Зарубежный опыт в материальном стимулировании персонала

Материалы XVII Междунар. науч.-техн. конф. студентов, аспирантов и молодых ученых, Гомель, 27–28 апр. 2017 г

Решение обратной задачи кинематики шестизвенного робота

Материалы XX Междунар. науч.-техн. конф. студентов, аспирантов и молодых ученых, Гомель, 23–24 апр. 2020 г

Mapping private pharmacies and their characteristics in Ujjain district, Central India

<p>Abstract</p> <p>Background</p> <p>In India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines. These are often the first points of treatment seeking in parts of India and other low income settings around the world. The characteristics of these pharmacies including their location, drug availability, human resources and infrastructure have not been studied before. Given the ubiquity and popularity of private pharmacies in India, such information would be useful to harness the potential of these pharmacies to deliver desirable public health outcomes, to facilitate regulation and to involve in initiatives pertaining to rational drug use. This study was a cross sectional survey that mapped private pharmacies in one district on a geographic information system and described relevant characteristics of these units.</p> <p>Methods</p> <p>This study of pharmacies was a part of larger cross sectional survey carried out to map all the health care providers in Ujjain district (population 1.9 million), Central India, on a geographic information system. Their location vis-à-vis formal providers of health services were studied. Other characteristics like human resources, infrastructure, clients and availability of tracer drugs were also surveyed.</p> <p>Results</p> <p>A total 475 private pharmacies were identified in the district. Three-quarter were in urban areas, where they were concentrated around physician practices. In rural areas, pharmacies were located along the main roads. A majority of pharmacies simultaneously retailed medicines from multiple systems of medicine. Tracer parenteral antibiotics and injectable steroids were available in 83.7% and 88.7% pharmacies respectively. The proportion of clients without prescription was 39.04%. Only 11.58% of staff had formal pharmacist qualifications. Power outages were a significant challenge.</p> <p>Conclusion</p> <p>This is the first mapping of pharmacies & their characteristics in India. It provides evidence of the urban dominance and close relationship between healthcare provider location and pharmacy location. The implications of this relationship are discussed. The study reports a lack of qualified staff in the presence of a high proportion of clients attending without a prescription. The study highlights the need for the better implementation of regulation. Besides facilitating regulation & partnerships, the data also provides a sampling frame for future interventional studies on these pharmacies.</p

Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India

Background: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. Methods: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included. Surveillance for SSI was based on the Centre for Disease Control (CDC) definition and methodology. Incidence and risk factors for SSI, including those for specific procedure, were calculated from data collected on daily ward rounds. Results: A total of 1173 patients underwent a surgical procedure during the study period. The incidence of SSI in the cohort was 7.84% (95% CI 6.30-9.38). Majority of SSI were superficial. Obstetric surgeries had a lower SSI incidence compared to gynecological surgeries (1.2% versus 10.3% respectively). The risk factors for SSI identified in the multivariate logistic regression model were age (OR 1.03), vaginal examination (OR 1.31); presence of vaginal discharge (OR 4.04); medical disease (OR 5.76); American Society of Anesthesia score greater than 3 (OR 12.8); concurrent surgical procedure (OR 3.26); each increase in hour of surgery, after the first hour, doubled the risk of SSI; inappropriate antibiotic prophylaxis increased the risk of SSI by nearly 5 times. Each day increase in stay in the hospital after the surgery increased the risk of contacting an SSI by 5%. Conclusions: Incidence and risk factors from prospective SSI surveillance can be reported simultaneously for the Obstetric and Gynecological surgeries and can be part of routine practice in resource-constrained settings. The incidence of SSI was lower for Obstetric surgeries compared to Gynecological surgeries. Multiple risk factors identified in the present study can be helpful for SSI risk stratification in low-middle income countries

Feasibility of a Mobile Phone-Based Surveillance for Surgical Site Infections in Rural India

Objectives: To assess the feasibility of using mobile communication technology in completing a 30-day follow-up of surgical site infection (SSI). Subjects and Methods: SSIs are infections occurring up to 30 days after an operative procedure. This prospective exploratory study was conducted in a cohort of patients who were admitted and operated on in the general surgery wards of a rural hospital in India from October 2010 to June 2011. At the time of discharge, all patients were requested to follow-up in the surgical outpatient clinic at 30 days after surgery. If this was not done, a mobile phone-based surveillance was done to complete the follow-up. Results: The mean age of the 536 operated-on patients was 40 years (95% confidence interval [CI], 38-41 years). The mean duration of hospital stay was 10.7 days (95% CI, 9.9-11.6 days). Most (81%) operated-on patients were from rural areas, and 397 (75%) were male. Among the operated-on patients the ownership of mobile phones was 75% (95% CI, 73-78%). The remaining 25% of patients (n = 133) used a shared mobile phone. For 380 patients (74.5%) the follow-up was completed by mobile phones. The SSI rate at follow-up was 6.3% (n=34). In 10 patients, an SSI was detected over the mobile phone. Conclusions: Mobile communication technology is feasible to be used in rural settings to complete case follow-up for SSIs

Surgical site infections, occurrence, and risk factors, before and after an alcohol-based handrub intervention in a general surgical department in a rural hospital in Ujjain, India

