Implementing pediatric inpatient asthma pathways.

ObjectivePathways are succinct, operational versions of evidence-based guidelines. Studies have demonstrated pathways improve quality of care for children hospitalized with asthma, but we have limited information on other key factors to guide hospital leaders and clinicians in pathway implementation efforts. Our objective was to evaluate the adoption, implementation, and reach of inpatient pediatric asthma pathways.MethodsThis was a mixed-methods study of hospitals participating in a national collaborative to implement pathways. Data sources included electronic surveys of implementation leaders and staff, field observations, and chart review of children ages 2-17 years admitted with a primary diagnosis of asthma. Outcomes included adoption by hospitals, pathway implementation factors, and reach of pathways to children hospitalized with asthma. Quantitative data were analyzed using descriptive statistics and multivariable regression. Qualitative data were analyzed using thematic content analysis.ResultsEighty-five hospitals enrolled; 68 (80%) adopted/completed the collaborative. These 68 hospitals implemented pathways with overall high fidelity, implementing a median of 5 of 5 core pathway components (Interquartile Range [IQR] 4-5) in a median of 5 months (IQR 3-9). Implementation teams reported a median time cost of 78 h (IQR: 40-120) for implementation. Implementation leaders reported the values of pathway implementation included improvements in care, enhanced interdisciplinary collaboration, and access to educational resources. Leaders reported barriers in modifying electronic health records (EHRs), and only 63% of children had electronic pathway orders placed.ConclusionsHospitals implemented pathways with high fidelity. Barriers in modifying EHRs may have limited the reach of pathways to children hospitalized with asthma

EFFECT OF SELECTED YOGA TECHNIQUES ALONG WITH ASHWAGANDHA AND VACHA IN DEPRESSION IN THE AGE GROUP 65–75 YEARS

Objective: The study was done to compare the effect of selected yoga techniques, drugs, and combined therapy in depression in geriatrics. Methods: 75 patients between 65 and 75 years of age with depression were included in the study which was assessed by HAM D Score. The study population was randomly allocated to one control group and two study groups. The control group was given Aswangandha and Vacha churna with warm water as anupana after food, selected yoga techniques in the first study group, and combined yoga and the drug were given to the second study group. Outcome variables were assessed for the groups after the 30th day and follow-up after 45 days. Results: The results obtained in the study were analyzed using the ANOVA test. Yoga along with drug experienced a comparatively greater reduction in HAM-D score after treatment and follow-up (p<0.05) than other groups. Conclusion: Holistic approach can bring a better and static result than applying the treatment modalities alone

Intra-Tribal Differences in Social Progress of the Tribes in Kerala: Realities and the Need for Inclusive Actions

The tribes in Kerala are continuously encountering threats of development due to lack of ownership and control of the means of production, illiteracy, occupational immobility etc. They form the most deprived and vulnerable group, engendering indelible dark spots in the glorified development experience of the state, widely known as ‘the Kerala model’. Situate this community from the outliers level to the central tendency stage is of outmost necessity both in terms of equity and inclusive standpoints. This is because the notion of development has changed dramatically from just material attainment to human development which is about enlarging people’s choices and enables them to live long qualitatively and creatively in every walks of social life in the society. The article is linked to the theoretical framework of social exclusion and poverty as there has a culture of poverty among the tribes that influences all aspects of their life including social, economic, cultural, educational and developmental. The article is based on primary data using stratified random sampling method encompassing 300 samples collected from 5 clusters from Wayanad and 3 clusters from Palakkad. The article tries to explore development of the community based on the methodological framework proposed by Social Progress Imperative groups in a dichotomous framework of tribal and intra-tribal levels using Social Progress Index (SPI) embedding three basic areas of  ‘Basic Human Needs’, ‘wellbeing’ and  ‘Opportunity’. The empirical results obtained from the study shows that there is marked differences in the social progress levels of different tribal sub-groups of Kerala. Keywords: Tribes, Social Progress Index, poverty, social exclusion, SL

Smart Acknowledgement Distributed Channel Access Scheme for TCP in MANETs

TCP upon wireless networks is most challenging issue because of random losses and ACK interference. Also, TCP suffers from performance declination in terms of creating delay and overhead in network because of poor characteristics of wireless channel. In order to overcome these issues, we proposed a Smart Acknowledgement Distributed Channel Access (SADCA) scheme for TCP in MANETs. In the proposed scheme, first a separate Access Category (AC) for data less TCP acknowledgement packets is used and then it is assigned with highest priority. In this way, delay during transmission of packet can be reduced and also packet can be acknowledged immediately. Also, to increase the performance, delay window size can be adjusted by considering the parameters such as transmission rate, number of hops, and channel occupied ratio (COR). Hence the proposed scheme helps to avoid any kind of delay and overhead for sending TCP acknowledgemen

