Effect of Health Care Professionals’ Continuing Education Programme on Diabetic Patients’ Outcomes in Mukalla City, Yemen

Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility.Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers’ education on clinical patient outcomes was undertaken. The study took place in Al-Noor Charity Clinic (ACC), Mukalla City, Yemen. The subjects of this study were type 2 diabetes patients who received health services at ACC and met the inclusion criteria. Patients’ diabetes-related clinical parameter assessed were fasting blood glucose, weight, blood pressure, and lipid profile, i.e., cholesterol, triglyceride (TG), low density lipoprotein (LDL)-cholesterol and high density lipoprotein (HDL)-cholesterol) at baseline, i.e., before the intervention programme, and also at 6 months after the intervention.Results: There was significant improvement in clinical outcomes: fasting blood sugar (p = 0.004), systolic blood pressure (p = 0.003) diastolic blood pressure (p = 0.05), low density lipoprotein cholesterol (p = 0.005) and high density lipoprotein cholesterol (p = 0.001), but total cholesterol (p = 0.33) weight (p = 0.404) and triglyceride (p = 0.056) did not improve.Conclusions: Educational intervention of health care providers program does improve diabetic patients’ clinical outcomes.Keywords: Diabetes care; Health care providers, Patients' outcomes, Blood pressure, Lipid profile, Cholesterol, Yeme

Design of a Multisensing Control System

         The  goal   of   this  paper  is  to design  a reconfigurable multisensing  control system. The implemented design tools are based on static random access memory field programmable grid array  (SRAM FPGA)  circuit  board  and  a  very  high speed integrated circuit hardware description language (VHDL). The design steps  start with software development which consists of HDL  processes   where V HDL  program  that  describes  the architectural  behavior  of  the  multisensing  control system. An HDL synthesis is the second step, which converts the design in behavioral description file into gates. These steps are followed by implementation techniques and downloading the design from PC onto FPGA via a joint test action group (J TAG) cable. Different type   of   sensors; namely two ultrasonic, smoke detector, water level switch, thermostat, and light detector are connected to the inputs of the programmed FPGA and activated to test the design. The  results show that  the overall average delay timing between inputs to outputs is equal to 6.437 ns which is relatively small as compared with delay time at sensors and 1/0 modules. Therefore, it can be  clearly  stated  that the speed of  control  is limited by sensors  and 1/0  modules  rather  than  the processing performance of  the proposed design. This  is a  stark  contrast  to  traditional control  system  where  the  processing performance is typically the limiting factor. Thus  the use of  FPGA and V HDL to deploy multi sensing   control   system   efficiently  improves   its  reliability, flexibility, and  real  time  data  processing.  Finally,  it  can  be concluded  that the proposed multisensing control system can be effectively implemented in so many application areas including building security, home automation, robot activities, airports and industry control systems

Thermocouples Technology and Applications A review

This paper gives an intensive survey of thermocouples. In particular, it describes the principles of operation and compares between different types of junctions. It provides the major advances in thermocouples in conjunction with hardware and software for PC interfacing. Also it summarizes the main advantages and disadvantages of thermocouples. Finally the paper highlights the important areas of industrial applications. &nbsp

Serotype Distribution and Invasive Potential of Group B Streptococcus Isolates Causing Disease in Infants and Colonizing Maternal-Newborn Dyads

Serotype-specific polysaccharide based group B streptococcus (GBS) vaccines are being developed. An understanding of the serotype epidemiology associated with maternal colonization and invasive disease in infants is necessary to determine the potential coverage of serotype-specific GBS vaccines.Colonizing GBS isolates were identified by vaginal swabbing of mothers during active labor and from skin of their newborns post-delivery. Invasive GBS isolates from infants were identified through laboratory-based surveillance. GBS serotyping was done by latex agglutination. Serologically non-typeable isolates were typed by a serotype-specific PCR method. The invasive potential of GBS serotypes associated with sepsis within seven days of birth was evaluated in association to maternal colonizing serotypes.GBS was identified in 289 (52.4%) newborns born to 551 women with GBS-vaginal colonization and from 113 (5.6%) newborns born to 2,010 mothers in whom GBS was not cultured from vaginal swabs. The serotype distribution among vaginal-colonizing isolates was as follows: III (37.3%), Ia (30.1%), and II (11.3%), V (10.2%), Ib (6.7%) and IV (3.7%). There were no significant differences in serotype distribution between vaginal and newborn colonizing isolates (P = 0.77). Serotype distribution of invasive GBS isolates were significantly different to that of colonizing isolates (P<0.0001). Serotype III was the most common invasive serotype in newborns less than 7 days (57.7%) and in infants 7 to 90 days of age (84.3%; P<0.001). Relative to serotype III, other serotypes showed reduced invasive potential: Ia (0.49; 95%CI 0.31-0.77), II (0.30; 95%CI 0.13-0.67) and V (0.38; 95%CI 0.17-0.83).In South Africa, an anti-GBS vaccine including serotypes Ia, Ib and III has the potential of preventing 74.1%, 85.4% and 98.2% of GBS associated with maternal vaginal-colonization, invasive disease in neonates less than 7 days and invasive disease in infants between 7-90 days of age, respectively

The Effect of Quality of School Life and Resilience on Academic Stress in Students

