroski

    2003-06-01

    Full Text Available In the last few years, there has been considerable interest in the effects of excessive weight gain during childhood, due to the fact that the development of fat tissue in this period is a determinant of adult body composition. The objective of this study was to investigate the prevalence of infant obesity, to identify possible etiological factors, and to highlight treatments that have been used to reduce and/or prevent child obesity. Results have shown that obesity has increased more than any other nutritional problem in both developed and developing countries over the last decade. Etiological factors linked to childhood obesity were early weaning, introduction of inadequate nutrition, and physical inactivity. The treatment of childhood obesity requires a multidisciplinary team consisting of a doctor, nutritionist, psychologist, and physical educator. There are also some general recommendations to be followed: a balanced diet for adequate growth and weight control, and controlled physical exercise together with individual and family emotional support. Parental cooperation is important for the best results. Schools also have a fundamental role in teaching children positive attitudes and behavior towards physical activity and nutrition. RESUMO Nos últimos anos, o interesse sobre os efeitos do ganho de peso excessivo na infância tem aumentado consideravelmente, devido ao fato que o desenvolvimento da celularidade adiposa neste período ser determinante nos padrões de composição corporal de um indivíduo adulto. Este trabalho teve como objetivo investigar a prevalência da obesidade infantil, identificar os possíveis fatores etiológicos além de verifi car quais as intervenções que se destacaram nesta última década como forma de diminuir e/ou prevenir a obesidade em crianças. Os resultados encontrados foram que a obesidade é uma das enfermidades nutricionais que mais têm apresentado aumento de sua prevalência, tanto nos pa

  1. Ketosis in dairy cows: etiologic factors, monitoring, treatment

    NARCIS (Netherlands)

    van der Drift, S.G.A.

    2013-01-01

    Ketosis is a metabolic disorder that mainly occurs during the negative energy balance in early-lactation dairy cows. It is characterized by elevated concentrations of ketone bodies in blood (hyperketonemia), urine, and milk. The thesis of Saskia van der Drift covers investigations on etiologic

  2. The etiology and outcome of non-traumatic coma in critical care: a systematic review.

    Science.gov (United States)

    Horsting, Marlene Wb B; Franken, Mira D; Meulenbelt, Jan; van Klei, Wilton A; de Lange, Dylan W

    2015-04-29

    Non-traumatic coma (NTC) is a serious condition requiring swift medical or surgical decision making upon arrival at the emergency department. Knowledge of the most frequent etiologies of NTC and associated mortality might improve the management of these patients. Here, we present the results of a systematic literature search on the etiologies and prognosis of NTC. Two reviewers independently performed a systematic literature search in the Pubmed, Embase and Cochrane databases with subsequent reference and citation checking. Inclusion criteria were retrospective or prospective observational studies on NTC, which reported on etiologies and prognostic information of patients admitted to the emergency department or intensive care unit. Eventually, 14 studies with enough data on NTC, were selected for this systematic literature review. The most common causes of NTC were stroke (6-54%), post-anoxic coma (3-42%), poisoning (coma (54-89%) and lowest for poisoning (0-39%) and epilepsy (0-10%). NTC represents a challenge to the emergency and the critical care physicians with an important mortality and moderate-severe disability rate. Even though, included studies were very heterogeneous, the most common causes of NTC are stroke, post anoxic, poisoning and various metabolic etiologies. The best outcome is achieved for patients with poisoning and epilepsy, while the worst outcome was seen in patients with stroke and post-anoxic coma. Adequate knowledge of the most common causes of NTC and prioritizing the causes by mortality ensures a swift and adequate work-up in diagnosis of NTC and may improve outcome.

  3. Incidence of Etiologic Factors in Squamous Cell Carcinoma of Head and Neck in Ahvaz

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    Soheila Nikakhlagh

    2011-01-01

     Conclusion: According to this study, tobacco smoking was the most important etiologic factor and had a strong effect on risk of head and neck squamous cell carcinoma. Other factors are also important and need more research study.

  4. Assessment of the Etiologic Factors of Gingival Recession in a Group of Patients in Northwest Iran

    OpenAIRE

    Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

    2009-01-01

    Background and aims Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. Materials and methods In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experien...

  5. Critical factors for EIA implementation

    DEFF Research Database (Denmark)

    Zhang, Jasmine; Kørnøv, Lone; Christensen, Per

    2013-01-01

    After decades of development, the gap between expectations of Environment Impact Assessments (EIA) and their practical performance remains significant. Research has been done to identify the critical factors for an effective implementation of EIA. However, this research, to a large extent, has...... not been cumulated and analysed comprehensively according to the stages of the EIA process. This paper contributes to the critical review of the literature on EIA implementation and effectiveness by cumulating mainly empirical findings in an implementation theoretical perspective. It focuses on the links...... between different critical factors and how they relate to different stages in the EIA and thus influence the decision making process. After reviewing 33 refereed journal articles published between 1999 and 2011, we identified 203 notions of critical factors. Of these, 102 related to different stages...

  6. Chromosomal aberrations as etiological factors of intrauterine growth retardation

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    Petrović Bojana

    2008-01-01

    Full Text Available Background/Aim. Intrauterine growth retardation (IUGR is a pathological condition of pregnancy characterised by birth weight below the 10th centile. A number of fetal, placental and maternal causes can lead to IUGR; although, in most cases no specific causes can be identified. The aim of this study was to determine the part of chromosomal abnormalities in IUGR etiology. Methods. Fetal blood karyotype taken by cordocentesis from 168 fetuses with diagnosed IUGR was analyzed. Results. Chromosomal rearrangements both numerical and structural were detected in 14 cases (12.2%. Two cases were triploid. Patau syndrome, Edwards syndrome and Down syndrome were found in two cases each. There was one case of trisomy 7 (47, XY, +7 and one case of trisomy 16 (47, XX, +16; one translocation, 46, XY, t (2; 14(q23; q32 and a deletion 46, XYdel (12 (p12 as well as two cases of sex chromosomes abnormalities, 45, X (Turner syndrome and 47, XYY. Conclusion. These findings suggest that a consistent number of symmetrical IUGR cases (about 12% can be associated with chromosomal rearrangements. Chromosomal aberrations that cause IUGR are heterogeneous, aberration of autosomes, mostly autosomal trisomies, being the most common.

  7. Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

    Institute of Scientific and Technical Information of China (English)

    Theresa A Mikhailov; Sylvia E Furner

    2009-01-01

    Inflammatory bowel disease is a chronic, debilitating disorder of the gastrointestinal tract. The etiology of inflammatory bowel disease has not been elucidated, but is thought to be multifactorial with both environmental and genetic influences. A large body of research has been conducted to elucidate the etiology of inflammatory bowel disease. This article reviews this literature, emphasizing the studies of breastfeeding and the studies of genetic factors, particularly NOD2 polymorphisms.

  8. Newly Diagnosed Anemia in Admitted Diabetics, Frequency, Etiology and Associated Factors

    International Nuclear Information System (INIS)

    Shams, N.; Osmani, M. H.

    2015-01-01

    Objective:To determine the frequency of newly-diagnosed anemia in diabetics admitted to the Internal Medicine Department and its etiology and contributing factors. Study Design: A cross-sectional, analytical study. Place and Duration of Study: Department of Internal Medicine, Sir Syed Trust Hospital and College of Medical Sciences, Karachi, from July 2011 to December 2012. Methodology: Adult diabetic patients first diagnosed as having anemia upon hospital admission during the specified duration were included. Patients with active bleed, acute renal impairment, critical illness, pregnancy and previously diagnosed anemia were excluded. Etiology and risk factors of anemia were determined in each case on the basis of history, clinical findings and relevant laboratory investigations i.e. complete blood picture, red cell indices, iron profile, renal function tests, urine and stool examination. Association of anemia was determined using chi-square and t-tests with p-value < 0.05 taken as significant. Results: One hundred and thirty patients (34 males and 96 females) were included. Mean age was 51 ± 12.4 years, with mean BMI of 25.4 ± 5.2 kg/m2, mean duration of diabetes of 7.6 ± 5.5 years and mean glycated haemoglobin (HbA1c) 8.47 ± 1.58%, with 75% diabetics having unsatisfactory glycemic control. Mean haemoglobin was 11.6 ± 1.96 g/dl. Anemia was present in 63% diabetics (18 males and 64 females). It was normocytic in 59.8%, microcytic in 37.8% and macrocytic in 2.4%. Chronic Kidney Disease (CKD) was present in 44%, iron deficiency in 23%, mixed etiology in 6%, vitamin B-12 deficiency in 2% and thalassemia minor in 1% cases. Statistically significant association of anemia was found with poor glycemic control (p=0.002), dietary restriction for red meat (p < 0.001), history of blood loss (p < 0.001), gastrointestinal disorders (p < 0.001), CKD (p < 0.001) and retinopathy (p=0.011). Conclusion: Anemia in two out of every three diabetics in this study points to need for

  9. Etiology of Cesarean Uterine Scar Defect (Niche): Detailed Critical Analysis of Hypotheses and Prevention Strategies and Peritoneal Closure Debate.

    Science.gov (United States)

    Sholapurkar, Shashikant L

    2018-03-01

    There is an increasing incidence of cesarean scar (CS) defect/niche and its sequelae, probably not entirely explained by better diagnosis or rising cesarean rate. Discussion of possible etiological factors has received scant attention but would be important to formulate preventive strategies. Meaningful informative studies on long-term sequelae of cesarean section are very difficult and none are available for causation of CS defect. Hence, it is crucial to identify key areas in etiology of CS defect for focused research. This practical review proposes an "ischemia and mal-apposition hypothesis for CS niche", stating that the surgical technique of uterine incision closure is the most important determinant of CS defect formation. Other factors such as cervical location incision, adhesion formation and patient specific factors seem far less important in etiology. Rather than the headline theme of "single versus double-layer closure of uterus", the finer details of surgical technique which achieve good apposition without inducing tissue ischemia seem more important. Different techniques are discussed and it is proposed that continuous, non-locking absorbable sutures in two layers, without including much of decidua and without undue tight (constricting/devasculaizing) pulling of sutures are likely to result in good healing of uterine scar. Single-layer technique may be best reserved for thin myometrial edges especially during repeat cesareans. Adhesions between uterine isthmus and bladder/abdominal wall seem common associations but not causative for CS niche. It would be desirable to prove these surgical principles by good quality prospective randomized "quantitative" studies but the wait may be very long and this should not hinder the adoption of good surgical principles. Science is much cognitive and not just empirical. To consider a related example, the current recommendation of non-suturing of peritoneal layers during cesarean is mistakenly based on short

  10. 2011 Critical Success Factors Report

    Science.gov (United States)

    North Carolina Community College System (NJ1), 2011

    2011-01-01

    The Critical Success Factors Report is the North Carolina Community College System's major accountability document. This annual performance report serves to inform colleges and the public on the performance of North Carolina's 58 community colleges. In 1993, the State Board of Community Colleges began monitoring performance data on specific…

  11. 2012 Critical Success Factors Report

    Science.gov (United States)

    North Carolina Community College System (NJ1), 2012

    2012-01-01

    The Critical Success Factors Report is the North Carolina Community College System's major accountability document. This annual performance report is based on data compiled from the previous year and serves to inform colleges and the public on the performance of North Carolina's 58 community colleges. In 1993, the State Board of Community Colleges…

  12. [Etiological and exacerbation factors for COPD. Body weight loss].

    Science.gov (United States)

    Yokoyama, Akihito

    2016-05-01

    Hunger or malnutrition is not only a historical issue but also a current problem worldwide. Biological responses to hunger are evolutionary prepared in our body, including energy generation by degradation of body proteins. Extreme weight loss (malnutrition) can cause air space enlargement in human and rodents. However, the changes in rodents could be reversible, since refeeding could repair the pathology. On the other hand, weight loss is a common feature in patients with more severe COPD. Complex factors, such as increased energy consumption, decreased food uptake by low grade inflammation, socio-economic factors and so on, are involved in weight loss. Weight loss in patients with COPD also increases the risk of exacerbation, hospitalization, and death.

  13. Opium usage as an etiologic factor of oral cavity cancer.

    Science.gov (United States)

    Razmpa, Ebrahim; Saedi, Babak; Motiee-langroudi, Maziar; Garajei, Ata; Hoseinpor, Sareh; Motamedi, Mohammad Hosein Kalantar

    2014-09-01

    The aim of this study was to evaluate the role of opium in causing oral cancer. Eighty patients and 80 selected matched controls who were referred to the ear-nose-throat department of an academic hospital were included in this study between October 2008 and September 2010. In addition to demographic data, information regarding alcohol, tobacco, and opium use was documented in the subjects. Finally, the effect of each risk factor was assessed. There was no significant difference in patient demographics between the 2 groups. Smoking (P = 0.042) and poor oral hygiene (P = 0.016) significantly correlated with cancer. Finally, opium addiction showed a significant relationship with oral cavity cancer with an odds ratio of 4 (95% confidence interval, 1.2-13.6). Opium use is among the possible risk factors for oral cancer.

  14. Identification of Genetic Factors in the Etiology of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Argel Aguilar Valles

    2011-09-01

    Full Text Available ABSTRACT Schizophrenia is a mental disorder that affects approximately 1% of the worldwide population. It is characterized by psychotic episodes in which individuals have hallucinations or delusions. This disorder also involves a strong element of social dysfunction, lack of motivation and profound cognitive deficits. The causes of this disorder remain largely unknown, but evidence indicates that arises from changes in the development of the central nervous system. Among the identified risk factors for this disorder are several environmental events, including prenatal infections and malnutrition, and complications during childbirth. However, the most important factor seems to be genetics. Despite this, the identification of genes involved in the development of this disorder has emerged as one of the most difficult tasks facing modern genetics and genomics. The development of techniques for studying the human genome has allowed a more systematic approach to determine variations in the genome sequence and structure that area casually involved in schizophrenia. These studies suggest the participation hundreds of genes in schizophrenia development. In addition, it has been suggested that many of these genes are involved in various mental illnesses that today are diagnosed as separate entities, but whose biological substrate may be shared. Key words: schizophrenia, deletions, development, duplications, polymorphisms.

  15. Identification of genetic factors in the etiology of schizophrenia

    International Nuclear Information System (INIS)

    Aguilar Valles, Argel

    2011-01-01

    Schizophrenia is a mental disorder that affects approximately 1% of the worldwide population. It is characterized by psychotic episodes in which individuals have hallucinations or delusions. This disorder also involves a strong element of social dysfunction, lack of motivation and profound cognitive deficits. The causes of this disorder remain largely unknown, but evidence indicates that arises from changes in the development of the central nervous system. Among the identified risk factors for this disorder are several environmental events, including prenatal infections and malnutrition, and complications during childbirth. However, the most important factor seems to be genetics. Despite this, the identification of genes involved in the development of this disorder has emerged as one of the most difficult tasks facing modern genetics and genomics. The development of techniques for studying the human genome has allowed a more systematic approach to determine variations in the genome sequence and structure that area casually involved in schizophrenia. These studies suggest the participation of hundreds of genes in schizophrenia development. In addition, it has been suggested that many of these genes are involved in various mental illnesses that today are diagnosed as separate entities, but whose biological substrate may be shared.

  16. Preservatives as important etiologic factors of allergic contact dermatitis

    Directory of Open Access Journals (Sweden)

    Beata Kręcisz

    2015-07-01

    Full Text Available Background: Preservatives present in cosmetics and other industrial products can cause allergic contact dermatitis. The aim of the study was to assess the frequency of allergy to selected preservatives in consecutive patients examined due to contact dermatitis in the Nofer Institute of Occupational Medicine, Łódź, and to establish whether individuals sensitized to formaldehyde react simultaneously to formaldehyde releasers. Material and Methods: A group of 405 patients (308 females and 97 males was examined in 2011–2013. In all participants patch tests with a series of 13 preservatives (paraben mix, formaldehyde, Quaternium 15, chloromethylisothiazolinone/methylisothiazolinone mix, methyldibromoglutaronitrile, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, 2-bromo-2-nitropropane-1,3-diol, iodopropynyl butylcarbamate, benzalkonium chloride, sodium metabisulfite, produced by Chemotechnique Diagnostics, Sweden were performed. Results: Of the 405 patients 74 (including 52 females showed positive results of patch tests. Contact allergy to at least 1 preservative was noted in 47 (11.6% patients, including 34 (11% females and 13 (13.4% males. Methylisothiazolinone proved to be the most frequent sensitizer – 4.7% (5.2% females, 3.1% males while parabens, 2-bromo-2-nitropropane-1,3-diol and imidazolidinyl urea (0.2% were found to be the least frequent. Fourteen (3.4% participants, 10 women and 4 men, were allergic to formaldehyde and/or formaldehyde releasers. In 11 (78.6% of them monovalent hypersensitivity was observed. In 13 (3.2% of the examined group patients allergy to preservatives might have been of occupational origin. Conclusions: Preservatives, particularly isothiazolinones, are significant causal factors of allergic contact dermatitis, including occupational cases. Individuals sensitized to formaldehyde may react simultaneously to formaldehyde releasers, however, such reactions are relatively rare. Med Pr 2015;66(3:327–332

  17. A etiological factors of chronic liver disease in children

    International Nuclear Information System (INIS)

    Tahir, A.; Malik, F.R.; Akhtar, P.

    2011-01-01

    Background: Chronicity of liver disease is determined either by duration of liver disease or by evidence of either severe liver disease or physical stigmata of chronic liver disease. Chronic liver disease may be caused commonly by persistent viral infections, metabolic diseases, drugs, autoimmune hepatitis, or unknown factors. The objective of this study was to find out the aetiology of chronic liver disease (CLD) in children. Methodology: It was a descriptive, prospective study which used a structured proforma designed to collect data of cases of CLD from both indoor and outdoor Paediatrics units of Fauji Foundation Hospital, Rawalpindi, and Children Hospital, Pakistan Institute of Medical Sciences, Islamabad. All children under 12 years having either clinical or biochemical evidence of liver disease and/or elevated liver enzymes for more than 3 months were included in this study. Results: Sixty cases of CLD were enrolled from indoor and outdoor units from January 2010 to July 201. Thirty nine (65%) cases were male and 21 (35%) were female. Eleven children were less than 1 year, 18 were 1-5 years old and 31 were 5-12 years of age. Viral hepatitis was the most common cause found in 22 (36.7%) cases. Out of these 22 patients with viral aetiology 19 (31.66%) patients had Hepatitis C and 3 (5%) had Hepatitis B. Glycogen storage disease was seen in 8.3% cases, and biliary atresia and Wilson disease in 6.7% each. Other less commonly found cases were autoimmune hepatitis, TORCH infections, hepatoma and drug induced hepatitis (1.7% each). Cause couldn't be established in 35% cases which remained idiopathic. Conclusion: Viral hepatitis is the leading cause of chronic liver disease in children, with the highest incidence of chronic Hepatitis C followed by metabolic disorders (glycogen storage disease and Wilson disease) and biliary atresia. Chronic viral hepatitis was most prevalent between 11 months to 12 years of age. Wilson disease was common in 3-7 years age group, and

  18. Permanent maxillary canines - review of eruption pattern and local etiological factors leading to impaction.

    Science.gov (United States)

    Sajnani, Anand K

    2015-02-01

    The position of the permanent maxillary canine at the angle of the mouth is strategically significant in maintaining the harmony and symmetry of the occlusal relationship. However, the maxillary canine is the second most frequently impacted tooth, with prevalence reported to be between 1% and 2%. Moreover, treatment of this condition is often complex and involves substantial time and financial cost. Hence, it is only prudent to monitor the eruption and identify the etiological factors that lead to impaction of the maxillary canine. Numerous researchers have tried to identify specific and nonspecific etiological factors responsible for displacement of canines. The purpose of this review was to track the development processes of maxillary canines and determine the hindrances that affect the eruption at different ages. Awareness of the eruption process and etiology of noneruption will help to reduce the incidence of impacted canines by allowing for early recognition and interceptive treatment. © 2013 Wiley Publishing Asia Pty Ltd.

  19. Psychosocial factors in the etiology of breast cancer: review of a popular link

    NARCIS (Netherlands)

    Bleiker, E.M.A.; van der Ploeg, H.M.

    1999-01-01

    Breast cancer is the most frequently occurring type of cancer in women in the western world. The etiology of a large proportion of breast cancers is still unexplained, and the possibility that psychosocial factors could play a role is not ruled out. Already in pre-Christian times, it was assumed

  20. An update on studies on etiological factors, disease progression, and malignant transformation in oral submucous fibrosis

    Directory of Open Access Journals (Sweden)

    Samiha Bari

    2017-01-01

    Full Text Available Worldwide estimates of oral submucous fibrosis (OSMF show a confinement to Indians and Southeast Asians. In India, the prevalence of OSMF has increased over the past four decades from 0.03% to 6.42%. The condition is well recognized for its malignant potential rate of 7-30%. The condition has a multifactorial etiology and may remain either stationary or become severe, leaving an individual physically challenged both physically and psychologically. Hence, the study aims at reviewing studies done on various etiological factors leading to its onset. Their analysis may serve as an adjunct in defining the broad spectrum of the causation of this potentially malignant disorder.

  1. Associated risk factors for chronic kidney disease of unknown etiologies in 241 patients.

    Science.gov (United States)

    Xing, Xuexue; Lu, Jing; Wang, Zheng

    2015-04-01

    Apart from the well-known etiologies, there are still a high proportion of patients with chronic kidney disease of unknown etiology (CKDu), which has rarely been reported on. In this study, we explored the potential associated risk factors for CKDu and identified those that occur in childhood. 700 patients with CKD we were selected randomly from 4 hospitals in Chengdu and 241 were screened for CKDu. The following clinical information was analyzed: demographic data, life style, personal and family history, nephrotoxic drugs, exposure to poison, allergies, and recurrent respiratory infections in childhood. Among 700 CKD patients, 34.43% (241/700) were CKDu. Of the 241 patients, there were 67.63% (163/241) with at least 1 associated risk factor and 56.44% (92/163) with more than 1. Patients with a personal history of an associated risk factor represented the largest proportion (31.95%, 77/241), while 28.63% (69/241) of the CKDu patients had risk factors appearing in childhood. Logistic regression analysis supported the results. The study demonstrated that most so-called CKDu patients do have an identifiable etiology, and that several associated risk factors contribute to it. Of all the risk factors, age >60 years, nephrotoxic drugs, exposure to poison, and alcohol consumption were the independent significant factors for CKDu. Furthermore, many risk factors that caused kidney injury started in childhood.

  2. Psychosocial factors in the etiology of breast cancer: review of a popular link.

    Science.gov (United States)

    Bleiker, E M; van der Ploeg, H M

    1999-07-01

    Breast cancer is the most frequently occurring type of cancer in women in the western world. The etiology of a large proportion of breast cancers is still unexplained, and the possibility that psychosocial factors could play a role is not ruled out. Already in pre-Christian times, it was assumed that psychological factors might play a significant role in the development of breast cancer. However, studies have failed to produce conclusive results. There is still a lack of knowledge on the relationship between breast cancer development and psychosocial factors such as stressful life events, coping styles, depression, and the ability to express emotions. The results of this review show that there is not enough evidence that psychosocial factors like 'ways of coping' or 'non-expression of negative emotions', play a significant role in the etiology of breast cancer.

  3. Critical factors to bioenergy implementation

    International Nuclear Information System (INIS)

    Roos, A.; Hektor, B.; Rakos, C.

    1999-01-01

    Barriers to bioenergy technology implementation have received increased attention in recent years. This paper contributes to the identification and analysis of barriers and drivers behind bioenergy market growth, here labelled c ritical factors . It presents a framework for the analysis of both existing and projected bioenergy market potential, using economic concepts and models from transaction cost theory and industrial organization. The framework can be used for assessments of the potential for market growth of different bioenergy systems by decision makers in administration and industry. The following critical factors are identified: Integration with other economic activity, Scale effects on bioenergy markets, Competition in bioenergy markets, Competition with other business, National policy, Local policy and local opinion. The framework is demonstrated with five cases of real bioenergy markets: Pellet residential heating in USA, bioenergy power in USA, pellet residential heating in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. Different applications of the framework are discussed

  4. Inflammatory bowel diseases (IBD) - critical discussion of etiology, pathogenesis, diagnostics, and therapy

    International Nuclear Information System (INIS)

    Ochsenkuehn, T.; Sackmann, M.; Goeke, B.

    2003-01-01

    Aims Crohn's disease and ulcerative colitis are the most frequent inflammatory bowel diseases (IBD) with a prevalence of approximately one out of 500.Cytokine research opened new and potent treatment options and thus stimulated clinical and basic research.However, the IBD still remain a challenge for patients and physicians,demanding close cooperation between gastroenterologists,radiologists and surgeons.The basic understanding of IBD,which is necessary for efficient diagnostic and therapeutic concepts is reviewed. Based upon recent publications and our clinical experience we discuss aspects of etiology,pathogenesis,diagnostics,and therapy of Crohn's disease and ulcerative colitis. A genetically influenced, exaggerated and sustained immune response against the own gut flora seems to be one of the most important factors in the pathogenesis of IBD.Not less important are environmental influences.For instance, cigarette smoking had been judged to have some negative influence on the natural course of Crohn's disease.Now,however, recent studies show that smoking is even a significant independent risk factor in the pathogenesis of IBD. Since IBD and especially Crohn's disease can effect the whole body, detailed analysis of inflammatory organ involvement is necessary before therapy.For instance, the MRIenteroclysis technique adds a necessary diagnostic tool for the exploration of those parts of the small bowel that cannot been reached by routine endoscopy like the upper ileum and the lower jejunum. In terms of therapy, a change of paradigms can be observed: patients will no longer be treated only when symptoms arise, but will early be integrated into a therapeutic concept, which is determined by site and extent of the disease and adapted to the abilities and needs of the patient.Furthermore,immunosuppressive agents like azathioprine and 6-mercaptopurine will establish as central concept in the medical treatment of IBD.Discussion IBD-therapy should rather be adapted to the

  5. Assessment of the etiologic factors of gingival recession in a group of patients in northwest iran.

    Science.gov (United States)

    Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

    2009-01-01

    Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P teeth, existence of prosthesis, high frenal attachment, radiotherapy, systemic diseases and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05). Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

  6. Evaluation of risk factors for severe pneumonia in children: the Pneumonia Etiology Research for Child Health study

    NARCIS (Netherlands)

    Wonodi, Chizoba B.; Deloria-Knoll, Maria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Moïsi, Jennifer C.; Johnson, Hope L.; Murdoch, David R.; O'Brien, Katherine L.; Levine, Orin S.; Scott, J. Anthony G.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.; Baggett, Henry C.; Brooks, W. Abdullah; Chipeta, James; Ebruke, Bernard; Endtz, Hubert P.; Groome, Michelle; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen; Maloney, Susan A.; Moore, David; Otieno, Juliet; Seidenberg, Phil; Tapia, Milagritos; Thamthitiwat, Somsak; Thea, Donald M.; Zaman, Khaleque

    2012-01-01

    As a case-control study of etiology, the Pneumonia Etiology Research for Child Health (PERCH) project also provides an opportunity to assess the risk factors for severe pneumonia in hospitalized children at 7 sites. We identified relevant risk factors by literature review and iterative expert

  7. Risk factor and etiology analysis of ischemic stroke in young adult patients.

    Science.gov (United States)

    Renna, Rosaria; Pilato, Fabio; Profice, Paolo; Della Marca, Giacomo; Broccolini, Aldobrando; Morosetti, Roberta; Frisullo, Giovanni; Rossi, Elena; De Stefano, Valerio; Di Lazzaro, Vincenzo

    2014-03-01

    Approximately 10%-14% of ischemic strokes occur in young adults. To investigate risk factors and etiologies of strokes of young adults admitted to the "stroke unit" of Policlinico "Gemelli" of Rome from December 2005 to January 2013. In all, 150 consecutive patients younger than 50 years diagnosed with ischemic stroke were enrolled. Clinical evaluation consisted of a complete neurologic examination and the National Institutes of Health Stroke Scale. Diagnostic workup consisted of anamnesis, extensive laboratory, radiologic, and cardiologic examination. Stroke etiologies were classified according to the Trial of Org 10172 in Acute Stroke Treatment. Patients' mean age was 41 ± 8.0 years. The most common risk factors were dyslipidemia (52.7%), smoking (47.3%), hypertension (39.3%), and patent foramen ovale (PFO, 32.8%). Large-artery atherosclerosis was diagnosed as the cause of stroke in 17 patients (11.3%). Cardioembolism was presumed in 36 patients (24%), most of them presented a PFO at transesophageal echocardiography. Small-vessel occlusion was diagnosed in 12 patients (8%); all of them were hypertensive and most of them presented additional risk factors. Forty-one patients (27.3%) presented a stroke of other determined etiology and 44 (29.3%) presented a stroke of undetermined etiology. The 3-year survival was 96.8% and recurrent strokes occurred in only 3 cases. Traditional vascular risk factors are also very common in young adults with ischemic stroke, but such factors increase the susceptibility to stroke dependent to other causes as atherosclerosis and small-artery occlusion represent less than 20% of cases. Prognosis quoadvitam is good, being characterized by low mortality and recurrence rate. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. [Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements].

    Science.gov (United States)

    Lewańska, Magdalena; Walusiak-Skorupa, Jolanta

    2014-01-01

    Carpal tunnel syndrome (CTS) is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. We conducted the retrospective analysis of 300 patients (261 women, 39 men), mean age 52 years (standard deviation: +/-6.93) hospitalized with the suspicion of occupational CTS. The study revealed high percentage (68.7%) of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%), thyroid diseases (28.7%), hormone replacement therapy and/or oophorectomy (16.3%) and diabetes mellitus (12%). In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6%) patients only. The undeniable long-term (20(.2+/-9.3 years) occupational exposure to repetitive, forceful movements in the wrist was observed in this group. The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases.

  9. Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements

    Directory of Open Access Journals (Sweden)

    Magdalena Lewańska

    2014-04-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. Material and Methods: We conducted the retrospective analysis of 300 patients (261 women, 39 men, mean age 52 years (standard deviation: ±6.93 hospitalized with the suspicion of occupational CTS. Results: The study revealed high percentage (68.7% of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%, thyroid diseases (28.7%, hormone replacement therapy and/or oophorectomy (16.3% and diabetes mellitus (12%. In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6% patients only. The undeniable long-term (20.2±9.3 years occupational exposure to repetitive, forceful movements in the wrist was observed in this group. Conclusion: The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases. Med Pr 2014;65(2:261–270

  10. Characterization of Bacterial Etiologic Agents of Biofilm Formation in Medical Devices in Critical Care Setup

    Directory of Open Access Journals (Sweden)

    Sangita Revdiwala

    2012-01-01

    Full Text Available Background. Biofilms contaminate catheters, ventilators, and medical implants; they act as a source of disease for humans, animals, and plants. Aim. Critical care units of any healthcare institute follow various interventional strategies with use of medical devices for the management of critical cases. Bacteria contaminate medical devices and form biofilms. Material and Methods. The study was carried out on 100 positive bacteriological cultures of medical devices which were inserted in hospitalized patients. The bacterial isolates were processed as per microtitre plate. All the isolates were subjected to antibiotic susceptibility testing by VITEK 2 compact automated systems. Results. Out of the total 100 bacterial isolates tested, 88 of them were biofilm formers. A 16–20-hour incubation period was found to be optimum for biofilm development. 85% isolates were multidrug resistants and different mechanisms of bacterial drug resistance like ESBL, carbapenemase, and MRSA were found among isolates. Conclusion. Availability of nutrition in the form of glucose enhances the biofilm formation by bacteria. Time and availability of glucose are important factors for assessment of biofilm progress. It is an alarm for those who are associated with invasive procedures and indwelling medical devices especially in patients with low immunity.

  11. RISK FACTORS AND ETIOLOGY OF TRANSIENT ISCHEMIC ATTACKS IN PATIENTS WITH BRAIN INFARCTION

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2010-12-01

    Full Text Available   Abstract INTRODUCTION: Transient ischemic attacks (TIA are warnings of future stroke. There is no difference in risk factors, pathophysiology and prevention between TIA and brain infarction. methods: Consecutive patients with brain infarction admitted to Ghaem Hospital, Mashhad, Northeastern Iran, were enrolled in a prospective study during 2006. Diagnosis of ischemic stroke was established by a neurologist who also obtained history of TIA and vascular risk factors. All of the stroke patients underwent a standard battery of diagnostic investigations and etiology of ischemic stroke was determined by the Practical Iranian Criteria classification. Fisher’s exact test was used for statistical analysis. results: 348 stroke patients (186 women, 162 men were studied. History of TIA was present in 42 patients (29 women, 13 men, i.e. 12% of the stroke patients. TIA was more common in women (df=1, P=0.02. The frequency of hypertension, diabetes and ipsilateral carotid stenosis was not significantly different between patients with history of TIA and other stroke patients (P=0.87, P=0.64 and P=0.61, respectively. Hyper-cholesterolemia and smoking were significantly more frequent in stroke patients with history of TIA (P=0.011 and P=0.014, respectively. The frequency of TIA was not significantly different among patients with lacunar, versus large vessel territory infarcts (df=1, P=0.84. There was no significant difference in the frequency of various stroke etiologies in patients with and without history of TIA (df=4, P=0.61. CONCLUSIONS: Stroke patients with history of TIA have vascular risk factors similar to other stroke patients. A positive history of TIA does not affirm any specific etiology of ischemic stroke.     Keywords: Risk factors, etiology, transient ischemic attacks.

  12. Etiologic Subtypes, Risk Factors, and Outcomes of Acute Ischemic Stroke in Young Patients

    Directory of Open Access Journals (Sweden)

    İnci Şule Özer

    2015-04-01

    Full Text Available Objective: Stroke in people aged less than 45 years is less frequent than in older patients, but has major impacts on both the individual and society. The aim of this study was to determine the etiologic subtypes of acute ischemic stroke in the young. Materials and Methods: We reviewed the hospital records of 619 patients who were admitted with acute ischemic stroke between January 2011 and November 2014. Acute ischemic stroke in the young was defined as patients aged 45 years and under. Demographic data, the National Institutes of Health Stroke Scale (NIHSS scores at admission and detailed investigations aimed at determining etiologic cause were recorded. Etiologic stroke subtypes were determined using the automated Causative Classification System. Modified Rankin Scale (mRS scores were recorded in the follow-up. Results: There were 32 (5.2% young patients with acute ischemic stroke. The rates of hypertension, diabetes mellitus, atrial fibrillation, and coronary artery disease were significantly lower in young patients compared with patients aged more than 45 years (p<0.05. The mean NIHSS score at admission and hospital mortality was significantly lower in patients aged 45 years and under compared with those older than 45 years (p=0.006, p=0.043. Cardioaortic embolism was the most common etiologic stroke subtype in both groups. Other causes were significantly more frequent in the young acute ischemic stroke group compared with the older patients. The median follow-up mRS was significantly lower in patients aged 45 years and under compared with those older than 45 years (p<0.001. Conclusion: Young patients with ischemic stroke have different risk factors, stroke etiology, stroke severity and prognosis compared with patients older than 45 years with the same condition

  13. Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees.

    Directory of Open Access Journals (Sweden)

    Ryan C Johnson

    Full Text Available Military trainees are at high risk for skin and soft-tissue infections (SSTIs. Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis from July 2012 through December 2014. We used standard microbiology, serology, and high-throughput sequencing to determine the etiology of SSTI. Furthermore, we compared purported risk factors as well as anatomic site colonization for S. aureus. Among 201 SSTI cases evaluated for SSTI risk factors, cellulitis was associated with lower extremity blisters (P = 0.01 and abscess was associated with methicillin-resistant S. aureus (MRSA colonization (P<0.001. Among the 22 tested cellulitis cases that were part of the microbiome analysis, only 1 leading edge aspirate was culturable (Coagulase-negative Staphylococcus. Microbiome evaluation of aspirate specimens demonstrated that Rhodanobacter terrae was the most abundant species (66.8% average abundance, while abscesses were dominated by S. aureus (92.9% average abundance. Although abscesses and cellulitis share the spectrum of clinical SSTI, the bacterial etiologies as determined by current technology appear distinct. Furthermore, the presence of atypical bacteria within cellulitis aspirates may indicate novel mechanisms of cellulitis pathogenesis.NCT01105767.

  14. An emerging etiological factor for hand injuries in the pediatric population: public exercise equipment.

    Science.gov (United States)

    Akşam, Berrak; Akşam, Ersin; Ceran, Candemir; Demirseren, Mustafa Erol

    2016-01-01

    The purpose of this study was to describe the role of public exercise equipment in pediatric hand traumas as a preventable etiological factor. Pediatric patients with hand injuries referred from the emergency department were evaluated retrospectively. Age and gender of the patients, timing, etiology, mechanism of hand trauma, localization of the injury, diagnoses of the patients, and hospitalization rates were reviewed. Amongst the 310 pediatric patients evaluated, 31 patients (10%) experienced injury related to public exercise equipment. Within this group of patients, most were between 5 to 9 years of age, and all injuries were blunt and crush type. Lacerations and fractures were the main diagnoses. Complex injuries that required inpatient care were reported in 19.3% of the patients. Public exercise equipment-related injuries are increasingly prevalent in pediatric hand traumas. Preventive actions such as shielding the moving parts should be taken to reduce these rates.

  15. Assessment of the etiologic factors of gingival recession in a group of patients in Northwest Iran

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    Ardeshir Lafzi

    2009-09-01

    Full Text Available Background and aims. Gingival recession (GR, a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. Materials and methods. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Results. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000. Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05. The type of occlusion, axial inclination of teeth, existence of prosthesis, frenal attachment, and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05. Conclusions. Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

  16. Risk factor profile by etiological subtype of ischemic stroke in the young.

    Science.gov (United States)

    Jaffre, Aude; Ruidavets, Jean Bernard; Calviere, Lionel; Viguier, Alain; Ferrieres, Jean; Larrue, Vincent

    2014-05-01

    Studies of risk factors for ischemic stroke in the young have generally considered ischemic stroke as a whole. The purpose of the present study was to evaluate the association of traditional cardiovascular risk factors with etiological subtypes of ischemic stroke in young adults. Retrospective review of data from patients aged 16-54 years consecutively treated for first-ever ischemic stroke in an academic stroke unit. Definite causes of stroke were classified using the ASCO (A for atherothrombosis, S for small vessel disease, C for cardiac source, O for other cause) classification system. We used multinomial logistic regression analysis to evaluate associations of age, gender, smoking, hypertension, diabetes and blood lipids with each etiological subtype. A total of 400 patients were included: 244 men (61.1%), 156 women (38.9%); mean age (SD) 44.5 (8.5) years. A definite cause of stroke could be identified in 202 (50.5%) patients. Definite causes of stroke included: atherothrombosis, 72 (18.0%) patients; cardioembolism, 37 (9.25%) patients; small vessel disease, 28 (7.0%) patients; other definite cause, 65 (16.25%) patients including 44 patients with carotid or vertebral artery dissection. Atherothrombosis was associated with age, smoking, diabetes, hypertension and low HDL-cholesterol. Small vessel disease was associated with age and hypertension. Cardioembolism was associated with age. The risk factor profile differs between etiological subtypes of ischemic stroke in young adults. Our findings emphasize the impact of smoking, diabetes, hypertension and low HDL-cholesterol as risk factors for atherothrombosis, and of hypertension as a risk factor for small vessel disease in young adults. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Risk Factors and Etiology of Young Ischemic Stroke Patients in Estonia

    Directory of Open Access Journals (Sweden)

    Siim Schneider

    2017-01-01

    Full Text Available Objectives. Reports on young patients with ischemic stroke from Eastern Europe have been scarce. This study aimed to assess risk factors and etiology of first-ever and recurrent stroke among young Estonian patients. Methods. We performed a retrospective study of consecutive ischemic stroke patients aged 18–54 years who were treated in our two hospitals from 2003 to 2012. Results. We identified 741 patients with first-ever stroke and 96 patients with recurrent stroke. Among first-time patients, men predominated in all age groups. The prevalence of well-documented risk factors in first-time stroke patients was 83% and in the recurrent group 91%. The most frequent risk factors were hypertension (53%, dyslipidemia (46%, and smoking (35%. Recurrent stroke patients had fewer less well-documented risk factors compared to first-time stroke patients (19.8 versus 30.0%, P=0.036. Atrial fibrillation was the most common cause of cardioembolic strokes (48% and large-artery atherosclerosis (LAA was the cause in 8% among those aged <35 years. Compared to first-time strokes, recurrent ones were more frequently caused by LAA (14.3 versus 24.0%, P=0.01 and less often by other definite etiology (8.5 versus 1.0%, P=0.01. Conclusions. The prevalence of vascular risk factors among Estonian young stroke patients is high. Premature atherosclerosis is a cause in a substantial part of very young stroke patients.

  18. Investigation of Clinical Characteristics and Etiological Factors in Children with Molar Incisor Hypomineralization

    Directory of Open Access Journals (Sweden)

    Maria Rita Giuca

    2018-01-01

    Full Text Available Aim. The purpose of the present study was to evaluate the clinical defects and etiological factors potentially involved in the onset of MIH in a pediatric sample. Methods. 120 children, selected from the university dental clinic, were included: 60 children (25 boys and 35 girls; average age: 9.8 ± 1.8 years with MIH formed the test group and 60 children (27 boys and 33 girls; average age: 10.1 ± 2 years without MIH constituted the control group. Distribution and severity of MIH defects were evaluated, and a questionnaire was used to investigate the etiological variables; chi-square, univariate, and multivariate statistical tests were performed (significance level set at p<0.05. Results. A total of 186 molars and 98 incisors exhibited MIH defects: 55 molars and 75 incisors showed mild defects, 91 molars and 20 incisors had moderate lesions, and 40 molars and 3 incisors showed severe lesions. Univariate and multivariate statistical analysis showed a significant association (p<0.05 between MIH and ear, nose, and throat (ENT disorders and the antibiotics used during pregnancy (0.019. Conclusions. Moderate defects were more frequent in the molars, while mild lesions were more frequent in the incisors. Antibiotics used during pregnancy and ENT may be directly involved in the etiology of MIH in children.

  19. Investigation of Clinical Characteristics and Etiological Factors in Children with Molar Incisor Hypomineralization

    Science.gov (United States)

    Giuca, Maria Rita; Cappè, Maria; Carli, Elisabetta; Lardani, Lisa

    2018-01-01

    Aim The purpose of the present study was to evaluate the clinical defects and etiological factors potentially involved in the onset of MIH in a pediatric sample. Methods 120 children, selected from the university dental clinic, were included: 60 children (25 boys and 35 girls; average age: 9.8 ± 1.8 years) with MIH formed the test group and 60 children (27 boys and 33 girls; average age: 10.1 ± 2 years) without MIH constituted the control group. Distribution and severity of MIH defects were evaluated, and a questionnaire was used to investigate the etiological variables; chi-square, univariate, and multivariate statistical tests were performed (significance level set at p MIH defects: 55 molars and 75 incisors showed mild defects, 91 molars and 20 incisors had moderate lesions, and 40 molars and 3 incisors showed severe lesions. Univariate and multivariate statistical analysis showed a significant association (p MIH and ear, nose, and throat (ENT) disorders and the antibiotics used during pregnancy (0.019). Conclusions Moderate defects were more frequent in the molars, while mild lesions were more frequent in the incisors. Antibiotics used during pregnancy and ENT may be directly involved in the etiology of MIH in children. PMID:29861729

  20. Review of critical factors for SEA implementation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jie, E-mail: jasmine@plan.aau.dk; Christensen, Per; Kornov, Lone

    2013-01-15

    The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it in practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The

  1. Review of critical factors for SEA implementation

    International Nuclear Information System (INIS)

    Zhang Jie; Christensen, Per; Kørnøv, Lone

    2013-01-01

    The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it in practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The

  2. Model endophenotype for bipolar disorder: Qualitative Analysis, etiological factors, and research areas

    Directory of Open Access Journals (Sweden)

    Naraiana de Oliveira Tavares

    2014-12-01

    Full Text Available The aim of this study is to present an updated view of the writings on the endophenotype model for bipolar disorder using analytical methodologies. A review and analysis of networks was performed through descriptors and keywords that characterize the composition of the endophenotype model as a model of health. Information was collected from between 1992 and 2014, and the main thematic areas covered in the articles were identified. We discuss the results and question their cohesion, emphasizing the need to strengthen and identify the points of connection between etiological factors and characteristics that make up the model of endophenotypes for bipolar disorder.

  3. Survey of 2002 cases of liver cirrhosis: Identification of etiological factors and related complications

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    AI Min

    2013-05-01

    Full Text Available ObjectiveTo identify the etiologies and associated complications of liver cirrhosis for new cases emerging over the past decade in the region served by the Second Affiliated Clinical College of Chongqing University of Medical Sciences. MethodsThe institute′s inpatient medical record database was searched for all individuals admitted with a new diagnosis of liver cirrhosis between January 2002 and December 2011. Data on demographics and clinical findings were collected for retrospective analysis to determine the regional and temporal profiles of etiologies and complications. The count data, expressed as percent of total, was analyzed by the Chi-squared test. ResultsAmong the total 2002 liver cirrhosis cases, the most frequent etiologies (>1.5% of total were viral hepatitis type B (60.6%, fatty liver caused by both hepatitis B virus (HBV and alcohol (16.6%, alcoholic fatty liver (6.6%, autoimmune liver disease (3.4%, autoimmune liver disease and alcohol (3.2%, and nonalcoholic fatty liver (1.7%. From the first half of the decade to the second half (January 2002-December 2006 vs. January 2007-December 2011, the incidences of two etiologies significantly increased (HBV and alcohol: 13.6% vs. 17.7%, P<0.05 and autoimmune liver disease: 3.5% vs. 7.1%, P<0.05 and the incidence of HBV significantly decreased (641% vs. 59.3%, P<0.05. The most common major complications of cirrhosis were primary hepatocellular carcinoma (HCC; 221%, spontaneous peritonitis (21.3%, upper gastrointestinal bleeding (193%, hepatic encephalopathy (7.3%, and hepatorenal syndrome (4.0%. The incidence of liver cancer was significantly higher in patients with a family history of hepatitis B (31.1% vs. 222%, P<0.05 and positively correlated with HBV DNA load (χ2 = 10.88, P<0.05. ConclusionIn Chongqing, HBV remains a major cause of cirrhosis, even though alcoholism and autoimmune disease are rising in importance as etiological factors, and HCC is still the

  4. Balance of antiangiogenic and angiogenic factors in the context of the etiology of preeclampsia.

    Science.gov (United States)

    Seki, Hiroyuki

    2014-10-01

    The "two-stage disorder" theory that is assumed for the etiology of preeclampsia hypothesizes that antiangiogenic and angiogenic factors and/or placental debris play an important role in this disorder. The physiological actions of placental debris occur via the balance between antiangiogenic and angiogenic factors. Accordingly, this balance between antiangiogenic and angiogenic factors should be investigated to elucidate the various pathological features of preeclampsia. Their accurate evaluation is needed to investigate not only antiangiogenic factors (such as sFlt-1 and sEng) and angiogenic factors (such as vascular endothelial growth factor, placental growth factor and transforming growth factor-β) but also the expression level of their receptors such as Flt-1 and Eng. However, it is ethically and technically difficult to investigate the above-mentioned factors at antepartum in human patients. The examination of the ratios of sFlt-1/vascular endothelial growth factor receptor ligands and sEng/transforming vascular endothelial growth factor-β and the use of experimental animal models may help in elucidating various unresolved issues in preeclampsia. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Importance of genetic factors in the etiology of atopic dermatitis: a twin study

    DEFF Research Database (Denmark)

    Thomsen, Simon F; Ulrik, Charlotte S; Kyvik, Kirsten O

    2007-01-01

    The susceptibility to develop atopic dermatitis can be attributed both to genetic and environmental causes. We estimated the relative impact of genetic and environmental factors in the etiology of atopic dermatitis in a population-based sample of twins. From the birth cohorts of 1953-1982 who wer...... dermatitis both in male and female patients (p = 0.98). The estimates were adjusted for age. The susceptibility to develop atopic dermatitis is attributable to mainly genetic differences between people. However, differences in environmental exposures also are of importance......The susceptibility to develop atopic dermatitis can be attributed both to genetic and environmental causes. We estimated the relative impact of genetic and environmental factors in the etiology of atopic dermatitis in a population-based sample of twins. From the birth cohorts of 1953-1982 who were...... with a threefold increased risk among cotwins of an affected fraternal twin, relative to the general population. Genes accounted for 82% and nonshared environmental factors accounted for 18% of the individual susceptibility to develop atopic dermatitis. The same genes contributed to the susceptibility to atopic...

  6. Etiological factors for developing carpal tunnel syndrome in people who work with computers

    Directory of Open Access Journals (Sweden)

    Magdalena Lewańska

    2013-02-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. Material and Methods: The study group comprised 60 patients (58 women and 2 men; mean age: 53.8±6.35 years working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS were performed in all the subjects. Results: The patients worked with use of computer for 6.43±1.71h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09±5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. Conclusion: The results of our study show that CTS is usually generated by different causes not related with using computers at work. Med Pr 2013;64(1:37–45

  7. Halitosis: a review of the etiologic factors and association with systemic conditions and its management.

    Science.gov (United States)

    Mokeem, Sameer A

    2014-11-01

    Halitosis is a general term defined as an unpleasant or offensive odor emanating from the breath, arising from either oral or nonoral sources. Extraoral factors, such as ear-nose-throat conditions or gastrointestinal, respiratory, and systemic diseases, may also contribute to oral malodor. Although, halitosis has a multifactorial etiology, local factors play an important role in the majority of cases. Halitosis may lead to significant personal discomfort and social embarrassment. Assessment of halitosis can be performed using organoleptic measurements, sulfide monitoring, gas chromatography, microbial testing and chemical test strips. Management approaches are based on masking oral malodor, reducing the levels of volatile organic compounds (VOCs) and volatile sulfur compounds (VSCs), and mechanical and/or chemical treatment. This review aims to identify the etiology of oral halitosis, describe the methods available for assessment and differential diagnosis and introduce a variety of management strategies. The importance of a multidisciplinary approach for the improvement of overall health and for the management and prevention of halitosis is highlighted.

  8. A etiologia multifatorial da recessão periodontal The etiologic factors of periodontal recession

    Directory of Open Access Journals (Sweden)

    Karen Ferreira Gazel Yared

    2006-12-01

    Full Text Available A literatura apresenta vários fatores relacionados na etiologia da recessão periodontal, além do processo inflamatório induzido pelo biofilme bacteriano, os quais incluem fatores externos e anatômicos locais. Por meio deste estudo, revistou-se a literatura sobre tais fatores, cujo conhecimento é de grande importância para o ortodontista, contribuindo durante o diagnóstico, planejamento e tratamento ortodôntico propriamente dito.The literature shows that besides dental plaque, some external and anatomic local factors are still related to gingival recession etiology. This study reviewed the literature about those factors, which knownledge is of great benefit to the orthodontist, contributing during diagnostic, planning and orthodontic treatment.

  9. [Research progress in genetic abnormalities and etiological factors of congenital anorectal malformation].

    Science.gov (United States)

    Zhang, Yanli; Ren, Hongxia

    2016-01-01

    Congenital anorectal malformation (ARM) is one of the most common gastrointestinal congenital diseases, accounting for 1/4 in digestive tract malformation, and is one of the congenital malformations in routine surveillance by the World Health Organization. Because of the variety of risk factors and the complexity of the pathological changes, etiology of ARM is still not clear. It is mostly considered that ARM is resulted from hereditary factors and environmental factors in the development of embryogenesis. Through animal experiments, scholars have found that Hox, Shh, Fgf, Wnt, Cdx and TCF4, Eph and ephrin play crucial role during the development of digestive tract. When the genes/signaling pathway dysfunction occurs, ARM may happen. In addition, ARM is related to the external factors in pregnancy. Because of the complexity of related factors in the development of human embryogenesis, the research progress of human ARM is very slow. This paper reviews relevant literatures in genetic factors and environmental factors, in order to provide the theoretical basis for the treatment and prevention of ARM.

  10. Erectile Dysfunction Under Age 40: Etiology and Role of Contributing Factors

    Directory of Open Access Journals (Sweden)

    Tahir Karadeniz

    2004-01-01

    Full Text Available The aim of this study was to evaluate the etiology of erectile dysfunction (ED in patients under the age of 40 years. Eighty one patients were included in this study. All patients underwent a multidisciplinary diagnostic approach by color Doppler ultrasonography, dynamic pharmacocavernosometry (optional, selective pudendal pharmaco-arteriography (optional and nocturnal penile tumescence monitoring by a Rigi-Scan (optional. Mean age of the population was 32 years. Psychogenic impotence was diagnosed in 50% of the patients and organic impotence was diagnosed in 45%. After the 3rd decade of life, a vasculogenic etiology was the most common cause of impotence. Smoking and hypertension played a major role as chronic contributing factors in the overall study population. Primary impotence was diagnosed in 11 patients who were unmarried. The rate of organic causes was 45% in this group (all vasculogenic in nature. Erectile dysfunction in younger patients and in patients with primary impotence is due mainly to organic causes, usually vascular in origin.

  11. Critical success factors in ERP implementation

    Directory of Open Access Journals (Sweden)

    Blerta Abazi Chaushi

    2016-11-01

    Full Text Available This study conducts state of the art literature review of critical success factors for enterprise resource planning systems implementation success. Since research on critical success factors for ERP implementation success is very rare and fragmented, this study provides a more comprehensive list of ten factors that companies that have adopted and struggle with the implementation, as well as companies who are in the process of considering implementation of ERP system can easily adopt and follow. The main contribution of this paper is that these ten new critical success factors are identifi ed through a thorough analysis of 22 selected research papers and is more comprehensive and straightforwardly employable for use.

  12. Company Networks. Critical Design Factors

    OpenAIRE

    Villegas Arias, Gladis Cecilia

    2008-01-01

    En este trabajo se presentan los resultados de una investigación orientada a reconocer los factores críticos de éxito al diseño de cuatro redes productivas, operantes en el sector agrícola en Colombia: producción y comercialización de café, comercialización de banano, procesamiento de derivados lácteos y cultivo de flores. Las redes incluidas en el estudio se sometieron a observación durante el periodo de julio de 2001 a julio de 2004; los datos recolectados se procesaron usando la metodologí...

  13. Factor V G1691A (Leiden is a major etiological factor in Egyptian Budd-Chiari syndrome patients

    Directory of Open Access Journals (Sweden)

    Tawhida Y. Abdel Ghaffar

    2011-12-01

    Full Text Available Objective: Budd-Chiari syndrome is a multifactorial disease in which several prothrombotic disorders may predispose patients to the development of thrombosis at this uncommon location (hepatic veins. The aim of this study was to determine the prevalence and characteristics of inherited thrombophilia in Egyptian Budd-Chiari syndrome patients.Materials and Methods: The study included 47 Budd-Chiari syndrome patients (20 children and 27 adults. Genotyping of Factor V G1691A (Leiden, prothrombin G20210A (PT, and methylenetetrahydrofolate reductase C677T were performed using real-time PCR and fluorescence melting curve detection analysis.Results: Factor V Leiden was observed in 29 patients (61.7%. It is the only factor that caused Budd-Chiari syndrome in 18 of the patients and in 5 of the patients with inferior vena cava involvement. Myeloproliferative disease was noted in 12 (25.5% patients, antiphospholipid syndrome in 5 (10.6%, and Behcet’s disease in 3 (6.4%. Interestingly, 3 of the children with Budd-Chiari syndrome had lipid storage disease.Conclusion: Factor V Leiden was a major etiological factor in Egyptian Budd-Chiari syndrome patients, which may have been related to the high frequency of this mutation in the study region. Factor V Leiden was also a strong thrombophilic factor and the leading cause of inferior vena cava thrombosis in these patients. Lipid storage disease should be included as a risk factor for Budd-Chiari syndrome.

  14. Critical success factors for managing purchasing groups

    NARCIS (Netherlands)

    Schotanus, Fredo; Telgen, Jan; de Boer, L.

    2010-01-01

    In this article, we identify critical success factors for managing small and intensive purchasing groups by comparing successful and unsuccessful purchasing groups in a large-scale survey. The analysis of our data set suggests the following success factors: no enforced participation, sufficient

  15. Factor XIII Val34Leu is a genetic factor involved in the etiology of venous thrombosis

    NARCIS (Netherlands)

    Franco, R. F.; Reitsma, P. H.; Lourenço, D.; Maffei, F. H.; Morelli, V.; Tavella, M. H.; Araújo, A. G.; Piccinato, C. E.; Zago, M. A.

    1999-01-01

    A mutation in the factor XIII gene (FXIII Val34Leu) gene was recently reported to confer protection against myocardial infarction, but its relationship with venous thrombosis is unknown. In addition, a mutation in the 5'-untranslated region of the FXII gene (46 C->T) was identified which is

  16. The potential etiologic factors influencing tinnitus intensity in patients with temporomandibular disorders.

    Science.gov (United States)

    Demirkol, Nermin; Demirkol, Mehmet; Usumez, Aslihan; Sari, Fatih; Akcaboy, Cihan

    2017-08-30

    To investigate the potential relationships between the intensity of tinnitus associated with temporomandibular disorders (TMD) and potential etiologic factors, including age, gender, freeway space, sleep bruxism (SB), joint clicking, and headache. The sample was comprised of 90 patients without any hearing loss, as confirmed by otorhinolaryngology, who self-reported subjective tinnitus and simultaneous TMD, based on the Research Diagnostic Criteria for TMD (RDC/TMD). The results showed a positive, weak correlation between the intensity of tinnitus and age (r = 0.225, p = 0.033). The presence of SB and headache were seen in higher proportions in the present sample, at 75.5% (n = 68) and 66.6% (n = 60), respectively. In a population of patients with subjective tinnitus and TMD, no significant associations were found between tinnitus intensity and age, freeway space, SB, clicking presence, and headache, though gender did show a weak correlation with tinnitus intensity.

  17. Chronic pancreatitis: review and update of etiology, risk factors, and management [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Angela Pham

    2018-05-01

    Full Text Available Chronic pancreatitis is a syndrome involving inflammation, fibrosis, and loss of acinar and islet cells which can manifest in unrelenting abdominal pain, malnutrition, and exocrine and endocrine insufficiency. The Toxic-Metabolic, Idiopathic, Genetic, Autoimmune, Recurrent and Severe Acute Pancreatitis, Obstructive (TIGAR-O classification system categorizes known causes and factors that contribute to chronic pancreatitis. Although determining disease etiology provides a framework for focused and specific treatments, chronic pancreatitis remains a challenging condition to treat owing to the often refractory, centrally mediated pain and the lack of consensus regarding when endoscopic therapy and surgery are indicated. Further complications incurred include both exocrine and endocrine pancreatic insufficiency, pseudocyst formation, bile duct obstruction, and pancreatic cancer. Medical treatment of chronic pancreatitis involves controlling pain, addressing malnutrition via the treatment of vitamin and mineral deficiencies and recognizing the risk of osteoporosis, and administering appropriate pancreatic enzyme supplementation and diabetic agents. Cornerstones in treatment include the recognition of pancreatic exocrine insufficiency and administration of pancreatic enzyme replacement therapy, support to cease smoking and alcohol consumption, consultation with a dietitian, and a systematic follow-up to assure optimal treatment effect.

