Effect of routing flexibility on the performance of manufacturing system

[EN] This work presented in this paper is based on the simulation of the routing flexibility enabled manufacturing system. In this study four levels of each factor (i.e. routing flexibility, system load conditions, system capacity and four part sequencing rules) are considered for the investigation. The performance of the routing flexibility enabled manufacturing system (RFEMS) is evaluated using three performance measures like make-span time, resource utilization and work-in-process. The analysis of results shows that the performance of the manufacturing system may be improved by adding in routing flexibility at the initial level along with other factors. However, the benefit of this flexibility diminishes at higher levels of routing flexibilities.Khan, WU.; Ali, M. (2019). Effect of routing flexibility on the performance of manufacturing system. International Journal of Production Management and Engineering. 7(2):133-144. https://doi.org/10.4995/ijpme.2019.8726SWORD1331447

Diagnosis of Pneumonia in Children with Dehydrating Diarrhoea

The World Health Organization (WHO) guidelines for diagnosis of pneumonia are based on the history of cough or difficult breathing and age-adjusted respiration rates. Metabolic acidosis associated with dehydrating diarrhoea also influences the respiration rate. Two hundred and four children, aged 2 to 59 months, with dehydrating diarrhoea and a history of cough and/or fast breathing, were enrolled in a prospective study. Pneumonia diagnoses were made on enrollment and again 6 hours post-enrollment (after initial rehydration), using the WHO guidelines. These were compared with investigators\u2019 clinical diagnosis based on history and findings of physical examination and a chest x-ray at the same time points. Using the WHO guidelines, 149/152 (98%) infants in the 2-11 months age-group and 38/40 (95%) children in the 12-59 months age-group were diagnosed to have pneumonia on enrollment, which dropped to 107 (70%) and 30 (75%) respectively at 6 hours post-enrollment. The specificity of the WHO guidelines for diagnosis of pneumonia was very low (6.9%) at enrollment but increased to 65.5% at 6 hours post-enrollment, after initial rehydration. The specificity of the WHO guidelines for diagnosis of pneumonia in young children is significantly reduced in dehydrating diarrhoea. For young children with dehydrating diarrhoea, rehydration, clinical and radiological assessments are useful in identifying those with true pneumonia

Addressing Resistance to Antibiotics in Pluralist Health Systems

There is growing international concern about the threat to public health of the emergence and spread of bacteria resistant to existing antibiotics. An effective response must invest in both the development of new drugs and measures to slow the emergence of resistance. This paper addresses the former. It focuses on low and middle-income countries with pluralistic health systems, where people obtain much of their antibiotics in unorganised markets. There is evidence that these markets have enabled people to treat many infections and reduce mortality. However, they also encourage overuse of antibiotics and behaviour likely to encourage the emergence of resistance. The paper reviews a number of strategies for improving the use of antibiotics. It concludes that effective strategies need measures to ensure easy access to antibiotics, as well as those aimed at influencing providers and users of these drugs to use them appropriately.Funding for work on this paper was provided by a grant by the UK ESRC to the STEPS Centre and a grant by the UK Department for International Development to the Future Health Systems Consortium

Malaria Prevalence in Endemic Districts of Bangladesh

BACKGROUND: Following the 1971 ban of DDT in Bangladesh, malaria cases have increased steadily. Malaria persists as a major health problem in the thirteen south-eastern and north-eastern districts of Bangladesh. At present the national malaria control program, largely supported by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM), provides interventions including advocacy at community level, Insecticide Treated Net (ITN) distribution, introduction of Rapid Diagnostic Tests (RDT) and combination therapy with Coartem. It is imperative, therefore, that baseline data on malaria prevalence and other malaria indicators are collected to assess the effectiveness of the interventions and rationalize the prevention and control efforts. The objective of this study was to obtain this baseline on the prevalence of malaria and bed net use in the thirteen malaria endemic districts of Bangladesh. METHODS AND PRINCIPAL FINDINGS: In 2007, BRAC and ICDDR,B carried out a malaria prevalence survey in thirteen malaria endemic districts of Bangladesh. A multi-stage cluster sampling technique was used and 9750 blood samples were collected. Rapid Diagnostic Tests (RDT) were used for the diagnosis of malaria. The weighted average malaria prevalence in the thirteen endemic districts was 3.97%. In five south-eastern districts weighted average malaria prevalence rate was 6.00% and in the eight north-eastern districts weighted average malaria prevalence rate was (0.40%). The highest malaria prevalence was observed in Khagrachari district. The majority of the cases (90.18%) were P. falciparum infections. Malaria morbidity rates in five south-eastern districts was 2.94%. In eight north-eastern districts, morbidity was 0.07%. CONCLUSION AND SIGNIFICANCE: Bangladesh has hypoendemic malaria with P. falciparum the dominant parasite species. The malaria situation in the five north-eastern districts of Bangladesh in particular warrants urgent attention. Detailed maps of the baseline malaria prevalence and summaries of the data collected are provided along with the survey results in full, in a supplemental information

What the Future Holds for Resistance in Developing Countries

The challenge to controlling antimicrobial resistance in coming years is to put into practice recent policy and programmatic advances. Increasing attention to the problem of antimicrobial resistance, and how resistance in developing countries can affect industrialized countries, has led to increased attention to the problem of resistance in developing countries. Efforts, however, have lagged behind good intentions. Inappropriate use of antimicrobials, thought to be the major driver of resistance, remains the norm rather than the exception in most of the developing world, as well as in many industrialized countries. Enhanced educational outreach to both consumers and health-care providers to change the pattern of antimicrobial use is crucial and methods to do this effectively have been developed. There is an urgent need for greater regulation of antimicrobial distribution and sale so that private shops staffed by untrained owners and employees are no longer a common source of antimicrobials. Greater management capacity is required to ensure adherence to regulations, to audit prescribing in both the public and the private sectors, and to control corrupt practices and the proliferation of counterfeit or sub-standard drugs. Implementing and sustaining resistance surveillance systems that will alert the medical and public health communities to changes in resistance is also crucial. Development and introduction of rapid techniques to determine infecting pathogens and their susceptibility should enhance both surveillance and care. The substantial funding that is now flowing to targeted diseases - HIV and AIDS, tuberculosis, and malaria, all three of which have substantial problems with antimicrobial resistance - can in the coming years be both a boon (if funds are used to enhance infrastructure to manage all diseases of public health concern) and a detriment (if efforts remain narrowly focused on these diseases) to controlling resistance. Efforts to reduce disease burden - through health interventions such as immunizations and improved socioeconomic conditions - have the potential to have profound effects on the burden of resistance. Ultimately, control of resistance will depend on an integrated, multidimensional effort, the components of which can be implemented if the commitment, political will, and resources are made available