Search results for: drug policy

Authors: Ignacio Luis Ramirez, Brittney Holcomb

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This study examines attitudes toward sexual assault based on religious affiliation, religiosity, religious beliefs, attitude about sexual assault education, alcohol, and drug use. This study found respondents who identified themselves as Catholics had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements than Baptists or Protestants. Respondents who indicated a greater problem with alcohol had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements. In reference to gender, males had more negative attitudes toward sexual assault and were more likely to support victim-blaming statements than females. The respondent’s religiosity and religious beliefs did not affect their attitudes toward sexual assault. Additionally, attitudes about sexual assault education and drug use did not affect attitudes toward sexual assault.

Keywords: sexual assault, religion, education, alcohol, drugs

Procedia PDF Downloads 164

Authors: S. Boulenouar, A. Boukli Hacene, S. Brahmi

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Quality is an old concept but which recently became omnipresent in the society. It is a pledge of the well done job and therefore the satisfaction of the customer. Now, dispensing pharmacies seem to be held away from this approach. Officinal staff is called to dispense drugs. However this essential function is rarely studied and taken into account. To contribute to the good use of medicines and to reduce the dangers, it is important to consider the dispensation of drugs practised in the pharmacies. It is a both descriptive and retrospective study .The descriptive part is to conduct a survey near to the dispensary pharmacists. The retrospective section concentrates on the analysis of medicine prescriptions dispensed to patients. Following the survey that we carried out near the pharmacists of dispensary of the town of Oran, it appears that in majority, they are not inclined, by themselves, to take up the challenge of quality at the dispensary. The approach requires time and a motivation that pharmacists do not have for the moment. Efforts are still needed on the part of pharmacists, but also of authorities and organizations in charge of quality in the dispensary. At the end of this work, it seems to us that the implementation of a quality approach is part of our reflection on the added value of the pharmacist of dispensary in the drug chain.

Keywords: customer satisfaction, dispensary, dispensing of the drug, quality approach

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Authors: Anoff Anim, Lila Mahmoud, Maria Katsikogianni, Sanjit Nayak

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Sustained and controlled delivery of antimicrobial drugs have been largely studied recently using metal organic frameworks (MOFs)and different polymers. However, much attention has not been given to combining both MOFs and biodegradable polymers, which would be a good strategy in providing a sustained gradual release of the drugs. Herein, we report a comparative study of the sustained and controlled release of widely used antibacterial drugs, cephalexin and metronidazole, from zinc-based MOF-5 incorporated in biodegradable polycaprolactone (PCL) and poly-lactic glycolic acid (PLGA) membranes. Cephalexin and metronidazole were separately incorporated in MOF-5 post-synthetically, followed by their integration into biodegradable PLGA and PCL membranes. The pristine MOF-5 and the loaded MOFs were thoroughly characterized by FT-IR, SEM, TGA and PXRD. Drug release studies were carried out to assess the release rate of the drugs in PBS and distilled water for up to 48 hours using UV-Vis Spectroscopy. Four bacterial strains from both the Gram-positive and Gram-negative types, Staphylococus aureus, Staphylococuss epidermidis, Escherichia coli, Acinetobacter baumanii, were tested against the pristine MOF, pure drugs, loaded MOFs and the drug-loaded MOF-polymer composites. Metronidazole-loaded MOF-5 composite of PLGA (PLGA-Met@MOF-5) was found to show highest efficiency to inhibit the growth of S. epidermidis compared to the other bacteria strains while maintaining a sustained minimum inhibitory concentration (MIC). This study demonstrates that the combination of biodegradable MOF-polymer composites can provide an efficient platform for sustained and controlled release of antimicrobial drugs and can be a potential strategy to integrate them in biomedical devices.

Keywords: antimicrobial resistance, biodegradable polymers, cephalexin, drug release metronidazole, MOF-5, PCL, PLGA

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Authors: Muhammad Fayyaz Nazir, Ellen Wayenberg, Shahzadaah Faahed Qureshi

