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Institute
- Fakultät III - Medien, Information und Design (184) (remove)
Die binäre Putzfrau
(1993)
Niemals bis zum Mond
(1994)
Ob Veränderungsprojekte in Organisationen erfolgreich sind, hängt entscheidend davon ab, ob und wie die entwickelten Lösungen von den betroffenen Mitarbeitern angenommen und umgesetzt werden. Es sind nicht wirklich die Unternehmen, die sich verändern: Der Wandel muss in und mit den Menschen in den Unternehmen stattfinden. Dies kann aber nur durch Überzeugung gelingen und zwar im wesentlichen herbeigeführt durch Kommunikation. Von Bedeutung sind jedoch nicht so sehr die Massenmedien wie die Mitarbeiterzeitschrift, Broschüren oder das Intranet. Mit ihnen wird der Veränderungsprozess angestoßen und laufend unterstützt. Entscheidend für seinen Erfolg oder Misserfolg ist jedoch die geplante und organisierte persönliche Kommunikation vor allem zwischen dem Management und den Mitarbeitern. Führungskräfte müssen sich ihrer Rolle als Meinungsführer und Meinungsbildner bewusst werden und entsprechend handeln. Dazu gehört auch das Kommunikationsmanagement und der phasengerechte Einsatz von Kommunikationsinstrumenten zum gewünschten Zweck.
Einbände und Sammler - Joseph von Laßberg und das Lindauer Evangeliar (Pierpont Morgan Library Ms 1)
(2002)
Der Aufsatz schildert einen Teil der Besitzgeschichte des berühmten karolingischen Lindauer Evangeliars, das sich heute als wertvollstes Stück in der Pierpont Morgan Library in New York befindet. Von 1816 bis 1846 befand sich der Codex in Besitz des schwäbischen Handschriftensammlers Joseph von Laßberg, dem Schwager der Annette von Droste-Hülshoff.
This assignment is about the development of a general strategic marketing plan for academic libraries in Germany and can be used as a guideline for libraries that want to develop concrete marketing strategies for several products and services. Two examples of marketing projects are at its end presented for linking theoretical approaches to practice. Finally the development of an own marketing strategy for “information literacy” builds the last part of the assignment.
Noch bis vor wenigen Jahren galt die interne Kommunikation in den meisten Unternehmen im Vergleich zur Kommunikation mit externen Zielgruppen als deutlich weniger anspruchsvoll oder gar als in irgendeiner Weise wettbewerbsrelevant. Wurde sie lange als reine Sozialleistung betrachtet, rückt sie nun - insbesondere vor dem Hintergrund voranschreitender Globalisierung und ihren Auswirkungen auf die Wettbewerbsfähigkeit der Unternehmen - langsam als strategisches Führungsinstrument in das Bewusstsein vieler Unternehmenslenker. Denn mehr und mehr wird deutlich, dass die eigenen Mitarbeiter ausschlaggebender Faktor bei der Bewältigung von Veränderungen sind.
In diesem Beitrag erfahren Sie, warum das Wir-Gefühl vergangener Zeiten heutzutage nicht mehr fruchten kann und wie Mitarbeiterbindung in Zeiten des Wandels wertschöpfend herbeigeführt werden kann. Desweiteren wird geklärt, welche Bedeutung ein glaubwürdiges Wertesystem im Unternehmen für die Wertschöpfung hat, welche Kommunikationsaufgaben dem Management dabei zukommen und warum Verständnis bedeutsamer ist als das (Wir-)Gefühl.
Die vorliegenden Diplomarbeit bietet eine Übersicht über Filmbibliotheken, Filmarchiven und anderen Bibliotheken mit Filminformationsbeständen zum Thema. Zu diesem Zweck wurden Fragebögen an Einrichtungen verschickt, deren Arbeitsgebiet der Film im weiteren Sinne ist. Das methodische Vorgehen für diese Untersuchung wird ebenso aufgezeigt wie die sich daraus ergebende Übersicht über die Filminformationsbestände in Deutschland. Zum Vergleich des Umgangs mit der Filminformation in Deutschland und im Ausland werden einige Filminformationseinrichtungen in anderen Ländern betrachtet und beschrieben. Anschließend an die Darstellungen der Informationseinrichtungen wird der Versuch einer Systematisierung der unterschiedlichen Typen von Informationseinrichtungen und der verschiedenen Themenschwerpunkte der Bestände unternommen.
Background: In many research areas it is necessary to find differences between treatment groups with several variables. For example, studies of microarray data seek to find a significant difference in location parameters from zero or one for ratios thereof for each variable. However, in some studies a significant deviation of the difference in locations from zero (or 1 in terms of the ratio) is biologically meaningless. A relevant difference or ratio is sought in such cases.
Results: This article addresses the use of relevance-shifted tests on ratios for a multivariate parallel two-sample group design. Two empirical procedures are proposed which embed the relevanceshifted test on ratios. As both procedures test a hypothesis for each variable, the resulting multiple testing problem has to be considered. Hence, the procedures include a multiplicity correction. Both procedures are extensions of available procedures for point null hypotheses achieving exact control of the familywise error rate. Whereas the shift of the null hypothesis alone would give straight-forward solutions, the problems that are the reason for the empirical considerations discussed here arise by the fact that the shift is considered in both directions and the whole parameter space in between these two limits has to be accepted as null hypothesis.
Conclusion: The first algorithm to be discussed uses a permutation algorithm, and is appropriate for designs with a moderately large number of observations. However, many experiments have limited sample sizes. Then the second procedure might be more appropriate, where multiplicity is corrected according to a concept of data-driven order of hypotheses.
Background
To perform a systematic review about the effect of using clinical pathways on length of stay (LOS), hospital costs and patient outcomes. To provide a framework for local healthcare organisations considering the effectiveness of clinical pathways as a patient management strategy.
Methods
As participants, we considered hospitalized children and adults of every age and indication whose treatment involved the management strategy "clinical pathways". We include only randomised controlled trials (RCT) and controlled clinical trials (CCT), not restricted by language or country of publication. Single measures of continuous and dichotomous study outcomes were extracted from each study. Separate analyses were done in order to compare effects of clinical pathways on length of stay (LOS), hospital costs and patient outcomes. A random effects meta-analysis was performed with untransformed and log transformed outcomes.
Results
In total 17 trials met inclusion criteria, representing 4,070 patients. The quality of the included studies was moderate and studies reporting economic data can be described by a very limited scope of evaluation. In general, the majority of studies reporting economic data (LOS and hospital costs) showed a positive impact. Out of 16 reporting effects on LOS, 12 found significant shortening. Furthermore, in a subgroup-analysis, clinical pathways for invasive procedures showed a stronger LOS reduction (weighted mean difference (WMD) -2.5 days versus -0.8 days)).
There was no evidence of differences in readmission to hospitals or in-hospital complications. The overall Odds Ratio (OR) for re-admission was 1.1 (95% CI: 0.57 to 2.08) and for in-hospital complications, the overall OR was 0.7 (95% CI: 0.49 to 1.0). Six studies examined costs, and four showed significantly lower costs for the pathway group. However, heterogeneity between studies reporting on LOS and cost effects was substantial.
Conclusion
As a result of the relatively small number of studies meeting inclusion criteria, this evidence base is not conclusive enough to provide a replicable framework for all pathway strategies. Considering the clinical areas for implementation, clinical pathways seem to be effective especially for invasive care. When implementing clinical pathways, the decision makers need to consider the benefits and costs under different circumstances (e.g. market forces).
During the intraoperative radiograph generation process with mobile image intensifier systems (C-arm) most of the radiation exposure for patient, surgeon and operation room personal is caused by scattered radiation. The intensity and propagation of scattered radiation depend on different parameters, e.g. the intensity of the primary radiation, and the positioning of the mobile image intensifier. Exposure through scattered radiation can be minimized when all these parameters are adjusted correctly. Because radiation is potentially dangerous and could not be perceived by any human sense the current education on correct adjustment of a C-arm is designed very theoretical. This paper presents an approach of scattered radiation calculation and visualization embedded in a computer based training system for mobile image intensifier systems called virtX. With the help of this extension the virtX training system should enrich the current radiation protection training with visual and practical training aspects.
Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis
(2009)
Background and Aim:
Oral bisphosphonates have been shown to reduce the risk of fractures in patients with osteoporosis. It can be assumed that the clinical effectiveness of oral bisphosphonates depends on persistence with therapy.
Methods:
The influence of persistence with and adherence to oral bisphosphonates on fracture risk in a real-life setting was investigated. Data from 4451 patients with a defi ned index prescription of bisphosphonates were included. Fracture rates within 180, 360, and 720 days after index prescription were compared between persistent and non-persistent patients. In an extended Cox regression model applying multiple event analysis, the influence of adherence was analyzed. Persistence was defined as the duration of continuous therapy; adherence was measured in terms of the medication possession ratio (MPR).
