Objectives: To evaluate changes in the practice of using inhalers for outpatients have chronic obstructive pulmonary at Nam Dinh General Hospital after the intervention. To compare the effectiveness between intervention methods of direct consultation (DC) and direct counseling method incorporating information technology (DC – IT). Subject and method: Intervention study on two groups of patients, 30 patients have chronic obstructive pulmonary in each group with similar characteristics who were treated at Nam Dinh General Hospital from October 2019 to May 2020. Two research groups analyzed and compared the practice of patients at two times, the first time (T1) before the intervention and the second time (T2) after the intervention was 3 months with 3 consecutive interventions (each intervention was 1 month). One group intervened with the direct consultation method; one group intervened with the direct counseling method incorporating information technology. Data were collected by the observational method, using the inhaler procedure and entered and processed on SPSS 20.0 software. Results: The group of patients was intervened with the direct counseling method about practice using inhalers increased after the intervention, the average point of inhaler practice before the intervention was 6.50 ± 1.63 and after the intervention was 8.57 ± 0.63 with p <0.05. The group of patients who intervened with direct counseling method incorporating information technology about using an inhaler increased after the intervention from 6.70 ± 1.29 (before the intervention) to 8.80 ± 0.61 (after intervention), with p <0.05. The efficiency index of using the inhaler dose of (DC – IT) group was higher than the DC group at 63%. Conclusion: The average of the two groups increased significantly after the intervention. However, the intervention method of DC – IT was more effective than the DC method.
Occupational exposure to blood & body fluids among the nursing staff in a ter...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Knowledge and attitudes towards complementary and alternative medicine among ...home
Majority of the medical students were familiar with the CAM methods widely used in Turkey, while
most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they
were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific
development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the
medical curriculum, by taking expectations of and feedback from medical students into consideration in setting
educational standards
Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...Dr.Samsuddin Khan
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
Trends shaping corporate health in the workplaceApollo Hospitals
The paradigm for corporate health is morphing from traditional curative services to health protection and promotion. An epidemic of “lifestyle diseases” has developed in the India which warrants an organized integration of company's health, safety and environment policy through a directed wellness program. The current study explored the burden and determinants of lifestyle diseases among an organization.
A Descriptive Study to Assess the Knowledge and Practices Regarding COPD Prev...ijtsrd
A descriptive study to assess the knowledge and practices regarding COPD prevention and management among staff nurses in selected hospital of district Patiala. The global burden of disease study reports a prevalence of 251 million cases globally in 2016. Globally, it is estimated that 3.17 million deaths were caused by the disease in 2015 that is, 5 of all deaths globally in that year . COPD is an important cause of mortality and morbidity in our country and all over the world. Prevalence of COPD is being anticipated to increase due to continuing risk factors and aging of society. Although, COPD is a disease involving the respiratory medicine experts, its symptoms and diagnostic criteria should also be known by the primary healthcare providers considering its economic burden.The study is non experimental descriptive method and data was collected through convenient sampling technique i.e self structured questionnaire and check list. The analysis was done through ANNOVA analysis test. Practices like hand washing, proper medication, knowledge regarding medicines, oxygen therapies, diagnostic tests spirometry , pulmonary rehabilitation, infection control techniques, non invasive ventilation, inhalation techniques, and therapeutic outcomes regarding COPD prevention and management will be average among staff nurses. Lovekirat Singh | Dr. Priyanka Chaudhary | Mrs Raman Deep Kaur "A Descriptive Study to Assess the Knowledge and Practices Regarding COPD Prevention and Management among Staff Nurses in Selected Hospital of District Patiala" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47623.pdf Paper URL : https://www.ijtsrd.com/medicine/nursing/47623/a-descriptive-study-to-assess-the-knowledge-and-practices-regarding-copd-prevention-and-management-among-staff-nurses-in-selected-hospital-of-district-patiala/lovekirat-singh
Occupational exposure to blood & body fluids among the nursing staff in a ter...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Knowledge and attitudes towards complementary and alternative medicine among ...home
Majority of the medical students were familiar with the CAM methods widely used in Turkey, while
most of them had positive attitudes towards CAM as well as willingness to receive training on the subject, and they
were likely to recommend CAM methods to their patients in their future professional lives. With its gradual scientific
development and increasing popularity, there appears a need for a coordinated policy in integrating CAM into the
medical curriculum, by taking expectations of and feedback from medical students into consideration in setting
educational standards
Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...Dr.Samsuddin Khan
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
Trends shaping corporate health in the workplaceApollo Hospitals
The paradigm for corporate health is morphing from traditional curative services to health protection and promotion. An epidemic of “lifestyle diseases” has developed in the India which warrants an organized integration of company's health, safety and environment policy through a directed wellness program. The current study explored the burden and determinants of lifestyle diseases among an organization.
A Descriptive Study to Assess the Knowledge and Practices Regarding COPD Prev...ijtsrd
A descriptive study to assess the knowledge and practices regarding COPD prevention and management among staff nurses in selected hospital of district Patiala. The global burden of disease study reports a prevalence of 251 million cases globally in 2016. Globally, it is estimated that 3.17 million deaths were caused by the disease in 2015 that is, 5 of all deaths globally in that year . COPD is an important cause of mortality and morbidity in our country and all over the world. Prevalence of COPD is being anticipated to increase due to continuing risk factors and aging of society. Although, COPD is a disease involving the respiratory medicine experts, its symptoms and diagnostic criteria should also be known by the primary healthcare providers considering its economic burden.The study is non experimental descriptive method and data was collected through convenient sampling technique i.e self structured questionnaire and check list. The analysis was done through ANNOVA analysis test. Practices like hand washing, proper medication, knowledge regarding medicines, oxygen therapies, diagnostic tests spirometry , pulmonary rehabilitation, infection control techniques, non invasive ventilation, inhalation techniques, and therapeutic outcomes regarding COPD prevention and management will be average among staff nurses. Lovekirat Singh | Dr. Priyanka Chaudhary | Mrs Raman Deep Kaur "A Descriptive Study to Assess the Knowledge and Practices Regarding COPD Prevention and Management among Staff Nurses in Selected Hospital of District Patiala" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47623.pdf Paper URL : https://www.ijtsrd.com/medicine/nursing/47623/a-descriptive-study-to-assess-the-knowledge-and-practices-regarding-copd-prevention-and-management-among-staff-nurses-in-selected-hospital-of-district-patiala/lovekirat-singh
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
A Model of Integrated Primary Care: Anthroposophic Medicine ~ National Centre for Social Research
`
For more information, Please see websites below:
`
Organic Edible Schoolyards & Gardening with Children =
http://scribd.com/doc/239851214 ~
`
Double Food Production from your School Garden with Organic Tech =
http://scribd.com/doc/239851079 ~
`
Free School Gardening Art Posters =
http://scribd.com/doc/239851159 ~
`
Increase Food Production with Companion Planting in your School Garden =
http://scribd.com/doc/239851159 ~
`
Healthy Foods Dramatically Improves Student Academic Success =
http://scribd.com/doc/239851348 ~
`
City Chickens for your Organic School Garden =
http://scribd.com/doc/239850440 ~
`
Simple Square Foot Gardening for Schools - Teacher Guide =
http://scribd.com/doc/239851110 ~
Study Of Knowledge, Attitude And Practices Regarding Biomedical Waste Managem...lsij journal
Background: Biomedical waste is known as the second dangerous waste in the world that needs to be properly managed. Inadequate and improper technique may cause serious health hazard and environmental pollution. The study aimed to determine the status of knowledge, attitude and practices regarding biomedical waste management among healthcare personnel of Bangladesh. Methods: A cross sectional study was carried out in Gazipur Sadar Hospital of Bangladesh. Total 91 randomly selected healthcare personnel including 22 doctors, 45 nurses, 10 attenders and 14 housekeeping staffs were interviewed. Results: The results showed that poor knowledge level among healthcare personnel excluding doctors. Besides, no black colour coding bin was found in the hospital. Regarding practices and attitude related with waste management, housekeeping staffs ignored the standard operating procedures. Conclusion: It can be concluded from the present study that poor levels of knowledge, practices and attitude regarding biomedical waste management in Gazipur, Bangladesh. Lack of adequate knowledge impedes the waste management.
Complementary therapy use by patients and parents of children with asthma and...home
Complementary therapy use reflects patients' and parents' underlying desire for greater selfcare
and need of opportunities to address some of their concerns regarding NHS asthma care. Selfmanagement
of chronic conditions is increasingly promoted within the NHS but with little attention to
complementary therapy use as one strategy being used by patients and parents. With their desire for selfhelp,
complementary therapy users are in many ways adopting the healthcare personas that current
policies aim to encourage.
