Understanding Job Stress among Healthcare Staff

Introduction: Job life is an important part of a person’s daily life. There are many aspects of a job. A person may be satisfied with one or more aspects of his/her job but at the same time may be unhappy with other things related to the job. Objective: To evaluate the sources of job stress (stressful aspects of work) among the staff of a super specialty hospital & to suggest measures to decrease level of job stress. Methodology: Descriptive study employing 381 staff members of a super specialty hospital using a structured personal interview questionnaire consisting of 21 sources of stress. The hospital staff was asked to rate each item according to the extent to which it had contributed to their stress as experienced in their jobs in the past few months on a scale of 0 (not at all),1(a little), 2(quite a bit), 3 (a lot). A global rating of stress was also obtained. Result: The prime sources of stress were found to be underpayment (76%), excessive workload (70.3%), inadequate staff (48.6), & being involved in the emotional distress of patients (46.7%). Conclusion: The staffs of the hospital were in moderate stress due to the prime stressors so adequate measures should be taken to alleviate these stressors. This could be achieved through workload management, job redesign, & by offering occupational health education

Integrating Kano’s model into WhatsApp quality services

WhatsApp is being used by more than 160 million people in India and 1200 million people in the world which is record-breaking usage statistics in a history. This paper aims to find out the underlying Quality Dimensions and their elements for the features offered by WhatsApp. The authors conducted a survey to know about perceived quality of features based on users’ own feelings. This survey was conducted in the city of Ahmedabad, Gujarat state of India. The research sample consists the responses of 203 WhatsApp users. The authors adapted Kano’s model to further analyse the research objective. Kano’s model helped to identify the quality elements of each listed 19 features of WhatsApp. The subsequent analysis techniques include CSCs (Customer Satisfaction Coefficients), EFA (Exploratory Factor Analysis). From the analysis, the two Quality Dimensions are identified; Additional Features and Essential Features. The research shows that features like and audio calling can increase customer satisfaction from low to medium or high level. These findings can further help App developers to have better insights for designing and developing customer friendly applications.   Key Words: Kano’s Model and Service Quality Elements, Quality Dimensions, WhatsApp in India, Exploratory Factor Analysi

Prediction Based Efficient Resource Provisioning and Its Impact on QoS Parameters in the Cloud Environment

The purpose of this paper is to provision the on demand resources to the end users as per their need using prediction method in cloud computing environment. The provisioning of virtualized resources to cloud consumers according to their need is a crucial step in the deployment of applications on the cloud. However, the dynamical management of resources for variable workloads remains a challenging problem for cloud providers. This problem can be solved by using a prediction based adaptive resource provisioning mechanism, which can estimate the upcoming resource demands of applications. The present research introduces a prediction based resource provisioning model for the allocation of resources in advance. The proposed approach facilitates the release of unused resources in the pool with quality of service (QoS), which is defined based on prediction model to perform the allocation of resources in advance. In this work, the model is used to determine the future workload prediction for user requests on web servers, and its impact toward achieving efficient resource provisioning in terms of resource exploitation and QoS. The main contribution of this paper is to develop the prediction model for efficient and dynamic resource provisioning to meet the requirements of end users

Incidence and medical management of bisphosphonate-associated atypical femoral fractures in a major trauma centre: a retrospective observational study

BACKGROUND: Atypical femoral fractures (AFFs) are rare events associated with increased duration of bisphosphonate exposure. Recommended management of AFFs include cessation of bisphosphonates and imaging of the contralateral femur. The aims of this study were to identify the local incidence of AFFs in bisphosphonate users and to audit the medical management of AFFs against published recommendations. METHODS: A retrospective analysis of the admissions database for a major trauma centre identified all femoral fractures (3150) in a five-year period (July 2009 to June 2014). Electronic health records and radiographs were reviewed using the 2013 American Society for Bone and Mineral Research (ASBMR) diagnostic criteria for AFF to establish the number of cases. To estimate incidence, the total number of bisphosphonate users was derived from primary care prescription and secondary care day-case records. Medical management of cases with AFF on bisphosphonates was audited against guidance from ASBMR and Medicines & Healthcare Products Regulatory Agency. RESULTS: 10 out of 3150 femoral fractures met criteria for AFF; 7 of these patients had a history of exposure to bisphosphonates (6 oral, 1 intravenous). There were 19.1 AFFs per 100,000 years of bisphosphonate use in our region. Bisphosphonates were stopped and the contralateral femur imaged in only 2 of the 7 patients treated with bisphosphonates. CONCLUSION: Our local incidence is in line with published figures; however, this is the first published evidence suggesting that medical management and identification of AFF may be suboptimal. Managing these patients remains challenging due to their rarity and possible lack of awareness

