Search results for: medication compliance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1140

Search results for: medication compliance

600 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia

Authors: Khaleel Alyahya, Faizah Alotaibi

Abstract:

The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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599 Increasing Student Engagement through Culturally-Responsive Classroom Management

Authors: Catherine P. Bradshaw, Elise T. Pas, Katrina J. Debnam, Jessika H. Bottiani, Michael Rosenberg

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Worldwide, ethnically and culturally diverse students are at increased risk for school failure, discipline problems, and dropout. Despite decades of concern about this issue of disparities in education and other fields (e.g., 'school to prison pipeline'), there has been limited empirical examination of models that can actually reduce these gaps in schools. Moreover, few studies have examined the effectiveness of in-service teacher interventions and supports specifically designed to reduce discipline disparities and improve student engagement. This session provides an overview of the evidence-based Double Check model which serves as a framework for teachers to use culturally-responsive strategies to engage ethnically and culturally diverse students in the classroom and reduce discipline problems. Specifically, Double Check is a school-based prevention program which includes three core components: (a) enhancements to the school-wide Positive Behavioral Interventions and Supports (PBIS) tier-1 level of support; (b) five one-hour professional development training sessions, each of which addresses five domains of cultural competence (i.e., connection to the curriculum, authentic relationships, reflective thinking, effective communication, and sensitivity to students’ culture); and (c) coaching of classroom teachers using an adapted version of the Classroom Check-Up, which intends to increase teachers’ use of effective classroom management and culturally-responsive strategies using research-based motivational interviewing and data-informed problem-solving approaches. This paper presents findings from a randomized controlled trial (RCT) testing the impact of Double Check, on office discipline referrals (disaggregated by race) and independently observed and self-reported culturally-responsive practices and classroom behavior management. The RCT included 12 elementary and middle schools; 159 classroom teachers were randomized either to receive coaching or serve as comparisons. Specifically, multilevel analyses indicated that teacher self-reported culturally responsive behavior management improved over the course of the school year for teachers who received the coaching and professional development. However, the average annual office discipline referrals issued to black students were reduced among teachers who were randomly assigned to receive coaching relative to comparison teachers. Similarly, observations conducted by trained external raters indicated significantly more teacher proactive behavior management and anticipation of student problems, higher student compliance, less student non-compliance, and less socially disruptive behaviors in classrooms led by coached teachers than classrooms led teachers randomly assigned to the non-coached condition. These findings indicated promising effects of the Double Check model on a range of teacher and student outcomes, including disproportionality in office discipline referrals among Black students. These results also suggest that the Double Check model is one of only a few systematic approaches to promoting culturally-responsive behavior management which has been rigorously tested and shown to be associated with improvements in either student or staff outcomes indicated significant reductions in discipline problems and improvements in behavior management. Implications of these findings are considered within the broader context of globalization and demographic shifts, and their impacts on schools. These issues are particularly timely, given growing concerns about immigration policies in the U.S. and abroad.

Keywords: ethnically and culturally diverse students, student engagement, school-based prevention, academic achievement

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598 A Framework for the Design of Green Giga Passive Optical Fiber Access Network in Kuwait

Authors: Ali A. Hammadi

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In this work, a practical study on a commissioned Giga Passive Optical Network (GPON) fiber to the home access network in Kuwait is presented. The work covers the framework of the conceptual design of the deployed Passive Optical Networks (PONs), access network, optical fiber cable network distribution, technologies, and standards. The work also describes methodologies applied by system engineers for design of Optical Network Terminals (ONTs) and Optical Line Terminals (OLTs) transceivers with respect to the distance, operating wavelengths, splitting ratios. The results have demonstrated and justified the limitation of transmission distance of a PON link in Fiber to The Premises (FTTP) to not exceed 20 km. Optical Time Domain Reflector (OTDR) test has been carried for this project to confirm compliance with International Telecommunication Union (ITU) specifications regarding the total length of the deployed optical cable, total loss in dB, and loss per km in dB/km with respect to the operating wavelengths. OTDR test results with traces for segments of implemented fiber network will be provided and discussed.