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Association of CD4 T cell Recovery and Interpersonal Trust in Patient Physici...ijtsrd
The global HIV AIDS pandemic is still dangerous due to high incidence and high mortality rate. There are many factors associated with the immunological response beside treatment with medical practice. This paper aimed to assess the correlation of immunological responses and trust in physician measures in adult patients living with HIV AIDS. A cross sectional was studied to find the association between CD4 T cell changes and interpersonal trust in patient physician relationships. This study was carried out 93 aldult patients male accounted for 83.9 who were newly diagnosed with HIV AIDS infection at outpatient clinics, Tropical Diseases Hospital from October 2018 to August 2019. The mean TCD4 increased by 324.7 cells µl and 379.7 cells µl, respectively, compared to the original of 161.7 cells µl. Almost all patients had their immunity recovered after 3 and 6 months and the majority of patients have achieved virological success after 6 months of treatment. Factors associated with early immune recovery are youth, lower secondary education and single status. The majority of patients had truly trust in physician after 1 month and factors associated with trust in physician scale are male and employed. In Spearman rank correlation, CD4 T cell recovery and the trust present a strong relationship with p=0.008. Our finding is that the initial immunity recovery was strongly influenced by the interpersonal trust between the patients and the healthcare workers. Tao Gia Phu | Nguyen Hoang Lam | Cao Ngoc Nga | Vo Van Tam | Nguyen Phan Trong Hieu | Nguyen Van Trung "Association of CD4 T cell Recovery and Interpersonal Trust in Patient-Physician Relationship among HIV-Infected Adults in Hospital for Tropical Diseases, Vietnam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30752.pdf Paper Url :https://www.ijtsrd.com/medicine/other/30752/association-of-cd4-t-cell-recovery-and-interpersonal-trust-in-patientphysician-relationship-among-hivinfected-adults-in-hospital-for-tropical-diseases-vietnam/tao-gia-phu
Nursing Students' Opinions Regarding the Nursing Processinventionjournals
The aim of this descriptive study is to identify nursing students' opinions regarding the nursing process. Data of the study conducted in January 2014 on 240 students studying in the first, second and third classes of a nursing department of a university were collected using a questionnaire consisting of 17 questions in total. The data obtained as a result of the study were analyzed using numeric and percentage distribution in computer environment. It was found that 50% of the students in the study identified the nursing process as providing appropriate nursing care specific to the patient, 73.3% had difficulties in the nursing process, and 36.2% pointed the lecturer to be the source of difficulty. On the other hand, students stated that the nursing process was beneficial to students by increasing knowledge (45.8%) and to patients by preventing lack of care (58.2%). The result of this study suggests that students who find the nursing process useful for both the patient and themselves and who have difficulty in all phases of the nursing process should apply the nursing process on more cases.
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapa...DrHeena tiwari
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapadu Village of Guntur District, Andhra Pradesh, India: An Original Research
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Burnout among Health Workers: Case of the Military Hospital of Ouakam, Senegalinventionjournals
Background: Mental Health is responsible for 13% of global morbidity, and is a priority according to World Health Organization which predicts a duplication of this frequency by 2020. The cult of performance and the quest for maximum profit have led to the emergence of new types of diseases in societies such as professional exhaustion or burnout. The analysis of factors promoting burnout showed that this syndrome is primarily related to chronic stress. Studies in several countries, mostly Western, have showed its importance. This study has aimed to assess burnout in the military hospitalof Ouakam. Method: It was a qualitative study conducted among Ouakam Military Hospital workers in 2012. The sampling was complete and the target was made by all hospital workers: technical, administrative and support staff. Participation was free and voluntary. The collection tool consisted of Maslach Burnout Inventory (MBI) on socio-demographic characteristics and criteria of emotional exhaustion, depersonalization and personal achievement. As suggested by Maslach, burnout was first determined for each criterion; then their combination enabled to determine the overall burnout. Results: A total of 66 individuals participated in the study. The average age was 34.5 years, sex ratio1.64; Married 57.6% and singles 42.4%. About 94% had a level of education equal to or higher than secondary school. Paramedics were 78.8%, support staff 13.6%. Emotional exhaustion was observed in 30.3% of participants, depersonalization of the relationship in 21.2% and disorders of personal accomplishment at 36.3%. The combination of these three parameters has enabled to determine the overall burnout that was 68.2%, the mild form was 46.9% and the moderate form 21.2%; no severe form was observed. Burnout was more common among elderly and paramedics. These results are similar to those observed in other countries that have shown high prevalence of burnout among health workers. Conclusion: Burnout is a reality and, in long-term, can negatively impact health system’s performance.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
Inadequate management of asthma can lead to physical handicap and death. The study aimedto assess knowledge and practice of
asthmatic participants for use meter dose inhaler device. A descriptive study involved 105 participants, conducted at public
hospitals in Khartoum state from July to October2014. Questionnaire and observational check list were used for data collection.
The study enrolled (51%) female and (49%) male. Most of participants their age group ranged, between 36 to 45 years, (35%)
were workers and (31%) received University education while 44 % had a chronic asthma. Level of participant’s knowledge was a
very good regard care and storage of the device; sequent (77% - 79%). There were(64%) had moderate level of knowledge for
preparation dose (69%) replacing inhaler device and cleaning mouthpiece (60%), while 56% had very poor knowledge to rinse
mouth after puff. A highly significant difference between the level of knowledge and education (P value<0.001) regard replacing
the inhaler device, and cleansing mouthpiece. All participants demonstrated correct technique of using inhaler device, position,
removed, pressed replacement the cap, shaking inhaler device and took deep breath. While half of them had moderate skill level
for opened mouth technique, continuous breathing and rinsed mouth after puffuse, and fewer of participants had poor technique
during repeating the puff. Most of participants reflected moderate to poor level of knowledge and have very good practice for
correct used inhaler meter device; this reveals the discrepancy between knowledge and practice.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
A Model of Integrated Primary Care: Anthroposophic Medicine ~ National Centre for Social Research
`
For more information, Please see websites below:
`
Organic Edible Schoolyards & Gardening with Children =
http://scribd.com/doc/239851214 ~
`
Double Food Production from your School Garden with Organic Tech =
http://scribd.com/doc/239851079 ~
`
Free School Gardening Art Posters =
http://scribd.com/doc/239851159 ~
`
Increase Food Production with Companion Planting in your School Garden =
http://scribd.com/doc/239851159 ~
`
Healthy Foods Dramatically Improves Student Academic Success =
http://scribd.com/doc/239851348 ~
`
City Chickens for your Organic School Garden =
http://scribd.com/doc/239850440 ~
`
Simple Square Foot Gardening for Schools - Teacher Guide =
http://scribd.com/doc/239851110 ~
Study Of Knowledge, Attitude And Practices Regarding Biomedical Waste Managem...lsij journal
Background: Biomedical waste is known as the second dangerous waste in the world that needs to be properly managed. Inadequate and improper technique may cause serious health hazard and environmental pollution. The study aimed to determine the status of knowledge, attitude and practices regarding biomedical waste management among healthcare personnel of Bangladesh. Methods: A cross sectional study was carried out in Gazipur Sadar Hospital of Bangladesh. Total 91 randomly selected healthcare personnel including 22 doctors, 45 nurses, 10 attenders and 14 housekeeping staffs were interviewed. Results: The results showed that poor knowledge level among healthcare personnel excluding doctors. Besides, no black colour coding bin was found in the hospital. Regarding practices and attitude related with waste management, housekeeping staffs ignored the standard operating procedures. Conclusion: It can be concluded from the present study that poor levels of knowledge, practices and attitude regarding biomedical waste management in Gazipur, Bangladesh. Lack of adequate knowledge impedes the waste management.
Complementary therapy use by patients and parents of children with asthma and...home
Complementary therapy use reflects patients' and parents' underlying desire for greater selfcare
and need of opportunities to address some of their concerns regarding NHS asthma care. Selfmanagement
of chronic conditions is increasingly promoted within the NHS but with little attention to
complementary therapy use as one strategy being used by patients and parents. With their desire for selfhelp,
complementary therapy users are in many ways adopting the healthcare personas that current
policies aim to encourage.
