A global outbreak of a new strain of H1N1 influenza virus caused the 2009 flu pandemic. Taiwan was one of the 12 countries in the world capable of producing H1N1 vaccine domestically. The domestic vaccine manufactured by Adimmune Corporation proved to be safe and effective. However, the public opinion generally criticized negatively toward this H1N1 prevention work. This study explored the various entities and relations surrounding the prevention. The first experiment looked into people¡¦s recall toward government¡¦s promotion. This experiment used EyeLink to track subjects¡¦ eye movements on the promotional posters. The data showed the correlation between eye movement and recall, as well as the amount of information received by the subjects. The second experiment looked into people¡¦s decision toward H1N1 prevention. This experiment constructed an AHP model to study the problem. The subjects from various fields answered their view toward H1N1 prevention alternatives, and reported the actual inoculation rate of H1N1 vaccine. The goal aimed to choose a prevention method. The criteria included convenience, confidence, safety, and comfort. The alternatives included vaccination, medication, and sanitation. The experiment outcome summarized the inoculation statistics, attention distribution, involvement correlations, and decision priorities. The experiment result shows the subjects do not receive government¡¦s promotion well. The result also shows the subjects prefer sanitation for prevention. In addition, this study investigates Taiwan¡¦s vaccine and disease prevention development status. The analysis examines Adimmune Corporation and the vaccine market from different aspects. Finally, the conclusion provides recommendations for the people, the vaccine factory, and the government.

The main environmental concern in the textile industry is about the amount of water discharged and the chemical load it carries. The total quantity of chemicals used in textile mills varies from 10% to over 100% of the weight of the cloth produced. Many chemicals currently used in the textile industry affect the amount and the type of waste produced and their influence the aquatic life of the receiving stream. One of the critical steps in pollution prevention studies is auditing the use of chemicals and making the necessary chemical substitutions. Chemical substitution simply means the replacement and/or reduction of hazardous chemicals in products and processes with less- or non-hazardous ones. This study was conducted on one of the major textile factories in Turkey with a capacity of 20,000 tons of denim fabric per year. During this study, chemical consumption level, recipes applied, environmentally problematic and alternative chemicals were examined. Integrated Pollution Prevention and Control (IPPC) Reference Document on Best Available Techniques (BAT) for the Textile Industry was accepted as main reference document and also related case studies were examined. According to the study, over 60% reduction in sulphide, which is very toxic to aquatic life, was achieved by replacing sulphur dyestuff with low sulphide content. By replacing an alternative complexing agent, the mill not only prevented the 3100 kg/month COD load to the WWTP, but also obtained more biodegradable wastewater generated during production. On the other hand, some of the chemical substitution options were on progress or dropped.