Results:
In patients with a fracture before index prescription, fracture rates were reduced by 29% (p = 0.025) comparing persistent and non-persistent patients within 180 days after the index prescription and by 45% (p < 0.001) within 360 days. The extended Cox regression model showed that good adherence (MPR ≥ 0.8) reduced fracture risk by about 39% (HR 0.61, 95% CI 0.47–0.78; p < 0.01).
Conclusions:
In patients with osteoporosis-related fractures, good persistence and adherence to oral bisphosphonates reduced fracture risk significantly.
Über die vergangenen Jahrzehnte hat sich die Interne Unternehmenskommunikation stets auf durch ökonomische Herausforderungen bedingte organisationale Veränderungen eingestellt und ihre Modelle zur Motivation und Integration von Mitarbeitern den Veränderungen im strategischen und operativen Management angepasst. Ging es in den 70er und 80er Jahren dabei noch um das Herstellen von Mitarbeiterzufriedenheit, drehte sich seit den 90er Jahren in der Folge des zunehmenden globalen Wettbewerbs dann alles um das Mitarbeiterengagement.<br /> Dieser Beitrag unternimmt einen Versuch, die Geschichte der Internen Unternehmens-kommunikation in Deutschland zu beleuchten. Dazu wird der Blickwinkel des Kommunikationsmanagements eingenommen, welches die Funktion der generellen Unternehmenskommunikation und damit auch die ihrer Teildisziplin für die Anspruchsgruppe der Mitarbeiter unter betriebswirt-schaftlichen Gesichtspunkten betrachtet und in den Wertschöpfungsprozess eines Unternehmens einordnet. <br /> Es wird gezeigt, dass und wie sich die Interne Unternehmenskommunikation über die vergangenen Jahrzehnte auf durch ökonomische Herausforderungen bedingte organisationale Veränderungen eingestellt und diese unterstützt hat. Die jeweiligen Lösungsansätze der Internen Kommunikation dienten immer dazu, die Mitarbeiter zum Vorteil der Unternehmensführung in das Unternehmensgeschehen zu integrieren. <br /> Und so, wie sich im Laufe der Zeit das strategische und operative Management veränderte, entwickelte sich auch die hier zu beschreibende Disziplin weiter.<br /> Unterdessen ist der Wandel Normalität geworden, doch mehr als jeder dritte Veränderungsprozess kann auch heute noch vor allem durch eine mangelnde Integration der Mitarbeiter als nicht erfolgreich betrachtet werden. Aber mehr denn je ist die kreative Beteiligung der Betroffenen und die Übernahme von Eigenverant-wortung notwendig. Entsprechende Maßnahmen der Internen Unternehmenskommunikation müssen nun aus einem Modell für Mobilisierung erwachsen.<br /> Inzwischen stellen diese Zusammenhänge die Verantwortlichen für die Interne Kommunikation vor große Herausforderungen und erfordern ein hohes Maß an Professionalität, die aber in der Praxis noch längst nicht überall Einzug gehalten hat. So gibt dieser Beitrag auch einen Ausblick auf die aktuell zu erkennenden Unterstützungspotenziale der Internen Unternehmenskommunikation im Wertschöpfungsprozess.<br />
Hintergrund und Fragestellung: Die korrekte intraoperative Positionierung und Einstellung eines mobilen Bildverstärkers (auch C-Bogen) kann zurzeit theoretisch mit Hilfe von Lehrbüchern erlernt, am Gerät selbst aber nur ohne visuelle Rückmeldung, d.h. ohne ein zur Ausrichtung korrespondierendes Röntgenbild, trainiert werden. Hieraus ergibt sich die Fragestellung, inwiefern das Training der Handhabung und richtigen Einstellung des C-Bogens in verschiedenen Operationsszenarien durch ein C-Bogen Simulationssystem als Teil eines CBT-Systems (Computer Based Training) unterstützt werden kann. Methoden: In Kooperation mit Ärzten aus Unfallchirurgie und Radiologie wurde das computer-basierte Trainingssystem virtX entwickelt. virtX kann dem Nutzer verschiedene Aufgaben zur Einstellung eines C-Bogens stellen und die Ausführung und das Ergebnis bewerten. Die Aufgaben können mit Hilfe eines Autorensystems erstellt und vom Trainierenden in verschiedenen Modi erfüllt werden: im rein virtuellen Modus oder im kombinierten virtuell-realen Modus. Im rein virtuellen Modus steuert der Nutzer den virtuellen C-Bogen in einem virtuellen OP-Saal mittels einer grafisch-interaktiven Benutzungsoberfläche. Im virtuell-realen Modus hingegen wird die Ausrichtung eines realen C-Bogens erfasst und auf den virtuellen C-Bogen übertragen. Während der Aufgabenerfüllung kann der Benutzer zu jeder Zeit ein realitätsnahes, virtuelles Röntgenbild erzeugen und dabei alle Parameter wie Blendenstellung, Röntgenintensität, etc. wie bei einem realen C-Bogen steuern. virtX wurde auf einem dreitägigen Kurs für OP-Personal mit 120 Teilnehmern eingesetzt und auf der Basis von Fragebögen evaluiert. Ergebnisse: Von den Teilnehmern gaben 79 einen ausgefüllten Evaluations-Fragebogen ab. Das Durchschnittsalter der 62 weiblichen und 15 männlichen Teilnehmer (zwei o.A.) lag bei 34 ± 9 Jahren, die Berufserfahrung bei 8,3 ± 7,6 Jahren. 18 Personen (23%) gaben an, gelegentlich mit einem C-Bogen zu arbeiten, 61 (77%) arbeiteten regelmäßig damit. Über 83% der befragten Teilnehmer empfanden virtX als eine sinnvolle Ergänzung zur herkömmlichen Ausbildung am C-Bogen. Das virtuelle Röntgen wurde mit einer Zustimmung von 91% der befragten Teilnehmer als besonders wichtig für das Verständnis der Arbeitsweise eines C-Bogens beurteilt. Ebenso erhielt der kombinierte virtuell-reale Modus mit 84% Zustimmung einen vergleichsweise hohen Stellenwert. Schlussfolgerung: Die Befragung zeichnet ein positives Bild der Akzeptanz des virtX-System als substanzielle Ergänzung zur herkömmlichen Ausbildung am C-Bogen.
Hintergrund und Fragestellung: Die durch röntgentechnische Diagnoseverfahren in der Medizin entstehende Strahlenbelastung für Patient und Personal soll laut Strahlenschutzverordnung so gering wie möglich gehalten werden. Um dieses zu erreichen ist ein professioneller und bedachter Umgang mit den Röntgengeräten unabdingbar. Dieses Verhalten kann derzeit jedoch nur theoretisch vermittelt werden, da sich ein Üben mit realer Strahlung von selbst verbietet. Daher stellt sich die Frage wie man die Strahlenschutzausbildung durch eine verbesserte Vermittlung der komplexen Thematik unterstützen kann. Methoden: Das CBT-System (Computer Based Training) virtX, welches das Erlernen der korrekten Handhabung mobiler Röntgengeräte unterstützt, wurde um Aspekte aus dem Bereich des Strahlenschutzes erweitert. Es wurde eine prototypische Visualisierung der entstehenden Streustrahlung sowie die Darstellung des Nutzstrahlenganges integriert. Des Weiteren wurde die Berechnung und Anzeige der virtuellen Einfallsdosis für das durchstrahlte Volumen sowie für den Bereich des Bildverstärkers hinzugefügt. Für die Berechnung und Visualisierung all dieser Komponenten werden die in virtX parametrisierbaren C-Bogen-Einstellungen, z.B. Stellung der Blenden, Positionierung des Röntgengerätes zum durchstrahlten Volumen und Strahlenintensität, herangezogen. Das so erweiterte System wurde auf einem dreitägigen Kurs für OP-Personal mit über 120 Teilnehmern eingesetzt und auf der Basis von Fragebögen evaluiert. Ergebnisse: Von den Teilnehmern gaben 55 einen ausgefüllten Evaluations-Fragebogen ab (Responserate 82%). Das Durchschnittsalter der 39 weiblichen und 15 männlichen Teilnehmer (einer o.A.) lag bei 33±8 Jahren, die Berufserfahrung bei 9,37±7 Jahren. Die Erfahrung mit dem C-Bogen wurde von einem Teilnehmer (2%) mit „Keine oder bisher nur Einführung erhalten“, von acht Teilnehmern (14%) mit „bediene einen C-Bogen gelegentlich“ und von 46 (84%) mit „bediene einen C-Bogen regelmäßig“ angegeben. 45 (92%) der Teilnehmer gaben an, durch die Visualisierung der Streustrahlung etwas Neues zur Vermeidung unnötiger Strahlenbelastung dazugelernt zu haben. Schlussfolgerung: Trotz einer bislang nur prototypischen Visualisierung der Streustrahlung können mit virtX zentrale Aspekte und Verhaltensweisen zur Vermeidung unnötiger Strahlenbelastung erfolgreich vermittelt werden und so Lücken der traditionellen Strahlenschutzausbildung geschlossen werden.
