Richmond City Health District (RCHD), Bon Secours Richmond City Hospital (RCH), and Virginia Commonwealth Universities (VCU) Department of Health Behavior Policy (HBP): Partnering with Community Health Workers (CHW) to Improve Community Health Outcomes and Reduce Emergency Department (ED) Use

Background: Frequent ED users (5%) are sicker, poorer, not satisfied with the health system and cost 20% of total ED charges. Objective: A pilot study of feasibility of partnering with CHW to improve health knowledge and outcomes and reduce ED use in low income community. Methods: RCH ED utilizers were randomized to intervention and control groups. CHW contacted intervention group within 10 days of ED visit, surveyed about access to care, healthy living, and knowledge about chronic disease, and offered education, referrals to insurance and social and economic support. ED utilization and cost were recorded for all patients for 6 months. Preventable ED visits were classified according to Johnston et al1 and high utilizers have 2+ ED visits. Intervention and control characteristics and ED utilizations and cost were described and compared using t-tests, ANOVA, and Chi-square at alpha=0.1. Adjusted analyses were performed using linear and logistic regressions. Results: 91 and 61 randomized to intervention and control with 29 and 23 high utilizers respectively. Drop-in percent of patients with all and preventable ED visits was higher among intervention (12 and 17 percentage points, respectively). 65% of the total ED cost is preventable in the pre-intervention period. That dropped by 17 and 7% in intervention period among the intervention and control groups. The intervention estimated cost savings were $120K. Intervention group had significant improvement in self-reported general health, regular exercise, understanding of health benefits and chronic disease. Conclusions: hospital, academic, and CHW partnership reduces ED utilization and cost and improves health.https://scholarscompass.vcu.edu/gradposters/1116/thumbnail.jp

Evaluation of microbial quality of selected blister-packed paracetamol tablets and paracetamol syrups marketed in Nigeria

Ten brands of blister-packed paracetamol tablet and twenty brands of paracetamol syrup marketed in Nigeria were evaluated for their microbial quality. While no microbial contaminant was isolated from all blistered-packed paracetamol tablets, ten of syrups were contaminated with organisms such as Escherichia coli, Klebsiellaspp, Pseudomonas aeruginosa and Staphylococcus aureus at 14.3, 21.4, 21.4 and 42.9% occurrence respectively. Penicilliumspp was isolated from two brands. Antibiotic susceptibility profile revealed all bacterial isolates to be multidrug resistant with Escherichia coli resistant to all antibiotics tested, while Staphylococcus aureus isolates were sensitive to Oxacillin, Cefuroxime and vancomycin. Pseudomonas aeruginosa isolates were sensitive to ofloxacin and gentamycin while Klebsiella isolates were sensitive to ofloxacin and nitrofurantoin. The study concluded that compliance with the provisions of good manufacturing practice as well as good quality control play role in determining the microbial bioburden of pharmaceutical products while isolation of multi-drug resistant organisms calls for establishment and adherence to antibiotics use policy in Nigeria.Keywords: Blister-pack, multidrug resistance, good manufacturing practice, quality control, bioburde

A review of the possible prognostic values of biochemical changes in patients with SARS-CoV-2 infections

Because of high mortality and long-term hospital stay among patients with SARS-CoV-2 infections, it is important to search for biochemical changes in different organs and systems that could be useful in diagnosis and prognosis of COVID-19. We conducted a literature search of online databases including PubMed, Web of Science, Scopus and Google scholar for relevant materials on biochemical changes in SARS-COV-2 infections published between December 2019 and March 2021. The review shows that SARS-COV-2 uses the angiotensin converting enzyme 2 (ACE2) for attachment and entry into host cells. These ACE2 are abundantly expressed by the epithelial cells of the respiratory tract and moderately expressed by the epithelial cells of the esophagus, stomach, duodenum, ileum, rectum, cholangiocytes, liver  hepatocytes, pancreatic beta cells, and kidney tubular cells. This explains the systemic nature of SARS-COV-2 infection, and the high morbidity and mortality associated with COVID-19. Although, tests to assess biochemical changes are not specific enough for the diagnosis of SARS-CoV-2 infection, they may be useful for predicting outcome of COVID-19. This review highlights biochemical parameters that are significantly elevated or reduced in SARS-COV-2 infections, and which can be used as predictive factors of the severity and prognosis in COVID-19 patients.   French title: Un examen des valeurs pronostiques possibles des changements biochimiques chez les patients infectés par le SRAS-CoV-2 En raison de la mortalité élevée et du séjour à l'hôpital à long terme chez les patients infectés par le SRAS-CoV-2, il est important de rechercher des changements biochimiques dans différents organes et systèmes qui pourraient être utiles pour le diagnostic et le pronostic de COVID-19. Nous avons effectué une recherche documentaire dans des bases de données en ligne, notamment PubMed, Web of Science, Scopus et Google Scholar, pour rechercher des documents pertinents sur les changements biochimiques dans les infections par le SRAS-COV-2 publiés entre décembre 2019 et mars 2021. La revue montre que le SRAS-COV-2 utilise l'enzyme de conversion de l'angiotensine 2 (ACE2) pour la fixation et l'entrée dans les cellules hôtes. Ces ACE2 sont abondamment exprimés par les cellules épithéliales des voies respiratoires et modérément exprimés par les cellules épithéliales de l'oesophage, de l'estomac, du duodénum, de l'iléon, du rectum, des cholangiocytes, des hépatocytes du foie, des cellules bêta pancréatiques et des cellules tubulaires rénales. Cela explique la nature systémique de l'infection par le SRAS-COV-2, ainsi que la morbidité et la mortalité élevées associées au COVID-19. Bien que les tests pour évaluer les changements biochimiques ne soient pas assez spécifiques pour le diagnostic de l'infection par le SRAS-CoV-2, ils peuvent être utiles pour prédire l'issue du COVID-19. Cette revue met en évidence les paramètres biochimiques qui sont significativement élevés ou réduits dans les infections par le SRAS-COV-2, et qui peuvent être utilisés comme facteurs prédictifs de la gravité et du pronostic chez les patients COVID-19

