DETERMINING THE KNOWLEDGE, ATTITUDES AND BELIEFS OF HEALTHCARE PROVIDERS IN TREATING NON-SPECIFIC ACUTE AND CHRONIC BACK PAIN

An Abstract of the Scholarly Project by Stacey Kale Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients who have the risk for movement towards chronicity, disability, and medication misuse (Hudspeth, 2011). This educational needs assessment project asks questions regarding the knowledge, attitudes and beliefs (KABs) of health care providers in treating non-malignant acute and chronic back pain in the four state area (Kansas, Oklahoma, Arkansas, and Missouri) and rural Southeast Kansas four County area (Bourbon, Allen, Anderson and Neosho). The purpose of the study was to discover provider knowledge, attitudes and beliefs (KABs) in the assessment and management of NSABP and CBP. This will allow for consideration of recommendations regarding education and policy improvements in pain management. A modified version of the Knowpain-50, Knowpain-12 survey, was used to measure healthcare provider knowledge, attitudes and beliefs in back pain assessment and management

Estimating the impact of structural directionality: How reliable are undirected connectomes?

Directionality is a fundamental feature of network connections. Most structural brain networks are intrinsically directed because of the nature of chemical synapses, which comprise most neuronal connections. Due to limitations of non-invasive imaging techniques, the directionality of connections between structurally connected regions of the human brain cannot be confirmed. Hence, connections are represented as undirected, and it is still unknown how this lack of directionality affects brain network topology. Using six directed brain networks from different species and parcellations (cat, mouse, C. elegans, and three macaque networks), we estimate the inaccuracies in network measures (degree, betweenness, clustering coefficient, path length, global efficiency, participation index, and small worldness) associated with the removal of the directionality of connections. We employ three different methods to render directed brain networks undirected: (i) remove uni-directional connections, (ii) add reciprocal connections, and (iii) combine equal numbers of removed and added uni-directional connections. We quantify the extent of inaccuracy in network measures introduced through neglecting connection directionality for individual nodes and across the network. We find that the coarse division between core and peripheral nodes remains accurate for undirected networks. However, hub nodes differ considerably when directionality is neglected. Comparing the different methods to generate undirected networks from directed ones, we generally find that the addition of reciprocal connections (false positives) causes larger errors in graph-theoretic measures than the removal of the same number of directed connections (false negatives). These findings suggest that directionality plays an essential role in shaping brain networks and highlight some limitations of undirected connectomes.Comment: 29 pages, 6 figures, 9 supplementary figures, 4 supplementary table

DRUG UTILIZATION STUDY IN GERIATRIC PATIENTS AT RURAL TERTIARY CARE HOSPITAL

AbstractObjective: To study the drug utilization pattern in geriatric patients at rural tertiary care hospital.Materials and Methods:  This was a cross-sectional observational study involving 600 geriatric outpatients. The study was carried out from May 2014 to July 2014. The data was collected using predesigned pro forma specially designed for this purpose. Relevant information was obtained by analyzing the prescriptions for WHO core drug indicators.Results: - The total numbers of prescriptions studied were 600. The total number of drugs prescribed is a product of actual drugs and number of patient prescriptions. The majority of the patients were in the age group 65-70 years (69.33%). There was male preponderance (58.66%). Musculoskeletal diseases were the most common (26.33%), followed by cardiovascular diseases (26%). The average number of drugs per prescription was 2.79. Out of total number of drugs prescribed, 380 drugs (22.64%)  were prescribed by their generic name and 1298 drugs (77.35%) were prescribed by their brand name. 1308 drugs (77.94%)  prescribed were from World Health Organization's Essential Medicines List 2011 (WHO-EML). Drugs acting on the cardiovascular system (23.36%) were the most frequently prescribed, followed by vitamins, minerals (18.23%) and drugs acting on the gastrointestinal system (15.73%).Conclusion:  The study has shown the pattern of diseases prevalent in geriatric patients and drug use among them. Thus drug utilization study can help in assessment and promotion of rational use of drugsKeywords: Drug utilization, geriatric, polypharmacy, rational use

Role of Surface Energy and Nano-Roughness in the Removal Efficiency of Bacterial Contamination by Nonwoven Wipes from Frequently Touched Surfaces

Healthcare associated infections (HCAIs) are responsible for substantial patient morbidity, mortality and economic cost. Infection control strategies for reducing rates of transmission include the use of nonwoven wipes to remove pathogenic bacteria from frequently touched surfaces. Wiping is a dynamic process that involves physicochemical mechanisms to detach and transfer bacteria to fibre surfaces within the wipe. The purpose of this study was to determine the extent to which systematic changes in fibre surface energy and nano-roughness influence removal of bacteria from an abiotic polymer surface in dry wiping conditions, without liquid detergents or disinfectants. Nonwoven wipe substrates composed of two commonly used fibre types, lyocell (cellulosic) and polypropylene, with different surface energies and nano-roughnesses, were manufactured using pilot-scale nonwoven facilities to produce samples of comparable structure and dimensional properties. The surface energy and nano-roughness of some lyocell substrates were further adjusted by either oxygen (O2) or hexafluoroethane (C2F6) gas plasma treatment. Static adpression wiping of an inoculated surface under dry conditions produced removal efficiencies of between 9.4% and 15.7%, with no significant difference (p < 0.05) in the relative removal efficiencies of Escherichia coli, Staphylococcus aureus or Enterococcus faecalis. However, dynamic wiping markedly increased peak wiping efficiencies to over 50%, with a minimum increase in removal efficiency of 12.5% and a maximum increase in removal efficiency of 37.9% (all significant at p < 0.05) compared with static wiping, depending on fibre type and bacterium. In dry, dynamic wiping conditions, nonwoven wipe substrates with a surface energy closest to that of the contaminated surface produced the highest E. coli removal efficiency, while the associated increase in fibre nano-roughness abrogated this trend with S. aureus and E. faecalis. Plasma modification of the nano-roughness and surface energy of fibres in nonwoven wipes was found to influence the relative removal efficiencies of common bacterial pathogens from model healthcare surfaces under dynamic wiping conditions

