A Cross-Case Study Of The Competitive Advantage Of Private Higher Educational Institutions In Kuching, Sarawak [LB2328.52.S2 L219 2007 f rb].

Kajian ini meninjau kelebihan daya saingan (competitive advantage) dalam kalangan institusi pendidikan tinggi swasta (IPTS) di Kuching, Sarawak. Tumpuan utama kajian ini adalah untuk mengenal pasti bagaimana IPTS menganalisis dan mengurus persekitaran luaran dan dalaman dan mengeksploitasi sumber-sumber dalaman untuk menempatkan institusi mereka pada kedudukan strategik supaya mendapat kelebihan daya saingan. This study examined the competitive advantage of private higher educational institutions (PHEIs) in Kuching, Sarawak. The primary focus of the study was on how PHEIs analyze and manage their external and internal environments and exploit their internal resources in order to position their institution to gain competitive advantage

General Practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system

Background: Sponsoring of physicians meetings by life science companies has led to reduced participation fees but might influence physician's prescription practices. A ban on such sponsoring may increase participation fees. We aimed to evaluate factors associated with physicians' willingness to pay for medical meetings, their position on the sponsoring of medical meetings and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners in one state in Switzerland, identified through their affiliation to a medical association. The questionnaire evaluated physicians' willingness to pay for medical meetings, their perception of a bias in prescription practices induced by commercial support, their opinion on the introduction of a binding legislation and alternative financing options, their frequency of exchange with sales representatives and other relevant socioeconomic factors. We built a multivariate predictor logistic regression model to identify determinants of willingness to pay. Results: Of the 115 physicians who responded (response rate 26%), 48% were willing to pay more than what they currently pay for congresses, 79% disagreed that commercial support introduced a bias in their prescription practices and 61% disagreed that it introduced a bias in their colleagues' prescription practices. Based on the multivariate logistic regression, perception of a bias in peers prescription practices (OR=7.47, 95% CI 1.65-38.18) and group practice structure (OR=4.62, 95% CI 1.34-22.29) were significantly associated with an increase in willingness to pay. Two thirds (76%) of physicians did not support the introduction of a binding legislation and 53% were in favour of creating a general fund administered by an independent body. Conclusion: Our results suggest that almost half of physicians surveyed are willing to pay more than what they currently pay for congresses. Predictors of an increase in physicians' willingness to pay were perception of the influence of bias in peers prescription practices and group practice structure. Most responders did not agree that sponsoring introduced prescribing bias nor did they support the 2 introduction of a binding legislation prohibiting sponsoring but a majority did agree to an independent body that would centrally administer a general fund

Bacterial contamination of stethoscopes of anaesthetists in the department of anaesthesiology

A research report submitted to the Faculty of Health Sciences, University of Witwatersrand, in fulfilment of the requirements for the degree of Masters of Medicine. Johannesburg, 2016Background South Africa has a huge burden of infectious diseases as many patients are immunocompromised and are at an increased risk for infection. An almost unnoticed piece of equipment possibly harbouring pathogens is the stethoscope. Alcohol swabs are readily available and have been shown to effectively reduce the growth of micro-organisms on stethoscopes. Methods Data was collected from 26 anaesthetists and their stethoscopes in the Department of Anaesthesiology at two academic hospitals in Johannesburg. Two samples were taken from each stethoscope. Group A was assigned to the stethoscope samples that were taken prior to disinfecting the stethoscope with a 70% isopropyl alcohol swab and Group B was assigned to the stethoscope samples that were taken after disinfecting of the stethoscope. Anaesthetists were then asked about their frequency of cleaning the stethoscopes. Results In Group A 19 (73%) stethoscopes grew micro-organisms. Micro-organisms were identified on three stethoscopes in Group A. Two stethoscopes grew coagulase-negative staphylococcus (CNS) and one stethoscope grew Staphylococcus aureus. In Group B, 5 (19.2%) cultured micro-organisms. The only micro-organism identified in this group was CNS. The results showed that most anaesthetists even if infrequently disinfected their stethoscopes. Conclusion This study demonstrated the contamination of stethoscope diaphragms in the Department of Anaesthesiology and the effectiveness of disinfecting the stethoscope with a 70% isopropyl alcohol swab. Most of the anaesthetists reported disinfecting their stethoscopes.MT201

Secondary Metabolite Production In Plants: In Response To Biotic And Abiotic Stress Factors

Secondary metabolites (SMs) play vital roles in plant defence mechanisms, adaptation to environmental conditions, and interactions with other organisms. Biotic and abiotic stress factors can significantly influence the production, accumulation, and composition of SMs in plants. Understanding the intricate relationship between stress and SM production is crucial for enhancing plant resilience, agricultural productivity, and the development of novel phytopharmaceuticals. This research provides current knowledge regarding the impact of biotic and also abiotic stress on SMs in plants. Biotic stress factors such as pathogen infection, and herbivore attacks, as well as abiotic stress factors like drought, along with temperature extremes, and also salinity, can profoundly influence the biosynthesis and accumulation of SMs in plants. We discussed the methodology based on secondary sources underlying physiological, biochemical, and molecular mechanisms involved in stress-induced SM synthesis and highlight the potential implications for plant biology, agriculture, and human health. The study also emphasizes the functions of SMs in plants including defence against herbivores, pathogens, and abiotic stresses. The mechanism by which thesecompounds act as allelochemicals and signalling molecules is also discussed