Pengaruh Kualitas Pelayanan Terhadap Kepuasan Pelanggan PT. Indosat (Studi Pada Mahasiswa UMS)

Memuaskan kebutuhan konsumen adalah keinginan setiap perusahaan. Selain faktor penting bagi kelangsungan hidup perusahaan, memuaskan kebutuhan konsumen dapat meningkatkan keunggulan dalam persaingan. Kunci utama agar perusahaan mampu memenangkan persaingan pasar adalah menjadikan kepuasan konsumen sebagai tujuan utama perusahaan yang harus dicapai. Adapun tujuan penelitian ini adalah untuk mengetahui kepuasan konsumen dalam hal ini mahasiswa terhadap pemanfaatan produk dari Indosat. Metode penelitian yang digunakan adalah riset lapangan yaitu pengamatan yang dilakukan berdasarkan pengumpulan data menggunakan kuisioner. Populasi adalah seluruh konsumen Indosat yang diwakili oleh sampel mahasiswa dari Fakultas Ekonomi UMS sebanyak 70 responden. Teknik pengambilan sampel dengan purposive sampling yaitu mahasiswa yang telah menggunakan jasa dari Indosat selama paling sedikit satu tahun baik sebagai alat komunikasi panggilan telepon seluler sehari-hari maupun dalam pemanfaatan sebagai modem internet. Teknik analisis data digunakan dengan regresi linier berganda, uji t, uji F, dan koefisien determinasi R2. Hasil penelitian menunjukkan ada pengaruh yang positif dan signifikan dimensi layanan dari pemanfaatan produk Indosat yang diukur dari tangible, dan assurance terhadap kepuasan mahasiswa. Hal itu terbukti dari hasil uji t yang diketahui berpengaruh positif dan signifikan t-hitung tangible = 2,314, dan t-hitung assurance = 3,401 yang lebih besar dari t-tabel = 1,980. Kepuasan mahasiswa dalam memanfaatkan produk dari Indosat sebesar 35,7% dipengaruhi oleh faktor-faktor dimensi layanan seperti tangible, reliability, responsiveness, assurance, dan empathy. Hal tersebut terbukti dari hasil pemanfaatan produk Indosat dimana dimensi tangible atau wujud fisik serta assurance atau jaminan dari produk Indosat telah memberikan hasil pengaruh yang signifikan dalam mempengaruhi kepuasan mahasiswa

Surgical site infection and transfusion rates are higher in underweight total knee arthroplasty patients.

BACKGROUND: Underweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion. METHODS: A case-control study was conducted using a prospectively collected institutional database. Twenty-seven TKA patients were identified as UW (body mass index [BMI] \u3c 18.5 kg/m RESULTS: The average BMI was 17.1 kg/m CONCLUSIONS: Our study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The specific reasons are unclear, but we conjecture that it may be related to decreased wound healing capabilities and low preoperative hemoglobin. Investigation of local tissue coverage and hematologic status may be beneficial in this patient population to prevent SSI. Based on the results of this study, a prospective evaluation of these factors should be undertaken

Is Corporate Social Responsibility Ethical? - Recognizing Ethical Issues In Business