  18. Etiological factors correlated with temporomandibular disorder in complete denture wearers: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Ricardo Alexandre Zavanelli

    2009-01-01

    Full Text Available Objective: The aim of this study was to make a comparative evaluation of the prevalence of temporomandibular disorder in complete denturewearers, with regard to the etiological factors, such as gender, age, and complete dentures clinical conditions, according to the anamnestic(Ai and clinical (Di dysfunction index, developed by Helkimo.Methods: The randomized sample was composed of 90 institutionalized patients and bimaxillary complete denture wearers, with a mean ageof 67.2 years, who were included in this study. The collected data were tabulated and the Kruskal-Wallis and Chi-square statistical tests were applied, at the level of significance of 5% (p<0.05.Results: Statistically significant difference in the prevalence of temporomandibular disorder was observed with regard to the ages of the current complete dentures, free-way space, wear of the occlusal surfaces of the artificial teeth, and the conditions of retention and stability of the maxillary and mandibular complete dentures, according to both the indexes. Conclusion: The patients who wore complete dentures in adequate clinical conditions presented fewer signs and symptoms of temporomandibular disorder than the patients who wore complete dentures in poor clinical conditions.

  19. Disruption of Circadian Rhythms: A Crucial Factor in the Etiology of Depression

    Directory of Open Access Journals (Sweden)

    Roberto Salgado-Delgado

    2011-01-01

    Full Text Available Circadian factors might play a crucial role in the etiology of depression. It has been demonstrated that the disruption of circadian rhythms by lighting conditions and lifestyle predisposes individuals to a wide range of mood disorders, including impulsivity, mania and depression. Also, associated with depression, there is the impairment of circadian rhythmicity of behavioral, endocrine, and metabolic functions. Inspite of this close relationship between both processes, the complex relationship between the biological clock and the incidence of depressive symptoms is far from being understood. The efficiency and the timing of treatments based on chronotherapy (e.g., light treatment, sleep deprivation, and scheduled medication indicate that the circadian system is an essential target in the therapy of depression. The aim of the present review is to analyze the biological and clinical data that link depression with the disruption of circadian rhythms, emphasizing the contribution of circadian desynchrony. Therefore, we examine the conditions that may lead to circadian disruption of physiology and behavior as described in depressive states, and, according to this approach, we discuss therapeutic strategies aimed at treating the circadian system and depression.

  20. DEFINITION OF ETIOLOGICAL ANTIBIOTIC SENSITIVITY FACTORS IN PURULENT-INFLAMMATORY PROCESSES.

    Science.gov (United States)

    Dubovyk, O; Mishyna, М; Malanchuk, S; Kuzmenko, A; Kozlov, O

    2017-10-01

    The purpose of the study - assessment of purulent-inflammatory processes etiologic factors and determination of microbial agents' in forms of plankton and biofilms sensitivity to antibiotics. Clinical microbial strains isolated from patients with purulent-inflammatory processes were the subject of the study. The study material comprised of wound tissue, pus, bandage and suture, catheters and drainage devices. Sensitivity of isolates to antimicrobial preparations with various mechanism of activity on the microbial cells was studied with the help of micro-test system. Formation of biofilms was studied with the help of definition of bacteria strains ability to adhesion to the surface of polystyrene flatbeds. It was revealed that one of the leading factors of purulent-inflammatory process development is S.aureus, which disseminated in 36,5% of cases; E.coli disseminated in 17,3% of cases. Among the agents of purulent-inflammatory processes the specific gravity attributed to: Proteus spp. - 14,6%, S.рyogenes - 12,8%, P.aeruginosa - 6,9%, K.pneumoniae - 6,7%. It was revealed that all isolates formed dense biofilms. It was demonstrated that most isolates in plankton form were sensitive to Novapime, Cefepime, Gatifloxacin, Imipenem; sensitive strains were registered in a smaller quantity to Gentamicin, Clindamycin and Doxycycline. In terms of sensitivity of isolates in the form of biofilm to antibacterial preparations it was revealed that most isolates were polyresistant to them. Thus, the study of the sensitivity of allotted microbial strains to antimicrobial preparations demonstrated, that there were strains among cultures with multiple resistances which was the consequence of a wide and not always effective use of antimicrobial preparations.

  1. The Role of Infertility Etiology in Success Rate of Intrauterine Insemination Cycles: An Evaluation of Predictive Factors for Pregnancy Rate

    Science.gov (United States)

    Ashrafi, Mahnaz; Rashidi, Mandana; Ghasemi, Afsaneh; Arabipoor, Arezoo; Daghighi, Sara; Pourasghari, Parisa; Zolfaghari, Zahra

    2013-01-01

    Background: The objective of this study was to identify the prognostic factors that influence the outcome of ovarian stimulation with intrauterine insemination (IUI) cycles in couples with different infertility etiology. Materials and Methods: This retrospective study was performed in data of 1348 IUI cycles with ovarian stimulation by clomiphene citrate (CC) and/or gonadotropins in 632 women with five different infertility etiology subgroups at Akbarabbadi Hospital, Tehran, Iran. Results: The pregnancy rate (PR)/ cycle was highest (19.9%) among couples with unexplained infertility and lowest (10.6%) in couples with multiple factors infertility. In cases of unexplained infertility, the best PRs were seen after CC plus gonadotropins stimulation (26.3%) and with inseminated motile sperm count>30×106 (21.9%), but the tendency didn’t reach statistical significant. In the ovarian factor group, the best PRs were observed in women aged between 30 and 34 years (20.8%), with 2-3 preovulatory follicles (37.8%) and infertility duration between 1and 3 years (20.8%), while only infertility duration (p=0.03) and number of preovulatory follicles (p=0.01) were statistically significant. Multiple logistic regression analysis determined that number of preovulatory follicles (p=0.02), duration of infertility (p=0.015), age (p=0.019), infertility etiology (p=0.05) and stimulation regimen (p=0.01) were significant independent factors in order to predict overall clinical PR. Conclusion: The etiology of infertility is important to achieve remarkable IUI success. It is worth mentioning that within different etiologies of infertility, the demographic and cycles characteristics of couples did not show the same effect. Favorable variables for treatment success are as follows: age infertility ≤5 years and a cause of infertility except of multiple factors. PMID:24520471

  2. BRAVO identifies critical success factors for logistics

    NARCIS (Netherlands)

    Kokke, C.J.T.M.; Donselaar, van K.H.; Allessie, M.

    1997-01-01

    Good operational performance depends on knowing which operational factors are critical to success. Bravo, a research project involving 150 transport and distribution companies in The Netherlands, has developed a tool now being adopted nationally by all companies in the sector to find opportunities

  3. Critical Success Factors in Online Language Learning

    Science.gov (United States)

    Alberth

    2011-01-01

    With the proliferation of online courses nowadays, it is necessary to ask what defines the success of teaching and learning in these new learning environments exactly. This paper identifies and critically discusses a number of factors for successful implementation of online delivery, particularly as far as online language learning is concerned.…

  4. Urinary tract infections in Romanian patients with diabetes: prevalence, etiology, and risk factors

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    Chiţă T

    2016-12-01

    Full Text Available Teodora Chiţă,1,2 Bogdan Timar,1,2 Delia Muntean,1,2 Luminiţa Bădiţoiu,1,3 Florin Horhat,1,2 Elena Hogea,1 Roxana Moldovan,1,3 Romulus Timar,1,2 Monica Licker1,2 1Victor Babes University of Medicine and Pharmacy Timisoara, 2Pius Brinzeu Emergency Hospital, 3Regional Centre of Public Health, Timisoara, Romania Aim: Patients with diabetes mellitus (DM have an increased risk of infections, especially urinary tract infections (UTIs. The aim of this study was to assess the prevalence and etiology of UTIs and identify the risk factors for their development in patients with DM. Patients and methods: In this retrospective, noninterventional study, the medical records of 2,465 adult patients with DM who were hospitalized in a Diabetes Clinic were reviewed. Data regarding the presence of UTI and possible associated risk factors were collected and their possible relation was analyzed. The study protocol and procedures were approved by the Ethics Committee of Timişoara Emergency Hospital. All data were collected and analyzed using SPSS v.17 statistical software. Results: The prevalence of UTIs in patients with DM was 12.0% (297 cases, being higher in females than in males and higher in patients with type 2 DM compared with patients with type 1 DM. In univariate logistic regression analysis, risk factors associated with UTIs were female gender, age, type 2 DM, longer duration of DM, and the presence of chronic kidney disease and coronary artery disease. Multivariate analysis identified age, duration of DM, and metabolic control (hemoglobin A1c levels as independent risk factors for UTIs. The gram-negative bacilli from the Enterobacteriaceae family were predominant, with Escherichia coli being the most frequent of them (70.4%. Conclusion: UTIs are a frequent condition associated with DM. It is necessary to improve the care and the screening of UTIs in patients with DM to prevent the occurrence of possible associated severe renal complications

  5. CRITICAL THINKING AND ITS AFFECTING FACTORS

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    S Slameto

    2017-09-01

    Full Text Available The objectives of this research were to measure the success rate achieved by the alumni of Open/Distance Learning (O/DL, the Bachelor Education In-service Teachers Program (BEITP, Staya Jacana Christian University(SWCU, Salatiga in their critical thinking habit that lead to their success, and to find factors which determined their critical thinking habit. The factors concerned were student factor (learning motivation, alumni’s readiness to enter ICT community, prerequisite or teacher factor (teacher’s ability in creating and using a new instructional context. This quantitative research belongs to the causality ex-post facto research. The data source was one class of O/ DL, the BEITP, SWCUstudents, who were chosen out of four classes, as many as 32 alumni in the academic year 2015/2016. Data were screened using a self-rating scale, which consisted of 40 items tested valid and reliable, and then reduced to 5 variablas. The BEITP, SWCU Salatiga had graduated most of its alumni who owned critical thinking habit at a high rate. The critical thinking habit was affected by the instructional contexts which enabled a new situation (Model 1, alumni’s readiness to enter the ICT community (Model 2, pre-requisite, i.e., mastery of previous lecture materials (Model 3, and student’s learning motivation (Model 4 to reach 81%. The alumni’s critical thinking habit of 51.20% was determined by the teacher’s role in developing instructional contexts which made a new situation possible. This finding was useful for educational quality management for the effectiveness and productivity of higher education, which should have been focused on the teacher in developing an instructional strategy based on context, alumni readiness to enter the ICT community, prerequisite, and student’s learning motivation.

  6. Modifiable etiological factors and the burden of stroke from the Rotterdam study: a population-based cohort study.

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    Michiel J Bos

    2014-04-01

    Full Text Available BACKGROUND: Stroke prevention requires effective treatment of its causes. Many etiological factors for stroke have been identified, but the potential gain of effective intervention on these factors in terms of numbers of actually prevented strokes remains unclear because of the lack of data from cohort studies. We assessed the impact of currently known potentially modifiable etiological factors on the occurrence of stroke. METHODS AND FINDINGS: This population-based cohort study was based on 6,844 participants of the Rotterdam Study who were aged ≥55 y and free from stroke at baseline (1990-1993. We computed population attributable risks (PARs for individual risk factors and for risk factors in combination to estimate the proportion of strokes that could theoretically be prevented by the elimination of etiological factors from the population. The mean age at baseline was 69.4 y (standard deviation 6.3 y. During follow-up (mean follow-up 12.9 y, standard deviation 6.3 y, 1,020 strokes occurred. The age- and sex-adjusted combined PAR of prehypertension/hypertension, smoking, diabetes mellitus, atrial fibrillation, coronary disease, and overweight/obesity was 0.51 (95% CI 0.41-0.62 for any stroke; hypertension and smoking were the most important etiological factors. C-reactive protein, fruit and vegetable consumption, and carotid intima-media thickness in combination raised the total PAR by 0.06. The PAR was 0.55 (95% CI 0.41-0.68 for ischemic stroke and 0.70 (95% CI 0.45-0.87 for hemorrhagic stroke. The main limitations of our study are that our study population comprises almost exclusively Caucasians who live in a middle and high income area, and that risk factor awareness is higher in a study cohort than in the general population. CONCLUSIONS: About half of all strokes are attributable to established causal and modifiable factors. This finding encourages not only intervention on established etiological factors, but also further study of less

  7. ETIOLOGIC FACTOR IN THE DEVELOPMENT OF MYOCARDITIS IN THE KHARKIV REGION

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    Smelyanskaya MV

    2016-09-01

    Full Text Available Introduction. According to the research conducted in the last decade, there has been growth in the non-coronary disease infarction among all cardiovascular diseases. The prominent place among all non-coronary heart diseases is taken by myocarditis, which predominantly affects young people of working age (30-40 years old. According to the bibliography, the prevalence of myocarditis is 20% of the non-coronary heart lesions and by different authors 5 - 11% of the total amount of diseases of the cardiovascular system. To date, there are no clear criteria of infectious myocarditis. It is widely accepted that myocarditis is natural complication of infectious diseases in which any infectious agent may be the etiological factor. Until recently, Coxsackie virus of group A, B was considered the most cardiotropic. However, the role of enteroviruses has been recently reviewed in favor of persisting viruses and especially family Herpesviridae. Optimization of myocarditis diagnosis using noninvasive tests, will not only reveal the true extent of the disease but may also enable to examine viral myocarditis as a much more common pathology than it seems at present and will increase understanding of the significance of this pathology in the cardiovascular continuum. Material & methods. 87 people diagnosed with infectious myocarditis were examined. Blood and other biological fluids were subject to examination. Patients of the main group have also had their biopsy material, obtained in a result of endomyocardial biopsy, and pericardial fluid, derived as a result of diagnostic and therapeutic puncture under hydro pericarditis, examined. PCR was performed to determine the genomic sequence of enterovirus (HEV, adenovirus (HAdV, human cytomegalovirus (CMV, herpes simplex virus (HSV, Epstein-Barr virus (EBV, human herpes virus 6 (HHV6 and influenza A viruses and B. Results & discussion. Our research confirms the global trend of reducing the role of enteroviruses in

  8. The psychology of fear of flying (part I): a critical evaluation of current perspectives on the nature, prevalence and etiology of fear of flying.

    Science.gov (United States)

    Oakes, Margaret; Bor, Robert

    2010-11-01

    Fear of flying, its nature, prevalence, etiology and treatment, has been the subject of a substantial quantity of research over the past 30 years. With the exception of a dated review of treatment methods however, there has been no evaluation of this expanding body of evidence, its contribution to theory and influence on clinical practice. Published research has also generally failed to apply developments in the understanding and treatment of anxiety disorders generally to fear of flying. This review provides a critical evaluation of the existing literature and what it reveals about theory and practice. It does this from the perspective of Cognitive Behavioural Therapy. The evidence reviewed demonstrates that fear of flying is a heterogeneous phenomenon which is acquired under the influence of complex psychological, social and physiological factors unique to each affected individual. Effective psychological interventions must therefore be founded on a comprehensive functional assessment of each individual, a finding which is considered in detail in the second part of this review. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. An etiological model of perfectionism.

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    Gayle K Maloney

    Full Text Available OBJECTIVE: Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. METHOD: The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. RESULTS: Structural equation modeling showed a direct relationship between high Parental Expectations and Criticism, and Perfectionism. There was also an indirect relationship between Parental Bonding and Perfectionism that was mediated by core schemas of disconnection and rejection. Finally, it was found that Neuroticism had both an indirect relationship, which was mediated by core schemas, and a direct relationship with perfectionism. CONCLUSIONS: The study provided the first direct test of an etiological model of perfectionism to date. Clinical implications include investigating whether the inclusion of etiological factors in the understanding and treatment of perfectionism is effective.

  10. Critical success factors for renewable energy projects

    International Nuclear Information System (INIS)

    1995-01-01

    This project highlighted best practice in the planning and assessment of proposals with the aim of: encouraging more successful renewable energy projects and proposals; lowering financial and other barriers; and stimulating a climate for success. Based on the analysis of a number of case studies, data was collected through a series of extensive interviews to identify why certain schemes were considered successful, what might have been done differently and which factors were considered important when entering a market. The Critical Success Factors can be broken down into five groups: Universal CSFs; CSFs for funding bodies; CSFs for managing agencies; CSFs for niche markets; CSFs for individual technologies. (author)

  11. Clinico-biochemical factors to early predict biliary etiology of acute pancreatitis: age, female gender, and ALT.

    Science.gov (United States)

    Zarnescu, N O; Costea, R; Zarnescu Vasiliu, E C; Neagu, S

    2015-01-01

    Background/ Aims: Despite the existence of an easy tool to diagnose biliary tract disease as an etiology for acute pancreatitis (AP), the sensitivity of abdominal ultrasound is around 80%, which can be even lower in certain conditions. We have retrospectively reviewed data of 146 patients admitted for acute pancreatitis between 1999 and 2013. Bivariate analysis for clinical and biochemical variables was performed with respect to etiology of AP (biliary versus non-biliary). Multivariate analysis was performed by using binary logistic regression. There were 87 males (59.6%) and 59 females (40.4%), with a median age of 51. The etiology of acute pancreatitis was biliary in 71 patients (48.6%). Bivariate analysis found the following as significant association (p=0.001) with biliary pancreatitis: older age, female gender, and elevated AST, ALT. A binary logistic regression analysis identified as predictor factors for biliary etiology of acute pancreatitis: age OR = 1.031 (95% CI 1.004 - 1.059, p = 0.024), sex (female) OR = 2.34 (95% CI 1.022 - 5.359, p = 0.044) and ALT OR = 1.004 (95% CI 1.001 - 1.007, p =0.004). The two clinical scores included the three variables (A.S.ALT scores) in categorical format were generated and then checked with the ROC curves (areas under curve are 0.768 and 0.778). Age, female gender, and elevated ALT can help identifying cases with biliary etiology of acute pancreatitis.

  12. Personality factors of critical care nurses.

    Science.gov (United States)

    Levine, C D; Wilson, S F; Guido, G W

    1988-07-01

    Two hundred members of the American Association of Critical-Care Nurses responded to a mail-out survey done to determine the psychologic profile of critical care nurses in terms of self-esteem, gender identity, and selected personality characteristics. The instruments used were Cattell's 16 PR, the Personal Attributes Questionnaire (PAQ), and the Texas Social Behavior Inventory (TSBI). Their personality factors tended to be aggressive, assertive, competitive, persevering, moralistic, resourceful, and mechanical. The nurses who enjoyed the field most were of the androgynous or masculine type and had high levels of self-esteem. On the basis of these findings, the nurse recruiter or faculty member doing career counseling could assess the personality characteristics, gender identity, and self-esteem levels of interested nurses. The goal would be to identify nurses who would both enjoy the field and remain active in critical care nursing after orientation. The goal could also be to help nurses dissatisfied with critical care nursing to seek means of improving their self-esteem.

  13. Validation of Demographics, Etiology, and Risk Factors for Chronic Pancreatitis in the USA: A Report of the North American Pancreas Study (NAPS) Group.

    Science.gov (United States)

    Conwell, Darwin L; Banks, Peter A; Sandhu, Bimaljit S; Sherman, Stuart; Al-Kaade, Samer; Gardner, Timothy B; Anderson, Michelle A; Wilcox, C Mel; Lewis, Michele D; Muniraj, Thiruvengadam; Forsmark, Christopher E; Cote, Gregory A; Guda, Nalini M; Tian, Ye; Romagnuolo, Joseph; Wisniewski, Stephen R; Brand, Randall; Gelrud, Andres; Slivka, Adam; Whitcomb, David C; Yadav, Dhiraj

    2017-08-01

    Our aim was to validate recent epidemiologic trends and describe the distribution of TIGAR-O risk factors in chronic pancreatitis (CP) patients. The NAPS-2 Continuation and Validation (NAPS2-CV) study prospectively enrolled 521 CP patients from 13 US centers from 2008 to 2012. CP was defined by definitive changes in imaging, endoscopy, or histology. Data were analyzed after stratification by demographic factors, physician-defined etiology, participating center, and TIGAR-O risk factors. Demographics and physician-defined etiology in the NAPS2-CV study were similar to the original NAPS2 study. Mean age was 53 years (IQR 43, 62) with 55% males and 87% white. Overall, alcohol was the single most common etiology (46%) followed by idiopathic etiology (24%). Alcohol etiology was significantly more common in males, middle-aged (35-65 years), and non-whites. Females and elderly (≥65 years) were more likely to have idiopathic etiology, while younger patients (etiology. Variability in etiology was noted by participating centers (e.g., alcohol etiology ranged from 27 to 67% among centers enrolling ≥25 patients). Smoking was the most commonly identified (59%) risk factor followed by alcohol (53%), idiopathic (30%), obstructive (19%), and hyperlipidemia (13%). The presence of multiple TIGAR-O risk factors was common, with 1, 2, ≥3 risk factors observed in 27.6, 47.6, and 23.6% of the cohort, respectively. Our data validate the current epidemiologic trends in CP. Alcohol remains the most common physician-defined etiology, while smoking was the most commonly identified TIGAR-O risk factor. Identification of multiple risk factors suggests CP to be a complex disease.

  14. Critical success factors of Indian Entrepreneurs

    Directory of Open Access Journals (Sweden)

    Alex Antonites

    2013-12-01

    Full Text Available This research seeks to explore the critical success factors that influence the success of Indian small business owners in the largest metropolitan area in South Africa. To achieve this, the objective of the study was to confirm whether there are significant differences between a successful and less successful group of business owners in terms of general management skills, personal characteristics, and entrepreneurial orientation and financing of the business. Through analysing secondary evidence and empirical results it was possible to facilitate a better understanding of how Indian entrepreneurs operating in small and medium enterprises sustain success, thus contributing to the body of knowledge relating to entrepreneurship development in the domain of entrepreneurship. From the literature it became clear that cultural dimensions have an impact on the entrepreneurial process. The arrival of Indians in South Africa has contributed to a unique Indian culture. The characteristics that describe ethnic entrepreneurs and success factors attributed to their success are described. Small and medium enterprises (SMEs are crucial for the development of any country as they offer benefits of economic growth and employment generation. The success factors to sustain SMEs are also described. The findings of the study indicate that there are no significant differences between the comparable groups in relation to management skills and finance factors. There are, however, significant differences relating to personal factors, such as the level of education, family support and experience. Finally, an important learning is that the Indian entrepreneurs in this study are similar to ethnic entrepreneurs reviewed in literature. The study was conducted in Tshwane, the largest metropolitan area in South Africa, and amongst the largest in the world. Keywords: Culture, ethnic entrepreneurship, Indian entrepreneurship, critical success factors, small and medium enterprises

  15. Risky business: human factors in critical care.

    Science.gov (United States)

    Laussen, Peter C; Allan, Catherine K; Larovere, Joan M

    2011-07-01

    Remarkable achievements have occurred in pediatric cardiac critical care over the past two decades. The specialty has become well defined and extremely resource intense. A great deal of focus has been centered on optimizing patient outcomes, particularly mortality and early morbidity, and this has been achieved through a focused and multidisciplinary approach to management. Delivering high-quality and safe care is our goal, and during the Risky Business symposium and simulation sessions at the Eighth International Conference of the Pediatric Cardiac Intensive Care Society in Miami, December 2010, human factors, systems analysis, team training, and lessons learned from malpractice claims were presented.

  16. Critical success factors in information technology projects

    Directory of Open Access Journals (Sweden)

    Ayesha

    2017-02-01

    Full Text Available The purpose of this study is to determine the critical success factors (CSF of IT projects in Pa-kistan. The identified factors cannot only be functional to exact type IT projects but also to all types of IT projects, their success directly affects the achievement of whole organization. The proposed study of this paper has determined 15 factors influencing the most on the success of IT projects through multiple regression analysis. The survey has disclosed that many CSFs were found related to IT projects but these 15 factors are also the backbone of IT projects. The re-search results obtained clearly indicated that the Leadership Qualities played a significant role in obtaining Top Management support in order to access to resources however, the Leadership Qualities did not play any role on the trained and capable Project Team Members. Besides, it is undoubtedly defined effective communication of the project was established to be influential on the conclusion and contributing factor towards the Success of IT projects in Pakistan. Top Man-agement Support as a whole was not found to play a key role in the IT Project Success.

  17. Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre

    Directory of Open Access Journals (Sweden)

    Ramat Oyebunmi Braimah

    2016-01-01

    Full Text Available Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines.

  18. Phenotyping, Etiological Factors, and Biomarkers: Toward Precision Medicine in Autism Spectrum Disorders

    Science.gov (United States)

    2016-01-01

    ABSTRACT: Despite the progress made in understanding the biology of autism spectrum disorder (ASD), effective biological interventions for the core symptoms remain elusive. Because of the etiological heterogeneity of ASD, identification of a “one-size-fits-all” treatment approach will likely continue to be challenging. A meeting was convened at the University of Missouri and the Thompson Center to discuss strategies for stratifying patients with ASD for the purpose of moving toward precision medicine. The “white paper” presented here articulates the challenges involved and provides suggestions for future solutions. PMID:27676697

  19. Candidate genes and their interactions with other genetic/environmental risk factors in the etiology of schizophrenia.

    Science.gov (United States)

    Prasad, K M; Talkowski, M E; Chowdari, K V; McClain, L; Yolken, R H; Nimgaonkar, V L

    2010-09-30

    Identification of causative factors for common, chronic disorders is a major focus of current human health science research. These disorders are likely to be caused by multiple etiological agents. Available evidence also suggests that interactions between the risk factors may explain some of their pathogenic effects. While progress in genomics and allied biological research has brought forth powerful analytic techniques, the predicted complexity poses daunting analytic challenges. The search for pathogenesis of schizophrenia shares most of these challenges. We have reviewed the analytic and logistic problems associated with the search for pathogenesis. Evidence for pathogenic interactions is presented for selected diseases and for schizophrenia. We end by suggesting 'recursive analyses' as a potential design to address these challenges. This scheme involves initial focused searches for interactions motivated by available evidence, typically involving identified individual risk factors, such as candidate gene variants. Putative interactions are tested rigorously for replication and for biological plausibility. Support for the interactions from statistical and functional analyses motivates a progressively larger array of interactants that are evaluated recursively. The risk explained by the interactions is assessed concurrently and further elaborate searches may be guided by the results of such analyses. By way of example, we summarize our ongoing analyses of dopaminergic polymorphisms, as well as infectious etiological factors in schizophrenia genesis. Copyright © 2009 Elsevier Inc. All rights reserved.

  20. Critical Factors for Inducing Curved Somatosensory Saccades

    Directory of Open Access Journals (Sweden)

    Tamami Nakano

    2011-10-01

    Full Text Available We are able to make a saccade toward a tactile stimuli to one hand, but trajectories of many saccades curved markedly when the arms were crossed (Groh & Sparks, 2006. However, it remains unknown why some curved and others did not. We therefore examined critical factors for inducing the curved somatosensory saccades. Participants made a saccade as soon as possible from a central fixation point toward a tactile stimulus delivered to one of the two hands, and switched between arms-crossed and arms-uncrossed postures every 6 trials. Trajectories were generally straight when the arms were uncrossed, but all participants made curved saccades when the arms were crossed (12–64%. We found that the probability of curved saccades depended critically on the onset latency: the probability was less than 5% when the latency was larger than 250 ms, but the probability increased up to 70–80% when the onset latency was 160 ms. This relationship was shared across participants. The results suggest that a touch in the arms-crossed posture was always mapped to the wrong hand in the initial phase up to 160 ms, and then remapped to the correct hand during the next 100 ms by some fundamental neural mechanisms shared across participants.

  1. Malnutrition in Very Old Hospitalized Patients: A New Etiologic Factor of Anemia?

    Science.gov (United States)

    Frangos, E; Trombetti, A; Graf, C E; Lachat, V; Samaras, N; Vischer, U M; Zekry, D; Rizzoli, R; Herrmann, F R

    2016-01-01

    Anemia and malnutrition are highly prevalent, frequently concomitant and associated with negative outcomes and mortality in the elderly. To evaluate the association between these two entities, and test the hypothesis that protein-energy deficit could be etiology of anemia. Prospective case-control study. Geriatric and Rehabilitation Hospital, Geneva University Hospitals, Switzerland. 392 patients (mean age 84.8 years old, 68.6% female). Hematological (hemoglobin (Hb)), chemical (iron work up, cyanocobalamin, folates, renal function, C-Reactive Protein (CRP)) and nutrition (albumin, prealbumin) parameters, and mini nutritional assessment short form (MNA-SF). The prevalence of anemia (defined as Hbmalnutrition according to the MNA-SF (p=0.047), with lower serum albumin (p 10). Albumin levels are strongly associated with anemia in the elderly. Screening for undernutrition should be included in anemia assessment in those patients. Further prospective studies are warranted in order to explore the effect of protein and energy supplementation on hemoglobin level.

  2. Critical success factors in infrastructure projects

    Science.gov (United States)

    Zakaria, Siti Fairus; Zin, Rosli Mohamad; Mohamad, Ismail; Balubaid, Saeed; Mydin, Shaik Hussein; Mohd Rahim, E. M. Roodienyanto

    2017-11-01

    Construction of infrastructure project is different from buildings. The main difference is term of project site where infrastructure project need to command a long stretch while building mostly confine to a limited area. As such factors that are critical to infrastructure project may not be that significant to building project and vice versa. Flood mitigation can be classified under infrastructure projects under which their developments are planned by the government with the specific objective to reduce or avoid the negative effects of flood to the environment and livelihood. One of the indicators in project success is delay. The impact of project delay in construction industry is significant that it decelerates the projects implementation, specifically the government projects. This study attempted to identify and compare the success factors between infrastructure and building projects, as such comparison rarely found in the current literature. A model of flood mitigation projects' success factors was developed by merging the experts' views and reports from the existing literature. The experts' views were obtained from the responses to open-ended questions on the required fundamentals to achieve successful completion of flood mitigation projects. An affinity analysis was applied to these responses to develop the model. The developed model was then compared to the established success factors found in building project, extracted from the previous studies to identify the similarities and differences between the two models. This study would assist the government and construction players to become more effective in constructing successful flood mitigation projects for the future practice in a flood-prone country like Malaysia.

  3. Critical factors in the establishment of allopolyploids.

    Science.gov (United States)

    Fowler, Norma L; Levin, Donald A

    2016-07-01

    The growth and spread of new polyploid populations have been explained in terms of fitness advantages over their diploid progenitors. However, a fitness advantage is not sufficient to insure the establishment of a polyploid; it must also overcome the obstacles of demographic stochasticity and minority disadvantage. Several studies have addressed the population dynamics of autopolyploids, but the present study is the first to consider allopolyploids, which are affected by more factors than autopolyploids. We constructed a population dynamic model of four types of plants (two parent species, hybrids, allopolyploids) that also included an explicit breeding system. The numbers of plants of each type were the most important factors determining whether the new allopolyploid would become established. More polyploid plants greatly increased the likelihood of polyploid persistence. More plants of the parent species and more hybrids resulted in more polyploids being produced. The model parameters with the most effect on polyploid establishment were potential population size (K), individual plant fecundity, and niche separation (α). The most important breeding system parameters were selfing rates, which mitigated minority disadvantage imposed by pollen limitation. The importance of population sizes, and the parameters that controlled them, in overcoming demographic stochasticity parallels the well-recognized role of propagule pressure in determining the success of invasive species. We modeled the establishment of a new allopolyploid; analogous considerations would affect the establishment of a new autopolyploid. The critical role of population sizes in polyploid establishment should be more widely recognized. © 2016 Botanical Society of America.

  4. Investigating critical success factors in tile industry

    Directory of Open Access Journals (Sweden)

    Davood Salmani

    2014-04-01

    Full Text Available This paper presents an empirical investigation to determine critical success factors influencing the success of tile industry in Iran. The study designs a questionnaire in Likert scale, distributes it among some experts in tile industry. Using Pearson correlation test, the study has detected that there was a positive and meaningful relationship between marketing planning and the success of tile industry (r = 0.312 Sig. = 0.001. However, there is not any meaningful relationship between low cost production and success of tile industry (r = 0.13 Sig. = 0.12 and, there is a positive and meaningful relationship between organizational capabilities and success of tile industry (r = 0.635 Sig. = 0.000. Finally, our investigation states that technology and distributing systems also influence on the success of tile industry, positively. The study has also used five regression analyses where the success of tile industry was the dependent variable and marketing planning, low cost production and organizational capabilities are independent variables and the results have confirmed some positive and meaningful relationship between the successes of tile industry with all independent variables.

  5. Possible environmental, occupational, and other etiologic factors for Parkinson's disease: a case-control study in Germany.

    Science.gov (United States)

    Seidler, A; Hellenbrand, W; Robra, B P; Vieregge, P; Nischan, P; Joerg, J; Oertel, W H; Ulm, G; Schneider, E

    1996-05-01

    In a case-control study, we investigated the possible etiologic relevance to Parkinson's disease (PD) of rural factors such as farming activity, pesticide exposures, well-water drinking, and animal contacts; toxicologic exposures such as wood preservatives, heavy metals, and solvents; general anesthesia; head trauma; and differences in the intrauterine environment. We recruited 380 patients in nine German clinics, 379 neighborhood control subjects, and 376 regional control subjects in the largest case-control study investigating such factors and collected data in structured personal interviews using conditional logistic regression to control for educational status and cigarette smoking. The latter was strongly inversely associated with PD. There were significantly elevated odds ratios (OR) for pesticide use, in particular, for organochlorines and alkylated phosphates, but no association was present between PD and other rural factors. A significantly elevated OR was present for exposure to wood preservatives. Subjective assessment by the probands indicated that exposure to some heavy metals, solvents, exhaust fumes, and carbon monoxide was significantly more frequent among patients than control subjects, but this was not confirmed by a parallel assessment of job histories according to a job exposure matrix. Patients had undergone general anesthesia and suffered severe head trauma more often than control subjects, but a dose-response gradient was not present. Patients reported a significantly larger number of amalgam-filled teeth before their illness than control subjects. The frequency of premature births and birth order did not differ between patients and control subjects. Patients reported significantly more relatives affected with PD than control subjects. These results support a role for environmental and genetic factors in the etiology of PD.

  6. Trends in risk factors and etiology of 606 cases of infective endocarditis over 23 years (1984-2006) in slovakia.

    Science.gov (United States)

    Hricak, V; Liska, B; Kovackova, J; Mikusova, J; Fischer, V; Kovacik, J; Karvaj, M; Jurco, R; Ondrusova, A; Kalavsky, E; Marks, P; Beno, P; Krcmery, V

    2007-04-01

    The aim of this study was to assess trends in risk factors, etiology, outcome and treatment strategies for endocarditis over 23 years in Slovakia. A prospective survey of 606 cases of infective endocarditis (IE) was conducted from 1984-2006. Rheumatic fever as well as previous dental surgery showed decreasing trends within the last 23 years. Also embolic complications of IE declined along with increasing rates of surgically treated patients. No significant changes in etiology were detected apart from the fact that culture-negative endocarditis increased from 10.7% to 55.4% between 1998-2001. Surgically treated patients increased from 22.7% (1984-1990) to 50.1% (2002-2006) and mortality dramatically decreased from 26.7% (1984-1990) to 5.3% (2002-2006). Staphylococcus aureus and coagulase-negative staphylococci were the leading causes (22.4% - 48%) followed by viridans streptococci (12.2%-18.2%) were a relatively stable trend over 23 years of IE in Slovakia.

  7. Swimmer’s itch: etiology, impact, and risk factors in Europe

    Czech Academy of Sciences Publication Activity Database

    Soldánová, Miroslava; Selbach, C.; Kalbe, M.; Kostadinova, Aneta; Sures, B.

    2013-01-01

    Roč. 29, č. 2 (2013), s. 65-74 ISSN 1471-4922 R&D Projects: GA ČR GAP505/10/1562 Institutional support: RVO:60077344 Keywords : bird schistosomes * Trichobilharzia * swimmer's itch * Lymnaeidae * ecological factors * risk factors * Europe Subject RIV: EC - Immunology Impact factor: 6.217, year: 2013 http://www.sciencedirect.com/science/article/pii/S1471492212002000

  8. [Examination of the significance of psychological factors in the etiology of alopecia areata. I. Examining Type A behavior].

    Science.gov (United States)

    Wygledowska-Kania, M; Bogdanowski, T

    1995-01-01

    We tested the significance of psychic factors in the etiology of alopecia areata by means of the assessment of the Behaviour Pattern A (BPA)--a particular way of regulation of the relations between the individual and the environment, the basis of which is a great need for achievement in the individual who realizes this need by means of domination and aggressiveness. The testing was carried out by means of the Polish Questionnaire for the Assessment of the Behaviour Pattern A in adults. 60 patients were tested (31 women and 29 men). The results were compared with the normative groups described by Wrześniewski. The frequency of the occurrence of the Behaviour Pattern A in the tested patients may indicate the connection of this type of regulation of relations between the individual and the environment with the susceptibility to this disease.

  9. Arcanobacterium pyogenes: Virulence factors, importance in mastitis etiology and therapeutic (impossibilities

    Directory of Open Access Journals (Sweden)

    Milanov Dubravka

    2011-01-01

    Full Text Available Arcanobacterium pyogenes is an opportunistic pathogen, a causative agent of suppurative infections of organs and tissues in economically important livestock species. Most frequently this bacteria is isolated from inflamed lung lesions in pigs and cattle, in samples of uterine mucus of cows with endometritis and milk from cows with clinical mastitis. A. pyogenes possesses a number of virulence factors: cholesterol-dependent cytolysin (pyolysin, two neuraminidases, several proteases, extracellular matrix-binding proteins, DNases, fimbriae. The virulence factors are well studied in laboratory conditions, but the role of these factors in the pathogenesis of A. pyogenes infections remains to be elucidated. Lately, the ability of A. pyogenes to form biofilm in vivo has also been implicated as a virulence factor and a possible cause of therapeutic failure. Despite the fact that A. pyogenes milk isolates in cows with mastitis in vitro are very sensitive to β-lactam drugs and tetracycline, experience has shown that therapy is usually ineffective, prognosis is poor and the affected quarter is lost for milk production.

  10. Etiology, risk factors, epidemiology, and public health issues in melanoma and other cutaneous neoplasms

    International Nuclear Information System (INIS)

    Lee, J.A.

    1992-01-01

    The cytogenetic features of melanoma, including the contribution of specific genes, are beginning to be unraveled. Reproductive factors have been shown to have little relationship to melanoma. The puzzles over apparent systemic effects of exposure have persisted, however. Evidence was published that the history of reaction to sun exposure altered when a diagnosis of melanoma was made. An interesting suggestion was made that the classic melanoma risk factors are associated with promotion rather than initiation of the disease. There is further evidence that exposure decreases melanoma risk in people who tan well but increases it in those who do not. Also reviewed is the evidence that the ozone layer of the stratosphere began to decrease in thickness under the influence of the chlorofluorocarbon gases

  11. The interaction of genetic and environmental factors in the etiology of hypertension

    Czech Academy of Sciences Publication Activity Database

    Kuneš, Jaroslav; Zicha, Josef

    2009-01-01

    Roč. 58, Suppl.2 (2009), S33-S41 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GA305/08/0139; GA ČR(CZ) GA305/09/0336; GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : metabolic syndrome * hypertension * epigenetics Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.430, year: 2009

  12. Etiologies and contributing factors of perinatal mortality: A report from southeast of Iran

    Directory of Open Access Journals (Sweden)

    Maryam Hadavi

    2011-06-01

    Conclusion: Prematurity, cardiac arrest, and septicemia were the most important causes of neonatal mortality. It is concluded that attention to the following points is very important: adopting program for pregnancy care improvement, finding and removing risk factors of premature birth, control of infection in mother’s and newborn’s wards, examining of personnel skill about correct newborn resuscitation methods, and arrangement of training courses.

  13. Clinical manifestations of meningoencephalitis in HIV-positive patients depending on the etiological factor meningoencephalitis

    Directory of Open Access Journals (Sweden)

    A. I. Gozhenko

    2015-08-01

    Ukrainian Research Institute for Medicine of Transport, Odessa, Ukraine   Summary Authors analyzed of hospital charts a resume 132 patients of the Odessa regional center of fight and the prevention of AIDS which was on hospitalization with the diagnosis a meningoencephalitis. Causative agents of a meningoencephalitis were toxoplasmas, a cytomegalovirus, a cryptococcus, a mycobacteria of tuberculosis and not revealed agent. Authors established that irrespective of character of the activator development of a meningoencephalitis in HIV-positive people is characterized by a slow, sluggish current and a monotonous overall clinical picture. Some features connected with character of the activator take place at research of the neurologic status. Authors connect slackness and monotony of process with decrease general reactionary ability of an organism of HIV-infected, and feature of a neurologic picture with additional load on the brain structures to which affinity  causative agents of a meningoencephalitis. Keywords: HIV; meningoencephalitis; etiology; neurological status.     Резюме Авторы проанализировали данные историй болезни 132 больных Одесского областного центра борьбы и профилактики СПИДа, находившихся на стационарном лечении с диагнозом менингоэнцефалит. Возбудителями менингоэнцефалита были токсоплазмы, цитомегаловирус, криптококк, микобактерия туберкулеза. Авторы установили, что независимо от характера возбудителя развитие минингоэнцефалита у ВИЧ-позитивных людей характеризуется медленным, вялым течением и однообразной общей клинической к

  14. Critical role of environmental factors in the pathogenesis of psoriasis.

    Science.gov (United States)

    Zeng, Jinrong; Luo, Shuaihantian; Huang, Yumeng; Lu, Qianjin

    2017-08-01

    Psoriasis is a common cutaneous disease with multifactorial etiology including genetic and non-genetic factors, such as drugs, smoking, drinking, diet, infection and mental stress. Now, the role of the interaction between environmental factors and genetics are considered to be a main factor in the pathogenesis of psoriasis. However, it is a challenge to explore the mechanisms how the environmental factors break the body balance to affect the onset and development of psoriasis. In this article, we review the pathogenesis of psoriasis and summarize numerous clinical data to reveal the association between environmental factors and psoriasis. In addition, we focus on the mechanisms of environmental risk factors impact on psoriasis and provide a series of potential treatments against environmental risk factors. © 2017 Japanese Dermatological Association.

  15. Human papilloma virus: An etiological and prognostic factor for oral cancer?

    Science.gov (United States)

    Lafaurie, Gloria I; Perdomo, Sandra J; Buenahora, María R; Amaya, Sandra; Díaz-Báez, David

    2018-05-01

    The increasing prevalence of human papilloma virus (HPV)-positive oral tumors can be considered an epidemic. Although the incidence of HPV cervical cancer is decreasing, the incidence of oral cavity and oropharyngeal cancers associated with HPV is increasing. The presence of certain HPV genotypes could be a predictor of future oral cancer lesions, although lesions associated with HPV could be less aggressive and exhibit a higher survival rate. In the present study, we review the most important biologic, clinic, epidemiologic, and prognostic factors associated with HPV infection and oral cancer. © 2018 John Wiley & Sons Australia, Ltd.

  16. [Pediatric anesthesia emergence delirium after elective ambulatory surgery: etiology, risk factors and prevalence].

    Science.gov (United States)

    Gololobov, Alik; Todris, Liat; Berman, Yakov; Rosenberg-Gilad, Zipi; Schlaeffer, Pnina; Kenett, Ron; Ben-Jacob, Ron; Segal, Eran

    2015-04-01

    Emergence delirium (ED) is a common problem among children and adults recovering from general anesthesia after surgery. Its symptoms include psychomotor agitation, hallucinations, and aggressive behavior. The phenomenon, which is most probably an adverse effect of general anesthesia agents, harms the recovery process and endangers the physical safety of patients and their health. Ranging between 10% and 80%, the exact prevalence of ED is unknown, and the risk factors of the phenomenon are unclear. The aim of the current retrospective study was to determine the prevalence rate of ED in 3947 children recovering from general anesthesia after short elective ambulatory surgery, and to map the influence of various risk factors on this phenomenon. Data were collected using electronic medical records. ED severity was assessed using the Pediatric Anesthesia Emergence Delirium Scale. Results showed the prevalence of ED among children. ED was significantly correlated with patients' age, type of surgery and premedication. ED was not correlated with severity of pain, type of anesthesia or with patients' sex.

  17. Interactions Between Variation in Candidate Genes and Environmental Factors in the Etiology of Schizophrenia and Bipolar Disorder: a Systematic Review.

    Science.gov (United States)

    Misiak, Błażej; Stramecki, Filip; Gawęda, Łukasz; Prochwicz, Katarzyna; Sąsiadek, Maria M; Moustafa, Ahmed A; Frydecka, Dorota

    2017-08-18

    Schizophrenia and bipolar disorder (BD) are complex and multidimensional disorders with high heritability rates. The contribution of genetic factors to the etiology of these disorders is increasingly being recognized as the action of multiple risk variants with small effect sizes, which might explain only a minor part of susceptibility. On the other site, numerous environmental factors have been found to play an important role in their causality. Therefore, in recent years, several studies focused on gene × environment interactions that are believed to bridge the gap between genetic underpinnings and environmental insults. In this article, we performed a systematic review of studies investigating gene × environment interactions in BD and schizophrenia spectrum phenotypes. In the majority of studies from this field, interacting effects of variation in genes encoding catechol-O-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF), and FK506-binding protein 5 (FKBP5) have been explored. Almost consistently, these studies revealed that polymorphisms in COMT, BDNF, and FKBP5 genes might interact with early life stress and cannabis abuse or dependence, influencing various outcomes of schizophrenia spectrum disorders and BD. Other interactions still require further replication in larger clinical and non-clinical samples. In addition, future studies should address the direction of causality and potential mechanisms of the relationship between gene × environment interactions and various categories of outcomes in schizophrenia and BD.

  18. Diabetes Mellitus como causa de perda auditiva Diabetes mellitus as etiological factor of hearing loss

    Directory of Open Access Journals (Sweden)

    Clícia Adriana S. Maia

    2005-04-01

    Full Text Available Os pacientes com diabetes mellitus freqüentemente apresentam sintomas como tontura, zumbidos e hipoacusia. Via de regra, a perda auditiva é do tipo sensorioneural, confundindo-se, por vezes, com presbiacusia, principalmente por ocorrer em pacientes acima dos 40 anos de idade. A angiopatia e a neuropatia causadas pelo diabetes mellitus têm sido considerados importantes fatores responsáveis pelas manifestações vestibulococleares nesses pacientes. Porém, existe controvérsia no que se refere à etiopatogênese da perda auditiva, sendo que parte dos autores advoga que ela ocorre devido à neuropatia, outra parte à angiopatia, e outra, ainda, à associação das duas. Porém há também os que entendem que o diabetes mellitus e a perda auditiva poderiam ser partes integrantes de uma síndrome genética e não dependentes entre si. Realizamos uma extensa revisão bibliográfica procurando analisar se há relação "causa e efeito" entre o diabetes mellitus e a perda auditiva. Pudemos observar que, apesar do grande número de estudos realizados, a controvérsia ainda é grande, sendo que novas perspectivas, como no campo da genética, estão sendo estudadas, mostrando que novos rumos podem ser tomados para se chegar à conclusão do tema.Patients with diabetes mellitus often show symptoms such as dizziness, tinnitus, and hearing impairment. In general, hearing loss is sensorineural, which is sometimes confused with presbycusis, mainly because it develops in patients older than 40 years of age. Angiopathy and neuropathy caused by diabetes mellitus have been considered important factors for the vestibular-cochlear disorders found in these patients. However, there is controversy regarding the etiopathogenesis of hearing loss, as some researchers support that it develops due to neuropathy, others say it is due to angiopathy, or even a combination of both. Yet, some researchers believe diabetes mellitus and hearing loss are part of a genetic

  19. Critical Success Factors for IFRS Implementation

    DEFF Research Database (Denmark)

    Lønne, Henrik; Holm, Claus; Schøler, Finn

    n this paper we compare the implementation process to integrate IFRS in Ireland, Denmark and New Zealand and derive the critical succesfactors in capability to implement IFRS. The implementation phase is divided into three phases before, during and after the implementation process. The description......, it is essential to have a thorough and forward-looking debate and coordination between the legalislative authority, the administrating authority, the accounting profession and the stock exchange. During the implementation process it is vital that the accounting profession has become the right level of education...

  20. Physiopathology, Etiologic Factors, Diagnosis, and Course of Polycythemia Vera as Related to Therapy According to William Dameshek, 1940-1950

    Directory of Open Access Journals (Sweden)

    Jan Jacques Michiels

    2013-06-01

    Full Text Available According to Dameshek, true polycythemia (polycythemia vera: PV is a chronic myeloproliferative disorder of the total bone marrow without any evidence of invasiveness, in which erythrocytosis, leukocytosis, and thrombocytosis are all simultaneously present. A possible hereditary or transmitted tendency may be present, but actual familial polycythemia is rare. As to the etiology, Dameshek proposed 2 highly speculative possibilities in 1950: the presence of excessive bone marrow stimulation by an unknown factor or factors, and a lack or a diminution in the normal inhibitory factor or factors. Dameshek’s hypothesis was confirmed in 2005 by Vainchenker in France by the discovery of the acquired JAK2V617F mutation as the cause of 3 phenotypes of classical myeloproliferative neoplasms: essential thrombocythemia, PV, and myelofibrosis. The JAK2V617F mutation induces a loss of inhibitory activity of the JH2 pseudokinase part on the JH1 kinase part of Janus kinase 2 (JAK2. This leads to enhanced activity of the normal JH1 kinase activity of JAK2, which makes the mutated hematopoietic stem cells hypersensitive to the hematopoietic growth factors thrombopoietin, erythropoietin, insulin-like growth factor-1, stem cell factor, and granulocyte colony-stimulating factor, resulting in trilinear myeloproliferation. In retrospect, the situation observed by Dameshek where all “stops” to blood production in the bone marrow are pulled in PV is caused by the JAK2V617F mutation. Dameshek considered PV patients as fundamentally normal and therefore the treatment should be as physiologic as possible. For this reason, a systematic phlebotomy/iron deficiency method of treatment was recommended; the use of radioactive phosphorus is reserved for refractory cases and cases of major thrombosis. If the patient lives long enough and does not succumb to the effects of thrombosis or other complications, the marrow will gradually show signs of diminished activity. The blood

  1. Etiologies, Risk Factors and Impact of Severe Diarrhea in the Under-Fives in Moramanga and Antananarivo, Madagascar.

    Directory of Open Access Journals (Sweden)

    Rindra Vatosoa Randremanana

    Full Text Available Diarrheal disease remains a leading cause of death in children in low-income countries. We investigated the etiology, risk factors and effects on nutritional status of severe diarrhea in children from two districts in Madagascar.We performed a matched case-control study in 2011 to 2014, on children under the age of five years from Moramanga and Antananarivo. The cases were children hospitalized for severe diarrhea and the controls were children without diarrhea selected at random from the community. Stool samples were collected from both groups. Anthropometric measurements were made during follow-up visits about one and two months after enrolment.We enrolled 199 cases and 199 controls. Rotavirus infection was the most frequently detected cause of diarrhea. It was strongly associated with severe diarrhea (OR: 58.3; 95% CI: 7.7-439.9, accounting for 42.4% (95% CI: 37.6-43.1 of severe diarrhea cases. At the household level, possession of cattle (OR = 0.3; 95% CI: 0.1-0.6 and living in a house with electricity (OR = 0.4; 95% CI: 0.2-0.8 were protective factors. The presence of garbage around the house was a risk factor for severe diarrhea (OR = 3.2; 95% CI: 1.9-5.4. We found no significant association between severe diarrhea and the nutritional status of the children at follow-up visits, but evident wasting at enrolment was associated with a higher risk of severe diarrhea (OR = 9; 95% CI: 4.5-17.9.Severe childhood diarrhea is mostly caused by rotavirus infection. An anti-rotavirus vaccine has already been introduced in Madagascar and should be promoted more widely. However, post-licensing surveillance is required. Interventions to improve the nutritional status of children, preventive measures focused on household and personal hygiene and nutritional rehabilitation during severe diarrheal disease should be reinforced.

  2. Critical factors for EIA implementation: literature review and research options.

    Science.gov (United States)

    Zhang, Jie; Kørnøv, Lone; Christensen, Per

    2013-01-15

    After decades of development, the gap between expectations of Environment Impact Assessments (EIA) and their practical performance remains significant. Research has been done to identify the critical factors for an effective implementation of EIA. However, this research, to a large extent, has not been cumulated and analysed comprehensively according to the stages of the EIA process. This paper contributes to the critical review of the literature on EIA implementation and effectiveness by cumulating mainly empirical findings in an implementation theoretical perspective. It focuses on the links between different critical factors and how they relate to different stages in the EIA and thus influence the decision making process. After reviewing 33 refereed journal articles published between 1999 and 2011, we identified 203 notions of critical factors. Of these, 102 related to different stages defined in our comprehensive EIA implementation model, and 101 were identified as general factors related to the whole EIA system. The number of notions of stage factors and general factors is thus about equal. An overlap between stage factors and general factors was found, which demonstrates that critical factors function differently in different cases. The function of the critical factors is complex and it is difficult to determine contingencies and causations. In the sources we examined, there is evidently an imbalance between in-depth empirical research and general knowledge, and the paper offers some suggestions for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Etiology of Inguinal Hernias

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral...... and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared...... mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor....

  4. Critical factors in environmental impact assessment

    International Nuclear Information System (INIS)

    Creasey, R.

    1999-01-01

    Environmental impact assessment (EIA) has shown that it is of proven benefit to the overall planning and environmental management of resource development projects, but certain elements within the application and practice of EIA remain problematic for proponents and regulatory decision makers alike. The use of the word 'critical' in the title of this paper suggests that if the components identified are not considered or implemented properly through the process of EIA, the product will be of less value to both the proponent and decision maker. In the context of EIA, the regulatory, financial, legal and social benefits that accrue make the need for good EIA practice even more imperative. A discussion is included that highlights a number of issues that need to be addressed to improve the effectiveness of EIA, a tool necessary to attaining provincial and federal regulatory approvals. To a large extent, the discussion reflects items of contemporary public concern, and those emerging issues of the scientific and regulatory community. At the same time, it needs to be realized that not all the identified items are necessarily new to the practice of impact assessment, but are nonetheless important to professional environmental impact assessment and decision making. Insight is also provided into the direction of decision making of the Energy and Utilities Board as it will affect the regulatory review and administration of resource development projects in the province of Alberta. 16 refs

  5. Characterization of the etiological structure and genotypically determined phenotypic resistance to carbapenems of infectious complications leading pathogens in critically ill patients

    Directory of Open Access Journals (Sweden)

    O. A. Nazarchuk

    2018-06-01

    Full Text Available The aim is to investigate the genotypically determined phenotypic resistance to carbapenems of gram-negative microorganisms isolated from patients with critical states. Material and methods. Microbiological etiology of infectious complications in critically ill patients (n = 726 was investigated. In total, during the years 2011–2016, 933 clinical strains of infectious complications pathogens from patients with severe burns (n = 435 and from patients treated in intensive care units (n = 291 were isolated and identified. The sensitivity of microorganisms clinical isolates to antibiotics was investigated by means of the standard microbiological methods. In gram-negative bacteria resistant to carbapenems, a molecular genetic study of mechanisms of resistance, determined by the presence of VIM genes, was carried out using the method of real-time polymerase chain reaction. Results. Studies have shown that gram-negative microorganisms (Acinetobacter spp. – 36.3 %, P. aeruginosa – 31.7 %, Enterobacter spp. – 13.5 %, Proteus spp. – 7.9 %, E. coli – 3.8 %; K. pneumoniae – 3.6 %, etc. account for a significant part of infectious complications pathogens structure in critically ill patients. A. baumannii strains (67 % have expressed phenotypic resistance to most antibiotics, in particular to carbapenems (up to 63.2 %. Poly-antibiotic resistance was also found in P. aeruginosa (72 %, and above one the 3rd part of strains of this pathogen was found to have phenotypic resistance to carbapenems. In-depth study of molecular genetic determinants of the resistance mechanism to β-lactam antibiotics among clinical strains of gram-negative bacteria there was proved VIM-induced resistance to carbapenems in A. baumannii, P. aeruginosa, P. mirabilis. Conclusions. Enterobacteriaceae and non-fermenting gram-negative microorganisms (P. aeruginosa, P. mirabilis, A. baumannii, which are the leading causative agents of infectious complications in patients with

  6. "Actionable" critical success factors for supply chain information system implementations

    NARCIS (Netherlands)

    Denolf, Janne M.; Trienekens, Jacques H.; Nel Wognum, P.M.; Schütz, Verena; Vorst, Van Der Jack G.A.J.; Onno Omta, S.W.F.

    2018-01-01

    Implementing a supply chain information system (SCIS) incurs organizational and technical complexities. For managing these complexities, information system researchers have identified generic critical success factors. However, CSFs are abstract and, therefore, difficult to use in practice. To

  7. Determining critical success factor of it project management and its ...

    African Journals Online (AJOL)

    Determining critical success factor of it project management and its influence towards the ... Journal of Fundamental and Applied Sciences ... respondents who have background in IT management in both public and private sector to gain ...

  8. Advanced Manufacturing Technology Implementation Process in SME: Critical Success Factors

    Directory of Open Access Journals (Sweden)

    Jani Rahardjo

    2010-01-01

    Full Text Available The aim of this paper is to present critical factors that constitute a successful implementation of the Advanced Manufacturing Technologies (AMT in Small Medium Enterprise (SME. Many large companies have applied AMT and the applications have shown significant results in this global market era. Conveniently, these phenomenons are also engaged to Small Medium Enterprises (SME that of high demands on performing high quality product, fast delivery, reliable and more flexible. The implementation of AMT follow several processes namely pre installation, installation, improvement and mature. In order to guarantee the succesfull of running these processes, one should consider the Critical Success Factors (CSF. We conducted a survey to 125 SMEs that have implemented AMT, and found that the CSF for each process are moderately different. Good leadership is the main critical success factor for preparing and installation of the AMT. Once the AMT started or installed and arrived at growth stage, the financial availability factor turns into a critical success factor in the AMT implementation. In, mature stage, the support and commitment of top management becomes an important factor for gaining successful implementation. By means of factor analysis, we could point out that strategic factors are the main factors in pre-installation and installation stage. Finally, in the growth stage and mature stage, both tactical and strategic factors are the important factors in the successful of AMT implementation

  9. Periodontal and periimplant maintenance: a critical factor in long-term treatment success.

    Science.gov (United States)

    Shumaker, Nicholas D; Metcalf, Brett T; Toscano, Nicholas T; Holtzclaw, Dan J

    2009-09-01

    Periodontal maintenance (PM) is a critical factor in the long-term success of both periodontal and dental implant therapy. Studies have shown both modern periodontal and dental implant therapies are effective in maintaining natural teeth and replacing lost teeth, respectively. However, without a regular program of clinical reevaluation, plaque control, oral hygiene instruction, and reassessment of biomechanical factors, the benefits of treatment often are lost and inflammatory disease in the form of recurrent periodontitis or periimplantitis may result. This article reviews the goals, types, and appropriate frequency of PM in periodontal and dental implant therapy, as well as the incidence and etiology of periimplant disease and strategies for management when recurrent disease develops during the maintenance phase of treatment.