Keywords: passive optical networks (PONs), fiber to the premises (FTTx), access network, OTDR

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597 Impact of Firm Location and Organizational Structure on Receipt and Effectiveness of Social Assistance

Authors: Nalanda Matia, Julia Zhao, Amber Jaycocks, Divya Sinha

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Social assistance programs for businesses are intended to improve their survival and growth in the face of catastrophic events like the COVID-19 pandemic. However, that goal remains unfulfilled when the mostwantingbusinesses fail to participate in such programs. Reasons for non-participation can include lack of information, inability to cope with applications and program compliance, as well as some programs’ non-entitlement status. Some of these factors may be associated with the organizational and locational characteristics of these businesses. This research investigates these organizational and locational factorsthat determine receipt and effectiveness of social assistance among the firms that receive it. of A sample of firms from the universe of 3 rounds of Small Business Administration backed Paycheck Protection Program recipient and similarly profiled non recipient businesses are used to analyze this question. Initial results show firm organizational factors like size and spatial factors like broadband coverage at firm location impact application for and subsequent receipt of assistance for digitally administered programs. Further, Line of business and wage structure of recipients’ impact effectiveness of the assistance dollars.

Keywords: public economics, economics of social assistance, firm organizational structure, survival analysis

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596 Self-Management among the Ethnic Groups with Type 2 Diabetes Mellitus in Thailand

Authors: Siwarak Kitchanapaibul, Warren Gillibrand, Rob Burton

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The prevalence of diabetes mellitus has been rising all over the world. Self-management is required for diabetes mellitus patients. The objective of this study is to explore the self-management among the ethnic groups with type 2 diabetes mellitus in Thailand, an upper middle-income country which is located in South East Asia. The ethnic groups in Thailand are a minority group which has limited education and a different culture, language, costume and lifestyle from Thai people. The qualitative exploratory study was used in this study. In-depth interviews with semi-structured open questions were conducted by 20 participants from purposive sampling. These participants were the ethnic groups who have type 2 diabetes mellitus, received the services from a region hospital, understood Thai and were willing to participate. Content analysis was adopted for the study. The results showed that all of the participants controlled their diet before the appointment day and never miss their appointment. Only 3 participants did their exercise while 2 participants stated that they occasionally forgot to take medicine. 10 participants use the herbs for reducing the sugar level. 12 participants drank a lot of water after a lapse in the diet because they believed that water could dilute the sugar. The findings identified 5 themes; ‘controlling diet before appointment day’; ‘drinking water after a lapse in diet’; ‘medication being a vital importance’; ‘exercise is unimportant’; and ‘taking herbs for sugar reduction’. The results of this study are important to the health professionals to understand the self-management of Ethnic groups and use the data to create the appropriate intervention for promoting health among the ethnic groups with type 2 diabetes mellitus in Thailand. The findings will lead to the revision of health policy and the procedure for promoting health in this special ethnic groups.

Keywords: self-management, diabetes, ethnic groups, Thailand

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595 Teenagers in Conflict with Law: Exploratory Study about Psychic Suffering

Authors: Carolina Alcântara, Ileno Costa

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This study had the objective to systemize the main psycho-social and socioeducational aspects that related with the psychic suffering of adolescents in conflict of law and freedom privation. This research wanted to verify the signals and symptoms identified trough themselves perceptions related to their condition of health/insanity. In a similar way, it was objectified to know the opinions of the ambient conditions of the institution the use of the currently available resources for Health Service and Educational Service. The methodological proposal is based on the quant-qualitative analysis of interviews half-structuralized carried through with 36 teenagers was using psychiatric medication continuously. The data had pointed the experiences of sleeplessness and nightmares, associates or not with experiences of loss of reality (hallucinations) had constituted the illness most frequent. The self-punishment behavior appeared at second place. With regard to the ambient factors, it was verified that institution had, in general way, guaranteed the physical integrity and the maintenance of the health. Amongst the current available resources of Health Service, the administration of anticonvulsivants, in association with other psychotropic drugs has been widely used. The school was viewed as important device of available in the institution. By means of the adolescent’s understanding who do not like to go to the school, they don’t disqualify the knowledge, in contrast, they wanted for knowledge, however, they were frustrated for not having their educational supplies adequately, affirming that the school is weak or they do not learn. Finally, among the possible conclusions guided for the Winnicott’s thought, it was observed that institution in analysis is a representative of the paternal function. However, to begin the self-cure process is necessary that formation of therapeutical bonds. The group of teachers is identified as the main tool of change.

