Perceived Absorptive Capacity Of Individual Users In Performance Of Enterprise Resource Planning (Erp) Usage: The Case For Penang Manufacturing Firms

Penyelidikan ini memeriksa kesan keupayaan menyerap pengguna Perancangan Sumber Perusahaan (ERP) di kilang-kilang pembuatan Pulau Pinang. The research examines the effect of absorptive capacity of users on their use of ERP in Penang manufacturing firms

Anti-inflammatory effects of nicotine in obesity and ulcerative colitis

Cigarette smoke is a major risk factor for a number of diseases including lung cancer and respiratory infections. Paradoxically, it also contains nicotine, an anti-inflammatory alkaloid. There is increasing evidence that smokers have a lower incidence of some inflammatory diseases, including ulcerative colitis, and the protective effect involves the activation of a cholinergic anti-inflammatory pathway that requires the α7 nicotinic acetylcholine receptor (α7nAChR) on immune cells. Obesity is characterized by chronic low-grade inflammation, which contributes to insulin resistance. Nicotine significantly improves glucose homeostasis and insulin sensitivity in genetically obese and diet-induced obese mice, which is associated with suppressed adipose tissue inflammation. Inflammation that results in disruption of the epithelial barrier is a hallmark of inflammatory bowel disease, and nicotine is protective in ulcerative colitis. This article summarizes current evidence for the anti-inflammatory effects of nicotine in obesity and ulcerative colitis. Selective agonists for the α7nAChR could represent a promising pharmacological strategy for the treatment of inflammation in obesity and ulcerative colitis. Nevertheless, we should keep in mind that the anti-inflammatory effects of nicotine could be mediated via the expression of several nAChRs on a particular target cell

Administering Dexamethasone Prior to Peripheral Nerve Blocks

Post-operative pain creates burdens for the patient and their family members while also drastically increasing the price of cost to the healthcare system. The Institute of Medicine Committee on Advancing Pain Research, Care, and Education states that the annual economic cost of chronic pain in adults is $560-630 billion (IOM, 2011). Regional anesthesia has been shown to provide potent analgesia that often times leads to a reduction in systemic analgesic requirements, opioid related side effects, general anesthesia requirements, and possibly the incidence of chronic post-operative pain. There are several adjunct medications that can be combined with peripheral nerve blocks to prolong the duration of action and provide longer periods of analgesia. Dexamethasone is a glucocorticoid that has been shown to increase the efficacy of peripheral nerve blocks during the post-operative phase of surgery when administered intravenously. An informal survey was performed at a hospital in the southeastern portion of the United States among anesthesia providers revealing that dexamethasone was not being administered when performing peripheral nerve blocks. A quality improvement educational project was performed from literature supporting the project. A pre-intervention survey was implemented followed by the presentation. A post-intervention was then provided to the participating anesthesia providers and the results of the two surveys were then compared. The results showed an increase in the number of providers who administered dexamethasone intravenously prior to peripheral nerve blocks. A majority of the participants stated that the intervention influenced their decision to administer intravenous dexamethasone when performing peripheral nerve blocks

Intravenous lipid emulsion in clinical toxicology

Intravenous lipid emulsion is an established, effective treatment for local anesthetic-induced cardiovascular collapse. The predominant theory for its mechanism of action is that by creating an expanded, intravascular lipid phase, equilibria are established that drive the offending drug from target tissues into the newly formed 'lipid sink'. Based on this hypothesis, lipid emulsion has been considered a candidate for generic reversal of toxicity caused by overdose of any lipophilic drug. Recent case reports of successful resuscitation suggest the efficacy of lipid emulsion infusion for treating non-local anesthetic overdoses across a wide spectrum of drugs: beta blockers, calcium channel blockers, parasiticides, herbicides and several varieties of psychotropic agents. Lipid emulsion therapy is gaining acceptance in emergency rooms and other critical care settings as a possible treatment for lipophilic drug toxicity. While protocols exist for administration of lipid emulsion in the setting of local anesthetic toxicity, no optimal regimen has been established for treatment of acute non-local anesthetic poisonings. Future studies will shape the evolving recommendations for lipid emulsion in the setting of non-local anesthetic drug overdose

Swift trust and behavioral change: facilitating factors of crowdsourcing in chronic disease prevention