Pengaruh Pengungkapan Enterprise Risk Management Dan Pengungkapan Intellectual Capital Terhadap Nilai Perusahaan

This research aims to find out empirical evidences on the effect of ERM disclosure and IC disclosure on firm value. The sample of the research is 73 non-financial companies listed in Indonesia Stock Exchange for the period of 2010-2014. Regression analysis of panel data was applied to analyze the data. The results show that ERM disclosure has positive and significant effect on the firm value. This study also finds that IC disclosure has positive and significant effect on the firm value. Firm size, profitability, and leverage, as control variables, are also contributing positive and significant effects on the firm value. The results of this research can be used as a consideration for the company\u27s management to increase ERM and IC disclosures in the annual report as ERM and IC disclosures can be a positive signal to encourage the increase in corporate value. In addition, since ERM and IC information are very significant for investors, it can also be beneficial for the regulator to set up and establish instruments of mandatory disclosure related to ERM and IC to minimize the asymmetry of information which can disadvantage company\u27s related parties.---Penelitian ini bertujuan untuk mendapatkan bukti empiris mengenai pengaruh pengungkapan Enterprise Risk Management (ERM) dan pengungkapan Intellectual Capital (IC) pada nilai Perusahaan. Sampel penelitian adalah 73 Perusahaan nonkeuangan yang terdaftar di Bursa Efek Indonesia pada periode tahun 2010-2014. Teknik analisis data yang digunakan adalah analisis regresi data panel. Hasil penelitian membuktikan bahwa pengungkapan ERM berpengaruh positif dan signifikan pada nilai Perusahaan. Hasil penelitian juga menunjukkan bahwa pengungkapan IC berpengaruh positif dan signifikan pada nilai Perusahaan. Ukuran Perusahaan, profitabilitas, dan leverage, sebagai variabel kontrol, juga berpengaruh positif dan signifikan pada nilai Perusahaan. Hasil penelitian ini dapat dijadikan sebagai bahan pertimbangan bagi pihak manajemen Perusahaan untuk meningkatkan pengungkapan ERM dan IC di dalam laporan tahunan karena pengungkapan ERM dan IC dapat dijadikan sebagai sinyal positif untuk mendorong peningkatan nilai Perusahaan. Selain itu, karena informasi ERM dan IC sangat penting bagi investor, maka penelitian ini bermanfaat bagi regulator untuk menetapkan instrumen pengungkapan wajib terkait dengan ERM dan IC untuk memperkecil asimetri informasi yang dapat merugikan pihak-pihak yang berkepentingan terhadap Perusahaan

Food Choice Motives among the Students of a Dental Institution in Mysore City, India

Background: In pursuit of a more gholistich dentistry and an increasing focus on promoting oral health, dental students are increasingly being trained to take a more active part in health promotion and education. In particular, this incorporates an emphasis on diet and educating people to eat in more healthy ways.Aim: This paper works from the premise that if dental students are toengage in oral health promotion, they will do so more effectively if they have first explored their own food choice motivations. Subjects and Methods: A descriptive, cross.sectional questionnaire study. The food choice questionnaire (FCQ) was distributed to a comparative  group of 1st and 5th year dental students in timetabled lecture slots. The FCQ is a previously validated measure designed to assess ten main factors relevant to peoplesh food choices. The data was analyzed using SPSS version 18.0 (Chicago, IL, USA) using descriptive statistics and  independent sample t-test.Results: Nearly 77% (122/159) students responded. Findings were  analyzed using independent sample t-test. Results indicated statistically significant differences in terms of food choice motivations between male and female students of 1st and 5th year.Conclusion: Awareness and an understanding of the differences in  motivational factors affecting food choice between dental students is important as they are increasingly taught to play an active role in oral health promotion. Keywords: Africa, Food, Oral healt

The Effective Quantitative Analysis for Brain Tumor Diagnosis Using an Efficient Deep Learning Algorithm

In the medical field, imaging analysis is the hottest topic. It has attracted many researchers to accurately analyses the disease severity and predict the outcome. However, if the trained images are more complex, the noise pruning results have decreased, which has tended to gain less prediction exactness score. So, a novel Chimp-based Boosting Multilayer Perceptron (CbBMP) prediction framework has been built in this present study. Moreover, the objective of this study is brain tumor prediction and severity analysis from the MRI brain images. The boosting function is employed to earn the most acceptable error pruning outcome. Henceforth, the feature analysis and the tumor prediction process were executed accurately with the help chimp solution function. The planned framework is tested in the MATLAB environment, and the prediction improvement score is analyzed by performing a comparative analysis. A novel CbBMP model has recorded the finest tumor forecasting rate