Keywords: serious psychic suffering, adolescent in conflict with the law, delinquency, privation of freedom

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594 Proposals for the Thermal Regulation of Buildings in Algeria: A New Energy Label for Social Housing

Authors: Marco Morini, Nicolandrea Calabrese, Dario Chello

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Despite the international commitment of Algeria towards the development of energy efficiency and renewable energy in the country, the internal energy demand has been continuously growing during the last decade due to the substantial increase of population and of living conditions, which in turn has led to an unprecedented expansion of the residential building sector. The thermal building regulation is the technical document that establishes the calculation framework for the thermal performance of buildings in Algeria, setting up minimum obligatory targets for the thermal performance of new buildings. An update of this regulation is due in the coming years, and this paper discusses some proposals in this regard, with the aim to improve the energy efficiency of the building sector, particularly with regard to social housing. In particular, it proposes a methodology for drafting an energy performance label of new Algerian residential buildings, moving from the results of the thermal compliance verification and sizing of technical systems as defined in the RTB. Such an energy performance label – whose calculation method is briefly described in the paper – aims to raise citizens' awareness of the benefits of energy efficiency. It can represent the first step in a process of integrating technical installations into the calculation of the energy performance of buildings in Algeria.

Keywords: building, energy certification, energy efficiency, social housing, international cooperation, Mediterranean region

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593 Emergency Management of Poisoning Tracery Care Hospital in India

Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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592 Exploring the Safety of Sodium Glucose Co-Transporter-2 Inhibitors at the Imperial College London Diabetes Centre, UAE

Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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591 Media Usage, Citizenship Norms, and Political Participation of Transition to Democracy in Indonesia

Authors: Najmuddin Najmuddin

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The purpose of this study is to determine whether media usage and change of citizenship norms influence political participation. The focus of this study is to examine citizenship norms in the context of the development of information, and communication technology and how it will impact political participation in the context of Indonesia's transition to democracy. The study use survey method. The main theoretical framework is media and political participation. The results of this study reveal that gender, age and educational background of the respondents did not influence significantly media usage and citizenship norms. The Results also show that educational background is not a factor that distinguishes media usage but it becomes differentiating factor in citizenship norms. The results further show that the media usage has a significant correlation with citizenship norms and citizenship norms has a significant relationship with political participation. In addition, media usage and citizenship norms impact significantly to political participation. The sub-dimensions of citizenship norms (compliance, duty, and engaged citizen) provides a significant contribution to the sub-dimensions of political participation (traditional political participation, modern political participation, civic political participation). Based on the findings it can be concluded that the political euphoria in the era of transition to democracy has changed pattern media usage and citizenship norms of among the young generation.

Keywords: media, citizenship, norms, political, participation, democracy

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590 Tokenization of Blue Bonds as an Emerging Green Finance Tool

Authors: Rodrigo Buaiz Boabaid

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Tokenization of Blue Bonds is an emerging Green Finance tool that has the potential to scale Blue Carbon Projects to fight climate change. This innovative solution has a huge potential to democratize the green finance market and catalyze innovations in the climate change finance sector. Switzerland has emerged as a leader in the Green Finance space and is well-positioned to drive the adoption of Tokenization of Blue & Green Bonds. This unique approach has the potential to unlock new sources of capital and enable global investors to participate in the financing of sustainable blue carbon projects. By leveraging the power of blockchain technology, Tokenization of Blue Bonds can provide greater transparency, efficiency, and security in the investment process, while also reducing transaction costs. Investments are in line with the highest regulations and designed according to the stringent legal framework and compliance standards set by Switzerland. The potential benefits of Tokenization of Blue Bonds are significant and could transform the way that sustainable projects are financed. By unlocking new sources of capital, this approach has the potential to accelerate the deployment of Blue Carbon projects and create new opportunities for investors to participate in the fight against climate change.