Background: Fall events contribute significantly to mortality, morbidity and costs in our ageing population. In order to identify persons at risk and to target preventive measures, many scores and assessment tools have been developed. These often require expertise and are costly to implement. Recent research investigates the use of wearable inertial sensors to provide objective data on motion features which can be used to assess individual fall risk automatically. So far it is unknown how well this new method performs in comparison with conventional fall risk assessment tools. The aim of our research is to compare the predictive performance of our new sensor-based method with conventional and established methods, based on prospective data.
Methods: In a first study phase, 119 inpatients of a geriatric clinic took part in motion measurements using a wireless triaxial accelerometer during a Timed Up&Go (TUG) test and a 20 m walk. Furthermore, the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) was performed, and the multidisciplinary geriatric care team estimated the patients’ fall risk. In a second follow-up phase of the study, 46 of the participants were interviewed after one year, including a fall and activity assessment. The predictive performances of the TUG, the STRATIFY and team scores are compared. Furthermore, two automatically induced logistic regression models based on conventional clinical and assessment data (CONV) as well as sensor data (SENSOR) are matched.
Results: Among the risk assessment scores, the geriatric team score (sensitivity 56%, specificity 80%) outperforms STRATIFY and TUG. The induced logistic regression models CONV and SENSOR achieve similar performance values (sensitivity 68%/58%, specificity 74%/78%, AUC 0.74/0.72, +LR 2.64/2.61). Both models are able to identify more persons at risk than the simple scores.
Conclusions: Sensor-based objective measurements of motion parameters in geriatric patients can be used to assess individual fall risk, and our prediction model’s performance matches that of a model based on conventional clinical and assessment data. Sensor-based measurements using a small wearable device may contribute significant information to conventional methods and are feasible in an unsupervised setting. More prospective research is needed to assess the cost-benefit relation of our approach.
Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups
(2012)
Background: Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients’ assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2).
Methods: A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital’s data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances.
Results: The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity.
Conclusions: Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified automatically from existing geriatric assessment data, especially when combined with domain knowledge in a hybrid classification model. Further work is necessary to validate our approach in a controlled prospective setting.
Wearable sensors in healthcare and sensor-enhanced health information systems: all our tomorrows?
(2012)
Wearable sensor systems which allow for remote or self-monitoring of health-related parameters are regarded as one means to alleviate the consequences of demographic change. This paper aims to summarize current research in wearable sensors as well as in sensor-enhanced health information systems. Wearable sensor technologies are already advanced in terms of their technical capabilities and are frequently used for cardio-vascular monitoring. Epidemiologic predictions suggest that neuro-psychiatric diseases will have a growing impact on our health systems and thus should be addressed more intensively. Two current project examples demonstrate the benefit of wearable sensor technologies: long-term, objective measurement under daily-life, unsupervised conditions. Finally, up-to-date approaches for the implementation of sensor-enhanced health information systems are outlined. Wearable sensors are an integral part of future pervasive, ubiquitous and person-centered health
care delivery. Future challenges include their integration into sensor-enhanced health information systems and sound evaluation studies involving measures of workload reduction and costs.
The present investigation was conducted to investigate the in-vitro activity of ethanolic extract of roots of Centaurea behens by using DPPH radical scavenging activity, nitric oxide radical scavenging activity, hydrogen peroxide radical scavenging activity, hydroxyl radical. Result suggests that the extract possess significant antioxidant activity as compared to the standard ascorbic acid and thus further in vivo investigation is required to evaluate the medicinal significance of the extract which can be used for assessing the possible therapeutic importance of the drug.
Background: Physician-rating websites are currently gaining in popularity because they increase transparency in the health care system. However, research on the characteristics and content of these portals remains limited.
Objective: To identify and synthesize published evidence in peer-reviewed journals regarding frequently discussed issues about physician-rating websites.
Methods: Peer-reviewed English and German language literature was searched in seven databases (Medline (via PubMed), the Cochrane Library, Business Source Complete, ABI/Inform Complete, PsycInfo, Scopus, and ISI web of knowledge) without any time constraints. Additionally, reference lists of included studies were screened to assure completeness. The following eight previously defined questions were addressed: 1) What percentage of physicians has been rated? 2) What is the average number of ratings on physician-rating websites? 3) Are there any differences among rated physicians related to socioeconomic status? 4) Are ratings more likely to be positive or negative? 5) What significance do patient narratives have? 6) How should physicians deal with physician-rating websites? 7) What major shortcomings do physician-rating websites have? 8) What recommendations can be made for further improvement of physician-rating websites?
Results: Twenty-four articles published in peer-reviewed journals met our inclusion criteria. Most studies were published by US (n=13) and German (n=8) researchers; however, the focus differed considerably. The current usage of physician-rating websites is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90% of all ratings on physician-rating websites were positive. Although often a concern, we could not find any evidence of "doctor-bashing". Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and ex-ternal purpose. Several shortcomings limit the significance of the results published on physician-rating websites; some recommendations to address these limitations are presented.
Conclusions: Although the number of publications is still low, physician-rating websites are gaining more attention in research. But the current condition of physician-rating websites is lacking. This is the case both in the United States and in Germany. Further research is necessary to increase the quality of the websites, especially from the patients’ perspective.
We compare the effect of different segmentation strategies for passage retrieval of user generated internet video. We consider retrieval of passages for rather abstract and complex queries that go beyond finding a certain object or constellation of objects in the visual channel. Hence the retrieval methods have to rely heavily on the recognized speech. Passage retrieval has mainly been studied to improve document retrieval and to enable question answering. In these domains best results were obtained using passages defined by the paragraph structure of the source documents or by using arbitrary overlapping passages. For the retrieval of relevant passages in a video no author defined paragraph structure is available. We compare retrieval results from 5 different types of segments: segments defined by shot boundaries, prosodic segments, fixed length segments, a sliding window and semantically coherent segments based on speech transcripts. We evaluated the methods on the corpus of the MediaEval 2011 Rich Speech Retrieval task. Our main conclusions are (1) that fixed length and coherent segments are clearly superior to segments based on speaker turns or shot boundaries; (2) that the retrieval results highly depend on the right choice for the segment length; and (3) that results using the segmentation into semantically coherent parts depend much less on the segment length. Especially, the quality of fixed length and sliding window segmentation drops fast when the segment length increases, while quality of the semantically coherent segments is much more stable. Thus, if coherent segments are defined, longer segments can be used and consequently fewer segments have to be considered at retrieval time.
BACKGROUND: Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. OBJECTIVE: To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. METHODS: This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. RESULTS: In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models. CONCLUSIONS: Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers.
Der Bedeutungszuwachs von Online-Medien hat eine gesellschaftliche Debatte über mögliche Folgen dieser Entwicklung ausgelöst. Weit verbreitet ist zum Beispiel die Wahrnehmung, dass Online-Medien maßgeblich beeinflussen, wie insbesondere jüngere Menschen politische Prozesse sehen und bewerten. Vor dem Hintergrund theoretischer Ansätze wie dem Influence-of-Presumed-Media-Influence-Approach wurde untersucht, welche kommunikationspolitischen Maßnahmen von der Bevölkerung als Reaktion auf solche Wahrnehmungen als angemessen eingeschätzt werden. Hierzu wurde im Kontext der Landtagswahl in Nordrhein-Westfalen 2012 eine Online-Befragung durchgeführt (n = 485). Die Befunde zeigen, dass die Wahrnehmung starker politischer Online-Einflüsse auf jüngere Menschen vor allem zu einer gesteigerten Akzeptanz von Aufklärung und Erziehung führt, weniger aber zu einer gesteigerten Akzeptanz restriktiver Maßnahmen zur Einflussbeschränkung.
