Search results for: inpatient medication order entry system

Authors: Enji E. Alzamzami, Kholod A. Almwallad, Rahaf J. Alwafi, Roaa H. Alansari, Shatha S. Alshehri, Aeshah A. Alsiyami

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This paper demonstrates a system that helps solve the congestion problem at the entrance gates and limits the spread of viruses among people in crowded environments, such as COVID-19, using the IoT (Internet of Things). This system may assist in organizing the campus entry process efficiently by developing a smart card application supported by NFC (Near Field Communication) technology through which users' information could be sent to a reader to share it with the server and allow the server to perform its tasks and send a confirmation response for the request either by acceptance or rejection.

Keywords: COVID-19, IoT, NFC technology, smart card

Procedia PDF Downloads 109

Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

Procedia PDF Downloads 100

Authors: Max Moleke

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Manufacturing industries are faced with different types of problems. One of the most important role of controlling and monitoring a production process is to actually determine how to deal with unforeseen disruption when they arise. A majority of manufacturing tern to spend huge amount of money in order to meet up with their customers requirements and demand but due to instabilities within the manufacturing process, this objectives and goals are difficult to be achieved. In this research, we have developed a feedback control system that can minimize instability within the manufacturing system in order to boost the system output and productivity.

Keywords: disruption, scheduling, manufacturing, instability

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Authors: Ali Afaghi, Sehraneh Ghaemi

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The coordination of the multi-agent systems has been one of the interesting topic in recent years, because of its potential applications in many branches of science and engineering such as sensor networks, flocking, underwater vehicles and etc. In the most of the related studies, it is assumed that the dynamics of the multi-agent systems are integer-order and linear and the multi-agent systems with the fractional-order nonlinear dynamics are rarely considered. However many phenomena in nature cannot be described within integer-order and linear characteristics. This paper investigates the leader-following consensus problem for a class of nonlinear fractional-order multi-agent systems based on observer-based cooperative control. In the system, the dynamics of each follower and leader are nonlinear. For a multi-agent system with fixed directed topology firstly, an observer-based consensus protocol is proposed based on the relative observer states of neighboring agents. Secondly, based on the property of the stability theory of fractional-order system, some sufficient conditions are presented for the asymptotical stability of the observer-based fractional-order control systems. The proposed method is applied on a five-agent system with the fractional-order nonlinear dynamics and unavailable states. The simulation example shows that the proposed scenario results in the good performance and can be used in many practical applications.

Keywords: fractional-order multi-agent systems, leader-following consensus, nonlinear dynamics, directed graphs

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: A. Mech

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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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Authors: Shrikant Ghadage

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Study of shock waves generated in the Scramjet engine is typically restricted to pressure, temperature, density, entropy and Mach number variation across the shock wave. The present work discusses the impact of inlet shock wave angles on the specific impulse of the Scramjet engine. A mathematical analysis has done for the isentropic hypersonic flow of air flowing through a Scramjet with hydrogen fuel at an altitude of 30 km. Analysis has been done in order to get optimum shock wave angle to achieve maximum impulse. Since external drag has excluded from the analysis, the losses due to friction are not considered for the present analysis. When Mach number of the airflow at the entry of the nozzle reaches unity, then that flow is choked. This condition puts limitations on increasing the inlet shock wave angle. As inlet shock wave angle increases, speed of the flow entering into the nozzle decreases, which results in an increase in the specific impulse of the engine. When the speed of the flow at the entry of the nozzle reduces below sonic speed, then there is no further increase in the specific impulse of the engine. Here the Conclusion is the thrust and specific impulse of a scramjet engine, which increases gradually with an increase in inlet shock wave angle up to the condition when airflow speed reaches sonic velocity at the exit of the combustor. In addition to that, variation in drag force at the inlet of the scramjet and variation in hypersonic flow conditions at every stage of the scramjet also studied in order to understand variation on flow characteristics with respect to flow deflection angle. Essentially, it helps in designing inlet profile for the Scramjet engine to achieve optimum specific impulse.

Keywords: hypersonic flow, scramjet, shock waves, specific impulse, mathematical analysis

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Authors: Somsak Assavasirisilp

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The purposes of this research were to study the level of participation in the politic activities of Thai women, to study the factors influencing the Thai women’s entry into national politics, and to study the problems and obstacles to prevent women from enter national politics. This was a mixed research method of both qualitative and quantitative technique. The findings revealed that there were many problems and obstacles, especially culture and social norm, to prevent women from enter national politics and did not have many factors to support Thai women to become successful women politician.