The therapeutic potential of a novel multi-targeted small-interfering RNA (siRNA) was investigated in human breast cancer cells. Previous studies had identified an siRNA that specifically and potently inhibited expression of thymidylate synthase (TS) by directly targeting human TS mRNA. TS is a folate-dependent enzyme that catalyzes the key reaction involved in synthesizing nucleotide precursors for DNA biosynthesis, and as such, it plays a critical role in maintaining cell growth. The goal of this thesis was to design and develop a novel siRNA molecule that targeted TS mRNA as well as a cellular mRNA that encodes a different cellular protein involved in cancer cell growth and proliferation, such as a member of the ErbB family. Gene sequence analysis was performed and identified an overlapping sequence between TS and ErbB2 mRNAs. An siRNA duplex was then designed to simultaneously target human TS and ErbB2 mRNA. Transfection of the multi-targeted siRNA (TS1M17) revealed that both ErbB2 and TS proteins were significantly suppressed in a time and dose-dependent manner in ErbB2-overexpressing human breast cancer SKBR3 cells. The corresponding mRNA levels, as determined by RT-PCR, were also decreased. Protein levels of other ErbB family members, including ErbB1 and ErbB3, remained unchanged with siRNA treatment. An ErbB2-specific siRNA (B2450) inhibited ErbB2, but had no effect on TS expression demonstrating the specificity of the multi-targeted siRNA against both TS and ErbB2. Mismatched (TS1-Mismatch) and control (GL2) siRNAs had no inhibitory effects on expression of the two target proteins. Suppression of activated ErbB2, as determined by expression of phosphorylated ErbB2 protein, was observed with transfection of TS1M17 siRNA. In addition, the expression of downstream signaling proteins, such as phosphorylated mitogen activated protein kinase (p-MAPK), p27Kip1, p21Cip1, cyclin D1, and survivin were significantly changed. In contrast, control siRNAs did not exert any inhibitory effects on downstream signaling. Taken together, these findings suggest that TS1M17 siRNA inhibits signaling of the ErbB2 pathway. The effect of TS1M17 siRNA on cytotoxicity was analyzed by WST-1 assay. Upon transfection into SKBR3 cells, the TS1M17 siRNA significantly suppressed cell proliferation with an IC50 value of 0.65 nM, which is 154-fold more potent than ErbB2- and TS-specific siRNAs. This study suggests that targeting expression of ErbB2 and TS, two key proteins involved in distinct and critical pathways for cancer growth and proliferation, with a single siRNA molecule may provide a novel approach for cancer chemotherapy.

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BACKGROUND: Pain intensity, functional status and beliefs and attitudes towards pain are dynamic elements involved in the experience of chronic pain. Lidocaine infusion (LI) is a therapeutic intervention used to relieve pain. OBJECTIVES: The primary objective of this study was to determine if people with chronic pain who received LI and reported a decrease in pain intensity at 4 days post-infusion differed from those who did not report a decrease in pain intensity with respect to the following: a) baseline beliefs and attitudes towards pain; b) changes in belief and attitudes towards pain; c) and changes in functional status. This study also investigated if these differences were associated with being a novel or repeat LI user. A secondary objective was to estimate the sample size required for a larger study. METHODS: This project was an exploratory study. Thirty-three subjects were monitored for pain intensity using the Visual Analogue Scale (VAS) just before the infusion, and then at four days, two weeks, and three weeks after the infusion. The subjects were separated into groups depending on the criteria of whether or not they had: a) criterion-based pain intensity decrease or not on the fourth day post infusion, and b) received a previous LI or not. Since no subjects who received their first LI reported pain intensity decrease four days later, three groups emerged from this classification: first time LI users with no pain decrease, repeat LI users with no pain decrease, and repeat LI users with pain decrease. The subjects completed two self-administered questionnaires the Survey of Pain Attitudes (SOPA-32) and the Short Musculoskeletal Function Assessment (SMFA) - before the infusion, and at two and three weeks post-infusion. The most important change at two or three weeks post-infusion was used for comparison purposes. RESULTS: No significant changes in function (SMFA) were found. However, changes in specific beliefs and attitudes towards pain (SOPA-32) were associated with the group variable as follows: 1) All three groups showed a significantly stronger belief that 'others, especially family members, should be solicitous in response to their experience of pain' after the infusion. 2) Those who received their first LI and did not report pain intensity decrease also showed a significantly stronger belief that 'medications are an appropriate treatment for chronic pain' after the infusion. 3) Subjects who had previous LI and did not report pain intensity decrease were the only ones to believe significantly less that 'medications are an appropriate treatment for chronic pain' and more 'in a medical cure for their pain problem' after the infusion. 4) Subjects who had previous LI and did report pain intensity decrease had a significantly stronger belief in the appropriateness of medications and that 'that they should avoid exercise' after the infusion. 5) Finally, subjects who believed more that 'medications are an appropriate treatment for chronic pain' and less 'that they should avoid exercise' at baseline, had significantly higher chances of experiencing decrease in pain intensity 4 days after a LI. CONCLUSION: The impact of a LI on the individuals' beliefs and attitudes towards pain differs depending if their pain intensity decreased or not four days after the infusion, and if they had previous LI or not. By contrast, their pre-infusion beliefs and attitudes profile impacts on the efficacy of this intervention. Because of the small sample size, the heterogeneity of the subjects in terms of the localization of their pain, and our choice of measurement tool, it is not possible to determine if LI impacts on function. Nevertheless, this exploratory study generated some novel observations and questions that are of great interest for future research. A particular question of interest would be to determine if repeated LI fosters a more passive attitude towards pain management. It was also determined that a sample size of 70 subjects per group would be necessary for future research on this question. / Keywords: Chronic pain, lidocaine, beliefs and attitudes towards pain, function, pain intensity.