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Introduction: The study is based on the Contextual Interaction Theory (CIT) constructs to explore the role of policy actors in implementing the COVID-19 Disease Prevention and Control (DP&C) Policy. The study analyzes the role of healthcare workers' contextual factors, such as cognition, motives, and resources, and their interactions in implementing Social Distancing (SD). In this way, we test a two actors policy implementation theory, i.e., the CIT in a three-actor context. Methods: Data was collected through document analysis and semi-structured interviews. For a qualitative study design, interviews were conducted with questions on cognition, motives, and resources from the healthcare workers involved in implementing SD in the local context in Multan – Pakistan. The possible interactions resulting from contextual factors of the policy actors – healthcare workers were identified through framework analysis protocol guided by CIT and supported by trustworthiness criterion and data saturation. Results: This inquiry resulted in theory application, addition, and enrichment. The theoretical application in the three actor's contexts illustrates the different levels of motives, cognition, and resources of healthcare workers – senior administrators, managers, and healthcare professionals. The senior administrators working in National Command and Operations Center (NCOC), Provincial Technical Committees (PTCs), and Districts Covid Teams (DCTs) were playing their role with high motivation. They were fully informed about the policy and moderately resourceful. The policy implementors: healthcare managers working on implementing the SD within their respective hospitals were playing their role with high motivation and were fully informed about the policy. However, they lacked the required resources to implement SD. The target medical and allied healthcare professionals were moderately motivated but lack of resources and information. The interaction resulted in cooperation and the need for learning to manage the future healthcare crisis. However, the lack of resources created opposition to the implementation of SD. Objectives of the Study: The study aimed to apply a two actors theory in a multi actors context. We take this as an opportunity to qualitatively test the theory in a novel situation of the Covid-19 pandemic and make way for its quantitative application by designing a survey instrument so that implementation researchers can apply CIT through multivariate analyses or higher-order statistical modeling. Conclusion: Applying two actors' implementation theory in exploring a complex case of healthcare intervention in three actors context is a unique work that has never been done before, up to the best of our knowledge. So, the work will contribute to the policy implementation studies by applying, extending, and enriching an implementation theory in a novel case of the Covi-19 pandemic, ultimately fulfilling the gap in implementation literature. Policy institutions and other low or middle-income countries can learn from this research and improve SD implementation by working on the variables with weak significance levels.

Keywords: COVID-19, disease prevention and control policy, implementation, policy actors, social distancing

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Authors: Loizos A. Hadjivasiliou, May Chehab

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Confronted with the human tragedy unfolding in the Mediterranean during the 2011-2016 period, the European Union introduced for the first time the “hotspot approach”, the establishment of facilities for initial reception, identification registration, and fingerprinting of asylum seekers and migrants arriving in the EU by sea, at the frontline Member States. However, the lack of a comprehensive collective policy on migration management and border security left the Mediterranean Member States, mainly Italy, Greece, and Cyprus, struggling to overcome these challenges. The current study sheds light on the implementation of the hotspot approach as the frontispiece of the European response to the migration challenges, which, limited to the operational and financial support of the hosting member states, leads to heterogeneous burden-sharing. Within this framework, it highlights the fact that the implementation of the hotspots as a panacea carries the risk of transforming the Mediterranean member states into giant hotspots with unpredictable consequences for the future of the Schengen area.

Keywords: asylum, burden sharing, hotspots, migration management policy, Schengen area

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Authors: Nor Jannah Mohd Sebri, Khairul Anuar Mat Amin

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Dication cross-linked gellan gum hydrogel loaded with Ibuprofen with excellent mechanical properties had been synthesized as potential candidate for non-toxic biocompatible polymer material in tissue engineering. The gellan gum hydrogel with 5% Ibuprofen had produced a slow release profile with total drug release time of 25 hours as a resulting low swelling value recorded at 22+0.5%. Its compressive strength, 200.13+21 kPa was highest of all other hydrogel ratio of 0.5% and 1.0% Ibuprofen incorporation. Young’s Modulus of the hydrogel with 5% Ibuprofen was recorded at 1.8+0.01 MPa, indicating good gel strength in which it is capable of withstanding a fair amount of subjected force during topical wound dressing application. Excellent mechanical properties, together with slow release profile, make the ibuprofen-loaded hydrogel a prospect candidate as biocompatible extracellular matrices in wound management.

Keywords: gellan gum, ibuprofen, slow drug release, hydrogel

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Authors: Lei Zhao, Zhe Yuan, Wenyue Kuang

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This paper studies two-warehouse inventory models for a deteriorating item considering that the demand is influenced by inventory levels. The problem mainly focuses on the optimal order policy and the optimal order cycle with inventory-level-dependent demand in two-warehouse system for retailers. It considers the different deterioration rates and the inventory holding costs in owned warehouse (OW) and rented warehouse (RW), and the conditions of transportation cost, allowed shortage and partial backlogging. Two inventory models are formulated: last-in first-out (LIFO) model and first-in-first-out (FIFO) model based on the policy choices of LIFO and FIFO, and a comparative analysis of LIFO model and FIFO model is made. The study finds that the FIFO policy is more in line with realistic operating conditions. Especially when the inventory holding cost of OW is high, and there is no difference or big difference between deterioration rates of OW and RW, the FIFO policy has better applicability. Meanwhile, this paper considers the differences between the effects of warehouse and shelf inventory levels on demand, and then builds retailers’ inventory decision model and studies the factors of the optimal order quantity, the optimal order cycle and the average inventory cost per unit time. To minimize the average total cost, the optimal dispatching policies are provided for retailers’ decisions.