Keywords: culture, social norm, national politics, Thai women

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Authors: Maha Bakkari, R.Tadili

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The present work is a study of the performance of a solar copper coil heating system in a greenhouse microclimate. Our system is based on the circulation of a Heat transfer fluid, which is water in our case, in a closed loop under the greenhouse's roof in order to store heat all day, and then this heat will supply the greenhouse during the night. In order to evaluate our greenhouse, we made an experimental study in two identical greenhouses, where the first one is equipped with a heating system and the second (without heating) is used for control. The heating system allows the establishment of the thermal balance and determines the mass of water necessary for the process in order to ensure its functioning during the night. The results obtained showed that this solar heating system and the climatic parameters inside the experimental greenhouse were improved, and it presents a significant gain compared to a controlled greenhouse without a heating system. This research is one of the solutions that help to reduce the greenhouse effect of the planet Earth, a problem that worries the world.

Keywords: solar energy, energy storage, greenhouse, environment

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Authors: Bashara Want

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One of the key factors limiting the performance of magnetic memory is that the coercivity has a distribution with finite width, and the reversal starts at the weakest link in the distribution. So one must first know the distribution of coercivities in order to learn how to reduce the width of distribution and increase the coercivity field to obtain a system with narrow width. First Order Reversal Curve (FORC) method characterizes a system with hysteresis via the distribution of local coercivities and, in addition, the local interaction field. The method is more versatile than usual conventional major hysteresis loops that give only the statistical behaviour of the magnetic system. The FORC method will be presented and discussed at the conference.

Keywords: magnetic materials, hysteresis, first-order reversal curve method, nanostructures

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

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The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: Ahmad Abdulkadir Ibrahim

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The Islamic law of transactions laid down the methods and instruments of accounting and analyzed its basic assumptions in the modern world. There is a need to examine the implications of accounting initiatives in the Muslim world and attempt to outline the important characteristics of Islamic accounting and how Islamic accounting resolves the problem of measuring the cost of Murabaha goods in case of exchange rate variation. The research tends to discuss an analytical approach to the Islamic accounting concept as well as elaborating the jurisprudential matter and practical aspects of accounting in Islamic financial transactions. It also aims to alert the practitioners of accounting in the Islamic world to be aware of the concept of accounting in Islamic jurisprudence and its historical development. The methodology adopted in this research is the qualitative method through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that Islamic accounting is unique in its norms as it has been characterized by fairness, accuracy in measuring tools, truthfulness, mutual trust, moderation in making a profit, and tolerance. It was also qualified by capacity and flexibility in terms of the tools and terminology used and invented by Islamic jurisprudence in the accounting system, which indicates its validity and consistency anytime and anywhere. An important conclusion of the research also lies in the refutation of the popular idea that an Italian writer known as Luca Pacilio was the first writer who developed the basis of double-entry due to the presented proofs by Muslim scholars of critical accounting developments, which cannot be ignored. It concludes further that Islamic jurisprudence draws the accounting system codified in the foundations of a market that is far from usury, fraud, cheating, and unfair competition in all areas.

Keywords: accounting, Islamic accounting, Islamic transactions, Islamic jurisprudence, double entry, murabaha, characteristics

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Anand Kishore Kola, G. Uday Bhaskar Babu, Kotturi Ajay Kumar

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The modern dynamic systems used in industries are complex in nature and hence the fractional order controllers have been contemplated as a fresh approach to control system design that takes the complexity into account. Traditional integer order controllers use integer derivatives and integrals to control systems, whereas fractional order controllers use fractional derivatives and integrals to regulate memory and non-local behavior. This study provides a method based on the maximumsensitivity (Ms) methodology to discover all resilient fractional filter Internal Model Control - proportional integral derivative (IMC-PID) controllers that stabilize the closed-loop system and deliver the highest performance for a time delay system with a Smith predictor configuration. Additionally, it helps to enhance the range of PID controllers that are used to stabilize the system. This study also evaluates the effectiveness of the suggested controller approach for minimum phase system in comparison to those currently in use which are based on Integral of Absolute Error (IAE) and Total Variation (TV).

Keywords: modern dynamic systems, fractional order controllers, maximum-sensitivity, IMC-PID controllers, Smith predictor, IAE and TV

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Authors: Cristina Siserman-Gray

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TheTreaty on the Prohibition of Nuclear Weapons(TPNW)will mark in January 2022 one year since the entry into force of the treaty. TPNW provides that within one year of entry into force, the 86 countries that have signed it so far will convene to discuss and take decisions on the treaty’s implementation at the first meeting of states-parties. Austria has formally offered to host the meeting in Vienna in the spring of 2022. At this first meeting, the States Parties would need to work. Among others, on the interpretations of some of the provisions of the Treaty, disarmament timelines under Article 4, and address universalization of the Treaty. The main objective of this paper is to explore the legal implications of the TPNW for States-Parties and discuss how these will impact non-State Parties, particularly the United States. In a first part, the article will address the legal requirements that States Parties to this treaty must adhere to by illustrating some of the progress made by these states regarding the implementation of the TPNW. In a second part, the paper will address the challenges and opportunities for universalizing the treaty and will focus on the response of Nuclear Weapons States, and particularly the current US administration. Since it has become clear that TPNW has become a new and important element to the nonproliferation and disarmament architecture, the article will provide a number of suggestions regarding ways US administration could positively contribute to the international discourse on TPNW.