Keywords: blue carbon, blue bonds, green finance, Tokenization, blockchain solutions

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589 Evaluation Demografical Factors for Suicide Attempts among Hazrat Abolfazl Hospital of Minab City during 1389-1390 Years

Authors: Zahra khaksari, Mahboobeh Mehrabi

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One of the biggest health problems in communities, suicide is now one of the top ten causes of death in the world. This study aimed to investigate the risk factors of suicide attempt in Minab city over two years. This was a descriptive and cross-sectional study. Subjects of this study were cases who admitted in Hazrat Abolfazl hospital of minab city over two years Since the beginning of 1389 to end of 1390. During this period,their cases were reviewed. To analyze data, descriptive statistics was applied. During this two-year period, 275 patients who had attempted suicide, of which 65 percent are female and most of them were 15-24 years. 60% of them were single and 70 % of rural areas. 51% of suicides in 1390 and most of the suicide attempts occurred at a rate of 37 percent in summer. and the most common way of attempting suicide was medication poisoning (74%). The suicide rate leading to death was 1.5% The chi-square test showes that there were significant relationship between suicide by gender and residence status. This means that more women are committing suicide of rural areas.based on The chi-square test there were significant relation between the gender and method, gender and the result of suicide and means that more women than men commit suicide with the use of drugs. Males were more successful suicide. who had attempted with organophosphates and hanging were more successful in suicide. The finding of the current study showed that most of the suicide victims were female ,rural deweller,14-24 years old,single, serious attention must be paid to the problems of this group. It also extends the field of education professionals and health centers, and psychological therapy that focuses specifically on this topic.

Keywords: attempt to suicide, minab, risk factors, suicide

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588 Public Accountability, a Challenge to Sustainable Development: A Case Study of Uganda

Authors: Nassali Celine Lindah

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The study sought to find out how public accountability is a challenge to sustainable development in Uganda. The study was guided by the following set of objectives included establishing the challenges of Public accountability, the importance of accountability in Uganda, and the possible solutions to the problems identified in the study. In order to ensure proper accountability there should be proper control of resources, specifically the control of both public revenue and expenditures. Stakeholders should also be involved in the accountability process. Accountability can reduce corruption and other abuses, assure compliance with standards and procedures, and improve performance and organizational learning. The study involved qualitative and quantitative data collection techniques. A sample of 20 respondents from various districts/towns was used using both technical staff and non-technical staff members. The study utilized secondary and primary data, which was obtained using interviews and observations. The study reached a conclusion that the major challenges of Public accountability in Uganda are poor leadership, poor resource management, unethical behavior by the government officials and political involvement, among others. The study also recommended that the policymakers should design relevant guidelines/policies to help promote the process of public accountability in Uganda like prosecution and convictions, strengthen public expenditure management benchmarking and performance measurements, among others.

Keywords: accountability, sustainability, government activities, government sector

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587 Feasibility Studies through Quantitative Methods: The Revamping of a Tourist Railway Line in Italy

Authors: Armando Cartenì, Ilaria Henke

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Recently, the Italian government has approved a new law for public contracts and has been laying the groundwork for restarting a planning phase. The government has adopted the indications given by the European Commission regarding the estimation of the external costs within the Cost-Benefit Analysis, and has been approved the ‘Guidelines for assessment of Investment Projects’. In compliance with the new Italian law, the aim of this research was to perform a feasibility study applying quantitative methods regarding the revamping of an Italian tourist railway line. A Cost-Benefit Analysis was performed starting from the quantification of the passengers’ demand potentially interested in using the revamped rail services. The benefits due to the external costs reduction were also estimated (quantified) in terms of variations (with respect to the not project scenario): climate change, air pollution, noises, congestion, and accidents. Estimations results have been proposed in terms of the Measure of Effectiveness underlying a positive Net Present Value equal to about 27 million of Euros, an Internal Rate of Return much greater the discount rate, a benefit/cost ratio equal to 2 and a PayBack Period of 15 years.