Keywords: FIFO model, inventory-level-dependent, LIFO model, two-warehouse inventory

Procedia PDF Downloads 267

Authors: Anoff Anim, Lila A. M. Mahmoud, Maria Katsikogianni, Sanjit Nayak

Abstract:

Sustained and controlled delivery of antimicrobial drugs have been largely studied recently using metal organic frameworks (MOFs)and different polymers. However, much attention has not been given to combining both MOFs and biodegradable polymers, which would be a good strategy in providing a sustained gradual release of the drugs. Herein, we report a comparative study of the sustained and controlled release of widely used antibacterial drugs, cephalexin and metronidazole, from zinc-based MOF-5 incorporated in biodegradable polycaprolactone (PCL) and poly-lactic glycolic acid (PLGA) membranes. Cephalexin and metronidazole were separately incorporated in MOF-5 post-synthetically, followed by their integration into biodegradable PLGA and PCL membranes. The pristine MOF-5 and the loaded MOFs were thoroughly characterized by FT-IR, SEM, TGA and PXRD. Drug release studies were carried out to assess the release rate of the drugs in PBS and distilled water for up to 48 hours using UV-Vis Spectroscopy. Four bacterial strains from both the Gram-positive and Gram-negative types, Staphylococus aureus, Staphylococuss epidermidis, Escherichia coli, Acinetobacter baumanii, were tested against the pristine MOF, pure drugs, loaded MOFs and the drug-loaded MOF-polymer composites. Metronidazole-loaded MOF-5 composite of PLGA (PLGA-Met@MOF-5) was found to show highest efficiency to inhibit the growth of S. epidermidis compared to the other bacteria strains while maintaining a sustained minimum inhibitory concentration (MIC). This study demonstrates that the combination of biodegradable MOF-polymer composites can provide an efficient platform for sustained and controlled release of antimicrobial drugs and can be a potential strategy to integrate them in biomedical devices.

Keywords: antimicrobial resistance, biodegradable polymers, cephalexin, drug release metronidazole, MOF-5, PCL, PLGA

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Authors: Abdullah Almalky, Colin Evers

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Gifted individuals in rural areas may lack access and opportunities compared with urban students. This case study research provides research-based evidence to identify the professional needs of principals running rural schools with gifted education (GE) programs. The data were obtained from diverse cases (high-performing [HP] and low-performing [LP] schools) by conducting interviews with principals and teachers, conducting focus groups with gifted students, and analyzing policy documents. The findings reveal a lack of knowledge among principals in relation to GE. However, HP schools were more concerned with the needs of gifted students compared with LP schools. In addition, principals of HP schools were mostly instructional leaders, whereas LP schools were mostly led by building managers. Therefore, the study recommends a revision of GE policy in Saudi Arabia and urges ministries of education and universities to consider including GE in principals’ and teachers’ preparation programs to better serve gifted students in schools.

Keywords: gifted, Saudi Arabia, leadership, policy, rural education, case study, interview

Procedia PDF Downloads 155

Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

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Authors: Yuvraj Singh Dangi, Brajesh Kumar Tiwari, Ashok Kumar Jain, Kamta Prasad Namdeo

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The potential use of liposomes as drug carriers by i.v. injection is limited by their low stability in blood stream. Firstly, phospholipid exchange and transfer to lipoproteins, mainly HDL destabilizes and disintegrates liposomes with subsequent loss of content. To avoid the pain associated with injection and to obtain better patient compliance studies concerning various dosage forms, have been developed. Conventional liposomes (unilamellar and multilamellar) have certain drawbacks like low entrapment efficiency, stability and release of drug after single breach in external membrane, have led to the new type of liposomal systems. The challenge has been successfully met in the form of Double Liposomes (DL). DL is a recently developed type of liposome, consisting of smaller liposomes enveloped in lipid bilayers. The outer lipid layer of DL can protect inner liposomes against various enzymes, therefore DL was thought to be more effective than ordinary liposomes. This concept was also supported by in vitro release characteristics i.e. DL formation inhibited the release of drugs encapsulated in inner liposomes. DL consists of several small liposomes encapsulated in large liposomes, i.e., multivesicular vesicles (MVV), therefore, DL should be discriminated from ordinary classification of multilamellar vesicles (MLV), large unilamellar vesicles (LUV), small unilamellar vesicles (SUV). However, for these liposomes, the volume of inner phase is small and loading volume of water-soluble drugs is low. In the present study, the potential of phosphatidylethanolamine (PE) lipid anchored double liposomes (DL) to incorporate two drugs in a single system is exploited as a tool to augment the H. pylori eradication rate. Preparation of DL involves two steps, first formation of primary (inner) liposomes by thin film hydration method containing one drug, then addition of suspension of inner liposomes on thin film of lipid containing the other drug. The success of formation of DL was characterized by optical and transmission electron microscopy. Quantitation of DL-bacterial interaction was evaluated in terms of percent growth inhibition (%GI) on reference strain of H. pylori ATCC 26695. To confirm specific binding efficacy of DL to H. pylori PE surface receptor we performed an agglutination assay. Agglutination in DL treated H. pylori suspension suggested selectivity of DL towards the PE surface receptor of H. pylori. Monotherapy is generally not recommended for treatment of a H. pylori infection due to the danger of development of resistance and unacceptably low eradication rates. Therefore, combination therapy with amoxicillin trihydrate (AMOX) as anti-H. pylori agent and ranitidine bismuth citrate (RBC) as antisecretory agent were selected for the study with an expectation that this dual-drug delivery approach will exert acceptable anti-H. pylori activity.