  10. Critical Success Factors for Limited Service Hotels in Malaysia

    OpenAIRE

    Wong, Chee Keng

    2015-01-01

    Critical success factors were used originally in Information technology areas when it was first introduced but has since been applied generically in other industries. This study explores the critical success factors for limited service hotels in Malaysia from both customer and hotel operator/ business owners’ perspective. The literature presents information from tourism in general and in Malaysia, definition of limited service hotels and its relevance to the hospitality industry in Malaysia, ...

  11. Incidence, Etiology and Risk Factors for Travelers' Diarrhea during a Hospital Ship-Based Military Humanitarian Mission: Continuing Promise 2011.

    Directory of Open Access Journals (Sweden)

    Jessica M Hameed

    Full Text Available Travelers' diarrhea (TD is the most common ailment affecting travelers, including deployed U.S. military. Continuing Promise 2011 was a 5-month humanitarian assistance/disaster response (HA/DR military and non-governmental organization training mission aboard the hospital ship USNS Comfort, which deployed to Central and South America and the Caribbean between April and September 2011. Enhanced TD surveillance was undertaken during this mission for public health purposes. Passive surveillance (clinic visits, active surveillance (self-reported questionnaires, and stool samples were collected weekly from shipboard personnel. Descriptive statistics and multivariate-logistic regression methods were used to estimate disease burden and risk factor identification. Two polymerase chain reaction methods on frozen stool were used for microbiological identification. TD was the primary complaint for all clinic visits (20% and the leading cause of lost duties days due to bed rest confinement (62%, though underreported, as the active self-reported incidence was 3.5 times higher than the passive clinic-reported incidence. Vomiting (p = 0.002, feeling lightheaded or weak (p = 0.005, and being a food handler (p = 0.017 were associated with increased odds of lost duty days. Thirty-eight percent of self-reported cases reported some amount of performance impact. Based on the epidemiological curve, country of exercise and liberty appeared to be temporally associated with increased risk. From the weekly self-reported questionnaire risk factor analysis, eating off ship in the prior week was strongly associated (adjusted odds ratio [OR] 2.4, p<0.001. Consumption of seafood increased risk (aOR 1.7, p = 0.03, though consumption of ice appeared protective (aOR 0.3, p = 0.01. Etiology was bacterial (48%, with enterotoxigenic Escherichia coli as the predominant pathogen (35%. Norovirus was identified as a sole pathogen in 12%, though found as a copathogen in an additional 6

  12. Stakeholders' perception of critical success factors for sustainable ...

    African Journals Online (AJOL)

    interval' and 'adherence to the tenets of the SD agenda (supply chain)' were selected as most critical of the success factors identified. It is expected that the study's findings will contribute to the development of a viable SFM strategy in SSA universities. Keywords: Facilities management, sub-Saharan Africa, success factors, ...

  13. Critical Success Factors for On-Line Course Resources.

    Science.gov (United States)

    Soong, M. H. Benson; Chan, Hock Chuan; Chua, Boon Chai; Loh, Koah Fong

    2001-01-01

    Describes a multiple case study that was used to evaluate hypotheses on the critical success factors for online course resources in a Singapore tertiary setting. Discusses educational media; human factors pertaining to instructors; technical competency of students and instructors; mindsets about learning; collaboration; and information technology…

  14. Epidemiologic study of neural tube defects in Los Angeles County. II. Etiologic factors in an area with low prevalence at birth

    Energy Technology Data Exchange (ETDEWEB)

    Sever, L.E.

    1982-01-01

    Epidemiologic characteristics of neural tube defect (NTD) births occurring in Los Angeles County, California, residents during the period 1966-1972 are presented. The prevalence at birth was 0.52/1000 births for anencephalus, 0.51/1000 for spina bifida, and 0.08/1000 for encephalocele, rates considered to be low for a predominantly white population. We hypothesized that environmental (nongenetic) factors are of less etiologic importance in a low-prevalence population than in areas or time periods with high prevalence. We tested that hypothesis by examining epidemiologic characteristics of NTDs in Los Angeles County and comparing them with high-prevalence populations. The data did not support a major etiologic role for environmental factors: (1) no significant differences between rates by month of birth or conception; (2) no significant association with maternal age or parity for anencephalus; for spina bifida a significant maternal age effect (P < 0.01) and for encephalocele a parity effect (P < 0.02); and (3) no significant relationship with father's occupational class for either anencephalus or encephalocele but a marginally significant (P < 0.05) inverse association for spina bifida when a statistic based on ordinal relationships was used. Findings supporting the importance of genetic factors in etiology included: (1) a high percentage of males; (2) a higher twin concordance rate than in high-prevalence populations; and (3) an anencephalus rate among blacks comparable with rates for blacks in other United States populations. Our findings in conjunction with those from other areas and times of low prevalence suggest environmental factors play a relatively insignificant role in the etiology of NTDs in such populations.

  15. Parachors in terms of critical temperature, critical pressure and acentric factor

    Energy Technology Data Exchange (ETDEWEB)

    Broseta, D.; Ragil, K.

    1995-12-31

    The method of parachors is widely used in conventional thermodynamic codes and reservoir simulators to calculate oil/gas interfacial tensions of complex hydrocarbon mixtures. In the low-to-moderate interfacial tension regime, a value p{approx}11/3 has previously been shown to be the {open_quotes}best{close_quotes} parachor exponent. This exponent is a critical exponent and its value is consistent with the values of critical exponents characterizing the liquid/vapor critical behavior. Therefore parachors may be viewed as critical amplitudes. By using critical scaling theory, parachors are related to other critical amplitudes and critical parameters that describe the bulk thermodynamic behavior of fluids. A simple expression relating the parachor of a pure compound to its critical temperature T{sub c}, critical pressure P{sub c}, and acentric factor {omega} is proposed: P= (0.85-0.19{omega})T{sub c}{sup 12/11}/P{sub c}{sup 9/11} where the parachor P is in units of (dyn/cm){sup 3/11}cm{sup 3}/mol, T{sub c} in K and P{sub c} in MPa. This equation matches (within experimental error) the known parachor values of normal fluids (e.g. alkanes, aromatics, CO{sub 2}, N{sub 2}, H{sub 2}S, etc...).

  16. Compression etiology in tendinopathy.

    Science.gov (United States)

    Almekinders, Louis C; Weinhold, Paul S; Maffulli, Nicola

    2003-10-01

    Recent studies have emphasized that the etiology of tendinopathy is not as simple as was once thought. The etiology is likely to be multifactorial. Etiologic factors may include some of the traditional factors such as overuse, inflexibility, and equipment problems; however, other factors need to be considered as well, such as age-related tendon degeneration and biomechanical considerations as outlined in this article. More research is needed to determine the significance of stress-shielding and compression in tendinopathy. If they are confirmed to play a role, this finding may significantly alter our approach in both prevention and in treatment through exercise therapy. The current biomechanical studies indicate that certain joint positions are more likely to place tensile stress on the area of the tendon commonly affected by tendinopathy. These joint positions seem to be different than the traditional positions for stretching exercises used for prevention and rehabilitation of tendinopathic conditions. Incorporation of different joint positions during stretching exercises may exert more uniform, controlled tensile stress on these affected areas of the tendon and avoid stresshielding. These exercises may be able to better maintain the mechanical strength of that region of the tendon and thereby avoid injury. Alternatively, they could more uniformly stress a healing area of the tendon in a controlled manner, and thereby stimulate healing once an injury has occurred. Additional work will have to prove if a change in rehabilitation exercises is more efficacious that current techniques.

  17. Critical Success Factors and information needs in Estonian industry

    Directory of Open Access Journals (Sweden)

    Aiki Tibar

    2002-01-01

    Full Text Available The article reports the results of the study on the critical success factors and related information needs in Estonian industry conducted in 1999. Data were collected by interviews with 27 managers and engineers from 16 manufacturing companies in various industries. Most of the critical success factors taken up were related to marketing, information management, quality management, product development and technological innovations. The information needs of managers and engineers were related to competitors, customers, markets, technology, regulations, etc. Some identified CSFs expressed also priorities for development by Estonian economic authorities: to support the implementation of new technologies and introduction of quality management methods. The finding that information management was perceived as a very critical area supports the result of the recent Finnish study on CSFs.

  18. Pareto analysis of critical factors affecting technical institution evaluation

    Directory of Open Access Journals (Sweden)

    Victor Gambhir

    2012-08-01

    Full Text Available With the change of education policy in 1991, more and more technical institutions are being set up in India. Some of these institutions provide quality education, but others are merely concentrating on quantity. These stakeholders are in a state of confusion about decision to select the best institute for their higher educational studies. Although various agencies including print media provide ranking of these institutions every year, but their results are controversial and biased. In this paper, the authors have made an endeavor to find the critical factors for technical institution evaluation from literature survey. A Pareto analysis has also been performed to find the intensity of these critical factors in evaluation. This will not only help the stake holders in taking right decisions but will also help the management of institutions in benchmarking for identifying the most important critical areas to improve the existing system. This will in turn help Indian economy.

  19. Critical Factors in Mobile Learning: A Quasi-Systematic Review

    Science.gov (United States)

    Rodrigues, Sergio Assis; dos Santos, Rodrigo Pereira; Arnaud, Lucas; de Souza, Jano Moreira

    2013-01-01

    The advance of mobile industry and research has expanded e-learning in order to support an efficient and effective educational process. However, the promised benefits are as much attractive as the existing difficulties and barriers. In this paper, we intend to identify and summarize the critical factors in mobile learning through a…

  20. Critical Factors in Data Governance for Learning Analytics

    Science.gov (United States)

    Elouazizi, Noureddine

    2014-01-01

    This paper identifies some of the main challenges of data governance modelling in the context of learning analytics for higher education institutions, and discusses the critical factors for designing data governance models for learning analytics. It identifies three fundamental common challenges that cut across any learning analytics data…

  1. Critical Success Factors for Franchised Restaurants Entering the Kenyan Market

    OpenAIRE

    Lucy Gikonyo; Adele Berndt; Joseph Wadawi

    2015-01-01

    In today’s globalized world, businesses look to expand to have a global presence. Restaurant businesses have expanded internationally using franchising. This study sought to determine the critical success factors (CSFs) of a franchised restaurant system entering the Kenyan market from the franchisors’ perspective. It sought to establish how franchisors define, identify, and evaluate success. This study provides a theor...

  2. Critical Success Factors in a High School Healthcare Education Program

    Science.gov (United States)

    Thessin, Rebecca A.; Scully-Russ, Ellen; Lieberman, Daina S.

    2017-01-01

    Research has demonstrated career and technical education (CTE) programs have a strong positive influence on secondary students' behavior, attendance, academic achievement, and college persistence. Critical success factors common to career academies, small schools, and CTE programs include socio-emotional support and community, along with a culture…

  3. African-Canadian Educators' Perspectives: Critical Factors for Success

    Science.gov (United States)

    Finlayson, Maureen

    2011-01-01

    This study investigates the perspectives of African-Canadian educators on critical factors for success in their educational careers. Interviews were conducted and life histories were constructed to analyze the complex and multifaceted nature of the experiences of ten African-Canadian educators. These data indicate that family and community…

  4. Implementation of critical success factors in construction research ...

    African Journals Online (AJOL)

    Construction research and development (R&D) process has a number of issues that affect its success. These issues imply that Critical Success Factors (CSFs) of construction R&D process are not properly addressed. Not knowing CSFs could lead to not implementing them and not paying proper attention for them. The study ...

  5. Surveying the critical success factors of BPM-systems implementation.

    NARCIS (Netherlands)

    Ravesteyn, P.; Batenburg, R.

    2010-01-01

    Purpose – The purpose of this paper is to explore if there is a common ground for the definition of business process management (BPM) and BPM-systems, as well as the critical success factors (CSFs) for BPM-system implementation. A BPM-system implementation framework is validated that classifies the

  6. CRITICAL SUCCESS FACTORS FOR INFRASTRUCTURE EUROPEAN FUNDED PROJECTS

    Directory of Open Access Journals (Sweden)

    Sebastian-Ion Ceptureanu

    2016-07-01

    Full Text Available Absorption of European funds is on top of Romania’s public agenda for the last years although the first programming period has ended and the necessary lessons were learned so far. To have a high degree of absorption of funds provided by the EU must be of quality projects and their implementation to be successful. Through this work we aimed to investigate the success factors of infrastructure projects with European funding in Romania, Bulgaria, Moldova, Ukraine, Serbia and Kosovo, and identify critical success factors of these projects through a research surveying the teams of consultants and support personnel from the countries in an international consulting company. The research results are therefore constitute the empirical evidence of what constitutes critical success factors of infrastructure projects financed by the European Union and can be used as a starting point for scientific studies of the management of European projects or other actions that investigates measures that can be taken to improve the success rate of projects implemented in the area mentioned above.One of the contributions of this paper is to identify the critical success factors of success factors present in literature. With more so as they are critical success factors of infrastructure projects with European funding still required field studies and analysis performed in the present context. In addition, the critical factors were operationalized in a conceptual framework. Moreover, this framework includes leadership style of project manager as critical success factor has been identified in the research as the most important in the context in which it was conducted. As such, this paper demonstrates, with the necessary limitations, the importance of management style of project managers in the context of specific European funded infrastructure projects. And this is happening even though there are sophisticated project management tools availabe and relevant knowledge exists

  7. RESILIENCE AS A CRITICAL SUCCESS FACTOR OF RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Angela BELOBROV

    2014-06-01

    Full Text Available All the economical entities operate in a complex economic environment marked by economic crisis and stressed the growing dynamism in terms of intensifying competition. In our opinion, changing the environment and enhancing the uncertainty is due to the existence of a number of factors that act as "mutagen" that have the ability to produce mutations environment with a higher frequency of spontaneous mutations. Analysis allows outlining the main factors influencing management approach necessary to increase efficiency and competitiveness of all of this. A proposed solution is to recognize the resilience as a Critical Success Factors for improve risk management.

  8. Validation of the bipolar disorder etiology scale based on psychological behaviorism theory and factors related to the onset of bipolar disorder.

    Directory of Open Access Journals (Sweden)

    Jae Woo Park

    Full Text Available OBJECTIVES: The aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD. To do so, the Bipolar Disorder Etiology Scale (BDES, based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD and BD and specific factors related only to BD were investigated. METHOD: The BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors. RESULTS: The BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response. CONCLUSIONS: Manic emotional response was identified as a specific factor related to the onset of BD, while parents' grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.

  9. Validation of the bipolar disorder etiology scale based on psychological behaviorism theory and factors related to the onset of bipolar disorder.

    Science.gov (United States)

    Park, Jae Woo; Park, Kee Hwan

    2014-01-01

    The aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD). To do so, the Bipolar Disorder Etiology Scale (BDES), based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD) and BD and specific factors related only to BD were investigated. The BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors. The BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response. Manic emotional response was identified as a specific factor related to the onset of BD, while parents' grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.

  10. Critical factors for the recovery of marine mammals.

    Science.gov (United States)

    Lotze, Heike K; Flemming, Joanna Mills; Magera, Anna M

    2017-12-01

    {en} Over the past decades, much research has focused on understanding the critical factors for marine extinctions with the aim of preventing further species losses in the oceans. Although conservation and management strategies are enabling several species and populations to recover, others remain at low abundance levels or continue to decline. To understand these discrepancies, we used a published database on abundance trends of 137 populations of marine mammals worldwide and compiled data on 28 potentially critical factors for recovery. We then applied random forests and additive mixed models to determine which intrinsic and extrinsic factors are critical for the recovery of marine mammals. A mix of life-history characteristics, ecological traits, phylogenetic relatedness, population size, geographic range, human impacts, and management efforts explained why populations recovered or not. Consistently, species with lower age at maturity and intermediate habitat area were more likely to recover, which is consistent with life-history and ecological theory. Body size, trophic level, social interactions, dominant habitat, ocean basin, and habitat disturbance also explained some differences in recovery patterns. Overall, a variety of intrinsic and extrinsic factors were important for species' recovery, pointing to cumulative effects. Our results provide insight for improving conservation and management strategies to enhance recoveries in the future. © 2017 Society for Conservation Biology.

  11. A survey on critical factors influencing organizational commitment

    Directory of Open Access Journals (Sweden)

    Hamidreza Kheirkhah

    2014-04-01

    Full Text Available Organizational commitment is an important issue and organization attitude has become an area of study among many researchers in the fields of organizational behavior. In fact, there are many studies on human resource management where the effects of organizational commitment on other issues have been investigated and the purpose of this research is to find critical factors influencing on organizational commitment. Based on an exploration of the literature review and interviews, the proposed study of this paper extracts 24 variables and using factor analysis, we select the most important factors, which are grouped in four categories. The implementation of our factor analysis has revealed Affective commitment, Continuous commitment, Moral commitment and Enduring commitment are the most important factors influencing organizational commitment.

  12. A survey on critical factors influencing agricultural insurance

    Directory of Open Access Journals (Sweden)

    Ali Valipour

    2013-01-01

    Full Text Available Agricultural business is a very high-risk job and an increase demand for agricultural products from one side and steady increase in production cost and weather changes, on the other side, have motivated many to use insurance for agricultural products. Insurance plays an important role in influencing crop production and insured satisfaction or farmers. The purpose of this research is to find critical components in agricultural insurance. Based on an exploration of the literature review and interviews, the proposed study of this paper extracts 24 variables and using factor analysis, we select the most important factors, which are grouped in seven categories. The implementation of our factor analysis has revealed uncertainty, moderator, market equilibrium, risky environment, empowering factor, education, training, structural hazards and natural ecosystems as the most important factors influencing agricultural industry.

  13. Six Sigma: Problems, Limitations, Critical Success Factors and Future Prospects

    Directory of Open Access Journals (Sweden)

    Paulo Mazieiro Pohlmann

    2015-12-01

    Full Text Available Six Sigma is a business strategy based on objective decision making and problem solving in order to achieve, maintain and maximize business success through understanding and meeting the needs of customers. The visualization of this methodology as a powerful tool in reducing variability and improving quality led to the interest in performing this bibliographical study, whose purpose was to assess the critical success factors and future prospects of this managerial system. A survey was conducted in order to discover the main critical success factors of the implementation of the methodology in organizations, among which stood out the proper selection of projects, connecting the project with the business strategy, customer focus, financial, human and infrastructure resources, the involvement of senior management, professional training, and cultural change.

  14. Etiological factors and clinical profile of adhesive capsulitis in patients seen at the Rheumatology clinic of a tertiary care hospital in India

    International Nuclear Information System (INIS)

    Rauoof, Malik A.; Lone, Nazir A.; Bhat, Bashir A.; Habib, Shahida

    2004-01-01

    This study was conducted to examine the clinical profile of patients with adhesive capsulitis (AC) and evaluate various possible etiological factors. The study was conducted in the Department of Physical Medicine and Rehabilitation, Sher-I-Kashmir Institute of Medical Sciences, Soure, Srinagar, Kashmir, India.100 patients fulfilling the criteria for the diagnosis of AC were studied for the severirty of shoulder pain and range of shoulder movements, The patients were also examined for the presence of various etiological factors for AC. Age of the subjects ranged from 25-70 years and duration of symptoms averaged 3.66+-2.36 months; left shoulder was more commonly involved (54%), 2% had bilateral involvement and 63% of subject were sedentary workers. Disease was seen most commonly in patients with diabetes mellitus (27%). Other identifiable risk factors included previous myocardial infarction (5%), immobilization (5%), stroke and chronic bronchitis (4%) each. 56% of the patients with AC had radiological evidence of cervical spondylisis. We conclude that AC mostly affects people in the 5-7 decade. The majority of the affected individuals are sedentary at time of sickness and the subjects with diabetes mellitus are the particular risk. (author)

  15. Critical success factors for implementing healthcare e-Learning.

    Science.gov (United States)

    Lee, Te-Shu; Kuo, Mu-Hsing; Borycki, Elizabeth M; Yunyong, David

    2011-01-01

    The use of e-Learning in educational institutes has rapidly increased along with the development of information and communication technology (ICT). In healthcare, more medical educators are using e-Learning to support their curriculum design, delivery and evaluation. However, no systematic work exists on characterizing a collective set of Critical Success Factors (CSFs) for implementing e-Learning in the healthcare education institutions. The aim of this paper is to study the CSFs of implementing healthcare e-Learning.

  16. Determining organizational information needs: the Critical Success Factors approach.

    Directory of Open Access Journals (Sweden)

    2001-01-01

    Full Text Available Reports on a series of investigations in the UK and Finland, in both academic and business institutions. The Critical Success Factors approach is defined and explored as a means of determining the information needs of organizations, rather than of individuals. Concludes that such use is appropriate and productive, enabling the identification of types of information that may aid the organization in its strategic policy making to achieve competitive advantage.

  17. Critical success factors for competitiveness of construction companies: A critical review

    Science.gov (United States)

    Hanafi, Abdul Ghafur; Nawi, Mohd Nasrun Mohd

    2016-08-01

    Making progress basically, a fundamental issue for the construction companies to get by in a highly competitive industry. From time to time, industry players are facing stiff and tough competition due to large number of players, whether existing or new players involved from various background and track record. Furthermore, the large numbers of component deciding the competitiveness of contractors, whose organization structures and governance have turned out to be more muddled. Different construction companies have their own unique criteria which may differ from one to another. The enormous amount of issues needs to bring down to manageable numbers so that measures can be identified and scrutinized to enhance competitiveness. This paper discusses the result from the critical investigation from past studies in the Asian countries, namely China, India, Thailand, Singapore and Malaysia. Several fundamental factors have been identified as CSFs in construction companies in respective country. Also highlighted a critical survey based upon various literatures written on this subject where critical success factors (CSFs) as a yardstick to gauge the relationship among CSFs in various construction companies in the Asian region. Far reaching estimation of an organization's performance and resulting input to its supervision is crucial for business change. Estimation additionally empowers organizations to be contrasted from one another on the premise of institutionalized data, permitting best practices to be distinguished and connected more widely. Different countries have their own set of critical success factors (CSFs) which may differ in term of priority and at the same time share common elements of success factor in accomplishment as a construction companies. The study, which is exploratory in nature, embraced the content investigation and inductive technique to accomplish its objectives.

  18. Peculiarities in cases of spina bifida cystica managed recently in south-east Nigeria: could antimalarial drugs be a major but unrecognized etiologic factor?

    Science.gov (United States)

    Emejulu, Jude-Kennedy C; Okwaraoha, Blaise Ogedi

    2011-01-01

    Spina bifida is a long-known disease arising from the incomplete fusion of the caudal neuropore in the first month of intrauterine life. It is thought to have a multifactorial etiology, the most important of which is folic acid deficiency. In evaluating its etiology, the role of antifolate agents like antimalarial drugs is rarely given a strong mention. This is a 44-month prospective study of consecutive cases of spina bifida cystica presenting to the Neurosurgery Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, South-East Nigeria. Data collection was with a structured proforma from presentation, and collation done with Microsoft Excel broadsheet and data analysis with SPSS and χ2 test. A total of 41 cases of spina bifida were attended to within the period, with 92.7% cases of spina bifida cystica. Most presented by >12-24 months, with a consistent history of maternal ingestion of antimalarial drugs during the first trimester of pregnancy. Spina bifida cystica was diagnosed mostly in children whose mothers ingested antimalarial drugs during the first trimester of gestation. There may be a need to critically evaluate the contribution of antimalarial drugs to the etiopathogenesis of this malformation and develop safer antimalarial treatment in pregnancy. Copyright © 2012 S. Karger AG, Basel.

  19. Critical factors for sustainable food procurement in zoological collections.

    Science.gov (United States)

    Hanson, Jonathan H

    2015-01-01

    Food procurement can play an important role in sustainable food supply chain management by zoos, linking organizational operations to the biodiversity conservation and sustainability mission of zoological collections. This study therefore examines the critical factors that shape sustainable food procurement in zoo and aquariums. Using a web-based survey data was collected from 41 members of the British and Irish Association of Zoos and Aquariums (BIAZA). This included information on the sustainable food procurement practices of these institutions for both their human and animal food supply chains, as well as profile information and data on the factors contributing to and inhibiting sustainable procurement practices. Zoological collections operated by charities, and those with a certified sustainability standard, were found to have significantly higher levels of sustainable food procurement. Zoos and aquariums whose human food operations were not contracted to an external party were also found to have significantly higher levels of sustainable food procurement in their human food supply chain. The most important drivers of sustainable food procurement were cost savings, adequate financial support and improved product quality. The highest ranking barriers were higher costs, other issues taking priority and a lack of alternative suppliers. The results suggest that a number of critical factors shape sustainable food procurement in zoological collections in the British Isles. Financial factors, such as cost savings, were important considerations. The significance of mission-related factors, such as charity status, indicated that core values held by zoos and aquariums can also influence their food procurement practices. © 2015 Wiley Periodicals, Inc.

  20. Six sigma critical success factors in manufacturing industries

    Science.gov (United States)

    Mustafa, Zainol; Jamaluddin, Z.

    2017-04-01

    The success of Six Sigma implementation is known to depend on a number of contributing factors. The purpose of this paper is to explore Six Sigma critical success factors (CSFs) in the context of Malaysian manufacturing organizations. Although Six Sigma success factors have been abundantly researched in the global context, in this paper, a maiden attempt is made to identify, through an extensive literature review, the CSFs for Six Sigma implementation followed by their validation using primary data collection from Malaysian manufacturing companies. A total of 33 indicators have thus been compiled through an extensive literature review which then been grouped into 6 contributing factors. These contributing success factors are then validated through an empirical research of selected Malaysian manufacturing companies at various stages of implementation of the Six Sigma process improvement methodology. There has been an overemphasis on the role and commitment of the management in the success of a Six Sigma program. Though it is undoubted, certain other factors also play an equally important role in ensuring that the Six Sigma programs are successful. The factor analysis of CSFs of the Malaysian manufacturing organizations selected in this study demonstrates that the top factor is a composite factor showing combination of the ability of the project teams to use the process management on quality initiative and a training using a proper analysis in problem solving. The CSFs extracted through the factor analysis could provide a basis for manufacturing organizations embarking on the Six Sigma journey to look beyond just management involvement. Thus, one can develop an integrated framework of other factors as outlined and give them appropriate priority and focus.

  1. Critical success factors in implementing clinical pathways/case management.

    Science.gov (United States)

    Choo, J

    2001-07-01

    With the advent of casemix reimbursement implementation, rapid technological changes, an ageing population and changing consumer behaviour, the Singapore health care industry is faced with the impetus to provide a cost-effective and efficient care delivery system. One ubiquitous tool used is the establishment of a clinical pathway/case management programme within the hospital. As the concept of clinical pathway for patient care is a relatively new concept in Singapore, several critical factors must be considered to ensure successful implementation of clinical pathway/case management programme. One key success factor lies in continued clinician support and acceptance. Other factors include top management leadership and support and a dedicated team of case managers, nurses and paramedical professionals.

  2. TECHNIQUES AND FACTORS CONTRIBUTING TO DEVELOPING CRITICAL THINKING SKILLS

    Directory of Open Access Journals (Sweden)

    Irina Vladimirovna Glukhova

    2015-01-01

    Full Text Available The paper deals with the issue of working out and introduction in educational process of higher educational institutions of the innovative technology for developing skills of critical thinking skills of the future specialists. Research is aimed at revealing of the factors promoting formation of students’ critical thinking in high schools; the search of strategy and the receptions actualizing creative abilities of students and helping to formation of an active, independent person. The author gives the reasoned proving that it’s necessary to set up the creative educational environment and adjustment of positive dialogue between the teacher and the trainee for education of such person, development of abilities of an objective reflection, interpretation of the phenomena, formulations of adequate conclusions, well-founded evaluating. Methods. The methods involve the analysis of the philosophical, psychology-pedagogical, methodical literature and the scientific periodical publications; generalisation of the Russian and foreign background, classification and arrangement of the considered issues, supervision. Results. Current approaches to the rendering of critical thinking and a problem of its formation in the scientific literature are considered; the concept «the creative educational environment» is specified; the ways of increasing the educational process efficiency are shown. Scientific novelty. The complex of procedures and the conditions promoting effective development of critical thinking skills is theoretically proved on the basis of the analysis of various information sources. Practical significance. The research outcomes and the recommended methods of critical thinking skills formation can be useful for the professors and lecturers of higher education institutions to optimize subject matter selection, techniques and methods of education under the conditions of dynamically updated educational process. 

  3. Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka.

    Science.gov (United States)

    Senevirathna, Lalantha; Abeysekera, Tilak; Nanayakkara, Shanika; Chandrajith, Rohana; Ratnatunga, Neelakanthi; Harada, Kouji H; Hitomi, Toshiaki; Komiya, Toshiyuki; Muso, Eri; Koizumi, Akio

    2012-05-01

    The alarming rise in the prevalence of chronic kidney disease of uncertain etiology (CKDu) among the low socioeconomic farming community in the North Central Province of Sri Lanka has been recognized as an emerging public health issue in the country. This study sought to determine the possible factors associated with the progression and mortality of CKDu. The study utilized a single-center cohort registered in 2003 and followed up until 2009 in a regional clinic in the endemic region, and used a Cox proportional hazards model. We repeatedly found an association between disease progression and hypertension. Men were at higher risk of CKDu than women. A significant proportion of the patients in this cohort were underweight, which emphasized the need for future studies on the nutritional status of these patients. Compared with findings in western countries and other regions of Asia, we identified hypertension as a major risk factor for progression of CKDu in this cohort.

  4. Etiological aspects of double monsters.

    Science.gov (United States)

    Jaschevatzky, O E; Goldman, B; Kampf, D; Wexler, H; Grünstein, S

    1980-06-01

    Four cases of double monsters are reported, including a rare case of craniofacial duplication (diprosopus). Based on the findings observed, etiological factors of these malformations are discussed. We suggest that exogenous (environmental) factors such as habits, way of life or religious practices of certain populations can influence the development of double monsters.

  5. Critical Success Factors for E-Learning Acceptance: Confirmatory Factor Models

    Science.gov (United States)

    Selim, Hassan M.

    2007-01-01

    E-learning, one of the tools emerged from information technology, has been integrated in many university programs. There are several factors that need to be considered while developing or implementing university curriculums that offer e-learning based courses. This paper is intended to specify e-learning critical success factors (CSFs) as…

  6. Inflammatory bowel diseases (IBD) - critical discussion of etiology, pathogenesis, diagnostics, and therapy; Chronisch entzuendliche Darmerkrankungen - Kritische Diskussion von Aetiologie, Pathogenese, Diagnostik und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Ochsenkuehn, T.; Sackmann, M.; Goeke, B. [Medizinische Klinik II, Klinikum der Universitaet Muenchen-Grosshadern (Germany)

    2003-01-01

    Aims Crohn's disease and ulcerative colitis are the most frequent inflammatory bowel diseases (IBD) with a prevalence of approximately one out of 500.Cytokine research opened new and potent treatment options and thus stimulated clinical and basic research.However, the IBD still remain a challenge for patients and physicians,demanding close cooperation between gastroenterologists,radiologists and surgeons.The basic understanding of IBD,which is necessary for efficient diagnostic and therapeutic concepts is reviewed. Based upon recent publications and our clinical experience we discuss aspects of etiology,pathogenesis,diagnostics,and therapy of Crohn's disease and ulcerative colitis. A genetically influenced, exaggerated and sustained immune response against the own gut flora seems to be one of the most important factors in the pathogenesis of IBD.Not less important are environmental influences.For instance, cigarette smoking had been judged to have some negative influence on the natural course of Crohn's disease.Now,however, recent studies show that smoking is even a significant independent risk factor in the pathogenesis of IBD. Since IBD and especially Crohn's disease can effect the whole body, detailed analysis of inflammatory organ involvement is necessary before therapy.For instance, the MRIenteroclysis technique adds a necessary diagnostic tool for the exploration of those parts of the small bowel that cannot been reached by routine endoscopy like the upper ileum and the lower jejunum. In terms of therapy, a change of paradigms can be observed: patients will no longer be treated only when symptoms arise, but will early be integrated into a therapeutic concept, which is determined by site and extent of the disease and adapted to the abilities and needs of the patient.Furthermore,immunosuppressive agents like azathioprine and 6-mercaptopurine will establish as central concept in the medical treatment of IBD.Discussion IBD-therapy should

  7. Electronic health records: critical success factors in implementation.

    Science.gov (United States)

    Safdari, Reza; Ghazisaeidi, Marjan; Jebraeily, Mohamad

    2015-04-01

    EHR implementation results in the improved quality of care, customer-orientation and timely access to complete information. Despite the potential benefits of EHR, its implementation is a difficult and complex task whose success depends on many factors. The purpose of this research is indeed to identify the key success factors of EHR. This is a cross-sectional survey conducted with participation of 340 work forces from different types of job from Hospitals of TUMS in 2014. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics. 58.2% of respondents were female and their mean age and work experience were 37.7 and 11.2 years, respectively and most respondents (52.5%) was bachelor. In terms of job, the maximum rate was related to nursing (33 %) and physician (21 %). the main category of critical success factors in Implementation EHRs, the highest rate related to Project Management (4.62) and lowest related to Organizational factors (3.98). success in implementation EHRs requirement more centralization to project management and human factors. Therefore must be Creating to EHR roadmap implementation, establishment teamwork to participation of end-users and select prepare leadership, users obtains sufficient training to use of system and also prepare support from maintain and promotion system.

  8. Critical Success Factors of Internet Shopping: The Case of Japan

    Science.gov (United States)

    Atchariyachanvanich, Kanokwan; Okada, Hitoshi; Sonehara, Noboru

    This paper presents the results from a study conducted on the effect of differing factors on a customer's attitude towards using Internet shopping in Japan. The research model used was an extended version of the consumers' acceptance of virtual stores model with the addition of a new factor, need specificity, and a grouping of critical success factors based on their customer-centric and website-centric viewpoints sources. It examines how differences in the individual characteristics of customers affect the actual use of Internet shopping. According to an online questionnaire filled out by 1,215 online customers used to conduct a multiple regression analysis and a structural equation modeling analysis, the participant's gender, education level, innovativeness, net-orientation, and need specificity, which are the factors for the customer-centric viewpoints, have a positive impact on the actual use of Internet shopping. The implication also shows that Japanese online customers do not worry about the quality of service of Internet shopping, a factor in the website-centric viewpoint, as significantly as offline customers do.

  9. Critical properties and acentric factors of ionic liquids

    International Nuclear Information System (INIS)

    Shariati, Alireza; Ashrafmansouri, Seyedeh-Soghra; Osbuei, Maryam Haji; Hooshdaran, Bahar

    2013-01-01

    Since most ionic liquids (ILs) decompose before reaching their critical state, the experimental measurement of their critical properties are not possible. In this study, the critical temperatures, critical pressures and acentric factors of ten commonly investigated ILs were determined by making an optimum fit of the calculated vapor-liquid equilibrium data of binary mixtures of CO 2 +IL to the experimental values found in literature. For this purpose, the Peng-Robinson equation of state (PR EoS) and the differential evolution optimization method were used. The ILs considered were 1-ethyl-3-methylimidazolium hexafluorophosphate ([emim][PF 6 ]), 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([emim][Tf 2 N]), 1-butyl-3-methylimidazolium tetrafluoroborate ([bmim][BF 4 ]), 1-butyl-3-methylimidazolium hexafluorophosphate ([bmim][PF 6 ]), 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([bmim][Tf 2 N]), 1-hexyl-3-methylimidazolium tetrafluoroborate ([hmim][BF 4 ]), 1-hexyl-3-methylimidazolium hexafluorophosphate ([hmim][PF 6 ]), 1-hexyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([hmim][Tf 2 N]), 1-octyl-3-methylimidazolium tetrafluoroborate ([omim][BF 4 ]) and 1-octyl-3-methylimidazolium hexafluorophosphate ([omim][PF 6 ]). To evaluate the ability of the determined parameters in predicting the phase behavior of systems other than the systems that were used for parameter optimization, both sets of parameters obtained in this work and that of Valderrama et al. were used to predict bubble-point pressures of CHF 3 +[bmim][PF 6 ] (by using the PR EoS and the Soave-Redlich-Kwong equation of state. The bubble-point pressures of CO 2 +IL systems optimized in this study by the PR EoS were also determined using the Soave-Redlich-Kwong equation of state (SRK EoS). In addition, liquid densities of pure ILs were predicted using a generalized correlation proposed by Valderrama and Abu-Shark. In all cases, the various predicted properties of

  10. Critical properties and acentric factors of ionic liquids

    Energy Technology Data Exchange (ETDEWEB)

    Shariati, Alireza; Ashrafmansouri, Seyedeh-Soghra; Osbuei, Maryam Haji; Hooshdaran, Bahar [Shiraz University, Shiraz (Iran, Islamic Republic of)

    2013-01-15

    Since most ionic liquids (ILs) decompose before reaching their critical state, the experimental measurement of their critical properties are not possible. In this study, the critical temperatures, critical pressures and acentric factors of ten commonly investigated ILs were determined by making an optimum fit of the calculated vapor-liquid equilibrium data of binary mixtures of CO{sub 2}+IL to the experimental values found in literature. For this purpose, the Peng-Robinson equation of state (PR EoS) and the differential evolution optimization method were used. The ILs considered were 1-ethyl-3-methylimidazolium hexafluorophosphate ([emim][PF{sub 6}]), 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([emim][Tf{sub 2}N]), 1-butyl-3-methylimidazolium tetrafluoroborate ([bmim][BF{sub 4}]), 1-butyl-3-methylimidazolium hexafluorophosphate ([bmim][PF{sub 6}]), 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([bmim][Tf{sub 2}N]), 1-hexyl-3-methylimidazolium tetrafluoroborate ([hmim][BF{sub 4}]), 1-hexyl-3-methylimidazolium hexafluorophosphate ([hmim][PF{sub 6}]), 1-hexyl-3-methylimidazolium bis(trifluoromethylsulfonyl) imide ([hmim][Tf{sub 2}N]), 1-octyl-3-methylimidazolium tetrafluoroborate ([omim][BF{sub 4}]) and 1-octyl-3-methylimidazolium hexafluorophosphate ([omim][PF{sub 6}]). To evaluate the ability of the determined parameters in predicting the phase behavior of systems other than the systems that were used for parameter optimization, both sets of parameters obtained in this work and that of Valderrama et al. were used to predict bubble-point pressures of CHF{sub 3}+[bmim][PF{sub 6}] (by using the PR EoS and the Soave-Redlich-Kwong equation of state. The bubble-point pressures of CO{sub 2}+IL systems optimized in this study by the PR EoS were also determined using the Soave-Redlich-Kwong equation of state (SRK EoS). In addition, liquid densities of pure ILs were predicted using a generalized correlation proposed by Valderrama and Abu

  11. The etiology of thyroid tumours

    International Nuclear Information System (INIS)

    Bellabarba, Diego

    1983-01-01

    The etiology of thyroid tumors is a complex subject, complicated by the fact that these tumors are not one entity, but separate neoplasms with different histology, evolution and prognosis. The recognized etiological factors of thyroid cancer include the iodine content of the diet, the inheritance, racial predispositions, the presence of an autoimmune thyroiditis and mostly, the exposure of the thyroid gland to external radiation following radiotherapy. The role played by these factors varies from one type of tumor to another. Thyroid radiation probably represents the most important factor in the development of a papillary carcinoma, with other factors (iodine-rich diet, inheritance, racial predispositions) having a minor role. The follicular carcinoma is more common in regions with low-iodine diet, therefore suggesting that TSH stimulation could be an etiological factor of these tumors. Thyroid radiation may also be carcinogenic for follicular carcinoma although less than for papillary carcinoma. Anaplastic carcinoma appears to originate from a papillary carcinoma already in the thyroid gland. In medullary carcinoma, inheritance plays a major role (autosomal dominant) and lymphomas occur in thyroids already affected by autoimmune thyroiditis. Recent experimental studies have suggested other possible cellular factors as responsible for the development of thyroid tumors. They include an alteration of the responsivity of TSH cellular receptors and the monoclonal mutation of C-cells. These new factors could provide a new insight on the etiology of thyroid tumors

  12. Identification of External Critical Success Factors in Microbial Biotechnology Firms

    Directory of Open Access Journals (Sweden)

    Alireza AZIMI

    2013-03-01

    Full Text Available Microbial biotechnology is expected to change production methods, the products themselves and the structure of the industries in the new economies. Hopefully, countries in the Middle-East, Latin America, Asia and Africa have already recognized the importance of microbial biotechnology's promise. In this sense, the importance of externalities which might affect the success or failure of these companies becomes an issue of paramount importance. In the present study, we will try to identify the main external factors which could lead in the success of microbial biotechnology firms in Iran. To do so, the research follows a qualitative research design to answer this main question. Based on our findings, critical success factors are categorized in the following categories: General Environment (GE, Political Position (PP, Economic Position (EP, and Market Position (MP.

  13. DEPENDENCE RELATIONSHIP BETWEEN THE CRITICAL QUALITY FACTORS AND SOCIAL IMPACT

    Directory of Open Access Journals (Sweden)

    José Álvarez García

    2014-10-01

    Full Text Available This paper shows the results of the empirical study conducted in 186 tourist accommodation businesses in Spain certified under the “Q for Tourist Quality”, own System Quality Management. It was raised with the purpose of analyzing the structure of the relationship between critical quality factors and results-social impact, how they operate and the level of their influence on obtaining these results within the company. Starting from a deep theoretical revision we propose a theoretical model together with the hypotheses to be tested, and we proceed to validation using the technique of Structural Equation Models. The results obtained show that companies wishing to improve their social impact should take into account that leadership is the most important factor to achieve it. Leadership indirectly affects the social impact through its influence on alliances and resources, quality policy/planning, personnel management and learning.

  14. Highly effective cystic fibrosis clinical research teams: critical success factors.

    Science.gov (United States)

    Retsch-Bogart, George Z; Van Dalfsen, Jill M; Marshall, Bruce C; George, Cynthia; Pilewski, Joseph M; Nelson, Eugene C; Goss, Christopher H; Ramsey, Bonnie W

    2014-08-01

    Bringing new therapies to patients with rare diseases depends in part on optimizing clinical trial conduct through efficient study start-up processes and rapid enrollment. Suboptimal execution of clinical trials in academic medical centers not only results in high cost to institutions and sponsors, but also delays the availability of new therapies. Addressing the factors that contribute to poor outcomes requires novel, systematic approaches tailored to the institution and disease under study. To use clinical trial performance metrics data analysis to select high-performing cystic fibrosis (CF) clinical research teams and then identify factors contributing to their success. Mixed-methods research, including semi-structured qualitative interviews of high-performing research teams. CF research teams at nine clinical centers from the CF Foundation Therapeutics Development Network. Survey of site characteristics, direct observation of team meetings and facilities, and semi-structured interviews with clinical research team members and institutional program managers and leaders in clinical research. Critical success factors noted at all nine high-performing centers were: 1) strong leadership, 2) established and effective communication within the research team and with the clinical care team, and 3) adequate staff. Other frequent characteristics included a mature culture of research, customer service orientation in interactions with study participants, shared efficient processes, continuous process improvement activities, and a businesslike approach to clinical research. Clinical research metrics allowed identification of high-performing clinical research teams. Site visits identified several critical factors leading to highly successful teams that may help other clinical research teams improve clinical trial performance.

  15. Elevated Norepinephrine may be a Unifying Etiological Factor in the Abuse of a Broad Range of Substances: Alcohol, Nicotine, Marijuana, Heroin, Cocaine, and Caffeine

    Directory of Open Access Journals (Sweden)

    Paul J. Fitzgerald

    2013-01-01

    Full Text Available A wide range of commonly abused drugs have effects on the noradrenergic neurotransmitter system, including alterations during acute intoxication and chronic use of these drugs. It is not established, however, that individual differences in noradrenergic signaling, which may be present prior to use of drugs, predispose certain persons to substance abuse. This paper puts forth the novel hypothesis that elevated noradrenergic signaling, which may be raised largely due to genetics but also due to environmental factors, is an etiological factor in the abuse of a wide range of substances, including alcohol, nicotine, marijuana, heroin, cocaine, and caffeine. Data are reviewed for each of these drugs comprising their interaction with norepinephrine during acute intoxication, long-term use, subsequent withdrawal, and stress-induced relapse. In general, the data suggest that these drugs acutely boost noradrenergic signaling, whereas long-term use also affects this neurotransmitter system, possibly suppressing it. During acute withdrawal after chronic drug use, noradrenergic signaling tends to be elevated, consistent with the observation that norepinephrine lowering drugs such as clonidine reduce withdrawal symptoms. Since psychological stress can promote relapse of drug seeking in susceptible individuals and stress produces elevated norepinephrine release, this suggests that these drugs may be suppressing noradrenergic signaling during chronic use or instead elevating it only in reward circuits of the brain. If elevated noradrenergic signaling is an etiological factor in the abuse of a broad range of substances, then chronic use of pharmacological agents that reduce noradrenergic signaling, such as clonidine, guanfacine, lofexidine, propranolol, or prazosin, may help prevent or treat drug abuse in general.

  16. Elevated Norepinephrine may be a Unifying Etiological Factor in the Abuse of a Broad Range of Substances: Alcohol, Nicotine, Marijuana, Heroin, Cocaine, and Caffeine.

    Science.gov (United States)

    Fitzgerald, Paul J

    2013-10-13

    A wide range of commonly abused drugs have effects on the noradrenergic neurotransmitter system, including alterations during acute intoxication and chronic use of these drugs. It is not established, however, that individual differences in noradrenergic signaling, which may be present prior to use of drugs, predispose certain persons to substance abuse. This paper puts forth the novel hypothesis that elevated noradrenergic signaling, which may be raised largely due to genetics but also due to environmental factors, is an etiological factor in the abuse of a wide range of substances, including alcohol, nicotine, marijuana, heroin, cocaine, and caffeine. Data are reviewed for each of these drugs comprising their interaction with norepinephrine during acute intoxication, long-term use, subsequent withdrawal, and stress-induced relapse. In general, the data suggest that these drugs acutely boost noradrenergic signaling, whereas long-term use also affects this neurotransmitter system, possibly suppressing it. During acute withdrawal after chronic drug use, noradrenergic signaling tends to be elevated, consistent with the observation that norepinephrine lowering drugs such as clonidine reduce withdrawal symptoms. Since psychological stress can promote relapse of drug seeking in susceptible individuals and stress produces elevated norepinephrine release, this suggests that these drugs may be suppressing noradrenergic signaling during chronic use or instead elevating it only in reward circuits of the brain. If elevated noradrenergic signaling is an etiological factor in the abuse of a broad range of substances, then chronic use of pharmacological agents that reduce noradrenergic signaling, such as clonidine, guanfacine, lofexidine, propranolol, or prazosin, may help prevent or treat drug abuse in general.

  17. A Research of Critical Factors in the Cloud Service Approach

    Directory of Open Access Journals (Sweden)

    Heli Nevala

    2012-03-01

    Full Text Available The purpose of this study is to find out how to manage knowhowin an old company with a new service. There are many differentmatters of concern when launching a new service on the market.That is why the aim of this study was to give priority to areas inmanaging the knowhow and thus support the management to aimin the right direction from the very beginning. This can also workas a competitive advantage for the new service. The point of viewhas been gained from management students who are experiencedin business life. The group members had a realistic basis fromtheir experiences to compare the existing systems to this newone. The chosen view can also help an existing company to seeits own functions and processes in a new way, which tends to becomedifficult after years of operation. This leads to another positiveaspect – improvement and developing. The study is based onthe Critical Factor Index method which had here a different functionthan it usually does. Basically all the other results given bythe Critical Factor Index are based on a questionnaire inside thecompanies. In this case, the study was carried out by using externalexperts. The aim of the study was also to find out the differencespointed out between different answering groups: managers,sales personnel and experts.

  18. A case-control study of hormonal exposures as etiologic factors for ALS in women : Euro-MOTOR

    NARCIS (Netherlands)

    Rooney, James P K; Visser, Anne E; D'Ovidio, Fabrizio; Vermeulen, Roel; Beghi, Ettore; Chio, Adriano; Veldink, Jan H.; Logroscino, Giancarlo; van den Berg, Leonard H.; Hardiman, Orla

    2017-01-01

    OBJECTIVE: To investigate the role of hormonal risk factors for amyotrophic lateral sclerosis (ALS) among women from 3 European countries. METHODS: ALS cases and matched controls were recruited over 4 years in Ireland, Italy, and the Netherlands. Hormonal exposures, including reproductive history,

  19. Critical Factors for Personal Cloud Storage Adoption in China

    Directory of Open Access Journals (Sweden)

    Jianya Wang

    2016-06-01

    Full Text Available Purpose: In order to explain and predict the adoption of personal cloud storage, this study explores the critical factors involved in the adoption of personal cloud storage and empirically validates their relationships to a user's intentions. Design/methodology/approach: Based on technology acceptance model (TAM, network externality, trust, and an interview survey, this study proposes a personal cloud storage adoption model. We conducted an empirical analysis by structural equation modeling based on survey data obtained with a questionnaire. Findings: Among the adoption factors we identified, network externality has the salient influence on a user's adoption intention, followed by perceived usefulness, individual innovation, perceived trust, perceived ease of use, and subjective norms. Cloud storage characteristics are the most important indirect factors, followed by awareness to personal cloud storage and perceived risk. However, although perceived risk is regarded as an important factor by other cloud computing researchers, we found that it has no significant influence. Also, subjective norms have no significant influence on perceived usefulness. This indicates that users are rational when they choose whether to adopt personal cloud storage. Research limitations: This study ignores time and cost factors that might affect a user's intention to adopt personal cloud storage. Practical implications: Our findings might be helpful in designing and developing personal cloud storage products, and helpful to regulators crafting policies. Originality/value: This study is one of the first research efforts that discuss Chinese users' personal cloud storage adoption, which should help to further the understanding of personal cloud adoption behavior among Chinese users.

  20. Critical factors in the implementation process of integrated management systems

    Directory of Open Access Journals (Sweden)

    Ademir Antonio Ferreira

    2015-09-01

    Full Text Available This study is the result of research whose purpose was to study the implementation process of integrated management systems, called ERP Enterprise Resource Planning in the business environment. This study, more specifically, tried to identify the variables in this process and that, somehow, made it easy or caused some type of difficulty implementing the system. Based on the mixed method approach (Creswell, 2003, the study was performed by means of the content analysis of technical and scientific publications about this theme and by means of a field research for data collection from primary sources. The content analysis was based on the per mile procedure by Bardin (1977, making it possible to identify critical factors that may be found in the implementation of ERP system projects. Primary data was collected from structured interviews with the managers in charge of the implementation of the system, in each of the 12 companies in different sectors of the economy and based in Brazil. Based on this information, it was possible to test the factors extracted from the content analysis and then develop a list of factors that may effectively influence the implementation process of the system. In order to recognize the possible relations between the selected factors, the Spearman (rsp correlation coefficient was applied and the multiple regression analysis was performed by means of the stepwise procedure. The purpose of the regression analysis was to determine the relation of the “Assessment of the Implementation” dependent variable with other dependent variables in the selected categories. The results of these analyses showed that the support of the top management, the communication process for the clear evidence of this support, the technical support of the ERP program provider together with the project team expertise, training and qualification processes of the team in the system operation are significantly correlated and relevant factors for a

  1. Critical Success Factors for Malaysian Construction Projects: An Investigative Review

    Directory of Open Access Journals (Sweden)

    Yee Cheong Yong

    2017-05-01

    Full Text Available Construction projects play an important role in the advancement of a nation through infrastructure development that leads to economic growth. They are planned carefully to accomplish certain goals. However, not all the projects achieved the goals as per planned. Many factors contribute to the successes and failures, and it becomes an interesting arena for research. The primary objective of this paper is to outline the development trend of project success measurement globally and locally. The research method employed was to make selected reviews on critical success factors' (CSFs literature and to compare international standards and progress in incorporating human behavioural aspects of project management to the situation in Malaysia. A somewhat similar pattern can be observed in Malaysia where the studies have departed from the usual criteria of time, cost and quality, to define project success in a more holistic way. However, the domestic industry has failed to respond to the emerging trend globally as there has yet been any widely published research on the importance of human-related factors towards project success. A consolidated framework of CSFs has therefore, been proposed in responding to the findings. This paper fulfils an identified need as there has been a dearth of research on the subject matter locally.

  2. Theory of sampling: four critical success factors before analysis.

    Science.gov (United States)

    Wagner, Claas; Esbensen, Kim H

    2015-01-01

    Food and feed materials characterization, risk assessment, and safety evaluations can only be ensured if QC measures are based on valid analytical data, stemming from representative samples. The Theory of Sampling (TOS) is the only comprehensive theoretical framework that fully defines all requirements to ensure sampling correctness and representativity, and to provide the guiding principles for sampling in practice. TOS also defines the concept of material heterogeneity and its impact on the sampling process, including the effects from all potential sampling errors. TOS's primary task is to eliminate bias-generating errors and to minimize sampling variability. Quantitative measures are provided to characterize material heterogeneity, on which an optimal sampling strategy should be based. Four critical success factors preceding analysis to ensure a representative sampling process are presented here.

  3. Project quality management critical success factors for buildings

    CERN Document Server

    Low, Sui Pheng

    2014-01-01

    The book presents the development of the Construction Quality Assessment System (CONQUAS), Singapore’s de facto quality performance measurement system, explains the application of the Quality Management System (QMS) to manage CONQUAS and identifies 33 critical success factors (CSFs) for achieving high CONQUAS scores. Through CONQUAS, the reader benefits from understanding how the Singapore government developed and implemented the first objective system for measuring what many building professionals have perceived to be elusive quality standards in the construction industry. The book presents both the theoretical concepts as well as the practical aspects to achieving strategic Project Quality Management that is anchored on the CSFs to building best practices. To realistically reflect the practical aspects and challenging issues faced by stakeholders in the construction industry, questionnaire surveys were conducted with building professionals to distinguish the importance level and extent of adoption of the ...

  4. Critical factors in SEM 3D stereo microscopy

    DEFF Research Database (Denmark)

    Marinello, F.; Bariano, P.; Savio, E.

    2008-01-01

    This work addresses dimensional measurements performed with the scanning electron microscope (SEM) using 3D reconstruction of surface topography through stereo-photogrammetry. The paper presents both theoretical and experimental investigations, on the effects of instrumental variables and measure......This work addresses dimensional measurements performed with the scanning electron microscope (SEM) using 3D reconstruction of surface topography through stereo-photogrammetry. The paper presents both theoretical and experimental investigations, on the effects of instrumental variables...... factors are recognized: the first one is related to the measurement operation and the instrument set-up; the second concerns the quality of scanned images and represents the major criticality in the application of SEMs for 3D characterizations....

  5. Critical factors in SEM 3D stereo microscopy

    International Nuclear Information System (INIS)

    Marinello, F; Savio, E; Bariani, P; Horsewell, A; De Chiffre, L

    2008-01-01

    This work addresses dimensional measurements performed with the scanning electron microscope (SEM) using 3D reconstruction of surface topography through stereo-photogrammetry. The paper presents both theoretical and experimental investigations, on the effects of instrumental variables and measurement parameters on reconstruction accuracy. Investigations were performed on a novel sample, specifically developed and implemented for the tests. The description is based on the model function introduced by Piazzesi and adapted for eucentrically tilted stereopairs. Two main classes of influencing factors are recognized: the first one is related to the measurement operation and the instrument set-up; the second concerns the quality of scanned images and represents the major criticality in the application of SEMs for 3D characterizations

  6. Hemiparetic cerebral palsy: etiological risk factors and neuroimaging Paralisia cerebral hemiparética: fatores de risco etiológico e neuroimagem

    Directory of Open Access Journals (Sweden)

    Ana Maria Sedrez Gonzaga Piovesana

    2001-03-01

    Full Text Available The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP, was to verify the etiological risk period for this disease. Etiological risk factors (ERF were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the prenatal and perinatal period was 41% and no ERF was 18% of the cases. The computerized tomographic scan (CT and MRI were performed on all the patients, who were then classified according to their etiopathogenic data: CT1= normal (18%; CT 2= unilateral ventricular enlargement (25%; CT 3= cortical/ subcortical cavities (28%; CT4= hemispheric atrophy and other findings (14%; CT 5= malformations (15%. CT 5 was associated with physical malformations beyond the central nervous system and with prenatal ERF's , while CT 2 was associated with the perinatal ERF's, mainly in premature births. Magnetic resonance imaging was performed on 57 patients and demonstrated a good degree of concordance with the CT. Etiology remained undefined in only 37% of the cases after neuroimaging was related to ERF. A high perinatal RF frequency (59% was observed and emphasized the need for special care during this period.Foram estudadas 175 crianças com paralisia cerebral hemiparética (PC-H para elucidar o período de risco etiológico. Através da anamnese constataram-se fatores de risco para etiologia (FRE pré-natal em 23%, perinatal em18% e período indefinido em 59% dos pacientes (com FRE pré e perinatal 41% e sem FRE 18%. A tomografia computadorizada (TC foi realizada em todos os sujeitos e classificada de acordo com dados etiopatogênicos em: TC1= normal (18%; TC2= alargamento ventricular unilateral (25%; TC3= cavidades córtico-subcorticais (28%; TC4= atrofia hemisférica e outros achados (14%; TC5= malformações (15%. A TC5 se associada a malformações físicas fora do sistema nervoso central e aos FRE pré-natais e a TC2 aos

  7. A factor analysis to find critical success factors in retail brand

    OpenAIRE

    Naser Azad; Seyed Foad Zarifi; Somayeh Hozouri

    2013-01-01

    The present exploratory study aims to find critical components of retail brand among some retail stores. The study seeks to build a brand name in retail level and looks to find important factors affecting it. Customer behavior is largely influenced when the first retail customer experience is formed. These factors have direct impacts on customer experience and satisfaction in retail industry. The proposed study performs an empirical investigation on two well-known retain stores located in cit...

  8. Critical Design Factors for Sector Transport Maintenance in DEMO

    Energy Technology Data Exchange (ETDEWEB)

    Utoh, H.; Someya, Y.; Tobita, K.; Asakura, N.; Hoshino, K.; Nakamura, M., E-mail: uto.hiroyasu@jaea.go.jp [Japan Atomic Energy Agency, Rokkasho (Japan)

    2012-09-15

    Full text: Maintenance is a critical issue for fusion DEMO reactor because the design conditions and requirements of DEMO maintenance scheme are different from that of ITER remote handling. The sector transport maintenance scheme has advantages to maintain blankets and divertors without the use of sophisticated remote handling devices including sensitive devices to radiation in the reactor. SlimCS designed in JAEA adopts the sector transport maintenance scheme in which every sector is pulled out horizontally through a port between TF coils. A critical design issue for the horizontal sector transport maintenance scheme is how to support an enormous turnover force of the toroidal field (TF) coils. We propose following two options; first option is the horizontal transport maintenance scheme in which every sector is pulled out through four horizontal ports connected with the corridor. Second option is the vertical sector transport maintenance scheme with small vertical maintenance ports (total: 6 ports). The new horizontal sector transport limited in the number of maintenance ports is a more realistic maintenance scheme, and the key engineering issue is the transferring mechanism of sector in the vacuum vessel. In the maintenance scenario, the key design factors are the cool down time in reactor and the cooling method in maintenance scheme for keeping components under operation temperature. By one-dimensional heat conduction analysis, the sector should be transported to hot cell within 40 hours in the case the cool down time is one month. In the horizontal sector transport maintenance, the maintenance time including removal of cooling piping, drain of cooling water and sector transport to hot cell is about 32 hours. Furthermore, the tritium release in the sector transport can be suppressed because the components temperature drops by forced-air cooling system. This paper mainly focuses on a sector transport maintenance scheme from the aspects of high plant availability

  9. Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults.