Keywords: disarmament, arms control and nonproliferation, legal regime, TPNW

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Authors: Daira Radouane, Naim Boudmagh, Hamada Adel

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The but of this handling is to use the technique of the shearing with a mechanism lapping machine of image: a prism of Wollaston. We want to characterize this prism in order to be able to employ it later on in an analysis by shearing. A prism of Wollaston is a prism produced in a birefringent material i.e. having two indexes of refraction. This prism is cleaved so as to present the directions associated with these indices in its face with entry. It should be noted that these directions are perpendicular between them.

Keywords: non destructive control, aluminium, interferometry, treatment of image

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Authors: Yu-Hong Lin

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Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

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Authors: Pinisetti Swami Sairam, Meera C. S.

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Marker pens are widely used all over the world, mainly in educational institutions due to their neat, accurate and easily erasable nature. But refilling the ink in these pens is a tedious and time consuming job. Besides, it requires careful handling of the pens and ink bottle. A fully automated marker filling system is a solution developed to overcome this problem. The system comprises of pneumatics and electronics modules as well as PLC control. The system design is done in such a way that the empty markers are dumped in a marker container which then sent through different modules of the system in order to refill it automatically. The filled markers are then collected in a marker container. Refilling of ink takes place in different stages inside the system. An ink detecting system detects the colour of the marker which is to be filled and then refilling is done. The processes like capping and uncapping of the cap as well as screwing and unscrewing of the tip are done with the help of robotic arm and gripper. We make use of pneumatics in this system in order to get the precision while performing the capping, screwing, and refilling operations. Thus with the help of this system we can achieve cleanliness, accuracy, effective and time saving in the process of filling a marker.

Keywords: automated system, market filling, information technology, control and automation

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Authors: Abdullah Abu-Tineh, Hissa Sadiq, Fatma Al-Mutawah, Youmen Chaaban

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The past 20 years have seen a proliferation of empirical research into various licensure systems. Extensive quantitative work investigates these systems of appraisal from different countries, but there is far less research on the implementation of the Qatari licensure system and the adoption of professional standards. In this paper, we provided a quantitatively and qualitatively descriptive look at the process that moves educators from their point of entry into the profession through their certification as accomplished professionals. Specifically, we focused on the perceptions of teachers and school leaders on the licensure system currently adopted by Ministry of Education and Higher Education in Qatar. The paper aims to inform progress towards a system of reliable, valid, and nationally appropriate teacher and school leader evaluation procedures. Such a system can support decision-making based on a common, comprehensive set of standards that ensures the placement of only the most effective educators in Qatari schools. This paper was made possible by NPRP grant # (NPRP7-1224-5-178) from the Qatar national research fund (a member of Qatar foundation) to Abdullah M. Abu-Tineh. The statements made herein are solely the responsibility of the author.

Keywords: licensure system, professional standards, professional portfolio, educator voice

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Shaowei Sun

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Let G be a graph with vertex set V(G)={v_1,v_2,...,v_n} and edge set E(G). For any vertex v belong to V(G), let d_v denote the degree of v. The normalized Laplacian matrix of the graph G is the matrix where the non-diagonal (i,j)-th entry is -1/(d_id_j) when vertex i is adjacent to vertex j and 0 when they are not adjacent, and the diagonal (i,i)-th entry is the di. In this paper, we discuss some bounds on the largest and the second smallest normalized Laplacian eigenvalue of trees and graphs. As following, we found some new bounds on the second smallest normalized Laplacian eigenvalue of tree T in terms of graph parameters. Moreover, we use Sage to give some conjectures on the second largest and the third smallest normalized eigenvalues of graph.