Keywords: Helicobacter pylorI, amoxicillin trihydrate, Ranitidine Bismuth citrate, phosphatidylethanolamine, multi vesicular systems

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Authors: Reenu Yadav, Vidhi Guha, Udit N. Soni, Jay Ram Patel

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Chewing gums are mobile novel drug delivery systems, with a potential for administering drugs either for local action or for systemic absorption via the buccal route. An antimicrobial chewing gum delivery system of the methanolic extracts of Beatea monosperma (barks and twigs), Cordia obliqua (leaves and seeds) and Cuminun cyminum (seeds) against periodontal diseases caused by some oral pathogens, was designed and characterized on various parameters.The results of the study support the traditional application of the plants and suggest, plant extracts possess compounds with antimicrobial properties that can be used as potential antimicrobial agents and gums can be a good carrier of herbal extracts. Developed formulation will cure/protect from various periodontal diseases. Further development and evaluations chewing gums including the isolated compounds on the commercial scale and their clinical and toxicological studies are the future challenges.

Keywords: periodontal diseases, herbal chewing gum, herbal extracts, novel drug delivery systems

Procedia PDF Downloads 376

Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Heesu Kim

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This paper determines the varieties of state roles played in East Asia’s telecommunication market, regarding broadband industry. Technological capacity and the relationship between state and market affect the varieties of state role. In explaining the state’s engagement in the market, technology has always been considered as a necessary and sufficient condition. However technology variable has been useful in only explaining the extent of state’s involvement. This paper contributes by bringing in the political-economic factor, which is the relationship between state and market. This factor aids in distinguishing the varieties of state role played in emerging industries. Interaction between these two variables distinguishes 4 types of state roles played in the broadband industry. These roles are distinguished and characterized by the intensity of state’s intervention and the existence of technological capacity. This paper classifies four types of state role through the case of Singapore, China, Taiwan and Korea’s broadband industrial policy.

Keywords: East Asia, entrpreneurial state, industrial policy, regulatory state, technological capacity

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Authors: Tessa Heeren

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The following proposal pertains to the complex process of successfully implementing health policies that are based on public health research. A systematic review was conducted by myself and faculty at the Cluj School of Public Health in Romania. The reviewed articles covered a wide range of topics, such as barriers and facilitators to multi-sector collaboration, differences in professional cultures, and systemic obstacles. The reviewed literature identified communication, collaboration, user-friendly dissemination, and documentation of processes in the execution of applied research as important themes for the promotion of evidence in the public health decision-making process. This proposal fits into the Academy Health National Health Policy conference because it identifies and examines differences between the worlds of research and politics. Implications and new insights for federal and/or state health policy: Recommendations made based on the findings of this research include using politically relevant levers to promote research (e.g. campaign donors, lobbies, established parties, etc.), modernizing dissemination practices, and reforms in which the involvement of external stakeholders is facilitated without relying on invitations from individual policy makers. Description of how evidence and/or data was or could be used: The reviewed articles illustrated shortcomings and areas for improvement in policy research processes and collaborative development. In general, the evidence base in the field of integrating research into policy lacks critical details of the actual process of developing evidence based policy. This shortcoming in logistical details creates a barrier for potential replication of collaborative efforts described in studies. Potential impact of the presentation for health policy: The reviewed articles focused on identifying barriers and facilitators that arise in cross sector collaboration, rather than the process and impact of integrating evidence into policy. In addition, the type of evidence used in policy was rarely specified, and widely varying interpretations of the definition of evidence complicated overall conclusions. Background: Using evidence to inform public health decision making processes has been proven effective; however, it is not clear how research is applied in practice. Aims: The objectives of the current study were to assess the extent to which evidence is used in public health decision-making process. Methods: To identify eligible studies, seven bibliographic databases, specifically, PubMed, Scopus, Cochrane Library, Science Direct, Web of Science, ClinicalKey, Health and Safety Science Abstract were screened (search dates: 1990 – September 2015); a general internet search was also conducted. Primary research and systematic reviews about the use of evidence in public health policy in Europe were included. The studies considered for inclusion were assessed by two reviewers, along with extracted data on objective, methods, population, and results. Data were synthetized as a narrative review. Results: Of 2564 articles initially identified, 2525 titles and abstracts were screened. Ultimately, 30 articles fit the research criteria by describing how or why evidence is used/not used in public health policy. The majority of included studies involved interviews and surveys (N=17). Study participants were policy makers, health care professionals, researchers, community members, service users, experts in public health.

