Reduce Patient Falls at Skilled Nursing Facility

Falls and related injuries are becoming a massive concern for healthcare systems. Preventing falls should be the top priority for healthcare organizations. Since the risk of falling cannot be eliminated, implementing a plan that addresses fall prevention strategies can significantly reduce the number of falls. This article explores evidence-based practice (EBP) interventions in order to prevent elderly patient falls in a skilled nursing facility (SNF). The EBP research interventions, such as fall screening tools used for patient assessment, safety education classes for staff, bedside nursing communication exchange, and daily nursing leadership rounds, can have a vital effect on patient and staff safety. The fall prevention interventions were implemented in 2019 for a fall reduction project at a 120-bed SNF located in the San Francisco Bay area. The goal was to reduce fall incidents by 50% and increase safety knowledge among the staff by 50% within one year of the Centers for Medicare & Medicaid Services state survey window. The ongoing project outcome data show dramatically reduced inpatient falls and increased safety knowledge among the staff

Optimization-based decision support system for retail souring

Thesis (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; and, (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division; in conjunction with the Leaders for Global Operations Program at MIT, 2012.Cataloged from PDF version of thesis.Includes bibliographical references (p. 83-84).Some of the biggest challenges in the retail sourcing lie in predicting demand for a new article and making purchase decisions such as quantity, source, transportation mode and time of the order. Such decisions become more complex and time consuming as the number of SKUs and suppliers increase. The thesis addresses the issue of managing retail sourcing using forecasting and optimization based decision system developed for Zara, a leading fast-fashion clothing retailer. We started with an existing pre-season demand forecasting method that uses POS data from a comparable older article to forecast demand for a new article after adjusting for stock-outs and seasonality. We developed and compared various forecast updating methods for accuracy and found that an exponential smoothing-based model, modified to accommodate for changes in level few steps ahead, resulted in highest accuracy using Cumulative Absolute Percentage Error (CAPE). Next, we implemented a profit-maximizing optimization model to produce explicit sourcing decisions such as quantity, time and source of orders. The model takes in distributional forecasts, supply constraints, holding cost, pricing information and outputs explicit sourcing decisions mentioned above. A prototype for forecasting and optimization code is ready and currently being evaluated to secure approval for a live pilot for Summer 2013 campaign sourcing.by Jalpa Patel.S.M.M.B.A

Performance Analysis of Reputation based Proof of Credibility Consensus Mechanism for Blockchain based Applications

Blockchain is a decentralized transaction and data management technology first developed for the Bitcoin cryptocurrency. Blockchain technology is gaining popularity due to its core attributes which provides security, anonymity and data integrity without any involvement of third party. Consensus mechanism is a procedure by which all peers in the blockchain network agrees to a common agreement on the current state of the distributed ledger. It plays vital role in increasing efficiency of any blockchain environment. Though we have many consensus mechanisms working currently in different areas but they still lack in parameters like status of validators, latency, node failure etc. In Our proposed algorithm Proof of credibility, we have tried to incorporate all above factors in it. We have also implemented two or more factors of proposed algorithm and have evaluated and compared with existing consensus algorithm. In future research we aim to implement RPoC in any blockchain network and then we will evaluate it in terms of different evaluation parameters such as performance, security, scalability

Acute Toxicity Sudy of Eladi Quatha: A Compound Ayurvedic Formulation

In the modern era, the Indian Ayurvedic system of Medicine is believed to treat diseases from the root cause. The ayurvedic system claims to have many indigenous plants and herbal preparations, which provide therapeutic benefit in the treatment of kidney diseases. Aim – To study the benefits of herbal preparation Eladi quatha for kidney disease Urothalisis. Method - This study was undertaken to explore the effects of Eladi quatha in animals to treat kidney stone diseases. However, no safety profile for this formulation has been reported to date; thus, in this study, freshly prepared Eladi quatha was evaluated for acute toxicity. Acute toxicity test was evaluated as per OECD 423 guidelines with 5000 mg/kg as a limit test in Wistar strain Albino rats. Test formulations were administered to overnight fasted animals and parameters like body weight, behavioral changes, and mortality were assessed for 14 days. Hematological and biochemical parameters were assessed on the 14th day after administration. Result - No significant changes were noted in terms of behavioral changes, mortality, and body weight. The samples did not affect any of the hematological parameters. However, an increase in blood urea level was observed. Conclusion- This study concludes that freshly prepared Eladi quatha is relatively safe up to the dose of 5000 mg/kg. However, further chronic toxicity evaluation is necessary to establish its safety profile on chronic administration

Prescribing quality in patients with chronic diseases at primary and secondary health care facilities using prescription quality index tool