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Association of CD4 T cell Recovery and Interpersonal Trust in Patient Physici...ijtsrd
The global HIV AIDS pandemic is still dangerous due to high incidence and high mortality rate. There are many factors associated with the immunological response beside treatment with medical practice. This paper aimed to assess the correlation of immunological responses and trust in physician measures in adult patients living with HIV AIDS. A cross sectional was studied to find the association between CD4 T cell changes and interpersonal trust in patient physician relationships. This study was carried out 93 aldult patients male accounted for 83.9 who were newly diagnosed with HIV AIDS infection at outpatient clinics, Tropical Diseases Hospital from October 2018 to August 2019. The mean TCD4 increased by 324.7 cells µl and 379.7 cells µl, respectively, compared to the original of 161.7 cells µl. Almost all patients had their immunity recovered after 3 and 6 months and the majority of patients have achieved virological success after 6 months of treatment. Factors associated with early immune recovery are youth, lower secondary education and single status. The majority of patients had truly trust in physician after 1 month and factors associated with trust in physician scale are male and employed. In Spearman rank correlation, CD4 T cell recovery and the trust present a strong relationship with p=0.008. Our finding is that the initial immunity recovery was strongly influenced by the interpersonal trust between the patients and the healthcare workers. Tao Gia Phu | Nguyen Hoang Lam | Cao Ngoc Nga | Vo Van Tam | Nguyen Phan Trong Hieu | Nguyen Van Trung "Association of CD4 T cell Recovery and Interpersonal Trust in Patient-Physician Relationship among HIV-Infected Adults in Hospital for Tropical Diseases, Vietnam" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30752.pdf Paper Url :https://www.ijtsrd.com/medicine/other/30752/association-of-cd4-t-cell-recovery-and-interpersonal-trust-in-patientphysician-relationship-among-hivinfected-adults-in-hospital-for-tropical-diseases-vietnam/tao-gia-phu
Nursing Students' Opinions Regarding the Nursing Processinventionjournals
The aim of this descriptive study is to identify nursing students' opinions regarding the nursing process. Data of the study conducted in January 2014 on 240 students studying in the first, second and third classes of a nursing department of a university were collected using a questionnaire consisting of 17 questions in total. The data obtained as a result of the study were analyzed using numeric and percentage distribution in computer environment. It was found that 50% of the students in the study identified the nursing process as providing appropriate nursing care specific to the patient, 73.3% had difficulties in the nursing process, and 36.2% pointed the lecturer to be the source of difficulty. On the other hand, students stated that the nursing process was beneficial to students by increasing knowledge (45.8%) and to patients by preventing lack of care (58.2%). The result of this study suggests that students who find the nursing process useful for both the patient and themselves and who have difficulty in all phases of the nursing process should apply the nursing process on more cases.
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapa...DrHeena tiwari
An Epidemiological Data of Oral Health Status and Treatment Needs in Pamulapadu Village of Guntur District, Andhra Pradesh, India: An Original Research
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Burnout among Health Workers: Case of the Military Hospital of Ouakam, Senegalinventionjournals
Background: Mental Health is responsible for 13% of global morbidity, and is a priority according to World Health Organization which predicts a duplication of this frequency by 2020. The cult of performance and the quest for maximum profit have led to the emergence of new types of diseases in societies such as professional exhaustion or burnout. The analysis of factors promoting burnout showed that this syndrome is primarily related to chronic stress. Studies in several countries, mostly Western, have showed its importance. This study has aimed to assess burnout in the military hospitalof Ouakam. Method: It was a qualitative study conducted among Ouakam Military Hospital workers in 2012. The sampling was complete and the target was made by all hospital workers: technical, administrative and support staff. Participation was free and voluntary. The collection tool consisted of Maslach Burnout Inventory (MBI) on socio-demographic characteristics and criteria of emotional exhaustion, depersonalization and personal achievement. As suggested by Maslach, burnout was first determined for each criterion; then their combination enabled to determine the overall burnout. Results: A total of 66 individuals participated in the study. The average age was 34.5 years, sex ratio1.64; Married 57.6% and singles 42.4%. About 94% had a level of education equal to or higher than secondary school. Paramedics were 78.8%, support staff 13.6%. Emotional exhaustion was observed in 30.3% of participants, depersonalization of the relationship in 21.2% and disorders of personal accomplishment at 36.3%. The combination of these three parameters has enabled to determine the overall burnout that was 68.2%, the mild form was 46.9% and the moderate form 21.2%; no severe form was observed. Burnout was more common among elderly and paramedics. These results are similar to those observed in other countries that have shown high prevalence of burnout among health workers. Conclusion: Burnout is a reality and, in long-term, can negatively impact health system’s performance.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
Inadequate management of asthma can lead to physical handicap and death. The study aimedto assess knowledge and practice of
asthmatic participants for use meter dose inhaler device. A descriptive study involved 105 participants, conducted at public
hospitals in Khartoum state from July to October2014. Questionnaire and observational check list were used for data collection.
The study enrolled (51%) female and (49%) male. Most of participants their age group ranged, between 36 to 45 years, (35%)
were workers and (31%) received University education while 44 % had a chronic asthma. Level of participant’s knowledge was a
very good regard care and storage of the device; sequent (77% - 79%). There were(64%) had moderate level of knowledge for
preparation dose (69%) replacing inhaler device and cleaning mouthpiece (60%), while 56% had very poor knowledge to rinse
mouth after puff. A highly significant difference between the level of knowledge and education (P value<0.001) regard replacing
the inhaler device, and cleansing mouthpiece. All participants demonstrated correct technique of using inhaler device, position,
removed, pressed replacement the cap, shaking inhaler device and took deep breath. While half of them had moderate skill level
for opened mouth technique, continuous breathing and rinsed mouth after puffuse, and fewer of participants had poor technique
during repeating the puff. Most of participants reflected moderate to poor level of knowledge and have very good practice for
correct used inhaler meter device; this reveals the discrepancy between knowledge and practice.
Patient satisfaction and side effects in primary care: An observational study...home
Overall patient satisfaction was significantly higher in homeopathic than in
conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to
three times fewer side effects than conventional care
Patient satisfaction and side effects in primary care: An observational study...home
Overall patient satisfaction was significantly higher in homeopathic than in
conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to
three times fewer side effects than conventional care
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Effectiveness of the nursing educational program upon nurse's knowledge and p...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
A Quasi Experimental Study to Assess the Effectiveness of Selected Nursing In...iosrjce
A study to assess the effectiveness of selected nursing interventions on health related quality of life
and activities of daily living among COPD patients in selected tertiary hospital, Chennai, Tamilnadu, India.
The aim of the study was to impart the selected nursing interventions applied to the COPD patients in medical
and pulmonary wards. The conceptual framework used in this study was Widenbach’s Helping art Theory. An
Evaluative approach was used for the present study. Using purposive sampling technique 50 samples were
selected from Chettinad Hospital and Research Institute, Tamil Nadu, India. The tool used was self
administered questionnaire. The collected data was analyzed using descriptive and inferential statistics. The
findings of the study revealed a significantly increase in the COPD patients health related quality of life and
activities of daily living after given the selected nursing interventions. The mean pre test score was 1867 and
the mean post test score was 1861 and the difference between pre test and post test knowledge score was 5.54.
Based on the objectives of the study the findings of the level of health related quality of life and activities of
daily living among COPD patients shows that increased health related quality of life and activities of daily
living. The study shows that the COPD patients in post test were having post score1861 mean difference
5.54.standard deviation 2.35.p value (0.02). Selected nursing interventions are effective in increasing the health
related qualityof life and activities of daily living among COPD patients.. The findings of the study revealed that
a significantly increased in the post test health related quality of life and activities of daily living after given the
selected nursing interventions
2
Annotated Bibliography
3164 words
Rough Draft on Infection Control
by
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Infection Control
1
Introduction of the Paper
Background
According to various reports by the Centers for Disease Control and Prevention, a significant number of lives are lost each passing year due to the spread of infections in hospitals that could otherwise have been prevented (Alp & Damani, 2015). Therefore, effort geared towards understanding infection control plays a significant role in reducing the otherwise unnecessary loss of lives. Infection control entails the power to directly prevent or determine the spread of infections with the aim of avoiding it (Berríos-Torres, et al., 2017). Indeed, the pathological state resulting from the invasion of the body by pathogenic microorganisms has far-reaching consequences. While so much has been done to prevent its spread, there is still a lot more to be done. This research paper intends to focus on Healthcare-associated Infections and how it can be prevented if not eliminated altogether.