Keywords: cost-benefit analysis, evaluation analysis, demand management, external cost, transport planning, quality

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586 Aircraft Automatic Collision Avoidance Using Spiral Geometric Approach

Authors: M. Orefice, V. Di Vito

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This paper provides a description of a Collision Avoidance algorithm that has been developed starting from the mathematical modeling of the flight of insects, in terms of spirals and conchospirals geometric paths. It is able to calculate a proper avoidance manoeuver aimed to prevent the infringement of a predefined distance threshold between ownship and the considered intruder, while minimizing the ownship trajectory deviation from the original path and in compliance with the aircraft performance limitations and dynamic constraints. The algorithm is designed in order to be suitable for real-time applications, so that it can be considered for the implementation in the most recent airborne automatic collision avoidance systems using the traffic data received through an ADS-B IN device. The presented approach is able to take into account the rules-of-the-air, due to the possibility to select, through specifically designed decision making logic based on the consideration of the encounter geometry, the direction of the calculated collision avoidance manoeuver that allows complying with the rules-of-the-air, as for instance the fundamental right of way rule. In the paper, the proposed collision avoidance algorithm is presented and its preliminary design and software implementation is described. The applicability of this method has been proved through preliminary simulation tests performed in a 2D environment considering single intruder encounter geometries, as reported and discussed in the paper.

Keywords: ADS-B Based Application, Collision Avoidance, RPAS, Spiral Geometry.

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585 The Disposable Identities; Enabling Trust-by-Design to Build Sustainable Data-Driven Value

Authors: Lorna Goulden, Kai M. Hermsen, Jari Isohanni, Mirko Ross, Jef Vanbockryck

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This article introduces disposable identities, with reference use cases and explores possible technical approaches. The proposed approach, when fully developed as an open-source toolkit, enables developers of mobile or web apps to employ a self-sovereign identity and data privacy framework, in order to rebuild trust in digital services by providing greater transparency, decentralized control, and GDPR compliance. With a user interface for the management of self-sovereign identity, digital authorizations, and associated data-driven transactions, the advantage of Disposable Identities is that they may also contain verifiable data such as the owner’s photograph, official or even biometric identifiers for more proactive prevention of identity abuse. These Disposable Identities designed for decentralized privacy management can also be time, purpose and context-bound through a secure digital contract; with verification functionalities based on tamper-proof technology.

Keywords: dentity, trust, self-sovereign, disposable identity, privacy toolkit, decentralised identity, verifiable credential, cybersecurity, data driven business, PETs, GDPRdentity, trust, self-sovereign, disposable identity, privacy toolkit, decentralised identity, verifiable credential, cybersecurity, data driven business, PETs, GDPRI

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584 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in the incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently cross-checked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014–September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification, and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, an introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: antibiotic resistance, antibiotic stewardship, dental infection, hygiene standards

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583 Comparison and Description of Enhanced Department-Based Arc Flash Safety Assessment with Substation-Based Arc Flash Safety Assessment for the Improvement of Work Place Safety

Authors: Md. Abid Khan

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Arc Flash safety assessment is a critical component for continuous improvement of any company’s safe electrical arc flash standard (SEAFS). The standard requires periodic internal or external audits to verify compliance and assess implementation. Assessments will identify strengths and opportunities for improvement, and serve as the basis for corrective actions. An arc flash safety assessment is comprised of a review of any existing safe electrical arc flash standard documentation (e.g., such as work procedures or other supporting documents), onsite interviews, and observations (e.g., facility inspections and work task observations). Substation-based arc flash assessment is very popular as it is more specific for each substation. The enhanced department-based arc flash safety assessment will shift focus to more effective hazard control measures and emphasis will be placed on highlighting inherently unsafe equipment to support resolution actions by facility management, rather than relying on lessor effective control methods in the hierarchy of controls currently deployed at a number of facilities.