Indirekte Medienwirkungen, wie sie im Rahmen des Influence-of-Presumed-Media-Influence-Approachs und des Third-Person-Effekts diskutiert werden, sind im Hinblick auf einzelne politische Ereignisse und für Online-Medien bislang nur selten geprüft worden. Aus diesem Grund wurde der unterstellte Einfluss verschiedener On- und Offline-Medien auf Meinungsbildung und Mobilisierung im Kontext der Volksabstimmung zum Umbau des Stuttgarter Hauptbahnhofes im November 2011 („Stuttgart 21“) untersucht. Daneben stehen Konsequenzen der Einflusswahrnehmungen im Fokus des Beitrags. Als Grundlage dient eine Online-Befragung der baden-württembergischen Bevölkerung mit Internetanschluss (n = 502). Die Befragten schreiben Zeitungen und Fernsehen einen stärkeren politischen Einfluss zu als den in der Studie berücksichtigten Online-Medien, und zwar sowohl auf die Meinungsbildung als auch auf die Mobilisierung. Zudem führt ein unterstellter großer und negativ bewerteter Medieneinfluss auf die Bevölkerung bei einigen Befragtengruppen zu einer Verstärkung von Kommunikationsaktivitäten – verbunden mit dem Ziel, diesen unterstellten Einfluss zu korrigieren. Die vermuteten negativen Einflüsse führen aber auch dazu, dass eine schärfere Kontrolle des Internets befürwortet wird.
Background: After kidney transplantation, immunosuppressive therapy causes impaired cellular immune defense leading to an increased risk of viral complications. Trough level monitoring of immunosuppressants is insufficient to estimate the individual intensity of immunosuppression. We have already shown that virus-specific T cells (Tvis) correlate with control of virus replication as well as with the intensity of immunosuppression. The multicentre IVIST01-trial should prove that additional steering of immunosuppressive and antiviral therapy by Tvis levels leads to better graft function by avoidance of over-immunosuppression (for example, viral infections) and drug toxicity (for example, nephrotoxicity).
Methods/design: The IVIST-trial starts 4 weeks after transplantation. Sixty-four pediatric kidney recipients are randomized either to a non-intervention group that is only treated conservatively or to an intervention group with additional monitoring by Tvis. The randomization is stratified by centre and cytomegalovirus (CMV) prophylaxis. In both groups the immunosuppressive medication (cyclosporine A and everolimus) is adopted in the same target range of trough levels. In the non-intervention group the immunosuppressive therapy (cyclosporine A and everolimus) is only steered by classical trough level monitoring and the antiviral therapy of a CMV infection is performed according to a standard protocol. In contrast, in the intervention group the dose of immunosuppressants is individually adopted according to Tvis levels as a direct measure of the intensity of immunosuppression in addition to classical trough level monitoring. In case of CMV infection or reactivation the antiviral management is based on the individual CMV-specific immune defense assessed by the CMV-Tvis level. Primary endpoint of the study is the glomerular filtration rate 2 years after transplantation; secondary endpoints are the number and severity of viral infections and the incidence of side effects of immunosuppressive and antiviral drugs.
Discussion: This IVIST01-trial will answer the question whether the new concept of steering immunosuppressive and antiviral therapy by Tvis levels leads to better future graft function. In terms of an effect-related drug monitoring, the study design aims to realize a personalization of immunosuppressive and antiviral management after transplantation. Based on the IVIST01-trial, immunomonitoring by Tvis might be incorporated into routine care after kidney transplantation.
The drugs we use to treat any condition – from an innocuous cough to a life-threatening cancer – are the outcome of painstaking human clinical trials. These trials are the only way to credibly determine the safety and efficacy of drugs. In recent years there has been a clear shift in clinical trial sites from core developed countries like USA, European countries to developing countries like India, China, South American countries. This shift is related to challenges and opportunities like costs of trials, recruitment issues, and regulatory challenges in developed vs. developing countries. Developing countries and developed countries have their unique disease burden patterns based on various parameters like but not limited to age, health care facilities, health insurance, sanitary conditions, environmental issues, education, nutrition
and GDP. Previous studies have reported that many of the important global diseases are not much explored in clinical trials and many published clinical trials have very less international health relevance. This study was aimed at finding the correlation between disease burdens, number of clinical trials done and trial success rates. We compared 2005 - 2010 Global Burden of Disease data for Germany, India and number of clinical trials from clinicaltrials.gov database done in the same period. Our findings indicated that there was a good correlation between the disease burden and clinical trials for Germany in 2005 and 2010. For India in 2005 there was a moderate positive correlation, 2010 data showed the improvement in India in terms of match between disease burden and clinical trials. But careful observation of the data shows still a need for more trials on Communicable, maternal, neonatal and nutritional disorders.
Nanotechnology is emerging as one of the key technologies of the 21st century and is expected to enable developments across a wide range of sectors that can benefit citizens. Nanomedicine is an application of nanotechnology in the areas of healthcare, disease diagnosis, treatment and prevention of disease. Nanomedicines pose problem of nanotoxicity related to factors like size, shape, specific surface area, surface morphology, and crystallinity. Currently, nanomedicines are regulated as medicinal products or as medical devices and there is no specific regulatory framework for nanotechnology-based products neither in the EU nor in the USA. This review presents a scheme for classification and regulatory approval process for nanotechnology based medicines.
Background: Epidemiological and experimental studies suggest that exposure to ultrafine particles (UFP) might aggravate the allergic inflammation of the lung in asthmatics.
Methods: We exposed 12 allergic asthmatics in two subgroups in a double-blinded randomized cross-over design, first to freshly generated ultrafine carbon particles (64 μg/m3; 6.1 ± 0.4 × 105 particles/cm3 for 2 h) and then to filtered air or vice versa with a 28-day recovery period in-between. Eighteen hours after each exposure, grass pollen was instilled into a lung lobe via bronchoscopy. Another 24 hours later, inflammatory cells were collected by means of bronchoalveolar lavage (BAL). (Trial registration: NCT00527462)
Results: For the entire study group, inhalation of UFP by itself had no significant effect on the allergen induced
inflammatory response measured with total cell count as compared to exposure with filtered air (p = 0.188). However, the subgroup of subjects, which inhaled UFP during the first exposure, exhibited a significant increase in total BAL cells (p = 0.021), eosinophils (p = 0.031) and monocytes (p = 0.013) after filtered air exposure and subsequent allergen challenge 28 days later. Additionally, the potential of BAL cells to generate oxidant radicals was
significantly elevated at that time point. The subgroup that was exposed first to filtered air and 28 days later to UFP did not reveal differences between sessions.
Conclusions: Our data demonstrate that pre-allergen exposure to UFP had no acute effect on the allergic inflammation. However, the subgroup analysis lead to the speculation that inhaled UFP particles might have a long-term effect on the inflammatory course in asthmatic patients. This should be reconfirmed in further studies with an appropriate study design and sufficient number of subjects.
Background: Maintenance of metal homeostasis is crucial in bacterial pathogenicity as metal starvation is the most important mechanism in the nutritional immunity strategy of host cells. Thus, pathogenic bacteria have evolved sensitive metal scavenging systems to overcome this particular host defence mechanism. The ruminant pathogen Mycobacterium avium ssp. paratuberculosis (MAP) displays a unique gut tropism and causes a chronic progressive intestinal inflammation. MAP possesses eight conserved lineage specific large sequence polymorphisms (LSP), which distinguish MAP from its ancestral M. avium ssp. hominissuis or other M. avium subspecies. LSP14 and LSP15 harbour many genes proposed to be involved in metal homeostasis and have been suggested to substitute for a MAP specific, impaired mycobactin synthesis.
Results: In the present study, we found that a LSP14 located putative IrtAB-like iron transporter encoded by mptABC was induced by zinc but not by iron starvation. Heterologous reporter gene assays with the lacZ gene under control of the mptABC promoter in M. smegmatis (MSMEG) and in a MSMEGΔfurB deletion mutant revealed a zinc dependent, metalloregulator FurB mediated expression of mptABC via a conserved mycobacterial FurB recognition site. Deep sequencing of RNA from MAP cultures treated with the zinc chelator TPEN revealed that 70 genes responded to zinc limitation. Remarkably, 45 of these genes were located on a large genomic island of approximately 90 kb which harboured LSP14 and LSP15. Thirty-five of these genes were predicted to be controlled by FurB, due to the presence of putative binding sites. This clustering of zinc responsive genes was exclusively found in MAP and not in other mycobacteria.
Conclusions: Our data revealed a particular genomic signature for MAP given by a unique zinc specific locus, thereby suggesting an exceptional relevance of zinc for the metabolism of MAP. MAP seems to be well adapted to maintain zinc homeostasis which might contribute to the peculiarity of MAP pathogenicity.