Statement of the Problem
Healthcare-Associated Infections are a common occurrence in the modern healthcare setting resulting in huge financial losses and loss of lives. According to the Office of Disease Prevention and Healthcare Promotion (ODPHP), these are infections that patients contract while receiving treatment in a medical facility. Percival, Suleman, Vuotto & Donelli, (2015) pointed out that its prevalence is as a result of the employment of invasive devices and procedures meant to treat patients and to help them recover. While most of them are accidental in nature, they still remain to be seen as accidents that could have been prevented. The US government, through the establishment of Healthy People 2020 and the U.S. Department of Health and Human Services (HHS) have taken a lead role in spreading the news on infection control. To that effect, recent research reveals that there could be a 70% reduction in infections by implementing existing prevention practices. This translates to a financial benefit estimated to be $31.5 billion in medical cost savings (ODPHP, 2019). Understanding these prevention measures should, therefore, be a priority to all healthcare practitioners. That is why this research study intends to shade more light on nosocomial infections. These are infections that occur within 48 hours upon admission into a hospital. They can also occur in three days of discharge or 30 days of operation. They affect one in every 10 patients admitted in a hospital (Khan, Baig & Mehboob, 2017; Suleyman, & Alangaden, 2016).
Rationale for addressing the issue
Addressing this issue is important to the health sector from a political, social as well as environmental perspective. As a matter of fact, its impact will be on a short term, interim basis and long term basis. Politically, health has always been a major subject of concern as it is used by voters to determi.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
With the increase of tuberculosis patients in India that constantly need visits to medical centers almost 40 times in the course of 6 months. Microsoft explores the role of a biometric attendance terminal in persuading patients to complete follow-up health visits in slum communities of New Delhi, India.
Homeopathic treatment of patients with chronic sinusitis: A prospective obser...home
This observational study showed relevant improvements that persisted for 8 years
in patients seeking homeopathic treatment because of sinusitis. The extent to which the observed
effects are due to the life-style regulation and placebo or context effects associated with the
treatment needs clarification in future explanatory studies.
Evidence based projectMSN, Walden UniversityNURS-6052CDr. BetseyCalderon89
Evidence based project
MSN, Walden University
NURS-6052C
Dr. Emily Keyes
10/01/2021
introduction
Most of the health care facilities have implemented Evidence Based Practices mostly in nursing
EBP involves the use of research evidence, clinical expertise as well as patient’s preferences
There is a confusion on the pros and cons of EBP in nursing
Thus, PICOT questions are based on the use of EBP in each day’s nursing project.
Picot question
With the mechanically ventilated patients in the ICU aged 40 years or older, does the use of oral chlorhexidine in comparison to no chlorhexidine aid in reducing the incidence of VAP in 5 weeks?
population
intervention
comparison
outcome
Time
mechanically ventilated patients in the ICU aged 40 years or older
use of oral chlorhexidine
use of no oral chlorhexidine
reducing the incidence of VAP
5 weeks
Databases used for the research
PubMed:
The database aids in ensuring easy search per topic by using the search terms in order to filter results and find certain peer reviewed articles
Google Scholar
Allows me to easily navigate as well as filter the results to fit in my research
Cochrane Library
The database offers a wide range of systematic reviews as well as peer reviewed articles
CINAHL
Provides access to associated health topics as well as nursing based literature using electronic books and journals.
Peer reviewed articles
Al-Rabeei, N., Al-jaradi, A., Al-Wesaby, S., & Alrubaiee, G. (2019). Nursing Practice for Prevention of Ventilator-Associated Pneumonia in ICUs at Public Hospitals in Sana’a, City-Yemen. Al-Razi University Journal of Medical Sciences, 3(2), 69–80.
Frota, M. L., Campanharo, C. R. V., Lopes, M. C. B. T., Piacezzi, L. H. V., Okuno, M. F. P., & Batista, R. E. A. (2019). Good practices for preventing ventilator-associated pneumonia in the emergency department. Revista Da Escola de Enfermagem Da USP, 53. https://doi.org/10.1590/s1980-220x2018010803460
Jam, R., Mesquida, J., Hernández, S., Sandalinas, I., Turégano, C., Carrillo, E., Delgado-Hito, P. (2018). Nursing workload and compliance with non-pharmacological measures to prevent ventilator-associated pneumonia: a multicentre study. Nursing in Critical Care, 23(6), 291–298. https://doi.org/10.1111/nicc.12380
Kapucu, S., & ÖZden, G. (2017). Nursing Interventions to Prevent Ventilator-Associated Pneumonia in ICUs. Konuralp Tıp Dergisi. https://doi.org/10.18521/ktd.285554
Levels of evidence
The level of evidence for the article by Jam et al (2018) is level II since an observational study design was used.
The level of evidence for this article by Fronta et al., (2019) is level I since it a cross sectional study
The level of evidence for this article by Al-Rabeei, et al., (2019) is level III since it is a descriptive, cross sectional study
The level of evidence for this article by Boltey, et al., (2017) is level IV since it is a systematic review.
Strengths of systematic reviews
Systematic reviews aids ...
Homeopathic treatment of elderly patients - a prospective observational study...home
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
Comparative efficacy of interventions to promote hand hygiene
in hospital: systematic review and network meta-analysis
Nantasit Luangasanatip,1, 2 Maliwan Hongsuwan,1 Direk Limmathurotsakul,1, 3 Yoel Lubell,1, 4
Andie S Lee,5, 6 Stephan Harbarth,5 Nicholas P J Day,1, 4 Nicholas Graves,2, 7 Ben S Cooper1, 4
Noninvasive Mechanical Ventilation of Critically Ill Patients in ICUs in Main...semualkaira
Although noninvasive mechanical ventilation (NIV) has been very
common used for ICU patients, limited information exists about
the epidemiological information of NIV in mainland China. This is
a cross-sectional study in which patients with NIV were observed
in September, 2012 from 15 ICUs. Epidemiological data
Similar to Change in Practice of using Inhalers for Outpatients have Chronic Obstructive Pulmonary at Nam Dinh General Hospital after Health Education (20)
The Statutory Interpretation of Renewable Energy Based on Syllogism of Britis...AI Publications
The current production for energy consumption generates harmful impacts of carbon dioxide to the environment causing instability to sustainable development goals. The constitutional reforms of British Government serve to be an important means of resolving any encountered incompatibilities to political environment. This study aims to evaluate green economy using developed equation for renewable energy towards political polarization of corporate governance. The Kano Model Assessment is used to measure the equivalency of 1970 Patents Act to UK Intellectual Property tabulating the criteria for the fulfillment of sustainable development goals in respect to the environment, artificial intelligence, and dynamic dichotomy of administrative agencies and presidential restriction, as statutory interpretation development to renewable energy. The constitutional forms of British government satisfy the sustainable development goals needed to fight climate change, advocate healthy ecosystem, promote leadership of magnates, and delegate responsibilities towards green economy. The presidential partisanship must be observed to delineate parties of concerns and execute the government prescriptions in equivalence to the dichotomous relationship of technology and the environment in fulfilling the rights and privileges of all citizens. Hence, the political elites can execute corporate governance towards sustainable development of renewable energy promoting environmental parks and zero emission target of carbon dioxide discharges. The economic theory developed in statutory interpretation for renewable energy serves as a tool to reduce detrimental impacts of carbon dioxide to the environment, mitigate climate change, and produce artefacts of bioenergy and artificial intelligence promoting sustainable development. It is suggested to explore other vulnerabilities of artificial intelligence to prosper economic success.
Enhancement of Aqueous Solubility of Piroxicam Using Solvent Deposition SystemAI Publications
Piroxicam is a non-steroidal anti-inflammatory drug that is characterized by low solubility-high permeability. The present study was designed to improve the dissolution rate of piroxicam at the physiological pH's through its increased solubility by using solvent deposition system.
Analysis of Value Chain of Cow Milk: The Case of Itang Special Woreda, Gambel...AI Publications
Ethiopia has a long and rich history of dairy farming, which was mostly carried out by small and marginal farmers who raised cattle, camels, goats, and sheep, among other species, for milk. Finding the Itang Special Woreda cow milk value chain is the study's main goal. In order to gather primary data, 204 smallholder dairy farmer households were randomly selected, and the market concentration ratio was calculated using 20 traders. Descriptive statistics, econometric models, and rank analysis were used to achieve the above specified goals. Out of all the participants in the milk value chain, producers, cafés, hotels, and dairy cooperatives had the largest gross marketing margins, accounting for 100% of the consumer price in channels I and II, 55% in channels III and V, and 25.5% in channels V. The number of children under five, the number of milking cows owned, the amount of money from non-dairy sources, the frequency of extension service contacts, the amount of milk produced each day, and the availability of market information were found to have an impact on smallholders' involvement in the milk market. Numerous obstacles also limited the amount of milk produced and marketed. The poll claims that general health issues, sickness, predators, and a lack of veterinary care are plaguing farmers. In order to address the issue of milk perishability, the researchers recommended the host community and organization to construct an agro milk processor, renovate the dairy cooperative in the study region, and restructure the current conventional marketing to lower the transaction and cost of milk marketing.