In vitro i in vivo protuupalna, antibakterijska i farmakokinetička svojstva baikaleina

Baicalein is a bioactive flavone originally isolated from the roots of Scutellaria baicalensis, Scutellariala teriflora and Oroxylum indicum. The in vitro and in vivo anti-inflammatory and antibacterial properties of baicalein and pharmacokinetics after its single intramuscular administration were studied in Wistar rats. The in vitro anti-inflammatory activity of baicalein (10, 50 and 100 µM) was tested for its ability to inhibit the COX-2 enzyme by measuring PGE2 levels and determination of nitric oxide (NO) production in lipopolysaccharide (LPS) treated RAW 264.7 macrophage cells, in which baicalein was found to have significant inhibition of NO and PGE2 production in RAW 264.7 macrophage cells as compared with the LPS control group. The in vivo anti-inflammatory activity of baicalein (200 mg/kg) was assessed using the carrageenan-induced rat paw oedema model, following intramuscular injection. A significant percentage of inhibition of oedema volume was observed when compared with the carrageenan control group. In vitro and in vivo antibacterial activities of baicalein were determined by the micro broth dilution technique and neutropenic rat thigh infection model, wherein baicalein did not show any antibacterial property. Concentrations of baicalein were determined in rat plasma by high performance liquid chromatography (HPLC) after a single intramuscular administration at a dose of 200 mg/kg body weight, in which the mean peak plasma drug concentration (Cmax) of 0.77 ± 0.02 μg/mL was achieved at 0.08 h. The mean elimination half-life (t½β), the apparent volume of distribution (Vd(area)), total body clearance (Cl(B)) and mean residence time (MRT) were observed as 0.63 ± 0.06 h, 601.03 ± 28.18 L/kg, 677.39 ± 35.36 L/h/kg and 0.76 ± 0.06 h, respectively. Conclusively, in the present study, baicalein did not show in vitro or in vivo antibacterial property, but proved to have good anti-inflammatory activity. The available anti-inflammatory drugs have proved to have side effects in veterinary and human therapeutics. In this situation, baicalein may become an effective alternative to non-steroidal anti-inflammatory drugs and should also be studied in target animal species. Further research should be carried out to improve the solubility and bioavailability of baicalein through injectable routes.Baikalein je bioaktivni flavon izvorno izoliran iz korijena biljaka Scutellaria baicalensis, Scutellariala teriflora i Oroxylum indicum. U ovom su radu istraživana in vitro i in vivo protuupalna i antibakterijska svojstva baikaleina te farmakokinetika nakon njegove pojedinačne intramuskularne primjene u wistar štakora. In vitro protuupalno djelovanje baikaleina (10, 50 i 100 µM) analizirano je s obzirom na sposobnost inhibicije enzima COX-2 mjerenjem razine PGE2 i određivanjem proizvodnje dušikova oksida (NO) u makrofagnim stanicama RAW 264,7 tretiranim lipopolisaharidom (LPS). Ustanovljeno je da baikalein znakovito inhibira proizvodnju NO i PGE2 u makrofagnim stanicama RAW 264,7 u usporedbi s LPS kontrolnom skupinom. In vivo protuupalno djelovanje baikaleina (200 mg/ kg) procijenjeno je pomoću modela za mjerenje edema šape nakon intramuskularne injekcije karagenana, te je uočena znakovita inhibicija volumena edema u usporedbi s kontrolnom skupinom. In vitro i in vivo antibakterijsko djelovanje baikaleina određeno je metodom razrjeđivanja mikrobujona te modelom infekcije bedra neutropeničnog štakora, pri čemu baikalein nije pokazao antibakterijska svojstva. Koncentracije baikaleina utvrđene su u plazmi štakora tekućinskom kromatografijom visoke djelotvornosti (HPLC) nakon pojedinačne intramuskularne primjene u dozi od 200 mg/kg tjelesne mase u kojoj je prosječna vršna koncentracija lijeka (Cmax) bila 0,77 ± 0,02 μg/mL, a postignuta je za 0,08 h. Prosječan poluživot eliminacije (t½β) bio je 0,63 ± 0,06 h, providni volumen distribucije (Vd(površina)) 601,03 ± 28,18 L/kg, ukupni tjelesni klirens (Cl(B)) 677.39 ± 35.36 L/h/kg, a prosječno vrijeme zadržavanja (MRT) 0,76 ± 0,06 h. Zaključeno je da u ovom istraživanju baikalein nije pokazao in vitro i in vivo antibakterijska svojstva, ali je pokazao dobro protuupalno djelovanje. S obzirom na to da dostupni protuupalni lijekovi imaju nuspojave u liječenju ljudi i životinja, baikalein bi mogao biti učinkovita alternativa nesteroidnim protuupalnim lijekovima te bi ga trebalo istražiti i kod ciljanih životinjskih vrsta. Potrebna su daljnja istraživanja kojima bi se poboljšala topljivost i bioraspoloživost baikaleina injekcijskom primjenom