Clinical scores and motion-capturing gait analysis are today’s gold standard for outcome measurement after knee arthroplasty, although they are criticized for bias and their ability to reflect patients’ actual quality of life has been questioned. In this context, mobile gait analysis systems have been introduced to overcome some of these limitations. This study used a previously developed mobile gait analysis system comprising three inertial sensor units to evaluate daily activities and sports. The sensors were taped to the lumbosacral junction and the thigh and shank of the affected limb. The annotated raw data was evaluated using our validated proprietary software. Six patients undergoing knee arthroplasty were examined the day before and 12 months after surgery. All patients reported a satisfactory outcome, although four patients still had limitations in their desired activities. In this context, feasible running speed demonstrated a good correlation with reported impairments in sports-related activities. Notably, knee flexion angle while descending stairs and the ability to stop abruptly when running exhibited good correlation with the clinical stability and proprioception of the knee. Moreover, fatigue effects were displayed in some patients. The introduced system appears to be suitable for outcome measurement after knee arthroplasty and has the potential to overcome some of the limitations of stationary gait labs while gathering additional meaningful parameters regarding the force limits of the knee.
Background: Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented.
Objective: We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature.
Methods: The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents’ hospital choices were associated with particular information design elements.
Results: Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data (“N/A” as a value). When investigating the RAMR in a sample of 10 hospitals’ report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature.
Conclusions: To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a “good quality” range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.
The objective was to establish and standardise a broth microdilution susceptibility testing method for porcine Bordetella (B.) bronchiseptica. B. bronchiseptica isolates from different geographical regions and farms were genotyped by macrorestriction analysis and subsequent pulsed-field gel electrophoresis. One reference and one type strain plus two field isolates of B. bronchiseptica were chosen to analyse growth curves in four different media: cation-adjusted Mueller-Hinton broth (CAMHB) with and without 2% lysed horse blood, Brain-Heart-Infusion (BHI), and Caso broth. The growth rate of each test strain in each medium was determined by culture enumeration and the suitability of CAMHB was confirmed by comparative statistical analysis. Thereafter, reference and type strain and eight epidemiologically unrelated field isolates of B. bronchiseptica were used to test the suitability of a broth microdilution susceptibility testing method following CLSI-approved performance standards given in document VET01-A4. Susceptibility tests, using 20 antimicrobial agents, were performed in five replicates, and data were collected after 20 and 24 hours incubation and statistically analysed. Due to the low growth rate of B. bronchiseptica, an incubation time of 24 hours resulted in significantly more homogeneous minimum inhibitory concentrations after five replications compared to a 20-hour incubation. An interlaboratory comparison trial including susceptibility testing of 24 antimicrobial agents revealed a high mean level of reproducibility (97.9%) of the modified method. Hence, in a harmonization for broth microdilution susceptibility testing of B. bronchiseptica, an incubation time of 24 hours in CAMHB medium with an incubation temperature of 35°C and an inoculum concentration of approximately 5 x 105 cfu/ml was proposed.
BACKGROUND: Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE). METHODS: Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information. RESULTS: Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication. CONCLUSIONS: Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.
Objectives: To assess the relation between the number of clinical trials conducted and respective new drug approvals in India and South Africa.
Design: Construction and analysis of a comprehensive database of completed randomised controlled clinical trials based on clinicaltrials.gov from 1 January 2005 to 31 December 2010 and drug approval data from 2006 until 2013 for India and South Africa.
Setting: USA, the EU, India and South Africa.
Main outcome measures: Percentage of completed randomised clinical trials for an Investigational Medicinal Product (IMP) leading to new drug approval in India and South Africa.
Results: A total of 622 eligible randomised controlled trials were identified as per search criteria for India and South Africa. Clustering them for the same sponsor and the same Investigational New Drug (IND) resulted in 453 eligible trials, that is, 224 for India and 229 for South Africa. The distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centres in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorisation in the EU/USA without a New Drug Application (NDA) approval in India or South Africa.
Conclusions: Despite an increase in clinical trial activities, there is a clear gap between the number of trials conducted and market availability of these new drugs in India and South Africa. Drug regulatory authorities, investigators, institutional review boards and patient groups should direct their efforts to ensuring availability of new drugs in the market that have been tested and researched on their population.
The Wnt signaling pathway has been associated with many essential cell processes. This study aims to examine the effects of Wnt signaling on proliferation of cultured HEK293T cells. Cells were incubated with Wnt3a, and the activation of the Wnt pathway was followed by analysis of the level of the β-catenin protein and of the expression levels of the target genes MYC and CCND1. The level of β-catenin protein increased up to fourfold. While the mRNA levels of c-Myc and cyclin D1 increased slightly, the protein levels increased up to a factor of 1.5. Remarkably, MTT and BrdU assays showed different results when measuring the proliferation rate of Wnt3a stimulated HEK293T cells. In the BrdU assays an increase of the proliferation rate could be detected, which correlated to the applied Wnt3a concentration. Oppositely, this correlation could not be shown in the MTT assays. The MTT results, which are based on the mitochondrial activity, were confirmed by analysis of the succinate dehydrogenase complex by immunofluorescence and by western blotting. Taken together, our study shows that Wnt3a activates proliferation of HEK293 cells. These effects can be detected by measuring DNA synthesis rather than by measuring changes of mitochondrial activity.
Background: Foodstuff traders operating from warehouses (FTFW) are potentially exposed to dangerous rodenticides/pesticides that may have adverse effects on cardiopulmonary function. Methods: 50 consenting male foodstuff traders, comprising 15 traders (21–63 years) operating outside warehouses and 35 FTFW (20–64 years), were randomly recruited at Ogbete Market, Enugu, in a cross-sectional observational study of spirometric and electrocardiographic parameters. 17 FTFW (21–57 years) participated in focus group discussions. Qualitative and quantitative data were analysed thematically and with independent t-test and Pearson correlation coefficient at p < 0.05, respectively. Results: Most FTFW experienced respiratory symptoms, especially dry cough (97,1%) and wheezing (31.4%) with significant reductions in forced vital capacity (FVC) (t = -2.654; p = 0.011), forced expiratory volume in one second (FEV1) (t = -2.240; p = 0.030), maximum expiratory flow rate (FEF200-1200) (t = -1.148; p = -0.047), and forced end-expiratory flow (FEF25-75) (t = -1.11; p = 0.007). The maximum mid-expiratory flow (FEF25-75) was marginally decreased (p > 0.05) with a significantly prolonged (p < 0.05) QTc interval. Conclusion: Allergic response was evident in the FTFW. Significant decrease in FVC may negatively impact lung flow rates and explains the marginal decrease in FEF25-75, which implies a relative limitation in airflow of peripheral/distal airways and elastic recoil of the lungs. This is consistent with obstructive pulmonary disease; a significant decrease in FEF75-85/FEV1 supports this conclusion. Significant decrease in FEF200-1200 indicates abnormalities in the large airways/larynx just as significantly prolonged ventricular repolarization suggests cardiac arrhythmias.
Background: Physician-rating websites have become a popular tool to create more transparency about the quality of health care providers. So far, it remains unknown whether online-based rating websites have the potential to contribute to a better standard of care. Objective: Our goal was to examine which health care providers use online rating websites and for what purposes, and whether health care providers use online patient ratings to improve patient care. Methods: We conducted an online-based cross-sectional study by surveying 2360 physicians and other health care providers (September 2015). In addition to descriptive statistics, we performed multilevel logistic regression models to ascertain the effects of providers' demographics as well as report card-related variables on the likelihood that providers implement measures to improve patient care. Results: Overall, more than half of the responding providers surveyed (54.66%, 1290/2360) used online ratings to derive measures to improve patient care (implemented measures: mean 3.06, SD 2.29). Ophthalmologists (68%, 40/59) and gynecologists (65.4%, 123/188) were most likely to implement any measures. The most widely implemented quality measures were related to communication with patients (28.77%, 679/2360), the appointment scheduling process (23.60%, 557/2360), and office workflow (21.23%, 501/2360). Scaled-survey results had a greater impact on deriving measures than narrative comments. Multilevel logistic regression models revealed medical specialty, the frequency of report card use, and the appraisal of the trustworthiness of scaled-survey ratings to be significantly associated predictors for implementing measures to improve patient care because of online ratings. Conclusions: Our results suggest that online ratings displayed on physician-rating websites have an impact on patient care. Despite the limitations of our study and unintended consequences of physician-rating websites, they still may have the potential to improve patient care.
Background
Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend.
Methods
Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05.
Results
Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727).
Conclusions
Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.
Background: Often preventive measures are not accessed by the people who were intended to be reached. Programs for older adults may target men and women, older adults, advanced old age groups and/or chronically ill patients with specific indications. The defined target groups rarely participate in the conception of programs or in the design of information materials, although this would increase accessibility and participation. In the German “Reaching the Elderly” study (2008–2011), an approach to motivating older adults to participate in a preventive home visit (PHV) program was modified with the participatory involvement of the target groups. The study examines how older men and women would prefer to be addressed for health and prevention programs.
Methods: Four focus groups (N = 42 participants) and 12 personal interviews were conducted (women and men in 2 age groups: 65–75 years and ≥ 76 years). Participants from two districts of a major German city were selected from a stratified random sample (N = 200) based on routine data from a local health insurance fund. The study focused on the participants’ knowledge about health and disease prevention and how they preferred to be approached and addressed. Videos of the focus groups were recorded and analysed using mind mapping techniques. Interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis.