Minds and Machines: Impact of Emotional Intelligence on Investment Decisions ...AI Publications
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Bronchopulmonary cancers are common cancers with a poor prognosis. It is the leading cause of death by cancer in Algeria and in the world. Behind this unfavorable prognosis hides numerous disparities according to age, sex, and exposure to risk factors, ranking 4th among incident cancers and developing countries including Algeria, all sexes combined. It ranks 2nd cancers in men and 3rd among women. Whatever the age observed, the incidence of this cancer is higher in men than in women, however the gap is narrowing to the detriment of the latter. The results of scientific research agree to relate trends in incidence and mortality rates to tobacco consumption, including passive smoking. Furthermore, other risk factors are mentioned such as exposure to asbestos in the workplace or to radon for the general population, or even genetic predisposition. However, the weight of these etiological and/or predisposing factors is in no way comparable to that of tobacco in the genesis of lung cancer and the resulting mortality. We provide a literature review in our article on the descriptive and analytical epidemiology of lung cancer.
Further analysis on Organic agriculture and organic farming in case of Thaila...AI Publications
The objective of this paper is to present Further analysis on Organic agriculture and organic farming in case of Thailand agriculture and enhancing farmer productivity. In view of the demand for organic fertilizers, efforts should also be made to enhance and to develop more effective of compost, bio-fertilizer, and bio-pesticides currently used by farmers. Likewise, emphasis should also be laid on the cultivation of legumes and other crops that can enhance the fertility of the soil, as practiced by farmers in many developing countries to fertilize their lands. On the other hand, most of the farmers who practice this farm system found that they are adopting a number of SLMs and interested in joining the meeting or training to gain more and more knowledge.
Current Changes in the Role of Agriculture and Agri-Farming Structures in Tha...AI Publications
The objective os this study is to present Current Changes in the Role of Agriculture and Agri-Farming Structures in Thailand and Vietnam with SLM practices. Farmer’s adoption and investment in SLM is a key for controlling land degradation, enhancing the well-being of society, and ensuring the optimal use of land resources for the benefit of present and future generations (World Bank, 2006; FAO, 2018). And agriculture remains an essential element of lives of many farmers in term of the strong cultural and symbolic values that attach current working generation to do and to spend time for it but not intern of income generating.
Growth, Yield and Economic Advantage of Onion (Allium cepa L.) Varieties in R...AI Publications
Haphazard and low soil fertility, low yielding verities and poor agronomic practices are among the major factors constraining onion production in the central rift valley of Ethiopia. Therefore, a field experiment was conducted in East Showa Zone of Adami Tulu Jido Combolcha district in central rift valley areas at ziway from October 2021 to April 2022 to identify appropriate rate of NPSB fertilizer and planting pattern of onion varieties. The experiment was laid out in split plot design of factorial arrangement in three replications. The main effect of NPSB blended fertilizer rates and varieties (red coach and red king) significantly (p<0.01) influenced plant height, leaf length, leaf diameter, leaf number and fresh leaf weight, shoot dry matter per plant, and harvest index. Total dry biomass, bulb diameter, neck diameter, average fresh bulb weight, bulb dry matter, marketable bulb yield, and total bulb yield were significantly (p<0.01) influenced only by the main effect of NPSB blended fertilizer rates. In addition, unmarketable bulb yield was statistically significantly affected (p≥0.05) by the blended fertilizer rates and planting pattern. Moreover, days to 90% maturity of onion was affected by the main factor of NPSB fertilizer rate, variety and planting pattern. The non-fertilized plants in the control treatment were inferior in all parameters except unmarketable bulb yield and harvest index. Significantly higher marketable bulb yield (41 t ha-1) and total bulb yield (41.33 t ha-1) was recorded from 300 kg ha-1 NPSB blended fertilizer rate applied. Double row planting method and hybrid red coach onion variety had also gave higher growth and yields. The study revealed that the highest net benefit of Birr, 878,894 with lest cost of Birr 148,006 by the combinations of 150 kg blended NPSB ha-1 with double row planting method (40cm*20cm*7cm) and red coach variety which can be recommendable for higher marketable bulb yield and economic return of hybrid onion for small scale farmers in the study area. Also, for resource full producers (investors), highest net benefit of Birr 1,205,372 with higher cost (159,628 Birr) by application of 300 kg NPSB ha-1 is recommended as a second option. However, the research should be replicated both in season and areas to more verify the recommendations.
Evaluation of In-vitro neuroprotective effect of Ethanolic extract of Canariu...AI Publications
The ethanolic extract of canarium solomonense leaves (ecsl) was studied for its neuroprotective activity. The neuroprotective activity of ECSL was found to have a significant impact on neuronal cell death triggered by hydrogen peroxide (MTT assay) in human SH-SY5Y neuroblastoma cells. Scopolamine, a muscarinic receptor blocker, is frequently used to induce cognitive impairment in laboratory animals. Injections of scopolamine influence multiple cognitive functions, including motor function, short-term memory, and attention. Using the Morris water maze, the Y maze, and the passive avoidance paradigm, memory enhancing activity in scopolamine-induced amnesic rats was evaluated. Using the Morris water maze, the Y maze, and the passive avoidance paradigm, ECSL was found to have a substantial effect on the memory of scopolamine- induced amnesic rats. Our experimental data indicated that ECSL can reverse scopolamine induced amnesia and assist with memory issues.
The goal of neuroprotection is to shield neurons against damage, whether that damage is caused by environmental factors, pathogens, or neurodegenerative illnesses. Inhibiting protein-based deposit buildup, oxidative stress, and neuroinflammation, as well as rectifying abnormalities of neurotransmitters like dopamine and acetylcholine, are some of the ways in which medicinal herbs have neuroprotective effects [1-3]. This review will focus on the ways in which medicinal herbs may protect neurons.
A phytochemical and pharmacological review on canarium solomonenseAI Publications
The genus Canarium L. consists of 75 species of aromatic trees which are found in the rainforests of tropical Asia, Africa and the Pacific. The medicinal uses, botany, chemical constituents and pharmacological activities are now reviewed. Various compounds are tabulated according to their classes their structures are given. Traditionally canarium solomonense have been used to treat a broad array of illnesses. Pharmacological actions for canarium solomonense as discussed in this review include antibacterial, antimicrobial, antioxidant, anti-inflammatory, hepatoprotective and antitumor activity.
Influences of Digital Marketing in the Buying Decisions of College Students i...AI Publications
This research investigates the influence of digital marketing channels on purchasing decisions among college students in Ramanathapuram District. The study highlights that social media marketing, online advertising, and mobile marketing exhibit substantial positive effects on purchase decisions. However, email marketing's impact appears to be more complex. Moreover, the study explores how demographic variables like gender and academic level shape these effects. Notably, freshman students display varying susceptibility to specific digital marketing messages compared to their junior, senior, or graduate counterparts. These findings offer crucial insights for marketers aiming to tailor their strategies effectively to the preferences and behaviors of college students. By understanding the differential impacts of various digital marketing channels and considering demographic nuances, marketers can refine their approaches, optimize engagement, and ultimately enhance the effectiveness of their campaigns in targeting this demographic.
A Study on Performance of the Karnataka State Cooperative Agriculture & Rural...AI Publications
The Karnataka State Co-operative Agriculture and Rural Development Bank Limited is the apex bank of all the primary co-operative agriculture and rural development banks in the state. All the PCARD Banks in the state are affiliated to it. The KSCARD Bank provides financial accommodation to the PCARD Banks for their lending operations. In order to quick sanction and disbursement of loans and supervision over the PCARD Banks the KSCARD Bank has opened district level branches. Bank has established Women Development Cell to promote entrepreneurship among women in 2005. The Bank is identifying women borrowers in the rural areas by assigning suitable projects to motivate their self-confidence to lead independent life. Progress made in financing women entrepreneurs women.