    Science.gov (United States)

    Koivunen, R-J; Satopää, J; Meretoja, A; Strbian, D; Haapaniemi, E; Niemelä, M; Tatlisumak, T; Putaala, J

    2015-01-01

    Intracerebral hemorrhage (ICH) is a common and severe form of stroke but is scarcely studied in young adults. Our aim was to study risk factors, clinical presentation and early mortality of ICH in the young and compare these features with older patients. All consecutive patients aged between 16 and 49 diagnosed with a first-ever ICH at the Departments of Neurology or Neurosurgery of the Helsinki University Central Hospital between January 2000 and March 2010 (n = 336) were analyzed retrospectively. Comparisons were performed amongst demographic subgroups and with patients over 49 years of age enrolled between January 2005 and March 2010 (n = 921). In the young patients, median age was 42 years (interquartile range 34-47), 59.5% were male, and annual incidence was 4.9 (95% confidence interval 4.5-5.3) per 100 000. The most prevalent risk factors were hypertension (29.8%) and smoking (22.3%). Compared with older patients hypertensive microangiopathy was less common (25.0% vs. 34.3%, P = 0.002) and structural lesions more common (25.0% vs. 4.9%, P young patients and in 22.5% of those who underwent magnetic resonance imaging and any angiography (n = 89, P = 0.023). Three-month mortality rate was lower in young patients compared with older ones (17.0% vs. 32.7%, P ages (P = 0.324) and independently predicted mortality in older patients but not in the young. Intracerebral hemorrhage (ICH) in the young appears less fatal and has a different spectrum of causes and factors associated with short-term mortality than for the elderly. © 2014 EAN.

  10. Etiologic profile of spastic quadriplegia in children.

    Science.gov (United States)

    Venkateswaran, Sunita; Shevell, Michael I

    2007-09-01

    The etiologic profile and possible predictors of etiology in children with spastic quadriplegia were assessed in a consecutive cohort of children with this motor impairment. Medical records from a single pediatric neurology practice over a 14-year interval were retrospectively and systematically reviewed. Variables comprised possible demographic, prenatal, perinatal, and postnatal risk factors. Of the 99 patients included in the study, 39 were premature (quadriplegia was 83%, with differing underlying etiologies depending on gestational age. These results should help guide physicians in investigating possible underlying etiologies in patients with spastic quadriplegia.

  11. Etiology and Pathogenesis of Epithelial Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Samuel C. Mok

    2007-01-01

    Full Text Available Ovarian cancer is complex disease composed of different histological grades and types. However, the underlying molecular mechanisms involved in the development of different phenotypes remain largely unknown. Epidemiological studies identified multiple exogenous and endogenous risk factors for ovarian cancer development. Among them, an inflammatory stromal microenvironment seems to play a critical role in the initiation of the disease. The interaction between such a microenvironment, genetic polymorphisms, and different epithelial components such as endosalpingiosis, endometriosis, and ovarian inclusion cyst in the ovarian cortex may induce different genetic changes identified in the epithelial component of different histological types of ovarian tumors. Genetic studies on different histological grades and types provide insight into the pathogenetic pathways for the development of different disease phenotypes. However, the link between all these genetic changes and the etiological factors remains to be established.

  12. The effect of anti-tumor necrosis factor alpha agents on the outcome in pediatric uveitis of diverse etiologies.

    Science.gov (United States)

    Deitch, Iris; Amer, Radgonde; Tomkins-Netzer, Oren; Habot-Wilner, Zohar; Friling, Ronit; Neumann, Ron; Kramer, Michal

    2018-04-01

    This study aimed to report the clinical outcome of children with uveitis treated with anti-tumor necrosis factor alpha (TNF-α) agents. This included a retrospective cohort study. Children with uveitis treated with infliximab or adalimumab in 2008-2014 at five dedicated uveitis clinics were identified by database search. Their medical records were reviewed for demographic data, clinical presentation, ocular complications, and visual outcome. Systemic side effects and the steroid-sparing effect of treatment were documented. The cohort included 24 patients (43 eyes) of whom 14 received infliximab and 10 received adalimumab after failing conventional immunosuppression therapy. Mean age was 9.3 ± 4.0 years. The most common diagnosis was juvenile idiopathic arthritis-related uveitis (n = 10), followed by Behçet's disease (n = 4), sarcoidosis (n = 1), and ankylosing spondylitis (n = 1); eight had idiopathic uveitis. Ocular manifestations included panuveitis in 20 eyes (46.5%), chronic anterior uveitis in 19 (44.2%), and intermediate uveitis in 4 (9.3%). The duration of biologic treatment ranged from 6 to 72 months. During the 12 months prior to biologic treatment, while on conventional immunosuppressive therapy, mean visual acuity deteriorated from 0.22 to 0.45 logMAR, with a trend of recovery to 0.25 at 3 months after initiation of biologic treatment, remaining stable thereafter. A full corticosteroid-sparing effect was demonstrated in 16 of the 19 patients (84.2%) for whom data were available. Treatment was well tolerated. Treatment of pediatric uveitis with anti-TNF-α agents may improve outcome while providing steroid-sparing effect, when conventional immunosuppression fails. The role of anti-TNF-α agents as first-line treatment should be further investigated in controlled prospective clinical trials.

  13. [Effects of critical ultrasonic management of Peking Union Medical College Hospital on the etiological diagnosis of patients with acute respiratory failure].

    Science.gov (United States)

    Zhao, Hua; Wang, Xiaoting; Liu, Dawei; Zhang, Hongmin; He, Huaiwu; Long, Yun

    2015-12-15

    To evaluate the diagnostic value and potential therapeutic impact of Peking Union Medical College Hospital critical ultrasonic management (PCUM) in the early management of critically ill patients with acute respiratory failure (ARF). Patients admitted into the ICU of Peking Union Medical College Hospital for ARF were consecutively recruited over a 18-month period. Patients were randomly divided into conventional group and PCUM group (critical care ultrasonic examination was added in addition to conventional examinations). The two groups were compared with respect to time to preliminary diagnosis, time to final diagnosis, diagnostic accuracy, time to treatment response, time to other examination. A total of 187 patients were included in this study. The two groups showed no significant differences in general clinical information or final diagnosis (P > 0.05). The PCUM group had a shorter time to preliminary diagnosis, time to final diagnosis, time to treatment response, time to X-ray/CT examination, and a higher diagnostic accuracy than the conventional group (P < 0.001). PCUM had high sensitivity and specificity for the diagnosis of acute respiratory distress syndrome (ARDS) (sensitivity 92.0%, specificity 98.5%), acute pulmonary edema (sensitivity 94.7%, specificity 96.1%), pulmonary consolidation (sensitivity 85.7%, specificity 98.6%), COPD/asthma (sensitivity 84.2%, specificity 98.7%). The PCUM is seem to be an attractive complementary diagnostic tool and able to contribute to an early therapeutic decision for the patients with ARF.

  14. Altered autonomic nervous system activity as a potential etiological factor of premenstrual syndrome and premenstrual dysphoric disorder.

    Science.gov (United States)

    Matsumoto, Tamaki; Ushiroyama, Takahisa; Kimura, Tetsuya; Hayashi, Tatsuya; Moritani, Toshio

    2007-12-20

    menstrual cycle compared to those of the other two groups. Several theories have been proposed to explain the underlying mechanisms of PMS with its complex web of bio-psycho-social factors. Although causes and consequences continue to elude, the present study provides intriguing and novel findings that the altered functioning of the autonomic nervous system in the late luteal phase could be associated with diverse psychosomatic and behavioral symptoms appearing premenstrually. In addition, when symptoms become more severe (as seen in women with PMDD), the sympathovagal function might be more depressed regardless of the menstrual cycle.

  15. Etiology, antimicrobial susceptibility profile of Staphylococcus spp. and risk factors associated with bovine mastitis in the states of Bahia and Pernambuco

    Directory of Open Access Journals (Sweden)

    Carina C. Krewer

    2013-05-01

    Full Text Available The purpose of this paper was to study the etiology of mastitis, determine the antimicrobial susceptibility profile of Staphylococcus spp. and to identify the risk factors associated with infection in dairy cows in the states of Bahia and Pernambuco, Brazil. From the 2,064 milk samples analyzed, 2.6% were associated with cases of clinical mastitis and 28.2% with subclinical mastitis. In the microbiological culture, Staphylococcus spp. (49.1% and Corynebacterium spp. (35.3% were the main agents found, followed by Prototheca spp. (4.6% and Gram negative bacilli (3.6%. In the antimicrobial susceptibility testing, all 218 Staphylococcus spp. were susceptible to rifampicin and the least effective drug was amoxicillin (32.6%. Multidrug resistance to three or more drugs was observed in 65.6% of Staphylococcus spp. The risk factors identified for mastitis were the extensive production system, not providing feed supplements, teat drying process, not disinfecting the teats before and after milking, and inadequate hygiene habits of the milking workers. The presence of multiresistant isolates in bovine milk demonstrates the importance of the choice and appropriate use of antimicrobial agents. Prophylactic and control measures, including teat antisepsis and best practices for achieving hygienic milking should be established in order to prevent new cases of the disease in herds.

  16. Critical successful factors for innovation in vietnamese firms

    Directory of Open Access Journals (Sweden)

    Tran Hoai Nam

    2017-09-01

    Full Text Available Purpose: Innovation is considered as a core element of sustainable competitive advantage in the rapidly changing environment. However, in Vietnam, researches on innovation are very rare, which are mostly general reports without underlying analyses of innovation in firms, especially determinants for innovation. Therefore, this paper focuses on analyzing critical successful factors for innovation in Vietnamese firms.  Design/methodology/approach: This study used primary data through questionnaire survey from November 2015 to February 2016. Respondents were senior managers of firms located mostly at Hanoi (Northern, Hochiminh (Southern and Danang city (Central. The questionnaire included multi-items designed to measure factors. Each item was measured by 5 point Likert scale: 1 (strongly disagree to 5 (strongly agree. Questionnaires were administerd to 500 firms belonging to list of Vietnam Chamber of Commerce and Industry (VCCI in these three cities with rate of 40% (Hochiminh city, 40% (Hanoi city and Danang (20%. However, there were 360 returned questionnaires and valid to next analyses. Analysis methodologies of reliability, factor analysis and regression are utilized in this paper.  Findings: We developed and tested a model of determinants for Innovation in Vietnamese firms. The major contribution of this study is testing six determinants for innovation in Vietnamese companies. The results showed that awareness of innovation, innovation strategy and policy, organization for innovation, HR for innovation and building capabilities have positive impact on innovation.  Originality/value: This study makes a contribution for both academics and practitioners. For academics, this study provided one more empirical evidence of the determinants for innovation. Regarding practical implications, this study suggests that Vietnamese companies have to strengthen capabilities for employees through training, encourage generation of new ideas, rule breaking

  17. Critical successful factors for innovation in vietnamese firms

    International Nuclear Information System (INIS)

    Tran Hoai Nam; Nham Phong Tuan; Nguyen Van Minh

    2017-01-01

    Innovation is considered as a core element of sustainable competitive advantage in the rapidly changing environment. However, in Vietnam, researches on innovation are very rare, which are mostly general reports without underlying analyses of innovation in firms, especially determinants for innovation. Therefore, this paper focuses on analyzing critical successful factors for innovation in Vietnamese firms. Design/methodology/approach: This study used primary data through questionnaire survey from November 2015 to February 2016. Respondents were senior managers of firms located mostly at Hanoi (Northern), Hochiminh (Southern) and Danang city (Central). The questionnaire included multi-items designed to measure factors. Each item was measured by 5 point Likert scale: 1 (strongly disagree) to 5 (strongly agree). Questionnaires were administerd to 500 firms belonging to list of Vietnam Chamber of Commerce and Industry (VCCI) in these three cities with rate of 40% (Hochiminh city), 40% (Hanoi city) and Danang (20%). However, there were 360 returned questionnaires and valid to next analyses. Analysis methodologies of reliability, factor analysis and regression are utilized in this paper. Findings: We developed and tested a model of determinants for Innovation in Vietnamese firms. The major contribution of this study is testing six determinants for innovation in Vietnamese companies. The results showed that awareness of innovation, innovation strategy and policy, organization for innovation, HR for innovation and building capabilities have positive impact on innovation. Originality/value: This study makes a contribution for both academics and practitioners. For academics, this study provided one more empirical evidence of the determinants for innovation. Regarding practical implications, this study suggests that Vietnamese companies have to strengthen capabilities for employees through training, encourage generation of new ideas, rule breaking, and innovative behaviors by

  18. Critical successful factors for innovation in vietnamese firms

    Energy Technology Data Exchange (ETDEWEB)

    Tran Hoai Nam; Nham Phong Tuan; Nguyen Van Minh

    2017-07-01

    Innovation is considered as a core element of sustainable competitive advantage in the rapidly changing environment. However, in Vietnam, researches on innovation are very rare, which are mostly general reports without underlying analyses of innovation in firms, especially determinants for innovation. Therefore, this paper focuses on analyzing critical successful factors for innovation in Vietnamese firms. Design/methodology/approach: This study used primary data through questionnaire survey from November 2015 to February 2016. Respondents were senior managers of firms located mostly at Hanoi (Northern), Hochiminh (Southern) and Danang city (Central). The questionnaire included multi-items designed to measure factors. Each item was measured by 5 point Likert scale: 1 (strongly disagree) to 5 (strongly agree). Questionnaires were administerd to 500 firms belonging to list of Vietnam Chamber of Commerce and Industry (VCCI) in these three cities with rate of 40% (Hochiminh city), 40% (Hanoi city) and Danang (20%). However, there were 360 returned questionnaires and valid to next analyses. Analysis methodologies of reliability, factor analysis and regression are utilized in this paper. Findings: We developed and tested a model of determinants for Innovation in Vietnamese firms. The major contribution of this study is testing six determinants for innovation in Vietnamese companies. The results showed that awareness of innovation, innovation strategy and policy, organization for innovation, HR for innovation and building capabilities have positive impact on innovation. Originality/value: This study makes a contribution for both academics and practitioners. For academics, this study provided one more empirical evidence of the determinants for innovation. Regarding practical implications, this study suggests that Vietnamese companies have to strengthen capabilities for employees through training, encourage generation of new ideas, rule breaking, and innovative behaviors by

  19. A factor analysis to find critical success factors in retail brand

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2013-03-01

    Full Text Available The present exploratory study aims to find critical components of retail brand among some retail stores. The study seeks to build a brand name in retail level and looks to find important factors affecting it. Customer behavior is largely influenced when the first retail customer experience is formed. These factors have direct impacts on customer experience and satisfaction in retail industry. The proposed study performs an empirical investigation on two well-known retain stores located in city of Tehran, Iran. Using a sample of 265 people from regular customers, the study uses factor analysis and extracts four main factors including related brand, product benefits, customer welfare strategy and corporate profits using the existing 31 factors in the literature.

  20. Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

    Science.gov (United States)

    Lai, Chao-Chih; Ji, Dar-Der; Wu, Fang-Tzy; Mu, Jung-Jung; Yang, Ji-Rong; Jiang, Donald Dah-Shyong; Lin, Wen-Yun; Chen, Wei-Ting; Yen, Muh-Yong; Wu, Ho-Sheng; Chen, Tony Hsiu-Hsi

    2016-01-01

    Background The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96), attending a banquet (aOR 2.29; 95% CI, 1.64–3.20), dining out (aOR 1.70; 95% CI, 1.13–2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41), abdominal pain (TR 1.20; 95% CI, 1.07–1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05), winter season (aOR 0.45; 95% CI, 0.28–0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63). Conclusions Acute bacterial gastroenteritis was highly associated with season

  1. Critical Success Factors for Franchised Restaurants Entering the Kenyan Market

    Directory of Open Access Journals (Sweden)

    Lucy Gikonyo

    2015-10-01

    Full Text Available In today’s globalized world, businesses look to expand to have a global presence. Restaurant businesses have expanded internationally using franchising. This study sought to determine the critical success factors (CSFs of a franchised restaurant system entering the Kenyan market from the franchisors’ perspective. It sought to establish how franchisors define, identify, and evaluate success. This study provides a theoretical framework that helps to understand the background of why organizations seek to expand using franchising method and consequently the CSFs of franchised restaurants entering the Kenyan market. The study used qualitative methodology with the use of in-depth interviews for collecting data. The results yielded CSFs from the franchisors’ perspective. As revealed by the study, the CSFs include brand power/concept, competitive environment, government policies, distance management, cultural appeal, excellent selection of franchisees, good site/location selection, good relationship with the franchisees, and proper contract management. These findings can be used by restaurant franchises that seek to establish successful businesses in the Kenyan market and other similar regional markets. The Africa franchise partners may also find some useful information from this article as they seek to set up the Franchise Association of Kenya. Other franchise businesses may also benefit from some aspects of the study.

  2. Selecting physician leaders for clinical service lines: critical success factors.

    Science.gov (United States)

    Epstein, Andrew L; Bard, Marc A

    2008-03-01

    Clinical service lines and interdisciplinary centers have emerged as important strategic programs within academic health centers (AHCs). Effective physician leadership is significant to their success, but how these leaders are chosen has not been well studied. The authors conducted a study to identify current models for selecting the physician leaders of clinical service lines, determine critical success factors, and learn how the search process affected service line performance. In 2003 and 2004, the authors interviewed clinical and executive personnel involved in 14 programs to establish, or consider establishing, heart or cancer service lines, at 13 AHCs. The responses were coded to identify and analyze trends and themes. The key findings of the survey were (1) the goals and expectations that AHCs set for their service line leaders vary greatly, depending on both the strategic purpose of the service line in the AHC and the service line's stage of development, (2) the matrix organizational structure employed by most AHCs limits the leader's authority over necessary resources, and calls forth a variety of compensating strategies if the service line is to succeed, (3) the AHCs studied used relatively informal processes to identify, evaluate, and select service line leaders, and (4) the leader's job is vitally shaped by the AHC's strategic, structural, and political context, and selection criteria should be determined accordingly. Institutions should be explicit about the strategic purpose and stage of development of their clinical service lines and be clear about their expectations and requirements in hiring service line leaders.

  3. Etiology of Inguinal Hernias

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral a...

  4. Von Hippel-Lindau (VHL inactivation in sporadic clear cell renal cancer: associations with germline VHL polymorphisms and etiologic risk factors.

    Directory of Open Access Journals (Sweden)

    Lee E Moore

    2011-10-01

    Full Text Available Renal tumor heterogeneity studies have utilized the von Hippel-Lindau VHL gene to classify disease into molecularly defined subtypes to examine associations with etiologic risk factors and prognosis. The aim of this study was to provide a comprehensive analysis of VHL inactivation in clear cell renal tumors (ccRCC and to evaluate relationships between VHL inactivation subgroups with renal cancer risk factors and VHL germline single nucleotide polymorphisms (SNPs. VHL genetic and epigenetic inactivation was examined among 507 sporadic RCC/470 ccRCC cases using endonuclease scanning and using bisulfite treatment and Sanger sequencing across 11 CpG sites within the VHL promoter. Case-only multivariate analyses were conducted to identify associations between alteration subtypes and risk factors. VHL inactivation, either through sequence alterations or promoter methylation in tumor DNA, was observed among 86.6% of ccRCC cases. Germline VHL SNPs and a haplotype were associated with promoter hypermethylation in tumor tissue (OR = 6.10; 95% CI: 2.28-16.35, p = 3.76E-4, p-global = 8E-5. Risk of having genetic VHL inactivation was inversely associated with smoking due to a higher proportion of wild-type ccRCC tumors [former: OR = 0.70 (0.20-1.31 and current: OR = 0.56 (0.32-0.99; P-trend = 0.04]. Alteration prevalence did not differ by histopathologic characteristics or occupational exposure to trichloroethylene. ccRCC cases with particular VHL germline polymorphisms were more likely to have VHL inactivation through promoter hypermethylation than through sequence alterations in tumor DNA, suggesting that the presence of these SNPs may represent an example of facilitated epigenetic variation (an inherited propensity towards epigenetic variation in renal tissue. A proportion of tumors from current smokers lacked VHL alterations and may represent a biologically distinct clinical entity from inactivated cases.

  5. The voyage to McDonalds--short and long-term factors in the etiology of obesity in Mäori children in Aotearoa.

    Science.gov (United States)

    Gray, George

    2003-09-01

    In Aotearoa, it has been revealed that 14.7% of European adults are obese, compared with 27.5% for Mäori adults. It has been difficult to elucidate the recent trends in children and adolescents without large-scale population analysis, but a recent study of obesity in Auckland schoolchildren revealed a prevalence rate of 15.8% for Mäori children, compared with 8.6% for European children. This essay will review factors affecting the etiology of obesity in Mäori children. The classification of obesity will be examined before a discussion of short-term and long-term factors leading to obesity in this ethnic group. Measuring Obesity in Children It has been recommended that the BMI range for overweight in Mäori be increased to 27-32, and obesity a BMI greater than 32. Unfortunately though, there is no consensus among researchers and some studies may use the conventional obesity range of a BMI greater than 30 for both Mäori and non-Mäori children. Mäori disproportionately occupy low socioeconomic strata in Aotearoa. The significant discrepancy between obesity prevalence rates for Mäori and European children indicates that other factors are involved. Dietary fat intake, and by extension obesity, tend to be more prevalent for people in low socioeconomic groups, as numerous studies have shown. Therefore, the Mäori-European obesity discrepancy can be further explained by the discrepancy in socioeconomic status between these two groups, as national census data reveal that Mäori are disproportionately represented in all negative socioeconomic indices. However, for completeness, it is necessary to understand exactly why Mäori dominate these indices.

  6. The etiology, risk factors, and interactions of enteric infections and malnutrition and the consequences for child health and development study (MAL-ED): description of the Tanzanian site.

    Science.gov (United States)

    Mduma, Estomih R; Gratz, Jean; Patil, Crystal; Matson, Kristine; Dakay, Mary; Liu, Sarah; Pascal, John; McQuillin, Lauren; Mighay, Emmanuel; Hinken, Elizabeth; Ernst, Alexandra; Amour, Caroline; Mvungi, Regisiana; Bayyo, Eliwaza; Zakaria, Yeconia; Kivuyo, Sokoine; Houpt, Eric R; Svensen, Erling

    2014-11-01

    The Haydom, Tanzania, site (TZH) of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Study is in north-central Tanzania, 300 km from the nearest urban center. TZH is in a remote rural district where most of the population are agropastoralists and grow maize as the staple food. The average household size is 7. The average woman achieves a parity of 6 and has 1 child death. Socioeconomic indicators are poor, with essentially no household having access to electricity, piped water, or improved sanitary facilities (compared with 14%, 7%, and 12%, respectively, reported nationally). The Demographic Health Survey Tanzania 2004 indicated that the region had high rates of stunting and underweight (40% and 31% of children aged child mortality rate of 5.8%. Human immunodeficiency virus prevalence among 18-month-old children is rural African population with profound poverty and malnutrition, but a strong community-based research infrastructure. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. [Study of etiologic factors of infectious diseases of respiratory tract in school-age children during period of remission of a respiratory disease].

    Science.gov (United States)

    Maĭorov, R V; Chereshneva, M V; Chereshnev, V A

    2013-01-01

    Detect features of microflora of upper respiratory tract on the example of flora of palatine tonsils and level of antibodies against intracellular parasites as markers of etiologic factors of respiratory infections in school-age children in remission period. 466 children from frequently and episodically ill groups were examined. Bacteriologic study of smears from the surface of palatine tonsils was carried out in all the children. By using EIA with the corresponding commercial test systems IgG level against Herpes simplex virus, Cytomegalovirus, Chlamydophila pneumoniae, Mycoplasma pneumoniae, Human respiratory syncytial virus was determined in blood sera according to instruction manual. During remission period of infectious process in the structure of microflora of upper respiratory tract in frequently ill children characteristic differences from their episodically ill peers were detected. In children with frequent respiratory infections a higher occurrence of antibodies against intracellular causative agents of these diseases was also detected. In the group of frequently ill, a direct correlation between frequency of infectious diseases of respiratory tract and occurrence of carriage of pathogenic and opportunistic microorgan isms as well as increase of antibodies against Herpesviridae, Cytomegalovirus, C. pneumoniae and M. pneumoniae was detected. Higher occurrence ofintra- and extra-cellular infectious agents as well as their associations may be considered as one of the reasons of insufficient effectiveness of prophylaxis measures in frequently ill children.

  8. Etiology and Factors Associated with Pneumonia in Children under 5 Years of Age in Mali: A Prospective Case-Control Study

    Science.gov (United States)

    Messaoudi, Mélina; Sánchez Picot, Valentina; Telles, Jean-Noël; Diakite, Abdoul-Aziz; Komurian-Pradel, Florence; Endtz, Hubert; Diallo, Souleymane; Paranhos-Baccalà, Gláucia; Vanhems, Philippe

    2015-01-01

    Background There are very limited data on children with pneumonia in Mali. The objective was to assess the etiology and factors associated with community-acquired pneumonia in hospitalized children pneumonia; Controls were hospitalized children without respiratory features, matched for age and period. Respiratory specimens, were collected to identify 19 viruses and 5 bacteria. Whole blood was collected from cases only. Factors associated with pneumonia were assessed by multivariate logistic regression. Results Overall, 118 cases and 98 controls were analyzed; 44.1% were female, median age was 11 months. Among pneumonia cases, 30.5% were hypoxemic at admission, mortality was 4.2%. Pneumonia cases differed from the controls regarding clinical signs and symptoms but not in terms of past medical history. Multivariate analysis of nasal swab findings disclosed that S. pneumoniae (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.6–7.0), human metapneumovirus (aOR = 17.2, 95% CI: 2.0–151.4), respiratory syncytial virus [RSV] (aOR = 7.4, 95% CI: 2.3–23.3), and influenza A virus (aOR = 10.7, 95% CI: 1.0–112.2) were associated with pneumonia, independently of patient age, gender, period, and other pathogens. Distribution of S. pneumoniae and RSV differed by season with higher rates of S. pneumoniae in January-June and of RSV in July-September. Pneumococcal serotypes 1 and 5 were more frequent in pneumonia cases than in the controls (P = 0.009, and P = 0.04, respectively). Conclusions In this non-PCV population from Mali, pneumonia in children was mainly attributed to S. pneumoniae, RSV, human metapneumovirus, and influenza A virus. Increased pneumococcal conjugate vaccine coverage in children could significantly reduce the burden of pneumonia in sub-Saharan African countries. PMID:26696249

  9. Critical Success Factors of Public-Private-Partnership Projects in ...

    African Journals Online (AJOL)

    , to identify their relative importance in promoting good governance. Data obtained from experienced professionals and clients in PPP projects were critically analysed using influence index value. A total of 26 constraints and 12 CSFs were ...

  10. Critical factors which shaped Iranian cities in History

    International Nuclear Information System (INIS)

    Tabibian, M.

    1997-01-01

    The history of Iranian Cities and its associated urban a paces are long and colourful. the role of urban areas has always been an important one. It is important for the purpose at hand, to examine, albeit in a cursory fashion, some of critical factors which shaped the development of Iranian Cities, including urban spaces. Moreover, I believe that these forces created, in Iran, a variable, rational urban system and that the currency set of p roblems i n Iranian Cities results from new technological forces interacting with l der, historical forces. Of course, making generalizations about Persian towns is at best, a risky business, The wide range of natural and historical forces which have played across the face of this country have created special conditions in each urban settlement. But, in spite of the fact that each Persian town has a distinct character and ambience, one can easily see that these differences occur within a framework which is remarkably similar in both basic principles and details. Now, however, even greater forces are operating in Iran, as all over the world, to alter towns almost beyond recognition. The internal combustion engine is introducing a new scale of distance to the city; telecommunications are giving the city a new time scale; industrialization is challenging the traditional economic bases of cities. Tine and again, for both the East and West, these new forces have overwhelmed the more modest human scale of old towns. Times and again, planners and administrators have realized very late in the process that the other scales must be preserved as well. Iran is no exception. This article offers some suggestion as to how Iranian planners and administrators might preserve the human scale in Persian towns. It begins with a look at the history of Persian towns in an attempt to define (implicitly) the Persian human scale by describing the rational urban systems and details which developed in Iran over some 5,000 years of urbanisation. Then we

  11. Expression Profile of Three Splicing Factors in Pleural Cells Based on the Underlying Etiology and Its Clinical Values in Patients with Pleural Effusion

    Directory of Open Access Journals (Sweden)

    A-Lum Han

    2018-02-01

    Full Text Available Splicing factors (SFs are involved in oncogenesis or immune modulation, the common underlying processes giving rise to pleural effusion (PE. The expression profiles of three SFs (HNRNPA1, SRSF1, and SRSF3 and their clinical values have never been assessed in PE. The three SFs (in pellets of PE and conventional tumor markers were analyzed using PE samples in patients with PE (N = 336. The sum of higher–molecular weight (Mw forms of HNRNPA1 (Sum-HMws-HNRNPA1 and SRSF1 (Sum-HMws-SRSF1 and SRSF3 levels were upregulated in malignant PE (MPE compared to benign PE (BPE; they were highest in cytology-positive MPE, followed by tuberculous PE and parapneumonic PE. Meanwhile, the lowest-Mw HNRNPA1 (LMw-HNRNPA1 and SRSF1 (LMw-SRSF1 levels were not upregulated in MPE. Sum-HMws-HNRNPA1, Sum-HMws-SRSF1, and SRSF3, but neither LMw-HNRNPA1 nor LMw-SRSF1, showed positive correlations with cancer cell percentages in MPE. The detection accuracy for MPE was high in the order of carcinoembryonic antigen (CEA, 85%, Sum-HMws-HNRNPA1 (76%, Sum-HMws-SRSF1 (68%, SRSF3, cytokeratin-19 fragments (CYFRA 21-1, LMw-HNRNPA1, and LMw-SRSF1. Sum-HMws-HNRNPA1 detected more than half of the MPE cases that were undetected by cytology and CEA. Sum-HMws-HNRNPA1, but not other SFs or conventional tumor markers, showed an association with longer overall survival among patients with MPE receiving chemotherapy. Our results demonstrated different levels of the three SFs with their Mw-specific profiles depending on the etiology of PE. We suggest that Sum-HMws-HNRNPA1 is a supplementary diagnostic marker for MPE and a favorable prognostic indicator for patients with MPE receiving chemotherapy.

  12. The factors influencing burnout and job satisfaction among critical care nurses: a study of Saudi critical care nurses.

    Science.gov (United States)

    Alharbi, Jalal; Wilson, Rhonda; Woods, Cindy; Usher, Kim

    2016-09-01

    The aim of the study was to explore the prevalence of burnout and job satisfaction among Saudi national critical care nurses. Burnout is caused by a number of factors, including personal, organisational and professional issues. Previous literature reports a strong relationship between burnout and job satisfaction among critical care nurses. Little is known about this phenomenon among Saudi national critical care nurses. A convenience sample of 150 Saudi national critical care nurses from three hospitals in Hail, Saudi Arabia were included in a cross-sectional survey. Saudi national critical care registered nurses reported moderate to high levels of burnout in the areas of emotional exhaustion and depersonalisation. Participants also reported a feeling of ambivalence and dissatisfaction with their jobs but were satisfied with the nature of their work. Saudi national critical care nurses experience moderate to high levels of burnout and low levels of job satisfaction. Burnout is a predictor of job satisfaction for Saudi national critical care nurses. These results provide clear evidence of the need for nurse managers and policy makers to devise strategies to help nurses better cope with a stressful work environment, thereby also improving job satisfaction among Saudi national critical care nurses. © 2016 John Wiley & Sons Ltd.

  13. Influence of Critical Success Factors on Business Development in IT Consulting

    Directory of Open Access Journals (Sweden)

    Roman Vasiliev

    2015-08-01

    Full Text Available This study is intended to explore identification and usage of critical success factors in the activity of IT consulting service providers. Critical success factors and their measures are identified at the industrial level. For the corporate level, the study provides recommendations on elaboration of critical success factors for their further usage. Particular attention is paid to the role of critical success factors in activities of IT consulting service providers involving strategic management, project management, partnership and client relations. This issue has become the subject of the study.

  14. Queratitis infecciosa no viral: factores predisponentes, agentes etiológicos y diagnóstico de laboratorio Non viral infectious keratitis: predisposing factors, etiologic agents and laboratory diagnosis

    Directory of Open Access Journals (Sweden)

    Federico Nicola

    2005-12-01

    Full Text Available Las queratitis infecciosas poseen una elevada morbilidad, poniendo en riesgo la visión en casos graves. Dada la eficaz protección que brinda el epitelio corneal, para que ocurra una infección se requiere la presencia de factores condicionantes. El principal predisponente para las queratitis infecciosas es el uso de lentes de contacto, seguido por traumatismos y cirugías oculares y luego diversas afecciones locales o generales. Los agentes etiológicos abarcan una enorme diversidad de microorganismos, incluyendo bacterias, micobacterias, virus, hongos y parásitos. Para poder instaurar un tratamiento acotado se necesita un diagnóstico etiológico, lo que requiere una correcta toma de muestra y un exhaustivo análisis microbiológico.Infectious keratitis cause significant morbidity and, if it is not promptly and appropriately treated, can lead to severe ocular disability. Almost all cases of keratitis are associated to predisposing conditions. In occident, the main risk factor is contact lens wear, but previous ocular surgery or trauma are also important, as well as various ocular surface diseases. An enormous diversity of etiologic agents for infectious keratitis exist, including virus, bacteria, mycobacteria, fungi and parasites. This review provides literature and personal based information about main predisposing factors, etiologic agents and pathophysiology of infectious keratitis, excluding those of viral origin. Focus is made on microbiologic procedures, describing stains and media that should be used, and highlighting their utility. A special mention on particular situations is made, including laboratory diagnosis of Acanthamoeba keratitis, utility of lens cases analysis, keratitis in patients with previous treatment, as well as molecular biology techniques described in ophthalmology.

  15. Critical success factors in industrial marketing supply chain management

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2012-10-01

    Full Text Available Implementation of better marketing strategies in industry plays an important role in increasing sales and profitability of industrial part suppliers. Understanding the weakness in each part of supply chain helps reduce different cost component and increases profitability. In this paper, we present an empirical study to find important factors influencing marketing strategies based on factor analysis. The study designs and distributes a questionnaire consists of 64 questions. The proposed study uses Skewness analysis to reduce the factors into 44 items and reports 8 important factors including business environment, communication chain technology, good organizational relationship, leadership cost strategy, performance risk, ecommerce strategy, encouraging strategy and consistency in organizational performance.

  16. [Etiology of adult insomnia].

    Science.gov (United States)

    Dollander, M

    2002-01-01

    In the article, the author develops an analysis of external and intrapsychic factors related to adults' insomnia. First she undertakes a literature review to describe semiological, evolutive and etiological levels of insomnia. From a semiological point of view, it is usual to differenciate initial insomnia (associated to the first phase of sleeping), intermittent insomnia (related to frequent awakenings) and final insomnia (related to early morning awakenings). From an evolutive point of view, we can identify transitory insomnia (characterized by frequent awakenings) and chronic insomnia. On the other hand, we are allowed to distinguish organic insomnia (disorder where an organic cerebral injury is demonstrated or suspected) from insomnias related to psychiatric or somatic disease or idiopathic one. Then, the author makes a literary review to identify various insomnia causes and points out. Social factors: insomnia rates are higher by divorced, separated or widowed people. Percentages are higher when scholastic level is weak, domestic income is less then 915 O a month, or by unemployed people. Besides, sleep quality is deteriorated by ageing. Sleeping and waking rhythm is able to loose its synchronization. Complaints about insomnia occur far frequently from women than men. Environmental factors: working constraints increase sleep disorders. It is possible to make the same conclusion when we have to face overcharge of external events, deep intrapsychic conflicts (related to grief, unemployment, damage or hospitalization) or interpersonal conflicts' situations where we are confronted to stress related to socio-affective environment, lack of social support or conjugal difficulties. Medical and physiologic causes: legs impatience syndrome, recurrent limbs shakings syndrome, breathe stop during sleep, narcolepsy, excessive medicine or hypnotic drugs use, some central nervous system injuries, every nocturnal awakening (related to aches.), surgical operation

  17. Stakeholders' perception of critical success factors for sustainable ...

    African Journals Online (AJOL)

    Keywords: Facilities management, sub-Saharan Africa, success factors, sustainable ... which FM forms an integral part (Swearingen, 2014: 235). However, whereas ..... Early integrated smart and sustainable principle. 3.44. 13. 3.65. 11. 3.57.

  18. Critical success factors in industrial marketing supply chain management

    OpenAIRE

    Naser Azad; Seyed Mohsen; Seyed Aliakbar; Ali Nayeri

    2012-01-01

    Implementation of better marketing strategies in industry plays an important role in increasing sales and profitability of industrial part suppliers. Understanding the weakness in each part of supply chain helps reduce different cost component and increases profitability. In this paper, we present an empirical study to find important factors influencing marketing strategies based on factor analysis. The study designs and distributes a questionnaire consists of 64 questions. The proposed study...

  19. A Synthesis and Survey of Critical Success Factors for Computer Technology Projects

    Science.gov (United States)

    Baker, Ross A.

    2012-01-01

    The author investigated the existence of critical success factors for computer technology projects. Current research literature and a survey of experienced project managers indicate that there are 23 critical success factors (CSFs) that correlate with project success. The survey gathered an assessment of project success and the degree to which…

  20. 2010 Critical Success Factors for the North Carolina Community College System. Twenty First Annual Report

    Science.gov (United States)

    North Carolina Community College System (NJ1), 2010

    2010-01-01

    First mandated by the North Carolina General Assembly in 1989 (S.L. 1989; C. 752; S. 80), the Critical Success Factors report has evolved into the major accountability document for the North Carolina Community College System. This twenty first annual report on the critical success factors is the result of a process undertaken to streamline and…

  1. [Chronic diarrhea with uncommon etiology].

    Science.gov (United States)

    Gil Borrás, R; Juan Vidal, O; Talavera Encinas, M I; Bixquert Jiménez, M

    2005-03-01

    Chronic diarrhea is a common syndrome. An etiological diagnosis is often reached through clinical history, physical examination and simple tests. In some cases, when the etiology is not found, the syndrome is called functional diarrhea, even though established criteria are often not fulfilled. We present the case of a patient with diarrhea for several months. The most common causes were ruled out through clinical history, physical examination, radiographic studies and laboratory tests, and the patient was diagnosed with functional diarrhea. Three months later, the patient presented a neck mass, and biopsy revealed medullary carcinoma of the thyroid. A review of recommendations for the systematic evaluation of chronic diarrhea is presented. A general approach should include careful history taking characteristics of diarrhea (onset, associated symptoms, epidemiological factors, iatrogenic causes such as laxative ingestion), a thorough physical examination with special attention to the anorectal region, and routine laboratory tests (complete blood count and serum chemistry). In addition, stool analysis including electrolytes (fecal osmotic gap), leukocytes, fecal occult blood, excess stool fat and laxative screening can yield important objective information to classify the diarrhea as: osmotic (osmotic gaps > 125 mOsm/Kg), secretory (osmotic gaps diarrhea described above. A systematic approach to the evaluation of chronic diarrhea is warranted. Medullary thyroid carcinoma and other endocrine syndromes causing chronic diarrhea are very rare. Measurement of serum peptide concentrations should only be performed when clinical presentation and findings in stool or radiographic studies suggest this etiology.

  2. A critical examination of factors that might encourage secrecy

    Science.gov (United States)

    Tough, Allen

    If a signal is detected someday from extraterrestrial intelligence, several factors might encourage complete and immediate secrecy. As a result, all data might be restricted to the receiving facility or nation instead of being shared promptly with SETI scientists around the world. Seven factors seem particularly like to encourage secrecy: (1) the belief that people may panic; (2) the fear of a negative impact on religion, science, and culture; (3) embarrassment; (4) the individual and national competitive urge; (5) avoiding a harmful premature reply; (6) a national trade or military advantage; and (7) the fear of a Trojan Horse. Three steps might alleviate the particularly difficult factors (numbers 4, 5, 6): an international treaty for immediate sharing of possible signals with SETI scientists in several other countries; implementation and frequent use of an actual network of scientists for such sharing; and further study of the possible need for partial restriction of data about the location and channel of a suspected signal.

  3. Bioaccumulation factors in aquatic ecosystems. A critical review

    International Nuclear Information System (INIS)

    Karlsson, Sara; Meili, Markus; Bergstroem, Ulla

    2002-07-01

    The calculated concentrations of radionuclides in organisms are often obtained by means of bioaccumulation factors (BAF) that describe the internal concentration relative to an external concentration e.g. in the abiotic environments at steady-state conditions. Such factors are often used when modelling the dose to man from radio-nuclides released to the biosphere. Values of bioaccumulation factors vary widely in magnitude among elements, organisms, and environmental conditions which is not always considered. In order to relate the bioaccumulation factors for some radionuclides to environmental conditions as well as to the trophic level of the organism of concern we have compiled an extensive database with bioaccumulation factors (about 5,500 values) together with information on some environmental conditions. The data for nine radionuclides has been extracted and examined. A comparison between the bioaccumulation factors found in this study and values given in literature by IAEA and NCRP shows that the ranges presented in this study are generally somewhat higher with the exception of BAF for molybdenum in freshwater fish which is of the same order of magnitude. This is startling and calls for a thorough research. The amount of readily accessible and reliable values of BAF is limited, often because basic information such as e.g. units and part of organism examined, is not reported. This is surprising and also unfortunate for those who need such data for use in generic or specific models. A major update of recommended values appears to be necessary for many elements to account for the development of analytical methods and experiences from case studies over the past two decades

  4. Bioaccumulation factors in aquatic ecosystems. A critical review

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Sara; Meili, Markus; Bergstroem, Ulla [Studsvik Eco and Safety AB, Nykoeping (Sweden)

    2002-07-01

    The calculated concentrations of radionuclides in organisms are often obtained by means of bioaccumulation factors (BAF) that describe the internal concentration relative to an external concentration e.g. in the abiotic environments at steady-state conditions. Such factors are often used when modelling the dose to man from radio-nuclides released to the biosphere. Values of bioaccumulation factors vary widely in magnitude among elements, organisms, and environmental conditions which is not always considered. In order to relate the bioaccumulation factors for some radionuclides to environmental conditions as well as to the trophic level of the organism of concern we have compiled an extensive database with bioaccumulation factors (about 5,500 values) together with information on some environmental conditions. The data for nine radionuclides has been extracted and examined. A comparison between the bioaccumulation factors found in this study and values given in literature by IAEA and NCRP shows that the ranges presented in this study are generally somewhat higher with the exception of BAF for molybdenum in freshwater fish which is of the same order of magnitude. This is startling and calls for a thorough research. The amount of readily accessible and reliable values of BAF is limited, often because basic information such as e.g. units and part of organism examined, is not reported. This is surprising and also unfortunate for those who need such data for use in generic or specific models. A major update of recommended values appears to be necessary for many elements to account for the development of analytical methods and experiences from case studies over the past two decades.

  5. New technology planning and approval: critical factors for success.

    Science.gov (United States)

    Haselkorn, Ateret; Rosenstein, Alan H; Rao, Anil K; Van Zuiden, Michele; Coye, Molly J

    2007-01-01

    The steady evolution of technology, with the associated increased costs, is a major factor affecting health care delivery. In the face of limited capital resources, it is important for hospitals to integrate technology management with the strategic plan, mission, and resource availability of the organization. Experiences in technology management have shown that having a well-organized, consistent approach to technology planning, assessment, committee membership, approval, evaluation, implementation, and monitoring are key factors necessary to ensure a successful program. We examined the results of a survey that assessed the structure, processes, and cultural support behind hospital committees for new technology planning and approval.

  6. Exploring the critical factors influencing online lending intentions

    OpenAIRE

    Wang, Peng

    2015-01-01

    Background: Online lending (P2P lending) is a type of internet finance mainly used to meet the financial needs of small and medium-sized enterprises and groups of individuals. It is a supplement to the traditional financial system. Method: This paper uses PPDai.com - the most influential online lending platform in China - as a research object to study the leading factors that affect lenders' loan trust and perception of information asymmetry. It also studies the impacts of these factors on le...

  7. Critical Success Factors of Suggestions Systems. | Marx | IFE ...

    African Journals Online (AJOL)

    A literature study approach is followed to establish which factors contribute to the success and failure of various suggestion systems. It was found ... The value of the paper firstly, shows the importance of creativity and innovation within the organisation's own culture and the framework of a formal suggestion system. Secondly ...

  8. Growth factor choice is critical for successful functionalization of nanoparticles

    Directory of Open Access Journals (Sweden)

    Josephine ePinkernelle

    2015-09-01

    Full Text Available Nanoparticles (NPs show new characteristics compared to the corresponding bulk material. These nanoscale properties make them interesting for various applications in biomedicine and life sciences. One field of application is the use of magnetic NPs to support regeneration in the nervous system. Drug delivery requires a functionalization of NPs with bio-functional molecules. In our study, we functionalized self-made PEI-coated iron oxide NPs with nerve growth factor (NGF and glial cell-line derived neurotrophic factor (GDNF. Next, we tested the bio-functionality of NGF in a rat pheochromocytoma cell line (PC12 and the bio-functionality of GDNF in an organotypic spinal cord culture. Covalent binding of NGF to PEI-NPs impaired bio-functionality of NGF, but non-covalent approach differentiated PC12 cells reliably. Non-covalent binding of GDNF showed a satisfying bio-functionality of GDNF:PEI-NPs, but turned out to be instable in conjugation to the PEI-NPs. Taken together, our study showed the importance of assessing bio-functionality and binding stability of functionalized growth factors using proper biological models. It also shows that successful functionalization of magnetic NPs with growth factors is dependent on the used binding chemistry and that it is hardly predictable. For use as therapeutics, functionalization strategies have to be reproducible and future studies are needed.

  9. Media Bias: Context, Redundancy, and Critical Threshold as Cultural Factor.

    Science.gov (United States)

    Becker, Samuel L.

    Bias in mass communication can be defined as interpretation based on factors that are independent of the original information, or as shaping the meaning of information according to the context in which it is placed. Although research has explored the concept of bias from a number of perspectives, its subtle manifestations can be understood best by…

  10. Factors affecting mortality of critical care trauma patients | Hefny ...

    African Journals Online (AJOL)

    The most common mechanism of injury was road traffic collisions (72.3 %). The overall mortality was 13.9%. A direct logistic regression model has shown that factors that affected mortality were decreased GCS (p < 0.0001), mechanism of injury (p = 0.004) with burns having the highest mortality, increased age (p = 0.004), ...

  11. Critical success factors for reverse logistics in Indian industries

    DEFF Research Database (Denmark)

    Mangla, Sachin Kumar; Govindan, Kannan; Luthra, Sunil

    2016-01-01

    Industries face significant pressures to enact eco-friendly practices in their supply chain due to the constraints of natural resources and growing ecological awareness among customers. Reverse logistics (RL) has been considered as a systematic approach for industries to improve their environmental...... Economic and Strategic main factors belong to effect group. This model will help business analysts and supply chain managers formulate both short-term and long-term, flexible decision strategies for successfully managing and implementing RL adoption in the supply chain scenarios....... of the CSFs, while the DEMATEL approach categorizes the causal relationships among them. The findings of this work shows that the Global competitiveness main factor is highly prioritized, and thus, needs to be focused greatly in order to increase the effectiveness of RL adoption in business. The relative...

  12. Critical Success Factor for Implementing Vocational Blended Learning

    Science.gov (United States)

    Dewi, K. C.; Ciptayani, P. I.; Surjono, H. D.; Priyanto

    2018-01-01

    Blended learning provides many benefits to the flexibility of time, place and situation constraints. The research’s objectives was describing the factors that determine the successful implementation of blended learning in vocational higher education. The research used a qualitative approach, data collected through observations and interviews by questionnare based on the CSFs indicators refers to TAM and Kliger. Data analysis was inductive method. The result provided an illustration that the success of vocational blended learning implementation was largely determined by the selection of instructional models that are inline with learning achievement target. The effectiveness of blended learning required the existence of policy support, readiness of IT infrastructure. Changing lecturer’s culture by utilizing ICT can also encourage the accelerated process of successful implementation. It can concluded that determinant factor of successful implementation of blended learning in vocational education is determined by teacher’s ability in mastering the pedagogical knowledge of designing instructional models.

  13. Critical factors in recruiting health maintenance organization physicians.

    Science.gov (United States)

    Fisher, N B; Smith, H L; Pasternak, D P

    1993-01-01

    What factors facilitate successful physician recruiting by health care organizations? Answers surfaced in a study of physician recruiting by a large HMO in the Southwest. Professional networking and word-of-mouth advertising appear to be the prominent means by which physicians learn of attractive staff positions. Successful recruiting also depends on a practice setting that fosters quality care, emphasis on patient care delivery, and collegial interaction.

  14. A critical review on factors influencing fermentative hydrogen production.

    Science.gov (United States)

    Kothari, Richa; Kumar, Virendra; Pathak, Vinayak V; Ahmad, Shamshad; Aoyi, Ochieng; Tyagi, V V

    2017-03-01

    Biohydrogen production by dark fermentation of different waste materials is a promising approach to produce bio-energy in terms of renewable energy exploration. This communication has reviewed various influencing factors of dark fermentation process with detailed account of determinants in biohydrogen production. It has also focused on different factors such as improved bacterial strain, reactor design, metabolic engineering and two stage processes to enhance the bioenergy productivity from substrate. The study also suggest that complete utilization of substrates for biological hydrogen production requires the concentrated research and development for efficient functioning of microorganism with integrated application for energy production and bioremediation. Various studies have been taken into account here, to show the comparative efficiency of different substrates and operating conditions with inhibitory factors and pretreatment option for biohydrogen production. The study reveals that an extensive research is needed to observe field efficiency of process using low cost substrates and integration of dark and photo fermentation process. Integrated approach of fermentation process will surely compete with conventional hydrogen process and replace it completely in future.

  15. A survey on critical factors influencing new advertisement methods

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2013-02-01

    Full Text Available Soft drink beverages are important part of many people’s foods and many prefer soft drink to water when they have dinner. Therefore, this business model can be considered as the longest lasting sector for many years and there has been not much change in these products. However, new methods of advertisement play important role for increasing market share. In this paper, we study the impact of new methods of advertisement in product development. The proposed study of this paper designs a questionnaire for one of Iranian soft drink producers, which consisted of 274 questions in Likert scale and uses factor analysis (FA to analyze the results. The study selects 250 people who live in city of Tehran, Iran and Cronbach alpha has been calculated as 0.88, which is well above the minimum desirable limit. According to our results, there were six important factors impacting in product development, including modern advertisement techniques, emotional impact, strategy of market leadership, pricing strategy, product life chain and supply entity. The most important factor loading in these six components include impact of social values, persuading unaware and uninformed customers, ability to monopolizing in production, improving pricing techniques, product life cycle and negative impact of high advertisement.

  16. Critical factors in career decision making for women medical graduates.

    Science.gov (United States)

    Lawrence, Joanna; Poole, Phillippa; Diener, Scott

    2003-04-01

    Within the next 30 years there will be equal numbers of women and men in the medical workforce. Indications are that women are increasing their participation in specialties other than general practice, although at a slower rate than their participation in the workforce as a whole. To inform those involved in training and employment of medical women, this study investigated the influencing factors in career decision making for female medical graduates. A total of 305 women medical graduates from the University of Auckland responded to a mail survey (73% response rate) which examined influences on decision making, in both qualitative and quantitative ways, as part of a larger survey. Most women were satisfied with their careers. The principal component analysis of the influencing factors identified four distinct factors important in career choice - interest, flexibility, women friendliness and job security, although the first two of these were rated more highly than the others. Barriers to full participation by medical women in training and employment need to be systematically examined and removed. This is not only to allow women themselves to reach their full potential, but for workforce and socio-economic reasons. Initiatives that allow and value more flexible training and work practices, particularly through the years of child raising, are necessary for women and the health care workforce at large.

  17. Three factors critical for end-of-life care.

    Science.gov (United States)

    Franey, S G

    1996-01-01

    Appropriate care of persons with life-threatening illnesses requires a different, perhaps higher level of response from organized healthcare than has been typical in the past. This involves three critical components: Leaders must be committed, visible advocates of high-quality end-of-life care. This enables them to plan changes, deploy resources, and integrate this commitment throughout the organization's strategic plan. Ensuring appropriate care of the dying requires adequate human and financial resources. First, the organization must fully identify the educational and service needs of patients, families, and care givers experiencing life-threatening illnesses. The organization must work well with other community-based organizations to address identified needs. Senior managers can improve care by personally commissioning teams, acknowledging success, and rewarding performance. Finally, organizational goals, strategies, and performance objectives must be shaped by a commitment to ensure appropriate care of the dying. Our commitment to the dying must be based on our values. An organizational "statement of rights and responsibilities" is one way of providing a visible expression of the mission, core values, and mutual responsibilities among care givers and patients, residents, HMO members, and clients.

  18. Comparing critical success factors for PV between three regions

    International Nuclear Information System (INIS)

    Groenendaal, B.J.; Roosmalen, J.A.M. van

    2000-01-01

    As a research method the project team has chosen to survey the opinion of PV experts and persons involved in the implementation of PV. Therefore, a questionnaire was sent to about 300 persons spread among 3 regions America, Europe and Asia. The returned questionnaires have been statistical analysed with the software tool SPSS. The used analytical methods can be divided in a comparing method (Mann-Whitney test) and ranking methods (Friedman test and the medal classification test). General conclusions are that there is a significant difference in answers between America and Europe about the significance of 'cost reduction'. Also Asia is significant different from America and Europe for the factor 'technical' reliability. There is a significant difference about the status of financing between America and Europe versus Asia. All the regions have a different opinion about the status of RD and D'. Also the status of 'the PV network' is significant different between Asia and America. America and Europe rank 'financial aspects' and 'cost reduction' as the most significant aspects while Asia rank 'specialist knowledge' and 'the PV network' as the most significant. All regions rank 'specialist knowledge' having the worst status and rank 'environmental merits' and 'technical reliability' having the best status. Finally Europe and Asia differ significant about which aspect is the most important for the factors 'internationalisation and other activities'. Europe finds 'harmonisation of policy' the most important internationalisation aspect and Asia prefers 'development aid'. Asia prefers 'pioneering activities' and Europe prefers 'initiatives by social organisations' as most important other activity. (au)

  19. Perinatal Depression and Patterns of Attachment: A Critical Risk Factor?

    Directory of Open Access Journals (Sweden)

    Valentina Meuti

    2015-01-01

    Full Text Available Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS and the Experience in Close Relationship (ECR. A clinical group of subjects with perinatal depression (PND, 89 subjects was selected and compared with a control group (C, regarding psychopathological variables and attachment patterns. Results. The ECR showed a prevalence of “Fearful-Avoidant” attachment style in PND group (29.2% versus 1.1%, p<0.001; additionally, the EPDS average score increases with the increasing of ECR dimensions (Avoidance and Anxiety. Conclusion. The severity of depression increases proportionally to attachment disorganization; therefore, we consider attachment as both an important risk factor as well as a focus for early psychotherapeutic intervention.

  20. Factors predicting labor induction success: a critical analysis.

    Science.gov (United States)

    Crane, Joan M G

    2006-09-01

    Because of the risk of failed induction of labor, a variety of maternal and fetal factors as well as screening tests have been suggested to predict labor induction success. Certain characteristics of the woman (including parity, age, weight, height and body mass index), and of the fetus (including birth weight and gestational age) are associated with the success of labor induction; with parous, young women who are taller and lower weight having a higher rate of induction success. Fetuses with a lower birth weight or increased gestational age are also associated with increased induction success. The condition of the cervix at the start of induction is an important predictor, with the modified Bishop score being a widely used scoring system. The most important element of the Bishop score is dilatation. Other predictors, including transvaginal ultrasound (TVUS) and biochemical markers [including fetal fibronectin (fFN)] have been suggested. Meta-analyses of studies identified from MEDLINE, PubMed, and EMBASE and published from 1990 to October 2005 were performed evaluating the use of TVUS and fFN in predicting labor induction success in women at term with singleton gestations. Both TVUS and Bishop score predicted successful induction [likelihood ratio (LR)=1.82, 95% confidence interval (CI)=1.51-2.20 and LR=2.10, 95%CI=1.67-2.64, respectively]. As well, fFN and Bishop score predicted successful induction (LR=1.49, 95%CI=1.20-1.85, and LR=2.62, 95%CI=1.88-3.64, respectively). Although TVUS and fFN predicted successful labor induction, neither has been shown to be superior to Bishop score. Further research is needed to evaluate these potential predictors and insulin-like growth factor binding protein-1 (IGFBP-1), another potential biochemical marker.

  1. Critical Success Factors for Electronic Commerce in Chinese Electronic Information Industry

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Critical success factors (CSF) for electronic commerce (EC) are important for enterprises.This research discusses both assessment indicators and impact factors for EC success to help Chinese enterprises to achieve successful EC implementations. On the basis of literature review and experts survey, the research suggests some assessment indicators and impact factors for EC success. A hypothesis is proposed that leadership, strategy, management, organization, technology, customers,and suppliers factors would affect EC success. Furthermore, the research conducts an empirical study on the Chinese Electronic Information Industry to verify the hypothesis. Using factor analysis and regression analysis, the research finds out several critical factors--leadership, strategy, and organization--and critical sub-factors, such as leadership belief and organization management. These findings indicate the usefulness of this research model, especially for Chinese enterprises.

  2. Critical success factors for physical activity promotion through community partnerships.

    Science.gov (United States)

    Lucidarme, Steffie; Marlier, Mathieu; Cardon, Greet; De Bourdeaudhuij, Ilse; Willem, Annick

    2014-02-01

    To define key factors of effective evidence-based policy implementation for physical activity promotion by use of a partnership approach. Using Parent and Harvey's model for sport and physical activity community-based partnerships, we defined determinants of implementation based on 13 face-to-face interviews with network organisations and 39 telephone interviews with partner organisations. Furthermore, two quantitative data-sets (n = 991 and n = 965) were used to measure implementation. In total, nine variables were found to influence implementation. Personal contact was the most powerful variable since its presence contributed to success while its absence led to a negative outcome. Four contributed directly to success: political motive, absence of a metropolis, high commitment and more qualified staff. Four others resulted in a less successful implementation: absence of positive merger effects, exposure motive and governance, and dispersed leadership. Community networks are a promising instrument for the implementation of evidence-based policies. However, determinants of both formation and management of partnerships influence the implementation success. During partnership formation, special attention should be given to partnership motives while social skills are of utmost importance for the management.

