Identification of surface water and groundwater relationship at Universiti Tun Hussein Onn Malaysia (UTHM) Campus

Descriptions of the surface water and groundwater relationships are required for enhanced water resource management. The increase in population and rapid development has boosted the demand and use of water supply each year in Parit Raja. Moreover, no further research related to relationships between both sources has been carried out in this flat topography area. Thus, the descriptions of surface water and groundwater relationships are required to enhance water resource management in UTHM campus in order to meet the future demands. The Schlumberger array was used for Electrical Resistivity Imaging (ERI) during data acquisition to identify potential shallow aquifers and suitable locations for boreholes which function as observation wells. Three new boreholes were installed and the ERI results showed that this area recorded low resistivity values less than 10 Ωm with potential groundwater at varying depths between 10 to 30 m. Meanwhile, in hydrochemical analysis the chemical properties of major cations (Na+, Mg2+, K+, Ca2+) and anions (Cl-, SO42-, NO3-) were analysed to characterise surface water and groundwater. The result showed that all surface water is characterized by Ca2+ - Mg2+- Cl- - SO42- types of fresh water, while the groundwater is characterized by Na-Cl type of saline water due to seawater intrusion which indicated that the interaction of surface water and groundwater were not occur in this study area and the recharge areas might be located outside this area. This result interpreted that the lakes and swale were remained in good quality whereas groundwater at this aquifer was seriously intruded by seawater. Even though, the isotopic composition for δ18O and δ2H values of surface water were relatively similar to that of groundwater samples in Station A and Station C as they varying between -4.32%o to -9.74%o for δ18O and from -33.86%o to -65.82%o for δ2H, these surface water samples had low salinity (Cl- 3000 mg/l). This result could be explained by effects of evaporation and seawater intrusion on these groundwater samples rather than interaction with surface water. Thus, the relationships of surface water and groundwater might not occur in UTHM campus and the recharge areas might be located outside this area

Strategies for sustainable socio-economic development and mechanisms their implementation in the global dimension

The authors of the book have come to the conclusion that it is necessary to effectively use modern approaches to developing and implementation strategies of sustainable socio-economic development in order to increase efficiency and competitiveness of economic entities. Basic research focuses on economic diagnostics of socio-economic potential and financial results of economic entities, transition period in the economy of individual countries and ensuring their competitiveness, assessment of educational processes and knowledge management. The research results have been implemented in the different models and strategies of supply and logistics management, development of non-profit organizations, competitiveness of tourism and transport, financing strategies for small and medium-sized enterprises, cross-border cooperation. The results of the study can be used in decision-making at the level the economic entities in different areas of activity and organizational-legal forms of ownership, ministries and departments that promote of development the economic entities on the basis of models and strategies for sustainable socio-economic development. The results can also be used by students and young scientists in modern concepts and mechanisms for management of sustainable socio-economic development of economic entities in the condition of global economic transformations and challenges

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

Conservación de servicios ecosistémicos en humedales altoandinos: la participación social en la creación de un área natural protegida