Keywords: cross-sector, dissemination, health policy, policy implementation

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Authors: Yihao Kuang, Bowen Ding

Abstract:

With the increasing scale and complexity of knowledge graph, modern knowledge graph contains more and more types of entity, relationship, and attribute information. Therefore, in recent years, it has been a trend for knowledge graph inference to use reinforcement learning to deal with large-scale, incomplete, and noisy knowledge graphs and improve the inference effect and interpretability. The Proximal Policy Optimization (PPO) algorithm utilizes a near-end strategy optimization approach. This allows for more extensive updates of policy parameters while constraining the update extent to maintain training stability. This characteristic enables PPOs to converge to improved strategies more rapidly, often demonstrating enhanced performance early in the training process. Furthermore, PPO has the advantage of offline learning, effectively utilizing historical experience data for training and enhancing sample utilization. This means that even with limited resources, PPOs can efficiently train for reinforcement learning tasks. Based on these characteristics, this paper aims to obtain a better and more efficient inference effect by introducing PPO into knowledge inference technology.

Keywords: reinforcement learning, PPO, knowledge inference

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: A. M. S. S. Amarasiri, A. P. Attanayake, K. A. P. W. Jayatilaka, L. K. B. Mudduwa

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Adriamycin (ADR) is an effective anthracyclin antitumor drug, but its clinical use is limited due to renal toxicity. The leaves of Asparagus falcatus (Family: Liliaceae) have been used in the management of renal diseases since antiquity. In the present investigation, the aqueous leaf extract of A. falcatus was evaluated for acute nephroprotective activity in ADR induced nephrotoxic rats. Nephrotoxicity was induced in healthy male Wistar rats by intraperitoneal administration of ADR 20 mg/kg. The lyophilized powder of the aqueous refluxed (4h) leaf extract of A. falcatus was administered orally at three selected doses; 200, 400 and 600 mg/kg for three consecutive days. Fosinopril sodium (0.09 mg/kg) was used as the standard drug. Administration of the plant extract and the standard drug was commenced 24 hours after the induction of nephrotoxicity to rats. The nephroprotective effect was determined by selected biochemical parameters and by the assessment of histopathology on H and E stained kidney sections. The results were compared to a group of control rats with ADR induced nephrotoxicity. A group of rats administered with the equivalent volume of normal saline served as the healthy control. Administration of ADR 20 mg/kg produced a significant increase in the concentrations of serum creatinine (61%) and urine protein (73%) followed by a significant decrease in serum total protein (21%) and albumin (44%) of the plant extract treated animals compared to the healthy control group (p < 0.05). The aqueous extract of Asparagus falcatus at the three doses; 200, 400 and 600 mg/kg and the standard drug were found to decrease the elevation of concentrations of serum creatinine (33%, 51%, 54% and 42%) and urine protein (8%, 63%, 80% and 86%) respectively. The serum concentrations of total protein (12%, 17%, 29% and 12%) and albumin (3%, 17%, 17% and 16%) were significantly increased compared to the nephrotoxic control group respectively. Assessment of histopathology on H and E stained kidney sections demonstrated that ADR induced renal injury, as evidenced by loss of brush border, cytoplasmic vacuolization, pyknosis in renal tubular epithelial cells, haemorrhages, glomerular congestion and presence of hyaline casts. Treatment with the plant extract and the standard drug resulted in attenuation of the morphological destruction in rats. The results of the present study revealed that the aqueous leaf extract of A. falcatus possesses significant nephroprotective activity against adriamycin induced acute nephrotoxicity. The improved kidney functions were supported with the results of selected biochemical parameters and histological changes observed on H and E stained sections of the kidney tissues in Wistar rats.

Keywords: adriamycin induced nephrotoxicity, asparagus falcatus, biochemical assessment, histopathological assessment, nephroprotective activity

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Authors: Ranjith Ihalanayake, Lalith Seelanatha, John Breen

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In this study, we explored the current working capital management practices as applied in small businesses in Victoria, filling an existing theoretical and empirical gap in literature in general and in Australia in particular. Amidst the current global competitive and dynamic environment, the short term insolvency of small businesses is very critical for the long run survival. A firm’s short-term insolvency is dependent on the availability of sufficient working capital for feeding day to day operational activities. Therefore, given the reliance for short-term funding by small businesses, it has been recognized that the efficient management of working capital is crucial in respect of the prosperity and survival of such firms. Against this background, this research was an attempt to understand the current working capital management strategies and practices used by the small scale businesses. To this end, we conducted an internet survey among 220 small businesses operating in Victoria, Australia. The survey results suggest that the majority of respondents are owner-manager (73%) and male (68%). Respondents participated in this survey mostly have a degree (46%). About a half of respondents are more than 50 years old. Most of respondents (64%) have business management experience more than ten years. Similarly, majority of them (63%) had experience in the area of their current business. Types of business of the respondents are: Private limited company (41%), sole proprietorship (37%), and partnership (15%). In addition, majority of the firms are service companies (63%), followed by retailed companies (25%), and manufacturing (17%). Size of companies of this survey varies, 32% of them have annual sales $100,000 or under, while 22% of them have revenue more than $1,000,000 every year. In regards to the total assets, majority of respondents (43%) have total assets $100,000 or less while 20% of respondents have total assets more than $1,000,000. In regards to WCMPs, results indicate that almost 70% of respondents mentioned that they are responsible for managing their business working capital. The survey shows that majority of respondents (65.5%) use their business experience to identify the level of investment in working capital, compared to 22% of respondents who seek advice from professionals. The other 10% of respondents, however, follow industry practice to identify the level of working capital. The survey also shows that more than a half of respondents maintain good liquidity financial position for their business by having accounts payable less than accounts receivable. This study finds that majority of small business companies in western area of Victoria have a WCM policy but only about 8 % of them have a formal policy. Majority of the businesses (52.7%) have an informal policy while 39.5% have no policy. Of those who have a policy, 44% described their working capital management policies as a compromise policy while 35% described their policy as a conservative policy. Only 6% of respondents apply aggressive policy. Overall the results indicate that the small businesses pay less attention into the management of working capital of their business despite its significance in the successful operation of the business. This approach may be adopted during favourable economic times. However, during relatively turbulent economic conditions, such an approach could lead to greater financial difficulties i.e. short-term financial insolvency.