Results: A gender-specific approach profile was observed. Men were more likely to favor competitive and exerciseoriented activities, and they associated healthy aging with mobility and physical activity. Women, on the other hand, displayed a broader understanding of healthy aging, which included physical activity as only one aspect as well as a healthy diet, relaxation/wellness, memory training and independent living; they preferred holistic and socially oriented services that were not performance-oriented. The “older seniors” (76+) were ambivalent towards
certain wordings referring to aging.
Conclusions: Our results suggest that gender-specific needs must be considered in order to motivate older adults to participate in preventive services. Age-specific characteristics seem to be less relevant. It is more important to pay attention to factors that vary according to the individual state of health and life situation of
the potential participants.
Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76 ± 8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using -test for proportional significance and chi-square test for determining relationship between variables, at p < 0.05. Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke ( = 21.680, df = 6, and p = 0.001), yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.
A decline in the CD4 count is a common feature in HIV/AIDS, suggesting a compromise in immunity of patients. In response, highly active antiretroviral therapy (HAART) is prescribed to slow-down a diminution in the CD4 count and risk of AIDS-related malignancies. However, exercise may improve both the utility and population of innate immune cell components, and may be beneficial for patients with HIV infection. Comparing the effects of different exercises against HAART, on CD4 count, helps in understanding the role and evidence-based application of exercises to ameliorate immune deficiency.
Malnutrition, nutritional deficiency, or undernutrition is an imbalanced nutritional status resulting from insufficient intake of nutrients to meet normal physiologic requirements. Malnutrition in childhood has both short-term consequences and long-term consequences on mental and physical health as well as the overall health development of children. Of all regions in the world, the Asia and the Pacific region has achieved the fastest rate of economic growth. There is no evidence that this rapid economic growth translates into a decline in malnutrition of children in Asian countries such as India.
The use of secondary data in health care research has become a very important issue over the past few years. Data from the treatment context are being used for evaluation of medical data for external quality assurance, as well as to answer medical questions in the form of registers and research databases. Additionally, the establishment of electronic clinical systems like data warehouses provides new opportunities for the secondary use of clinical data. Because health data is among the most sensitive information about an individual, the data must be safeguarded from disclosure.
Malnutrition is the condition in which the body does not get the right amount of proteins, vitamins, or other nutrients.1 The global prevalence of malnutrition was reported as 13% in 2015.2 The subregion of South Asia is especially known as a critical area for severe wasted children aged <5 years.3 In India, 38.4% of children aged <3 years are stunted, and 46% are underweight.4 Malnutrition can lead to mortality as well as disabilities and long-term consequences such as cognitive disabilities, less economic productivity, or diseases.
The world health organization defines musculoskeletal disorder (MSD) as “a disorder of muscles, tendons, peripheral vascular system not directly resulting from an acute or instantaneous event.1 Work related MSDs are one of the most important occupational hazards.1 Among many other occupations, dentistry is a highly demanding profession that requires good visual acuity, hearing, depth perception, psychomotor skills, manual dexterity, and ability to maintain occupational postures over long periods.
From an ethical perspective, clinical research involving humans is only acceptable if it involves the potential for benefit. Various characteristics can be applied to differentiate research benefit. Often benefit is categorized in direct or indirect benefit, whereby indirect benefit might be further differentiated in collective or benefit for the society, excluding or including the trial patient in the long term. Ethical guidelines, such as the Declaration of Helsinki in its latest version, do not precisely favor a particular type of benefit.
Type 2 Diabetes Mellitus: Risk Evaluation and Advice in Undergraduate Students in Ashrafieh, Lebanon
(2016)
Type 2 diabetes mellitus (T2DM) is a chronic lifestyle disease. It has become evident that T2DM occurs even among the younger age groups.1 In Lebanon, T2DM has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities.2
The medical devices sector helps save lives by providing innovative health care solutions regarding diagnosis, prevention, monitoring, treatment, and alleviation. Medical devices are classified into 1 of 3 categories in the order of increasing risk: Class I, Class II, and Class III.1 Medical devices are distinguished from drugs for regulatory purposes based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect.
Ever since the 1996 revision of the Declaration of Helsinki, the World Medical Association has attempted to address ethical and scientific concerns of its diverse stakeholders for Articles 33 (use of placebo) and 34 (posttrial provisions), most recently in 2013. Both are inextricably linked to standard of care, an essential element of any comparative, interventional clinical trial. But has this now 20-year-long ethical debate truly been put to rest? The choice of standard of care in clinical trials remains a complex issue, particularly for comparative trials conducted in emerging countries.
Immunization is the most cost-effective intervention for infectious diseases, which are the major cause of morbidity and mortality worldwide. Vaccines not only protect the individual who is vaccinated but also reduce the burden of infectious vaccine-preventable diseases for the entire community.
1 Adult vaccination is very important given that >25% of mortality is due to infectious diseases.
2 There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India.
The most important attribute for which we all aspire as human beings is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled us to explore and define several parameters of “health” by drawing boundaries around factors that are known to impact the achievement of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration.
Publication Bias
(2016)
According to the Declaration of Helsinki, as well as the Statement on Public Disclosure of Clinical Trial Results of the World Health Organization, every researcher has the ethical obligation to publish research results on all trials with human participants in a complete and accurate way within 12 months after the end of the trial.1,2 Nevertheless, for several reasons, not all research results are published in an accurate way in case they are released at all. This phenomenon of publication bias may not only create a false impression on the reliability of clinical research business, but it may also affect the evidence of clinical conclusions about the best treatments, which are mostly based on published data and results.
Diabetes is fast gaining the status of a potential epidemic in India, with >62 million individuals currently diagnosed with the disease.1 India currently faces an uncertain future in relation to the potential burden that diabetes may impose on the country. An estimated US$ 2.2 billion would be needed to sufficiently treat all cases of type 2 diabetes mellitus (T2DM) in India.2 Many interventions can reduce the burden of this disease. However, health care resources are limited; thus, interventions for diabetes treatment should be prioritized.
Hypertension is a serious global public health problem. It accounts for 10% of all deaths in India and is the leading noncommunicable disease.1 Recent studies have shown that the prevalence of hypertension is 25% in urban and 10% in rural people in India.2 It exerts a substantial public health burden on cardiovascular health status and health care systems in India.3 Antihypertensive treatment effectively reduces hypertension-related morbidity and mortality.1 The cost of medications has always been a barrier to effective treatment.
Research question: Rivalries in team sports are commonly conceptualized as a threat to the fans’ identity. Therefore, past research has mainly focused on the negative consequences. However, theoretical arguments and empirical evidence suggest that rivalry has both negative and positive effects on fans’ self-concept. This research develops and empirically tests a model which captures and integrates these dual effects of rivalry.
Research methods: Data were collected via an on-site survey at home games of eight German Bundesliga football teams (N = 571). Structural equation modeling provides strong support for the proposed model.
Results and findings: In line with previous research, the results show that rivalry threatens fans’ identity as reflected in lower public collective self-esteem in relation to supporters of the rival team. However, the results also show that there are crucial positive consequences, such as higher perceptions of public collective self-esteem in relation to supporters of non-rival opponents, perceived ingroup distinctiveness and ingroup cohesion. These positive effects are mediated through increases in disidentification with the rival and perceived reciprocity of rivalry.
Implications: We contribute to the literature by providing a more balanced view of one of team sports’ key phenomena. Our results indicate that the prevalent conceptualization of rivalry as an identity threat should be amended by the positive consequences. Our research also offers guidance for the promotion of rivalries, where the managerial focus should be on creating a perception that a rivalry is reciprocal.
According to the third-person effect or the influence of presumed media influence approach, the presumption that the media has strong effects on other people can affect individuals’ attitudes and behavior. For instance, if people believe in strong media influences on others, they are more likely to increase their communication activities or support demands for restrictions on media. A standardized online survey among German journalists (N = 960) revealed that the stronger the journalists perceive the political online influence on the public to be, the more frequently they contradict unwanted political views in their articles. Moreover, even journalists are more likely to approve of restrictions on the Internet’s political influence, the stronger they believe the effects of online media to be. The data reveal no connections between communication activities and demands for restrictions.
Background:
The increase in food intolerances poses a burgeoning problem in our society. Food intolerances not only lead to physical impairment of the individual patient but also result in a high socio-economic burden due to factors such as the treatment required as well as absenteeism. The present study aimed to explore whether lactose intolerant (LI) patients exhibit more frequent comorbidities than non-LI patients.