Cimetidine as a free radical scavenger

The present study was undertaken to determine the effects and possible mechanism of action of cimetidine in cancer and Alzheimer’s disease (AD). Throughout this study emphasis is placed on free radical levels since the magnitude of the relationship between diseases and the levels of free radicals vary from one disease to another. Studies were carried out to examine the effect of cimetidine on free radical levels using superoxide formation and lipid peroxidation as indicators of free radical levels. The experiments revealed that addition of cimetidine, especially in high concentrations (0.5 and 1.0 x10-6 M) significantly inhibited WHCO6 cancer cell growth rather than cancer cell growth, as no normal control was available. Free radical formation as well as hydroxyl radical formation were reduced in the deoxyribose assay. In addition, cimetidine exhibits properties of binding to metals such as copper and iron. To maintain consistency in the experiments, a WHCO6 (Wits Human Carcinoma of the Oesophagus) cell line was used to investigate the effect of cimetidine in cancer. Neurodegeneration was induced in the rat brain using neurotoxins such as cyanide to investigate the relationship between cimetidine in AD. A decrease in cancer cell growth was accompanied by a concomitant decrease in the levels of free radicals and lipid peroxidation, suggesting that the growth-inhibitory effects of cimetidine on WHCO6 cancer cells in vitro may be due to free radical scavenging properties. This proposal was further strengthened by determination of free radical levels in the rat brain. After treatment with neurotoxins to induce neurodegeneration, the levels of free radicals in the rat brain suggest that addition of cimetidine reduces free radical levels in the rat brain in a dosedependent manner. Further experiments were done in an attempt to uncover the underlying mechanism by which cimetidine exhibits free radical scavenging properties. Metal binding studies were done using electrochemical, HPLC and UV/Vis studies. The results show that cimetidine binds iron and copper. These metals have been implicated in free radical production via the Fenton reaction. By binding with cimetidine the metals become unavailable to produce free radicals and hence cimetidine indirectly reduces the formation of free radicals. The final experiment was the determination of cimetidine as a hydroxyl radical scavenger in the deoxyribose assay. Cimetidine was shown to act as a potent hydroxyl radical scavenger, thereby confirming its activity as a free radical scavenger. In addition, cimetidine protects against damage to the deoxyribose sugar, a component of DNA. Whilst there are many theories that explain the therapeutic role of cimetidine in degenerative disease, the actual mechanism of the role of cimetidine is emphasized as a free radical scavenger. Regardless of the mechanism of action, cimetidine does inhibit tumour growth according to this study and also reduce free radical levels in neurodegeneration, which suggests a role for cimetidine as a possible additive in treatment of patients with such disease states. These findings have important clinical implications, and needs to be investigated further

The role of tribal authorities in a democratic KwaZulu-Natal.

Thesis (M.Soc.Sci.)-University of Natal, Pietermaritzburg, 1996.This thesis attempts to define the role of tribal authorities in the structures of the democratic government in the South African province of KwaZulu-Natal. However, the major difficulty lies in the nature of the institution of tribal authorities itself. In African tradition, leadership is hereditary. It is not subject to any electoral process. Besides this, the hereditary process is fundamentally male primogeniture and by nature excludes women. This contradicts the principles of democracy and the bill of rights which the democratic government of South Africa has adopted. Nevertheless, the institution of tribal authorities is not new in South Africa. It has existed and worked hand in hand with previous governments in South Africa since the period of the British colonial rule in the early 19th century. During the apartheid era, tribal authorities served as the local government in the rural areas of the KwaZulu Bantustan. Chiefs only lost this status after the formation of the Government of National Unity in 1994. However, most chiefs still have great influence and respect among the traditional people who live in rural areas. Besides this, among the Zulus, the institution of tribal authorities symbolizes Zulu nationalism and culture. Because of their closeness to the people at the grassroots, chiefs have good relationships with different political parties, particularly the Inkatha Freedom Party and the African National Congress. Probably they are seen by these political parties as potential allies and agents for political mobilization and recruitment in rural tribal areas. Consequently, abandoning the institution of tribal authorities in the democratic dispensation is unrealistic and irresponsible. To meet the political realities of KwaZulu-Natal, a certain form of representation in the structures of democratic government at both the provincial and local levels needs to be given to the institution of tribal authorities as part of the democratization process, and also as a means of expanding the scope of democracy in rural areas. This also fulfils one of the precepts of democracy which entails including all the concerned groups of people in a society, irrespective of colour, creed, sex, race, tradition and culture. Nevertheless, to achieve this, some adjustment is necessary to make possible the incorporation of the institution of tribal authorities in the structures of the democratic government. How can this institution be accommodated? What will the status and position of chiefs be in these structures? What will be their new role? How well can democratically elected structures work with non-elected ones? Is the inclusion of tribal authorities in the democratic government not going to conceptualize ethnicity? In other words, does ethnicity have any room in South Africa's democratic dispensation? To address these questions, this thesis assesses a number of aspects, which include examining the role chiefs played in the previous government, their relationships with the people, the Bantustan government and Inkatha Yenkululeko Yesizwe, and other political parties especially in the democratic dispensation. The thesis also examines legislation passed by the Government of National Unity, as well as the constitutional proposals of the Inkatha Freedom Party, the African National Congress and other political parties in the provincial government of KwaZulu-Natal concerning the role of tribal authorities