Keywords: assessment, remote racking device (RRD), key performance indicator (KPI), personal protective equipment (PPE), operation & maintenance (O&M), safety management system (SMS), safe electrical arc flash standard (SEAFS)

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582 Shunt Placement in Treatment of Hydrocephalus in Patients with Myelomeningocele

Authors: M. M. Akhmediev, J. R. Ashrapov, T. M. Akhmediev

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Hydrocephalus frequently occurs with spina bifida, and up to 80% of such patients need to be shunted. Objective: It’s sought to improve the results of the surgical treatment of hydrocephalus in children with spina bifida. Methods: We have analyzed the results of the surgical treatment of 80 patients aged between 1 month and 1,5-year-old with hydrocephalus and myelomeningocele. All patients underwent surgery in the period of 2013-2018. Results: In all patients, spina bifida was associated with hydrocephalus with a predominant extension of the posterior horns of the lateral ventricles in the form of colpocephaly, Chiari malformation type 2. Based on the method “Choose right shunt” the determination of the point of critical deformation of the ventricular system was established, 47 (58.8%) patients for the 1st stage underwent ventriculoperitoneal (VP) shunt surgery with a low-pressure valve, 28 (35.0%) patients with medium pressure and 5 (6.2%) with high-pressure valve. Under or over drainage complications were not observed in the postoperative period. The 2nd stage of surgery for myelomeningocele repair was planned in 1-2 months with the follow-up head ultrasonography and electromyography study. Conclusion: The implantable shunt systems parameters chosen before surgery in the surgical management of hydrocephalus in children with myelomeningocele are important in the causes of under or over drainage states, cerebrospinal fluid leakage from the myelomeningocele sac. Management of hydrocephalus should be performed by considering myelomeningocele affecting craniospinal compliance.

Keywords: hydrocephalus, spina bifida, myelomeningocele, ventriculoperitoneal (VP) shunt

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581 Survey on the Use of Anti-ticks in Cattle by Breeders in the Department of Korhogo

Authors: Coulibaly Fatoumata, Seme Kpassi, Aboly Nicolas, Ccoulibaly Zonzereke

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Introduction and Objective: Microbial resistance is nowadays a major public health problem. In the perspective of a better understanding of the resistance of ticks against acaricides, a study was conducted in the Department of Korhogo. The general objective was to verify the knowledge and skills of breeders on the use of acaricides and contribute to reducing the impact of ticks on livestock productivity. Methodology: To carry out the work, a cross-sectional survey was conducted using elaborate questionnaires, followed by specific interviews with livestock stakeholders in the Korhogo sub-prefecture. Results: The results showed that in the study area, cattle breeders, the majority of whom (58.06%) are Ivorians, use anti-ticks without strict compliance with recommendations of the instructions and standards for use. 68% of them performed under-dosed treatments, and 32% an over-dosed treatment. The most common method for treating cattle against ticks was spraying. Conclusion: Despite the use of tick repellents by these breeders, tick-borne diseases still persist. This could be explained by the misuse of the products (under dosage and overdose), which can cause harmful effects or even resistance of certain ticks. It is, therefore important to respect the normal dosage of the products used as well as the methods of use (bath, spray, pour-on, etc.). In order to minimize the problems of resistance, awareness is necessary among breeders for the proper use of acaricidal products as well as all other drugs.

Keywords: ticks, resistance, anti-tick, cattle, korhogo

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580 Evaluation of Published Materials in Meeting the Information Needs of Students in Three Selected College Libraries in Oyo State, Nigeria

Authors: Rafiat Olasumbo Akande

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Most college libraries in Oyo State show signs of unhealthy collection practices like the preponderance of non-recent collections and indiscriminate acquisition of sub-standard books from hawkers. The objective of this study, therefore, is to determine the extent at which available published materials in those college libraries are able to meet both knowledge and information needs of students in those institutions. A descriptive survey was conducted among 18 librarians and 21 library officers in three colleges purposively selected for the exercise using simple sampling technique. In all, 279 questionnaires were administered and out of those 279 administered, 265 were returned and analyzed using Statistical Package for Social Science (SPSS). Three College Librarian were also interviewed. Findings from the study showed that due to the paucity of funds, obsolete materials, and sub-standard materials being procured from roadside book hawkers hinders the college libraries in meeting the information needs of the students in these college libraries. It then concluded that only when there is standard procedure for collection management and acquisition of library materials that the knowledge and information needs of the students could be met. The study recommends that students and curriculum review committee members from various departments should always be involved in determining materials needed by the library to meet students information needs and that institution authority must fund, monitor and ensure compliance with the acquisition policy in place in the college libraries.