Methods:
The study was conducted on a case-control basis and the results were determined using routine data analysis. Routine data from the IMS Disease Analyzer database were used for this purpose. A total of 6,758 data records were processed and analyzed.
Results:
There were significant correlations between LI and the incidence of osteoporosis, changes in mental status, and the presence of additional food intolerances. Comparing 3,379 LI vs. 3,379 non-LI patients, 34.5% vs. 17.7% (P<0.0001) suffered from abdominal pain; 30.6% vs. 17.2% (P<0.0001) from gastrointestinal infections; and 20.9% vs. 16.0% (P=0.0053) from depression. Adjusted odds ratios (OR) were the highest for fructose intolerance (n=229 LI vs. n=7 non-LI; OR 31.06; P<0.0001), irritable bowel syndrome (n=247 LI vs. n=44 non-LI; OR 5.23; P<0.0001), and bloating (n=351 LI vs. n=68 non-LI; OR 4.94; P<0.0001).
Conclusion:
The study confirms that LI should not be regarded as an isolated illness but considered a possible trigger for further diseases. Additional research is necessary to assert more precise statements.
A systematic review of the literature on survey questionnaires to assess self-medication practices
(2017)
Self-medication is of great public health importance as it often bypasses regulatory mechanisms to assure quality of health care. Nevertheless there are no established standards on how to assess self-medication. We therefore intended to systematically retrieve questionnaires and survey tools used to capture self-medication, with the aim to identify the scope of information investigated in this context and commonalities between the tools. We conducted a systematic review of the literature on questionnaires used for self-medication assessment by searching PubMed and Web of Science databases using the combinations of following keywords; self-medication, self-prescription, non-prescription, questionnaire. Truncation was used to ensure retrieval of all possible variations of search terms. The search was limited to articles published between 1st January 2000 and 31st December 2015, human studies and English language. Duplicate and irrelevant studies were excluded from the final review. A total of 158 studies were included in the review. Studies were from diverse geographical locations, most of the studies were from Nigeria 16 (10.1%) followed by India 10 (6.3%) and Iran 8 (5%). Forty-three studies (27.2%) focused on antibiotic self-medication. Majority of the studies (106; 67%) were done with adult populations. The components addressed by the questionnaires covered: reasons for self-medications in 147 (93%) studies, purchasing source in 136 (86%) studies, medical conditions to be treated in 153 (96.8%) studies, adverse events in 67 (42.4%) studies, use of prescribing information in 24 (15.1%) studies and antibiotic resistance awareness in 20 (46.5%) antibiotic studies. For 74 (46.8%) studies, survey questionnaires were self-administered and most studies (57; 36%) were done at homes of respondents. Thirty-seven (23.4%) studies did not report any recall period for self-medication practices. Study response rates varied from 17.9% to 100%, and while validity of the study questionnaire was reported for 100 (63.3%) studies, 15 (9.5%) studies reported reliability test of the study questionnaire. There is a large variety of questionnaires being used for investigating self-medication practices making comparability and meta-analyses very difficult. It is desirable to have a basic set of standardized survey questions on this topic to make available for future research groups in this field.
Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i) to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model) and (ii) to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate model.
For indexing archived documents the Dutch Parliament uses a specialized thesaurus. For good results for full text retrieval and automatic classification it turns out to be important to add more synonyms to the existing thesaurus terms. In the present work we investigate the possibilities to find synonyms for terms of the parliaments thesaurus automatically. We propose to use distributional similarity (DS). In an experiment with pairs of synonyms and non-synonyms we train and test a classifier using distributional similarity and string similarity. Using ten-fold cross validation we were able to classify 75% of the pairs of a set of 6000 word pairs correctly.
Background: Physician-rating websites (PRWs) may lead to quality improvements in case they enable and establish a peer-to-peer communication between patients and physicians. Yet, we know little about whether and how physicians respond on the Web to patient ratings.
Objective: The objective of this study was to describe trends in physicians’ Web-based responses to patient ratings over time, to identify what physician characteristics influence Web-based responses, and to examine the topics physicians are likely to respond to.
Methods: We analyzed physician responses to more than 1 million patient ratings displayed on the German PRW, jameda, from 2010 to 2015. Quantitative analysis contained chi-square analyses and the Mann-Whitney U test. Quantitative content techniques were applied to determine the topics physicians respond to based on a randomly selected sample of 600 Web-based ratings and corresponding physician responses.
Results: Overall, physicians responded to 1.58% (16,640/1,052,347) of all Web-based ratings, with an increasing trend over time from 0.70% (157/22,355) in 2010 to 1.88% (6377/339,919) in 2015. Web-based ratings that were responded to had significantly worse rating results than ratings that were not responded to (2.15 vs 1.74, P<.001). Physicians who respond on the Web to patient ratings differ significantly from nonresponders regarding several characteristics such as gender and patient recommendation results (P<.001 each). Regarding scaled-survey rating elements, physicians were most likely to respond to the waiting time within the practice (19.4%, 99/509) and the time spent with the patient (18.3%, 110/600). Almost one-third of topics in narrative comments were answered by the physicians (30.66%, 382/1246).
Conclusions: So far, only a minority of physicians have taken the chance to respond on the Web to patient ratings. This is likely because of (1) the low awareness of PRWs among physicians, (2) the fact that only a few PRWs enable physicians to respond on the Web to patient ratings, and (3) the lack of an active moderator to establish peer-to-peer communication. PRW providers should foster more frequent communication between the patient and the physician and encourage physicians to respond on the Web to patient ratings. Further research is needed to learn more about the motivation of physicians to respond or not respond to Web-based patient ratings.
Objective: To evaluate the impact of different dissemination channels on the awareness and usage of hospital performance reports among referring physicians, as well as the usefulness of such reports from the referring physicians’ perspective.
Data sources/Study setting: Primary data collected from a survey with 277 referring physicians (response rate = 26.2%) in Nuremberg, Germany (03–06/2016).
Study design: Cluster-randomised controlled trial at the practice level. Physician practices were randomly assigned to one of two conditions: (1) physicians in the control arm could become aware of the performance reports via mass media channels (Mass Media, npr MM=132, nph MM=147); (2) physicians in the intervention arm also received a printed version of the report via mail (Mass and Special Media, npr MSM=117; nph MSM=130). <br> Principal findings: Overall, 68% of respondents recalled hospital performance reports and 21% used them for referral decisions. Physicians from the Mass and Special Media group were more likely to be aware of the performance reports (OR 4.16; 95% CI 2.16–8.00, p < .001) but not more likely to be influenced when referring patients into hospitals (OR 1.73; 95% CI 0.72–4.12, p > .05). On a 1 (very good) to 6 (insufficient) scale, the usefulness of the performance reports was rated 3.67 (±1.40). Aggregated presentation formats were rated more helpful than detailed hospital quality information.
Conclusions: Hospital quality reports have limited impact on referral practices. To increase the latter, concerns raised by referring physicians must be given more weight. Those principally refer to the underlying data, the design of the reports, and the lack of important information.
Roads to Health in Developing Countries: Understanding the Intersection of Culture and Healing
(2017)
Background:
The most important attribute to which all human beings aspire is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled scientists to explore and define several parameters of health by drawing boundaries around factors that are known to influence the attainment of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration. Their definition of health also included a caveat that says, “not merely the absence of sickness.”
This definition has guided scientists and health care providers in the Western world in the development of health care programs in non-Western societies.
Objective:
However, ethnomedical beliefs about the cause(s) of illness have given rise to alternative theories of health, sickness, and treatment approaches in the developing world. Thus, there is another side to the story.
Method:
Much of the population in developing countries lives in rural settings where the knowledge of health, sickness, and care has evolved over centuries of practice and experience. The definition of health in these settings tends to orient toward cultural beliefs, traditional practices, and social relationships. Invariably, whereas biomedicine is the dominant medical system in Western societies, traditional medicine — or ethno-medicine — is often the first port of call for patients in developing countries.
Results:
The 2 medical systems represent, and are influenced by, the cultural environment in which they exist. On one hand, biomedicine is very effective in the treatment of objective, measurable disease conditions. On the other hand, ethnomedicine is effective in the management of illness conditions or the experience of disease states. Nevertheless, an attempt to supplant 1 system of care with another from a different cultural environment could pose enormous challenges in non-Western societies.
Conclusion:
In general, we, as human beings, are guided in our health care decisions by past experiences, family and friends, social networks, cultural beliefs, customs, tradition, professional knowledge, and intuition. No medical system has been shown to address all of these elements; hence, the need for collaboration, acceptance, and partnership between all systems of care in cultural communities. In developing countries, the roads to health are incomplete without an examination of the intersection of culture and healing. Perhaps mutual exclusiveness rather inclusiveness of these 2 dominant health systems is the greatest obstacle to health in developing countries.
