Knowledge, attitude and practices of postgraduates, interns and nurses, on adverse drug reaction reporting in a tertiary care hospital: a comparative study

Background: Pharmacovigilance is multidisciplinary field of the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs). The incidences of ADRs about 95% are undocumented worldwide. However, there is a lack of information on ADR burden in developing countries due to lack of resources, infrastructure, and expertise.Methods: A cross-sectional questionnaire-based study was conducted on 90 staff nurses 90interns and 90 postgraduates. The validated questionnaire contained items to check knowledge including 7 questions, 9 questions to analyze attitude and 5 for practices. Comparison between knowledge, attitude and practice data obtained from resident doctors and nurses was performed using Chi square test.Results: A total of 270 healthcare professionals participated in the study. In our study the participants had good knowledge regarding the purpose of monitoring and reporting ADRs etc. The result shows that health care professionals felt reporting of ADRs is a professional obligation and all ADRs should be reported. There was no significant difference in the knowledge and attitude between interns and nurses but few questionnaires show significant variations between post graduate and staff nurse. The practice of ADR reporting was significantly higher in postgraduate compared to nurses.Conclusions: This study concluded that post graduate, intern and staff nurse had good knowledge and positive attitude towards pharmacovigilance and ADR reporting, but unfortunately the actual practice of ADR reporting is still deficient among staff nurse and intern. This can be improved by adequate training and motivation

Analysis of the Stability of Openings Excavated in Anisotropic Rocks

Openings excavated in rocks with anisotropic strength are often affected by serious instability, related to slip along the weakness planes. The Jaeger criterion, which is a discontinuous approach, is widely used in the mining and oil and gas industry, because is based on well-known rock strength parameters. However, this model cannot capture features related to the stability of openings drilled in some anisotropic rocks with the combined effect of the in situ state of stress. The Hoek & Brown criterion, adapted to anisotropic rocks, is a continuous criterion that can describe the complex behavior of different types of anisotropy exhibited by rock material. Here we interpreted the results of triaxial tests carried out on a shale and we defined the parameters of the Jaeger criterion and the modified Hoek & Brown criterion. We investigated the stability of boreholes drilled in this shale by varying the in situ state of stress and we compared the results of the two criteria. We found that the Hoek & Brown criterion can appropriately describe the behavior of this shale and can predict more accurately the width of the instability of openings excavated in different conditions

Energetics Based Spike Generation of a Single Neuron: Simulation Results and Analysis

Existing current based models that capture spike activity, though useful in studying information processing capabilities of neurons, fail to throw light on their internal functioning. It is imperative to develop a model that captures the spike train of a neuron as a function of its intracellular parameters for non-invasive diagnosis of diseased neurons. This is the first ever article to present such an integrated model that quantifies the inter-dependency between spike activity and intracellular energetics. The generated spike trains from our integrated model will throw greater light on the intracellular energetics than existing current models. Now, an abnormality in the spike of a diseased neuron can be linked and hence effectively analyzed at the energetics level. The spectral analysis of the generated spike trains in a time–frequency domain will help identify abnormalities in the internals of a neuron. As a case study, the parameters of our model are tuned for Alzheimer’s disease and its resultant spike trains are studied and presented. This massive initiative ultimately aims to encompass the entire molecular signaling pathways of the neuronal bioenergetics linking it to the voltage spike initiation and propagation; due to the lack of experimental data quantifying the inter dependencies among the parameters, the model at this stage adopts a particular level of functionality and is shown as an approach to study and perform disease modeling at the spike train and the mitochondrial bioenergetics level

Research to develop Spiritual Pedagogy, Awareness and Change

This is an Accepted Manuscript of an article published by Taylor & Francis in British Journal of Guidance and Counselling on 21-4-16, available online: http://dx.doi.org/10.1080/03069885.2016.1174976A co-operative inquiry group consisting of 8 counsellors met for 11 months to explore their experience of spirituality in their counselling training and in their work with clients (Swinton, 2010; 2015). The aim was to explore whether spirituality was absent from the process of counselling training, specifically to discover (1) how counsellors perceived and described their experience of spirituality in their training and (2) with a view to developing spiritual pedagogy; how spirituality could be incorporated into the training process of practitioner

Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett's oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry.

BACKGROUND: Barrett's oesophagus (BE) is a pre-malignant condition leading to oesophageal adenocarcinoma (OAC). Treatment of neoplasia at an early stage is desirable. Combined endoscopic mucosal resection (EMR) followed by radiofrequency ablation (RFA) is an alternative to surgery for patients with BE-related neoplasia. METHODS: We examined prospective data from the UK registry of patients undergoing RFA/EMR for BE-related neoplasia from 2008 to 2013. Before RFA, visible lesions were removed by EMR. Thereafter, patients had RFA 3-monthly until all BE was ablated or cancer developed (endpoints). End of treatment biopsies were recommended at around 12 months from first RFA treatment or when endpoints were reached. Outcomes for clearance of dysplasia (CR-D) and BE (CR-IM) at end of treatment were assessed over two time periods (2008-2010 and 2011-2013). Durability of successful treatment and progression to OAC were also evaluated. RESULTS: 508 patients have completed treatment. CR-D and CR-IM improved significantly between the former and later time periods, from 77% and 56% to 92% and 83%, respectively (p<0.0001). EMR for visible lesions prior to RFA increased from 48% to 60% (p=0.013). Rescue EMR after RFA decreased from 13% to 2% (p<0.0001). Progression to OAC at 12 months is not significantly different (3.6% vs 2.1%, p=0.51). CONCLUSIONS: Clinical outcomes for BE neoplasia have improved significantly over the past 6 years with improved lesion recognition and aggressive resection of visible lesions before RFA. Despite advances in technique, the rate of cancer progression remains 2-4% at 1 year in these high-risk patients. TRIAL REGISTRATION NUMBER: ISRCTN93069556

Web services at the European Bioinformatics Institute-2009

The European Bioinformatics Institute (EMBL-EBI) has been providing access to mainstream databases and tools in bioinformatics since 1997. In addition to the traditional web form based interfaces, APIs exist for core data resources such as EMBL-Bank, Ensembl, UniProt, InterPro, PDB and ArrayExpress. These APIs are based on Web Services (SOAP/REST) interfaces that allow users to systematically access databases and analytical tools. From the user's point of view, these Web Services provide the same functionality as the browser-based forms. However, using the APIs frees the user from web page constraints and are ideal for the analysis of large batches of data, performing text-mining tasks and the casual or systematic evaluation of mathematical models in regulatory networks. Furthermore, these services are widespread and easy to use; require no prior knowledge of the technology and no more than basic experience in programming. In the following we wish to inform of new and updated services as well as briefly describe planned developments to be made available during the course of 2009–2010

Evaluation of Mental Health First Aid from the Perspective Of Workplace End UseRs—EMPOWER: protocol of cluster randomised trial phase

Background: Mental Health First Aid (MHFA) is a mental health intervention that teaches people how to identify, understand and help someone who may be experiencing a mental health issue. Reviews of the implementation of MHFA found between 68 and 88% of trained Mental Health First Aiders had used their skills when in contact with someone experiencing mental health difficulties. Reviews evaluating the impact of MHFA suggest positive outcomes. However, to date, there has been no systematic, rigorous evaluation of the impact of MHFA on recipients of the intervention, the organisations providing it and the cost-effectiveness of MHFA overall. This trial will evaluate the effectiveness and cost-effectiveness of MHFA. Methods: The study is a multi-centred, two-arm clustered randomised controlled trial. Organisations will be randomly allocated to the control or intervention (estimated sample size 800 recipients). The intervention is the standard MHFA intervention provided by Mental Health First Aid England (MHFAE). The control condition will be organisations having a brief consultation from MHFAE on promoting mental health and well-being in the workplace. The primary outcome is health seeking behaviour, measured using the Actual Help Seeking Questionnaire, at 6 months’ follow-up. Data collection will be undertaken at baseline (T0), post-intervention—up to 3 months (T1), at 6 months (T2), 12 months (T3) and 24 months (T4). The primary analysis will be conducted on those participants who receive MHFA, a per protocol analysis. Discussion: The study is the first to evaluate the effect of MHFA in the workplace on employees with direct and indirect experience of the intervention, when compared with usual practice. Being also the first to assess, systematically, the social impact of MHFA and investigate its cost-effectiveness adds to the originality of the study. The study promises to yield important data, as yet unknown, regarding the effectiveness, cost-effectiveness, implementation issues, and the sustainability of MHFA in the workplace

Integration of time-series meta-omics data reveals how microbial ecosystems respond to disturbance.

The development of reliable, mixed-culture biotechnological processes hinges on understanding how microbial ecosystems respond to disturbances. Here we reveal extensive phenotypic plasticity and niche complementarity in oleaginous microbial populations from a biological wastewater treatment plant. We perform meta-omics analyses (metagenomics, metatranscriptomics, metaproteomics and metabolomics) on in situ samples over 14 months at weekly intervals. Based on 1,364 de novo metagenome-assembled genomes, we uncover four distinct fundamental niche types. Throughout the time-series, we observe a major, transient shift in community structure, coinciding with substrate availability changes. Functional omics data reveals extensive variation in gene expression and substrate usage amongst community members. Ex situ bioreactor experiments confirm that responses occur within five hours of a pulse disturbance, demonstrating rapid adaptation by specific populations. Our results show that community resistance and resilience are a function of phenotypic plasticity and niche complementarity, and set the foundation for future ecological engineering efforts