Mind over matter: investigation of materialization of intentions

In this article, we present our investigation of materialization of intentions using the input-output data based Six Sigma methodology for problem solving. The investigation is inspired by our respective Gurus, the wisdom of present and past seers, and the works of several scientists. We present two examples of materialization of intentions (change of pH and levitation). The pH example is preliminary requiring additional experimentation. We believe that the evidence presented is very supportive of the hypothesis of materialization of intentions. We hope this paper will contribute towards the unfolding of a Copernican-like revolution which will have profound positive impact on humanity

Two-Piece Multivariate lognormal distribution

We have extended the univariate bilognormal distribution to two piece multivariate lognormal distribution. The density function of two piece multivariate lognormal distribution is given and the maximum likelihood estimates of the parameters when the variance - covariance matrix of two component multivariate lognormal distributions are proportional to each other are obtained. Its truncated distribution and estimation of parameters are also considered in this paper

Comparative study of peri-operative outcome following laparotomy versus laparoscopic technique of abdominal hysterectomy for benign gynaecological lesions

Background: Laparoscopic technique of hysterectomy is becoming increasingly popular in developing and developed world. Laparoscopic hysterectomy is a minimal access procedure that allows patients to recover faster. The study was undertaken to assess the impact of two abdominal techniques (laparoscopic and conventional laparotomy) on various variables like operative time, hospital stay, complications and convalescence period.Methods: An observational longitudinal study was carried out at tertiary care centre. Two hundred and ten women, as per inclusion and exclusion criteria, who had undergone abdominal hysterectomy for benign uterine pathology, either by laparotomy (Group A) or by laparoscopic technique (Group B) during study period were included. Data was analyzed and compared by using different variables between two methods of hysterectomy, using percentages and Chi square test for normal distribution. P value less than 0.05 was considered significant.Results: The mean duration of surgery was 100 minutes in group A and 175 minutes in Group B. There were two cases (1.90%) of minor injury to urinary bladder in Group A and one case (0.95%) of thermal injury to urinary bladder in Group B. The mean blood loss was around 240 ml and 70 ml in Group A and B respectively. The need for postoperative analgesia was observed in 100% cases from Group A and 38.09% from group B. The average duration required for out of bed ambulation was 25 hours and 14 hours in Group A and B respectively. The mean hospital stay in group A and B was 7.5 days and 3.5 days respectively.Conclusions: Following laparoscopic hysterectomy, women had less morbidity, less need for post-operative pain relief, had early ambulation, short hospital stay and early resumption of routine activities at home as compared to women who had undergone abdominal hysterectomy by conventional method