The goal of the present work is synthesizing the process of collective construction developed to protect the high-altitude wetlands of the Blanco River basin, located in the Andes Mountains, Mendoza province. The participatory process arose out of an initiative of basin residents and users, and was conducted by the Integrative Committee for Creation of Potrerillos Municipal Environmental Protected Area (MEPA), composed of civil society organizations, government agencies and scientific institutions. The major pressures affecting the wetlands, identified through participatory assessment of the socio-ecosystem are: water pollution, reduction and total loss of habitat, stoppage of of groundwater flows, artificial drainage, poldering of the meadow, and fragmentation of the wetland system, among other pressures.In order to identify priority sites for conservation of the ecosystem services (ES) wetlands provide, local people identified and prioritized the six most important of them according to their perception: water for human consumption, agriculture and industry; aesthetic, spiritual and non-use representations; recreation and ecotourism; erosion control; water regulation and regulation of the biotic environment. The areas supplying ES were identified on the map of land use and land cover of the basin, with the wetland area, with tourist use and water catchment, and the watershed?s headwaters standing out as areas with higher ES provision. This process culminated in the creation of a protected area to halt the intense degradation affecting the wetland system, promoting maintenance of the natural area and improving its provision of ES. This collective process allowed integrating local and scientific knowledge, becoming an experience to be replicated in other areas in terms of conservation and land management. Among its major strengths is a strong coordination between the different social actors involved, which allowed success in reaching the implementation stage of a public policy for conservation.El objetivo del presente trabajo consiste en sintetizar el proceso de construcción colectiva desarrollado con el fin de proteger los humedales de altura pertenecientes a la cuenca del Río Blanco de Potrerillos, localizados en la Cordillera de Los Andes, Provincia de Mendoza. El proceso participativo surgió ante una iniciativa de los pobladores locales y usuarios de la cuenca, y fue conducido por la Comisión Integradora para la Creación del Área Ambiental Protegida Municipal (AAMP) Potrerillos, integrada por organizaciones de la sociedad civil, instituciones gubernamentales y organismos científicos. Las principales presiones que afectan al humedal, identificadas a través del diagnóstico participativo del socioecosistema son: contaminación del agua, reducción y pérdida total de hábitat, corte del flujo de alimentación, drenaje artificial, polderización definitiva de vegas, fragmentación del sistema hidrológico, entre otras. A fin de determinar los sitios prioritarios para la conservación de servicios ecosistémicos (SE) que brinda el Sistema de humedales, la población local identificó y priorizó los seis más importantes de acuerdo a su percepción: agua para consumo humano, agricultura e industria; representaciones estéticas, espirituales y de no uso; recreación y ecoturismo; regulación de la erosión; regulación del ciclo hídrico y del ambiente biótico. Sobre el mapa de uso y cobertura de la tierra de la cuenca, fueron identificadas sus zonas proveedoras, destacándose el área de humedales con uso turístico y captación de agua, y las cabeceras de cuencas hídricas como las zonas con mayor provisión de SE. Este proceso culminó con la creación de un área natural protegida para detener el proceso de degradación intensiva que afecta al humedal, lo cual promueve el mantenimiento y la mejora de sus SE. Este proceso colectivo permitió integrar saberes locales con conocimiento científico, y se constituyó como una experiencia a replicar en otros territorios en el plano de la conservación y del ordenamiento territorial. Entre sus principales fortalezas se destaca la articulación sólida entre los diferentes actores sociales involucrados, que permitió alcanzar con éxito la etapa de implementación de una política pública de conservación.Fil: Rubio, María Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rubio, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Salomon, Mario. Universidad Nacional de Cuyo. Facultad de Ingeniería; ArgentinaFil: Abraham, Elena Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentin

Pulmonary arterial hypertension: the burden of disease and impact on quality of life.

Pulmonary arterial hypertension (PAH) is a debilitating disease that pervades all aspects of a patients daily life. It is also increasingly acknowledged that the burden of PAH extends to older patients and carers. Until recently, the adverse effect of disease symptoms on the physical, emotional and social factors governing patient health-related quality of life (HRQoL) remained largely unrecognised. With a shift in therapeutic objectives to longer term improvements and HRQoL benefits, clinical trials now frequently include HRQoL measures as study end-points. Most HRQoL instruments used in patients with PAH are generic or non-disease-specific questionnaires and therefore may not accurately capture PAH disease burden. New PAH-specific HRQoL instruments currently undergoing validation include emPHasis-10 and Pulmonary Arterial Hypertension-Symptoms and Impact (PAH-SYMPACT; Actelion Pharmaceuticals Ltd, Allschwil, Switzerland). Using various HRQoL measures, pharmacological therapies have been shown to improve HRQoL in patients with PAH. Patients also derive HRQoL benefits from nonpharmacological strategies, which include the emotional support provided by multidisciplinary care and support groups that is fundamental to patient wellbeing. Looking to the future, validated PAH-specific HRQoL instruments together with dedicated guidelines and procedures are essential to support the translation of HRQoL scores to the clinic, thus enabling a holistic treatment approach to the management of patients with PAH

Knowledge evaluation for knowledge management implementation : : the case study of the radio-pharmaceutical center of IPEN

In recent years organizations are using multiple methods and approaches to design their strategic and action plans. In this context, Resource-based View (RBV) and Knowledge-based View (KBV) frameworks are receiving increased attention as instrumental to strategy formulation. The synergy of these approaches with Knowledge Management initiatives is intuitive and their use are in a common framework is discussed here to show the importance of methods and instruments to mapping and assessing the knowledge assets of the organization. The application of such methods to the Radio-pharmaceutical Center of IPEN is discussed in this paper.Knowledge management, Nuclear knowledge management