Keywords: small business, working capital management, Australia, sufficient, financial insolvency

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Authors: Fatin Mansour Daas

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Language education responds to and is reflective of emerging social and political trends. Language policies and practices are shaped by political, economic, social and cultural considerations. Following this, Israeli language education policy as implemented in Arab schools in Israel is influenced by the particular political and social situation of Arab-Palestinian citizens of Israel. This national group remained in their homeland following the war in 1948 between Israel and its Arab neighbors and became Israeli citizens following the establishment of the State of Israel. This study examines language policy in Arab schools in Israel from 1948 until the present time in light of the unique experience of the Palestinian Arab homeland minority in Israel with a particular focus on questions of politics and identity. The establishment of the State of Israel triggered far-reaching political, social and educational transformations within Arab Palestinian society in Israel, including in the area of language and language studies. Since 1948, the linguistic repertoire of Palestinian Arabs in Israel has become more complex and diverse, while the place and status of different languages have changed. Following the establishment of the State of Israel, only Hebrew and Arabic were retained as the official languages, and Israeli policy reflected this in schools as well: with the advent of the Jewish state, Hebrew language education among Palestinians in Israel has increased. Similarly, in Arab Palestinian schools in Israel, English is taught as a third language, Hebrew as a second language, and Arabic as a first language – even though it has become less important to native Arabic speakers. This research focuses on language studies and language policy in the Arab school system in Israel from 1948 onwards. It will analyze the relative focus of language education between the different languages, the rationale of various language education policies, and the pedagogic approach used to teach each language and student achievements vis-à-vis language skills. This study seeks to understand the extent to which Arab schools in Israel are multi-lingual by examining successes, challenges and difficulties in acquiring the respective languages. This qualitative study will analyze five different components of language education policy: (1) curriculum, (2) learning materials; (3) assessment; (4) interviews and (5) archives. Firstly, it consists of an analysis examining language education curricula, learning materials and assessments used in Arab schools in Israel from 1948-2018 including a selection of language textbooks for the compulsory years of study and the final matriculation (Bagrut) examinations. The findings will also be based on archival material which traces the evolution of language education policy in Arabic schools in Israel from the years 1948-2018. This archival research, furthermore, will reveal power relations and general decision-making in the field of the Arabic education system in Israel. The research will also include interviews with Ministry of Education staff who provide instructional oversight in the instruction of the three languages in the Arabic education system in Israel. These interviews will shed light on the goals of language education as understood by those who are in charge of implementing policy.

Keywords: language education policy, languages, multilingualism, language education, educational policy, identity, Palestinian-Arabs, Arabs in Israel, educational school system

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Authors: Pramod Jagtap, Kisan Jadhav, Neha Dand

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Risperidone (RISP) is an antipsychotic agent and has low water solubility and nontargeted delivery results in numerous side effects. Hence, an attempt was made to develop SLNs hydrogel for intranasal delivery of RISP to achieve maximum bioavailability and reduction of side effects. RISP loaded SLNs composed of 1.65% (w/v) lipid mass were produced by high shear homogenization (HSH) coupled ultrasound (US) method using glyceryl monostearate (GMS) or Imwitor 900K (solid lipid). The particles were loaded with 0.2% (w/v) of the RISP & surface-tailored with a 2.02% (w/v) non-ionic surfactant Tween® 80. Optimization was done using 32 factorial design using Design Expert® software. The prepared SLNs dispersion incorporated into Polycarbophil AA1 hydrogel (0.5% w/v). The final gel formulation was evaluated for entrapment efficiency, particle size, rheological properties, X ray diffraction, in vitro diffusion, ex vivo permeation using sheep nasal mucosa and histopathological studies for nasocilliary toxicity. The entrapment efficiency of optimized SLNs was found to be 76 ± 2 %, polydispersity index <0.3., particle size 278 ± 5 nm. This optimized batch was incorporated into hydrogel. The pH was found to be 6.4 ± 0.14. The rheological behaviour of hydrogel formulation revealed no thixotropic behaviour. In histopathology study, there was no nasocilliary toxicity observed in nasal mucosa after ex vivo permeation. X-ray diffraction data shows drug was in amorphous form. Ex vivo permeation study shows controlled release profile of drug.

