Drug Management Reviews in District Drug Management Unit and General Hospital

Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following the decentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had not been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years

Zero-bias molecular electronics: Exchange-correlation corrections to Landauer's formula

Standard first principles calculations of transport through single molecules miss exchange-correlation corrections to the Landauer formula. From Kubo response theory, both the Landauer formula and these corrections in the limit of zero bias are derived and calculations are presented.Comment: 4 pages, 3 figures, final version to appear in Phys. Rev. B, Rapid Communication

Call-by-Name Gradual Type Theory

We present gradual type theory, a logic and type theory for call-by-name gradual typing. We define the central constructions of gradual typing (the dynamic type, type casts and type error) in a novel way, by universal properties relative to new judgments for gradual type and term dynamism. These dynamism judgements build on prior work in blame calculi and on the "gradual guarantee" theorem of gradual typing. Combined with the ordinary extensionality (eta) principles that type theory provides, we show that most of the standard operational behavior of casts is uniquely determined by the gradual guarantee. This provides a semantic justification for the definitions of casts, and shows that non-standard definitions of casts must violate these principles. Our type theory is the internal language of a certain class of preorder categories called equipments. We give a general construction of an equipment interpreting gradual type theory from a 2-category representing non-gradual types and programs, which is a semantic analogue of the interpretation of gradual typing using contracts, and use it to build some concrete domain-theoretic models of gradual typing

Follow-up question handling in the IMIX and Ritel systems: A comparative study

One of the basic topics of question answering (QA) dialogue systems is how follow-up questions should be interpreted by a QA system. In this paper, we shall discuss our experience with the IMIX and Ritel systems, for both of which a follow-up question handling scheme has been developed, and corpora have been collected. These two systems are each other's opposites in many respects: IMIX is multimodal, non-factoid, black-box QA, while Ritel is speech, factoid, keyword-based QA. Nevertheless, we will show that they are quite comparable, and that it is fruitful to examine the similarities and differences. We shall look at how the systems are composed, and how real, non-expert, users interact with the systems. We shall also provide comparisons with systems from the literature where possible, and indicate where open issues lie and in what areas existing systems may be improved. We conclude that most systems have a common architecture with a set of common subtasks, in particular detecting follow-up questions and finding referents for them. We characterise these tasks using the typical techniques used for performing them, and data from our corpora. We also identify a special type of follow-up question, the discourse question, which is asked when the user is trying to understand an answer, and propose some basic methods for handling it

Anomalous Axion Interactions and Topological Currents in Dense Matter

Recently an effective Lagrangian for the interactions of photons, Nambu-Goldstone bosons and superfluid phonons in dense quark matter has been derived using anomaly matching arguments. In this paper we illuminate the nature of certain anomalous terms in this Lagrangian by an explicit microscopic calculation. We also generalize the corresponding construction to introduce the axion field. We derive an anomalous axion effective Lagrangian describing the interactions of axions with photons and superfluid phonons in the dense matter background. This effective Lagrangian, among other things, implies that an axion current will be induced in the presence of magnetic field. We speculate that this current may be responsible for the explanation of neutron star kicks.Comment: 10 page

Patient attitudes towards analgesia and their openness to non-pharmacological methods such as acupuncture in the emergency department

Aims: To investigate patient attitudes to analgesia, opioids and non-pharmacological analgesia including acupuncture, in the ED. Methods: ED patients with pain were surveyed regarding: pain scores, satisfaction, addiction concern, non-pharmacological methods of pain relief, and acupuncture. Data were analysed using logistic regression. Results: Of 196 adult patients, 52.8% were ‘very satisfied’ with analgesia. Most patients (84.7%) would accept non-pharmacological methods including acupuncture (68.9%) and 78.6% were not concerned about addiction. Satisfaction was associated with male gender, and ‘adequate analgesia’ but not with opioids. Conclusion: Most patients were generally satisfied with ED analgesia and were open to non-pharmacologic analgesia including acupuncture

Sarana Dan Prasarana Rumah Sakit Pemerintah Dalam Upaya Pencegahan Dan Pengendalian Infeksi Di Indonesia

Nosocomial infections is an important issue around the world. Hospitals are required to provide qualified, efficient and effective service to ensure patient safety. The Ministry of Health has revitalized prevention and control of infection program (PPI) in hospitals which is one of the cornerstones towards patient Safety. The purpose of this study is to identify the preparedness of hospitals to implement the PPI program. The data source is Health Facility Research of 2011 which was done by National Institute of Health Research and Development. The aspects examined include facility, infrastructure, human resource, organization, guidelines, compliance in prescribing, the availability of clean water and hospital sewage treatment. The results show that many hospitals are not yet ready to conduct PPI, especially in terms of infrastructure, clean water sterilization and processing waste, mostly hospitals of classes C and D. Sewage treatment is important in the control or prevention of spread of antimicrobial resistance. This program gives many benefits especially in preventing the occurrence of total resistance or back to the era before antibiotics. The PPI program does require a large fee such that hospital management often disapproves, although the result of available cost analysis indicates that PPI is highly cost-effective

Protocol for the Reconstructing Consciousness and Cognition (ReCCognition) Study

Important scientific and clinical questions persist about general anesthesia despite the ubiquitous clinical use of anesthetic drugs in humans since their discovery. For example, it is not known how the brain reconstitutes consciousness and cognition after the profound functional perturbation of the anesthetized state, nor has a specific pattern of functional recovery been characterized. To date, there has been a lack of detailed investigation into rates of recovery and the potential orderly return of attention, sensorimotor function, memory, reasoning and logic, abstract thinking, and processing speed. Moreover, whether such neurobehavioral functions display an invariant sequence of return across individuals is similarly unknown. To address these questions, we designed a study of healthy volunteers undergoing general anesthesia with electroencephalography and serial testing of cognitive functions (NCT01911195). The aims of this study are to characterize the temporal patterns of neurobehavioral recovery over the first several hours following termination of a deep inhaled isoflurane general anesthetic and to identify common patterns of cognitive function recovery. Additionally, we will conduct spectral analysis and reconstruct functional networks from electroencephalographic data to identify any neural correlates (e.g., connectivity patterns, graph-theoretical variables) of cognitive recovery after the perturbation of general anesthesia. To accomplish these objectives, we will enroll a total of 60 consenting adults aged 20–40 across the three participating sites. Half of the study subjects will receive general anesthesia slowly titrated to loss of consciousness (LOC) with an intravenous infusion of propofol and thereafter be maintained for 3 h with 1.3 age adjusted minimum alveolar concentration of isoflurane, while the other half of subjects serves as awake controls to gauge effects of repeated neurobehavioral testing, spontaneous fatigue and endogenous rest-activity patterns