Human Resources: Overview of the Company's reputation from weaknesses, strengths and challenges in a crisis

This article discusses the human resources of the company reputation review of the weaknesses, strengths, and challenges in the crisis. A company that has a good reputation will be more attractive to qualified prospective employees, get free mass media coverage so it doesn't require large advertising costs, and get other benefits that contribute to company profits. Steps are needed to be taken to overcome the crisis by analyzing the crisis in depth, systematically, informatively, and descriptively of the crisis that occurred through a neatly prepared report. HR development is generally more focused on the long-term needs of the organization. The results are indirect and can be measured in the long term

Aversive reaction between disulfiram and betel quid among inpatients with alcohol use disorder in Bhutan: A preliminary study

Betel Quid (BQ) is commonly used in the Asia-Pacific region. Disulfiram is prescribed for people with alcohol use disorders (PwAUDs) after the completion of detoxification as an alternative to rehabilitation. This prospective observational study reports the aversive reactions and common symptoms of Disulfiram and BQ in PwAUDs. Participants included PwAUDs admitted to the psychiatric ward at the Jigme Dorji Wangchuck National Referral Hospital for detoxification, who were on Disulfiram and using BQ at the same time. Aversive reactions between Disulfiram and BQ were observed for 100 patients over a year. Twenty participants showed aversive reactions between BQ and Disulfiram. Common symptoms included sweating, diarrhea, dizziness, tremors, palpitations, shortness of breath, nausea and vomiting, and headache. Since PwAUDs in Bhutan are inducted on Disulfiram after detoxification, and most use BQ simultaneously, this study will help inform health care providers to educate people about the aversive reactions of Disulfiram and BQ

Gender with marital status, cultural differences, and vulnerability to hypertension: Findings from the national survey for noncommunicable disease risk factors and mental health using WHO STEPS in Bhutan

Cardiovascular disease is the leading cause of death in the Kingdom of Bhutan. Thus, the early detection and prevention of hypertension is critical for reducing cardiovascular disease. However, the influence of sociocultural factors on vulnerability to hypertension needs further investigation. This study performed secondary data analysis on 1, 909 individuals in a cross-sectional study (the National survey for noncommunicable disease risk factors and mental health using World Health Organization (WHO) STEPS approach in Bhutan– 2014). Multivariate logistic regression demonstrated a significant association between gender with marital status and hypertension. Women had a higher odds ratio than men (Ref) when married (AOR: 1.27, 95% confidence intervals (CI): 1.23–1.31), and when separated, divorced, or widowed (AOR: 1.18, 95% CI: 1.12–1.26). People who speak the Tshanglakha language scored the highest odds (AOR: 1.24, 95% CI: 1.20–1.27), followed by Lhotshamkha (AOR: 1.09, 95% CI: 1.06–1.12) and Dzongkha (Ref) after adjusting for various social and biomedical factors. Additionally, tobacco use displayed decreased odds for hypertension. To promote the early detection and prevention of hypertension, these cultural factors should be considered even within small geographic areas, such as Bhutan. It is necessary to strengthen hypertension preventive strategies for people who speak Tshanglakha and Lhotshamkha. Furthermore, careful consideration should be given to preventing hypertension among adults aged 40 years or more, women who are married, separated, divorced, or widowed, and men who never married in Bhutan

Yield of Brain MRI in Clinically Diagnosed Epilepsy in the Kingdom of Bhutan: A Prospective Study