Role of Panchashirisha Agada in Dermatological Toxicity w.s.r. to Visha - A Review

Ayurveda consists of many branches of which Agada Tantra is one of them, which deals with toxicology. Any substance which comes in contact with skin gets easily absorbed. So, in case, if any Visha (Toxin) comes in contact then for sure there will be consequences. My aim is to study these Dermatological manifestations occurring due to various Visha. For its management, various formulations are mentioned in Samhita. Among which Panchashirisha Agada is considered to be best in treating any Vishajanya condition. It has both Vishaghna and dermatological properties like Kushthghna, Kandughna, Twachya, Varnya, Shothaghna. It can be used both internally and externally. This review is an attempt to explore the role of Panchashirisha Agada in dermatological toxicity

General practitioners' willingness to pay for continuing medical education in a fee-for-service universal coverage health care system [article]

Abstract: Background: Sponsoring of medical meetings by life science companies has led to reduced participation fees for physicians but questions potential drawbacks. Ongoing discussions are proposing to ban such sponsoring which may increase participation fees. Objectives: To evaluate factors associated with general practitioners' willingness to pay for medical meetings, their support of a binding legislation prohibiting sponsoring and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners' of one state in Switzerland, identified through their affiliation to a medical association. Results: Of the 115 physicians answering, 48% were willing to pay more than what they currently pay for medical meetings and 79% disagreed that sponsoring introduced a bias in their own prescription practices. In univariate analyses, factors most associated with physician's willingness to pay were perception of a bias in peers prescription practices (OR=6.67; 95% CI: 1.60-27.74), group practice (OR=3.01; 95% CI: 0.94-9.65) and having <4 meetings with sales representatives per month (OR=2.39; 95% CI: 0.91-6.33). 78% did not support the introduction of a binding legislation and 56% were in favor of creating a general fund set up by life science companies and centrally administered by an independent body as an alternative financing option. Conclusions: Our results suggest that almost half of physicians surveyed were willing to pay more than what they currently pay for medical meetings and that an independent body that would centrally administer a general fund set up by life science companies might be better received by general practitioners' than a legislation banning the sponsoring of medical meetings by life science companies

Carbon dioxide levels of ventilated adult critically ill post-operative patients on arrival to the intensive care unit

Background. The transportation of critically ill patients presents a precarious situation in which adverse events may occur. At Chris Hani Baragwanath Academic Hospital (CHBAH) patients were manually ventilated using a manual resuscitator bag during transportation from theatre to the intensive care unit (ICU). Objectives. To evaluate the arterial partial pressure of carbon dioxide (PaCO2) levels of ventilated adult critically ill post-operative patients on arrival at the ICU at CHBAH. Methods. This was a cross-sectional study using convenience sampling. Pre- and post-transportation arterial blood gases were obtained from 47 patients. Results. There was a statistically significant difference in the pre- and post-transport PaCO2 level (p=0.03), with a mean difference of 3.3 mmHg. The pre- and post-transport arterial partial pressure of oxygen (PaO2) level (p≤0.001) and the week and weekend pre-transport (p≤0.001) and post-transport (p=0.01) PaCO2 were statistically significantly different. No statistically significant difference was found in the other arterial blood gas parameters or in the post-transport PaCO2 of those patients (26 (55.3%)), who received a neuromuscular blocking drug compared with those that did not. Adverse events were noted during 12 (25.6%) of the transports, 5 (41.7%) of which were patient-related, and 7 (58.3%) of which were infrastructure-related. Conclusion. There was a statistically but not clinically significant difference in the pre- and post-transport PaCO2 level and between week and weekend transportations. Hypercarbia was the most common derangement in all transports. Adverse events occurred during one-quarter of transportations. Keywords: manual resuscitation bag ventilation, transportation of critically ill patients, carbon dioxide level

Krill’s Disease: A Newer Management Option

Purpose: To report a case of a young female who presented with scotoma in the right eye for few days. Case Report: Krill’s disease or acute retinal pigment epithelitis (ARPE) is a self-limiting retinal disease with no specific treatment. Typical clinical and imaging features helped us to diagnose her with ARPE. Intravenous methylprednisolone (IVMP), which gives a rapid anti-inflammatory response, was advised. An SD-OCT scan post-injection showed a reduction in hyperreflectivity and height of lesion at day 3 and near total resolution by day 5. Conclusion: This case suggests rapid resolution of ARPE with the use of IVM