Keywords: graph, normalized Laplacian eigenvalues, normalized Laplacian matrix, tree

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Authors: Mohamed Hassan Abdullahi

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Decomposition is used as a synthesis tool in several physical systems. It can also be used for tearing and restructuring, which is large-scale system analysis. On the other hand, the commutativity of series-connected systems has fascinated the interest of researchers, and its advantages have been emphasized in the literature. The presentation looks into the necessary conditions for decomposing any third-order discrete-time linear time-varying system into a commutative pair of first- and second-order systems. Additional requirements are derived in the case of nonzero initial conditions. MATLAB simulations are used to verify the findings. The work is unique and is being published for the first time. It is critical from the standpoints of synthesis and/or design. Because many design techniques in engineering systems rely on tearing and reconstruction, this is the process of putting together simple components to create a finished product. Furthermore, it is demonstrated that regarding sensitivity to initial conditions, some combinations may be better than others. The results of this work can be extended for the decomposition of fourth-order discrete-time linear time-varying systems into lower-order commutative pairs, as two second-order commutative subsystems or one first-order and one third-order commutative subsystems.

Keywords: commutativity, decomposition, discrete time-varying systems, systems

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Authors: M. Jahanandish, M. B. Zeydabadinejad

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In this paper, von Mises and Drucker-Prager yield criteria, as typical ones that consider the effect of intermediate principal stress σ2, have been selected and employed for investigating the influence of σ2 on the solution of a typical stability problem. The bearing capacity factors have been calculated under plane strain condition (strip footing) and axisymmetric condition (circular footing) using the method of stress characteristics together with the criteria mentioned. Different levels of σ2 relative to the other two principal stresses have been considered. While a higher σ2 entry in yield criterion gives a higher bearing capacity; its entry in equilibrium equations (axisymmetric) causes substantial reduction.

Keywords: intermediate principal stress, plane strain, axisymmetric, yield criteria

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Authors: Majse Lind, Carla Sharp, Salome Vanwoerden

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Narrative identity is the dynamic and evolving story individuals create about their personal pasts, presents, and presumed futures. This storied sense of self develops in adolescence and is crucial for fostering a sense of self-unity and purpose in life. A growing body of work has shown that several characteristics of narrative identity are disturbed in adults suffering from borderline personality disorder (BPD). Very little research, however, has explored the stories told by adolescents with BPD features. Investigating narrative identity early in the lifespan and in relation to personality pathology is crucial; BPD is a developmental disorder with early signs appearing already in adolescence. In the current study, we examine narrative identity (focusing on themes of agency and communion) coded from self-defining memories derived from the child attachment interview in 174 inpatient adolescents (M = 15.12, SD = 1.52) at the time of admission. The adolescents’ social cognition was further assessed on the basis of their reactions to movie scenes (i.e., the MASC movie task). They also completed a trauma checklist and self-reported BPD features at three different time points (i.e., at admission, at discharge, and 6 months after admission). Preliminary results show that adolescents who told stories containing themes of agency and communion evinced better social cognition, and lower emotional abuse on the trauma checklist. In addition, adolescents who disclosed stories containing lower levels of agency and communion demonstrated more BPD symptoms at all three time points, even when controlling for the occurrence of traumatic life events. Surprisingly, social cognitive abilities were not significantly associated with BPD features. These preliminary results underscore the importance of narrative identity as an indicator, and potential cause, of incipient personality pathology. Thus, focusing on diminished themes of narrative-based agency and communion in early adolescence could be crucial in preventing the development of personality pathology over time.

Keywords: borderline personality disorder, inpatient adolescents, narrative identity, follow-ups

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Authors: Bubaker F. Shareia, Almuetaz R. Boubakr

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The aim of this paper is to show how Libya’s legal, economic, political, social, and cultural systems have shaped Libyan development. This will provide a background to develop an understanding of the current role of the accounting information system in Libya and the challenges facing the design of the aeronautical information system to meet the development needs of Libya. Our knowledge of the unified economic operating systems of the world paves the way for the economic development of every developing country. In order to achieve this understanding, every developing country should be provided with a high-efficiency communications system in order to be able to interact globally. From the point of view of the theory of globalization, Libya's understanding of its socio-economic and political systems is vital in order to be able to adopt and apply accounting techniques that will assist in the economic development of Libya.

Keywords: accounting, economic development, globalisation theory, information system

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Authors: Guillermo Manuel Flores Figueroa, Juan Alejandro Vazquez Feijoo, Jose Navarro Antonio

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A continuous nonlinear system response may be obtained by an infinite sum of the so-called Volterra operators. Each operator is obtained from multidimensional convolution of nth-order between the nth-order Volterra kernel and the system input. These operators can also be obtained from the Associated Linear Equations (ALEs) that are linear models of subsystems which inputs and outputs are of the same nth-order. Each ALEs produces a particular nth-Volterra operator. As linear models a unitary impulse response can be obtained from them. This work shows the relationship between this unitary impulse responses and the corresponding order Volterra kernel.

Keywords: Volterra series, frequency response functions FRF, associated linear equations ALEs, unitary response function, Voterra kernel

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Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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