ELVIS - ELectromagnetic Vector Information Sensor

The ELVIS instrument was recently proposed by the authors for the Indian Chandrayaan-1 mission to the Moon and is presently under consideration by the Indian Space Research Organisation (ISRO). The scientific objective of ELVIS is to explore the electromagnetic environment of the moon. ELVIS samples the full three-dimensional (3D) electric field vector, E(x,t), up to 18 MHz, with selective Nyqvist frequency bandwidths down to 5 kHz, and one component of the magnetic field vector, B(x,t), from a few Hz up to 100 kHz.As a transient detector, ELVIS is capable of detecting pulses with a minimum pulse width of 5 ns. The instrument comprises three orthogonal electric dipole antennas, one magnetic search coil antenna and a four-channel digital sampling system, utilising flexible digital down conversion and filtering together with state-of-the-art onboard digital signal processing.Comment: 8 pages, 3 figures. Submitted to the DGLR Int. Symposium "To Moon and Beyond", Bremen, Germany, 2005. Companion paper to arXiv:astro-ph/050921

Effect of nanoclay loading on zeta potential of polyester nanocomposite fibre

Polyester (PET) nanocomposite fibres have been melt spun by adding master batches of linear low density polyethylene (LLDPE) loaded with organophilic nanoclay after compatibilizing the PET and LLDPE. The spun fibres show increased hydrophobicity which further increases progressively with the amount of nanoclay loaded into the fibre. The addition of this nanoclay also results in improved dyeability of the nanocomposite fibres with acid dyes due to the presence of quaternary ammonium organic substituent that is present in the nanoclay. There is slight decrease in tensile strength of the fibre accompanied by the decrease in elongation %, indicating that the addition of nanoclay makes the filaments stiffer. The onset of crystallization temperature occurs at higher temperature in case of composite fibres than in case of neat PET fibre because of nucleating effect of nanoclay

Influence of Socioeconomic Factors on Nutrition During Childhood in Germany and India

Malnutrition, nutritional deficiency, or undernutrition is an imbalanced nutritional status resulting from insufficient intake of nutrients to meet normal physiologic requirements. Malnutrition in childhood has both short-term consequences and long-term consequences on mental and physical health as well as the overall health development of children. Of all regions in the world, the Asia and the Pacific region has achieved the fastest rate of economic growth. There is no evidence that this rapid economic growth translates into a decline in malnutrition of children in Asian countries such as India

High-Fidelity Control, Detection, and Entanglement of Alkaline-Earth Rydberg Atoms

Trapped neutral atoms have become a prominent platform for quantum science, where entanglement fidelity records have been set using highly excited Rydberg states. However, controlled two-qubit entanglement generation has so far been limited to alkali species, leaving the exploitation of more complex electronic structures as an open frontier that could lead to improved fidelities and fundamentally different applications such as quantum-enhanced optical clocks. Here, we demonstrate a novel approach utilizing the two-valence electron structure of individual alkaline-earth Rydberg atoms. We find fidelities for Rydberg state detection, single-atom Rabi operations and two-atom entanglement that surpass previously published values. Our results pave the way for novel applications, including programmable quantum metrology and hybrid atom–ion systems, and set the stage for alkaline-earth based quantum computing architectures

Feasibility analysis of design for remanufacturing in bearing using hybrid fuzzy-topsis and taguchi optimization

The tremendous advancement in technology, productivity and improved standard of living has come at the cost of environmental deterioration, increased energy and raw material consumption. In this regard, remanufacturing is viable option to reduce energy usage, carbon footprint and raw material usage. In this manuscript, using computational intelligence techniques we try to determine the feasibility of remanufacturing in case of roller bearings. We collected used N308 bearings from 5 different Indian cities. Using Fuzzy-TOPSIS, we found that the roundness, surface roughness and weight play a vital role in design for remanufacturing of roller bearings. Change in diameter, change in thickness and change in width showed minimal influence.  We also used Taguchi analysis to reassess the problem. The roundness of inner and outer race was found to be the most influential parameters in deciding the selection of bearing for remanufacturing. The results suggest the bearing designer to design the bearing in such a way that roundness of both races will be taken cared while manufacturing a bearing. However, using Taguchi the weight of the rollers was found to be of least influence. Overall, the predictions of Taguchi analysis were found to be similar to Fuzzy-TOPSIS analysis