  3. A Cross-Industry Review of B2B Critical Success Factors.

    Science.gov (United States)

    Eid, Riyad; Trueman, Myfanwy; Ahmed, Abdel Moneim

    2002-01-01

    Presents a comprehensive review of B2B (business-to- business) international Internet marketing and identifies 21 critical success factors in five categories: marketing strategy, including management support, strategic goals, and collaboration; Web site factors, including Web site design; global factors, including multilanguage sites and cultural…

  4. Analysis Of Critical Factors Of Microfinance Institutions Of Pakistan

    Directory of Open Access Journals (Sweden)

    Ather Azim Khan

    2010-12-01

    Full Text Available This article is about the performance of Microfinance Institutions MFIs of Pakistan. In this article the types of MFIs operating is Pakistan is discussed with their details i.e. Microfinance Banks, Rural Support Programs and NGOs. Some other organizations are also involved in micro financing but their percentage is very low. It is found that Rural Support Programs RSPs are not totally involved in microfinance but have a large chunk of funds for microfinance. Micro loans are given for various purposes including starting a new business. The real theme of microcredit is to give money to a poor person to start a small or micro business and increase his family income but micro loans are often used for many other purposes such as paying another expensive loan, paying for medical expenses of bread earner of the family, marriages, construction etc. In this research work the researcher has tried to analyze the performance of MFIs of Pakistan and to find out those factors which contribute in their effectiveness. Two approaches of microfinance i.e. Institutionists Approach and Welfarists Approach are discussed. To analyze the performance of MFIs both approaches are considered i.e. Institutionists and Welfarists. Seventeen parameters are selected, many of these are financial ratios and these are divided into four groups i.e. sustainability, transparency, outreach and efficiency. Some ratios/figures of each area of these MFIs are taken in the data and analysis is performed to find out that which ones are contributing more or less. This research can be helpful for the MFIs which want to improve their performance and check their areas of significance for further improvement and development considering their approach of alleviating poverty from the society.

  5. Defining critical success factors in TOD implementation using rough set analysis

    NARCIS (Netherlands)

    Thomas, R.; Bertolini, L.

    2017-01-01

    This paper defines critical success conditions in transit-oriented development (TOD), evaluating the impact of practices, policies, and governance models on implementation. As part of a meta-analysis of 11 international case studies, 16 critical success factors were developed and validated using

  6. Knowledge Management : Review of the Critical Success Factors and Development of a Conceptual Classification Model

    NARCIS (Netherlands)

    Sedighi, M.; Zand, F.

    2012-01-01

    Knowledge management is a critical issue in today's business world. Knowledge is considered as one of the most strategic resources of the firm and sources of competitive advantage. This research provides a comprehensive review of the literature on the Critical Success Factors (CSFs) and identifies

  7. The Critical Success Factor Method: Establishing a Foundation for Enterprise Security Management

    National Research Council Canada - National Science Library

    Caralli, Richard A; Stevens, James F; Willke, Bradford J; Wilson, William R

    2004-01-01

    .... The organization must perform well in key areas on a consistent basis to achieve the mission. These key areas unique to the organization and the industry in which it competes can be defined as the organization's critical success factors...

  8. Critical Success Factors and Their Application to DOD Weapon System Acquisition

    National Research Council Canada - National Science Library

    Harris, Chad M

    2006-01-01

    .... The goal of this project was to identify Critical Success Factors and determine if they could be applied to DoD acquisition programs in order to improve the acquisition process and provide program...

  9. [Epidemiologic findings of the etiology of psychogenic diseases].

    Science.gov (United States)

    Franz, M; Schellberg, D; Schepank, H

    1993-01-01

    In an epidemiological longitudinal field study, a sample of high risk probands suffering from medium psychogenic impairment was investigated with regard to the etiological relevancy of factors influencing psychogenic disorders (psychoneuroses, character neuroses, psychosomatic and/or psychosomatic functional diseases). The study focused the question of the etiological impact of personality, life events, and social support. With theoretical reference to the psychodynamic concept of personality trained physicians and psychologists investigated 240 probands in a half standardized psychodynamic interview which included psychometric and social empiric instruments. Expert ratings and self ratings were used to assess the current psychogenic impairment. The impact of the constructs personality, critical life events, and social support on psychogenic impairment was specified in two path models. In both models psychodynamic personality variables had the highest impact on the criterium. Psychodynamically consistent, the ability to establish mature object relations and the maturity of ego functions was inversely related to the degree of psychogenic impairment, whereas an immature organisation of defense mechanisms exerted an aggravating influence on the severity of impairment. The present path analyses altogether point to a possible central etiological impact of personality and/or psychodynamic variables on the severity of psychogenic impairment.

  10. Navy Contracting Analyzing Critical Success Factors and Perceived Impact on Success within an Organization

    OpenAIRE

    Hill, Josh R.; McGraw, Kevin L.

    2012-01-01

    MBA Professional Report Approved for public release, distribution unlimited Critical Success Factors (CSF) are essential ingredients within an organization that are necessary to meet critical mission objectives. Identifying those factors can be a vital asset and assist leadership in achieving successful outcomes in contract management. This report will focus on three major contracting commands within the United States Navy Naval Supply Systems Command, Global Logistics Support (NAVSUP-G...

  11. Critical success factors model developing for sustainable Kaizen implementation in manufactur-ing industry in Ethiopia

    Directory of Open Access Journals (Sweden)

    Haftu Hailu

    2017-12-01

    Full Text Available The purpose of the research is to identify critical success factors and model developing for sustaining kaizen implementation. Peacock shoe is one of the manufacturing industries in Ethiopia facing challenges on sustaining. The methodology followed is factor analysis and empirically testing hypothesis. A database was designed using SPSS version 20. The survey was validated using statistical validation using the Cronbach alpha index; the result is 0.908. The KMO index value was obtained for the 32 items and had a value of 0.642 with Bartlett's Test of Sphericity Approx. Chi-Square 4503.007, degree of freedom 496 and significance value 0.000. A factor analysis by principal components and varimax rotation was applied for finding the critical success factors. Finding designates that 32 items were merged into eight critical success factors. All the eight factors together explain for 76.941 % of the variance. Multiple regression model analysis has indicated that some of the critical success factors had relationship with success indicators. Due to constraint of time, the researcher focused only at peacock shoe manufacturing industry. Other limitation also includes the absence of any local research that shows the critical success factors at the moment.

  12. Quest to identify geochemical risk factors associated with chronic kidney disease of unknown etiology (CKDu) in an endemic region of Sri Lanka-a multimedia laboratory analysis of biological, food, and environmental samples.

    Science.gov (United States)

    Levine, Keith E; Redmon, Jennifer Hoponick; Elledge, Myles F; Wanigasuriya, Kamani P; Smith, Kristin; Munoz, Breda; Waduge, Vajira A; Periris-John, Roshini J; Sathiakumar, Nalini; Harrington, James M; Womack, Donna S; Wickremasinghe, Rajitha

    2016-10-01

    The emergence of a new form of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka's North Central Province (NCP) has become a catastrophic health crisis. CKDu is characterized as slowly progressing, irreversible, and asymptomatic until late stages and, importantly, not attributed to diabetes, hypertension, or other known risk factors. It is postulated that the etiology of CKDu is multifactorial, involving genetic predisposition, nutritional and dehydration status, exposure to one or more environmental nephrotoxins, and lifestyle factors. The objective of this limited geochemical laboratory analysis was to determine the concentration of a suite of heavy metals and trace element nutrients in biological samples (human whole blood and hair) and environmental samples (drinking water, rice, soil, and freshwater fish) collected from two towns within the endemic NCP region in 2012 and 2013. This broad panel, metallomics/mineralomics approach was used to shed light on potential geochemical risk factors associated with CKDu. Based on prior literature documentation of potential nephrotoxins that may play a role in the genesis and progression of CKDu, heavy metals and fluoride were selected for analysis. The geochemical concentrations in biological and environmental media areas were quantified. Basic statistical measurements were subsequently used to compare media against applicable benchmark values, such as US soil screening levels. Cadmium, lead, and mercury were detected at concentrations exceeding US reference values in many of the biological samples, suggesting that study participants are subjected to chronic, low-level exposure to these elements. Within the limited number of environmental media samples, arsenic was determined to exceed initial risk screening and background concentration values in soil, while data collected from drinking water samples reflected the unique hydrogeochemistry of the region, including the prevalence of hard or very hard water, and

  13. Identify and Classify Critical Success Factor of Agile Software Development Methodology Using Mind Map

    OpenAIRE

    Tasneem Abd El Hameed; Mahmoud Abd EL Latif; Sherif Kholief

    2016-01-01

    Selecting the right method, right personnel and right practices, and applying them adequately, determine the success of software development. In this paper, a qualitative study is carried out among the critical factors of success from previous studies. The factors of success match with their relative principles to illustrate the most valuable factor for agile approach success, this paper also prove that the twelve principles poorly identified for few factors resulting from qualitative and qua...

  14. Burning mouth syndrome: etiology.

    Science.gov (United States)

    Cerchiari, Dafne Patrícia; de Moricz, Renata Dutra; Sanjar, Fernanda Alves; Rapoport, Priscila Bogar; Moretti, Giovana; Guerra, Marja Michelin

    2006-01-01

    The Burning Mouth Syndrome (BMS) is an oral mucosa pain--with or without inflammatory signs--without any specific lesion. It is mostly observed in women aged 40-60 years. This pain feels like a moderate/severe burning, and it occurs more frequently on the tongue, but it may also be felt at the gingiva, lips and jugal mucosa. It may worsen during the day, during stress and fatigue, when the patient speaks too much, or through eating of spicy/hot foods. The burning can be diminished with cold food, work and leisure. The goal of this review article is to consider possible BMS etiologies and join them in 4 groups to be better studied: local, systemic, emotional and idiopathic causes of pain. Knowing the different diagnoses of this syndrome, we can establish a protocol to manage these patients. Within the local pain group, we must investigate dental, allergic and infectious causes. Concerning systemic causes we need to look for connective tissue diseases, endocrine disorders, neurological diseases, nutritional deficits and salivary glands alterations that result in xerostomia. BMS etiology may be of difficult diagnosis, many times showing more than one cause for oral pain. A detailed interview, general physical examination, oral cavity and oropharynx inspection, and lab exams are essential to avoid a try and error treatment for these patients.

  15. Etiology of homosexuality.

    Science.gov (United States)

    Headings, V E

    1980-08-01

    The range of expression of homosexuality and its association with certain cultural, environmental, and genetic factors are most consistent with the concept of a multifactorial trait. Additionally, genetic heterogeneity in this phenotype (alternative mutants corresponding to a single phenotype) is highly probable. In certain nonhuman and presumably in human species the normal sexual development of the hypothalamus is guided by an appropriate exposure to androgen at a critical early stage, and this in turn presumably contributes to sociopsychologic sex development. Particularly instructive in this regard have been the monogenic experiments of nature in man--XY females with insensitivity to androgens, congenital adrenal hyperplasia, and male pseudohermaphrodites (5-alpha-reductase deficiency). Additionally, in the human, sociopsychologic sex also appears to be molded by sex assigned at birth and sex of rearing. Several of the intersexuality syndromes and psychoses are accompanied by increased homosexuality, but a majority of homosexuals are not in these categories. A limited number of family studies, including twins, tentatively suggests a heritable risk, at least in some families.

  16. Critical Factors Explaining the Leadership Performance of High-Performing Principals

    Science.gov (United States)

    Hutton, Disraeli M.

    2018-01-01

    The study explored critical factors that explain leadership performance of high-performing principals and examined the relationship between these factors based on the ratings of school constituents in the public school system. The principal component analysis with the use of Varimax Rotation revealed that four components explain 51.1% of the…

  17. Modelling the critical success factors of agile software development projects in South Africa

    Directory of Open Access Journals (Sweden)

    Tawanda B. Chiyangwa

    2017-10-01

    Full Text Available Background: The continued in failure of agile and traditional software development projects have led to the consideration, attention and dispute to critical success factors that are the aspects which are most vital to make a software engineering methodology fruitful. Although there is an increasing variety of critical success factors and methodologies, the conceptual frameworks which have causal relationship are limited. Objective: The objective of this study was to identify and provide insights into the critical success factors that influence the success of software development projects using agile methodologies in South Africa. Method: Quantitative method of collecting data was used. Data were collected in South Africa through a Web-based survey using structured questionnaires. Results: These results show that organisational factors have a great influence on performance expectancy characteristics. Conclusion: The results of this study discovered a comprehensive model that could provide guidelines to the agile community and to the agile professionals.

  18. Critical Factors of E-Learning Adoption and Acceptance in Pakistan: A Literature Review

    Directory of Open Access Journals (Sweden)

    F. Kanwal

    2017-08-01

    Full Text Available This review paper examines the prior studies on critical factors of e-learning adoption in Pakistan. The search terms identified 40 papers reporting 25 conceptual and qualitative and 15 quantitative evidence about the e-learning adoption and critical factors that may influence the adoption of e-learning in Pakistan. The findings revealed that modern paradigm shift requires the in-depth analysis of government policies, institutional and management role, students and faculty attitude, social norms, cultural values as well as technological advancement. These factors may directly or indirectly affect the intention of students towards e-learning adoption. The lack of quantitative evidences illustrate that policy makers, practitioners and researchers need to pay attention for further research of identifying and analyzing the critical factors which enhances the e-learning adoption in Pakistan.

  19. Using the partial least squares (PLS) method to establish critical success factor interdependence in ERP implementation projects

    OpenAIRE

    Esteves, José; Pastor Collado, Juan Antonio; Casanovas Garcia, Josep

    2002-01-01

    This technical research report proposes the usage of a statistical approach named Partial Least squares (PLS) to define the relationships between critical success factors for ERP implementation projects. In previous research work, we developed a unified model of critical success factors for ERP implementation projects. Some researchers have evidenced the relationships between these critical success factors, however no one has defined in a form...

  20. Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

    Science.gov (United States)

    Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

    1999-01-01

    The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

  1. Critical Success in E-learning: An Examination of Technological and Institutional Support Factors

    Directory of Open Access Journals (Sweden)

    Maslin Masrom

    2008-12-01

    Full Text Available In recent years, information technology (IT becomes prominent to support teaching and learning activities. IT tools allow us to create, collect, store and use the information and knowledge. E-learning was one of IT tools introduced at College of Science and Technology (CST, University Technology Malaysia (UTM Kuala Lumpur since 2001. It has enabled a paradigm shift from institutio n-centered instruction to anywhere, anytime and anybody learning models. In CST the e-learning technology was used for accessing the syllabus and course content, submitting assignments, and taking class quizzes. This paper focuses on issues relating to the e-learning critical success factors (CSFs from university students’ perspective. In this study, two main factors related to the e-learning CSFs within a university environment included technological and institutional support factors were examined. Confirmatory factor modeling approach was used to assess the criticality of the measures included in each factor. The results indicated that the most critical measures for technological factor in terms of ease of access and infrastructure are the browser efficiency, course website ease of use and computer network reliability. Meanwhile, for institutional support factor, the most critical measure is the availability of technical support or help desk.

  2. STRATEGIC MAPS AND CRITICAL FACTORS FOR PROJECT MANAGEMENT MATURITY: A PROPOSAL

    Directory of Open Access Journals (Sweden)

    Sady Darcy Silva Junior

    2010-06-01

    Full Text Available Project Management (PM and Strategic Management (SM are two subjects of growing importance in the corporate environment which are normally considered in isolation. One way of integrating these two concepts might be via the concept of project management maturity (Westphal et al., 2008. Rabechini and Pessoa (2005 state that to obtain project management maturity, it is necessary to achieve success in a number of critical factors which include organizational culture and structure, as well as sponsorship at both tactical and strategic levels (Silva et al., 2008. Another way of achieving this connection is by using Balanced Scorecard (BSC as an auxiliary tool to integrate between projects and organizational strategy (Brock et al., 2003. The original developers of the BSC, Kaplan e Norton, subsequently developed the concept of strategy mapping, which they affirm "represents the missing link between the formulation and the execution of the strategy" (Kaplan e Norton, 2004. This paper proposes a strategy map identifying critical factors for attaining project management maturity. To formulate the map, we used a qualitative, exploratory approach oriented by Project Management theory and strategy mapping. We first identified 13 critical factors, then developed a strategy map, which was evaluated by six specialists (three in SM area and three in PM area.The results suggest links between strategic mapping nad critical factors in project management. It also contributes to both areas independently. Specifically, the study identifies critical factors for project management maturity while demonstrating the applicability of strategic mapping techniques to Balanced Scorecard concepts.

  3. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    OpenAIRE

    Yu-Chih Chen

    2009-01-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving a...

  4. Infección urinaria adquirida en la comunidad en pacientes pediátricos: clínica, factores de riesgo, etiología, resistencia a los antibióticos y respuesta a la terapia empírica Urinary tract infection acquired in the community in pediatric patients: Clinical picture, risk factors, etiology, antibiotic resistance, and response to empirical therapy

    Directory of Open Access Journals (Sweden)

    Álvaro Hoyos

    2012-06-01

    Full Text Available Objetivos. Describir la presentación clínica, factores de riesgo (FR, etiología y patrones de resistencia bacterianos en pacientes pediátricos hospitalizados con infección del tracto urinario (ITU de la comunidad. Explorar factores de riesgo en ITU por bacterias resistentes. Evaluar respuesta clínica a la terapia empírica con aminoglucósidos y el protocolo institucional de antibióticos en ITU frente al perfil de sensibilidad de los aislamientos. Métodos. Estudio de corte trasversal entre febrero 2009-febrero 2011. Resultados: ingresaron 106 pacientes, 47 hombres (44,3% vs. 59 mujeres (55,6%. El rango de edad más frecuente en ambos sexos fue 1-12 meses (63.2%. La ITU febril se presentó en el 78,7% de los hombres y en el 83,0% de las mujeres. Se encontraron FR en 59,4% de los pacientes y en el 27,3% se presentaron dos o más. Los principales agentes etiológicos fueron: Escherichia coli, Proteus mirabilis y Klebsiella pneumoniae; dos y 12 aislamientos (13.1% expresaron β-lactamasas de espectro extendido (βLEE o de tipo AmpC (presuntivo, respectivamente. En el análisis exploratorio, se observó una frecuencia significativamente superior del antecedente de malformación renal o de la vía urinaria en el grupo de pacientes con ITU causada por bacterias βLEE o AmpC (p=0,0095. La defervescencia como respuesta a la terapia empírica inicial con aminoglucósidos ocurrió en las primeras 36 horas en el 87,4% de los pacientes con ITU febril, independientemente del perfil de resistencia. Conclusiones. La ITU febril fue la principal presentación clínica. Se aislaron bacterias de la comunidad que expresaron βLEE+ o AmpC+. A nivel institucional el uso de aminoglucósidos son una buena alternativa para el tratamiento inicial debido a su alta efectividad clínica y bajo perfil de resistencia.Objectives: to describe the clinical presentation, risk factors (RF, etiology and bacterial resistance patterns in pediatric patients hospitalized with

  5. Microstructural factors influencing critical-current densities of high-temperature superconductors

    International Nuclear Information System (INIS)

    Suenaga, M.

    1992-01-01

    Microstructural defects are the primary determining factors for the values of critical current densities in superconductors. A review is made to assess, (1) what would be the maximum achievable critical-current density in the oxide superconductors if nearly ideal pinning sites were introduced? and (2) what types of pinning defects are currently introduced in these superconductors and how effective are these in pinning the vortices? Only the case where the applied field is parallel to the c-axis is considered here

  6. Critical constants and acentric factors for long-chain alkanes suitable for corresponding states applications

    DEFF Research Database (Denmark)

    Kontogeorgis, Georgios; Dimitrios, Tassios

    1997-01-01

    Several methods for the estimation of the critical temperature T-c, the critical pressure P-c, and the acentric factor omega for long-chain n-alkanes are reviewed and evaluated for the prediction of vapor pressures using Corresponding States (CS) methods, like the Lee-Kesler equation and the cubic....... Anselme, Correlation of the critical properties of alkanes and alkanols, Fluid Phase Equilibria, 56 (1990) 153-169; W. Hu, J. Lovland and P. Vonka. Generalized vapor pressure equations for n-alkanes, 1-alkenes, and 1-alkanols, Presented at the 11th Int. Congress of Chemical Engineering, Chemical Equipment...

  7. The Critical Factors of Scrum Implementation in IT Project - the Case Study

    Directory of Open Access Journals (Sweden)

    Aneta Ozierańska

    2016-07-01

    Full Text Available The paper first presents basic information about the Scrum method. Then it summarizes the state of art in the domain of Scrum implementation, especially as far as the critical factors of its success are concerned. On the basis of literature survey a new model classifying Scrum implementation critical factors is proposed. The model divides Scrum implementation critical factors into five categories: Project Team factors, Psychological and cultural factors, Process and Method, Environment and Technology. The model is then developed and verified using the case study method. The research was carried out in a French IT company by means of a participating observation. The company was implementing Scrum, which ended up as a success. A journal of the Scrum implementation was conducted, presenting the experiences of the Scrum Team, their opinions and changes in the Scrum method which were introduced. On its basis critical factors, crucial for the success of Scrum implementation, classified according to the above mentioned model, were identified, completing those which had been found in the literaturę.

  8. Critical success factors for positive user experience in hotel websites:applying Herzberg’s two factor theory for user experience modeling

    OpenAIRE

    Sambhanthan, Arunasalam; Good, Alice

    2013-01-01

    This research presents the development of a critical success factor matrix for increasing positive user experience of hotel websites based upon user ratings. Firstly, a number of critical success factors for web usability have been identified through the initial literature review. Secondly, hotel websites were surveyed in terms of critical success factors identified through the literature review. Thirdly, Herzberg’s motivation theory has been applied to the user rating and the critical succ...

  9. Symptomatology and etiology of chronic pediatric rhinosinusitis.

    Science.gov (United States)

    Ilhan, Adem Emre; Karaman, Murat; Tekin, Arman

    2012-01-01

    This study aims to define symptoms and etiology and determine how to prevent chronic rhinosinusitis in children. Between February 2003 and February 2005, 50 pediatric patients (25 girls and 25 boys; mean age 8.22 years; range 4 to 14 years) with chronic rhinosinusitis were included in the study. The patients were questioned about anterior/posterior nasal dripping, night cough, headache, nausea, vomiting and nasal obstruction for symptomatology; about school condition, smoking behavior of parents and history of asthma for etiology. Hemogram, serum biochemistry, allergy test, nasal smear, chest and lateral neck radiography and sweat test were performed. Symptomatologic examination revealed that 48% had anterior nasal dripping, 62% with postnasal dripping, 70% with headache and 90% with nasal obstruction. Evaluation of etiological factors revealed that 68% were going to school, 48% of the parents had the history of smoking, 42% with allergy test-positivity and 60% with adenoid vegetation. Our study results indicated that environmental factors are important as etiological factors in rhinosinusitis. For prevention, we recommend restriction of close relationship at school, not to smoke at home and vaccination in each year with influenza and S. pneumonia vaccine.

  10. Critical success factors simplified implementing the powerful drivers of dramatic business improvement

    CERN Document Server

    Howell, Marvin T

    2010-01-01

    Critical-to-success factors (CSFs) have become essential elements to strategic planning and no business can achieve consistent success without effectively adopting them. To take full advantage of CSFs, however, an organization must first understand what they are and how they can be used to drive organizational initiatives and processes. Critical Success Factors Simplified: Implementing the Powerful Drivers of Dramatic Business Improvement provides a concise manual on CSFs that will teach you how to identify and select the right CSFs, measure their impact, and adjust them as needed to reach your goals.

  11. Factors affecting criticality for spent-fuel materials in a geologic setting

    International Nuclear Information System (INIS)

    Gore, B.F.; Jenquin, U.P.; Serne, R.J.

    1981-04-01

    Following closure of a geologic repository for spent fuel, geologic process may change geometries and spacings, and water may enter the repository. In this study the conditions required for the criticality of spent fuel constituents are determined. Many factors affect criticality, and the effects of various possible post-closure changes are investigated. Factors having the greatest effect on criticality are identified to provide guidance for research programs and for design and evaluation studies. Section II describes the calculational methods and computer codes used to determine critical conditions. Section III of this document addresses effects of the fissile content of spent fuel on criticality. Calculations have been performed to determine the minimum critical mass of spent fuel actinides as a function of the duration of in-reactor fuel exposure for a variety of possible conditions. Section IV addresses the conditions required for criticality under a scenario believed to be highly unlikely but having a unique possibility. Pu quantities and concentrations required for criticality without water were determined for various conditions of Pu separation, rock moderation and reflection, rock impurities and isotopic content of the Pu. Section V addresses the possibility of geochemical processes separating Pu from other spent fuel constituents. Solubilities of U and Pu are calculated for groundwaters characteristic of basalt, tuff, granite, bedded and dome salt. Maximum concentrations which could be adsorbed on geologic media in contact with these groundwaters are then calculated. Comparison of these maximum adsorbed concentrations with the results presented in Section IV yields the conclusion that criticality cannot occur in sorbed deposits of Pu in geologic media due to the low Pu concentrations achievable. The possibility of selective Pu precipitation, however, is not ruled out by these arguments

  12. HIV lipodystrophy etiology and pathogenesis. Body composition and metabolic alterations: etiology and pathogenesis.

    Science.gov (United States)

    Kotler, Donald P

    2003-04-01

    The results of epidemiologic investigations have clearly indicated that the development of lipodystrophy is multifactorial. Factors related to HIV infection, hormonal influences, mitochondrial dysfunction, cytokine activation related to immune reconstitution, and individual genetic predisposition all have been hypothesized as etiologic. Recent studies suggest that immune dysregulation rather than HIV infection per se may be the predominant factor in the development of lipodystrophy.

  13. Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

    Science.gov (United States)

    Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

    2018-03-01

    To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

  14. An empirical study on critical success factors for electronic commerce in the Chinese publishing industry

    Institute of Scientific and Technical Information of China (English)

    HUANG Jinghua; ZHAO Chunjun; LI Jingting

    2007-01-01

    Critical success factors for electronic commerce (e-commerce) have been a hot topic in both the academe and industry. This paper puts forward hypotheses on success factors for e-commerce of traditional companies first. Then, it conducts an empirical study on the Chinese publishing industry in order to verify the hypotheses. After testing the validity and reliability of the data, this paper verifies the hypotheses with regression analyses, and finally identifies factors impacting e-commerce success such as leadership, strategy, organization, management, IT, customers, comprehensive functions of website and customer- oriented functions. In addition, customers, strategy, IT and comprehensive functions of website are identified as the critical factors impacting e-commerce success. This research not only stimulates e-commerce research in China, but also has an instructional effect on the implementation of e-commerce so that Chinese publishing enterprises can increase the success rate of their e-commerce objectives.

  15. Critical Success Factors of Mobile Application Development Projects: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Hamza Khastar

    2016-07-01

    Full Text Available This study seeks to identify the critical success factors of teams in the application-development project. To achieve this goal, a qualitative approach and content analysis was utilized. Semi-structured interviews with 14 developers and experts was performed for data collection. A systematic review of previous research shows that after 9 critical success factors. With the analysis interviews, the CSf's raised to 12; including user experience, strategy and project management, support and promotion, business models, planning and goal setting, financial and budgeting, marketing and customer needs, infrastructure, technical issues and design, contextual factors, teamwork and staffing. The results show that the customer experience, teamwork and contextual factors are core categories in the research paradigm model.

  16. Professional liability. Etiology.

    Science.gov (United States)

    White, K C

    1988-03-01

    Once again, I find Mr. Cooper quote-worthy for his statement, "It is incumbent upon the trial bar not to support the status quo merely because it is in our economic interest. Change is in the wind, and our tort system will be blown away on the winds of change for change's sake unless we participate in correcting deficiencies in the tort system and civil jury trial process." I suggest that we cannot ask for change for our own economic interest, nor can we lay blame exclusively to the other etiologic elements. We must improve those elements within our purview. The prayer of serenity may serve us well: God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. In the game of professional liability litigation as played by the rules extant there are clearly winners and losers. The winners are the legal profession, both plaintiff and defense, and the insurers, who in the face of adversity simply increase premiums or withdraw from the market. The losers are the medical profession, the patients for whom they care and, in the broadest sense, our society as a whole. So as not to close on a note of gloom, one last quote. Lawrence H. Cooke, former Chief Judge of New York State, in remarks to the April 1986 National Symposium on Civil Justice Issues stated, "Our justice systems are beset with very real problems.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Critical success factors model developing for sustainable Kaizen implementation in manufactur-ing industry in Ethiopia

    OpenAIRE

    Haftu Hailu; Abdelkadir Kedir; Getachew Bassa; Kassu Jilcha

    2017-01-01

    The purpose of the research is to identify critical success factors and model developing for sustaining kaizen implementation. Peacock shoe is one of the manufacturing industries in Ethiopia facing challenges on sustaining. The methodology followed is factor analysis and empirically testing hypothesis. A database was designed using SPSS version 20. The survey was validated using statistical validation using the Cronbach alpha index; the result is 0.908. The KMO index value was obtained for th...

  18. E-commerce evolution in Hungary: an investigation of critical succes factor

    OpenAIRE

    Kolos, Krisztina; Gáti, Mirkó; Gyulavári, Tamás

    2011-01-01

    In this paper we highlight how the use of internet has changed from 2004 to 2009 among Hungarian companies, how their expectations about the role of e-commerce as a competitive advantage has evolved and whether perceived benefits of e-commerce show a shift from 2004 to 2009.We investigate the role of environmental factors and market orientation as two relevant types of critical success factors proposed by the management literature and measure their impacts on Internet usage, ex...

  19. Etiology of Inguinal Hernias: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Stina Öberg

    2017-09-01

    Full Text Available BackgroundThe etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias.ResultsLateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue homeostasis.ConclusionThe etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor.

  20. CKD of Uncertain Etiology: A Systematic Review.

    Science.gov (United States)

    Lunyera, Joseph; Mohottige, Dinushika; Von Isenburg, Megan; Jeuland, Marc; Patel, Uptal D; Stanifer, John W

    2016-03-07

    Epidemics of CKD of uncertain etiology (CKDu) are emerging around the world. Highlighting common risk factors for CKD of uncertain etiology across various regions and populations may be important for health policy and public health responses. We searched PubMed, Embase, Scopus and Web of Science databases to identify published studies on CKDu. The search was generated in January of 2015; no language or date limits were used. We used a vote-counting method to evaluate exposures across all studies. We identified 1607 articles, of which 26 met inclusion criteria. Eighteen (69%) were conducted in known CKDu-endemic countries: Sri Lanka (38%), Nicaragua (19%), and El Salvador (12%). The other studies were from India, Japan, Australia, Mexico, Sweden, Tunisia, Tanzania, and the United States. Heavy metals, heat stress, and dietary exposures were reported across all geographic regions. In south Asia, family history, agrochemical use, and heavy metal exposures were reported most frequently, whereas altitude and temperature were reported only in studies from Central America. Across all regions, CKDu was most frequently associated with a family history of CKDu, agricultural occupation, men, middle age, snake bite, and heavy metal exposure. Studies examining etiologies of CKDu have reported many exposures that are heterogeneous and vary by region. To identify etiologies of CKDu, designing consistent and comparative multisite studies across high-risk populations may help elucidate the importance of region-specific versus global risk factors. Copyright © 2016 by the American Society of Nephrology.

  1. 9 CFR 381.303 - Critical factors and the application of the process schedule.

    Science.gov (United States)

    2010-01-01

    ... PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Critical factors and the application of the process schedule. 381.303 Section 381.303 Animals and Animal Products FOOD SAFETY AND...

  2. 9 CFR 318.303 - Critical factors and the application of the process schedule.

    Science.gov (United States)

    2010-01-01

    ... of the process schedule. 318.303 Section 318.303 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY...; REINSPECTION AND PREPARATION OF PRODUCTS Canning and Canned Products § 318.303 Critical factors and the...

  3. Key lessons: Twelve factors critical to the success of WDM at the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    English · Français ... Key lessons: Twelve factors critical to the success of WDM at the policy and at the operational levels ... from slums in central New Delhi to the city's desolate periphery face daily indignities and danger as they collect water o.

  4. Exploring Critical Factors of Self Concept among High Income Community College Graduates

    Science.gov (United States)

    Rasul, Mohamad Sattar; Nor, Ahmad Rosli Mohd; Amat, Salleh; Rauf, Rose Amnah Abdul

    2015-01-01

    This study was undertaken to explore the critical factors influencing the self-concept of community college graduates in the development of their careers. Individuals with a positive self-concept are often associated with a good career choices and a well-panned career development path. Hence community college students should be girded with a…

  5. Basement to surface expressions and critical factors in the genesis of unconformity-related deposits

    International Nuclear Information System (INIS)

    Potter, Eric

    2014-01-01

    Two subprojects: 1) Basement to surface expressions of deep mineralization and refinement of critical factors leading to the genesis of unconformity-related uranium deposits; and 2) Recognition of uranium ore system alteration signatures in complex terranes: IOCG vs albite-hosted uranium vs volcanic-hosted uranium.

  6. Contractors perspective for critical factors of cost overrun in highway projects of Sindh, Pakistan

    Science.gov (United States)

    Sohu, Samiullah; Abdullah, Abd Halid; Nagapan, Sasitharan; Fattah, Abdul; Ullah, Kaleem; Kumar, Kanesh

    2017-10-01

    Construction industry of Pakistan is creating a number of opportunities in employment as well as plays a role model for economy development of the country. This construction industry has a serious issue of cost overrun in all construction projects especially in construction of highway projects. Cost overrun is a serious and critical issue in construction of highway projects which gives negative impact to construction practitioners because it is not only cross the approved budget but also approved time of the project. The main objective of this study is to find out critical factors causing cost overrun in highway projects of Sindh according to contractors' perspectives. Deep literature review was carried out and a total of 64 factors of cost overrun were identified. To achieve the objective, a questionnaire was designed and distributed among 16 selected respondents who have more than 20 years of experience in construction of highway projects. The results from analysis found that most critical factors of cost overrun in the order of importance include financial and cash flow difficulties faced by contractor, frequent changes in design, changes in price of materials, poor planning by client, change in scope of project, change in specification of materials and delay in taking decisions. This study will assist contractors to narrow down some of the critical factors that would lead to cost overrun, and therefore be prepared with the ways to mitigate these problems in construction of highway projects of Sindh province.

  7. Critical success factors for implementing supply chain information systems : insights from the pork industry

    NARCIS (Netherlands)

    Denolf, J.M.

    2014-01-01

    Critical success factors for implementing supply chain information systems – Janne M. Denolf

    Due to intensified competition, companies realize that they should closely collaborate with their supply-chain partners to further cut costs and stay competitive. To do so,

  8. Towards a framework of critical success factors for implementing supply-chain information systems

    NARCIS (Netherlands)

    Denolf, J.M.; Wognum, P.M.; Trienekens, J.H.; Vorst, van der J.G.A.J.; Omta, S.W.F.

    2015-01-01

    Supply chain information systems (SCISs) have emerged as the core of successful management in supply chains. However, the difficulties of SCIS implementations have been widely cited in the literature. Research on the critical success factors (CSFs) for SCIS implementation is rather scarce and

  9. Critical Factors Affecting Students' Satisfaction with Higher Education in Sri Lanka

    Science.gov (United States)

    Weerasinghe, I. M. S.; Fernando, R. L. S.

    2018-01-01

    Purpose: The purpose of this study is to explain critical factors affecting student satisfaction levels in selected state universities in Sri Lanka. Design/methodology/approach: The study has applied an quantitative survey design guided by six hypotheses. A conceptual framework has been developed to address the research questions on the basis of a…

  10. Critical Success Factors: How One Multinational Company Develops Global E-Learning

    Science.gov (United States)

    Nathan, Edward Pavel

    2011-01-01

    This research study examined how a multinational company determined what the critical success factors (CSFs) were for developing global e-learning. The study analyzed how these CSFs were grouped together to make their management more efficient. There were 21 participants in the study who were key stakeholders from the United States, Europe, Latin…

  11. Critical Success Factors in Crafting Strategic Architecture for E-Learning at HP University

    Science.gov (United States)

    Sharma, Kunal; Pandit, Pallvi; Pandit, Parul

    2011-01-01

    Purpose: The purpose of this paper is to outline the critical success factors for crafting a strategic architecture for e-learning at HP University. Design/methodology/approach: A descriptive survey type of research design was used. An empirical study was conducted on students enrolled with the International Centre for Distance and Open Learning…

  12. Organisational Issues for E-Learning: Critical Success Factors as Identified by HE Practitioners

    Science.gov (United States)

    McPherson, Maggie; Nunes, Miguel Baptista

    2006-01-01

    Purpose: The purpose of this paper is to report on a research project that identified organisational critical success factors (CSFs) for e-learning implementation in higher education (HE). These CSFs can be used as a theoretical foundation upon which to base decision-making and strategic thinking about e-learning. Design/methodology/approach: The…

  13. Unleashing the Effectiveness of Process-oriented Information Systems: Problem Analysis, Critical Success Factors, Implications

    NARCIS (Netherlands)

    Mutschler, B.B.; Reichert, M.U.; Bumiller, J.

    2008-01-01

    Process-oriented information systems (IS) aim at the computerized support of business processes. So far, contemporary IS have often fail to meet this goal. To better understand this drawback, to systematically identify its rationales, and to derive critical success factors for business process

  14. Student Satisfaction with Learning Management Systems: A Lens of Critical Success Factors

    Science.gov (United States)

    Naveh, Gali; Tubin, Dorit; Pliskin, Nava

    2012-01-01

    Institutions of higher education have invested heavily in learning management systems (LMS) for creating course websites. Yet, how to assess LMS effectiveness is not fully agreed upon. Based on institutional theory, this article considers student satisfaction as indicative of LMS success and proposes a lens of critical success factors (CSF) as a…

  15. Vicious and virtuous cycles in ERP implementation : a case study of interrelations between critical success factors

    NARCIS (Netherlands)

    Akkermans, H.A.; Helden, van K.

    2002-01-01

    ERP implementations are complex undertakings. Recent research has provided us with plausible critical success factors (CSFs) for such implementations. This article describes how one list of CSFs (Somers & Nelson, 2001) was used to analyse and explain project performance in one ERP implementation in

  16. Validation of an e-Learning 3.0 Critical Success Factors Framework: A Qualitative Research

    Science.gov (United States)

    Miranda, Paula; Isaias, Pedro; Costa, Carlos J.; Pifano, Sara

    2017-01-01

    Aim/Purpose: As e-Learning 3.0 evolves from a theoretical construct into an actual solution for online learning, it becomes crucial to accompany this progress by scrutinising the elements that are at the origin of its success. Background: This paper outlines a framework of e-Learning 3.0's critical success factors and its empirical validation.…

  17. Operation, Safety and Human: Critical Factors for the Success of Railway Transportation

    NARCIS (Netherlands)

    Rajabali Nejad, Mohammadreza; Martinetti, Alberto; van Dongen, Leonardus Adriana Maria

    2016-01-01

    This paper focuses on three categories of performance indicators for railway transportation: the excellence of operation, system safety and human factors. These are among the most critical indicators for delivering high quality services. This paper discusses the main issues, challenges and future

  18. Critical Multicultural Citizenship Education among Black Immigrant Youth: Factors and Challenges

    Science.gov (United States)

    Kumi-Yeboah, Alex; Smith, Patriann

    2016-01-01

    This study uses qualitative interviews with 18 participants across five states to examine the factors that promote enhancement of critical multicultural education for Black immigrant youth. Findings suggest that class discussion, influence of social media and technology, non-educational practices, and cultural and language differences are the…

  19. STUDY ON ETIOLOGY OF ASCITES

    Directory of Open Access Journals (Sweden)

    Konatham

    2015-07-01

    Full Text Available In this study 100 cases of ascites, evaluated for the etiological causes. And observed as cirrhosis with portal hypertension 82%, heart failure 8%, chronic kidney disease 3%, nephritic syndrome 2%, peritoneal calcinomatosis 2%, chronic pancreatitis 1% por tal vein thrombosis 1%, Budd - chiari syndrome 1%. AIM OF THE STUDY: To study the various etiologies and their incidence of Ascites.

  20. From equity to power: Critical Success Factors for Twinning between midwives, a Delphi study.

    Science.gov (United States)

    Cadée, Franka; Nieuwenhuijze, Marianne J; Lagro-Janssen, Antoine L M; de Vries, Raymond

    2018-02-28

    To gain consensus for Critical Success Factors associated with Twinning in Midwifery. International publications identify midwifery as important for improving maternity care worldwide. Midwifery is a team effort where midwives play a key role. Yet their power to take on this role is often lacking. Twinning has garnered potential to develop power in professionals, however, its success varies because implementation is not always optimal. Critical Success Factors have demonstrated positive results in the managerial context and can be helpful to build effective Twinning relationships. We approached 56 midwife Twinning experts from 19 countries to participate in three Delphi rounds between 2016 - 2017. In round 1, experts gave input through an open ended questionnaire and this was analysed to formulate Critical Success Factors statements that were scored on a 1-7 Likert scale aiming to gain consensus in rounds 2 and 3. These statements were operationalized for practical use such as a check list in planning, monitoring and evaluation in the field. Thirty-three experts from 14 countries took part in all three Delphi rounds, producing 58 initial statements. This resulted in 25 Critical Success Factors covering issues of management, communication, commitment and values, most focus on equity. The Critical Success Factors formulated represent the necessary ingredients for successful Twinning by providing a practical implementation framework and promote further research into the effect of Twinning. Findings show that making equity explicit in Twinning may contribute towards the power of midwives to take on their identified key role. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  1. Critical Success Factors in Construction Projects (Governmental Projects as a Case Study

    Directory of Open Access Journals (Sweden)

    Hatem Khaleefah Al-Ageeli

    2016-03-01

    Full Text Available The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A selected 75 engineer (department managers, project managers and engineers are asked to fill the questionnaire form, Sixty-seven valid questionnaire forms were analyzed statistically to get search results, which were as follows : Twelve critical success factors, the most important factors of it were ("contractor financial efficiency ", " security ,political , economic stability ", "the project manager competence" and " Integration and clarity of contract documents " , thirteen critical failure factors, the most important factors of it were ("corruption " , " external circumstances ", "Financial difficulties of owner", and ten success criteria , the most important criteria of it were ("within allocated budget" , " within time period" , "Quality" .

  2. A Neighborhood Condition for Fractional ID-[A, B]-Factor-Critical Graphs

    Directory of Open Access Journals (Sweden)

    Zhou Sizhong

    2016-05-01

    Full Text Available Let G be a graph of order n, and let a and b be two integers with 1 ≤ a ≤ b. Let h : E(G → [0, 1] be a function. If a ≤ ∑e∋x h(e ≤ b holds for any x ∈ V (G, then we call G[Fh] a fractional [a, b]-factor of G with indicator function h, where Fh = {e ∈ E(G : h(e > 0}. A graph G is fractional independent-set-deletable [a, b]-factor-critical (in short, fractional ID-[a, b]- factor-critical if G − I has a fractional [a, b]-factor for every independent set I of G. In this paper, it is proved that if for any two nonadjacent vertices x, y ∈ V (G, then G is fractional ID-[a, b]-factor-critical. Furthermore, it is shown that this result is best possible in some sense.

  3. The Critical Factors for Korean Freight Forwarders’ Purchasing Negotiation in International Logistics

    Directory of Open Access Journals (Sweden)

    Soo Yong Shin

    2016-12-01

    Full Text Available The roles of freight forwarders as intermediaries continue to expand and become significant in international logistics. Purchasing negotiation is considered an important business process for freight forwarders and achieving a successful negotiation outcome should help forwarders to manage their business more effectively. This study used the analytical hierarchy process (AHP approach to identify the critical factors for successful purchasing negotiation for freight forwarders in Korea. A three-level AHP structure was constructed to examine the successful purchasing negotiation. The findings indicate that information (specifically quality of information is the most critical factor for a successful negotiation outcome for freight forwarders. This result turned out to be the same as the result found from the literature review. Literature review also indicated information as the most important factor.

  4. A Primary Human Critical Success Factors Model for the ERP System Implementation

    Directory of Open Access Journals (Sweden)

    Jenko Aleksander

    2016-08-01

    Full Text Available Background and Purpose: Many researchers have investigated various Critical success factors (CSFs and the different causes of ERP implementation project failures. Despite a detailed literature preview, we were unable to find an appropriate research with a comprehensive overview of the true causes behind CSFs, observed from a human factors perspective. The objective of this research was therefore to develop and evaluate the Primary human factors (PHFs model and to confirm the significant impact of PHFs on traditional CSFs and on the project success.

  5. An analysis on human factor issues in criticality accident at a uranium processing plant

    International Nuclear Information System (INIS)

    Sasou, Kunihide; Goda, Hidenori; Hirotsu, Yuko

    2000-01-01

    This report analyses latent factors of a human behavior directly contributing to the criticality accident. It is pouring some 16 kg-U with an enrichment of 18.8% into the precipitation tank. It is the fact that the direct cause of this accident is the workers' unsafe act. However, the authors find lots of latent factors relating to the production-biased company's policy, the poor climate for safety in the work place, the inadequate safety management and the unsuitable equipment. This accident was caused by many organizational factors. This paper also discusses lessons learned from this accident. (author)

  6. Eight critical factors in creating and implementing a successful simulation program.

    Science.gov (United States)

    Lazzara, Elizabeth H; Benishek, Lauren E; Dietz, Aaron S; Salas, Eduardo; Adriansen, David J

    2014-01-01

    Recognizing the need to minimize human error and adverse events, clinicians, researchers, administrators, and educators have strived to enhance clinicians' knowledge, skills, and attitudes through training. Given the risks inherent in learning new skills or advancing underdeveloped skills on actual patients, simulation-based training (SBT) has become an invaluable tool across the medical education spectrum. The large simulation, training, and learning literature was used to provide a synthesized yet innovative and "memorable" heuristic of the important facets of simulation program creation and implementation, as represented by eight critical "S" factors-science, staff, supplies, space, support, systems, success, and sustainability. These critical factors advance earlier work that primarily focused on the science of SBT success, to also include more practical, perhaps even seemingly obvious but significantly challenging components of SBT, such as resources, space, and supplies. SYSTEMS: One of the eight critical factors-systems-refers to the need to match fidelity requirements to training needs and ensure that technological infrastructure is in place. The type of learning objectives that the training is intended to address should determine these requirements. For example, some simulators emphasize physical fidelity to enable clinicians to practice technical and nontechnical skills in a safe environment that mirrors real-world conditions. Such simulators are most appropriate when trainees are learning how to use specific equipment or conduct specific procedures. The eight factors-science, staff, supplies, space, support, systems, success, and sustainability-represent a synthesis of the most critical elements necessary for successful simulation programs. The order of the factors does not represent a deliberate prioritization or sequence, and the factors' relative importance may change as the program evolves.

  7. Análise crítica dos resultados da reabilitação vestibular em relação à etiologia da tontura Critical analysis of vestibular rehabilitation outcome according to dizziness etiology

    Directory of Open Access Journals (Sweden)

    Roseli Saraiva Moreira Bittar

    2007-12-01

    Full Text Available A reabilitação vestibular (RV é uma ótima opção terapêutica para tratamento dos pacientes vestibulopatas. Contudo, mesmo quando bem conduzida, algumas vezes não surte os efeitos propostos. OBJETIVO: Avaliar a resposta de pacientes submetidos à RV em relação às etiologias apresentadas. Forma de Estudo: Retrospectivo descritivo. PACIENTES E MÉTODO: Analisamos pacientes que concluíram a RV e tinham diagnóstico entre janeiro de 2002 e dezembro de 2004. Dividimos os pacientes em três grupos, de acordo com a resposta à RV e os comparamos em relação às etiologias. RESULTADOS: Observamos 13 casos sem melhora com a RV, 24 com melhora parcial e 22 com remissão dos sintomas. As etiologias encontradas foram cervical, trauma, metabólica, central, transtornos da ansiedade e do humor, doença auto-imune, intolerância ortostática. A etiologia metabólica apresentou evolução significativamente melhor do que as demais. CONCLUSÃO: Quando associada à adequada correção etiológica, a RV é uma ótima opção no tratamento das vestibulopatias.Vestibular rehabilitation (VR is an excellent therapy for dizziness patients. However, despite well managed, sometimes results are not suitable. AIM: evaluate VR outcome between patients according to dizziness etiology. Study design: Retrospective review of medical records. METHOD: Patients’ records were analyzed between January 2002 and December 2004. As for inclusion criteria, patients should have had finished VR therapy and an established diagnosis. Patients were included in three VR outcome groups and compared according to etiology. RESULTS: according to VR outcome 13 patients had no improvement, 24 had partial improvement and 22 complete improvement. The main etiologies were cervical syndrome, trauma, metabolic disorders, central nervous system disorders, anxiety and mood disorders, autoimmune disease and orthostatic intolerance. Patients with metabolic disorders showed better VR outcome than

  8. Intellectual disability: definition, etiological factors, classification, diagnosis, treatment and prognosis Discapacidad intelectual: definición, factores etiológicos, clasificación, diagnóstico, tratamiento y prognosis

    Directory of Open Access Journals (Sweden)

    Gregorio Katz

    2008-01-01

    Full Text Available Etiology and classification: Causal factors related with cognitive disability are multiples and can be classified as follows: Genetic, acquired (congenital and developmental, environmental and sociocultural. Likewise, in relation to the classification, cognitive disability has as a common denominator a subnormal intellectual functioning level; nevertheless, the extent to which an individual is unable to face the demands established by society for the individual’s age group has brought about four degrees of severity: Mild, moderate, severe and profound. Diagnostic: The clinical history must put an emphasis on healthcare during the prenatal, perinatal and postnatal period and include the results of all previous studies, including a genealogical tree for at least three generations and an intentional search for family antecedents of mental delay, psychiatric illnesses and congenital abnormalities. The physical exam should focus on secondary abnormalities and congenital malformations, somatometric measurements and neurological and behavioral phenotype evaluations. If it is not feasible to establish a clinical diagnosis, it is necessary to conduct high-resolution cytogenetic studies in addition to metabolic clinical evaluations. In the next step, if no abnormal data are identified, submicroscopic chromosomal disorders are evaluated. Prognosis: Intellectual disability is not curable; and yet, the prognostic in general terms is good when using the emotional wellbeing of the individual as a parameter. Conclusions: Intellectual disability should be treated in a comprehensive manner. Nevertheless, currently, the fundamental task and perhaps the only one that applies is the detection of the limitation and abilities as a function of subjects’ age and expectations for the future, with the only goal being to provide the support necessary for each one of the dimensions or areas in which the person’s life is expressed and exposed.Etiología y clasificaci

  9. [Testing the significance of psychic factors in the etiology of alopecia areata. II. Examination of personality by means of Eysenck's Personality Inventory (MPI) adapted by Choynowski].

    Science.gov (United States)

    Wygledowska-Kania, M; Bogdanowski, T

    1995-01-01

    We evaluated the role of psychic factors in the etiopathogenesis of alopecia areata on the basis of Eysenck's Personality Inventory adapted by Choynowski. 55 patients were tested (28 women and 27 men). The control group consisted of 50 volunteers. The analysis of the results showed that the neurotic type of personality was predominant in the group of patients (43.64%). Neurotic personality found in such a high percentage of the patients with alopecia areata may be an additional element in the group of psychic factors that possibly have some influence on the development of the disease.

  10. Etiology, Localization and Prognosis in Cerebellar Infarctions

    Directory of Open Access Journals (Sweden)

    Yavuz Yücel

    2006-01-01

    Full Text Available Cerebrovasculer disease are the most frequent disease of the brain. Cerebellar infarct remains % 1.5-4.2 of these diseases. Etiological factors, lesion localization, symptoms and findings and relationship with prognosis of our patients with cerebellar infarct were investigated in our study. For this purpose, 32 patients were evaluated who were admitted to the Dicle University Medical School Department of Neurology in 1995-2001 hospitalized with the diagnosis of clinically and radiological confirmed cerebellar infarction.All of patients in the study group, 21 (%65.6 were male and 11 (%34.3 female. Age of overall patients ranged between 40 and 75 years with a mean of 57.8±10.2 years. Atherothrombotic infarct was the most frequent reason at the etiologic clinical classification. The most frequently found localization was the posterior inferior cerebellar artery infarct (%50. The leading two risk factors were hypertension (%78.1 and cigarette smoking (%50. The most common sign and symptoms were vertigo (%93.7, vomiting (%75, headache (%68.7 and cerebellar dysfunction findings (%50. The mean duration of hospitalization was 16.3±7.6 days. Overall mortality rate was found to be % 6.2. Finally, the most remarkable risk factors at cerebellar infarct patients are hypertension and atherosclerosis at etiology. We are considering that, controlling of these factors will reduce the appearance frequency of cerebellar infarcts.

  11. e-Healthcare in India: critical success factors for sustainable health systems.

    Science.gov (United States)

    Taneja, Udita; Sushil

    2007-01-01

    As healthcare enterprises seek to move towards an integrated, sustainable healthcare delivery model an IT-enabled or e-Healthcare strategy is being increasingly adopted. In this study we identified the critical success factors influencing the effectiveness of an e-Healthcare strategy in India. The performance assessment criteria used to measure effectiveness were increasing reach and reducing cost of healthcare delivery. A survey of healthcare providers was conducted. Analytic Hierarchy Process (AHP) and Interpretive Structural Modeling (ISM) were the analytical tools used to determine the relative importance of the critical success factors in influencing effectiveness of e-Healthcare and their interplay with each other. To succeed in e-Healthcare initiatives the critical success factors that need to be in place are appropriate government policies, literacy levels, and telecommunications and power infrastructure in the country. The focus should not be on the IT tools and biomedical engineering technologies as is most often the case. Instead the nontechnology factors such as healthcare provider and consumer mindsets should be addressed to increase acceptance of, and enhance the effectiveness of, sustainable e-Healthcare services.

  12. Critical Success Factors in The Infusion of Instructional Technologies for Open Learning in Development Settings

    Directory of Open Access Journals (Sweden)

    Philip M. Uys

    2003-10-01

    Full Text Available This article seeks to identify critical success factors for the appropriate infusion of instructional technologies to advance open learning in higher education within developing settings. Describe here is a descriptive account of a two-year case study based on the author’s personal analysis of, and reflection on, factors that contributed to the infusion of instructional technologies to advance open learning at the University of Botswana. The first critical success factors identified in this article include: a clear vision, support of committed leadership, and dedicated personnel/ change agents to ensure successful project implementation. The second critical success factor identified was the need for all involved to fully appreciate and understand the systemic nature of the infusion of instructional technologies for open learning purposes, as well as garner the commitment of strategic partners working in related systems. Finally highlighted, are the requirements needed to address the complex nature of the infusion of instructional technologies into the University’s educational offerings. It is hoped that those involved in education in developing countries, and particularly those desirous of advancing open learning through the use of instructional technologies, will find this descriptive analysis useful. Indeed, those of us involved in implementing instructional technologies in developing nations are still in the initial stages of this exciting yet challenging endeavour.

  13. An empirical study on identifying critical success factors on chaos management

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2012-08-01

    Full Text Available Chaos management is one of the most necessary efforts on managing business units. Many organizations fail to cope with undesirable circumstances, which may happen without any prior notice and as a result, they may face with significant financial losses. In this paper, we present an empirical study to determine critical success factors, which could help handle any possible chaos in organizations. The proposed study of this paper is implemented for a set of travel agencies located in Tehran, Iran. Chronbach alpha is calculated as 0.821, which is well above the minimum desirable level. In addition, we have also performed factor analysis, which yields a KMO value of 0.576 with the level of significance of 0.000. The results indicate that there are six important factors including effective management strategy, internal environmental factors, creative and innovative attitudes, external environmental factors and top level management thoughts.

  14. An exploratory study to identify critical factors of innovation culture in organizations

    Directory of Open Access Journals (Sweden)

    Hamed Asgari

    2013-07-01

    Full Text Available During the past two decades, there has been a growing trend on knowledge-based organizations. Innovation, on the other hand, plays essential role on building competitive business units. In this paper, we present an exploratory study to identify critical factors of innovation culture in organizations. We detect important factors influencing innovation culture in construction industry based on the implementation of factor analysis. The proposed study designs a questionnaire and distributes it among 400 experts who are involved in construction industry. Cronbach alpha has been calculated as 0.779, which validates the overall questionnaire. The results of factor analysis have indicated that six factors of building cultural infrastructures, education, organizational vision, established culture, strategic culture and flexible culture are the most important items influencing innovation culture.

  15. INTRA-ABDOMINAL HYPERTENSION AS A RISK FACTOR FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS

    Directory of Open Access Journals (Sweden)

    Sreelatha

    2016-05-01

    Full Text Available BACKGROUND AND AIMS Increased intra-abdominal pressure (IAP, also referred to as intra-abdominal hypertension (IAH, affects organ function in critically ill patients. The prevalence of IAH is between 32% - 65% in intensive care units. Normal IAP is ≈ 5–7 mmHg. According to WSACS definition, IAH = IAP ≥12 mmHg and is divided into 4 grades. They are Grade I (12-15 mmHg, Grade II (16-20 mmHg, Grade III (21-25 mmHg, Grade IV (>25 mmHg. Transvesical measurement of IAP currently is the most popular technique. Several systems with or without the need for electronic equipment are available that allow IAP measurement. The aim is to study the incidence of IAH in critically ill patients, to assess the risk factors for development of IAH, to study the role of IAH as a risk factor for Acute Kidney Injury (AKI, to assess the role of IAH as a risk factor for increased (Intensive Care Unit ICU mortality. SUBJECTS AND METHODS This is a prospective observational study. Study period was six months. The study included 52 patients admitted to Medical ICU in Government Medical College, Kozhikode, Kerala. RESULTS AND CONCLUSION There was a very high incidence of intra-abdominal hypertension in critically ill patients. IAH was significantly associated with risk factors like sepsis, mechanical ventilation, pancreatitis, capillary leak, ascites, cumulative fluid balance and cirrhosis. IAH is an independent risk factor for development of acute kidney injury. IAH is an independent predictor of mortality in critically ill patients.

  16. CRITICAL SUCCESS FACTORS FOR BROWN-FIELD CAPITAL AND RENEWAL PROJECTS

    Directory of Open Access Journals (Sweden)

    J. Warchol

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: Manufacturing companies operate in a business environment where incremental growth may be achieved through expansion and renewal of existing plant and facilities. Effective management of the critical success factors of such capital development projects may also provide competitive advantage. These projects tend to be of a brown-field nature, characterised by a significant level of risk arising from the interaction between the project implementation and concurrent operation of the existing physical asset base. So it is vital to understand the factors that influence the success of capital expansion and renewal projects in the brown-field context. Although each project has unique features, there are critical success factors that can be customised for successful outcomes in the brown-field environment. This study identifies five critical success factors applicable to brown-field capital expansion and renewal projects. Managerial focus on the critical factors, and the prospects for successful brown-field projects, are discussed in the paper.

    AFRIKAANSE OPSOMMING: Vervaardigers funksioneer in ‘n sakeomgewing waar voortgesette groei bereik word via uitbreiding en hernuwing van bestaande fasiliteite. Die doeltreffende bestuur van kritiese suksesfaktore van sodanige kapitaalprojekte bied geleentheid vir mededingende voordeel. Projekte van hierdie aard neig om geklassifiseer te word as van herontwikkelingsaard, met betekenisvolle gepaardgaande risiko wat voortspruit uit die interaksie tussen projekimplementering en gelyktydige bedryf van bestaande fisiese bates. Derhalwe is dit belangrik om in die konteks van herontwikkeling aandag te gee aan die kritiese faktore wat ‘n rol speel in die bereiking van sukses. Die navorsing identifiseer vyf kritiese suksesfaktore van belang vir uitbreidings- en vernuwingsprojekte.