This study aimed to test empirically the effect of quality of school life and resilience on academic stress in university students. The subjects of this study were bachelor degree students of Semarang's Walisongo Islamic State University, who were in their second to eighth semester. Using technique of Purposive Sampling, the samples of 318 students were gathered. Data were collected using Quality of School Life Scale, Resilience Scale, and Academic Stress Scale. The data obtained were analyzed with multiple regression technique. The result of the analysis showed that quality of school life and resilience has effect on academic stress both partially and simultaneously. Tujuan dari penelitian ini adalah untuk menguji secara empiris pengaruh quality of school life dan resiliensi terhadap stres akademik pada mahasiswa. Populasi dari penelitian ini adalah mahasiswa S1 UIN Walisongo Semarang semester dua sampai delapan. Pengambilan sampel dilakukan dengan teknik Purposive Sampling. Dengan teknik tersebut diperoleh sampel 318 mahasiswa. Pengumpulan data dilakukan dengan menggunakan skala Quality of School Life, skala Resiliensi, dan skala Stres Akademik. Teknik analisis data yang digunakan adalah regresi ganda. Hasil analisis data menunjukkan bahwa quality of school life dan resiliensi berpengaruh terhadap stres akademik baik secara parsial maupun secara simultan

Characteristics of seizure frequency among Malaysian children diagnosed with structural– metabolic epilepsy

Introduction: Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes. Materials and Methods: A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form. Results: Seizure frequency showed no significant association with patient’s demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 ± 56.66, 10.94 ± 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001). Conclusion: Among children with structural–metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients

Cost-effectiveness analysis for the use of serum antiepileptic drug level monitoring in children diagnosed with structural-metabolic epilepsy

Treatment with antiepileptic drugs is commonly guided by serum level monitoring. Such monitoring requires expensive laboratory equipment and products. However, well-conducted studies on the cost-effectiveness of therapeutic drug monitoring for antiepileptic drugs are lacking particularly in patients with structural-metabolic epilepsy. The study aims to assess the cost-effectiveness of serum level monitoring services in the management of children with structural-metabolic epilepsy during the first year of diagnosis. A retrospective cost-effectiveness analysis was conducted from the provider perspective. It included patients attended a paediatric neurology clinic. The effectiveness measures used in this analysis were the number of patients that achieved ≥50% reduction in seizure frequency, and the number of patients with 3-month seizure free. Medical records of the patients were reviewed for the required information. Medical chart/billing data obtained from the hospital were collected to estimate the resources used (One Malaysian Ringgit MYR is equivalent to 0.31 USD). The recruited children were followed for one year following their first visit. The average cost effectiveness ratio for the monitored patients (MYR 2735 per patient that achieved a ≥50% reduction in seizure frequency) was lower than that for non-monitored patients (MYR 2921 per patients that achieved a ≥50% reduction in seizure frequency), with incremental cost-effectiveness ratio of MYR 2357 per one additional patient that achieved a ≥50% reduction in seizure frequency. The average cost effectiveness ratios for monitored and non-monitored group were MYR 8279 and MYR 6433 per patient with a 3-month seizure-free period, respectively, with incremental cost-effectiveness ratio of MYR 29,666 per one additional patient with a 3-month seizure-free period. In terms of the effectiveness measures used, serum level monitoring of antiepileptic drugs was found to be cost-effective. However, the incremental cost-effectiveness ratio was found to be sensitive to the cost of management

Medical care costs of newly diagnosed children with structural-metabolic epilepsy: a one year prevalence-based approached

Purpose Aims of this study were to estimate the first-year medical care costs of newly diagnosed children with structural-metabolic epilepsy and to determine the cost-driving factors in the selected population. Method This was a prevalence-based retrospective chart review that included patients who attended a pediatric neurology clinic in a tertiary referral center in Malaysia. The total first-year medical care costs were estimated from the provider (i.e., hospital) perspective, using a bottom-up, microcosting analysis. Medical chart/billing data (i.e., case reports) obtained from the hospital (i.e., provider) were collected to determine the resources used. Prices or cost data were standardized for the year 2010 (One Malaysian Ringgit MYR is equivalent to 0.26 Euro or 0.32 USD). Results The most expensive item in the costs list was antiepileptic drugs, whereas ultrasound examination represented the cheapest item. Hospitalization and the use of non-antiepileptic drugs were the second and third most costly items, respectively. The cost of therapeutic drug monitoring comprised only a small proportion of the total annual expenditure. None of the demographic variables (i.e., gender, race, and age) significantly impacted the first-year medical care costs. Similarly, child development, seizure type, therapy type (i.e., polytherapy versus monotherapy), and therapeutic drug monitoring utilization were also not associated with the cost of management. The first-year medical care costs positively correlated with seizure frequency (rs=0.294, p=0.001). However, the only variable that significantly predict the first-year medical care costs was the type of antiepileptic drugs (R2=0.292, F=7.772, p<0.001). Conclusion This investigation was the first cost analysis study of epilepsy in Malaysia. The total first-year medical care costs for 120 patients with structural-metabolic epilepsy were MYR 202,816 (i.e., MYR 1690.13 per patient per year). The study findings highlight the importance of optimizing seizure control in reducing the cost of manageme