Breast hamartoma is a rare, well-circumscribed, benign lesion made up of a variable quantity of glandular, adipose and fibrous tissue. This is a lesion that can affect women at any age from puberty. With the increasingly frequent use of imaging methods such as mammography and ultrasound as well as breast biopsy, cases of hamartoma diagnosed are increasing. The diagnosis of these lesions is made by mammography. The histological and radiological aspects are variable and depend on its adipose tissue content. The identification of these lesions is important in order to avoid surgical excisions. We report radio-clinical and pathological records of breast hamartoma.
A retrospective study on ovarian cancer with a median follow-up of 36 months ...AI Publications
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This study presents a case of tea and coffee crops , esp. environment protection and sustainable agriculture in Son La and Thai Nguyen of Vietnam. Research results show us that The process of having an agricultural product goes through many steps such as planting, planning, harvesting, packing, transporting, storing and distributing. - The State adopts policies to encourage innovation of agricultural production models and methods towards sustainability, adapting to climate change, saving water, and limiting the use of inorganic fertilizers and pesticides. chemicals and products for environmental treatment in agriculture; develop environmentally friendly agricultural models. Our research limitation is that we can expand for other crops, industries and markets as well.
Assessment of Growth and Yield Performance of Twelve Different Rice Varieties...AI Publications
The present investigation entitled “Assessment of growth and yield performance of twelve different rice varieties under north Konkan coastal zone of Maharashtra” was carried out during the kharif season of the year 2021 and 2022 on the field of ASPEE, Agricultural Research and Development Foundation, Tansa Farm, At Nare, Taluka Wada, District Palghar, Maharashtra, India. The experiment was laid out in Randomized Block Design (RBD). The twelve varieties namely Zini, Jaya, Dandi, Rahghudya, Govindbhog, Dangi, Gurjari, VNR-7, VNR-8, VNR-9, Karjat-3, and Karjat-5 were replicated thrice. The plant height (cm), number of tillers per plant, number of panicles per plant, number of panicles (m²), and length of panicle (cm) were noted to the maximum with cv. “VNR-7”. The highest number of seeds per panicle, test weight (gm), grain yield (q/ha), and straw yield (q/ha) were recorded with the cv. “VNR-7”. While the lowest number of days to 50% flowering was also recorded with cv. “VNR-7” during the year 2021 and 2022.
Cultivating Proactive Cybersecurity Culture among IT Professional to Combat E...AI Publications
In the current digital landscape, cybercriminals continually evolve their techniques to execute successful attacks on businesses, thus posing a great challenge to information technology (IT) professionals. While traditional cybersecurity approaches like layered defense and reactive security have helped IT professionals cope with traditional threats, they are ineffective in dealing with evolving cyberattacks. This paper focuses on the need for a proactive cybersecurity culture among IT professionals to enable them combat evolving threats. The paper emphasis that building a proactive security approach and culture can help among IT professionals anticipate, identify, and mitigate latent threats prior to them exploiting existing vulnerabilities. This paper also points out that as IT professionals use reactive security when dealing with traditional attacks, they can use it collaboratively with proactive security to effectively protect their networks, data, and systems and avoid heavy costs of dealing with cyberattack’s aftermaths and business recovery.
The Impacts of Viral Hepatitis on Liver Enzymes and BilrubinAI Publications
Viral hepatitis is an infection that causes liver inflammation and damage. Several different viruses cause hepatitis, including hepatitis A, B, C, D, and E. The hepatitis A and E viruses typically cause acute infections. The hepatitis B, C, and D viruses can cause acute and chronic infections. Hepatitis A causes only acute infection and typically gets better without treatment after a few weeks. The hepatitis A virus spreads through contact with an infected person’s stool. Protection by getting the hepatitis A vaccine. Hepatitis E is typically an acute infection that gets better without treatment after several weeks. Some types of hepatitis E virus are spread by drinking water contaminated by an infected person’s stool. Other types are spread by eating undercooked pork or wild game. Hepatitis B can cause acute or chronic infection. Recommendation for screening for hepatitis B in pregnant women or in those with a high chance of being infected. Protection from hepatitis B by getting the hepatitis B vaccine. Hepatitis C can cause acute or chronic infection. Doctors usually recommend one-time screening of all adults ages 18 to 79 for hepatitis C. Early diagnosis and treatment can prevent liver damage. The hepatitis D virus is unusual because it can only infect those who have a hepatitis B virus infection. A coinfection occurs when both hepatitis D and hepatitis B infections at the same time. A superinfection occurs already have chronic hepatitis B and then become infected with hepatitis D. The aim of this study is to find the effect of each type of viral hepatitis on the bilirubin (TB , DSB) , and liver enzymes; AST, ALT, ALP,GGT among viral hepatitis patients. 200 patients were selected from the viral hepatitis units in the central public health laboratory in Baghdad city, all the chosen cases were confirmed as a positive samples , they are classified into four equal group each with fifty individual and with a single serological viral hepatitis type either; anti-HAV( IgM ) , HBs Ag , anti-HCV ,or anti-HEV(IgM ). All patients were tested for; serum bilirubin ( TB ,D.SB ) , AST , ALT , ALP , GGT. Another fifty quite healthy and normal person was selected as a control group for comparison. . Liver enzymes and bilirubin changes are more pronounced in HAV, HEV than HCV and HBVAST and ALT lack some sensitivity in detecting HCV ,HBV and mild elevations of ALT or AST in asymptomatic patients can be evaluated efficiently by considering ,hepatitis B, hepatitis C. ALT is generally a more sensitive indicator of acute liver cell damage than AST, It is relatively specific for hepatocyte necrosis with a marked elevations in viral hepatitis. Liver enzymes and bilirubin changes are more pronounced in HAV, HEV than HCV and HBV.AST and ALT lack some sensitivity in detecting HCV ,HBV and mild elevations of ALT or AST in asymptomatic patients can be evaluated efficiently by considering ,hepatitis B, hepatitis C. ALT is generally a more sensitive indicator of acute liver
Determinants of Women Empowerment in Bishoftu Town; Oromia Regional State of ...AI Publications
The purpose of this study was to determine the status of women's empowerment and its determinants using women's asset endowment and decision-making potential as indicators. To determine representative sample size, this study used a two-stage sampling technique, and 122 sample respondents were selected at random. To analyze the data in this study, descriptive statistics and a probit model were used. The average women's empowerment index was 0.41, indicating a relatively lower status of women's empowerment in the study area. According to the study's findings, only 40.9% of women were empowered, while the remaining 59.1% were not. The probit model results show that women's access to the media, women's income, and their husbands' education status have a significant and positive impact on the status of women's empowerment, while the family size of households has a negative impact. As a result, it is important to enhance women's access to the media and income, promote family planning and contraception, and improve men's educational status in order to improve the status of women's empowerment.
Characterization and the Kinetics of drying at the drying oven and with micro...Open Access Research Paper
The objective of this work is to contribute to valorization de Nephelium lappaceum by the characterization of kinetics of drying of seeds of Nephelium lappaceum. The seeds were dehydrated until a constant mass respectively in a drying oven and a microwawe oven. The temperatures and the powers of drying are respectively: 50, 60 and 70°C and 140, 280 and 420 W. The results show that the curves of drying of seeds of Nephelium lappaceum do not present a phase of constant kinetics. The coefficients of diffusion vary between 2.09.10-8 to 2.98. 10-8m-2/s in the interval of 50°C at 70°C and between 4.83×10-07 at 9.04×10-07 m-8/s for the powers going of 140 W with 420 W the relation between Arrhenius and a value of energy of activation of 16.49 kJ. mol-1 expressed the effect of the temperature on effective diffusivity.
Willie Nelson Net Worth: A Journey Through Music, Movies, and Business Venturesgreendigital
Willie Nelson is a name that resonates within the world of music and entertainment. Known for his unique voice, and masterful guitar skills. and an extraordinary career spanning several decades. Nelson has become a legend in the country music scene. But, his influence extends far beyond the realm of music. with ventures in acting, writing, activism, and business. This comprehensive article delves into Willie Nelson net worth. exploring the various facets of his career that have contributed to his large fortune.
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Introduction
Willie Nelson net worth is a testament to his enduring influence and success in many fields. Born on April 29, 1933, in Abbott, Texas. Nelson's journey from a humble beginning to becoming one of the most iconic figures in American music is nothing short of inspirational. His net worth, which estimated to be around $25 million as of 2024. reflects a career that is as diverse as it is prolific.