Mechanical stresses and flow dynamics alteration in a stented artery region are known to stimulate intimal thickening and increase the risk of restenosis, the closure of a revascularized artery. Particle imaging velocimetry (PIV) is an optical flow visualization technique that can be used to characterize the local flow dynamics around different stent structures. However, the usual cylindrical stent geometries present visualization difficulties when using an optical measurement technique such as the PIV technique. Using a flat configuration of a stent model presents advantages over the usual cylindrical model. A planar stent model makes data acquisition easier in planes cutting through the model due to its flat geometry that is compatible with the PIV planar flow investigation technique. Furthermore, with the planar stent configuration model velocity measurements and their associated flow features can be done without inducing refraction of the laser light sheet occurring with the cylindrical model's curvature. The refraction of light should be avoided since measurement errors and reflections are the resulting effects of this laser light plane deviation when passing through the curvature of a cylindrical stent model. / The spatial and temporal distribution of the Wall Shear Stress (WSS), which is believed to be of primary importance in the development of restenosis should be comparable between the flat and the cylindrical stent configuration models. The velocity and shear strain rate distributions will be compared between the flat and cylindrical stent configurations using computational fluid dynamics (CFD) simulations in order to analyse the feasibility of using a flat instead of a cylindrical version of the stent model for PIV experiments. It will be shown that for a physiological pulsatile flow the flat model yields results in shear strain rate spatial and temporal distribution that is comparable to the cylindrical model. A more PIV compatible, efficient and less refractive error prone validated flat model would be advantageous when several stent designs influence on the local hemodynamics around the strut geometries have to be studied quantitatively and optimized.

Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index.

Osteoporosis is a common condition characterized by bone fragility and fractures. Hip fracture, leads to disability, morbidity, excess mortality and growing costs to health care systems. / Antiresorptive agents are used to treat osteoporosis and fractures; it is unknown if these agents are effective in preventing recurrent fractures in individuals who have sustained a hip fracture. / Using health services administrative databases, we ascertained the incidence of hip fractures and associated-mortality rates in the elderly population in Quebec, from 1996 to 2002 and, evaluated the effectiveness of antiresorptive agents for the prevention of recurrent hip fractures. / We identified 33,243 hip fractures. Age-adjusted annual rates of hip fractures decreased in women by 11% from 1996 to 2002 while they did not change in men. Overall one-year mortality rates were higher in men than in women (37% versus 24%), and remained stable over time. Patients exposed to antiresorptives had a 26% reduction in the rate of recurrent fractures (95% CI, 0.64--0.86) compared to patients who were not exposed to these agents. / Hip fractures remain a prevalent disease with serious complications. Further research is essential to confirm our results and, to clarify the association between increasing use of antiresorptive agents and the trend reversal in the incidence of hip fractures.

<p>The program that was studied is part of the Child Health Program devised and supported by CARE International and implemented in Kanyama, a high density and low cost community found on the outskirts of Lusaka, Zambia. Diarrhoea was identified as one of the three most common diseases affecting the children under the age of five years. Through community participation, the program was implemented by the Kanyama residents to reduce the cases of diarrhoea, malaria and pneumonia among children aged five years and under. The main aim of this study was to explore the perceptions of the impact of community participation by the community leaders and community members in the diarrhoea prevention program and to establish constraints affecting participation.</p>