Behind Internet usage habits there is a common vocabulary: trust. In order to promote preventive medicine, Internet medical care has been trying to cultivate user habits and behavior change, but whoever increases trust can go further. The Internet has accelerated the pace of work and life and generalized the temporary involvement of individuals and teams. In many organizations, there is usually no time to develop trust among team members or between the team and customers in traditional ways such as mutual familiarity, experience sharing, mutual disclosure, and verification of commitments. These new situations have led to the study of a new form of trust: "swift trust". According to Hurd et al. (2017), "swift trust" focuses on expecting that a person has the necessary attributes to be relied upon. In the "swift trust" theory, a group or individual assumes the existence of trust initially, and later verifies and adjusts trust beliefs accordingly. Faced with the problem of the rapid spread of chronic diseases and the high proportion of medical expenses needed to combat them and that have posed challenges to the national finances in China, this thesis focuses on studying the factors that may facilitate the establishment of "swift trust" in the Internet based chronic disease crowdsourcing model. Grounded on the idea that trust affects behavior and speed affects efficiency, we have reviewed extant literature and, with the help of ROST Content Mining (ROST-CM) text mining software, we dug millions of Internet data and conducted in-depth research on the "swift trust" problem. Results, later verified through two ongoing healthcare projects showed that "profession" followed by "platform", "dissemination" and "propensity" are the most critical factors that affect the establishment of swift trust. These results may be of interest to professionals, organizations and government decision makers in need of establishing and winning trust, and particularly "swift trust", as an essential ingredient in the sharing economy.Existe uma palavra comum por detrás de todos os hábitos de utilização da Internet: confiança. Com o objetivo de promover a medicina preventiva, alguns cuidados médicos prestados através da Internet têm vindo a procurar motivar os utilizadores para uma mudança de hábitos e comportamentos, mas apenas quem conseguir ganhar a confiança poderá ir mais longe. A Internet acelerou o ritmo da vida e do trabalho e generalizou a participação temporária de indivíduos e grupos. Em muitas organizações, não há tempo suficiente para se criar confiança entre os membros de um grupo ou entre grupos e indivíduos através de formas tradicionais como a convivência e o conhecimento mútuos, a partilha de experiências ou a verificação do cumprimento de compromissos. Esta situação levou ao estudo de uma nova forma de confiança: "a confiança imediata". Hurd et al. (2017) afirmam que este conceito se refere à expetativa de que uma determinada pessoa reúna os atributos necessários para ser confiável. Segundo a teoria que estuda a "confiança imediata", um grupo ou indivíduo assume desde logo a presença de confiança e reserva para mais tarde a confirmação da sua existência. Considerando os desafios colocados pelo rápido desenvolvimento de doenças crónicas num país tão populoso como a China e a necessidade de as combater, esta tese estuda os fatores que poderão facilitar a construção de "confiança imediata" no modelo de colaboração aberta através da Internet com vista à prevenção destas doenças. Partindo do princípio de que a confiança afeta os comportamentos e de que a rapidez afeta a eficiência procedeu-se à revisão de literatura sobre o tema e, com a ajuda do "software" de mineração de texto ROST-CM (ROST Content Mining) foram recolhidos e tratados milhões de dados extraídos da Internet. Os resultados foram depois confrontados com a prática de dois projetos na área da saúde e revelaram que a "profissão" seguida da "plataforma", "disseminação" e "propensão" são os fatores que mais contribuem para a formação de "confiança imediata". Os resultados obtidos poderão ser de interesse para profissionais, organizações e decisores governamentais que necessitam de construir e manter confiança e, em particular "confiança imediata", enquanto ingrediente essencial na economia de partilha

Mathematical modelling of nanoparticle-mediated topical drug delivery to skin tissue

Peer reviewedPostprin

The influence of exercise on ulcer healing in patients with chronic venous insufficiency

Venous leg ulcer (VLU) is a common chronic clinical problem and it is the most serious complication of chronic venous insufficiency. Although venous ulcer has a huge burden on individuals and states, the standard type of treatment for this debilitating condition, compression therapy, has not changed in the last 2000 years. There is growing evidence that exercise could help in venous ulcer management. This study investigated the effect of exercise on 80 VLU patients. These patients were randomised into four groups; a control group, a compression therapy only group, an exercise only group and a compression and exercise group. Non-invasive measurements were performed at the beginning of the 3 month period of regular exercise, and again at the end of the exercise period. This was necessary in order to evaluate the effect of exercise on VLU healing parameters, which include; tcPO2 level, laser Doppler measurements, resting skin flux (RF), range of ankle joint movement (ROM) and ulcer size. The exercise composed of 10 dorsiflexions each hour, while the participant was awake over a period of 3 months. Findings included, an increase in the tcPO2 level and range of ankle joint movement in individuals who had performed the exercise compared to those who did not (p < 0.001). Moreover tcPO2 measurements were higher in the exercise and compression group than those seen in the exercise only group. Ulcer size and RF measurements decreased in patients who had performed exercise compared to those who did not, groups 3 and 4 showed a significant decrease in ulcer size with p values = 0.001 and < 0.001 respectively. With RF measurements, only groups 3 and 4 showed significant decrease, p < 0.001. The findings indicated that there were changes in the VLU parameters in response to the 3 months period of regular exercise. Regular unsupervised exercise may be included as an integral part of the leg ulcer management.Open Acces