Background: This study set out to determine occurrence of and risk factors for surgical site infections (SSIs) before and after implementation of an alcohol-based handrub (ABHR) intervention in general surgery wards in a rural, tertiary care hospital in India. Methods: Patients who underwent surgery between October 2010 and August 2011 (preintervention period) or September 2011 and August 2013 (intervention period) in the department of surgery were included. ABHR was introduced in September 2011. SSI was defined as per the Centers for Disease Control and Prevention guidelines. Comparison of SSI rate between the 2 periods was performed using analysis of variance. Risk factors were determined using multiple logistic regression models. Results: Incidence of SSI was 5% (36/720) and 6.5% (103/1,581) respectively, showing nonsignificant difference (P = .5735). The risk factor common for SSI in both periods was the duration of surgery (OR = 2.6 vs OR = 1.96, pre- and intervention periods, respectively). Risk factors in the intervention period were being a woman (OR = 2.18), renal disease (OR = 3.61), diabetes (OR = 4.43), smoking (OR = 2.14), preoperative hospitalization (&lt;3 vs &gt;15 days; OR = 3.22), and previous hospitalization (OR = 3.5). Compared with other studies, the amount of ABHR used in our study was low. Conclusion: The amount of ABHR used might not be sufficient to interrupt the chain of contamination of microorganisms; therefore, continuation of the intervention and surveillance is recommended

A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra—A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper

Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing

Experience of Elderly People Regarding the Effect of Yoga/Light Exercise on Sedentary Behavior: A Longitudinal Qualitative Study in Madhya Pradesh, India

This study is set on the background of a randomized control trial (RCT) in which intervention was carried to observe the effects of yoga/light exercise on the improvement in health and well-being among the elderly population. A longitudinal qualitative study was conducted as part of RCT interventions to explore the experience of the elderly practicing yoga/light exercise in relation to sedentary behavior in the Ujjain district of Madhya Pradesh, India. Participants of the RCT were selected for this study. Eighteen focus group discussions were conducted&mdash;six during each phase of RCT interventions (before, during, and after). The findings regarding motivating and demotivating factors in various phases of intervention were presented in three categories: experience and perception of the effects of yoga/light exercise on sedentary behavior (1) before, (2) during, and (3) after intervention. This study explores the positive effect of yoga/light exercise on sedentary behavior and subjective well-being on the elderly population. They were recognized to have undergone changes in their physical and emotional well-being by consistently practicing yoga/light exercise. The main driving factors were periodic health check-ups and the encouragement of qualified trainers without any cost. This study concludes with the notion that these interventions should be encouraged in the community to use physical exercise as a method to better control the physical and social effects of aging

Tablet-based participatory syndromic surveillance at Simhashta festival in India

Objective: To develop, test and study tablet-based participatory syndromic surveillance system for common infectious disease conditions at community level in Simhashta religious mass gathering in Ujjain, India, 2016.Introduction: Infectious disease surveillance for generating early warnings to enable a prompt response during mass gatherings has long been a challenge in India 1,2 as well as in other parts of the world 3,4,5. Ujjain, Madhya Pradesh in Central India hosted one of the largest religious festival in the world called ‘Simhasth kumbh mela’ on the banks of River Kshipra, where more than 50 million attendees came for holy dip during April 22 to May 21, 2016. The attendees included pilgrims (residents and visitors), observers, officials and volunteers. We developed an android application with automated summary reports and an interactive dashboard for syndromic surveillance during the gathering.Methods: We established the participatory surveillance at all 22 sectors of the festival area, and at 20 out-patient hospitals and 12 pharmacies. We trained 55 nursing and social work graduate trainees to collect data from all these settings. The data collectors visited designated spots daily during a fixed time and collected age, gender, residence and self-reported symptoms from consenting attendees during the festival period. The application automatically added date, time and location of interview to each record and data was transmitted to a web server. We monitored the data in the interactive dashboard and prepared summary report on a periodic basis. Daily summary report of self-reported symptoms by time, place and person was shared daily evening with the festival surveillance authority.Results: Of the total 93,020 invited pilgrims, 91% participated in the surveillance. Almost 90% of those were from outside the festival city, 60% were men and 57% were aged 15 to 44 years. Almost 50% of them self-reported presence of at least one symptom. Most frequently reported symptoms were dehydration due to heat (13%), cold (13%), fever (7%) and loose stool (5%). During the festival period of over one month, surveillance data indicated increasing trends of self-reported cough and fever and declining trends of self-reported dehydration (Figure-1). The designated public health authorities for the festival did make use of the information for appropriate action. This tablet-based application was able to collect, process and visualise around 2500 records per day from the community without any data loss.Conclusions: To our knowledge, this is the first report from India documenting real-time surveillance of the community using hand-held devices during a mass gathering. Despite some implementation issues and limitations in the approach and data collected, the use of digital technology provided well-timed information avoiding tedious manual work and reduced a good amount of human resources and logistics involved in reporting symptoms with a traditional paper-based method in such a large population. In retrospect, the main utility of the surveillance output was that of giving reassurance to the officials, as no major outbreaks occurred during the event. We believe that this experience and further analyses will provide input for the establishment and use of such a surveillance system during mass gatherings. The team of investigators propose improving the methods and tools for future use