Keywords: libraries, published materials, information needs, college, evaluation, students

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579 Development of Nanostructrued Hydrogel for Spatial and Temporal Controlled Release of Active Compounds

Authors: Shaker Alsharif, Xavier Banquy

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Controlled drug delivery technology represents one of the most rapidly advancing areas of science in which chemists and chemical engineers are contributing to human health care. Such delivery systems provide numerous advantages compared to conventional dosage forms including improved efficacy, and improved patient compliance and convenience. Such systems often use synthetic polymers as carriers for the drugs. As a result, treatments that would not otherwise be possible are now in conventional use. The role of bilayered vesicles as efficient carriers for drugs, vaccines, diagnostic agents and other bioactive agents have led to a rapid advancement in the liposomal drug delivery system. Moreover, the site avoidance and site-specific drug targeting therapy could be achieved by formulating a liposomal product, so as to reduce the cytotoxicity of many potent therapeutic agents. Our project focuses on developing and building hydrogel with nanoinclusion of liposomes loaded with active compounds such as proteins and growth factors able to release them in a controlled fashion. In order to achieve that, we synthesize several liposomes of two different phospholipids concentrations encapsulating model drug. Then, formulating hydrogel with specific mechanical properties embedding the liposomes to manage the release of active compound.

Keywords: controlled release, hydrogel, liposomes, active compounds

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578 Outcome-Based Water Resources Management in the Gash River Basin, Eastern Sudan

Authors: Muna Mohamed Omer Mirghani

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This paper responds to one of the key national development strategies and a typical challenge in the Gash Basin as well as in different parts of Sudan, namely managing water scarcity in view of climate change impacts in minor water systems sustaining over 50% of the Sudan population. While now focusing on the Gash river basin, the ultimate aim is to replicate the same approach in similar water systems in central and west Sudan. The key objective of the paper is the identification of outcome-based water governance interventions in Gash Basin, guided by the global Sustainable Development Goal six (SDG 6 on water and sanitation) and the Sudan water resource policy framework. The paper concluded that improved water resources management of the Gash Basin is a prerequisite for ensuring desired policy outcomes of groundwater use and flood risk management purposes. Analysis of various water governance dimensions in the Gash indicated that the operationalization of a Basin-level institutional reform is critically focused on informed actors and adapted practices through knowledge and technologies along with the technical data and capacity needed to make that. Adapting the devolved Institutional structure at state level is recommended to strengthen the Gash basin regulatory function and improve compliance of groundwater users.

Keywords: water governance, Gash Basin, integrated groundwater management, Sudan

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577 User Requirements Study in Order to Improve the Quality of Social Robots for Dementia Patients

Authors: Konrad Rejdak

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Introduction: Neurodegenerative diseases are frequently accompanied by loss and unwanted change in functional independence, social relationships, and economic circumstances. Currently, the achievements of social robots to date is being projected to improve multidimensional quality of life among people with cognitive impairment and others. Objectives: Identification of particular human needs in the context of the changes occurring in course of neurodegenerative diseases. Methods: Based on the 110 surveys performed in the Medical University of Lublin from medical staff, patients, and caregivers we made prioritization of the users' needs as high, medium, and low. The issues included in the surveys concerned four aspects: user acceptance, functional requirements, the design of the robotic assistant and preferred types of human-robot interaction. Results: We received completed questionnaires; 50 from medical staff, 30 from caregivers and 30 from potential users. Above 90% of the respondents from each of the three groups, accepted a robotic assistant as a potential caregiver. High priority functional capability of assistive technology was to handle emergencies in a private home-like recognizing life-threatening situations and reminding about medication intake. With reference to the design of the robotic assistant, the majority of the respondent would like to have an anthropomorphic appearance with a positive emotionally expressive face. The most important type of human-robot interaction was a voice-operated system and by touchscreen. Conclusion: The results from our study might contribute to a better understanding of the system and users’ requirements for the development of a service robot intended to support patients with dementia.