Anaesthesia and Pain Management for Use in Orthopaedic Day Surgery

Day surgery has gained a large popularity during the last decades. In Finland, 57% of the elective procedures, and 50% at Turku University Hospital, were already conducted on day basis during 2012. The steady growth of day surgery is mostly due to an increased safety in perioperative care and cost-effectiveness. The development of surgical techniques and anaesthetic methods has advanced the modern day surgery and extended the repertory of the procedures for use in day surgery operations. Day surgery also offers certain benefits like reduced risk for hospital-related infections, stress and confusion. Patient satisfaction, regarding several issues, is high. Most concerns and complaints are related to postoperative pain, nausea and vomiting pain and nausea. Pain can hamper recovery and pain management is a crucial factor for hospital discharge. Appropriate pain treatment is effective, safe, easy and economical. A procedure-specific approach and an individually planned, multimodal analgesia should be the basis of modern pain management. The main aim of this thesis was to evaluate the effectiveness and safety of anaesthetic technique and methods in pain treatment of orthopaedic day case surgery, and following conclusions were made. Unilateral spinal block was achieved using hyperbaric bupivacaine with a small dose of clonidine but clonidine prolonged the block. Continuous subacromial bupivacaine was found to be safe but conferring only moderate efficacy in pain care after shoulder arthroscopy. Transdermal fentanyl, 12 g/h, as part of multimodal analgesia, offered a safe and easy option to pain management in this patient group. However, after forefoot surgery, it did not reduce pain any further. In general, pain scores in all patient groups were low and the need for rescue opioid moderate.Ortopedisen päiväkirurgisen potilaan anestesia ja kivunhoito Päiväkirurgian suosio on kasvanut viime vuosikymmeninä. Jo 57 % elektiivisistä leikkauksista Suomessa on päiväkirurgisia. Turun yliopistollisessa keskussairaalassa vastaava osuus on 50 %. Päiväkirurgian jatkuva kasvu johtuu ennen kaikkea lisääntyneestä perioperatiivisen hoidon turvallisuudesta ja kustannustehokkuudesta. Kirurgisten tekniikoiden ja anestesiamenetelmien kehitys on mahdollistanut nykyaikaisen päiväkirurgian ja laajentanut päiväkirurgisena tehtävien toimenpiteiden valikoimaa. Päiväkirurgialla saavutetaan myös tiettyjä hyötyjä, kuten sairaalainfektioriskin, stressin ja sekavuuden vähenemistä. Päiväkirurgiset potilaat ovat yleisesti ottaen erittäin tyytyväisiä; suurimpana huolen- ja palautteenannon aiheena ovat kipu ja pahoinvointi. Kipu voi haitata toipumista, ja kivunhoito onkin keskeinen tekijä kotiutuksen onnistumisessa. Hyvä kivunhoito on yksilöllisesti suunniteltua, tehokasta, turvallista, helppokäyttöistä ja taloudellista. Nykyaikaisessa päiväkirurgiassa hyödynnetään tyypillisesti multimodaalista eli useita eri kivunlievitysmenetelmiä käyttävää kivunhoitoa. Tämän työn tarkoituksena oli selvittää tiettyjen kivunhoitomenetelmien tehoa ja turvallisuutta ortopedisillä päiväkirurgisilla potilailla. Hyperbarisen ja pieniannoksisen klonidiinin yhdistelmällä saavutettiin toispuoleinen puudutus, mutta klonidiini pidensi puutumusta. Subakromiaalisesti eli olkalisäkkeen alaiseen tilaan annettu bupivakaiiniinfuusio osoittautui turvalliseksi, mutta sen hyöty olkapäätähystyksen jälkeisessä kivunhoidossa oli vähäistä. Fentanyyliä 12 µg/h vapauttava laastari osana multimodaalista kivunhoitoa tarjosi turvallisen ja helpon vaihtoehdon olkäpääntaähystyksen jälkeen. Jalkateräleikkauksen jälkeen se ei kuitenkaan vähentänyt kipua. Yleisesti ottaen kivun intensiteetti kaikissa tutkimusryhmissä oli matala ja tarve lisäopioidilääkitykselle vähäistä.Siirretty Doriast