Background: People with epilepsy (PWE) in low- and middle-income countries may not access the health resources that are considered optimal for epilepsy diagnosis. The diagnostic yield of magnetic resonance imaging (MRI) has not been well studied in these settings. Objectives: To report the diagnostic yield of brain MRI and identify clinical associations of abnormal MRI findings among PWE in a neurocysticercosis-endemic, resource-limited setting and to identify the proportion and putative structural brain causes of drug-resistant epilepsy. Methods: PWE were prospectively enrolled at the Jigme Dorji Wangchuck National Referral Hospital in Bhutan (2014-2015). Each participant completed clinical questionnaires and a 1.5-Tesla brain MRI. Each MRI was reviewed by at least 1 radiologist and neurologist in Bhutan and the United States. A working definition of drug-resistant epilepsy for resource-limited settings was given as (a) seizures for >1 year, (b) at least 1 seizure in the prior year, and (c) presently taking 2 or more antiepileptic drugs (AEDs). Logistic regression models were constructed to test the cross-sectional association of an abnormal brain MRI with clinical variables. Findings: A total of 217 participants (125 [57%] female; 54 [25%] neurocysticercosis (n = 26, 12%, including 1 child) and congenital/perinatal abnormalities (n = 29, 14%, including 14 children). The number of AEDs (odds ratio = .59, 'P' = .03) and duration of epilepsy (odds ratio = 1.11, 'P' = .02) were significantly associated with an abnormal MRI. Seizure in the prior month was associated with the presence of mesial temporal sclerosis (odds ratio = .47, 'P' = .01). A total of 25 (12%) participants met our definition of drug-resistant epilepsy, with mesial temporal sclerosis (n = 10), congenital malformations (n = 5), and neurocysticercosis (n = 4) being the more common findings. Conclusions: The prevalence of abnormalities on brain MRI for PWE in resource-limited settings is high as a result of a diffuse range of etiologies, most commonly mesial temporal sclerosis. Drug-resistant epilepsy accounted for 12% of the referral population in a conservative estimation

The Myth Behind Alcohol Happiness

By drawing on the socio-cultural, religious, and traditional practices that encourage the use of alcohol in Bhutan, the author will examine the causes and factors that induce and maintain drinking habits among Bhutanese. Next, the impact of heavy drinking on Gross National Happiness will be examined. As an outcome of this study, some relevant strategies to minimize harm related to alcohol in Bhutan will be presented

Bhutanese Health Care Reform: A Paradigm Shift in Health Care to Increase Gross National Happiness

Health care services in Bhutan have improved significantly in recent decades. Yet enormous challenges remain because of the lack of resources and increase in lifestyle- and stress-related disorders. Buddhist practices, including mindfulness meditation, will have an important role to play in mitigating the effects of modernization and material desires. The hitherto doctor-centered "medical model" of treatment will need to give way to a holistic, patientcentered bio-psychosocial approach to health care management. In addition, the private sector will need to play a major role to sustain quality health care service in the country

Achieving Gross National Happiness Through Community-based Mental Health Services in Bhutan

Gross National Happiness, by definition, is closely linked to mental health, which is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community. Across cultures, concepts of mental health, as with GNH, include subjective well-being; perceived self-efficiency; autonomy; competence; inter-generational independence; and self-actualisation of one's intellectual and emotional potential, among others. It is generally agreed that the concept of mental health is broader than a lack of mental disorders. Mental health must address the entire spectrum of issues affecting the mental well-being of all sectors of society

Time-Resolved Non-Linear Electric Field Simulation on Liquid Embedded Substrate

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Partial Discharges and Electroluminescence Measurements on Power Electronic Substrates Embeded in Liquids

This paper presents an experimental study of partial discharges (PD) and electroluminescence properties of dielectric liquids (dibenzyltoluene & silicone oil) embedding a Silicon Nitride (Si3N4) ceramic substrate. With silicone oil partial discharges appear above 3 kV whereas no PD activity is recorded with dibenzyltoluene up to 6 kV. This indicates that with this Si3N4 substrate, partial discharges actually originate from the liquid, contrary to previous similar measurements carried out with other ceramics (Al2O3, AlN). Optical light detection and visualization also shows that DBT is highly electroluminescent. Silicone oil and Si3N4 show no electroluminescence, making it possible to study PD activity with a high sensitivity via measurement of emitted light. Since light measurements can be done whatever the shape of voltage wave, contrary to electrical PD recording, the detection of PDs with fast rise voltage becomes possible

Assessment of contribution of EHD to the cooling of power semiconductor devices immersed in dielectric liquids

International audienceThis paper presents an experimental study of EHD heat transfer enhancement in dielectric liquids, and an evaluation of its contribution to cooling of power electronic components. Heat transfer measurements are carried out in a vertical coaxial electrode system filled with benzyltoluene liquids. The influence of voltage wave shape (AC, DC, impulses), frequency, and liquid viscosity on heat transfer enhancement are measured. The optimal heat transfer occurs for a specific frequency with ac and impulse voltages, and liquids of lower viscosity. Unfortunately, in a typical power electronics module geometry (power diode on a ceramic substrate), almost no improvement of the diode cooling is recorded when this structure is filled with a liquid