Keywords: assistant robot, dementia, long term care, patients

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576 Need of Medicines Information OPD in Tertiary Health Care Settings: A Cross Sectional Study

Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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575 Simplifying Health Risk Assessment (HRA) and Its Operationalisation for Turnaround Activities

Authors: Thirumila Muthukamaru

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The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

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574 Anagliptin: A Japanese Made Dipeptidyl Peptidase-4 Inhibitor That Naturally Lowers LDL-Cholesterol in Type 2 Diabetes

Authors: C. Iitake, K. Iitake

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Background and Aims: The number of diabetic patients based on obesity is increasing drastically in Asia. Since most patients have multiple complications, if one medicine can treat those at the same time, it would contribute to financial savings and patients’ compliance. A Japanese-made DPP-4 inhibitor, Anagliptin is only sold in Japan and South Korea. It is said to have its unique aspect of lowering LDL-cholesterol (LDL-C) levels together with lowering blood glucose. We have assessed 63 patients in our faculty to investigate this fact clinically and statistically. Method: Patients with type 2 diabetes who has been treated with Anagliptin for the first time was investigated changes in HbA1c, fasting and random blood glucose and LDL-C levels from the baseline at 1 month, 6 months and 1 year. Results: 29 patients (46.1%) were given DPP-4 inhibitors for the first time (original group), and 34 patients (53.9%) were using other DPP-4 inhibitors before Anagliptin (exchanged group). The change in HbA1c and fasting glucose from the baseline were -2.0% (P < 0.001) and -38.3mg/dl (P < 0.01) respectively with original group, -0.5% (P < 0.01) and -29.4mg/dl (P < 0.01) respectively with exchanged group. 23 patients (36.5%) were using statins or fibrates and 28 patients (44.4%) were using none, and its LDL-C change were -8.1mg/dl (P = 0.2582) and -10.1mg/dl(P < 0.05) respectively. 16 patients(25%) with LDL-C level ≥ 140mg/dl, change were -21.7mg/dl(P < 0.05). LDL-C change did not have a correlation coefficient (=-0.03238) with change in HbA1c and was not affected by other diabetic drugs. Conclusion: These findings indicate that Anagliptin is a potential treatment option for type 2 diabetes complicated by hyperlipidemia.

Keywords: DPP-4 inhibitors, anagliptin, LDL-cholesterol, type 2 diabetes

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573 Significance of Occupational Safety for Healthcare Professionals

Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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572 Explaining the Role of Iran Health System in Polypharmacy among the Elderly

Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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571 NanoCelle®: A Nano Delivery Platform to Enhance Medicine

Authors: Sean Hall

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Nanosystems for drug delivery are not new; as medicines evolve, so too does the desire to deliver a more targeted, patient-compliant medicine. Though, historically the widespread use of nanosystems for drug delivery has been fouled by non-replicability, scalability, toxicity issues, and economics. Examples include steps of manufacture and thus cost to manufacture, toxicity for nanoparticle scaffolding, autoimmune response, and considerable technical expertise for small non-commercial yields. This, unfortunately, demonstrates the not-so-obvious chasm between science and drug formulation for regulatory approval. Regardless there is a general and global desire to improve the delivery of medicines, reduce potential side effect profiles, promote increased patient compliance, and increase and/or speed public access to medicine availability. In this paper, the author will discuss NanoCelle®, a nano-delivery platform that specifically addresses degradation and solubility issues that expands from fundamental micellar preparations. NanoCelle® has been deployed in several Australian listed medicines and is in use of several drug candidates across small molecules, with research endeavors now extending into large molecules. The author will discuss several research initiatives as they relate to NanoCelle® to demonstrate similarities seen in various drug substances; these examples will include both in vitro and in vivo work.

Keywords: NanoCelle®, micellar, degradation, solubility, toxicity

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