Keywords: ex vivo, particle size, risperidone, solid lipid nanoparticles

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Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

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In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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Authors: Endalew Fufa Kufi

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One of the major concerns in educational provision and success determination is access to available opportunities. In that, girls’ access to education has been a point of concern, and more emphasis has come to be at the forefront regarding success. Researches have mostly been held on extremes such as equal access and success, but only a few works deal with process issues related to home and school interplay, issues of progress from lower to higher levels, and spatial conditions related to girls’ education. Hence, this survey assessed experiences in three countries of Africa: Ethiopia, Ghana, and Botswana regarding girls’ education in policy and practice as related to contextual matters in girls’ education. Contextual discourse analysis of qualitative design was used to materialize the study. From each country, five research works held 2010 onwards were purposively selected through criterion-sampling. On the policy aspect, workable documents were looked into. The findings denoted that educational access was of more stretch and generic nature, and the narration was dominated by institutional expectations, not identifying which group should benefit what. The researches largely dealt with either subject-specific dealings or access alone at large. Success studies, by far, dealt with a comparison of girls with boys rather than determinant-related projections. Moreover, the cultural representation of girls’ education had a very minimal part in both policy and researches. From that, it could be found that in-depth scrutiny on the individual, institutional, and leadership determinants of girls’ education would be necessary.

Keywords: determinants, girls, education, feminism

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Authors: Doaa Nounou

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This research examines the public policy energy subsidies reform efforts in Egypt since 2014. Egypt’s widely used energy subsidies have been controversial since they were first introduced, as they inadequately target the poorest part of the population. Also, their effect on economic development and democratic transition became very challenging in recent years. This research argues that although subsidy reform is a highly politicalized issue in democratizing countries, there are still a number of pragmatic public policies that can be applied to make the subsidy system function more efficiently and at the same time decrease inequality which could facilitate a more orderly and peaceful transition to democracy. Therefore, this research attempts to study the role of the executive branch in reforming the subsidy programmes to support the poor and bring about structural changes to achieve social justice and economic growth. This research also attempts to analyze the role of the military and civil society in reforming the subsidy system. Moreover, it attempts to discuss the role of the state media in social mobilization to rationalize consumption and its contribution to subsidies reform.

Keywords: subsidies, public policy, political economy, democratization, equality

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Authors: Dhiraj Neupane

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Decentralized policy and practices have largely concentrated on the transformation of decision-making authorities from central to local institutions (or people) in the developing world. Such policy and practices always aimed for the equitable and efficient management of resources in the line of poverty reduction. The transformation of forest decision-making autonomy has also glorified as the best forest management alternatives to maximize the forest benefits and improve the livelihood of local people living nearby the forests. However, social heterogeneity and poor decision-making capacity of local institutions (or people) pose a nexus while managing the resources and sharing the forest benefits among the user households despite the policy objectives. The situation is severe in the lowland of Nepal, where forest resources have higher economic potential and user households have heterogeneous socio-economic conditions. The study discovered that utilizing the power of decision-making autonomy, user households were putting low values of timber considering the equitable access of timber to all user households as it is the most valuable product of community forest. Being the society is heterogeneous by socio-economic conditions, households of better economic conditions were always taking higher amount of forest benefits. The low valuation of timber has negative consequences on equitable benefit sharing and poor support to livelihood improvement of user households. Moreover, low valuation has possibility to increase the local demands of timber and increase the human pressure on forests.

Keywords: decentralized forest policy, Nepal, poverty, social heterogeneity, Terai

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Authors: Taoufik Djennane

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Algeria is characterized by a fragmented language education policy. While pre-university education is entirely conducted in Arabic, higher education remains linguistically divided, with some fields offered in Arabic and others exclusively based on French. Within this linguistic policy, English remains far behind French. However, there has been a significant shift in the state’s linguistic orientation since the social riot of March 2019, known as El-Hirak, which ousted away the ex-president. Since then, social calls were voiced to get rid of French, and English started to receive an unprecedented political push. The historical decision only came at the beginning of the academic year 2023-2024 when the ministry of higher education imposed English as medium of instruction (hereafter EMI), especially in scientific and technological fields. As such, this paper considered this abrupt switch in the medium of instruction and its effects on the community of teachers. Building on a socio-psychological approach, teachers’ attitudes towards EMI were measured. Data were collected using classroom observation, semi-structured interviews and a survey. The results showed that a clear majority of teachers hold negative attitudes towards EMI. The point is that they are linguistically incompetent, and they are not ready yet to deliver content subjects in a language they have no, or little, command of. The study showed the importance of considering attitudes in the ‘policy-formation’ stage before the ‘implementation’ stage. The findings also proved that teachers are not passive bystanders; they can rather be the final arbiters imposing themselves as policy-makers resisting ministerial instructions through their linguistic practices inside the classroom which only acknowledge French. The study showed the necessity to avoid sudden switch and opt for gradual change, without putting aside those who are directly concerned with political/pedagogical measures (teachers, learners, etc).