Early Life and Musical Beginnings
Humble Origins
Willie Hugh Nelson was born during the Great Depression. a time of significant economic hardship in the United States. Raised by his grandparents. Nelson found solace and inspiration in music from an early age. His grandmother taught him to play the guitar. setting the stage for what would become an illustrious career.
First Steps in Music
Nelson's initial foray into the music industry was fraught with challenges. He moved to Nashville, Tennessee, to pursue his dreams, but success did not come . Working as a songwriter, Nelson penned hits for other artists. which helped him gain a foothold in the competitive music scene. His songwriting skills contributed to his early earnings. laying the foundation for his net worth.
Rise to Stardom
Breakthrough Albums
The 1970s marked a turning point in Willie Nelson's career. His albums "Shotgun Willie" (1973), "Red Headed Stranger" (1975). and "Stardust" (1978) received critical acclaim and commercial success. These albums not only solidified his position in the country music genre. but also introduced his music to a broader audience. The success of these albums played a crucial role in boosting Willie Nelson net worth.
Iconic Songs
Willie Nelson net worth is also attributed to his extensive catalog of hit songs. Tracks like "Blue Eyes Crying in the Rain," "On the Road Again," and "Always on My Mind" have become timeless classics. These songs have not only earned Nelson large royalties but have also ensured his continued relevance in the music industry.
Acting and Film Career
Hollywood Ventures
In addition to his music career, Willie Nelson has also made a mark in Hollywood. His distinctive personality and on-screen presence have landed him roles in several films and television shows. Notable appearances include roles in "The Electric Horseman" (1979), "Honeysuckle Rose" (1980), and "Barbarosa" (1982). These acting gigs have added a significant amount to Willie Nelson net worth.
Television Appearances
Nelson's char
UNDERSTANDING WHAT GREEN WASHING IS!.pdfJulietMogola
Many companies today use green washing to lure the public into thinking they are conserving the environment but in real sense they are doing more harm. There have been such several cases from very big companies here in Kenya and also globally. This ranges from various sectors from manufacturing and goes to consumer products. Educating people on greenwashing will enable people to make better choices based on their analysis and not on what they see on marketing sites.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Micro RNA genes and their likely influence in rice (Oryza sativa L.) dynamic ...Open Access Research Paper
Micro RNAs (miRNAs) are small non-coding RNAs molecules having approximately 18-25 nucleotides, they are present in both plants and animals genomes. MiRNAs have diverse spatial expression patterns and regulate various developmental metabolisms, stress responses and other physiological processes. The dynamic gene expression playing major roles in phenotypic differences in organisms are believed to be controlled by miRNAs. Mutations in regions of regulatory factors, such as miRNA genes or transcription factors (TF) necessitated by dynamic environmental factors or pathogen infections, have tremendous effects on structure and expression of genes. The resultant novel gene products presents potential explanations for constant evolving desirable traits that have long been bred using conventional means, biotechnology or genetic engineering. Rice grain quality, yield, disease tolerance, climate-resilience and palatability properties are not exceptional to miRN Asmutations effects. There are new insights courtesy of high-throughput sequencing and improved proteomic techniques that organisms’ complexity and adaptations are highly contributed by miRNAs containing regulatory networks. This article aims to expound on how rice miRNAs could be driving evolution of traits and highlight the latest miRNA research progress. Moreover, the review accentuates miRNAs grey areas to be addressed and gives recommendations for further studies.
Natural farming @ Dr. Siddhartha S. Jena.pptxsidjena70
A brief about organic farming/ Natural farming/ Zero budget natural farming/ Subash Palekar Natural farming which keeps us and environment safe and healthy. Next gen Agricultural practices of chemical free farming.
"Understanding the Carbon Cycle: Processes, Human Impacts, and Strategies for...MMariSelvam4
The carbon cycle is a critical component of Earth's environmental system, governing the movement and transformation of carbon through various reservoirs, including the atmosphere, oceans, soil, and living organisms. This complex cycle involves several key processes such as photosynthesis, respiration, decomposition, and carbon sequestration, each contributing to the regulation of carbon levels on the planet.
Human activities, particularly fossil fuel combustion and deforestation, have significantly altered the natural carbon cycle, leading to increased atmospheric carbon dioxide concentrations and driving climate change. Understanding the intricacies of the carbon cycle is essential for assessing the impacts of these changes and developing effective mitigation strategies.
By studying the carbon cycle, scientists can identify carbon sources and sinks, measure carbon fluxes, and predict future trends. This knowledge is crucial for crafting policies aimed at reducing carbon emissions, enhancing carbon storage, and promoting sustainable practices. The carbon cycle's interplay with climate systems, ecosystems, and human activities underscores its importance in maintaining a stable and healthy planet.
In-depth exploration of the carbon cycle reveals the delicate balance required to sustain life and the urgent need to address anthropogenic influences. Through research, education, and policy, we can work towards restoring equilibrium in the carbon cycle and ensuring a sustainable future for generations to come.
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smoke. Waterpipe tobacco is a major risk factor, and air
pollution and smoke are also important risk factors for the
disease [2]. COPD ranks third among the causes of death
and is one of 10 diseases that cannot be cured globally [13].
An estimated 329 million people suffer from COPD around
the world and this number will continue to increase in the
coming decades. Because exposure risk factors and the old
population are increasing. In Vietnam, the rate of COPD in
the population aged 40 and over is 4.2%, with 7.1% male
and 1.9% female, it is estimated that about 1.3 million
people suffering from COPD need diagnosis and treatment
[1]. In the US, COPD is predicted to rank fifth worldwide
about the burden of disease and third in mortality by 2020
(M. Molimard, 2014) [12]. COPD has a close relationship
with dyspnea, decrease physical capacity, decrease activity
and decrease quality of life (GOLD, 2014) [10]. Incorrect
use of inhalers is common with COPD. Consequences of
poor inhalation technique lead to reduce therapeutic doses,
increase the incidence of acute illness, decrease quality of
life and increase a burden on the healthcare system. Regular
assessment of understanding and reassessment of inhaler
using for patients, caregivers and health care professors can
significantly improve the benefits of patients from
inhalation therapy [5]. According to the study of Francisca
Leiva-Fernández (2012), an intervention study on 495
patients diagnosed with COPD, showed that 75% patients
used the wrong inhaler technique. After the intervention,
reduced to only 17% patients used wrong inhalers technique
[11].
According to Adhikari Baral (2019), the patient had the best
practice was holding the inhaler horizontally (99.5%), then
holding the inhaler vertically (99%) and open the inhaler
and remove the empty capsule (97.5%). In contrast, the
most incorrect step was breathing in and holding the breath
for 10 seconds (4.9%) [4]. Therefore, the interventions will
contribute to reduce risk factors, prevent complications,
reduce exacerbations, minimize hospitalization and costs,
improve patient's quality of life and it is important to reduce
the incidence of disease [7].
Aim of the study: To assess the current situation and change
the patient's practice about using inhaler after the
intervention by two methods: direct consultation method
(DC) and direct counseling method and incorporating
information technology (DC – IT).
Research subject: COPD patients were being treated
outpatient at Nam Dinh General Hospital.
Selection criteria: The patient was diagnosed with COPD,
used or was using a dosing inhaler. The patient has able to
communicate.
Exclusion criteria: The patient did not agree to participate
in the study or did not come to the follow-up examination.
The patient is unable to cooperate.
II. METHODS
Research setting
Intervention study on two groups with pre-and post-
intervention evaluation at At Nam Dinh General Hospital
treated most of the patients with COPD in Nam Dinh
province. According to the survey, about 340 patients with
COPD receiving outpatient treatment. COPD patients are
treated with bronchodilators mainly using a dosed inhaler,
using 2-3 times per one patient every day.
Measurements:
Based on the Decision 4562 / QD-BYT about the
professional document guiding the diagnosis and treatment
of chronic obstructive pulmonary disease in Viet Nam
(2018) [2] and the 9-step dosing inhaler procedure, each
step that patients do correctly was 1 point, wrong or not was
0 point. Satisfactory practice if patients doing right and
enough actions, unsatisfactory practice if patients have at
least one step was wrong [3].
Data collection:
Data were collected from October 2019 to May 2020
Sample size: Collecting in seven months was 60 patients.
Sample selection method: Convenient sample selection
60 patients were divided into two random groups: Group
one was 30 patients who intervened with the DC method
and group two was 30 patients who intervened with DC - IT
method.
A checklist for using of the inhaler to observe patients
perform the process at a private office in the hospital. The
evaluation and intervention were carried out by research
members at Nam Dinh University of Nursing.