  17. Historical perspectives on theories of periodontal disease etiology

    DEFF Research Database (Denmark)

    Hujoel, Philippe; Zina, Lívia Guimarães; Cunha-Cruz, Joana

    2012-01-01

    Our understanding of the causes of periodontal disease have changed greatly over time. The aim of this review is to provide a critical and historical perspective, dating back over more than a century, on two competing paradigms. While we understand that this stark dichotomization may be viewed...... as extreme, and is legitimately open to challenge, it is our hope that this didactic approach will serve to stimulate debate. The distinction made focuses on whether the primary etiology involves local causes, such as dental plaque, or involves remote causes, such as nutrition, tobacco use or other systemic...... factors. We provide a brief historical overview of the local and remote cause hypotheses and discuss some key reasons why the local cause hypothesis has become dominant....

  18. Identifying Critical Factors in the Eco-Efficiency of Remanufacturing Based on the Fuzzy DEMATEL Method

    Directory of Open Access Journals (Sweden)

    Qianwang Deng

    2015-11-01

    Full Text Available Remanufacturing can bring considerable economic and environmental benefits such as cost saving, conservation of energy and resources, and reduction of emissions. With the increasing awareness of sustainable manufacturing, remanufacturing gradually becomes the research priority. Most studies concentrate on the analysis of influencing factors, or the evaluation of the economic and environmental performance in remanufacturing, while little effort has been devoted to investigating the critical factors influencing the eco-efficiency of remanufacturing. Considering the current development of the remanufacturing industry in China, this paper proposes a set of factors influencing the eco-efficiency of remanufacturing and then utilizes a fuzzy Decision Making Trial and Evaluation Laboratory (DEMATEL method to establish relation matrixes reflecting the interdependent relationships among these factors. Finally, the contributions of each factor to eco-efficiency and mutual influence values among them are obtained, and critical factors in eco-efficiency of remanufacturing are identified. The results of the present work can provide theoretical supports for the government to make appropriate policies to improve the eco-efficiency of remanufacturing.

  19. Surface water acidification and critical loads: exploring the F-factor

    Directory of Open Access Journals (Sweden)

    K. Bishop

    2009-11-01

    Full Text Available As acid deposition decreases, uncertainties in methods for calculating critical loads become more important when judgements have to be made about whether or not further emission reductions are needed. An important aspect of one type of model that has been used to calculate surface water critical loads is the empirical F-factor which estimates the degree to which acid deposition is neutralised before it reaches a lake at any particular point in time relative to the pre-industrial, steady-state water chemistry conditions.

    In this paper we will examine how well the empirical F-functions are able to estimate pre-industrial lake chemistry as lake chemistry changes during different phases of acidification and recovery. To accomplish this, we use the dynamic, process-oriented biogeochemical model SAFE to generate a plausible time series of annual runoff chemistry for ca. 140 Swedish catchments between 1800 and 2100. These annual hydrochemistry data are then used to generate empirical F-factors that are compared to the "actual" F-factor seen in the SAFE data for each lake and year in the time series. The dynamics of the F-factor as catchments acidify, and then recover are not widely recognised.

    Our results suggest that the F-factor approach worked best during the acidification phase when soil processes buffer incoming acidity. However, the empirical functions for estimating F from contemporary lake chemistry are not well suited to the recovery phase when the F-factor turns negative due to recovery processes in the soil. This happens when acid deposition has depleted the soil store of BC, and then acid deposition declines, reducing the leaching of base cations to levels below those in the pre-industrial era. An estimate of critical load from water chemistry during recovery and empirical F functions would therefore result in critical loads that are too low. Therefore, the empirical estimates of the F-factor are a significant source of

  20. Burden, etiology and predictors of visual impairment among children ...

    African Journals Online (AJOL)

    . Knowledge of CVI is important in planning preventive measures. The aim of this study was determine the prevalence, etiology and the factors associated with childhood visual impairment among the children attending the eye clinic in Mulago ...

  1. Modern views on the epidemiology, etiology and pathogenesis of gynecomastia

    Directory of Open Access Journals (Sweden)

    Yu. N. Yashina

    2014-01-01

    Full Text Available The review deals with one of the pressing andrological issues – gynecomastia, its etiology and pathogenesis. Based on the current epidemiological and experimental data, most common etiological factors of gynecomastia were investigated. A multiple-valued role of various causes of gynecomastia in several age-groups was revealed. Literature data show that gynecomastia may be a manifestation of various diseases: endocrine, genetic, systematic. As well as that, gynecomastia may occur in patients with oncological diseases. However, gynecomastia can be an iatrogenic complication. Currently, we continue to make insights to the problem of gynecomastia in order to be able to classify its etiological factors and determine its basic pathogenesis pathways.

  2. Noncarious Cervical Lessions: From Etiology to Therapy

    OpenAIRE

    Marta Krolo; Aleksandra Kovačević

    2015-01-01

    The purpose of this article was to briefly summarize the most important characteristics of non-carious cervical lesions, as well as the etiological factors that lead to their formation. Cervical area represents one of the most sensitive parts of the tooth due to the specific position, as well as the structure and thickness of hard tissue. It is less resistant to various chemical and mechanical stimuli, and as a result the lesions in this area are frequently encountered in everyday practice.

  3. Reproductive glycogenetics--a critical factor in pregnancy success and species hybridisation.

    Science.gov (United States)

    Jones, C J P; Aplin, J D

    2009-03-01

    Hybridisation occurs rarely in nature and experiments using interspecific transfer of embryos generally result in implantation failure. Here we show that appropriate glycosylation of the apposing surfaces of endometrium and trophoblast probably is an important factor and may play a critical role in pregnancy success. Examination of closely related species shows that each has its own specific pattern of glycosylation, or glycotype, at the fetomaternal interface and that interacting surfaces appear to show complementarity, suggesting the existence of a glycocode. Studies on a camel/llama hybrid show that for successful implantation to occur, a hybrid must have a placental glycosylation pattern similar to that of the host species, suggesting that the glycocode and appropriate glycosylation may be critical factors in the establishment and maintenance of pregnancy. This new field of reproductive glycogenetics is not only relevant to the development of new species but may also have important implications in the area of human fertility.

  4. A Comparison Between Recent and Prospective Critical Success Factors in Lithuanian Printing Industry

    OpenAIRE

    Vilte Auruskeviciene; Laura Salciuviene; Ruta Kazlauskaite; Andrius Trifanovas

    2006-01-01

    The paper looks into the problem of identifying critical success factors in an industry. Though by definition all business organisations aim to be successful, companies within an industry differ a lot as regards their level of success. What makes some firms highly successful, when others have rather moderate success within the same industry? Can the above problems be explained by the wrong choice of strategic alternatives or inadequate strategy implementation? An empirical research of the Lit...

  5. Critical success factors for TQM implementation and their impact on performance of SMEs

    OpenAIRE

    Salaheldin, S.I.

    2009-01-01

    Abstract: Purpose – The purpose of this paper is to identify the critical success factors of TQM implementation, to evaluate their impact on the primary measures as expressed by the operational performance and the secondary measures as expressed by the organizational performance, and to find out the effect of the operational performance on the organizational performance of small and medium-sized enterprises (SMEs) in the Qatari industrial sector using the structured equation modeling (SEM) ap...

  6. Critical success factors of a business tourism destination: Supply side analysis

    OpenAIRE

    Milandrie Marais; Engelina du Plessis; Melville Saayman

    2017-01-01

    Orientation: Globally, destinations offer various products and services to visitors featuring different attributes and characteristics, making each destination unique. The critical success factors (CSFs) of each of these destinations may differ, making the management process more complex. Research purpose: The purpose of this research was to identify the CSFs for business tourism destinations in South Africa from a supply viewpoint. Motivation for the study: Because of the importance of...

  7. Critical Success Factors in Construction Projects (Governmental Projects as a Case Study)

    OpenAIRE

    Hatem Khaleefah Al-Ageeli; Abdul Salam J. Ali Alzobaee

    2016-01-01

    The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A select...

  8. Critical success factors for implementing supply chain information systems : insights from the pork industry

    OpenAIRE

    Denolf, J.M.

    2014-01-01

    Critical success factors for implementing supply chain information systems – Janne M. Denolf Due to intensified competition, companies realize that they should closely collaborate with their supply-chain partners to further cut costs and stay competitive. To do so, supply-chain partners should intensify information sharing, which is often facilitated through supply chain information systems (SCIS). Implementation of such a system is a complex undertaking due to the umpteen technical and organ...

  9. Unleashing the Effectiveness of Process-oriented Information Systems: Problem Analysis, Critical Success Factors, Implications

    OpenAIRE

    Mutschler, B.B.; Reichert, M.U.; Bumiller, J.

    2008-01-01

    Process-oriented information systems (IS) aim at the computerized support of business processes. So far, contemporary IS have often fail to meet this goal. To better understand this drawback, to systematically identify its rationales, and to derive critical success factors for business process support, we conducted three empirical studies: an exploratory case study in the automotive domain, an online survey among 79 IT professionals, and another online survey among 70 business process managem...

  10. The Etiology of Primary Hyperhidrosis

    DEFF Research Database (Denmark)

    Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.

    2017-01-01

    of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies.......Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...

  11. Etiology of pediatric acute liver failure

    Directory of Open Access Journals (Sweden)

    GUO Jing

    2017-10-01

    Full Text Available Pediatric acute liver failure (PALF is a complex syndrome with rapid progression, and the cause of PALF is age-dependent. This article analyzes the common causes of PALF in clinical practice, including infection factors, inherited metabolic factors, poisoning and drugs, abnormal perfusion, and autoimmune diseases, among which infection factors are the most common cause. With the improvement in diagnosis and treatment techniques, the diagnostic rate of PALF caused by inherited metabolic diseases and autoimmune diseases keeps increasing. Due to the small number of PALF patients, there lacks experience in etiological diagnosis. This article summarizes related reports, in order to provide a reference for screening the causes of PALF.

  12. The COTECH knowledge database: assessment of critical factors in micro moulding

    DEFF Research Database (Denmark)

    Tosello, Guido; Griffiths, C.A.; Hansen, Hans Nørgaard

    2012-01-01

    input parameters and process quality factors and material characteristics have been established. To meet the goal of high accuracy processing and manufacturing during the whole process chain, different means of optimization technologies based on the design of experiments method have been employed....... Methods to enhance the performance of the optimization methods have been demonstrated and validated. Based on the research work carried out, selected μlM critical factors including μlM pressure, surface replication, filing flow pattern analysis, and process simulation are presented in this paper...

  13. Implementation of Green New Product Development Among SMEs: Barriers and Critical Success Factors

    Directory of Open Access Journals (Sweden)

    Abu Noor Hidayah

    2018-01-01

    Full Text Available Green New Product Development (GNPD is very important due to environmental issues increasing. GNPD is defined as creating, designing and develop ecological product which could help in protecting the environment. Small and medium enterprise (SME firms is one of the contributor to the environmental issues but they could not afford to implement GNPD because there are several obstacles which prevent the successful of GNPD implementation. The objective of this paper are to identify the critical success factors and to determine the obstacles of GNPD implementation among SMEs. The method used in this study is conceptual review of previous literature in green and NPD area of research. The result finding of this paper consist of 9 critical success factors and 12 obstacles. All the critical success factors and obstacles will be grouped. The finding of this study could be a source and fundamental guideline for future study in developing framework for GNPD implementation especially for manufacturing SMEs in Malaysia. Besides that, the result of this study could help organization especially SMEs’s owner and manager in assessing their initiative to implement GNPD in organization.

  14. Assessment of critical success factors of TQM culture in hospitality sector in Kosovo

    Directory of Open Access Journals (Sweden)

    Bujar Pira

    2017-02-01

    Full Text Available This paper attemts to ilustrate how the managers and the staff of a 5 star hotel in Kosovo define quality. Furthermore, it explores the number of critical success factors related to TQM culture and how they are applied in the hotel operations. Different theories related to the quality in the field of service provision, more particular in hospitality or hotel sector and the introduction of the TQM culture in the same sector. A conceptual framework based on existing theories and literature is developed which is than confirms through the research findings and analysis. The findings suggest that most features associated with TQM, like critical success factors assessed throughout the research (leadership, customer focus, training, communication, teams and staff empowerment can produce an advantage for the 5 star hotel operations that will affect the quality of service. Furthermore, it confirms that some of the TQM aspects are applied and can be applied in 5 star hotel operations in Kosovo. The issue is whether these aspects are understood as TQM principles and whether their added value is embraced in the day-to-day running of the hotel. The outcomes imply that, indeed, the TQM culture is present in the The Hotel, a 5 star hotel in Kosovo. Some of the critical success factors are directly linked to TQM and some less and it also provides suggestions for improvement where needed, especially related to specific tools that are integral parts of the TQM culture.

  15. Critical success factors for implementing risk management systems in developing countries

    Directory of Open Access Journals (Sweden)

    M.Reza Hosseini

    2016-03-01

    Full Text Available A review of published studies on risk management in developing countries reveals that critical success factors for implementing risk management has remained an under-researched area of investigation. This paper is aimed at investigating the perceptions of construction professionals concerning the critical success factors (CSFs for implementation of risk management systems (IRMS. Survey data was collected from 87 construction professionals from the Iranian construction industry as a developing country. The results indicate that four factors are regarded as highly critical: ‘support from managers’, ‘inclusion of risk management in construction education and training courses for construction practitioners’, ‘attempting to deliver projects systematically’, and ‘awareness and knowledge of the process for implementing risk management’. Assessing the associations among CSFs also highlighted the crucial role of enhancing the effectiveness of knowledge management practices in construction organisations. Study also revealed that parties involved in projects do not agree on the level of importance of CSFs for implementing risk management in developing countries. This study contributes to practice and research in several ways. For practice, it increases understanding of how closely knowledge management is associated with the implementation of risk management systems in developing countries. For research, the findings would encourage construction practitioners to support effective knowledge management as a precursor to higher levels of risk management implementation on construction projects.

  16. Getting it right! Critical Success Factors of BPM in the Public Sector: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Rehan Syed

    2018-01-01

    Full Text Available The continuously evolving and dynamic social, economic, political environments and public pressures demand governments to deliver effective and efficient public services. In the quest for meeting these demands, governments respond by designing extensive reforms and performance objectives to improve the efficiency and responsiveness of their agencies. Many governments have adopted Business Process Management (BPM as a strategy to achieve these reforms. However, the successful implementation of BPM initiatives has been a challenging task for agencies responsible for these initiatives, with many projects not reaching completion or not achieving the intended outcomes. This paper reports the results of a systematic literature review on critical success factors (CSFs related to BPM projects in the public sector. We analysed 31 papers in this review covering both the developed and developing country contexts, sourced from refereed and peer reviewed journals. A quasi-deductive approach was applied for the qualitative data analysis using NVivo 10 software. This resulted in the synthesis and identification of 14 critical success factors of BPM in the public sector, each defined and described in detail with specific attention to the sub-factors mentioned within the literature. Any differences between developed and developing country contexts were sought for, and the observations critically analysed. We propose a series of research questions, designed to support the progression of BPM in the public sector of developed as well as developing countries.

  17. Identifying the Critical Factors Affecting Safety Program Performance for Construction Projects within Pakistan Construction Industry

    Directory of Open Access Journals (Sweden)

    Zubair Ahmed Memon

    2013-04-01

    Full Text Available Many studies have shown that the construction industry one of the most hazardous industries with its high rates of fatalities and injuries and high financial losses incurred through work related accident. To reduce or overcome the safety issues on construction sites, different safety programs are introduced by construction firms. A questionnaire survey study was conducted to highlight the influence of the Construction Safety Factors on safety program implementation. The input from the questionnaire survey was analyzed by using AIM (Average Index Method and rank correlation test was conducted between different groups of respondents to measure the association between different groups of respondent. The finding of this study highlighted that management support is the critical factor for implementing the safety program on projects. From statistical test, it is concluded that all respondent groups were strongly in the favor of management support factor as CSF (Critical Success Factor. The findings of this study were validated on selected case studies. Results of the case studies will help to know the effect of the factors on implementing safety programs during the execution stage.

  18. User acceptability--a critical success factor for picture archiving and communication system implementation.

    Science.gov (United States)

    Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

    2000-05-01

    The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

  19. Critical success factors for offshoring of enterprise resource planning (ERP implementations

    Directory of Open Access Journals (Sweden)

    Rajneesh Chauhan

    2012-01-01

    Full Text Available Background: In recent years, offshoring enterprise resource planning (ERP implementation has been an emerging trend in the field of offshoring information technology (IT. However, both ERP implementations and IT offshoring are fraught with risks, and when both ERP implementation and IT offshoring happen together, the risks become even more pronounced. Therefore, it is important to understand and identify the issues of ERP implementation in an offshoring situation. Objectives: The purpose of this paper is to highlight the key factors that enable successful offshoring ERP implementation from the client and the vendor perspective. Methods/Approach: The paper uses literature as a basis for identifying a critical success factor, data collected through semi-structured interviews with ERP managers at various levels of the subject organizations, and eventually their analysis. Results: The findings of the paper reveal that various factors are critical while implementing offshoring ERP. They include: offshoring partnership, project management, project team composition, people issues, communications and compliance of the onsite team composition. It is also noticed that ten factors are grouped into three categories: the client side, the vendor side, and both. Conclusions: Organizations are currently undertaking or considering the offshoring ERP implementation particularly from India. This paper will enable them to understand the possible challenges and areas of offshoring the ERP implementation program. The value and originality of the paper comes from the fact that up to now, ERP implementation in offshoring has not been comprehensively explored. This research provides a complete understanding of the critical success factors from the client, the vendor or both the client and the vendor perspective. It also enables researchers to analyse ili rethink ili review offshoring in different service areas.

  20. Information system support as a critical success factor for chronic disease management: Necessary but not sufficient.

    Science.gov (United States)

    Green, Carolyn J; Fortin, Patricia; Maclure, Malcolm; Macgregor, Art; Robinson, Sylvia

    2006-12-01

    Improvement of chronic disease management in primary care entails monitoring indicators of quality over time and across patients and practices. Informatics tools are needed, yet implementing them remains challenging. To identify critical success factors enabling the translation of clinical and operational knowledge about effective and efficient chronic care management into primary care practice. A prospective case study of positive deviants using key informant interviews, process observation, and document review. A chronic disease management (CDM) collaborative of primary care physicians with documented improvement in adherence to clinical practice guidelines using a web-based patient registry system with CDM guideline-based flow sheet. Thirty community-based physician participants using predominantly paper records, plus a project management team including the physician lead, project manager, evaluator and support team. A critical success factor (CSF) analysis of necessary and sufficient pathways to the translation of knowledge into clinical practice. A web-based CDM 'toolkit' was found to be a direct CSF that allowed this group of physicians to improve their practice by tracking patient care processes using evidence-based clinical practice guideline-based flow sheets. Moreover, the information and communication technology 'factor' was sufficient for success only as part of a set of seven direct CSF components including: health delivery system enhancements, organizational partnerships, funding mechanisms, project management, practice models, and formal knowledge translation practices. Indirect factors that orchestrated success through the direct factor components were also identified. A central insight of this analysis is that a comprehensive quality improvement model was the CSF that drew this set of factors into a functional framework for successful knowledge translation. In complex primary care settings environment where physicians have low adoption rates of

  1. Critical success factors in implementing an e-rostering system in a healthcare organisation.

    Science.gov (United States)

    Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

    2017-01-01

    Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

  2. Prediction of safety critical software operational reliability from test reliability using testing environment factors

    International Nuclear Information System (INIS)

    Jung, Hoan Sung; Seong, Poong Hyun

    1999-01-01

    It has been a critical issue to predict the safety critical software reliability in nuclear engineering area. For many years, many researches have focused on the quantification of software reliability and there have been many models developed to quantify software reliability. Most software reliability models estimate the reliability with the failure data collected during the test assuming that the test environments well represent the operation profile. User's interest is however on the operational reliability rather than on the test reliability. The experiences show that the operational reliability is higher than the test reliability. With the assumption that the difference in reliability results from the change of environment, from testing to operation, testing environment factors comprising the aging factor and the coverage factor are developed in this paper and used to predict the ultimate operational reliability with the failure data in testing phase. It is by incorporating test environments applied beyond the operational profile into testing environment factors. The application results show that the proposed method can estimate the operational reliability accurately. (Author). 14 refs., 1 tab., 1 fig

  3. The human factor: the critical importance of effective teamwork and communication in providing safe care.

    Science.gov (United States)

    Leonard, M; Graham, S; Bonacum, D

    2004-10-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

  4. Factors Influencing Critical Care Nurses' Perception of Their Overall Job Satisfaction: An Empirical Study.

    Science.gov (United States)

    Moneke, Ngozi; Umeh, Ogwo J

    2015-10-01

    The aim of this study was to explore the factors influencing critical care nurses’ perception of their overall job satisfaction. Nurses’ job satisfaction is a key issue to consider in the retention of critical care nurses. Shortages of nurses result in unsafe patient care, increased expense, and increased stress levels among other nurses. The Leadership Practices Inventory was used among a sample of critical care nurses to measure perceived leadership practices, the Organizational Commitment Questionnaire measured nurses commitment, and the Job in General scale was used to measure nurses’ overall job satisfaction. Four different hypotheses were tested using bivariate and multivariate statistical analytical techniques. Statistically significant relationships were found among the following hypotheses: (a) perceived leadership and job satisfaction; (b) organizational commitment and job satisfaction; and (c) perceived leadership practices, organizational commitment, and job satisfaction. No significant relationships were found among critical care nurses’ demographic variables and job satisfaction. Organizational commitment was the strongest predictor of job satisfaction. Encourage the heart (B = 0.116, P = .035) and organizational commitment (B = 0.353, P = .000) were found to be significantly associated with job satisfaction. These findings have implications for nurse educators, preceptors, administrators, recruiters, and managers in promoting satisfaction.

  5. Two factors important to the criticality potential of spent fuel in geologic repositories

    International Nuclear Information System (INIS)

    Gore, B.F.; Jenquin, U.P.

    1981-02-01

    Two factors important to the criticality potential of spent fuel in geologic repositories are: the residual fissile content of the fuel, and the extent to which geochemical processes might somehow separate and accumulate plutonium from other spent fuel materials. This paper presents the results of two calculational surveys defining conditions required for criticality. In the first, homogeneous spherical mixtures of spent fuel actinide oxides and water with water reflection are analyzed. Graphs of minimum critical mass vs duration of in-reactor exposure are presented. Parametric variations from a base case are explored, including the effects of initial enrichment, post exposure radioactive decay and addition of rock materials to the mixture. In the second study, homogeneous spherical mixtures devoid of water, containing plutonium and a neutronically optimized rock material, with a thick rock neutron reflector are analyzed. Graphs of Pu critical mass are presented as a function of concentration over the range from 2 to 100 g Pu/l. Parametric variations from a base case are explored, including effects of rock composition, 240 Pu content and uranium contamination of the plutonium

  6. Transferring disease management and health promotion programs to other countries: critical success factors.

    Science.gov (United States)

    Azarmina, Pejman; Prestwich, Graham; Rosenquist, Joel; Singh, Debbie

    2008-12-01

    Governments and health service providers around the world are under pressure to improve health outcomes while containing rising healthcare costs. In response to such challenges, many regions have implemented services that have been successful in other countries-but 'importing' initiatives has many challenges. This article summarizes factors found to be critical to the success of adapting a US disease management and health promotion programme for use in Italy and the UK. Using three illustrative case studies, it describes how in each region the programme needed to adapt (i) the form and content of the disease management service, (ii) the involvement and integration with local clinicians and services and (iii) the evaluation of programme outcomes. We argue that it is important to implement evidence-based practice by learning lessons from other countries and service initiatives, but that it is equally important to take into consideration the '3Ps' that are critical for successful service implementation: payers, practitioners and patients.

  7. Pilot Critical Incident Reports as a Means to Identify Human Factors of Remotely Piloted Aircraft

    Science.gov (United States)

    Hobbs, Alan; Cardoza, Colleen; Null, Cynthia

    2016-01-01

    It has been estimated that aviation accidents are typically preceded by numerous minor incidents arising from the same causal factors that ultimately produced the accident. Accident databases provide in-depth information on a relatively small number of occurrences, however incident databases have the potential to provide insights into the human factors of Remotely Piloted Aircraft System (RPAS) operations based on a larger volume of less-detailed reports. Currently, there is a lack of incident data dealing with the human factors of unmanned aircraft systems. An exploratory study is being conducted to examine the feasibility of collecting voluntary critical incident reports from RPAS pilots. Twenty-three experienced RPAS pilots volunteered to participate in focus groups in which they described critical incidents from their own experience. Participants were asked to recall (1) incidents that revealed a system flaw, or (2) highlighted a case where the human operator contributed to system resilience or mission success. Participants were asked to only report incidents that could be included in a public document. During each focus group session, a note taker produced a de-identified written record of the incident narratives. At the end of the session, participants reviewed each written incident report, and made edits and corrections as necessary. The incidents were later analyzed to identify contributing factors, with a focus on design issues that either hindered or assisted the pilot during the events. A total of 90 incidents were reported. Human factor issues included the impact of reduced sensory cues, traffic separation in the absence of an out-the-window view, control latencies, vigilance during monotonous and ultra-long endurance flights, control station design considerations, transfer of control between control stations, the management of lost link procedures, and decision-making during emergencies. Pilots participated willingly and enthusiastically in the study

  8. Etiology and Management of Sexual Dysfunction

    Directory of Open Access Journals (Sweden)

    Narendra Kumar Muthugaduru Shivarudrappa

    2009-09-01

    Full Text Available Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its management

  9. CRITICAL FACTORS IN HRD PROJECTS’ IMPLEMENTATION: EVIDENCE FROM PUBLIC UNIVERSITIES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Brancu Laura

    2013-07-01

    Full Text Available For Romania, European Integration came with new challenges for the entire society, especially for investment project promoters, including public higher education institutions. Investments in human capital development and education have an important role in a country’s economic development and growth but, in spite of the large number of human resources development public projects being financed, major problems were identified in their implementation process, particularly factors from the macro-economic and institutional environment. Most of the current interest in this area is centered on identifying and analyzing these key factors since their understanding might lead to ensuring an improvement of the implementation process and to a project’s success. In this context, our paper’s objective is to provide a set of critical success factors for HRD projects’ implementation process by developing a framework for external environment factors’ analysis from a public project management perspective. Taking into consideration the current impact of the external environment’ factors upon projects in Romania, in this paper we chose to focus our attention only on the critical success factors of the external socio-economic, institutional, technological and cultural environment, that affect the implementation phase of a project. We started with an analysis of the Romanian context that allowed us to develop a conceptual framework. We then realized a survey on a sample of three Romanian public universities which implemented projects in human capital development by developing and applying a questionnaire to 112 persons involved as management in projects in order to identify the key factors from the external environment that affect a project’s implementation process. Results show that the most significant factors, with a negative impact, are political and economical ones while technological and cultural factors are

  10. On the critical success factors for B2B e-marketplace

    Directory of Open Access Journals (Sweden)

    Sareh Ahmad Khan Beige

    2015-01-01

    Full Text Available Advancement of network technology, quick growth of Internet and Internet based solutions lead many firms to apply online processes as well as electronic businesses. Internet based B2B E-C requires applying Internet and affiliated technologies for exchanging products, services and information. Implementation of business to business (B2B requires long-term commitment of organizations. Carrying out research in this field is regarded as very important issue for recognizing effective factors on successful implementation and execution of B2B and determining current status of organization. This research deals with studying effective critical factors on successful implementation and execution of B2B. Factors are recognized through studying literature review and IT experts. Then, through case study (studying a vehicle manufacturing firm and by using analytical network process (ANP, the importance of factor and their rank are determined. The factors that are regarded at this research are including: culture, commitment and support of senior management, government support, purposes, organizational strategies, trust, partial advantage and technical infrastructure. Results of research show that support and commitment of senior management are the highest priority factors.

  11. [Urinary incontinence as a risk factor for pressure sores does not withstand a critical examination].

    Science.gov (United States)

    Krause, Tom; Anders, Jennifer; von Renteln-Kruse, Wolfgang

    2005-10-01

    The association between urinary incontinence and pressure sores is put down to various causes. Most frequently urinary wet and following maceration of the skin are mentioned. However, it is possible that urinary incontinence is only an indicator for other risk factors or a measure of the need for care without any causal relation to pressure sores. There are hardly any controlled or randomised studies; this lack of scientific evidence is problematic. Based on a case-control-study including data of 200 patients as well as on the existing models of explanation, the following study tries to examine critically the connections between pressure sores and urinary incontinence. Out of the patients in our study population 97.5 percent were incontinent. Different categories of the risk factor urinary incontinence and different dichotomisations have led to different statistical results. Statements concerning the connection between urinary incontinence and pressure sores have to be interpreted critically. The dependence of urinary incontinence on other risk factors such as patients' need for care or compliance suggests that the causal connection to pressure sores be not reduced to the influence of wetness. We advise to research connections between urinary incontinence and pressure sores in a methodologically appropriate setting.

  12. Prospects of competitive process innovation business in Brazil: critical factors for competitiveness, productivity and growth

    Directory of Open Access Journals (Sweden)

    Kátia Keiko Kitaguti

    2017-09-01

    Full Text Available The economic conditions of recent times require a structural changing and, mainly, behavioral ones of Brazilian business. The scenario created by big economic powers shows the difference between Brazilian industries and service sectors when it is compared business issues, for example, competitiveness, productivity and innovation, with others countries. The technological innovation consists in a critical factor for competitiveness and for the global economic development; moreover, it can be found in industrial sectors (responsible for materialization and organization of operational system of production process and in service sectors (which make planning of the contracted activity. Innovation should not be included only in these two economic sectors; however, it has to be included in the economic thought of countries. It has to be highlighted the fact that innovation is not the unique factor of competitiveness, but, productivity and knowledge make the same impact in competitiveness as innovation does. Besides, external and internal demands predict trends in terms of searching products, process an strategies, which can promote a better interaction between market and productivity control. In a global context, Brazil, specially, has a lot of techniques to learn in terms of how to use its resources in a adequate way, independently if they are natural or not. That is why studies about critical factors for competitiveness are determined for the Brazil's sustainable growth.

  13. Identification of risk factors for enteral feeding intolerance screening in critically ill patients

    Science.gov (United States)

    Xu, Lei; Wang, Ting; Chen, Ting; Yang, Wen-Qun; Liang, Ze-Ping; Zhu, Jing-Ci

    2017-01-01

    Objectives: To identify risk factors for enteral feeding intolerance screening in critically ill patients, thereby, provide some reference for healthcare staff to assess the risk of feeding intolerance, and lay the foundation for future scale development. Methods: This study used a mixed methodology, including a literature review, semi-structured interviews, the Delphi technique, and the analytic hierarchy process. We used the literature review and semi-structured interviews (n=22) to draft a preliminarily item pool for feeding intolerance, Delphi technique (n=30) to screen and determine the items, and the analytic hierarchy process to calculate the weight of each item. The study was conducted between June 2014 and September 2015 in Daping Hospital, Third Military Medical University, Chongqing, China. Results: Twenty-three risk factors were selected for the scale, including 5 dimensions. We assigned a weight to each item according to their impact on the feeding intolerance, with a higher score indicating a greater impact. The weight of each dimension was decreasing as follows: patient conditions, weight score equals 42; general conditions, weight score equals 23; gastrointestinal functions, weight score equals 15; biochemical indexes, weight score equals 14; and treatment measures, weight score equals 6. Conclusion: Developed list of risk factors based on literature review, survey among health care professionals and expert consensus should provide a basis for future studies assessing the risk of feeding intolerance in critically ill patients. PMID:28762434

  14. Critical Failure Factors in Selling Shoplots towards Sustainability of New Township Development

    Directory of Open Access Journals (Sweden)

    Tawil N.M.

    2014-01-01

    Full Text Available The focus of this research is to identify the critical factors of shop houses sale failure in Nilai New Township. The critical factors of sale failure of commercial property types, shop houses in new township need to be discover as reported by Valuation and Property Services Department (JPPH showed 5,931 units of shop houses in Malaysia is currently completed but remained unsold where Johor was recorded as the highest with unsold units followed by Negeri Sembilan. Thus Nilai New towship is chosen as research sample for unsold shop houses units due to its strategic location which is near to KLIA, International Sepang Circuit, educational instituitions and surrounded by housing scheme but yet still has numbers of unsold units. Data was gathered from survey question between developers, local authority, purchasers/tenant and local residents.. Generally, the factors of sale failure are economy, demography, politic, location and access, public and basic facilities, financial loan, physical of product, current stock of shop houses upon completion, future potential of subsale and rental, developer’s background, promotion and marketing, speculation and time.

  15. [Delirium in stroke patients : Critical analysis of statistical procedures for the identification of risk factors].

    Science.gov (United States)

    Nydahl, P; Margraf, N G; Ewers, A

    2017-04-01

    Delirium is a relevant complication following an acute stroke. It is a multifactor occurrence with numerous interacting risk factors that alternately influence each other. The risk factors of delirium in stroke patients are often based on limited clinical studies. The statistical procedures and clinical relevance of delirium related risk factors in adult stroke patients should therefore be questioned. This secondary analysis includes clinically relevant studies that give evidence for the clinical relevance and statistical significance of delirium-associated risk factors in stroke patients. The quality of the reporting of regression analyses was assessed using Ottenbacher's quality criteria. The delirium-associated risk factors identified were examined with regard to statistical significance using the Bonferroni method of multiple testing for forming incorrect positive hypotheses. This was followed by a literature-based discussion on clinical relevance. Nine clinical studies were included. None of the studies fulfilled all the prerequisites and assumptions given for the reporting of regression analyses according to Ottenbacher. Of the 108 delirium-associated risk factors, a total of 48 (44.4%) were significant, whereby a total of 28 (58.3%) were false positive after Bonferroni correction. Following a literature-based discussion on clinical relevance, the assumption of statistical significance and clinical relevance could be found for only four risk factors (dementia or cognitive impairment, total anterior infarct, severe infarct and infections). The statistical procedures used in the existing literature are questionable, as are their results. A post-hoc analysis and critical appraisal reduced the number of possible delirium-associated risk factors to just a few clinically relevant factors.

  16. ONLINE SALE SYSTEMS: AN ANALYSIS OF THEIR CRITICAL FACTORS FOR SMALL BUSINESS

    Directory of Open Access Journals (Sweden)

    Jordi Vilaseca Requena

    2007-05-01

    Full Text Available This work contributes to a general vision on the process of development of online sale of small business, such as final consumers oriented as well as to other organizations. The data presented were obtained through a survey with owners and top executives of 803 companies with less than 100 workers who carry out commercial distribution activities in Spain. The results show the diversity of critical factors (relative to the environment and the characteristics of the organization and their executives which influences in the implementation of online sale and in the importance that it reach as distribution channel, as well as their degree of contribution to both phenomena.

  17. An empirical study to determine the critical success factors of export industry

    Directory of Open Access Journals (Sweden)

    Masoud Babakhani

    2011-01-01

    Full Text Available Exporting goods and services play an important role on economy of developing countries. There are many countries in the world whose economy is solely based on exporting raw materials such as oil and gas. Many believe that countries cannot develop their economy as long as they rely on exporting one single group of raw materials. Therefore, there is a need to help other sectors of industries build good infrastructure for exporting diversified products. In this paper, we perform an empirical analysis to determine the critical success factors on exporting different goods. The results are analyzed using some statistical non-parametric methods and some useful guidelines are also suggested.

  18. Validation of an e-Learning 3.0 Critical Success Factors Framework: A Qualitative Research

    OpenAIRE

    Paula Miranda; Pedro Isaias; Carlos J Costa; Sara Pifano

    2017-01-01

    Aim/Purpose: As e-Learning 3.0 evolves from a theoretical construct into an actual solution for online learning, it becomes crucial to accompany this progress by scrutinising the elements that are at the origin of its success. Background: This paper outlines a framework of e-Learning 3.0’s critical success factors and its empirical validation. Methodology: The framework is the result of an extensive literature review and its empirical substantiation derives from semi-structured inte...

  19. Investigating the management information needs of academic Heads of Department: a Critical Success Factors approach

    Directory of Open Access Journals (Sweden)

    Francis Green

    1996-01-01

    Full Text Available This paper describes a research project in the Department of Information Studies at the University of Sheffield. With funding from the British Library Research and Development Department a critical success factors-based investigation of the management information needs of academic Heads of Department in an number of English universities was undertaken in 1994/1995, following publication of the results of a pilot study byPellow and Wilson (1993. Senior academic staff, university administrators and librarians in sixteen universities were interviewed between December, 1994 and March, 1995. Collation of data and analysis of results have been completed

  20. Nuclear critical opalescence and the M1 form factors of 12C and 13C

    International Nuclear Information System (INIS)

    Delorme, J.; Figureau, A.; Guichon, P.

    1981-01-01

    It is shown that core polarization by the nuclear pion field has opposite effects on the M1 form factors of 12 C(15.11 MeV) and 13 C(g.s.). New data on 13 C are found to agree with this prediction and a common interpretation of the experiments is shown to be possible for the two nuclei in terms of critical opalescence. Discrimination from alternative explanations of the observed anomalies should await further experiments, especially photopion reactions. (orig.)

  1. Etiology, diagnosis, and clinical management of vulvodynia

    Directory of Open Access Journals (Sweden)

    Sadownik LA

    2014-05-01

    Full Text Available Leslie A Sadownik University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada Abstract: Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. It may affect girls and women across all age groups and ethnicities. Vulvodynia is a significant burden to society, the health care system, the affected woman, and her intimate partner. The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. An approach to the diagnosis and management of a woman presenting with chronic vulvar pain should address the biological, psychological, and social/interpersonal factors that contribute to her illness. The gynecologist has a key role in excluding other causes for vulvar pain, screening for psychosexual and pelvic floor dysfunction, and collaborating with other health care providers to manage a woman's pain. An important component of treatment is patient education regarding the pathogenesis of the pain and the negative impact of experiencing pain on a woman's overall quality of life. An individualized, holistic, and often multidisciplinary approach is needed to effectively manage the woman's pain and pain-related distress. Keywords: vulvodynia, diagnosis, treatment, etiology, sexual pain disorder, dyspareunia, vestibulodynia, assessment, treatment, multidisciplinary

  2. Prioritizing critical success factors for reverse logistics implementation using fuzzy-TOPSIS methodology

    Science.gov (United States)

    Agrawal, Saurabh; Singh, Rajesh K.; Murtaza, Qasim

    2016-03-01

    Electronics industry is one of the fastest growing industries in the world. In India also, there are high turnovers and growing demand of electronics product especially after post liberalization in early nineties. These products generate e-waste which has become big environmental issue. Industries can handle these e-waste and product returns efficiently by developing reverse logistics (RL) system. A thorough study of critical success factors (CSFs) and their ordered implementation is essential for successful RL implementation. The aim of the study is to review the CSFs, and to prioritize them for RL implementation in Indian electronics industry. Twelve CSFs were identified through literature review, and discussion with the experts from the Indian electronics industry. Fuzzy-Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach is proposed for prioritizing these CSFs. Perusal of literature indicates that fuzzy-TOPSIS has not been applied earlier for prioritization of CSFs in Indian electronics industry. Five Indian electronics companies were selected for evaluation of this methodology. Results indicate that most of the identified factors are crucial for the RL implementation. Top management awareness, resource management, economic factors, and contracts terms and conditions are top four prioritized factor, and process capabilities and skilled workers is the least prioritized factor. The findings will be useful for successful RL implementation in Indian electronics industry.

  3. [Infectious mononucleosis: etiology, immunological variants, methods of correction].

    Science.gov (United States)

    Gordeets, A V; Savina, O G; Beniova, S N; Chernikova, A A

    2011-01-01

    Clinical options of infectious mononucleosis course depending on infecting agent etiology are presented for Epstein-Barr virus (EBV), cytomegalovirus (CMV), mono and mixed forms of the disease. Examined cytokine profiles demonstrate analogous changes of serum cytokines in the acute stage of the disease irrespective of etiological factors. Data show that it is important and useful clinically and immunologically to include immunomodulators--in particular, cycloferon--info a complex therapy of different types of mononucleosis.

  4. Sedimentary facies and lithologic characters as main factors controlling hydrocarbon accumulations and their critical conditions

    Directory of Open Access Journals (Sweden)

    Jun-Qing Chen

    2015-10-01

    Full Text Available Taking more than 1000 clastic hydrocarbon reservoirs of Bohai Bay Basin, Tarim Basin and Junggar Basin, China as examples, the paper has studied the main controlling factors of hydrocarbon reservoirs and their critical conditions to reveal the hydrocarbon distribution and to optimize the search for favorable targets. The results indicated that the various sedimentary facies and lithologic characters control the critical conditions of hydrocarbon accumulations, which shows that hydrocarbon is distributed mainly in sedimentary facies formed under conditions of a long-lived and relatively strong hydrodynamic environment; 95% of the hydrocarbon reservoirs and reserves in the three basins is distributed in siltstones, fine sandstones, lithified gravels and pebble-bearing sandstones; moreover, the probability of discovering conventional hydrocarbon reservoirs decreases with the grain size of the clastic rock. The main reason is that the low relative porosity and permeability of fine-grained reservoirs lead to small differences in capillary force compared with surrounding rocks small and insufficiency of dynamic force for hydrocarbon accumulation; the critical condition for hydrocarbon entering reservoir is that the interfacial potential in the surrounding rock (Φn must be more than twice of that in the reservoir (Φs; the probability of hydrocarbon reservoirs distribution decreases in cases where the hydrodynamic force is too high or too low and when the rocks have too coarse or too fine grains.

  5. Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness.

    Science.gov (United States)

    Leaf, David E; Jacob, Kirolos A; Srivastava, Anand; Chen, Margaret E; Christov, Marta; Jüppner, Harald; Sabbisetti, Venkata S; Martin, Aline; Wolf, Myles; Waikar, Sushrut S

    2017-06-01

    Elevated plasma levels of the osteocyte-derived hormone fibroblast growth factor 23 (FGF23) have emerged as a powerful biomarker of cardiovascular disease and death in patients with CKD. Whether elevated urinary or plasma FGF23 levels are prospectively associated with AKI and death in critically ill patients is unknown. We therefore conducted a prospective cohort study of 350 critically ill patients admitted to intensive care units at an academic medical center to investigate whether higher urinary FGF23 levels associate with the composite end point of AKI or in-hospital mortality (AKI/death). We measured urinary FGF23 levels within 24 hours of admission to the intensive care unit. In a subcohort ( n =131) we also measured plasma levels of FGF23, calcium, phosphate, parathyroid hormone, and vitamin D metabolites. Urinary and plasma FGF23 levels, but not other mineral metabolites, significantly associated with AKI/death. In multivariate analyses, patients in the highest compared with the lowest quartile of urinary FGF23 had a 3.9 greater odds (95% confidence interval, 1.6 to 9.5) of AKI/death. Higher urinary FGF23 levels also independently associated with greater hospital, 90-day, and 1-year mortality; longer length of stay; and several other important adverse outcomes. In conclusion, elevated FGF23 levels measured in the urine or plasma may be a promising novel biomarker of AKI, death, and other adverse outcomes in critically ill patients. Copyright © 2017 by the American Society of Nephrology.

  6. Etiologies and risk factors for dementia

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2016-01-01

    Full Text Available Dementia is understood as a clinical syndrome characterized by impairment in memory impairment along with cognitive deficits in other domains. Over the years, understanding about the causes of dementias has improved. Broadly, dementias can be classified as irreversible degenerative dementias and reversible dementias. Alzheimer′s disease is the prototype of degenerative dementias and is characterized by the accumulation of beta-amyloid protein (called as amyloid plaques outside the neurons and accumulation of tau protein (called tau tangles inside the neurons. Vascular dementias are characterized by cerebrovascular insults which lead to pathological brain changes that impair cognition. The pathological hallmark of Lewy body dementia is the presence of α-synuclein neuronal inclusions, also known as Lewy bodies, accompanied by neuronal loss. Frontotemporal dementias are characterized by abnormal deposits of the microtubule-associated protein tau, the trans-activation response TAR DNA-binding protein with molecular weight 43 kDa (TDP-43, and the fused in sarcoma protein. Reversible dementias are characterized by the primary illness and may not present with characteristic brain deposits as seen with many degenerative dementias.

  7. Bronchiolitis: presenting signs and etiologic factors

    International Nuclear Information System (INIS)

    Hernandez, D.; Pallisa, E.; Sebastia, M. C.; Quiroga, S.; Alvarez-Castells, A.; Caceres, J.

    1999-01-01

    Bronchiolitis is a disease of the small airways that can effect both the terminal and respiratory bronchioles and the alveoli. The diagnosis is based on histological findings and it is generally divided into two types: proliferative and constrictive. In clinical practice, there are a number of entities, such as infections, connective tissue diseases and lug transplantation, that can results in involvement of the small airways. In high-resolution computed tomography (HRCT), signs of bronchiolitis include centrilobular nodules, bronchiolectasis, mosaic perfusion, parenchymal consolidations and air-trapping. The findings are nonspecific, although the predominant features change depending on the underlying disease. Familiarity with the radiological sings of bronchilitis in HRCT studies avoids incorrect diagnoses and broadens the available knowledge of the morphology of lung pathology. (Author) 16 refs

  8. Etiology of short stature in children

    International Nuclear Information System (INIS)

    Sultan, M.; Afzal, M.; Ali, S.

    2008-01-01

    To determine the causes of short stature in children with special emphasis on growth hormone deficiency. Two hundred and fourteen children (140 boys and 74 girls), ranging from 02 to 15 years presenting with short stature were studied. Height and weight were plotted on appropriate growth charts and centiles determined. Relevant hematological and biochemical investigations including thyroid profile were done. Bone age was determined in all cases. Growth hormone axis was investigated after excluding other causes. Karyotyping was done in selected cases. Data was analyzed by SPSS 10.0 by descriptive statistics. Mean values were compared using t-test. In this study, the five most common etiological factors in order of frequency were Constitutional Growth Delay (CGD), Familial Short Stature (FSS), malnutrition, coeliac disease and Growth Hormone Deficiency (GHD). In 37.4% of patients, the study revealed normal variants of growth - CGD, FSS or combination of both, 46.7% cases had nonendocrinological and 15.9% had endocrinological etiology. CGD (22.1%) in males and FSS (27%) in females were the most common etiology. GHD was found in 6.1% children and it comprised 38.2% of all endocrinological causes. Children with height falling below 0.4th centile were more likely to have a pathological short stature (79.2%) compared to 39.3% whose height was below 3rd centile but above 0.4th centile (p<0.05). CGD and FSS are most common causes of short stature in boys and girls respectively, whereas, GHD is a relatively uncommon etiology. (author)

  9. Calculation of multiplication factors regarding criticality aiming at the storage of fissile material

    International Nuclear Information System (INIS)

    Lima Barros, M. de.

    1982-04-01

    The multiplication factors of several systems with low enrichment, 3,5% and 3,2% in the isotope 235 U, aiming at the storage of fuel of ANGRA-I and ANGRA II, through the method of Monte Carlo, by the computacional code KENO-IV and the library of section of cross Hansen - Roach with 16 groups of energy. The method of Monte Carlo is specially suitable to the calculation of the factor of multiplication, because it is one of the most acurate models of solution and allows the description of complex tridimensional systems. Various tests of sensibility of this method have been done in order to present the most convenient way of working with KENO-IV code. The safety on criticality of stores of fissile material of the 'Fabrica de Elementos Combustiveis ', has been analyzed through the method of Monte Carlo. (Author) [pt

  10. Factors affecting management accounting and control systems. A critical review of empirical studies

    Directory of Open Access Journals (Sweden)

    Joanna Dyczkowska

    2015-12-01

    Full Text Available Knowledge of management accounting & control systems and factors which may affect the design of such systems has become crucial due to emerging changes both in the external and internal business environment. Therefore it is necessary to conduct comprehensive, long-term basic research in order to prove previously formulated hypotheses in new conditions and fulfil the research gap. Based on critical review of empirical studies published in prestigious scientific journals this paper aims at validating the assumed hypotheses and at generalising research findings on impacts of various determinants on man-agement accounting & control systems. The predominant contingent factors include: type of strategy implemented, national culture, perceived environment uncertainty and integrated information system.

  11. Critical Review on Labor Factors and Country Competitiveness: Comparison between Indonesia and Jordan

    Directory of Open Access Journals (Sweden)

    Sari Wahyuni

    2015-05-01

    Full Text Available The purpose of this study is to critically compare labor factors and country competitiveness of Jordan and Indonesia that affecting its country attractiveness in the textile industry. This study is a mix between qualitative quantitative approaches. The data were collected from the published materials of Better Work data, BAPPENAS, and in depth – interview with certified social compliance auditors, factory managers, and some workers to earn more information on textile industry in Indonesia and Jordan. The result of this study indicated that there are several labor factors that could boost up the Indonesian’s performance in Textile industry, i.e. working hours, occupational safety and health, compensation and benefits, and also discrimination.

  12. Incidence and risk factors of acute kidney injury among the critically ill neonates

    Directory of Open Access Journals (Sweden)

    Ayman A El-Badawy

    2015-01-01

    Full Text Available Acute kidney injury (AKI is a complex disorder with clinical manifestations ranging from mild dysfunction to complete kidney failure. The published literature on the incidence and outcome of AKI in the critically ill neonatal population is scarce. The aim of this study was to evaluate the types, the associated risk factors and short-term outcome of AKI in the critically ill neonates. A cohort study was conducted including 100 critically ill neonates successively admitted to the Neonatal Intensive Care Unit. The inclusion criteria were a gestational age ≥28 weeks and body weight ≥1 kg. Exclusion criteria included those with multiple congenital anomalies or on drugs altering glomerular filtration rate or AKI developing postoperatively. Neonates were evaluated for the development of AKI [creatinine >1.5 mg/dL and/or blood urea nitrogen (BUN >20 mg/dL] and were assigned as group A (who developed AKI and group B (who did not develop AKI. Forty-one patients developed AKI (group A among whom nine (22% showed oliguric AKI. The most common risk factors among group A patients were sepsis (75.6% and nephrotoxic drug administration (75.6%, followed by shock (39%. There were no statistically significant differences between both groups except for male sex predominance and necrotizing enterocolitis (NEC, which were significantly higher among group A (P <0.05. Use of continuous positive airway pressure (CPAP ventilation was significantly higher in neonates without AKI (13.6% vs 0.0%, P = 0.02. The mortality rate among group A reached 51.2%. Various risk factors including gender, gestational age, birth weight, shock, NEC, sepsis, nephrotoxic drugs, oliguria and mechanical ventilation were studied as regards outcome of group A, and all factors except gender and oliguria proved to be significantly higher in deceased neonates. Male sex and NEC were important risk factors for developing AKI that was predominantly non-oliguric. CPAP ventilation may have a

  13. Implementing Traceability Systems in Specific Supply Chain Management (SCM through Critical Success Factors (CSFs

    Directory of Open Access Journals (Sweden)

    Shahbaz Khan

    2018-01-01

    Full Text Available Traceability plays a vital role in the success of Halal Supply Chain (HSC. HSC revolve around the essential dimension of Halal Integrity (HI, whereas traceability is seemed to be medium to assure integrity. Thus, a need is felt to identify the factors which are critical to the successful implementation of traceability in Halal Supply Chain Management (HSCM. Identified Twelve Critical Success Factors (CSFs through an extensive review of literature and opinion of experts. Further, a contextual relationship among the CSFs is developed using Total Interpretive Structure Modelling (TISM approach and derived a model. The structural model is analyzed using Fuzzy MICMAC (Matrice d’Impacts Croises-Multipication Applique and Classment-cross-impact matrix multiplication applied to classification approach to identify the importance of CSFs by driving and dependence power. The primary result indicates towards; that improving the HSCM with the higher level of Halal awareness. Assuring HI will enhance the consumer satisfaction which leads to a competitive advantage for the organization. Academic researchers, industrial practitioners and Supply Chain executives can understand the complex interrelationship of CSFs by visualizing the TISM. It can help the management, lobbies and government to develop the policies regarding the implementation.

  14. Understanding critical factors for the quality and shelf-life of MAP fresh meat: a review.

    Science.gov (United States)

    Singh, Preeti; Wani, Ali Abas; Saengerlaub, Sven; Langowski, Horst-Christian

    2011-02-01

    Due to increased demands for greater stringency in relation to hygiene and safety issues associated with fresh food products, coupled with ever-increasing demands by retailers for cost-effective extensions to product shelf-lives and the requirement to meet consumer expectations in relation to convenience and quality, the food packaging industry has rapidly developed to meet and satisfy expectations. One of the areas of research that has shown promise, and had success, is modified atmosphere packaging (MAP). The success of MAP-fresh meat depends on many factors including good initial product quality, good hygiene from the source plants, correct packaging material selection, the appropriate gas mix for the product, reliable packaging equipment, and maintenance of controlled temperatures and humidity levels. Advances in plastic materials and equipment have propelled advances in MAP, but other technological and logistical considerations are needed for successful MAP systems for raw chilled meat. Although several parameters critical for the quality of MA packed meat have been studied and each found to be crucial, understanding of the interactions between the parameters is needed. This review was undertaken to present the most comprehensive and current overview of the widely available, scattered information about the various integrated critical factors responsible for the quality and shelf life of MA packed meat with an interest to stimulate further research to optimize different quality parameters.

  15. Identifying Critical Success Factors for TQM and Employee Performance in Malaysian Automotive Industry: A Literature Review

    Science.gov (United States)

    Nadia Dedy, Aimie; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Ariff, Mohd Shoki Md; Chin, Thoo Ai; Zameri Mat Saman, Muhamad

    2016-05-01

    TQM is a management philosophy embracing all activities through which the needs and expectations of the customer and the community and the goals of the companies are satisfied in the most efficient and cost effective way by maximizing the potential of all workers in a continuing drive for total quality improvement. TQM is very important to the company especially in automotive industry in order for them to survive in the competitive global market. The main objective of this study is to review a relationship between TQM and employee performance. Authors review updated literature on TQM study with two main targets: (a) evolution of TQM considering as a set of practice, (b) and its impacts to employee performance. Therefore, two research questions are proposed in order to review TQM constructs and employee performance measure: (a) Is the set of critical success factors associated with TQM valid as a whole? (b) What is the critical success factors should be considered to measure employee performance in automotive industry?

  16. Biosphere Dose Conversion Factors for Reasonably Maximally Exposed Individual and Average Member of Critical Group

    International Nuclear Information System (INIS)

    K. Montague

    2000-01-01

    The purpose of this calculation is to develop additional Biosphere Dose Conversion Factors (BDCFs) for a reasonably maximally exposed individual (RMEI) for the periods 10,000 years and 1,000,000 years after the repository closure. In addition, Biosphere Dose Conversion Factors for the average member of a critical group are calculated for those additional radionuclides postulated to reach the environment during the period after 10,000 years and up to 1,000,000 years. After the permanent closure of the repository, the engineered systems within the repository will eventually lose their abilities to contain radionuclide inventory, and the radionuclides will migrate through the geosphere and eventually enter the local water table moving toward inhabited areas. The primary release scenario is a groundwater well used for drinking water supply and irrigation, and this calculation takes these postulated releases and follows them through various pathways until they result in a dose to either a member of critical group or a reasonably maximally exposed individual. The pathways considered in this calculation include inhalation, ingestion, and direct exposure

  17. Benefits, challenges and critical factors of success for Zero Waste: A systematic literature review.

    Science.gov (United States)

    Pietzsch, Natália; Ribeiro, José Luis Duarte; de Medeiros, Janine Fleith

    2017-09-01

    Considering the growing concern with solid wastes problems and the pressing need for a holistic approach to their management, this study developed a literature review about the subject "Zero Waste". To that end, a systematic literature review was executed, through which 102 published articles were analyzed with the aim to, initially, comprehend the concept of Zero Waste, and, then, map its benefits, challenges, and critical success factors. The results show that scholars have not reached a consensus regarding the concept of ZW. While some studies fully address this philosophy, other studies are based on just one or on some of its topics. The benefits were grouped and organized into four dimensions: benefits to the community, financial-economic benefits, benefits to the environment and benefits to the industry and stakeholders. As to the challenges, barriers were identified both in the macro environment (mainly political and cultural) and in the meso and micro environments (stakeholders, industries, and municipalities). The analysis of the articles enabled listing critical success factors, supported by a set of activities that must be carried out. Regarding future studies, it is worth noting that more empirical studies about ZW implementation are necessary, particularly with regard to educational practices designed to promote changes in user behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. ETIOLOGY OF OROYA FEVER

    Science.gov (United States)

    Noguchi, Hideyo

    1926-01-01

    investigators as a result of the inoculation of monkeys with human verruga tissues. The striking fact brought out in the present study is the variety of responses to inoculation which animals of the same species may manifest. The clinical features of the infection may be typical of Oroya fever or may resemble those of verruga peruviana, and in M. rhesus 25 we have an instance of a type of infection in which the characteristic phenomena of both conditions are simultaneously present. Whether the appearance will resemble those of the one or the other condition appears to depend on the susceptibility of the individual as well as on the virulence of the organism. Moreover, it seems probable that different degrees of resistance to the invasion of the parasite on the part of the blood cells, internal organs, or skin of a given animal may determine the predominant clinical manifestations of the infection. The factor of variation in susceptibility of different individuals or different tissues of the same individual would account for the variety of types of human Bartonella infection. PMID:19869217

  19. Occupational diseases of dust etiology

    International Nuclear Information System (INIS)

    Sokolik, L.I.; Shkondin, A.N.

    1981-01-01

    Detailed etiologic and clinico-roentgenological characteristics of pneumoconiosis, as widely spread occupational disease caused by different kinds of dust, are given. The course of pneumoconiosis is discussed depending on working conditions of patients after the disease had been ascertained, as well as its complications, taking into account roentgeno-morphological types of fibrosis and the stages of the disease [ru

  20. Biomarkers of Acute Stroke Etiology (BASE) Study Methodology.

    Science.gov (United States)

    Jauch, Edward C; Barreto, Andrew D; Broderick, Joseph P; Char, Doug M; Cucchiara, Brett L; Devlin, Thomas G; Haddock, Alison J; Hicks, William J; Hiestand, Brian C; Jickling, Glen C; June, Jeff; Liebeskind, David S; Lowenkopf, Ted J; Miller, Joseph B; O'Neill, John; Schoonover, Tim L; Sharp, Frank R; Peacock, W Frank

    2017-05-05

    Acute ischemic stroke affects over 800,000 US adults annually, with hundreds of thousands more experiencing a transient ischemic attack. Emergent evaluation, prompt acute treatment, and identification of stroke or TIA (transient ischemic attack) etiology for specific secondary prevention are critical for decreasing further morbidity and mortality of cerebrovascular disease. The Biomarkers of Acute Stroke Etiology (BASE) study is a multicenter observational study to identify serum markers defining the etiology of acute ischemic stroke. Observational trial of patients presenting to the hospital within 24 h of stroke onset. Blood samples are collected at arrival, 24, and 48 h later, and RNA gene expression is utilized to identify stroke etiology marker candidates. The BASE study began January 2014. At the time of writing, there are 22 recruiting sites. Enrollment is ongoing, expected to hit 1000 patients by March 2017. The BASE study could potentially aid in focusing the initial diagnostic evaluation to determine stroke etiology, with more rapidly initiated targeted evaluations and secondary prevention strategies.Clinical Trial Registration Clinicaltrials.gov NCT02014896 https://clinicaltrials.gov/ct2/show/NCT02014896?term=biomarkers+of+acute+stroke+etiology&rank=1.