Keywords: micro planning, EMI, language education policy, agency

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Authors: Faraz Zarghami, Elham Anari, Nosratollah Zarghami, Yones Pilehvar-Soltanahmadi, Abolfazl Akbarzadeh, Sepideh Jalilzadeh-Tabrizi

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The development of nanotherapy has presented a new method of drug delivery targeted directly to the neoplasmic tissues, to maximize the action with fewer dose requirements. In the past two decades, poly(lactic-co-glycolic acid) (PLGA) has frequently been investigated by many researchers and is a popular polymeric candidate, due to its biocompatibility and biodegradability, exhibition of a wide range of erosion times, tunable mechanical properties, and most notably, because it is a FDA-approved polymer. Chrysin is a natural flavonoid which has been reported to have some significant biological effects on the processes of chemical defense, nitrogen fixation, inflammation, and oxidation. However, the low solubility in water decreases its bioavailability and consequently disrupts the biomedical benefits. Being loaded with PLGA-PEG increases chrysin solubility and drug tolerance, and decreases the discordant effects of the drug. The well-structured chrysin efficiently accumulates in the breast cancer cell line (T47D). In the present study, the structure and chrysin loading were delineated using proton nuclear magnetic resonance (HNMR), Fourier-transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM), and the in vitro cytotoxicity of pure and nanochrysin was studied by the MTT assay. Next, the RNA was exploited and the cytotoxic effects of chrysin were studied by real-time PCR. In conclusion, the nanochrysin therapy developed is a novel method that could increase cytotoxicity to cancer cells without damaging the normal cells, and would be promising in breast cancer therapy.

Keywords: MTT assay, chrysin, flavonoids, nanotherapy

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Authors: Daniel Silander

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This article explores the EU Initiated European Neighborhood Policy (ENP) towards Ukraine. It also explores Russian geopolitics in the region. We argue that Ukraine is sandwiched between two regional powers in the EU and Russia. By analyzing EU democracy promotion towards Ukraine and neighbors, we assess a weak EU normative capacity. Instead of building a “ring of friends”, as argued by the EU Commission, in an enlarged democratic community, the EU has achieved poor democratic records in Ukraine which opened for a revival of Russia in the region and causes the international crisis over Crime of 2014.

Keywords: regional neighborhood policy, European Union, Russia, Ukraine, domestic elites

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Authors: Bishwa Nath Oli

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Nepal is highly impacted by climate change and adaptation has been a major focus. This paper investigates the gaps and coherence in national policies across water, forestry, local development and agriculture sectors, identifies their links to climate change adaptation and national development plans and analyzes the effectiveness of climate change policy on adaptation. The study was based on a content analysis of relevant policy documents on the level of attention given to adaptation and key informant interviews. Findings show that sectoral policies have differing degrees of cross thematic coherence, often with mismatched priorities and differing the paths towards achieving climate change goal. They are somewhat coherent in addressing immediate disaster management issues rather than in climate adaptation. In some cases, they are too broad and complicated and the implementation suffers from barriers and limits due to lack of capacity, investment, research and knowledge needed for evidence-based policy process. They do not adequately provide operational guidance in supporting communities in adapting to climate change. The study recommends to a) embrace longer-term cross-sectoral planning within government structures to foster greater policy coherence and integrated adaptation planning, b) increase awareness and flow of information on the potential role of communities in climate change, c) review the existing development sectors from the climate change perspectives, and d) formulate a comprehensive climate change legislation based on the need to implement the new Constitution.

Keywords: agriculture, climate change adaptation, forestry, policies

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Authors: Mhaned Oubounyt, Jan Baumbach

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Differences in co-expression networks between two or multiple cells (sub)types across conditions is a pressing problem in single-cell RNA sequencing (scRNA-seq). A key challenge is to define those co-variations that differ between or among cell types and/or conditions and phenotypes to examine small regulatory networks that can explain mechanistic differences. To this end, we developed SCANet, an all-in-one Python package that uses state-of-the-art algorithms to facilitate the workflow of a combined single-cell GCN (Gene Correlation Network) and GRN (Gene Regulatory Networks) pipeline, including inference of gene co-expression modules from scRNA-seq, followed by trait and cell type associations, hub gene detection, co-regulatory networks, and drug-gene interactions. In an example case, we illustrate how SCANet can be applied to identify regulatory drivers behind a cytokine storm associated with mortality in patients with acute respiratory illness. SCANet is available as a free, open-source, and user-friendly Python package that can be easily integrated into systems biology pipelines.

Keywords: single-cell, co-expression networks, drug-gene interactions, co-regulatory networks

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