Statistical analysis: The score of each step in the process
was added to calculate the total scores, then calculate the
average score which a higher score indicates better practice.
Using t-test to compare two average scores between before
and after the intervention. Collected data were coded and
tabulated using a personal computer. Using an SPSS 20.0
program for Windows. Statistical significant was
considered at a p-value less than 0.05
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III. RESULTS
Table I. Socio-demographic characteristics of research subjects
Male patients account for a higher proportion than female patients. The average age score of patients was 70.45 ±
8.88. Patients have a high school education level of about 60%. There were no differences in gender, education level, age
between the DC group and the DC – IT group, the differences were not statistically significant with p> 0.05.
Table II. The practice about using dosed inhaler before the intervention
Variables Practice about using dose inhaler p
Practice
Mean±SD
(Min-Max)
Total The DC group The DC-IT group
6.60±1.74
(4-9)
6.50±1.64 6.70±1.29 t= 0.58
> 0.05
Practice about using dose inhaler between the DC group and the DC-IT group, the difference was not statistically
significant with p> 0.05.
Table III. Changing the practice about using dosed inhaler after the intervention
Practice about using dose
inhaler
Mean ± SD
p
Before the intervention After the intervention
The DC Group
(n=30)
6.50±1.63 8.57±0.63
t= -7.51;
p< 0.05
The DC – IT Group
(n=30)
6.70±1.29 8.80±0.61
t= -9.06;
p< 0.05
The DC group: The practice about using inhalers increased after the intervention: There was a difference about average
score of inhaler practice before the intervention (6.50 ± 1.63) and after the intervention (8.57 ± 0.63), the difference was
statistically significant with p <0.05.
The DC-IT group: The practice about using inhaler increased after the intervention DC-IT method: There was a
difference about average score of inhaler practice before the intervention (6.70 ± 1.29) and after the intervention card (8.80 ±
0.61), the difference was statistically significant with p <0.05.
Variables
Socio-demographic characteristics
p
Total The DC
group
The DC – IT
group
No
(Frequency)
No Frequency No Frequency
Gender
Male 49(81.7) 24 80 25 83.3 > 0.05
Female 11(18.3) 6 20 5 16.7
Educational
level
Middle school or
below
36(60) 18 60 18 60
> 0.05
High school 9(15) 4 13.3 5 16.7
Intermediate or
above
15(25) 8 26.7 7 23.3
Age
Mean±SD
(Min – Max)
70.45±8.79
(40 - 90)
70.87±9.21 70.07±8.61
>0.05
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Table IV. Compare the effectiveness of the two methods of the intervention between before and after the intervention
Practice about using
of dose inhaler
The DC group The DC -IT group
Before
No
(%)
After
No
(%)
Intervention
effect index
Before
No
(%)
After
No
(%)
Intervention
effect index
Satisfactory 4(13.3) 19(63.3)
375.9
5(16.7) 27(90)
438.9
Unsatisfactory 26(86.7) 11(36.7) 25(83.3) 3(10)
The effect of DC-IT method was higher than the DC method with the intervention effect index at 438,9 and 375,9
respectively (effectiveness of the intervention was 63%).
IV. DISCUSSION
Changing practice about using dose inhaler of COPD
patients:
The DC method: Practice about using dose inhaler before
and after intervention were 13.3% and 63.3% respectively.
There was a difference in the average scores before the
intervention 6.50 ± 1.63 and after the intervention 8.57 ±
0.63, the difference was statistically significant with p
<0.05.
The DC-IT method: Practice using an inhaler dose increased
from 16.7% to 90%. There was a difference in the average
score before the intervention (6.70 ± 1.29 ) and after the
intervention (8.80 ± 0.61), the difference was statistically
significant with p <0.05. Health education (DC method and
DC-IT method) are effective. Therefore, it is important to
help patients improve the practice of using the inhaler. This
result was similar to the study of author Nguyen Duc Tho
(2016) that health education was effective [3]. Before the
intervention, no patients had good practices and most of the
patients did not know the above practices. After the
intervention, the effect was significantly increased, using
the aerosol dose was correct from 10.1% to 74.8%, a
significant difference with p <0.001. However, the results
of this study were higher than the study of Nguyen Duc
Tho. Because the intervention method of studies was
different, the study of Nguyen Duc Tho was carried out in
the community, patients who did not discover the disease
and didn't know about using the inhaler. While this study
was performed on patients who were diagnosed and had
been treated in the hospital. Many studies about the
effectiveness of health education and educational
interventions for patients also achieve different effects
depending on the intervention form. Folch (2017) showed
that after education for patients with COPD, the number of
patients hospitalized decreased by 58.8%, give up smoking
accounted for 77.8%; using inhalers was the correct
technique accounted for 100% [8]. Clare Gardiner (2010),
the provision of palliative care services for COPD patients
is very necessary. Besides, health education and training for
medical professors and continue research to achieve the best
care services for patients [6]. According to author Fotokian
Z and et al (2017): The most important factor to improve the
practice of using inhalers was the provision of instructions
about inhaler using technique. Therefore, medical staffs
need to supplement verbal instructions about inhaling dry
powder to improve knowledge and practice for patients with
COPD [9].
Compare the effectiveness of two methods after
intervention: The study performed on 60 patients with
COPD, the research subjects divided into two random
groups and each group has 30 patients. There were no
differences in sex, education level, disease duration, age, the
practice of using dose inhalers between the two intervention
groups, the difference not statistically significant with p>
0.05. The effectiveness index of using dose inhaler of DC-
IT group was higher than the DC group with intervention
effect was 63%. Therefore, the DC – IT method intervention
was more effective. Because when COPD patients receive
health education, they will watch the videos as a form of
reviewing knowledge and skills to use the inhaler and
discovering their mistakes. This is a method of direct health
education and counseling go with using Audio-visual
devices (video - computer) which have illustrations and
complement speech were suitable for all subjects,
anywhere. Therefore, this method has many advantages to
improve practices for patients. In practice, COPD disease
have long-term treatment under the guidance of doctors,
routine examination and treatment management are very
necessary for preventing complication and improve the
quality of life for the patients. The role of doctors and the
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regular relationship between doctors and patients play an
important role in the prevention of COPD disease [3].
Research limitations: Due to the limited time, economy and
resources, the research only conducted an intervention study
about using dose inhalers in two groups: DC group and DC
– IT group with small sample size and no representation for
the entire population. Another hand, the research topic
focuses on health education and counseling intervention for
COPD patients with no mentions of related factors to
practices about using dosing inhalers.
V. CONCLUSIONS
Changing practice of using inhalers after intervention.
DC method: There was a difference in average score about
practice using dose inhaler before intervention (6.50 ± 1.63)
and after intervention (8.57 ± 0.63). The difference was
statistically significant with p <0.05.
DC - IT method: There was a difference in average score
about practice using dose inhaler before intervention (6.70
± 1.29) and after intervention (8.80 ± 0.61). The difference
was statistically significant with p <0.05.
Comparing the intervention effectiveness of DC
method and DC – IT method: The effectiveness index of
using dose inhaler of DC-IT group was higher than the DC
group with intervention effect was 63%.
VI. RECOMMENDATIONS
Based on the study results, the following recommendations
are suggested:
This study recommends instructions about practice
of using dose inhalers for COPD patients by DC method and
DC – IT method to improve practice of using dose inhalers.
Maintaining health education for all COPD patients was
necessary. Enhance the role and responsibility of medical
staffs in the process of guiding practice of using inhalers for
patients with COPD in the hospital and at home. Medical
staffs should guide and supervise COPD patients about
using dose inhaler in order to maintain effectiveness and
compliance using inhaler.
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[1] Nguyen Dinh Sy and et al (2010). Epidemiology of chronic
obstructive pulmonary disease (COPD in Vietnam and
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[2] Nguyen Viet Tien (2018). Decision 3874/QD-BYT, Viet
Nam, Document guide the diagnosis and treatment of
chronic obstructive pulmonary disease, Ha Noi Medical
Publishing House,13
[3] Nguyen Duc Tho (2016). The current status and
effectiveness of health education and communication
interventions on chronic obstructive pulmonary disease in
Kien Thiet and Kien Bai communes, Hai Phong city, 2014 -
2016, Community doctoral thesis, Hai Phong University of
Medicine and Pharmacy.
[4] Baral M. A (2019). Knowledge and practice of dry powder
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[9] Fotokian Z and et al (2017). The empowerment of elderly
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Inhaler Devices in Real Life: An Observational Study in
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