  1. An Exploratory Study of the Critical Factors Affecting the Acceptability of Automated Teller Machine (ATM) in Nigeria

    OpenAIRE

    Olusegun Folorunso; Oluwafunmilayo Ayobami Ateji; Gabriel Oludare Awe

    2010-01-01

    This paper uses the Technology Acceptance Model (TAM) as a basis for studying critical factors that affects the acceptability of Automated Teller Machine (ATM) in Nigeria. Questionnaire approach was used with the respondents predominantly between 20-29 years old. Factor analysis was used to test which of the factors are the main factors affecting the adoption of the technology in Nigeria. It was discovered that the major factors affecting people’s intention to accept ATM are the security issu...

  2. Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment.

    Science.gov (United States)

    Dong, Jingmei; Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

    2018-01-23

    It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents' health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents' activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children's and adolescents' activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively.

  3. Critical Factors Influencing Decision to Adopt Human Resource Information System (HRIS) in Hospitals

    Science.gov (United States)

    Alam, Md Golam Rabiul; Masum, Abdul Kadar Muhammad; Beh, Loo-See; Hong, Choong Seon

    2016-01-01

    The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS) in the hospital industry of Bangladesh—an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories—Human-Organization-Technology fit (HOT-fit) model and Technology-Organization-Environment (TOE) framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries. PMID:27494334

  4. Critical factors that impact purchase online of new telecom convergent services in the Mexican market

    Directory of Open Access Journals (Sweden)

    Rolando Zubiran Shetler

    2010-07-01

    Full Text Available The following article analyzes the principal factors that have an impact in the adoption of new telecom convergent services, through electronic commerce, that have been explored and studied primarily in developed markets such as the United States and that have been deemed as critical factors in the development and growth of online electronic transactions. Specifically, factors and latent variables of this study derive from the models of Technology Acceptance (Davis, 1989 and Diffusion of Innovations (Rogers, 2003. A summary of past empirical studies is provided deriving from the aforementioned theoretical models followed by results of an exploratory field study comprising of 253 valid observations randomly selected from within the population of urban internet users in Mexico. The methodology used to determine the causal relationship between variables (Betas was factor analysis (Principal Components and structural equation modeling, specifically Smart-PLS. The study determined that perceived utility and trust variables are statistically relevant and significant in determining purchase online of new telecom convergent services and the development of electronic commerce in the Mexican Market.

  5. Identifying the critical factors of green supply chain management: Environmental benefits in Pakistan.

    Science.gov (United States)

    Mumtaz, Ubaidullah; Ali, Yousaf; Petrillo, Antonella; De Felice, Fabio

    2018-05-30

    Pakistan is a developing country characterized by a growing industrialization, which is the major cause of environmental pollution in the country. To control the significant increase in pollution a green incentive has started, aiming to moderate the adverse effects of environmental pollution. Thus, Green Supply Chain Management (GSCM) plays an important role in influencing the total environment impact of any organizations. This study considers ten Pakistani industries that have implemented GSCM practices. The Decision-Making Trial and Evaluation Laboratory technique (DEMATEL) is used to find influential factors in selecting GSCM criteria. The results show that organizational involvement is the most important dimension useful to implement GSCM practices. In addition, commitment from senior managers, ISO 14000 certification of suppliers and recycle of waste heat are considered significant factors. The paper also signifies the casual relationship among the dimensions and the factors in the form of diagraphs. The main management implication of the paper is to help decision makers to focus on the critical dimensions/factors in order to implement the GSCM practices more effectively in Pakistan. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Critical Factors Influencing Decision to Adopt Human Resource Information System (HRIS in Hospitals.

    Directory of Open Access Journals (Sweden)

    Md Golam Rabiul Alam

    Full Text Available The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS in the hospital industry of Bangladesh-an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories-Human-Organization-Technology fit (HOT-fit model and Technology-Organization-Environment (TOE framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries.

  7. Organizational factors and reoccurrence protection on the JCO nuclear critical accident

    International Nuclear Information System (INIS)

    Takano, Kenichi

    2000-01-01

    A nuclear critical accident formed at a nuclear fuel conversion factory in Tokai-mura on September, 1999 became gradually clear not to be a simple human error formed at a level of workmen but to be an organizational error or accident relating to various organizational factors. As a nuclear power facility adopts a depth protection system fundamentally, a large accident with serious danger would not form only by a single trouble and a human error and unless some factors overlaps. By reviewing recent serious accidents and troubles, all of them seem to have a keyword of 'organizational factor'. In the JCO accident, there are some organizational factors such as a climate deviating from a manual, insufficient and loose check against change of procedure, reduction of operators from a reason of profit priority, attitude on priority of working efficiency, and so forth, which are partially common to the Chernobyl accident. Recently, accidents and troubles impossible to make them a cause of simple human error by a person but to have to say an organizational error, have increased. This trend seems to depend upon not only complication and scale-up of technology system but also graduate change of social and management systems operating them. Therefore, it seems to be necessary to introduce a concept of depth protection (multiple protection) in order to keep its reliability and safety when complicating and scaling-up of system. (G.K.)

  8. A Method to Evaluate Critical Factors for Successful Implementation of Clinical Pathways.

    Science.gov (United States)

    Dong, W; Huang, Z

    2015-01-01

    Clinical pathways (CPs) have been viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Despite widespread enthusiasm for CPs, research has shown that many CP initiatives are unsuccessful. To this end, this study provides a methodology to evaluate critical success factors (CSFs) that can aid healthcare organizations to achieve successful CP implementation. This study presents a new approach to evaluate CP implementation CSFs, with the aims being: (1) to identify CSFs for implementation of CPs through a comprehensive literature review and interviews with collaborative experts; (2) to use a filed study data with a robust fuzzy DEMATEL (the decision making trial and evaluation laboratory) approach to visualize the structure of complicated causal relationships between CSFs and obtain the influence level of these factors. The filed study data is provided by ten clinical experts of a Chinese hospital. 23 identified CSF factors which are initially identified through a review of the literature and interviews with collaborative experts. Then, a number of direct and indirect relationships are derived from the data such that different perceptions can be integrated into a compromised cause and effect model of CP implementation. The results indicate that the proposed approach can systematically evaluate CSFs and realize the importance of each factor such that the most common causes of failure of CP implementation could be eliminated or avoided. Therefore, the tool proposed would help healthcare organizations to manage CP implementation in a more effective and proactive way.

  9. Critical Factors Influencing Decision to Adopt Human Resource Information System (HRIS) in Hospitals.

    Science.gov (United States)

    Alam, Md Golam Rabiul; Masum, Abdul Kadar Muhammad; Beh, Loo-See; Hong, Choong Seon

    2016-01-01

    The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS) in the hospital industry of Bangladesh-an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories-Human-Organization-Technology fit (HOT-fit) model and Technology-Organization-Environment (TOE) framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries.

  10. Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment

    Science.gov (United States)

    Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

    2018-01-01

    It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents’ health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents’ activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children’s and adolescents’ activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively. PMID:29360730

  11. Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment

    Directory of Open Access Journals (Sweden)

    Jingmei Dong

    2018-01-01

    Full Text Available It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents’ health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA which conducts supervision of environmental pollution and survey of adolescents’ activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children’s and adolescents’ activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively.

  12. Acute Kidney Injury as a Risk Factor for Delirium and Coma during Critical Illness.

    Science.gov (United States)

    Siew, Edward D; Fissell, William H; Tripp, Christina M; Blume, Jeffrey D; Wilson, Matthew D; Clark, Amanda J; Vincz, Andrew J; Ely, E Wesley; Pandharipande, Pratik P; Girard, Timothy D

    2017-06-15

    Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. In a prospective cohort study of intensive care unit patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, nonrenal organ failure, sepsis, prior mental status, and sedative exposure. Acute kidney injury was characterized daily using the difference between baseline and peak serum creatinine and staged according to Kidney Disease Improving Global Outcomes criteria. Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion Assessment Method for the ICU and Richmond Agitation-Sedation Scale. Among 466 patients, stage 2 acute kidney injury was a risk factor for delirium (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.26) and coma (OR, 2.04; 95% CI, 1.25-3.34) as was stage 3 injury (OR for delirium, 2.56; 95% CI, 1.57-4.16) (OR for coma, 3.34; 95% CI, 1.85-6.03). Daily peak serum creatinine (adjusted for baseline) values were also associated with delirium (OR, 1.35; 95% CI, 1.18-1.55) and coma (OR, 1.44; 95% CI, 1.20-1.74). Renal replacement therapy modified the association between stage 3 acute kidney injury and daily peak serum creatinine and both delirium and coma. Acute kidney injury is a risk factor for delirium and coma during critical illness.

  13. Critical-Thinking Grudge Match: Biology vs. Chemistry--Examining Factors That Affect Thinking Skill in Nonmajors Science

    Science.gov (United States)

    Quitadamo, Ian J.; Kurtz, Martha J.; Cornell, Caitlyn Nicole; Griffith, Lindsay; Hancock, Julie; Egbert, Brandi

    2011-01-01

    Chemistry students appear to bring significantly higher critical-thinking skill to their nonmajors course than do biology students. Knowing student preconceptions and thinking ability is essential to learning growth and effective teaching. Of the factors investigated, ethnicity and high school physics had the largest impact on critical-thinking…

  14. Etiology, evaluation, and management of xerostomia.

    Science.gov (United States)

    Millsop, Jillian W; Wang, Elizabeth A; Fazel, Nasim

    Xerostomia is defined as the complaint of oral dryness. It is a condition that primarily affects older adults and can have a significant negative effect on one's quality of life. Patients with xerostomia often do not have objective signs of hyposalivation. The underlying etiology of xerostomia includes a variety of systemic diseases and local factors. Our aim is to provide a comprehensive review of the differential diagnosis, evaluation, and management of xerostomia. Prompt diagnosis and management can alleviate the clinical manifestations of this debilitating condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Etiological approach to chronic urticaria.

    Science.gov (United States)

    Krupa Shankar, D S; Ramnane, Mukesh; Rajouria, Eliz Aryal

    2010-01-01

    In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching). Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (6 weeks duration). Various clinical investigations may be initiated to diagnosis the cause. To evaluate the types of chronic urticaria with reference to etiology from history and investigations. A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST) was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA), IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex) was seen in one patient. Cholinergic (4.7%) and dermographic (4.7%) urticaria were the predominant physical urticarias. Prick test was performed in idiopathic urticaria with maximum

  16. Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Denollet, Johan; Zwisler, Ann-Dorthe

    2009-01-01

    Growing evidence supports the importance of psychological factors in the etiology and progression of cardiovascular disease (CVD). However, this research has been criticized due to overlap between psychological constructs. We examined whether psychological questionnaires frequently used...

  17. Factor H C-Terminal Domains Are Critical for Regulation of Platelet/Granulocyte Aggregate Formation

    Directory of Open Access Journals (Sweden)

    Adam Z. Blatt

    2017-11-01

    Full Text Available Platelet/granulocyte aggregates (PGAs increase thromboinflammation in the vasculature, and PGA formation is tightly controlled by the complement alternative pathway (AP negative regulator, Factor H (FH. Mutations in FH are associated with the prothrombotic disease atypical hemolytic uremic syndrome (aHUS, yet it is unknown whether increased PGA formation contributes to the thrombosis seen in patients with aHUS. Here, flow cytometry assays were used to evaluate the effects of aHUS-related mutations on FH regulation of PGA formation and characterize the mechanism. Utilizing recombinant fragments of FH spanning the entire length of the protein, we mapped the regions of FH most critical for limiting AP activity on the surface of isolated human platelets and neutrophils, as well as the regions most critical for regulating PGA formation in human whole blood stimulated with thrombin receptor-activating peptide (TRAP. FH domains 19–20 were the most critical for limiting AP activity on platelets, neutrophils, and at the platelet/granulocyte interface. The role of FH in PGA formation was attributed to its ability to regulate AP-mediated C5a generation. AHUS-related mutations in domains 19–20 caused differential effects on control of PGA formation and AP activity on platelets and neutrophils. Our data indicate FH C-terminal domains are key for regulating PGA formation, thus increased FH protection may have a beneficial impact on diseases characterized by increased PGA formation, such as cardiovascular disease. Additionally, aHUS-related mutations in domains 19–20 have varying effects on control of TRAP-mediated PGA formation, suggesting that some, but not all, aHUS-related mutations may cause increased PGA formation that contributes to excessive thrombosis in patients with aHUS.

  18. Human reliability and human factors in complex organizations: epistemological and critical analysis - practical avenues to action

    International Nuclear Information System (INIS)

    Llory, A.

    1991-08-01

    This article starts out with comment on the existence of persistent problems inherent to probabilistic safety assessments (PSA). It first surveys existing American documents on the subject which make a certain number of criticisms on human reliability analyses, e.g. limitations due to the scant quantities of data available, lack of a basic theoretical model, non-reproducibility of analyses, etc. The article therefore examines and criticizes the epistemological bases of these analyses. One of the fundamental points stressed is that human reliability analyses do not take account of all the special features of the work situation which result in human error (so as to draw up statistical data from a sufficiently representative number of cases), and consequently lose all notion of the 'relationships' between human errors and the different aspects of the working environment. The other key points of criticism concern the collective nature of work which is not taken into account, and the frequent confusion between what operatives actually do and their formally prescribed job-tasks. The article proposes aspects to be given thought in order to overcome these difficulties, e.g. quantitative assessment of the social environment within a company, non-linear model for assessment of the accident rate, analysis of stress levels in staff on off-shore platforms. The method approaches used in these three studies are of the same type, and could be transposed to human-reliability problems. The article then goes into greater depth on thinking aimed at developing a 'positive' view of the human factor (and not just a 'negative' one, i.e. centred on human errors and organizational malfunctions), applying investigation methods developed in the occupational human sciences (occupational psychodynamics, ergonomics, occupational sociology). The importance of operatives working as actors of a team is stressed

  19. Critical role of tumor necrosis factor receptor 1 in the pathogenesis of pulmonary emphysema in mice.

    Science.gov (United States)

    Fujita, Masaki; Ouchi, Hiroshi; Ikegame, Satoshi; Harada, Eiji; Matsumoto, Takemasa; Uchino, Junji; Nakanishi, Yoichi; Watanabe, Kentaro

    2016-01-01

    COPD is a major cause of chronic morbidity and mortality throughout the world. Although tumor necrosis factor-α (TNF-α) has a critical role in the development of COPD, the role of different TNF receptors (TNFRs) in pulmonary emphysema has not been resolved. We aimed to clarify the role of TNFRs in the development of pulmonary emphysema. TNF-α transgenic mice, a murine model of COPD in which the mice spontaneously develop emphysema with a large increase in lung volume and pulmonary hypertension, were crossed with either TNFR1-deficient mice or TNFR2-deficient mice. After 6 months, the gross appearance of the lung, lung histology, and pulmonary and cardiac physiology were determined. In addition, the relationship between apoptosis and emphysema was investigated. Pulmonary emphysema-like changes disappeared with deletion of TNFR1. However, slight improvements were attained with deletion of TNFR2. Apoptotic cells in the interstitium of the lung were observed in TNF-α transgenic mice. The apoptotic signals through TNFR1 appear critical for the pathogenesis of pulmonary emphysema. In contrast, the inflammatory process has a less important role for the development of emphysema.

  20. Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

    Science.gov (United States)

    Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

    2017-05-01

    Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

  1. Relationship between job burnout, psychosocial factors and health care-associated infections in critical care units.

    Science.gov (United States)

    Galletta, Maura; Portoghese, Igor; D'Aloja, Ernesto; Mereu, Alessandra; Contu, Paolo; Coppola, Rosa Cristina; Finco, Gabriele; Campagna, Marcello

    2016-06-01

    Burnout is a serious problem for critical care unit workers because they are exposed to chronic psychosocial stressors, including high responsibility, advanced technology and high patient acuity. Recent evidence showed that staff burnout was directly associated with hospital infections, thus affecting quality and safety of care provided. The research aim was to investigate how burnout was associated with some psychosocial factors and with health care-associated infections in hospitalised patients. A total of 130 healthcare professionals from critical care units completed a self-reported questionnaire. The infection data were collected prospectively over a six-month period. The results showed that emotional exhaustion was related to cynicism due to high work demands. Cynicism affected team communication, which in turn was positively related to team efficacy, thus acting as a mediator. Finally, team efficacy was negatively related to infections. The study showed that emotional exhaustion and cynicism were related to psychosocial aspects, which in turn had a significant impact on healthcare-associated infections. Our findings suggest how burnout can indirectly affect healthcare-related infections as a result of the quality of teamwork. Thus, reducing burnout can be a good strategy to decrease infections, thus increasing workers' well-being while improving patient care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Content validity of critical success factors for e-Government implementation in Indonesia

    Science.gov (United States)

    Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

    2018-05-01

    The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

  3. Critical discussion of social-cognitive factors in smoking initiation among adolescents

    DEFF Research Database (Denmark)

    Bidstrup, Pernille Envold; Tjørnhøj-Thomsen, Tine; Mortensen, Erik Lykke

    2011-01-01

    Social-cognitive models have often been used in research on prevention in adolescent populations, even though the models were designed to describe adult behavior. The aim of the study reported here was to examine critically and constructively the five social-cognitive factors in the 'attitude......, social influence, self-efficacy' (ASE) model. Methods. The examination draws on the results of a qualitative follow-up study of smoking initiation based on semi-structured interviews and observations of 12 adolescents in two Danish school classes, grades 7 and 8. The qualitative study was conducted...... and if relevant discussed these aspects using other theoretical frameworks. Results. The results showed that aspects other than those in the ASE model are also important. Smoking initiation was often situational and unplanned and was sometimes used in negotiating social relationships and identity. Furthermore...

  4. A Review on Critical Success Factors of Governance towards Sustainable Campus Operations

    Science.gov (United States)

    Halid Abdullah, Abd; Razman, Ruzaimah; Muslim, Rahmat

    2017-08-01

    Campus Sustainability is an effort that integrates environmentally sustainable practices into institutional practices. A successful transition to a sustainable campus requires the involvement of the university community; the administration, academics departments (faculty and students), researchers and he local community. Our research seeks to identify Critical Success Factors (CSFs) of university governance that contribute to the success in implementing Sustainable Campus Operation (SCO) initiatives. The common CSFs have been identified from 22 published and unpublished articles, conference proceedings, university reports, books, and website documents. The CSFs are mapped and ranked based on the frequency of the identified CSFs. 23 CSFs of SCO have been identified through this research. This research revealed that the CSF that contributes the highest frequency as indicated by most researchers is “developing network with external parties for gaining consensus and commitment”. By identifying these CSFs, this research will help assist universities in successfully plan and implement their SCO initiatives.

  5. Analysis of Critical Factors and Difficulties in Maintaining Historical Building - A Current Implementation

    Directory of Open Access Journals (Sweden)

    Baharuddin M.N.

    2014-01-01

    Full Text Available Historic buildingis one of the highly valuable assets to the country especially in a way to shows its history for the next generation instead to make a profit through the excellent promotion in tourism purpose.The Malaysian Government has allocated a huge of financial support in order to conserve and preserve the historic building. However, the majority of the historic building is still in ‘poor’ condition without any improvement regarding to the pro-active approach.This paper presents part of this research which investigates the key components consists of issues and difficulties in term of critical factors. The findings reveal that there are several difficulties in maintaining a historic building. The identification of key components will facilitate the stakeholders to focus on the variable and resources to make the success in maintaining and managing the historic building.

  6. Evaluation as a critical factor of success in local public health accreditation programs.

    Science.gov (United States)

    Tremain, Beverly; Davis, Mary; Joly, Brenda; Edgar, Mark; Kushion, Mary L; Schmidt, Rita

    2007-01-01

    This article presents the variety of approaches used to conduct evaluations of performance improvement or accreditation systems, while illustrating the complexity of conducting evaluations to inform local public health practice. We, in addition, hope to inform the Exploring Accreditation Program about relevant experiences involving accreditation and performance assessment processes, specifically evaluation, as it debates and discusses a national voluntary model. A background of each state is given. To further explore these issues, interviews were conducted with each state's evaluator to gain more in-depth information on the many different evaluation strategies and approaches used. On the basis of the interviews, the authors provide several overall themes, which suggest that evaluation is a critical tool and success factor for performance assessment or accreditation programs.

  7. Advanced Nursing Education: Critical Factors That Influence Diploma and Associate Degree Nurses to Advance.

    Science.gov (United States)

    McGhie-Anderson, Rose Lavine

    The purpose of this study was to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance academically. Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of nurses as educator, manager, nurse leader, and researcher who will effect policy changes, assume leadership roles as revolutionary thinkers, and implement paradigmatic shifts. Data were collected from two groups of participants using face-to-face, semistructured interviews. Group 1 consisted of diploma and associate degree nurses; Group 2 consisted of baccalaureate, masters, and doctoral degree nurses who have progressed academically. Emerging from the thick, rich data were core categories of rewarding, motivating, and supporting as critical factors that influence professional advancement. This qualitative study elucidated that professional advancement was the social process that grounds. The emergent theory was the theory of professional advancement.

  8. GEP, a local growth factor, is critical for odontogenesis and amelogenesis.

    Science.gov (United States)

    Cao, Zhengguo; Jiang, Baichun; Xie, Yixia; Liu, Chuan-ju; Feng, Jian Q

    2010-11-25

    Granulin epithelin precursor (GEP) is a new growth factor that functions in brain development, chondrogenesis, tissue regeneration, tumorigenesis, and inflammation. The goal of this study was to study whether GEP was critical for odontogenesis and amelogenesis both in vivo and in vitro. The in situ hybridization and immunohistochemistry data showed that GEP was expressed in both odontoblast and ameloblast cells postnatally. Knockdown of GEP by crossing U6-ploxPneo-GEP and Sox2-Cre transgenic mice led to a reduction of dentin thickness, an increase in predentin thickness, and a reduction in mineral content in enamel. The in vitro application of recombinant GEP up-regulated molecular markers important for odontogenesis (DMP1, DSPP, and ALP) and amelogenesis (ameloblastin, amelogenin and enamelin). In conclusion, both the in vivo and the in vivo data support an important role of GEP in tooth formation during postnatal development.

  9. Enhanced Vascular Endothelial Growth Factor Gene Expression in Ischaemic Skin of Critical Limb Ischaemia Patients

    Directory of Open Access Journals (Sweden)

    Silvia Bleda

    2012-01-01

    Full Text Available Objectives. To perform a quantitative analysis of the vascular endothelial growth factor (VEGF gene transcription in the skin of ischemic legs and provide information for VEGF in the pathogenesis in critical limb ischemia (CLI. Methods. Skin biopsies were obtained from 40 patients with CLI. Control samples came from 44 patients with chronic venous disease. VEGF gene expression was analysed using quantitative polymerase chain reaction. Results. Patients with CLI had higher skin VEGF expression than control group (RQ: 1.3 ± 0.1 versus 1, P=0.04. Conclusions. We found an association between ischemic skin and an elevated VEGF expression in legs from patients with CLI. These data support that the mechanism for VEGF upregulation in hypoxia conditions is intact and acts appropriately in the ischaemic limbs from patients with CLI.

  10. Perencanaan Strategis Sistem Informasi Pada Institusi Pendidikan Tinggi Menggunakan Analisis Critical Success Factors

    Directory of Open Access Journals (Sweden)

    Pipin Widyaningsih

    2014-01-01

    Full Text Available There  are  many  organization  which  develop  their  information  technology  only  based  on  the  recommendation  of  certain  vendors  and colleagues. The development of Information and Technology Systems need a proper consideration in order to avoid the chance of bigger loss in the financial and investation sectors. The unsystematic development of Information and Technology Systems will not fu lfil a long term needs, there is no priority scale on it and it is not in line with the bu ssiness organization rhyme. The Strategic Planning Information System is a systematic approach about what is considered to be the most effective and effecient to fulfil the needs of information. The Strategic Planning Information System stated by Ward and Peppard (2002, which becomes the basis of this research, uses some analysis methods, likeValue Chain and Critical Success Factors. The result of this research is a blue print of the strategic planning which is based on  the  bussiness  organization  planning  with  the  data  gathered  through  the  analysis  method  used  and  it  involves  all  the  organization component.Keywords: Strategic planning information system; Higher education institution, Critical success factors

  11. Validation of an e-Learning 3.0 Critical Success Factors Framework: A Qualitative Research

    Directory of Open Access Journals (Sweden)

    Paula Miranda

    2017-09-01

    Full Text Available Aim/Purpose: As e-Learning 3.0 evolves from a theoretical construct into an actual solution for online learning, it becomes crucial to accompany this progress by scrutinising the elements that are at the origin of its success. Background: This paper outlines a framework of e-Learning 3.0’s critical success factors and its empirical validation. Methodology: The framework is the result of an extensive literature review and its empirical substantiation derives from semi-structured interviews with e-Learning experts. Contribution: The viewpoints of the experts enable the confirmation and the refinement of the original framework and serve as a foundation for the prospective implementation of e-Learning 3.0. Findings: The analysis of the interviews demonstrates that e-Learning 3.0 remains in its early stages with a reticent dissemination. Nonetheless, the interviewees invoked factors related to technology, content and stakeholders as being critical for the success of this new phase of e-Learning. Recommendations for Practitioners: Practitioners can use the framework as a guide for promoting and implementing effective e-Learning 3.0 initiatives. Recommendation for Researchers: As a new phenomenon with uncharted potential, e-Learning 3.0 should be placed at the centre of educational research. Impact on Society: The understanding of what drives the success of e-Learning 3.0 is fundamental for its implementation and for the progress of online education in this new stage of its evolution. Future Research: Future research ventures can include the design of quantitative and self-administered data collection instruments that can provide further insight into the elements of the framework.

  12. Critical Factors for Successful Practice of Disaster-Resilient Community in Urban City

    Science.gov (United States)

    Chou, J. S.; Wu, J. H.

    2017-12-01

    Due to special geographical environment, Taiwan is a natural disaster-prone area, which often suffers from earthquakes, typhoons and other natural hazards, resulting in heavy casualties and huge property losses. Furthermore, effect of global warming increases extreme climate events and leads to frequent and severe natural disasters. Therefore, disaster prevention and response are not only an important issue of government policy, but also a critical issue of people's life. Rather than over-reliance on government assistance, the spontaneous participation and co-operation by people can complete specific disaster preparedness and reinforce local energy of disaster prevention and response. Although the concept of disaster-resilient community (DRC) has been shaped for a period of time, residents in the community cannot keep up the pace with government, which may decrease the effectiveness of DRC development. Thus, the study of theory and practice of urban DRC becomes an imperative need. This article is a qualitative case study, which uses the participant observation and self-reflection in action research methods to collect relevant information for empirical validation. Particularly, this investigation is supplemented by service work experience in DRC promotion conducted by the researchers. According to the qualitative analyses of case communities during training process of disaster prevention and preparedness, we can identify the critical factors affecting the level of community-based disaster prevention and protection works. Based on the literature and empirical supports, the factors are discussed through three spindle constructs respectively, namely coping strategy, operations management and organizational behavior. Based on the findings of this study, we make conclusions and suggestions for related authority in sustainably promoting DRC.

  13. Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients.

    Science.gov (United States)

    Weijs, Peter J M; Looijaard, Wilhelmus G P M; Dekker, Ingeborg M; Stapel, Sandra N; Girbes, Armand R; Oudemans-van Straaten, H M; Beishuizen, Albertus

    2014-01-13

    Higher body mass index (BMI) is associated with lower mortality in mechanically ventilated critically ill patients. However, it is yet unclear which body component is responsible for this relationship. This retrospective analysis in 240 mechanically ventilated critically ill patients included adult patients in whom a computed tomography (CT) scan of the abdomen was made on clinical indication between 1 day before and 4 days after admission to the intensive care unit. CT scans were analyzed at the L3 level for skeletal muscle area, expressed as square centimeters. Cutoff values were defined by receiver operating characteristic (ROC) curve analysis: 110 cm2 for females and 170 cm2 for males. Backward stepwise regression analysis was used to evaluate low-muscle area in relation to hospital mortality, with low-muscle area, sex, BMI, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and diagnosis category as independent variables. This study included 240 patients, 94 female and 146 male patients. Mean age was 57 years; mean BMI, 25.6 kg/m2. Muscle area for females was significantly lower than that for males (102 ± 23 cm2 versus 158 ± 33 cm2; P muscle area was observed in 63% of patients for both females and males. Mortality was 29%, significantly higher in females than in males (37% versus 23%; P = 0.028). Low-muscle area was associated with higher mortality compared with normal-muscle area in females (47.5% versus 20%; P = 0.008) and in males (32.3% versus 7.5%; P muscle area, sex, and APACHE II score, whereas BMI and admission diagnosis were not. Odds ratio for low-muscle area was 4.3 (95% confidence interval, 2.0 to 9.0, P muscle mass appeared as primary predictor, not sex. Low skeletal muscle area, as assessed by CT scan during the early stage of critical illness, is a risk factor for mortality in mechanically ventilated critically ill patients, independent of sex and APACHE II score. Further analysis suggests muscle mass as primary predictor, not

  14. [Etiological diagnosis of leg ulcers].

    Science.gov (United States)

    Debure, Clélia

    2010-09-20

    Etiological diagnosis of leg ulcers must be the first step of treatment, even if we know that veinous disease is often present. We can build a clinical decisional diagram, which helps us to understand and not forget the other causes of chronic wounds and choose some basic examination, like ultrasound and histological findings. This diagnosis helps to choose the right treatment in order to cure even the oldest venous ulcers. Educational programs should be improved to prevent recurrence.

  15. ETIOLOGY OF HYPERTHYROIDISM IN PREGNANCY.

    OpenAIRE

    Fayal El Guendouz; Hicham Boussouf; Nabil Hammoune.

    2017-01-01

    Hyperthyroidism is a common endocrine disorder in young women of childbearing age. Approximately one to three cases of gestational hyperthyroidism occur per 1000 pregnancies. All etiologies of hyperthyroidism may be encountered during pregnancy but they are dominated by Graves\\\\\\' disease and gestational transient thyrotoxicosis. The first requires an antithyroid drug treatment and the second progresses well under symptomatic treatment. Hence the interest of the Establishment of the cause of ...

  16. Is the staple diet eaten in Medawachchiya, Sri Lanka, a predisposing factor in the development of chronic kidney disease of unknown etiology? - A comparison based on urinary β2-microglobulin measurements.

    Science.gov (United States)

    Siriwardhana, E A Ranga I E; Perera, Ponnumperuma A J; Sivakanesan, Ramiah; Abeysekara, Thilak; Nugegoda, Danaseela B; Weerakoon, Kosala G A D

    2014-07-02

    Exact mechanism of causation of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka is not described to date, despite the identification of possible multiple risk factors. Questions have been raised as to why only some are affected while others remain intact, though they are inhabitants of the same locality. Comparative studies were carried out, assessing urinary β2 microglobulin (β2m) and the dietary patterns of CKDu patients and age sex matched non-CKDu subjects. Urinary β2m levels of spot urine samples were analyzed using the Enzyme-linked Immunosorbent assay (ELISA) and dietary patterns were studied using twenty four hour dietary recalls and frequency consumption of foods of animal origin performed on three occasions at six months intervals within a period of one and half years. The mean urinary β2m level of CKDu patients from Medawachchiya was significantly (pCKDu subjects. The mean urinary β2m level of the non-CKDu subjects was within the reference limits for spot urine samples (0 - 0.3 μg/mL). White raw rice was the staple diet of both CKDu patients and non-CKDu subjects and the level of consumption was almost the same. The consumption of fresh water fish products of CKDu patients under high (14, 14%), moderate (36, 36%), low (26, 26%) and less (20, 20%) categories did not show significant variations (p>0.05) compared to non-CKDu subjects. Staple food in diet and the consumption pattern of CKDu patients from Medawachchiya were similar to that of non-CKDu subjects from the same area despite their urinary β2m concentration being significantly higher.

  17. Health information exchange implementation: lessons learned and critical success factors from a case study.

    Science.gov (United States)

    Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

    2014-08-15

    statewide HIE were found. The most significant perceived success was accomplishing the implementation, although many interviewees also underscored the value of a project champion with decision-making power. In terms of lessons learned, social reasons were found to be very significant motivators for early implementation, frequently outweighing economic motivations. It was clear that understanding the guides early in the project would have mitigated some of the challenges that emerged, and early communication with the electronic health record vendor so that they have a solid understanding of the undertaking was critical. An HIE implementations evaluation framework was found to be useful for assessing challenges, motivations, value propositions for participating, and success factors to consider for future implementations. This case study illuminates five critical success factors for implementation of a health system onto a statewide HIE. This study also reveals that organizations have varied motivations and value proposition perceptions for engaging in the exchange of health information, few of which, at the early stages, are economically driven.

  18. Rhabdomyolysis with different etiologies in childhood

    Science.gov (United States)

    Alaygut, Demet; Torun Bayram, Meral; Kasap, Belde; Soylu, Alper; Türkmen, Mehmet; Kavukcu, Salih

    2017-01-01

    AIM To investigate different etiologies and management of the rhabdomyolysis in children. METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment. RESULTS Average diagnosis ages of eight cases were 129 (24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection (pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase II deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis (Meyer-Betz syndrome). CONCLUSION It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive. PMID:29184760

  19. Prevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness.

    Science.gov (United States)

    Gungabissoon, Usha; Hacquoil, Kimberley; Bains, Chanchal; Irizarry, Michael; Dukes, George; Williamson, Russell; Deane, Adam M; Heyland, Daren K

    2015-05-01

    We aimed to determine the incidence of enteral feed intolerance and factors associated with intolerance and to assess the influence of intolerance on nutrition and clinical outcomes. We conducted a retrospective analysis of data from an international observational cohort study of nutrition practices among 167 intensive care units (ICUs). Data were collected on nutrition adequacy, ventilator-free days (VFDs), ICU stay, and 60-day mortality. Intolerance was defined as interruption of enteral nutrition (EN) due to gastrointestinal (GI) reasons (large gastric residuals, abdominal distension, emesis, diarrhea, or subjective discomfort). Logistic regression was used to determine risk factors for intolerance and their clinical significance. A sensitivity analysis restricted to sites specifying a gastric residual volume ≥200 mL to identify intolerance was also conducted. Data from 1,888 ICU patients were included. The incidence of intolerance was 30.5% and occurred after a median 3 days from EN initiation. Patients remained intolerant for a mean (±SD) duration of 1.9 ± 1.3 days . Intolerance was associated with worse nutrition adequacy vs the tolerant (56% vs 64%, P intolerance remained associated with negative outcomes. Although mortality was greater among the intolerant patients, this was not statistically significant. Intolerance occurs frequently during EN in critically ill patients and is associated with poorer nutrition and clinical outcomes. © 2014 American Society for Parenteral and Enteral Nutrition.

  20. Critical factors of implementing Industrialised Building System in Sarawak: A research on SMEs

    Science.gov (United States)

    Hadi, N. A.; Muhamad, W. M. N. W.; Othman, M. K. F.

    2017-05-01

    Industrialised Building System (IBS) have been adopted in Malaysia for over five decades and is expected to grow consistent with Malaysia's economic development. In promoting the adoption of IBS in construction projects, the government has taken several steps such as levy exemption for contractors and developers. Despite its numerous advantages and efforts pulled by the government, the implementation and adoption of IBS are still below the expected figure. Many researchers investigated readiness, setbacks and issues related to the implementation of IBS in Malaysia's construction projects. However, most of the research mainly for projects located in urban areas of West Malaysia. Therefore, this paper aims to close the gap on factors affecting the implementation of IBS for SMEs in Sarawak, where the level urbanisation is low. A semi-structured interview was conducted with 10 SME's contractors to get better insight view. The study found that logistics and infrastructure problems, a limited number of the manufacturer, lack of incentive, conventional payment methods, lack of financial supports are among critical factors affecting the implementation of IBS. Therefore, it was concluded that government plays major role in providing supports, incentives and facilitating the improvement of infrastructure to successfully implementing IBS in Sarawak.

  1. A review of the alpha-1 foundation: its formation, impact, and critical success factors.

    Science.gov (United States)

    Walsh, John W; Snider, Gordon L; Stoller, James K

    2006-05-01

    Patient-advocacy organizations have proliferated because they can be an effective method to advance research and clinical care for those with the index condition, and can produce substantial benefits for the affected community, especially when the condition is uncommon. To clarify critical success factors in organizing a patient-advocacy organization and to provide a blueprint for others, including the respiratory-care advocacy community, this report examines features of one highly successful organization, the Alpha-1 Foundation, which is committed to helping those with the genetic condition alpha-1 antitrypsin deficiency. Features of the Alpha-1 Foundation that underlie its success include: consistently creating partnerships with key stakeholders, including the scientific and clinical communities, government, and pharmaceutical manufacturers; bringing passion to the cause (eg, by assuring that organizational leadership is provided by individuals affected by alpha-1 antitrypsin deficiency); and developing strategic business partnerships, as with a company that administers alpha-1 antitrypsin treatment (so-called intravenous augmentation therapy) and employs individuals with alpha-1 antitrypsin deficiency. Funds allocated by the company help to underwrite the foundation's research-funding commitment. The foundation also recruits and retains talent, including alpha-1 patients, to leadership roles (eg, on the board of directors) and has a voluntary group of committed scientists and clinicians. We believe that attention to these factors can help assure the success of patient-advocacy groups.

  2. Usability: a critical success factor for managing change in the clinical info-structure.

    Science.gov (United States)

    Kay, S

    2005-06-01

    There can be no doubt that the clinical info-structure is being significantly enriched with the deployment of new systems throughout the health sector. From a technological perspective, the initial emphasis has been mainly on functionality and only latterly on the usability of these clinical information systems. However, the large scale and rapid pace of the changes being wrought in the health sector will have a major impact on clinicians and patients, not least in how they interact with the technology. Therefore, it is not only hardware and software but people-ware, too, that needs to be actively managed; not simply a one-off functional specification but an ongoing, complex relationship. Usability is the human factor that encompasses the ethical, educational, and evaluative aspects of design. There is also a strong case for regarding usability of clinical information systems as a key critical success factor for the management of change within the health-care domain. In particular, the relationship between usability, and education and training is examined.

  3. Meteorology and ethnicity as critical factors in HRIPT: Comparing responses between Chinese and Indian ethnicities.

    Science.gov (United States)

    Yuan, Chao; Wang, Xue-Min; Galzote, Carlos; Tan, Yi-Mei; Bhagat, Kamlesh V; Yuan, Zhi-Kang; Du, Jian-Fei; Tan, Yuan

    2013-06-01

    Human repeated insult patch test (HRIPT) is regarded as one of the confirmatory test in determining the safety of skin sensitizers. A number of important factors should be considered when conducting and interpreting the results of the HRIPT. To investigate for probable critical factors that influence the results of HRIPT with the same protocol in Shanghai and Mumbai. Two HRIPTs were carried out in Shanghai and Mumbai in 2011. Six identical products and 1% sodium lauryl sulfate were tested. Two Chinese dermatologists performed the grading in the two cities. Climate conditions of Shanghai and Mumbai were also recorded. For four lower reaction ratio products, cumulative irritation scores in the induction phase were higher in individuals whose ethnicity was Indian rather than Chinese. Reaction ratio of the same four products was highly correlated to the climatic parameters. The other two higher reaction ratio products and the positive control had no difference between the two ethnicities. Greater attention ought to be paid to the impact of climate on the results of HRIPT, especially for the mild irritation cosmetics when giving the interpretation. Greater emphasis also needs to be placed on the ethnicity of the subjects. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  4. MSX1 gene in the etiology orofacial deformities

    Directory of Open Access Journals (Sweden)

    Anna Paradowska-Stolarz

    2015-12-01

    Full Text Available The muscle segment homeobox (MSX1 gene plays a crucial role in epithelial-mesenchymal tissue interactions in craniofacial development. It plays a regulative role in cellular proliferation, differentiation and cell death. The human MSX1 domain was also found in cow (Bt 302906, mouse (Mm 123311, rat (Rn13592001, chicken (Gg 170873 and clawed toad (XI 547690. Cleft lip and palate is the most common anomaly of the facial part of the skull. The etiology is not fully understood, but it is believed that the key role is played by the genetic factor activated by environmental factors. Among the candidate genes whose mutations could lead to formation of the cleft, the MSX1 homeobox gene is mentioned. Mutations in the gene MSX1 can lead to isolated cleft deformities, but also cause other dismorphic changes. Among the most frequently mentioned is loss of permanent tooth buds (mostly of less than 4 teeth – hypodontia, including second premolars. Mutations of MSX1 are observed in the Pierre- Robin sequence, which may be one of the features of congenital defects or is observed as an isolated defect. Mutation of the gene can lead to the occurrence of a rare congenital defect Wiktop (dental-nail syndrome. Deletion of a fragment MSX1 (4p16.3 located in the WHS critical region, may be a cause of some symptoms of Wolf-Hirschhorn syndrome.

  5. Critical Success Factors for E-Learning in Developing Countries: A Comparative Analysis between ICT Experts and Faculty

    Science.gov (United States)

    Bhuasiri, Wannasiri; Xaymoungkhoun, Oudone; Zo, Hangjung; Rho, Jae Jeung; Ciganek, Andrew P.

    2012-01-01

    This study identifies the critical success factors that influence the acceptance of e-learning systems in developing countries. E-learning is a popular mode of delivering educational materials in higher education by universities throughout the world. This study identifies multiple factors that influence the success of e-learning systems from the…

  6. Identification and Ranking of Critical Success Factors of Knowledge Management Using Fuzzy Quality Function Deployment Approach: A Case Study

    Directory of Open Access Journals (Sweden)

    Ali Mohaghar

    2014-02-01

    Based on the information accessible for the researchers, this is one of the first works which evaluates the key factors of successful knowledge management through fuzzy quality function deployment approach. It is expected that the proposed method would represent appropriate tools for enterprises which have decided to implement knowledge management because it prioritizes the critical success factors based on the knowledge management outcomes.

  7. The etiology of social change.

    Science.gov (United States)

    Carley, Kathleen M; Martin, Michael K; Hirshman, Brian R

    2009-10-01

    A fundamental aspect of human beings is that they learn. The process of learning and what is learned are impacted by a number of factors, both cognitive and social; that is, humans are boundedly rational. Cognitive and social limitations interact, making it difficult to reason about how to provide information to impact what humans know, believe, and do. Herein, we use a multi-agent dynamic-network simulation system, Construct, to conduct such reasoning. In particular, we ask, What media should be used to provide information to most impact what people know, believe, and do, given diverse social structures? All simulated agents are boundedly rational both at the cognitive and social level, and so are subject to factors such as literacy, education, and the breadth of their social network. We find that there is no one most effective intervention; rather, to be effective, messages and the media used to spread the message need to be selected for the population being addressed. Typically, a multimedia campaign is critical. Copyright © 2009 Cognitive Science Society, Inc.

  8. A CRITICAL ANALYSIS OF THE FACTORS LYING BEHIND RECENT PUBLIC DEBT ACCUMULATION IN ROMANIA

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    Irina BILAN

    2014-12-01

    Full Text Available Following Romania’s accession to the EU, its public debt expressed as a share of GDP has seen a steep upward trend. Although this situation has not been unprecedented, as public debt massively increased in many other European countries once the economic crisis emerged, and the current level of Romania’s public debt is still well below the European limit of 60% of GDP, the previous experience of other developing countries tells us that this situation cannot be appreciated as a comfortable one. Against this background, it is important to investigate the factors that led to the recent growth of Romania’s public debt, to see if their action is only temporary or, on the contrary, if they persist over time, and to see if, by the promoted public indebtedness policies, prerequisites have been created to foster economic growth, as a rational support of further debt reduction. Thus, the aim of our paper is to identify and critically evaluate the contribution of different factors underlying the growth of Romania’s public debt in 2007-2013. Our analysis is supported by data (on public debt, public budgetary revenues, expenditures and budget balance, inflation rate, GDP growth rate, etc., collected from the reports of the Ministry of Public Finance of Romania or databases of international institutions (European Commission, International Monetary Fund.The main conclusion of our work is that although, like in other European countries, the economic crisis has contributed, through its effects on the GDP growth rate and budget balance, to the increase of Romania’s public debt, other specific and more persistent factors have also had an important contribution (as the pro-cyclical fiscal policy, the tax evasion, the large volume of arrears to public budgets, especially of public companies, the relatively low tax base, the high expenses on goods and services, salaries or even the interests payments on public debt.

  9. Critical analysis of the factors associated with enteral feeding in preventing VAP: a systematic review.

    Science.gov (United States)

    Chen, Yu-Chih

    2009-04-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre-post) studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent), feeding site on aspiration (gastric vs. small bowel), and the timing of enteral feeding (early vs. late). The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP still need further

  10. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yu-Chih Chen

    2009-04-01

    Full Text Available Ventilator-associated pneumonia (VAP is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre–post studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent, feeding site on aspiration (gastric vs. small bowel, and the timing of enteral feeding (early vs. late. The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP

  11. Etiological approach to chronic urticaria

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    Krupa Shankar D

    2010-01-01

    Full Text Available Background: In 1769, William Cullen introduced the word "urticaria" (transient edematous papules, plaque with itching. Urticaria affects 15-25% of people at least once in their life time. It is a clinical reaction pattern triggered by many factors causing the liberation of vasoactive substances such as histamine, prostaglandins and kinins. Urticaria is classified according to its duration into acute (< 6 weeks duration and chronic (>6 weeks duration. Various clinical investigations may be initiated to diagnosis the cause. Aims: To evaluate the types of chronic urticaria with reference to etiology from history and investigations . Materials and Methods: A total of 150 patients with chronic urticaria of more than six weeks were studied. Autologous serum skin test (ASST was performed after physical urticarias were excluded. Standard batteries of tests were performed after ASST in all patients; and other specific investigations were done where necessary. Skin prick test was done in idiopathic urticaria. Results: The study sample consisted of 62 male and 88 female patients with a mean age of 21-40 years. About 50% of patients showed an ASST positive reaction, 3.9% were positive for antinuclear antibody (ANA, IgE titer was elevated in 37%, H. pylori antibodies was positive in 26.7%. Thyroid antibodies were positive in 6.2%. Giardia and entamoeba histolytica was reported in 3.3% on routine stool examination and on urinalysis 8% had elevated WBC counts; 12% showed para nasal sinusitis, with maxillary sinusitis of 7.3%. Random blood sugar was high in 5.3%. Four patients had ASOM, two had positive KOH mount for dermatophytes, abdominal USG showed cholecystitis in two patients. Recurrent tonsillitis was noted in two patients. Urticaria following intake of NSAIDs was observed in four patients and with oral contraceptive pills in one patient. Contact urticaria to condom (latex was seen in one patient. Cholinergic (4.7% and dermographic (4.7% urticaria were

  12. Identifying Critical Factors Influencing the Rents of Public Rental Housing Delivery by PPPs: The Case of Nanjing

    Directory of Open Access Journals (Sweden)

    Jingfeng Yuan

    2017-02-01

    Full Text Available The occupancy rate of Public Rental Housing (PRH in China is relatively low due to the unreasonable rents. At the same time, the development of PRH using Public Private Partnerships (PPPs increases the complexity of the rents. Therefore, the critical factors influencing the rents of PRH delivery by PPPs should be identified. Based on the comprehensive literature, this article identified a conceptual model for the factors influencing the rents of PRH delivery by PPPs in China, composed of 14 factors grouped in three factor packages, and discussed the relationships among three factor packages. A survey based on Nanjing was conducted to assess the relative significance of 14 factors. According to the results, six critical factors were identified: construction costs, household income, floor area and structure, transportation, market rents in the same district and public facilities. In addition, the proposed conceptual model had a good fit. The results also supported two hypothetical relationships among three factor packages: (1 the increase of the affordability of the target tenants had a positive effect on the increase of profits of private sectors; and (2 the increase of the affordability of the target tenants had a positive effect on the increase of level of the characteristics of PRH units. For future research, six critical factors and the relationships among three factor packages can be used to determine the reasonable rents for PRH delivery by PPPs in China.

  13. Hypothyroidism: etiology, diagnosis, and management.

    Science.gov (United States)

    Almandoz, Jaime P; Gharib, Hossein

    2012-03-01

    Hypothyroidism is the result of inadequate production of thyroid hormone or inadequate action of thyroid hormone in target tissues. Primary hypothyroidism is the principal manifestation of hypothyroidism, but other causes include central deficiency of thyrotropin-releasing hormone or thyroid-stimulating hormone (TSH), or consumptive hypothyroidism from excessive inactivation of thyroid hormone. Subclinical hypothyroidism is present when there is elevated TSH but a normal free thyroxine level. Treatment involves oral administration of exogenous synthetic thyroid hormone. This review presents an update on the etiology and types of hypothyroidism, including subclinical disease; drugs and thyroid function; and diagnosis and treatment of hypothyroidism. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Intrathoracic neoplasia: Epidemiology and etiology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1992-05-01

    Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

  15. Critical success factors in awareness of and choice towards low vision rehabilitation.

    Science.gov (United States)

    Fraser, Sarah A; Johnson, Aaron P; Wittich, Walter; Overbury, Olga

    2015-01-01

    The goal of the current study was to examine the critical factors indicative of an individual's choice to access low vision rehabilitation services. Seven hundred and forty-nine visually impaired individuals, from the Montreal Barriers Study, completed a structured interview and questionnaires (on visual function, coping, depression, satisfaction with life). Seventy-five factors from the interview and questionnaires were entered into a data-driven Classification and Regression Tree Analysis in order to determine the best predictors of awareness group: positive personal choice (I knew and I went), negative personal choice (I knew and did not go), and lack of information (Nobody told me, and I did not know). Having a response of moderate to no difficulty on item 6 (reading signs) of the Visual Function Index 14 (VF-14) indicated that the person had made a positive personal choice to seek rehabilitation, whereas reporting a great deal of difficulty on this item was associated with a lack of information on low vision rehabilitation. In addition to this factor, symptom duration of under nine years, moderate difficulty or less on item 5 (seeing steps or curbs) of the VF-14, and an indication of little difficulty or less on item 3 (reading large print) of the VF-14 further identified those who were more likely to have made a positive personal choice. Individuals in the lack of information group also reported greater difficulty on items 3 and 5 of the VF-14 and were more likely to be male. The duration-of-symptoms factor suggests that, even in the positive choice group, it may be best to offer rehabilitation services early. Being male and responding moderate difficulty or greater to the VF-14 questions about far, medium-distance and near situations involving vision was associated with individuals that lack information. Consequently, these individuals may need additional education about the benefits of low vision services in order to make a positive personal choice. © 2014

  16. An Exploratory Study of the Critical Factors Affecting the Acceptability of Automated Teller Machine (ATM in Nigeria

    Directory of Open Access Journals (Sweden)

    Olusegun Folorunso

    2010-01-01

    Full Text Available This paper uses the Technology Acceptance Model (TAM as a basis for studying critical factors that affects the acceptability of Automated Teller Machine (ATM in Nigeria. Questionnaire approach was used with the respondents predominantly between 20-29 years old. Factor analysis was used to test which of the factors are the main factors affecting the adoption of the technology in Nigeria. It was discovered that the major factors affecting people’s intention to accept ATM are the security issues and poor internet connectivity.

  17. Review: Recent Finding about Etiology of

    Directory of Open Access Journals (Sweden)

    Parvaneh Karim-Zadeh

    2000-10-01

    Full Text Available Autism and the other disorders in the autism spectrum are behaviorally defined syndromes that can be a prolonged disorder. The specific underlying neurophysiologic mechanisms simply not known, but probably several causes lead to disorders in the autism spectrum. This article is summary of recent research about etiology of autism but the search must continue. 1 Neurobiological origin, the neurobiological investigations show the role of dopamine and serotonin in pathogenesis of autism. 2 Genetic, studies in autism was established the hypothesis that genetic factors can be etiologically significant in subsets of patients. 3 With the Regional cerebral glucose metabolism measurement, autistic children had a left> right anterior rectal gyrus asymmetry as opposed to the normal right> left asymmetry in that region. 4 With the Regional cerebral blood flow measurement no cortical regional abnormalities were found. 5 Association of epilepsy and autism pediatric epilepsy lead to autistic regression. 6 Association of tuberous sclerosis and autism the number of tubers was significantly greater in individuals with a diagnosis of autism than in those without this diagnosis. 7 Embryological origin for autism, the results and two new lines of evidence that place the initiating injury for autism around the time of neural tube closure. 8 Obstetric complications and later autistic disorder, these data do not support the view that obstetric complications increase the risk for later autism. 9 Food allergy, recent findings show a relationship between food allergy and infantile autism. 10 Head circumferences measurement in children with autism show the large head circumference and increased growth.

  18. Recurring waterbird mortalities and unusual etiologies

    Science.gov (United States)

    Cole, Rebecca A.; Franson, J. Christian; Boere, Gerard C.; Galbraith, Colin A.; Stroud, David A.

    2006-01-01

    Over the last decade, the National Wildlife Health Center of the United States Geological Survey has documented various largescale mortalities of birds caused by infectious and non-infectious disease agents. Some of these mortality events have unusual or unidentified etiologies and have been recurring. While some of the causes of mortalities have been elucidated, others remain in various stages of investigation and identification. Two examples are discussed: 1) Leyogonimus polyoon (Class: Trematoda), not found in the New World until 1999, causes severe enteritis and has killed over 15 000 American Coot Fulica americana in the upper mid-western United States. The geographic range of this parasite within North America is predicted to be limited to the Great Lakes Basin. 2) In the early 1990s, estimates of up to 6% of the North American population of the Eared Grebe Podiceps nigricollis died at Salton Sea, California, with smaller mortalities occurring throughout the 1990s. Birds were observed to have unusual preening behaviour, and to congregate at freshwater drains and move onto land. Suggested etiologies included interactions of contaminants, immuno-suppression, an unusual form of a bacterial disease, and an unknown biotoxin. During studies carried out from 2000 to 2003, Eared Grebe mortality did not approach the level seen in the early 1990s and, although bacteria were identified as minor factors, the principal cause of mortality remains undetermined. The potential population impact of these emerging and novel disease agents is currently unknown.

  19. Use of wild trout for PBDE assessment in freshwater environments: Review and summary of critical factors

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    Juan M. Ríos

    2015-11-01

    Full Text Available Certain wild animals represent sentinels to address issues related to environmental pollution, since they can provide integrative data on both pollutant exposure and biological effects. Despite their technological benefits, PBDEs are considered a threat to environmental health due to their persistence, toxicity, and capacity to be accumulated. These pollutants have been found geographically widespread in fish, particularly in predator species such as trout. The aim of this work is to critically review the applicability and usefulness of wild trout for assessing PBDEs in freshwater environments. Reviewed reports include data from highly industrialized areas as well as areas from remote regions with relatively low human activity, including European and North American great lakes and freshwater environments in Europe, Greenland, subarctic areas and Patagonia, respectively. A summary of relevant factors were grouped into organism-specific factors (food habits, age, size, lipid content, sex and reproduction, tissue type, mechanism of contaminant uptake and metabolism, and PBDE levels in the surrounding environment (sediment. Five wild trout species [rainbow trout (Oncorhynchus mykiss, brown trout (Salmo trutta, lake trout (Salvelinus namaycush, arctic char (Salvelinus alpinus, and brook trout (Salvelinus fontinalis], collected worldwide within the 1994 to present time frame, were considered. Multivariate techniques (principal component analysis-PCA and mapping approach, showed clear differences in geographic distribution patterns of PBDE levels in trout depending on the region studied: wild trout from European and North American great lakes have the highest PBDE loads. This pattern could be due to high industrial activity at these locations. A correlational approach used to explore intraspecific relationships between PBDE levels and morphometry, showed positive relationships only for brown trout. Further, brown trout showed the highest trout

  20. Critical factors that impact on the efficiency of the Lagos seaports

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    Francis Ojadi

    2015-07-01

    Full Text Available Background: Since the past two decades, the Lagos seaports have experienced vessel and storage yard cargo congestion, resulting in dwell times of about 30 days for containerised imports and high trade logistics costs. Objectives: The purpose of this study was to identify the critical factors that impact the operational efficiency of the Lagos seaports with a view to improving liner trade activities. Method: The study adopted an operational-based approach to understand the dynamics of the various interfaces of the port value chain. The research paradigm adopted for the study was therefore a combination of constructivism and post-positivism paradigms, which entailed the exploration and understanding of the various stakeholders in the port value chain. The epistemology of the research relied on the use of the exploratory sequential mixed method research technique (i.e. the qualitative approach followed by the quantitative approach at the operational level of port operations. Results: The result of the research showed that significant challenges exist and that some of these challenges cut across all functions of port operations. Challenges are experienced in the areas of corruption, trade fraud, transport infrastructure deficits, the absence of a supply chain culture and shortcomings in the execution of the ‘contract of customs’. Additionally, these factors include the deficiencies in services and facilities provided by state agencies and government-appointed service providers and private sector companies such as truckers, inland container depots, Inland Container Depots (ICDs and terminal operators. Conclusion: Specific recommendations are made to address the issues identified which, if implemented, could significantly address the current inefficiencies observed in the Lagos seaport’s operations.

  1. Personal satisfaction and mentorship are critical factors for today's resident surgeons to seek surgical training.

    Science.gov (United States)

    Lukish, Jeffrey; Cruess, David

    2005-11-01

    The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.

  2. Tyrosyl-DNA Phosphodiesterase I a critical survival factor for neuronal development and homeostasis.

    Science.gov (United States)

    van Waardenburg, Robert C A M

    2016-01-01

    Tyrosyl-DNA phosphodiesterase I (TDP1), like most DNA repair associated proteins, is not essential for cell viability. However, dysfunctioning TDP1 or ATM (ataxia telangiectasia mutated) results in autosomal recessive neuropathology with similar phenotypes, including cerebellar atrophy. Dual inactivation of TDP1 and ATM causes synthetic lethality. A TDP1H 493 R catalytic mutant is associated with spinocerebellar ataxia with axonal neuropathy (SCAN1), and stabilizes the TDP1 catalytic obligatory enzyme-DNA covalent complex. The ATM kinase activates proteins early on in response to DNA damage. Tdp1-/- and Atm-/- mice exhibit accumulation of DNA topoisomerase I-DNA covalent complexes (TOPO1-cc) explicitly in neuronal tissue during development. TDP1 resolves 3'- and 5'-DNA adducts including trapped TOPO1-cc and TOPO1 protease resistant peptide-DNA complex. ATM appears to regulate the response to TOPO1-cc via a noncanonical function by regulating SUMO/ubiquitin-mediated TOPO1 degradation. In conclusion, TDP1 and ATM are critical factors for neuronal cell viability via two independent but cooperative pathways.