Corporate Social Responsibility is all about companies playing their responsible part in society and giving back to society and a big part of that is fund raising for valuable cause. Companies engage in Corporate Social Responsibility when they grant benefits to the communities where they work which are neither required by law nor an integral part of their primary objective is profit oriented company. Today, however businesses must also reflect on the legal, ethical, moral and social consequences of their decisions. The purpose of working on this paper is to identify the ethical issues faced by the organization and how the unethical behavior in organization is excessively aggressive to achieve business objectives. Evidences suggest that social corporate responsibility and the maintenance of high ethical standards is not an option but an obligation for all businesses. This paper also draws the inferences that often have the ethical implications of an action are overlooked for personal gain and the benefits are usually material. This frequently manifests itself in companies that attempt to cheat environmental regulations

A study on helicopter main gearbox planetary bearing fault diagnosis

The condition monitoring of helicopter main gearbox (MGB) is crucial for operation safety, flight airworthiness and maintenance scheduling. Currently, the helicopter health and usage monitoring system, HUMS, is installed on helicopters to monitor the health state of their transmission systems and predict remaining useful life of key helicopter components. However, recent helicopter accidents related to MGB failures indicate that HUMS is not sensitive and accurate enough to diagnose MGB planetary bearing defects. To contribute in improving the diagnostic capability of HUMS, diagnosis of a MGB planetary bearing with seeded defect was investigated in this study. A commercial SA330 MGB was adopted for the seeded defect tests. Two test cases are demonstrated in this paper: the MGB at 16,000 rpm input speed with 180 kW load and at 23,000 rpm input speed with 1760 kW load. Vibration data was recorded, and processed using signal processing techniques including self-adaptive noise cancellation (SANC), kurtogram and envelope analysis. Processing results indicate that the seeded planetary bearing defect was successfully detected in both test cases

Helicopter gearbox bearing fault detection using separation techniques and envelope analysis

The main gearbox (MGB) is a crucial part of a helicopter. MGB bearings suffer intensively from stress and friction during flights hence concerns for their health condition and detecting potential defects become critical for the sake of operation safety and system reliability. In this study, bearing defects were seeded in the second epicyclic stage bearing of a commercial Class A helicopter MGB. Vibration and tachometer signals were recorded simultaneously for the purpose of fault diagnosis. The tests were carried out at different power and speed conditions for various seeded bearing defects. This paper presents a comparison of signal processing techniques employed to identify the presence of the defects masked by strong background noise generated from an operation helicopter MGB

EFISIEBSI PEMASARAN KOPI DI DESA NGENEP KECAMATAN KARANGPLOSO KABUPATEN MALANG

Pemasaran merupakan proses yang harus dilalui petani sebagaiprodusenuntuk menyalurkan produknya hingga sampai ke tangan konsumen. penelitian ini bertujuan untuk mengidentifikasi dan mendiskripsikan saluran pemasaran kopi dan aktivitas pemasaran kopidan untuk mengetahui efisiensi pemasaran kopi dilihat dari besar margin, share margin, integrasi pasar dan elastisitas transmisi harga kopi pada masing-masing saluran pemasaran kopi di Desa Ngenep Kecamatan Karangploso Kabupaten Malang.Penelitian dilakukan pada 3 juni 2021-20 juli 2021. Pendekatan peneltian yang    digunakan yaitu metode analisis deskriptif dan metode analsisi kuantitatif.Analisis yang dilakukan meliputi analisis marjin Lembaga Pemasaran, Distribusi Margin,Share, Efisiensi Pemasaran, Analisis Integrasi Pasar, Analisis Elastisitas Transmisi Harga. Hasil dari penelitian didapatkan 2 saluran pemasaran yang terlibat yaitu:a.Saluran I: Petani-Pedagang Pengumpul-Konsumen.b.Saluran II: Petani-Pedagang Pengumpul-Pedagang Besar-Konsumen.Dari kedua saluran pemasaran dilahat dari margin yang lebih efisien yaitu pada saluran II dengan nilai margin yanglebih kecil dari saluran I yaitu sebesar Rp. 18.576/Kg, sedangkan margin pada saluran I sebesar Rp.18.950/Kg. Distribusi margin paling besar terjadi pada biaya penyusutan. Pada saluran I distribusi margin pada pedagang pengumpul sebesar Rp.16.660 sedangkan pada saluran II pada pedagang pengumpul sebesar RP. 15.159,95 dan pedagang besar sebesar Rp 485. Efisiensi margin pada saluran I yaitu sebesar 77,34%, saluran IIsebesar 76,60. Integrasi pasar yang terjadi adalah pasar persaingan tidak sempurna yang dimana struktur pasar merupakan pasar monopsoniyang dikarenakan nilai koefisien regresi 1 yang artinya jika harga kopi naik sebesar 1% ditingkat lembaga pemasaran diatasnya maka akan meningkatkan harga ditingkat produsen . Nilai Et >1atau < 1menunjukkan bahwa pemasaran kopi belum efisien yang dikarenakan oleh adanya pasar bersaing tidak sempurna.Katakunci: Kopi, Saluran pemasaran, margin pemasaran, bagian hasil yang diterima petani