Background: Prescribing quality is a matter of major concern worldwide. This study was carried out to determine the quality of prescribing in chronic diseases at primary health care (PHC) and secondary health care (SHC) settings using the new prescription quality index (PQI) tool.Methods: A cross-sectional observational study was carried out at four PHC and two SHC facilities in Anand district of India. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33), and high quality (score 34-43) based on PQI total score. The internal consistency of PQI was measured using item total correlation and Cronbach’s α so as to validate it in our settings. Data were analyzed using Statistical Package for Social Science 20.Results: A total of 134 prescriptions were collected and evaluated for quality of prescribing. Mean age of patients was 60.6 ± 13.5 years. Mean PQI score was 23.60 ± 9.3 with 71.6% prescriptions being of poor quality. Quality of prescribing did not differ at PHC and SHC (P>0.05). Of 22 criteria, PQI score was strongly correlated with drug indication, drug effectiveness, evidence-based prescribing, unnecessary duplication, duration of therapy, and cost (P<0.01). PQI total score was negatively correlated to the number of drugs per prescription. Cronbach’s α for the entire 22 criteria were 0.90.Conclusion: PQI was found to be a reliable tool for assessment of prescribing quality in chronic diseases

A study of vaginismus in patients presenting with infertility

Background: Vaginismus is an uncommonly reported entity, most of the patients present to the gynaecologist with complaint of inability to conceive. Female sexual dysfunctions are a common entity but difficult to diagnose and treat, Vaginismus is one of the categories of female sexual dysfunction.Methods: Total 25 patients out of 900 patients attending the outdoor of Shivanjali Women’s Hospital for infertility from the year 2008 to 2016 were found to be having vaginismus. With couple’s consent females were treated for vaginismus. This is a retrospective study of 25 patients identified having vaginismus.Results: Maximum 11 patients were in age group of 20 to 25 years. Forty percent 10 patients improved with counselling and education, lubricant gel and analgesic gel. Total 84% (21) patients conceived with different modes of treatment.Conclusions: Vaginismus is uncommonly reported. With proper history and counselling of the couple vaginismus can be revealed, managed and conception can be achieved

Inclusive Review on Existing Treatment and Management Modalities for Covid-19

COVID 19 is widely regarded as one of the worst pandemics of the twenty-first century. The World Health Organization (WHO) named the viral infection caused by the new coronavirus (COVID-19), which was first reported in December 2019, as severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV2), and it became a cause of death for many all over the world. As a result, a unique inquiry and clinical trial to find a solution for this catastrophic pandemic disease is under way. To manage and eradicate the disease, effective vaccinations and antiviral therapies are urgently needed. There were no treatments or vaccines available for this fatal virus at first, but several medications that are used to treat other diseases are now being used to treat Covid19. Remdesivir has been licenced for therapy since it has shown to shorten hospital stays. Corticosteroids reduced mortality in patients requiring oxygen supplementation or mechanical ventilation. The purpose of this review is to make readers aware of the possible efficacy and availability treatment for this viral infection

Comparison of oral nifedipine and oral labetalol as a single drug therapy for control of blood pressure in preeclampsia

Background: Worldwide hypertension during pregnancy is a common cause of maternal and fetal morbidity and mortality. Effective control of blood pressure is one of the important steps in management of preeclampsia. Few drugs like nifedipine, labetalol, methyldopa, and hydralazine have acceptable high safety profile during pregnancy.Methods: In this study 120 antenatal women with non-severe preeclampsia were compared by giving either nifedipine or labetalol as a single drug therapy for control of blood pressure. Various parameters like control of blood pressure, side effects of drugs, gestational age at the time of delivery, mode of delivery, any complication and perinatal outcome were assessed.Results: In this study authors found that in both group, adequate control of blood pressure was achieved. This study shows slightly higher rate of pre term delivery and LSCS with labetalol and minimal side effects with nifedipine but difference in each group is insignificant.Conclusions: Labetalol and nifedipine both the drugs are equally effective in reducing blood pressure and any of it can safely be used as a first choice of drug for management of hypertension in preeclampsia and it can be decided as per clinician’s experience and familiarity with drug

Metastatic Renal Cell Carcinoma Presenting as Gastrointestinal Bleeding

Approximately 85% of kidney tumors are renal cell carcinoma (RCC). RCC commonly metastasizes to the lung, bone, and lymph nodes; however, gastric metastasis is exceedingly rare. We present an 86-year-old woman with left-sided RCC with known metastatic disease to the lungs, lymph nodes, and bone, who presented with acute blood loss anemia. After hemodynamic stabilization, esophagogastroduodenoscopy revealed a large infiltrative, polypoid, and ulcerated polyp in the gastric body. After complete polypectomy, histological examination demonstrated gastric mucosa ulcerated by clear-cell carcinoma, compatible with metastatic RCC. Our patient was successfully treated with palliative radiation to the gastric body