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia within community dwelling populations

<b>Background</b><p></p> Various tools exist for initial assessment of possible dementia with no consensus on the optimal assessment method. Instruments that use collateral sources to assess change in cognitive function over time may have particular utility. The most commonly used informant dementia assessment is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).<p></p> A synthesis of the available data regarding IQCODE accuracy will help inform cognitive assessment strategies for clinical practice, research and policy.<p></p> <b>Objectives</b><p></p> Our primary objective was to determine the diagnostic accuracy of the informant based questionnaire IQCODE, for detection of all cause (undifferentiated) dementia in community-dwelling adults with no previous cognitive assessment. We sought to describe the accuracy of IQCODE (the index test) against a clinical diagnosis of dementia (the reference standard).<p></p> Our secondary objective was to describe the effect of heterogeneity on the summary estimates. We were particularly interested in the traditional 26-item scale versus the 16-item short form; and language of administration. We explored the effect of varying the threshold IQCODE score used to define 'test positivity'.<p></p> <b>Search methods</b><p></p> We searched the following sources on 28 January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), BIOSIS Previews (ISI Web of Knowledge), Web of Science with Conference Proceedings (ISI Web of Knowledge), LILACS (BIREME). We also searched sources relevant or specific to diagnostic test accuracy: MEDION (Universities of Maastrict and Leuven); DARE (York University); ARIF (Birmingham University). We used sensitive search terms based on MeSH terms and other controlled vocabulary.<p></p> <b>Selection criteria</b><p></p> We selected those studies performed in community settings that used (not necessarily exclusively) the IQCODE to assess for presence of dementia and, where dementia diagnosis was confirmed, with clinical assessment. Our intention with limiting the search to a 'community' setting was to include those studies closest to population level assessment. Within our predefined community inclusion criteria, there were relevant papers that fulfilled our definition of community dwelling but represented a selected population, for example stroke survivors. We included these studies but performed sensitivity analyses to assess the effects of these less representative populations on the summary results.<p></p> <b>Data collection and analysis</b><p></p> We screened all titles generated by the electronic database searches and abstracts of all potentially relevant studies were reviewed. Full papers were assessed for eligibility and data extracted by two independent assessors. For quality assessment (risk of bias and applicability) we used the QUADAS 2 tool. We included test accuracy data on the IQCODE used at predefined diagnostic thresholds. Where data allowed, we performed meta-analyses to calculate summary values of sensitivity and specificity with corresponding 95% confidence intervals (CIs). We pre-specified analyses to describe the effect of IQCODE format (traditional or short form) and language of administration for the IQCODE.<p></p> <b>Main results</b><p></p> From 16,144 citations, 71 papers described IQCODE test accuracy. We included 10 papers (11 independent datasets) representing data from 2644 individuals (n = 379 (14%) with dementia). Using IQCODE cut-offs commonly employed in clinical practice (3.3, 3.4, 3.5, 3.6) the sensitivity and specificity of IQCODE for diagnosis of dementia across the studies were generally above 75%.<p></p> Taking an IQCODE threshold of 3.3 (or closest available) the sensitivity was 0.80 (95% CI 0.75 to 0.85); specificity was 0.84 (95% CI 0.78 to 0.90); positive likelihood ratio was 5.2 (95% CI 3.7 to 7.5) and the negative likelihood ratio was 0.23 (95% CI 0.19 to 0.29).<p></p> Comparative analysis suggested no significant difference in the test accuracy of the 16 and 26-item IQCODE tests and no significant difference in test accuracy by language of administration. There was little difference in sensitivity across our predefined diagnostic cut-points.<p></p> There was substantial heterogeneity in the included studies. Sensitivity analyses removing potentially unrepresentative populations in these studies made little difference to the pooled data estimates. The majority of included papers had potential for bias, particularly around participant selection and sampling. The quality of reporting was suboptimal particularly regarding timing of assessments and descriptors of reproducibility and inter-observer variability.<p></p> <b>Authors' conclusions</b><p></p> Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality