ASSESSMENT OF ANTIBIOTIC USAGE PATTERN IN PATIENTS OF PEDIATRIC DEPARTMENT-A PROSPECTIVE STUDY

Objective: The study aimed to assess the antibiotic usage pattern in patients of the pediatric department in ESI Hospital, Indiranagar, Bangalore. Methods: A prospective six-month observational study was conducted in the pediatric department. The history of the patients was collected from the case sheets and the patient demographic details were also collected. The details of antibiotics prescribed and the other therapy applied to the patients were collected in terms of dosage, duration, and route of administration. The antibiotic consumption was assessed based on qualitative and quantitative indicators which assess the appropriateness of antibiotic use, and the dosage of antibiotics prescribed, respectively. Regarding the qualitative evaluation of antibiotic consumption, the World Health Organization (WHO) guideline was considered to appraise compliance with indication and dosing. Results: Distribution of drug prescription indicators showed that the average number of drugs per encounter was 3.7, which is more than the standards suggested by WHO and should be reduced as much as possible to mitigate polypharmacy and its consequences. 93.45% of encounters existed leastwise with one or more antibiotics, which was higher than the WHO standards. Almost 56.08% of drugs were prescribed considering their generic name, which was very much lower than the ideal percentage recommended by WHO. Conclusion: The percentage of encounters with one or more antibiotics was very higher than the WHO standard percentage, which indicates the irrationality of antibiotic prescribing. To minimize the irrationality of prescriptions and their inappropriateness, effective interventions and compliance with antibiotic prescribing guidelines are required

Enhanced meshfree RPIM with NURBS basis function for analysis of irregular boundary domain

Radial Point Interpolation Method (RPIM) has become a powerful tool to numerical analysis due to its ability to provide a higher-order approximation function with the Kronecker delta property, by which the field nodes can be fitted exactly. However, one of the major drawbacks of RPIM is the inefficiency in handling irregular domain problems. This paper presents an enhanced RPIM formulation that employs Non-Uniform Rational B-Splines (NURBS) basis functions to represent the exact geometry of the boundary domain. The NURBS is a mathematical model which provides an efficient and numerically stable algorithm to exactly represent all conic sections in engineering modelling. Taking advantage of the flexibility and adaptivity of RPIM approximation and the accuracy of geometric representations by NURBS, this new method is able to improve geometry accuracy and flexibility in numerical analysis, thus providing a better and more rational approach to analyze irregular domain problems. Numerical problem of steady heat transfer considering curved beam is presented to verify the validity and accuracy of the developed method. The essential boundary condition can simply be imposed using direct imposition as in Finite Element Method (FEM). The result shows that the RPIM/NURBS achieved the converged solution much faster than conventional RPIM and FEM, with the number of nodes required only less than 200 for an error of less than 0.01%. This shows the potential of the developed method as a powerful numerical technique for future development

Ablation of the Sam68 RNA Binding Protein Protects Mice from Age-Related Bone Loss

The Src substrate associated in mitosis of 68 kDa (Sam68) is a KH-type RNA binding protein that has been shown to regulate several aspects of RNA metabolism; however, its physiologic role has remained elusive. Herein we report the generation of Sam68-null mice by homologous recombination. Aged Sam68(−/−) mice preserved their bone mass, in sharp contrast with 12-month-old wild-type littermates in which bone mass was decreased up to approximately 75%. In fact, the bone volume of the 12-month-old Sam68(−/−) mice was virtually indistinguishable from that of 4-month-old wild-type or Sam68(−/−) mice. Sam68(−/−) bone marrow stromal cells had a differentiation advantage for the osteogenic pathway. Moreover, the knockdown of Sam68 using short hairpin RNA in the embryonic mesenchymal multipotential progenitor C3H10T1/2 cells resulted in more pronounced expression of the mature osteoblast marker osteocalcin when differentiation was induced with bone morphogenetic protein-2. Cultures of mouse embryo fibroblasts generated from Sam68(+/+) and Sam68(−/−) littermates were induced to differentiate into adipocytes with culture medium containing pioglitazone and the Sam68(−/−) mouse embryo fibroblasts shown to have impaired adipocyte differentiation. Furthermore, in vivo it was shown that sections of bone from 12-month-old Sam68(−/−) mice had few marrow adipocytes compared with their age-matched wild-type littermate controls, which exhibited fatty bone marrow. Our findings identify endogenous Sam68 as a positive regulator of adipocyte differentiation and a negative regulator of osteoblast differentiation, which is consistent with Sam68 being a modulator of bone marrow mesenchymal cell differentiation, and hence bone metabolism, in aged mice

Comparison of Random Walk Based Techniques for Estimating Network Averages

International audienceFunction estimation on Online Social Networks (OSN) is an important field of study in complex network analysis. An efficient way to do function estimation on large networks is to use random walks. We can then defer to the extensive theory of Markov chains to do error analysis of these estimators. In this work we compare two existing techniques, Metropolis-Hastings MCMC and Respondent-Driven Sampling, that use random walks to do function estimation and compare them with a new reinforcement learning based technique. We provide both theoretical and empirical analyses for the estimators we consider

Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

<p>Abstract</p> <p>Background</p> <p>When detected, HIV can be effectively treated with antiretroviral therapy. Nevertheless in the U.S. approximately 25% of those who are HIV-infected do not know it. Much remains unknown about how to increase HIV testing rates. New Internet outreach methods have the potential to increase disease awareness and screening among patients, especially as electronic personal health records (PHRs) become more widely available. In the US Department of Veterans' Affairs medical care system, 900,000 veterans have indicated an interest in receiving electronic health-related communications through the PHR. Therefore we sought to evaluate the optimal circumstances and conditions for outreach about HIV screening. In an exploratory, qualitative research study we examined patient and provider perceptions of Internet-based outreach to increase HIV screening among veterans who use the Veterans Health Administration (VHA) health care system.</p> <p>Findings</p> <p>We conducted two rounds of focus groups with veterans and healthcare providers at VHA medical centers. The study's first phase elicited general perceptions of an electronic outreach program to increase screening for HIV, diabetes, and high cholesterol. Using phase 1 results, outreach message texts were drafted and then presented to participants in the second phase. Analysis followed modified grounded theory.</p> <p>Patients and providers indicated that electronic outreach through a PHR would provide useful information and would motivate patients to be screened for HIV. Patients believed that electronic information would be more convenient and understandable than information provided verbally. Patients saw little difference between messages about HIV versus about diabetes and cholesterol. Providers, however, felt patients would disapprove of HIV-related messages due to stigma. Providers expected increased workload from the electronic outreach, and thus suggested adding primary care resources and devising methods to smooth the flow of patients getting screened. When provided a choice between unsecured emails versus PHRs as the delivery mechanism for disease screening messages, both patients and providers preferred PHRs.</p> <p>Conclusions</p> <p>There is considerable potential to use PHR systems for electronic outreach and social marketing to communicate to patients about, and increase rates of, disease screening, including for HIV. Planning for direct-to-patient communications through PHRs should include providers and address provider reservations, especially about workload increases.</p

A Re-conceptualization of Access for 21st Century Healthcare

Many e-health technologies are available to promote virtual patient–provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital “encounterless” utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access

‘Albania: €1’ or the story of ‘big policies, small outcomes’: how Albania constructs and engages its diaspora

Since the fall of the communist regime in the early 1990s, Albania has experienced one of the most significant emigrations in the world as a share of its population. By 2010 almost half of its resident population was estimated to be living abroad – primarily in neighbouring Greece and Italy, but also in the UK and North America. This chapter discusses the emergence and establishment of the Albanian diaspora, its temporal and geographical diversity, and not least its involvement with Albania itself. Albania’s policymaking and key institutions are considered, with a focus on matters of citizenship; voting rights; the debate on migration and development; and not least the complex ways in which kin-state minority policies – related to ethnic Albanians living in Kosovo, Montenegro, southern Serbia, Macedonia and Greece – are interwoven with Albania’s emigration policies

The Role of HIV-Related Knowledge and Ethnicity in Determining HIV Risk Perception and Willingness to Undergo HIV Testing Among Rural Women in Burkina Faso

We conducted a random community based survey of 300 young (15–29 years) rural women in Nouna, Burkina Faso. Only one-third of women were aware that a person could have HIV without having symptoms and these women were significantly more likely to classify themselves to be at high risk for getting HIV. Furthermore, multiple partners, Bwaba ethnicity and having mentioned a health worker as a source of HIV information were significantly associated with perceived high personal risk. Perceived willingness to participate in VCT was high (69%). The dissemination of information on the asymptomatic nature of HIV infection could potentially be very important in forming risk perception, awareness, and their willingness to participate in HIV interventions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44011/1/10461_2005_Article_3905.pd

Application of narration in architecture education

Narration in education by using all the elements of narrative literature is one of the active teaching methods. This method has already been used in teaching children and adolescents, but research about the application of method in different branches of academic education, such as engineering, medicine etc has recently started. Narration is one of the human mind bases for thinking in different areas of science and art. Considering the research topic is new, library studies ful bfiled first and then quasi-experimental study was used to prove the research results, Library studies was used by the researchers to compare the structure of both story and architecture in order to find their interactional relationship and bilateral effects on each. The psychological impact of narration on architecture education has been investigated in different subjects. A quasi-experimental study was carried out as two-groups, post-test only in faculty of architecture of Bushehr Azad University in 2010. Two groups each including 29 architecture students and achieved results were compared using t-test by SPSS software. As a result, considering to narrative nature of architecture, narration can be used in sense of space and architecture design. It is highly recommended to use narration in architecture education. It also helps the students to keep learned architecture concepts and ethic values in their mind for a long period of time. The mean of the total scores achieved by the lecture group was 11.7±1.31 and by storytelling group was 14.1±1.05 out of the total score 20. The difference between the two groups was statistically significant. The finding of this research can be applied in digital stories and, production of pedagogical books, films and computer games, which cause a familiarity with the architect tural by society as well as prepare children to understand the architecture