  3. Risk Management method to ERP systems implementation based os critical sucess factors

    Directory of Open Access Journals (Sweden)

    Márcio Saez Caputo

    2004-10-01

    Full Text Available From the second half of years 90, the Enterprise Resource Planning (ERP systems implementation appears like one of the main investment focus related to the use of information technology in the companies, which aimed to acquire competitive advantages through cost reduction and differentiation of products with the use of these systems. ERP implementation showed to be much more than a technology project, involving structural and managing changes, becoming a complex and high risk process for the organizations. In the literature specialized on ERP, there are many examples of the difficulties of this type of project and about implementations that had not reached the expected objectives, frustrating the expectations of the contractors. The present work describes, first of all, the development of a risk management method to ERP systems implementation, based on critical success factors. Then, a case of application of the considered method is analyzed, detailing the steps and the results gotten until the moment. To the end, evidences regarding to how the method helps to improve risk management during ERP implementations are presented.

  4. Critical Success Factors for Lean Thinking in the Application of Industrialised Building System (IBS)

    Science.gov (United States)

    Yunus, Riduan; Noor, Siti Rahimah Mohd; Halid Abdullah, Abd; Nagapan, Sasitharan; Hamid, Abdul Rahim Abdul; Tajudin, Saiful Azhar Ahmad; Rohani Mat Jusof, Siti

    2017-08-01

    Productivity in the manufacturing process of building components can be increased by optimising each advantage that is available in each activity. Identification of critical success factors (CSFs) for lean thinking in the Industrialised Building System (IBS) will be able to minimise cost and reduce time needed to complete a project. The focus of lean thinking in construction is on the production process and the client’s requirement. In developing countries such as Malaysia, the integration of lean thinking in IBS applications is still low and there is a shortage of comprehensive strategies to integrate lean thinking. As key stakeholders, feedback from contractors, manufacturers, developers and the local authority will be able to help the identification of CSFs in integrating lean thinking in IBS applications. The data was collected through a questionnaire survey and analysed quantitatively. There are 31 CSFs for lean thinking in IBS which have been identified in this study. A conceptual model was developed to assist researchers in investigating the influences of CSFs for lean thinking in IBS applications. This study will assist construction players to improvise their manufacturing process in the implementation of IBS to eliminate unnecessary activities and focus instead on significant processes without generating physical and non-physical waste.

  5. Terrorism in Australia: factors associated with perceived threat and incident-critical behaviours

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    Raphael Beverley

    2009-03-01

    Full Text Available Abstract Background To help improve incident preparedness this study assessed socio-demographic and socio-economic predictors of perceived risk of terrorism within Australia and willingness to comply with public safety directives during such incidents. Methods The terrorism perception question module was incorporated into the New South Wales Population Health Survey and was completed by a representative sample of 2,081 respondents in early 2007. Responses were weighted against the New South Wales population. Results Multivariate analyses indicated that those with no formal educational qualifications were significantly more likely (OR = 2.10, 95%CI:1.32–3.35, p Conclusion Low education level is a risk factor for high terrorism risk perception and concerns regarding potential impacts. The pattern of concern and response among those of migrant background may reflect secondary social impacts associated with heightened community threat, rather than the direct threat of terrorism itself. These findings highlight the need for terrorism risk communication and related strategies to address the specific concerns of these sub-groups as a critical underpinning of population-level preparedness.

  6. Off-critical statistical models: factorized scattering theories and bootstrap program

    International Nuclear Information System (INIS)

    Mussardo, G.

    1992-01-01

    We analyze those integrable statistical systems which originate from some relevant perturbations of the minimal models of conformal field theories. When only massive excitations are present, the systems can be efficiently characterized in terms of the relativistic scattering data. We review the general properties of the factorizable S-matrix in two dimensions with particular emphasis on the bootstrap principle. The classification program of the allowed spins of conserved currents and of the non-degenerate S-matrices is discussed and illustrated by means of some significant examples. The scattering theories of several massive perturbations of the minimal models are fully discussed. Among them are the Ising model, the tricritical Ising model, the Potts models, the series of the non-unitary minimal models M 2,2n+3 , the non-unitary model M 3,5 and the scaling limit of the polymer system. The ultraviolet limit of these massive integrable theories can be exploited by the thermodynamics Bethe ansatz, in particular the central charge of the original conformal theories can be recovered from the scattering data. We also consider the numerical method based on the so-called conformal space truncated approach which confirms the theoretical results and allows a direct measurement of the scattering data, i.e. the masses and the S-matrix of the particles in bootstrap interaction. The problem of computing the off-critical correlation functions is discussed in terms of the form-factor approach

  7. Critical success factors for business intelligence in the South African financial services sector

    Directory of Open Access Journals (Sweden)

    Lionel Dawson

    2013-06-01

    Objectives: This research aimed to determine which CSFs are the most important in the financial services sector of South Africa. Method: The authors used a Delphi-technique approach with key project stakeholders in three BI projects in different business units of a leading South African financial services group. Results: Authors regarded CSF categories of ‘committed management support and champion’,‘business vision’, ‘user involvement’ and ‘data quality’ as the most critical for BI success. Conclusions: Researchers in the BI field should note that the ranking of CSFs in this study only correlate partially with those a European study uncovered. However, the five factors the authors postulated in their theoretical framework ranked in the seven highest CSFs. Therefore, they provide a very strong validation of the framework. Research in other industries and other emerging economies may discover similar differences and partial similarities. Of special interest would be the degree of correlation between this study and future, and similar emerging market studies. Practitioners, especially BI project managers, would do well to check that they address the CSFs the authors uncovered before undertaking BI projects.

  8. Critical factors affecting the integration of biomass gasification and syngas fermentation technology

    Directory of Open Access Journals (Sweden)

    Karthikeyan D. Ramachandriya

    2016-05-01

    Full Text Available Gasification-fermentation is a thermochemical-biological platform for the production of fuels and chemicals. Biomass is gasified at high temperatures to make syngas, a gas composed of CO, CO2, H2, N2 and other minor components. Syngas is then fed to anaerobic microorganisms that convert CO, CO2 and H2 to alcohols by fermentation. This platform offers numerous advantages such as flexibility of feedstock and syngas composition and lower operating temperature and pressure compared to other catalytic syngas conversion processes. In comparison to hydrolysis-fermentation, gasification-fermentation has a major advantage of utilizing all organic components of biomass, including lignin, to yield higher fuel production. Furthermore, syngas fermentation microorganisms do not require strict CO:H2:CO2 ratios, hence gas reforming is not required. However, several issues must be addressed for successful deployment of gasification-fermentation, particularly those that involve the integration of gasification and fermentation. Most previous reviews have focused only on either biomass gasification or syngas fermentation. In this review, the critical factors that affect the integration of biomass gasification with syngas fermentation, such as carbon conversion efficiency, effect of trace gaseous species, H2 to CO ratio requirements, and microbial preference of carbon substrate, are thoroughly discussed.

  9. CRITICAL SUCCESS FACTORS FOR IMPLEMENTING LEAN PRACTICES IN IT SUPPORT SERVICES

    Directory of Open Access Journals (Sweden)

    Goutam Kundu

    2012-12-01

    Full Text Available Many studies have been done to identify the critical success factors (CSFs in for successful lean implementation in the manufacturing firms. But, till date, no systematic study has been done to identify the CSFs from the perspective of lean implementation in IT support service sector. This paper aims to address this area. A detailed literature review was undertaken to identify CSFs for lean implementation in manufacturing and services context and to consider their applicability to the IT support services sector. This paper is based on a conceptual discussion of CSFs as applied to the IT support services sector. The authors proposed a set of CSFs which is believed to be suitable for IT support service enterpri ses. The relevance of CSFs will need to be tested and qualitative research is needed to inform further work. The proposed CSFs are aimed at being useful to IT support services sector as a guideline, so as to ensure a positive outcome of the lean implementation process in IT support services sector.

  10. Critical success factor (CSF) service delivery for tahfiz institution teaching & learning environment

    Science.gov (United States)

    Ridza, B. H.; Jalil, R. A.; Sipan, I.; Nukman, Y.

    2017-11-01

    The exceptional existence of tahfiz institutions (TI) by a government and the private sector in Malaysia indicates that tahfiz education at par to fill mainstream education. Nevertheless, the level of TI facilities management (FM) provided is unstandardized since its infrastructure and establishment is initiated by the varied background of TI organizer. Thus, the effectiveness of TI education system is immeasurable. The significance of this research is to explore the critical success factor (CSF) of service delivery for TI teaching and learning environment. This research adopts both qualitative and quantitative method through survey instrument in order to review and analyze to achieve the research goal. The findings showed several important criteria for a transformation of TI education teaching and learning environment such top management of TI needs to be more responsible in providing better FM practice to achieve efficiency of manpower in providing a conducive learning environment for students for producing excellent huffaz. Thus, TI education system needs to have clear standard guidelines in operating their activities in producing huffaz that capable implement Islamic knowledge to the development of the country.

  11. Examining the Interrelationship among Critical Success Factors of Public Private Partnership Infrastructure Projects

    Directory of Open Access Journals (Sweden)

    Shiying Shi

    2016-12-01

    Full Text Available Examining the interrelationships among critical success factors (CSFs for public private partnership (PPP projects is of importance for improving PPP project performance and maintaining the sustainability of PPP project implementation. Previous studies mostly focused on the identification of the CSFs for PPP projects; limited studies investigated the interrelationships among CSFs. Hence, the research objectives are (a to determine the interrelationships among CSFs of PPP projects taking into account the public and (b to identify influence paths contributing to take advantage of CSFs in the process of PPP implementation. A literature review and expert interviews were adopted to construct the CSFs framework; nine hypotheses were constructed and tested by the structural equation modelling (SEM based on the data collected from a questionnaire survey. This research reveals that the relationship between public and private partners is the leader-follower relationship, not the partnership relationship, in PPP projects, indicating that the responsibilities, power or resources existing among partners are very unequal. It also highlights that public involvement has a negative effect on the process of service provisions, and costs and risks exist in the process of public involvement in PPP projects. The determined interrelationships among CSFs will contribute to the sustainability and success of a PPP project.

  12. The role of schizotypy in the study of the etiology of schizophrenia spectrum disorders.

    Science.gov (United States)

    Barrantes-Vidal, Neus; Grant, Phillip; Kwapil, Thomas R

    2015-03-01

    Schizotypy provides a useful construct for understanding the development of schizophrenia spectrum disorders. As research on the epidemiology of psychotic symptoms and clinical risk for psychosis has expanded, conceptual challenges have emerged to comprehend the nature and borders of the space comprised between personality variation and psychosis. Schizotypy is considered in light of these more recent constructs. It is suggested that rather than being superseded by them due to their higher specificity and predictive power for transition to psychosis, schizotypy integrates them as it constitutes a dynamic continuum ranging from personality to psychosis. The advantages of schizotypy for studying schizophrenia etiology are discussed (eg, it facilitates a developmental approach and the identification of causal, resilience, and compensating factors and offers a multidimensional structure that captures etiological heterogeneity). An overview of putative genetic, biological, and psychosocial risk factors is presented, focusing on communalities and differences between schizotypy and schizophrenia spectrum disorders. The found notable overlap supports etiological continuity, and, simultaneously, differential findings appear that are critical to understanding resilience to schizophrenia. For example, discrepant findings in genetic studies might be interpreted as suggestive of sets of independent genetic factors playing a differential role in schizotypy and schizophrenia: some would influence variation specifically on schizotypy dimensions (ie, high vs low schizotypy, thereby increasing proneness to psychosis), some would confer unspecific liability to disease by impacting neural properties and susceptibility to environmental factors (ie, high vs low resilience to disorder) and some might contribute to disease-specific characteristics. Finally, schizotypy's promise for studying gene-environment interactions is considered. © The Author 2015. Published by Oxford University

  13. Critical Factors Influencing Viability of Wave Energy Converters in Off-Grid Luxury Resorts and Small Utilities

    Directory of Open Access Journals (Sweden)

    Aksel Botne Sandberg

    2016-12-01

    Full Text Available This paper examines technical and non-technical factors that are critical to the viability of commercialization of wave energy converters in off-grid luxury resorts and small utilities. Critical factors are found by investigating Levelized Cost of Energy, and using the tools PESTEL and Porter’s five competitive forces. Identified factors are then applied on three business cases to investigate their impact on viability. The results show that one of the main challenges facing off-grid commercialization is the few wave energy converter units installed per location, negating the economy of scale that large wave energy farms count on to achieve competitive cost levels. In addition, factors like current cost of energy, available wave resources, distance from shore, infrastructure, supply chain logistics, and electricity demand are found to be deciding factors for viability. Despite these challenges, it is found that there are potentially viable off-grid business cases for commercialization of wave energy converters.

  14. Etiologies of sperm oxidative stress

    Directory of Open Access Journals (Sweden)

    Parvin Sabeti

    2016-04-01

    Full Text Available Sperm is particularly susceptible to reactive oxygen species (ROS during critical phases of spermiogenesis. However, the level of seminal ROS is restricted by seminal antioxidants which have beneficial effects on sperm parameters and developmental potentials. Mitochondria and sperm plasma membrane are two major sites of ROS generation in sperm cells. Besides, leukocytes including polymer phonuclear (PMN leukocytes and macrophages produce broad category of molecules including oxygen free radicals, non-radical species and reactive nitrogen species. Physiological role of ROS increase the intracellular cAMP which then activate protein kinase in male reproductive system. This indicates that spermatozoa need small amounts of ROS to acquire the ability of nuclear maturation regulation and condensation to fertilize the oocyte. There is a long list of intrinsic and extrinsic factors which can induce oxidative stress to interact with lipids, proteins and DNA molecules. As a result, we have lipid peroxidation, DNA fragmentation, axonemal damage, denaturation of the enzymes, over generation of superoxide in the mitochondria, lower antioxidant activity and finally abnormal spermatogenesis. If oxidative stress is considered as one of the main cause of DNA damage in the germ cells, then there should be good reason for antioxidant therapy in these conditions

  15. Studies of safety and critical work situations in nuclear power plants: A human factors perspective

    International Nuclear Information System (INIS)

    Jacobsson Kecklund, L.

    1998-05-01

    The purpose of this thesis was to develop and apply different approaches for analyzing safety in critical work situations in real work settings in nuclear power plants, and also to identify safety enhancing measures by using the framework of interaction between human, organizational and technical subsystems. A Cognitive Psychology as well as a Stress Psychology framework was used. All studies were related to the annual outage operational state where the need for coping with many infrequent tasks, often carried out under high time pressure, puts great strain on the staff and organisation of the plant. In three studies the natural variations in the plant state, normal operation and annual outage operation, were used to explore human performance, work-related factors as well as coping and the operators' own resources and the relationship between them. In the annual outage condition high work demands, decreased sleepiness at night shift, more errors and less satisfaction with work performance quality was reported by maintenance as well as by control room operators. A relationship between high work demands and more organizational problems and reports of more frequent human errors and lower satisfactions with work performance quality was also identified in the annual outage condition. Moreover, a relationship between increased sleepiness during night shift, more frequent use of coping strategies and a higher frequency of human errors was reported. In two studies the Event and Barrier Function Model was applied to analyze the safety of barrier function systems inserted into work process sequences to protect the systems from the negative consequences of failures and errors. The model was also used to assess safety in relation to a technical and organizational change. The last study addressed changes in work performance and work-related factors in relation to a technical and organizational change of a safety significant work process involving increased automation and new

  16. Etiology of severe pneumonia in Ecuadorian children.

    Directory of Open Access Journals (Sweden)

    Sivani Jonnalagadda

    Full Text Available In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador.This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated.Among 406 children tested, 159 (39.2% had respiratory syncytial virus (RSV, 71 (17.5% had human metapneumovirus (hMPV, and 62 (15.3% had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2% samples and Mycoplasma pneumoniae in three (0.74% samples. The yearly circulation pattern of RSV (P = 0.0003 overlapped with S. pneumoniae, (P = 0.03 with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01 and being underweight (aOR = 1.8, P = 0.04. Maternal education (aOR = 0.82, P = 0.003, pulse oximetry (aOR = 0.93, P = 0.005, and rales (aOR = 0.25, P = 0.007 were associated with influenza A. Younger age (aOR = 3.5, P = 0.007 and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03.These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available.ClinicalTrials.gov NCT 00513929.

  17. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

    Science.gov (United States)

    Dave, Tarjani Vivek; Mohammed, Faraz Ali; Ali, Mohammad Javed; Naik, Milind N

    2016-01-01

    Background The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). Patients and methods Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. Conclusion Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. PMID:27555748

  18. Can We Protect the Gut in Critical Illness: The Role of Growth Factors and Other Novel Approaches

    Science.gov (United States)

    Dominguez, Jessica A.; Coopersmith, Craig M.

    2010-01-01

    Synopsis The intestine plays a central role in the pathophysiology of critical illness and is frequently called the “motor” of the systemic inflammatory response. Perturbations to the intestinal barrier can lead to distant organ damage and multiple organ failure. Therefore, identifying ways to preserve intestinal integrity may be of paramount importance. Growth factors and other peptides have emerged as potential tools for modulation of intestinal inflammation and repair due to their roles in cellular proliferation, differentiation, migration, and survival. In this review, we will examine the involvement of growth factors and other peptides in intestinal epithelial repair during critical illness and their potential use as therapeutic targets. PMID:20643306

  19. Can we protect the gut in critical illness? The role of growth factors and other novel approaches.

    Science.gov (United States)

    Dominguez, Jessica A; Coopersmith, Craig M

    2010-07-01

    The intestine plays a central role in the pathophysiology of critical illness and is frequently called the "motor" of the systemic inflammatory response. Perturbations to the intestinal barrier can lead to distant organ damage and multiple organ failure. Therefore, identifying ways to preserve intestinal integrity may be of paramount importance. Growth factors and other peptides have emerged as potential tools for modulation of intestinal inflammation and repair due to their roles in cellular proliferation, differentiation, migration, and survival. This review examines the involvement of growth factors and other peptides in intestinal epithelial repair during critical illness and their potential use as therapeutic targets. Copyright 2010 Elsevier Inc. All rights reserved.

  20. An analysis on human factor issues in criticality accident at a uranium processing plant. Investigation on human behavior contributing to the criticality accident. Interim report

    International Nuclear Information System (INIS)

    Sasou, Kuonihide; Goda, Hideki; Hirotsu, Yuko

    1999-01-01

    At 10:30 am, September 30th, 1999, a criticality accident occurred in a conversion building of a uranium processing plant in Tokai, Ibaraki prefecture. 69 people including 3 workers who then worked at the building, 3 fire fighters who dispatched to rescue them were exposed to the radiation. People with a 350 m-radius of the site were recommended to evacuate themselves from the region to a temporarily prepared evacuation center. And about one hundred thousand people within a 10 km-radius were also advised to stay inside of their home. Nuclear Safety Commission's Accident Investigation Committee is investigating causes of this accident and have been revealing that deviation from government-authorized processing method and negligence of its illegal procedure had contributed to the accident. The influence of this accident is expanding not only to the plant operating company, local people but also to Japanese nuclear power policy, the whole nuclear industry in Japan. Especially pervasion of 'Safety Culture' is strongly being required. This report analyses latent factors of some human behavior directly contributing to the criticality accident. It also mentions that 4 critical points on the poor climate for safety in the work place, the inadequate safety management, the unsuitable equipment and the production-biased company's policy are the latent factors of this accident. It also finds that the poor climate and the production-biased policy are the most important factors. It can be said that some people directly or indirectly having caused the accident are the victims of them. (author)

  1. Etiology of Teen Dating Violence among Adolescent Children of Alcoholics.

    Science.gov (United States)

    Livingston, Jennifer A; Eiden, Rina D; Lessard, Jared; Casey, Meghan; Henrie, James; Leonard, Kenneth E

    2018-03-01

    Family processes in early life have been implicated in adolescent involvement in teen dating violence, yet the developmental pathways through which this occurs are not well understood. In this study, etiological pathways from parental psychopathology and marital conflict in infancy to involvement in dating violence in late adolescence were examined in a sample of children at high-risk due to parental alcohol problems. Families (N = 227) recruited when the child was 12 months of age were assessed at 12-, 24-, 36-months, kindergarten, 6th, 8th, and 12th grades. Slightly more than half of the children were female (51%) and the majority were of European American descent (91%). Parental psychopathology in infancy was indirectly associated with teen dating violence in late adolescence via low maternal warmth and self-regulation in early childhood, externalizing behavior from kindergarten to early adolescence, and sibling problems in middle childhood. Marital conflict was also indirectly associated with teen dating violence via child externalizing behavior. Maternal warmth and sensitivity in early childhood emerged as an important protective factor and was associated with reduced marital conflict and increased child self-regulation in the preschool years as well as increased parental monitoring in middle childhood and early adolescence. Family processes occurring in the preschool years and in middle childhood appear to be critical periods for creating conditions that contribute to dating violence risk in late adolescence. These findings underscore the need for early intervention and prevention with at-risk families.

  2. Voice Disorders: Etiology and Diagnosis.

    Science.gov (United States)

    Martins, Regina Helena Garcia; do Amaral, Henrique Abrantes; Tavares, Elaine Lara Mendes; Martins, Maira Garcia; Gonçalves, Tatiana Maria; Dias, Norimar Hernandes

    2016-11-01

    Voice disorders affect adults and children and have different causes in different age groups. The aim of the study is to present the etiology and diagnosis dysphonia in a large population of patients with this voice disorder.for dysphonia of a large population of dysphonic patients. We evaluated 2019 patients with dysphonia who attended the Voice Disease ambulatories of a university hospital. Parameters assessed were age, gender, profession, associated symptoms, smoking, and videolaryngoscopy diagnoses. Of the 2019 patients with dysphonia who were included in this study, 786 were male (38.93%) and 1233 were female (61.07). The age groups were as follows: 1-6 years (n = 100); 7-12 years (n = 187); 13-18 years (n = 92); 19-39 years (n = 494); 41-60 years (n = 811); and >60 years (n = 335). Symptoms associated with dysphonia were vocal overuse (n = 677), gastroesophageal symptoms (n = 535), and nasosinusal symptoms (n = 497). The predominant professions of the patients were domestic workers, students, and teachers. Smoking was reported by 13.6% patients. With regard to the etiology of dysphonia, in children (1-18 years old), nodules (n = 225; 59.3%), cysts (n = 39; 10.3%), and acute laryngitis (n = 26; 6.8%) prevailed. In adults (19-60 years old), functional dysphonia (n = 268; 20.5%), acid laryngitis (n = 164; 12.5%), and vocal polyps (n = 156; 12%) predominated. In patients older than 60 years, presbyphonia (n = 89; 26.5%), functional dysphonia (n = 59; 17.6%), and Reinke's edema (n = 48; 14%) predominated. In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  3. Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma--a critical review.

    Science.gov (United States)

    Morgan, Craig; Fisher, Helen

    2007-01-01

    There is renewed interest in the relationship between early childhood trauma and risk of psychosis in adulthood. There are a large number of studies of psychiatric inpatients, and of outpatients in which a majority have a psychotic disorder, that suggest the prevalence of childhood trauma in these populations is high. However, these are generally small studies of diagnostically heterogeneous and chronic samples and, as such, can tell us very little about whether childhood trauma is of etiological importance in psychosis. A small number of recent population-based studies provide more robust evidence of an association, and there are now plausible biological mechanisms linking childhood trauma and psychosis. However, there remain a number of conceptual and methodological issues, which mean much more research is needed before firm conclusions can be drawn about whether childhood trauma is a cause of psychosis.

  4. Application of lot quality assurance sampling for leprosy elimination monitoring--examination of some critical factors.

    Science.gov (United States)

    Gupte, M D; Murthy, B N; Mahmood, K; Meeralakshmi, S; Nagaraju, B; Prabhakaran, R

    2004-04-01

    The concept of elimination of an infectious disease is different from eradication and in a way from control as well. In disease elimination programmes the desired reduced level of prevalence is set up as the target to be achieved in a practical time frame. Elimination can be considered in the context of national or regional levels. Prevalence levels depend on occurrence of new cases and thus could remain fluctuating. There are no ready pragmatic methods to monitor the progress of leprosy elimination programmes. We therefore tried to explore newer methods to answer these demands. With the lowering of prevalence of leprosy to the desired level of 1 case per 10000 population at the global level, the programme administrators' concern will be shifted to smaller areas e.g. national and sub-national levels. For monitoring this situation, we earlier observed that lot quality assurance sampling (LQAS), a quality control tool in industry was useful in the initially high endemic areas. However, critical factors such as geographical distribution of cases and adoption of cluster sampling design instead of simple random sampling design deserve attention before LQAS could generally be recommended. The present exercise was aimed at validating applicability of LQAS, and adopting these modifications for monitoring leprosy elimination in Tamil Nadu state, which was highly endemic for leprosy. A representative sample of 64000 people drawn from eight districts of Tamil Nadu state, India, with maximum allowable number of 25 cases was considered, using LQAS methodology to test whether leprosy prevalence was at or below 7 per 10000 population. Expected number of cases for each district was obtained assuming Poisson distribution. Goodness of fit for the observed and expected cases (closeness of the expected number of cases to those observed) was tested through chi(2). Enhancing factor (design effect) for sample size was obtained by computing the intraclass correlation. The survey actually

  5. Duodenal Obstruction: Etiology, Morbidity and Mortality among Edo ...

    African Journals Online (AJOL)

    Duodenal obstruction in children is associated with poor outcome which has improved in developed but remained poor in developing countries. The objective of this study was to ascertain the etiology, morbidity, mortality and factors that contributed to poor outcome in a developing country. Retrospective analysis of pediatric ...

  6. Age is a critical risk factor for severe fever with thrombocytopenia syndrome.

    Directory of Open Access Journals (Sweden)

    Shujun Ding

    Full Text Available Severe Fever with Thrombocytopenia Syndrome (SFTS is an emerging infectious disease in East Asia. SFTS is a tick borne hemorrhagic fever caused by SFTSV, a new bunyavirus named after the syndrome. We investigated the epidemiology of SFTS in Laizhou County, Shandong Province, China.We collected serum specimens of all patients who were clinically diagnosed as suspected SFTS cases in 2010 and 2011 in Laizhou County. The patients' serum specimens were tested for SFTSV by real time fluorescence quantitative PCR (RT-qPCR. We collected 1,060 serum specimens from healthy human volunteers by random sampling in Laizhou County in 2011. Healthy persons' serum specimens were tested for specific SFTSV IgG antibody by ELISA.71 SFTS cases were diagnosed in Laizhou County in 2010 and 2011, which resulted in the incidence rate of 4.1/100,000 annually. The patients ranged from 15 years old to 87 years old and the median age of the patients were 59 years old. The incidence rate of SFTS was significantly higher in patients over 40 years old and fatal cases only occurred in patients over 50 years old. 3.3% (35/1,060 of healthy people were positive to SFTSV IgG antibody. The SFTSV antibody positive rate was not significantly different among people at different age groups.Our results revealed that seroprevalence of SFTSV in healthy people in Laizhou County was not significantly different among age groups, but SFTS patients were mainly elderly people, suggesting that age is the critical risk factor or determinant for SFTS morbidity and mortality.

  7. Platelet activating factor receptor binding plays a critical role in jet fuel-induced immune suppression

    International Nuclear Information System (INIS)

    Ramos, Gerardo; Kazimi, Nasser; Nghiem, Dat X.; Walterscheid, Jeffrey P.; Ullrich, Stephen E.

    2004-01-01

    Applying military jet fuel (JP-8) or commercial jet fuel (Jet-A) to the skin of mice suppresses the immune response in a dose-dependant manner. The release of biological response modifiers, particularly prostaglandin E 2 (PGE 2 ), is a critical step in activating immune suppression. Previous studies have shown that injecting selective cyclooxygenase-2 inhibitors into jet fuel-treated mice blocks immune suppression. Because the inflammatory phospholipid mediator, platelet-activating factor (PAF), up-regulates cyclooxygenase-2 production and PGE 2 synthesis by keratinocytes, we tested the hypothesis that PAF-receptor binding plays a role in jet fuel-induced immune suppression. Treating keratinocyte cultures with PAF and/or jet fuel (JP-8 and Jet-A) stimulates PGE 2 secretion. Jet fuel-induced PGE 2 production was suppressed by treating the keratinocytes with specific PAF-receptor antagonists. Injecting mice with PAF, or treating the skin of the mice with JP-8, or Jet-A, induced immune suppression. Jet fuel-induced immune suppression was blocked when the jet fuel-treated mice were injected with PAF-receptor antagonists before treatment. Jet fuel treatment has been reported to activate oxidative stress and treating the mice with anti-oxidants (Vitamins C, or E or beta-hydroxy toluene), before jet fuel application, interfered with immune suppression. These findings confirm previous studies showing that PAF-receptor binding can modulate immune function. Furthermore, they suggest that PAF-receptor binding may be an early event in the induction of immune suppression by immunotoxic environmental agents that target the skin

  8. Dissecting the critical factors for thermodynamic stability of modular proteins using molecular modeling approach.

    Directory of Open Access Journals (Sweden)

    Yuno Lee

    Full Text Available Repeat proteins have recently attracted much attention as alternative scaffolds to immunoglobulin antibodies due to their unique structural and biophysical features. In particular, repeat proteins show high stability against temperature and chaotic agents. Despite many studies, structural features for the stability of repeat proteins remain poorly understood. Here we present an interesting result from in silico analyses pursuing the factors which affect the stability of repeat proteins. Previously developed repebody structure based on variable lymphocytes receptors (VLRs which consists of leucine-rich repeat (LRR modules was used as initial structure for the present study. We constructed extra six repebody structures with varying numbers of repeat modules and those structures were used for molecular dynamics simulations. For the structures, the intramolecular interactions including backbone H-bonds, van der Waals energy, and hydrophobicity were investigated and then the radius of gyration, solvent-accessible surface area, ratio of secondary structure, and hydration free energy were also calculated to find out the relationship between the number of LRR modules and stability of the protein. Our results show that the intramolecular interactions lead to more compact structure and smaller surface area of the repebodies, which are critical for the stability of repeat proteins. The other features were also well compatible with the experimental results. Based on our observations, the repebody-5 was proposed as the best structure from the all repebodies in structure optimization process. The present study successfully demonstrated that our computer-based molecular modeling approach can significantly contribute to the experiment-based protein engineering challenge.

  9. Transforming growth factor alpha is a critical mediator of radiation lung injury.

    Science.gov (United States)

    Chung, Eun Joo; Hudak, Kathryn; Horton, Jason A; White, Ayla; Scroggins, Bradley T; Vaswani, Shiva; Citrin, Deborah

    2014-09-01

    Radiation fibrosis of the lung is a late toxicity of thoracic irradiation. Epidermal growth factor (EGF) signaling has previously been implicated in radiation lung injury. We hypothesized that TGF-α, an EGF receptor ligand, plays a key role in radiation-induced fibrosis in lung. Mice deficient in transforming growth factor (TGF-α(-/-)) and control C57Bl/6J (C57-WT) mice were exposed to thoracic irradiation in 5 daily fractions of 6 Gy. Cohorts of mice were followed for survival (n ≥ 5 per group) and tissue collection (n = 3 per strain and time point). Collagen accumulation in irradiated lungs was assessed by Masson's trichrome staining and analysis of hydroxyproline content. Cytokine levels in lung tissue were assessed with ELISA. The effects of TGF-α on pneumocyte and fibroblast proliferation and collagen production were analyzed in vitro. Lysyl oxidase (LOX) expression and activity were measured in vitro and in vivo. Irradiated C57-WT mice had a median survival of 24.4 weeks compared to 48.2 weeks for irradiated TGF-α(-/-) mice (P = 0.001). At 20 weeks after irradiation, hydroxyproline content was markedly increased in C57-WT mice exposed to radiation compared to TGF-α(-/-) mice exposed to radiation or unirradiated C57-WT mice (63.0, 30.5 and 37.6 μg/lung, respectively, P = 0.01). C57-WT mice exposed to radiation had dense foci of subpleural fibrosis at 20 weeks after exposure, whereas the lungs of irradiated TGF-α (-/-) mice were largely devoid of fibrotic foci. Lung tissue concentrations of IL-1β, IL-4, TNF-α, TGF-β and EGF at multiple time points after irradiation were similar in C57-WT and TGF-α(-/-) mice. TGF-α in lung tissue of C57-WT mice rose rapidly after irradiation and remained elevated through 20 weeks. TGF-α(-/-) mice had lower basal LOX expression than C57-WT mice. Both LOX expression and LOX activity were increased after irradiation in all mice but to a lesser degree in TGF-α(-/-) mice. Treatment of NIH-3T3 fibroblasts with TGF

  10. Factors Associated with the Development of Tertiary Peritonitis in Critically Ill Patients.

    Science.gov (United States)

    Ballus, Josep; Lopez-Delgado, Juan C; Sabater-Riera, Joan; Perez-Fernandez, Xose L; Betbese, Antoni J; Roncal, Joan A

    2017-07-01

    Critically ill surgical patients remain at a high risk of adverse outcomes as a result of secondary peritonitis (SP). The risk is even higher if tertiary peritonitis (TP) develops. Factors related to the development of TP, however, are scarce in the literature. The main aim of our study was to identify factors associated with the development of TP in patients with SP in the intensive care unit (ICU), and also to report differences in microbiologic patterns and antibiotic therapy in patients with the two conditions. A prospective, observational study was conducted at our institution from 2010 to 2014. Baseline characteristics on admission, outcomes, microbiologic results, and antibiotic therapy were recorded for analysis. We included 343 patients with SP, of whom TP developed in 185 (53.9%). Almost two-thirds (64.4%) were male; mean age was 63.7 ± 14.3 years, and mean APACHE was 19.4 ± 7.8. In-hospital death was 42.6% (146). Multivariable analysis showed that longer ICU stay (odds ratio [OR]: 1.019; 95% confidence interval [CI]: 1.004-1.034; p = 0.010), urgent operation on hospital admission (OR: 3.247; 95% CI: 1.392-7.575; p = 0.006), total parenteral nutrition (TPN) (OR: 3.079; 95% CI: 1.535-6.177; p = 0.002) and stomach-duodenum as primary infection site (OR: 4.818; 95% CI: 1.429-16.247; p = 0.011) were factors associated with the development of TP, whereas patients with localized peritonitis were less prone to have TP develop (OR: 0.308; 95% CI: 0.152-0.624; p = 0.001). Higher incidences of Candida spp. (OR: 1.275; 95% CI: 1.096-1.789; p = 0.016), Enterococcus faecium (OR: 1.085; 95% CI: 1.018-1.400; p = 0.002), and Enterococcus spp. (OR: 1.370; 95% CI: 1.139-1.989; p = 0.047) were found in TP, and higher rates of cephalosporin use in SP (OR: 3.51; 95% CI: 1.139-10.817; p = 0.035). Complicated peritonitis remains a cause of a high numbers of deaths in the ICU. The need for TPN, urgent operation on hospital admission

  11. Dry eyes: etiology and management.

    Science.gov (United States)

    Latkany, Robert

    2008-07-01

    Until recently, the cause of dry eye syndrome was uncertain and the treatment was palliative. Since discovering that dry eyes are caused by inflammation, there has been an abundance of research focusing on anti-inflammatory therapies, other contributing causes, and better diagnostic testing. This review summarizes some of the interesting published research on ocular surface disease over the past year. The definition of dry eye now highlights the omnipresent symptom of blurry vision. The re-evaluation of ocular surface staining, tear meniscus height, and visual change will allow for a better diagnosis and understanding of dry eyes. Punctal plugs, and oral and topical anti-inflammatory use will strengthen our arsenal against ocular surface disease. Major progress has occurred in the past few years in gaining a better understanding of the etiology of dry eye syndrome, which will inevitably lead to more effective therapeutic options.

  12. A study on the critical factors which influence habitual entrepreneurs' success in networking from the perspective of social captial theory

    OpenAIRE

    Li, SiQi

    2012-01-01

    The aim of the research is to provide an insight on the critical factors which influence habitual entrepreneurs’ success in networking through which effective networking strategies may lead to increased business performance. The perspective of explaining the factors adopts social capital theory and social dimensions of entrepreneurs’ network. The key findings suggest that social capital is in a form of non-linear pattern that the interactions are complex. Network configuration influences effe...

  13. Critical brand innovation factors (CBIF): understanding innovation and market performance in the Chinese high-tech service industry

    OpenAIRE

    Nguyen, Bang; Yu, Xiaoyu; Melewar, T. C.; Gupta, Suraksha

    2016-01-01

    Brand innovation sweeps aside established practices and disrupts the status quo, resulting in the transformation of markets. The present study develops and tests a model of critical brand innovation factors (CBIF) by examining key factors influencing firm-level brands' innovation and increased market performance. Adapting both organizational elements and market response characteristics, the model integrates four key variables in China's industrial service markets: innovation, internationaliza...

  14. Outcome and prognostic factors of critically ill patients with acute renal failure requiring continuous renal replacement therapy

    Directory of Open Access Journals (Sweden)

    Aldawood Abdulaziz

    2010-01-01

    Full Text Available Continuous renal replacement therapy (CRRT has proved to be beneficial for the treatment of critically ill patients with acute renal failure (ARF. The aim of this study is to determine the outcome and identify the predictors of mortality of critically ill patients treated with CRRT for ARF in the intensive care unit (ICU. This prospective cohort study of critically ill patients with ARF requiring CRRT admitted to the ICU was carried out at a tertiary care hospital in Saudi Arabia from 2002 to 2008. A total of 644 of 7173 patients with ARF required CRRT were studied. About 9% of the ARF patients required CRRT and comprised mainly those with medical causes, carrying a mortality of 64%. Multivariate analysis found high serum creatinine as an independent factor for better outcome and requirement of mechanical ventilation (MV as an independent factor for worse outcome. In our cohort study, ARF requiring CRRT in the ICU was associated with a high mortality.

  15. Acute pancreatitis caused by Mycoplasma pneumoniae: an unusual etiology.

    Science.gov (United States)

    Valdés Lacasa, Teresa; Duarte Borges, María Alejandra; García Marín, Alicia; Gómez Cuervo, Covadonga

    2017-06-01

    It is well known that the most important etiologies of acute pancreatitis are gallstones and alcohol consumption. Once these causes have been ruled out, especially in young adults, it is important to consider less frequent etiologic factors such as drugs, trauma, malformations, autoimmunity or systemic diseases. Other rare and less well studied causes of this pathology are infections, among which Mycoplasma pneumoniae has been reported to cause acute pancreatitis as an unusual extrapulmonary manifestation. Here, we report the case of a 21-year-old patient who had acute idiopathic pancreatitis associated with an upper respiratory tract infection. After an in-depth study, all other causes of pancreatitis were ruled out and Mycoplasma was established as the clinical etiology.

  16. CRITICAL THINKING TENDENCY LEVELS OF CANDITATE TEACHER OF VISUAL ARTS IN TERMS OF GENDER FACTOR

    Directory of Open Access Journals (Sweden)

    Asuman Aypek Arslan

    2017-04-01

    Full Text Available Critical thinking is an organized process aiming at obtaining knowledge in an original way, comparing, using and evaluating it. Critical thinking is a power triggering the knowledge production process and is the energy of knowledge. Science cannot be improved with the verification and repetition of what is known. It is only improved through questioning, emerging new information and new views. One of the high level needs of man in Maslow’s Needs Hierarchy is the realization of oneself. Individuals being able to realize themselves can decide what is true, what is wrong with their free wills. The most important task of education and the education of visual arts is to train creative and productive individuals being able to think all-round, learn how to learn, solve problems, respectful to humans, tolerant, having improved communication skills. It is of great importance to improve critical thinking skills at students in making them attain it. In making them attain these behaviours, it is of vital importance to improve critical thinking skills at students. In the current study, it was aimed to determine critical thinking levels of the candidates of visual arts and to determine whether the tendency of critical thinking differed in terms of gender. The data of the study was gathered through California Critical Thinking Tendency Scale. At the end of the study, it was found that candidate teachers of visual arts had tendency at medium level in general critical thinking. It was also found that the critical thinking tendencies of the candidate teachers of visual arts did not differ in terms of gender.

  17. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate

    Science.gov (United States)

    Burg, Madeleine L.; Chai, Yang; Yao, Caroline A.; Magee, William; Figueiredo, Jane C.

    2016-01-01

    Isolated cleft palate (CPO) is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of cases born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects) and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke has been found to be strongly associated with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1) monitoring of the occurrence of CPO (capacity building); (2) detailed phenotyping of the severity (biology); (3) understanding of the genetic and environmental risk factors (primary prevention); (4) access to early detection and multidisciplinary treatment (clinical services); and (5) understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention). PMID:26973535

  18. Surgery and Anesthesia Exposure Is Not a Risk Factor for Cognitive Impairment After Major Noncardiac Surgery and Critical Illness

    NARCIS (Netherlands)

    Hughes, Christopher G; Patel, Mayur B; Jackson, James C; Girard, Timothy D; Geevarghese, Sunil K; Norman, Brett C; Thompson, Jennifer L; Chandrasekhar, Rameela; Brummel, Nathan E; May, Addison K; Elstad, Mark R; Wasserstein, Mitzi L; Goodman, Richard B; Moons, Karel G; Dittus, Robert S; Ely, E Wesley; Pandharipande, Pratik P; MIND-ICU, BRAIN-ICU investigators

    OBJECTIVE: The aim of this study was to determine whether surgery and anesthesia exposure is an independent risk factor for cognitive impairment after major noncardiac surgery associated with critical illness. SUMMARY OF BACKGROUND DATA: Postoperative cognitive impairment is a prevalent individual

  19. Critical Success Factors in the Curriculum Alignment Process: The Case of the College of Business at Abu Dhabi University

    Science.gov (United States)

    Camba, Pitzel; Krotov, Vlad

    2015-01-01

    The main goals of this article are to (a) assist business schools in understanding the curriculum alignment process, and (b) uncover critical success factors in curriculum alignment. Based on a case study conducted at the College of Business at Abu Dhabi University, a detailed curriculum alignment process description is provided. The process…

  20. Critical Success Factors for an Effective Security Risk Management Program in an Organization: An Exploratory Case Study

    Science.gov (United States)

    Zafar, Humayun

    2010-01-01

    This study investigates differences in perception between layers of management (executive, middle, and lower) and staff with regard to the influence of critical success factors (CSFs) on security risk management (SRM) effectiveness. This is an in-depth case study conducted at a Fortune 500 company. Rockart's (1979) CSF method is modified through…

  1. Etiology, clinical features and management of acute recurrent pancreatitis.

    Science.gov (United States)

    Deng, Yi Yun; Wang, Rui; Wu, Hao; Tang, Cheng Wei; Chen, Xin Zu

    2014-10-01

    To study the etiology and clinical features of acute recurrent pancreatitis (ARP) and to determine its optimal management and outcomes. ARP cases among acute pancreatitis patients who were admitted to the West China Hospital, Sichuan University from January 2008 to December 2012 were retrospectively collected. Their etiology, clinical features, treatments and outcomes were analyzed. Of all pancreatitis patients, 8.9% were classified as ARP. The proportions of mild and severe diseases were 85.7% and 14.3%, respectively. The common etiological factors were biliogenic (31.0%), alcohol (26.2%), hyperlipidemia (21.4%) and pancreaticobiliary malformation (15.4%). At first 46 cases were cryptogenic and among them 36 were subsequently confirmed by endoscopic retrograde cholangiopancreatography (ERCP). Among the hyperlipidemic ARP patients, 72.2% failed to routinely monitor and control serum lipids. ERCP was performed in 88 cases, and 48 also required an endoscopic sphincterotomy or calculus removal. Twenty-two patients underwent cholangiopancreatic duct stent placement, and pancreatic necrosectomy was performed on eight severe cases. The overall outcomes indicate that 8.3% of the cases progressed to chronic pancreatitis and 33.3% of the cases receiving etiological treatment were recurrence-free. There were no deaths in this study. The etiological factors of ARP are similar to those of acute pancreatitis at the first attack. The management of ARP should be fully considered based on etiological investigation. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  2. Sarcomas: etiología y síntomas Sarcomas: etiology and symptoms

    Directory of Open Access Journals (Sweden)

    Roberto Gabriel Albín Cano

    2012-07-01

    Full Text Available Debido a la amplia diversidad de sarcomas, casi son inexistentes los textos que incluyen todas las variedades de este tipo de cáncer. Generalmente, su descripción y revisión se incluyen en las del sistema de órganos afectados específicamente, y la literatura que los aborda está muy fragmentada en las diferentes especialidades médicas. Se realiza una revisión bibliográfica sobre la etiología y síntomas de la mayor parte de los diferentes tipos de sarcomas. Es objetivo de esta revisión, lograr unir la información más actual disponible acerca de la etiología y síntomas de los sarcomas. Se han identificado diferentes factores de riesgo y factores etiológicos, tanto genéticos, infecciosos, como ambientales. Los grandes descubrimientos en relación con los mecanismos genéticos involucrados en los diferentes tipos de sarcoma, han abierto un camino de inestimable valor para introducir nuevos tratamientos, que incluyen ensayos con anticuerpos monoclonales y nuevos fármacos de terapia génica.

    Due to the wide diversity of sarcomas, almost no texts include all varieties of this type of cancer. Generally, their description and review is included in those of the specifically affected organ system, and the literature containing that information is very fragmented in different medical specialties. We performed a literature review on the etiology and symptoms of most types of sarcomas. It is aimed at achieving a recompilation of most current information available on the causes and symptoms of sarcomas. Different risks and etiologic factors have been identified regarding genetics, infections, and environment. The great discoveries regarding genetic mechanisms involved in different types of sarcomas, have opened an invaluable way to introduce new treatments, including monoclonal antibodies and new drugs of gene therapy.

  3. Effects of Some Neurobiological Factors in a Self-organized Critical Model Based on Neural Networks

    International Nuclear Information System (INIS)

    Zhou Liming; Zhang Yingyue; Chen Tianlun

    2005-01-01

    Based on an integrate-and-fire mechanism, we investigate the effect of changing the efficacy of the synapse, the transmitting time-delayed, and the relative refractoryperiod on the self-organized criticality in our neural network model.

  4. CRITICAL THINKING TENDENCY LEVELS OF CANDITATE TEACHER OF VISUAL ARTS IN TERMS OF GENDER FACTOR

    OpenAIRE

    Asuman Aypek Arslan

    2017-01-01

    Critical thinking is an organized process aiming at obtaining knowledge in an original way, comparing, using and evaluating it. Critical thinking is a power triggering the knowledge production process and is the energy of knowledge. Science cannot be improved with the verification and repetition of what is known. It is only improved through questioning, emerging new information and new views. One of the high level needs of man in Maslow’s Needs Hierarchy is the realization of oneself. Individ...

  5. The human factor: the critical importance of effective teamwork and communication in providing safe care

    OpenAIRE

    Leonard, M; Graham, S; Bonacum, D

    2004-01-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members...

  6. Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients

    OpenAIRE

    Weijs, Peter JM; Looijaard, Wilhelmus GPM; Dekker, Ingeborg M; Stapel, Sandra N; Girbes, Armand R; Straaten, Heleen M Oudemans-van; Beishuizen, Albertus

    2014-01-01

    Introduction Higher body mass index (BMI) is associated with lower mortality in mechanically ventilated critically ill patients. However, it is yet unclear which body component is responsible for this relationship. Methods This retrospective analysis in 240 mechanically ventilated critically ill patients included adult patients in whom a computed tomography (CT) scan of the abdomen was made on clinical indication between 1 day before and 4 days after admission to the intensive care unit. CT s...

  7. Overcoming SMEs Challenges through Critical Success Factors: A Case of SMEs in the Western Cape Province, South Africa

    Directory of Open Access Journals (Sweden)

    Takalani Ramukumba

    2014-03-01

    Full Text Available SMEs comprise over 90% of African business operations and contribute to over 50% of African employment and Growth Domestic Product (GDP. SMEs sector has shown positive signs in South Africa, Mauritius and North Africa. In South Africa, SMEs constitute 55% of all jobs. Research of Bowler, Dawood and Page (2007 reveal that 40% of new business ventures fail in their first year, 60% in their second year, and 90% in their first 10 years of existence. It seems that a number of challenges have been identified as contributing to the failure of SMEs in South Africa and worldwide. The purpose of this paper is to identify some of the critical success factors for the SMEs to improve their performance in order to overcome the challenges they are faced within the competitive market environment. The research problem of this study emanates from the current high business failure rate. The research investigates what are the critical success factors that can help these SMEs to be sustainable and have positive growth so to limit the high business failure rate in South Africa. The research established that attracting repeat customers and the performance of the product are the critical success factors that can lead to the sustenance of these SMEs. The study concluded that the resource-constraint SMEs need to focus on critical success factors to build competitive advantage to stay competitive amidst the challenges from globalisation and liberalisation. This study will make further contribution on understanding these critical success factors as they are central to business success, especially in South Africa where it is estimated that the failure rate of small, medium and micro enterprises (SMEs is between 70% and 80% (Brink and Cant, 2009.

  8. Does Closeness to Someone Who Is Gay, Lesbian, or Bisexual Influence Etiology Beliefs About Homosexuality?

    Science.gov (United States)

    Chonody, Jill M; Kavanagh, Phillip S; Woodford, Michael R

    2016-12-01

    Research suggests that contact with sexual minorities and etiology beliefs regarding the origins of homosexuality are associated with antigay bias; however, factors related to etiology beliefs have received little empirical attention. Our primary research question is: Does closeness to someone who is gay, lesbian, or bisexual influence etiology beliefs? Students (n = 851) from four U.S. universities completed an anonymous survey, and regression results indicated that contact and closeness were not significantly associated with etiology beliefs. Because both contact and relationship closeness were associated with antigay attitudes, and closeness demonstrated the largest effect, we tested three alternative structural equation models to determine if contact and closeness mediated etiology beliefs. Results suggested that contact and the degree of closeness are indirectly associated with students' etiology beliefs through antigay bias.

  9. Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors.

    Science.gov (United States)

    Altuwaijri, Majid M; Bahanshal, Abdullah; Almehaid, Mona

    2011-09-01

    The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live training", the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other

  10. Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors

    Directory of Open Access Journals (Sweden)

    Majid M Altuwaijri

    2011-01-01

    Full Text Available Objective: The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE system in a leading healthcare organization in Saudi Arabia. Materials and Methods: The National Guard Health Affairs (NGHA deployed the CPOE in a pilot department, which was the intensive care unit (ICU in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. Results: The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live" training, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. Conclusion: The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at

  11. A study on critical success factors on building IT based flat organization: A case study of Mellat Bank

    Directory of Open Access Journals (Sweden)

    Farajollah Rahnavard

    2014-07-01

    Full Text Available A flat organization is a firm that has an organizational structure with few or no levels of middle management between employee and executives. The idea is to take advantage of well-trained workers when they are more directly involved in the decision making process, rather than closely supervised by various layers of management. This paper presents an empirical investigation to determine critical success factors on building information technology (IT based flat organization in a case study of banking industry. Using principal component analysis, the study applies factor analysis for two internal and external factors. In terms of internal factors, there are three factors including Processes and the electronic decision making, Teaching and Electronic Learning and Work in IT. In addition, the study has detected four factors including Electronic Supply, IT structure, Appropriate IT usage and Electronic Communication.

  12. Critical Factors to Achieve Dockless Bike-Sharing Sustainability in China: A Stakeholder-Oriented Network Perspective

    Directory of Open Access Journals (Sweden)

    Jian-gang Shi

    2018-06-01

    Full Text Available In China, dockless bike-sharing programs (DBSPs play a significant role in promoting the goals of sustainable urban travel and carbon emissions reduction. However, the sustainability of DBSPs is increasingly being challenged as various issues associated with different stakeholders emerge. While numerous studies have focused on the barriers to traditional bike-sharing programs, the sustainability performance of new-generation DBSPs is largely overlooked. It is accordingly imperative to understand the primary challenges that impede the sustainability of DBSPs and to consider what stimulative measures can be taken. In this study, we investigate the factors that are critical to DBSPs’ sustainability from a network perspective. Stakeholder-associated factors and their interrelations were identified via literature analysis and interviews, and the social network analysis (SNA method was employed to recognize the critical factors and links in DBSPs. As a result, 10 critical factors and 10 major interactions were identified and further classified into six challenges. Sharing transport schemes, legislative perfection, public private partnership (PPP, and product lifecycle management (PLM were proposed to govern these challenges. This paper contributes to the existing body of knowledge of bike-sharing programs via a network approach that integrates the key influencing factors with those factors’ associated stakeholders. Furthermore, these findings provide the government and operators with implications for mitigating the tough challenges and facilitating the sustainability of DBSPs.

  13. Progress in etiology, diagnosis, and therapy of idiopathic orbital inflammatory disease

    NARCIS (Netherlands)

    Bijlsma, W.R.

    2011-01-01

    Idiopathic orbital inflammation (IOI) is a disease with signs and symptoms of an orbital inflammatory lesion with after local and systemic evaluation no apparent cause. Little is known about the etiology of the disease. This study aimed to answer three questions: a) what etiologic factors are

  14. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review.

    Science.gov (United States)

    Castillo, Víctor H; Martínez-García, Ana I; Pulido, J R G

    2010-10-15

    The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge

  15. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Martínez-García Ana I

    2010-10-01

    Full Text Available Abstract Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1 a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2 the definition of a base for the design of a conceptual

  16. Sustainable Competitive Advantage (SCA Analysis of Furniture Manufacturers in Malaysia: Normalized Scaled Critical Factor Index (NSCFI Approach

    Directory of Open Access Journals (Sweden)

    Tasmin Rosmaini

    2016-06-01

    Full Text Available The purpose of this paper is to investigate Malaysian furniture industry via Sustainable competitive advantages (SCA approach. In this case study, sense and respond method and Normalized Scaled Critical Factor Index (NSCFI are used to specify the distribution of companies’ resources for different criteria and detect the attributes which are critical based on expectation and experience of companies’ employs. Moreover, this study evaluates Malaysian furniture business strategy according to manufacturing strategy in terms of analyzer, prospector and defender. Finally, SCA risk levels are presented to show how much company’s resource allocations support their business strategy.

  17. Understanding and determining the etiology of autism.

    Science.gov (United States)

    Currenti, Salvatore A

    2010-03-01

    Worldwide, the rate of autism has been steadily rising. There are several environmental factors in concert with genetic susceptibilities that are contributing to this rise. Impaired methylation and mutations of mecp2 have been associated with autistic spectrum disorders, and related Rett syndrome. Genetic polymorphisms of cytochrome P450 enzymes have also been linked to autism, specifically CYP27B1 that is essential for proper vitamin D metabolism. Vitamin D is important for neuronal growth and neurodevelopment, and defects in metabolism or deficiency have been implicated in autistic individuals. Other factors that have been considered include: maternally derived antibodies, maternal infection, heavy metal exposure, folic acid supplementation, epigenetics, measles, mumps, rubella vaccination, and even electromagnetic radiation. In each case, the consequences, whether direct or indirect, negatively affect the nervous system, neurodevelopment, and environmental responsive genes. The etiology of autism is a topic of controversial debate, while researchers strive to achieve a common objective. The goal is to identify the cause(s) of autism to understand the complex interplay between environment and gene regulation. There is optimism that specific causes and risk factors will be identified. The results of future investigations will facilitate enhanced screening, prevention, and therapy for "at risk" and autistic patients.

  18. Priapism: etiology, pathophysiology and management

    Directory of Open Access Journals (Sweden)

    Van Der Horst C.

    2003-01-01

    Full Text Available The understanding of erectile physiology has improved the prompt diagnosis and treatment of priapism. Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation and failure to subside despite orgasm. Numerous etiologies of this condition are considered. Among others a disturbed detumescence mechanism, which may due to excess release of contractile neurotransmitters, obstruction of draining venules, malfunction of the intrinsic detumescence mechanism or prolonged relaxation of intracavernosal smooth muscle are postulated. Treatment of priapism varies from a conservative medical to a drastic surgical approach. Two main types of priapism; veno-occlusive low flow (ischemic and arterial high flow (non-ischemic, must be distinguished to choose the correct treatment option for each type. Patient history, physical examination, penile hemodynamics and corporeal metabolic blood quality provides distinction between a static or dynamic pathology. Priapism can be treated effectively with intracavernous vasoconstrictive agents or surgical shunting. Alternative options, such as intracavernous injection of methylene blue (MB or selective penile arterial embolization (SPEA, for the management of high and low flow priapism are described and a survey on current treatment modalities is given.

  19. [New etiological concepts in uveitis].

    Science.gov (United States)

    Bodaghi, B

    2005-05-01

    Uveitis remains an important cause of visual impairment, particularly in young patients. Idiopathic forms of intraocular inflammation should no longer be regarded as a presumed clinical entity, and the ophthalmologist must reconsider the specific etiology of primary uveitis when the clinical examination does not yield a definitive diagnosis or when the course of the disease on corticosteroids remains atypical. Laboratory tests based on serum analysis have limited value and should not be considered as diagnostic proof in different clinical presentations. The diagnostic management of infectious uveitis has been greatly improved by the use of molecular techniques applied to ocular fluids and tissues. Polymerase chain reaction (PCR) technology is a powerful tool that should be proposed in atypical cases of uveitis or retinitis of unclear but potentially infectious origin. This strategy is a major step before using unconventional and new immunomodulatory agents such as anti-TNF-alpha molecules. Under strict experimental conditions including adequate testing to rule out a possible contamination, PCR and its variants have changed our practical approach to intraocular inflammatory disorders and have provided new details for the understanding of infectious uveitis. The concept of pathogen-induced intraocular inflammation can be revisited in the light of molecular data obtained after anterior chamber paracentesis or diagnostic vitrectomy.

  20. Epigenetic Etiology of Intellectual Disability.

    Science.gov (United States)

    Iwase, Shigeki; Bérubé, Nathalie G; Zhou, Zhaolan; Kasri, Nael Nadif; Battaglioli, Elena; Scandaglia, Marilyn; Barco, Angel

    2017-11-08

    Intellectual disability (ID) is a prevailing neurodevelopmental condition associated with impaired cognitive and adaptive behaviors. Many chromatin-modifying enzymes and other epigenetic regulators have been genetically associated with ID disorders (IDDs). Here we review how alterations in the function of histone modifiers, chromatin remodelers, and methyl-DNA binding proteins contribute to neurodevelopmental defects and altered brain plasticity. We also discuss how progress in human genetics has led to the generation of mouse models that unveil the molecular etiology of ID, and outline the direction in which this field is moving to identify therapeutic strategies for IDDs. Importantly, because the chromatin regulators linked to IDDs often target common downstream genes and cellular processes, the impact of research in individual syndromes goes well beyond each syndrome and can also contribute to the understanding and therapy of other IDDs. Furthermore, the investigation of these disorders helps us to understand the role of chromatin regulators in brain development, plasticity, and gene expression, thereby answering fundamental questions in neurobiology. Copyright © 2017 the authors 0270-6474/17/3710773-10$15.00/0.