Objectives:
The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general.
Background:
Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results.
Methods:
Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research. The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results.
Results:
The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically expected individual patient benefit was the chance to receive up-to-date care (38.1%). A general increase in knowledge about health care, treatments, or drugs (70.6%) was the most commonly mentioned theoretically expected benefit for society. In contrast, all 13 publications reporting actual benefits of clinical drug development trials focused on personal benefits and only 1 of these publications also mentioned a societal benefit. The most commonly mentioned individual benefit was an increased quality of life (53.9%), whereas the only mentioned collective benefit to society was a general gain of knowledge (100.0%).
Conclusions:
Both theoretically expected and actually reported benefits in the majority of the included publications emphasized the importance of individual patient benefits from drug development rather than the collective benefits to society in general. The authors of these publications emphasized the right of each individual patient or subject to look for and expect some personal benefit from participating in a clinical trial rather than considering societal benefit as a top priority. From an ethical point of view, the benefits each individual patient receives from his or her participation in a clinical trial might also be seen as a societal benefit, especially when the drug or device tested, if approved for marketing, would eventually be made available for other similar patients from the country in which the clinical trial was conducted.
Objective: To determine the burden and factors associated with post-stroke depression in East central Nigeria.
Method: We carried out this cross-sectional study of 50 stroke survivors (mean age=54.8 ± 8.8 years), at the physiotherapy Department of the University of Nigeria Teaching Hospital, Enugu. Data were collected using Becks Depression Inventory , it was analyzed using Z-scores, Chi-square test and univariate logistic regression.
Results: PSD was more common in females (45.45%); middle-age(60%) adults(27-36/47-56 years respectively); living with spouse (45%); left cerebral lesions (40.74%). Self-employed and unemployed (66.67%), respectively. Age was significantly associated with depression (p=0.03), and was related to the risk ofOR3.7 (95% CI 1.1-12.0 )
Conclusion: Age could be a risk factor for PSD, which was more prevalent in the elderly than young/middle-age adults, female gender, left cerebral lesion, complications, cold case; those living with a spouse, self-employed and unemployed.
Background: Self-medication, practiced globally is an important public health problem. Research studies have indicated inappropriate self‐medication results in adverse drug reactions, disease masking, antibiotic resistance and wastage of healthcare resources. The objectives of the study were to explore overall self-medication and antibiotic self-medication prevalence among students of university students in Karachi, Pakistan along with probable reasons, indications, and sources of advice for self-medication. Methods: A descriptive, cross-sectional, questionnaire-based study was carried out among students from university of Karachi, Pakistan during the time period of September to November 2016. Pretested questionnaire was distributed to 320 students, collected data was analyzed using IBM SPSS version 24. Results: From 320 students, 311 (83 male and 228 female) students participated in the study giving a response rate of 97%. Prevalence of self-medication was 66%. Belonging to higher monthly family income group was associated with likelihood of self-medication. Antibiotic self-medication prevalence was 39%. Lack of time (39%), and old prescription (35%) were the main reasons for self-medication. Pharmacy shop (75%) was the main source for self-medication. In case of antibiotics, 44% students changed the dosage of antibiotic and 50% students stopped antibiotics after the disappearance of the symptoms. Conclusions: Antibiotic self-medication (39%) and self-medication with other drugs among university students of Karachi is a worrisome problem. Our findings highlight the need for planning interventions to promote the judicious use of general medicines as well as that of antibiotics.
Background: Health information systems (HIS) are one of the most important areas for biomedical and health informatics. In order to professionally deal with HIS well-educated informaticians are needed. Because of these reasons, in 2001 an international course has been established: The Frank – van Swieten Lectures on Strategic Information Management of Health Information Systems.
Objectives: Reporting about the Frank – van Swieten Lectures and about our students‘ feedback on this course during the last 16 years. Summarizing our lessons learned and making recommendations for such international courses on HIS.
Methods: The basic concept of the Frank – van Swieten lectures is to teach the theoretical background in local lectures, to organize practical exercises on modelling sub-information systems of the respective local HIS and finally to conduct Joint Three Days as an international meeting were the resulting models are introduced and compared.
Results: During the last 16 years, the Universities of Amsterdam, Braunschweig, Heidelberg/Heilbronn, Leipzig as well as UMIT were involved in running this course. Overall, 517 students from these universities participated. Our students‘ feedback was clearly positive.
The Joint Three Days of the Frank – van Swieten Lectures, where at the end of the course all students can meet, turned out to be an important component of this course. Based on the last 16 years, we recommend common teaching materials, agreement on equivalent clinical areas for the exercises, support of group building of international student groups, motivation of using a collaboration platform, ensuring quality management of the course, addressing different levels of knowledge of the students, and ensuring sufficient funding for joint activities.
Conclusions: Although associated with considerable additional efforts, we can clearly recommend establishing such international courses on HIS, such as the Frank – van Swieten Lectures.
Anlässlich einer bevorstehenden Curriculumsrevision führte der Bachelorstudiengang Informationsmanagement der Hochschule Hannover im März 2016 eine Studie unter all seinen bisherigen Absolventen durch (Abschlussjahrgänge 2008 bis 2015). Bei einer Grundgesamtheit von 303 Personen antworteten 200 (66%). Die Ergebnisse enthalten ein retrospektives Feedback auf das Studium und skizzieren die Strukturreform, die daraus als Konsequenz erwächst. Zudem geben sie Aufschluss über Berufseinmündung und Berufsverlauf der Alumni und umfassen Eckdaten über ihr erstes und aktuelles Beschäftigungsverhältnis.
Der Übergang vom Studium in den Beruf gestaltet sich bei dem Gros der Befragten problemlos. Ein Drittel der Alumni schließt ein Masterstudium an. Zum Befragungszeitpunkt liegt die Beschäftigungsquote bei 96%. Davon arbeiten 64 % unbefristet. Die thematische Breite des IM-Curriculums spiegelt sich in einer Vielfalt von Branchen und Tätigkeiten wider, die die Alumni mit ihrem aktuellen Beschäftigungsverhältnis abdecken. Die Befragten äußern insgesamt eine große Zufriedenheit mit ihrer beruflichen Entwicklung, allerdings hätten sie sich im Studium mehr Orientierung und größere Wahlfreiheit bei der Fächerbelegung gewünscht. Das revidierte Curriculum wird deshalb mehr Verbindlichkeit und zugleich größere Flexibilität bei der Schwerpunktwahl vorsehen.
Background: Immunization is the most cost-effective intervention for infectious diseases which are the major cause of morbidity and mortality worldwide. There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India. Objectives: Present study explored the adult vaccination status and influence of income and education of parents on adult vaccination status in university students from Mumbai, India.
Methods: On the basis of the eligibility criterion 149 students were selected for the present study. A total of 8 vaccines namely Tdap/DTP, Varicella, MMR, Influenza, Pneumococcal, Hepatitis A, Hepatitis B and Meningococcal were included in this study for all the respondents. In addition to these vaccines, Human Papilloma Virus vaccine was also included for female respondents.
Results: There were total of 149 (75 male and 74 females) respondents with the mean age of 21.5 years. The top 3 immunizations were Td/Tdap (97.3%), MMR (66.4%) and Hepatitis B (55%) among the respondents. Only 4 (5.5%) female respondents have been immunized against the HPV. Conclusions: Td/Tdap (97.3%) and MMR (66.4%) coverage was in line with the recommendations. For all the other vaccines the coverage was low varying from 5.5% to 35.4%. The vaccination coverage was better in respondents with higher educated and higher income parents. We suggest that patient education, planning by government for the implementation of policy for adult vaccination and involvement of physicians are must for better adult vaccination coverage.
Background: Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region.
Method: A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22–59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained.
Results: The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71–100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics.
Conclusion: Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.
Der Beitrag stellt zunächst die Ergebnisse einer Auswertung von Stellenanzeigen aus der Mailingliste InetBib vor, die zeigt, dass die Nachfrage nach Absolventinnen und Absolventen bibliothekarischer Studiengänge mit einer Qualifikation für den Aufgabenbereich der Vermittlung von Informationskompetenz
seit dem Jahr 2000 signifikant gestiegen ist. Ergänzend hierzu präsentieren die Autorinnen die Ergebnisse einer Befragung unter Vertreterinnen und Vertretern der bibliothekarischen Berufspraxis zu im Bereich der Vermittlung von Informationskompetenz geforderten Kompetenzen und deren
Gewichtung innerhalb der verschiedenen Qualifikationsstufen.
Background: Diabetes is fast gaining the status of a potential epidemic in India, with >62 million individuals currently diagnosed with the disease. India currently faces an uncertain future in relation to the potential burden that diabetes may impose on the country. An estimated US$ 2.2 billion would be needed to sufficiently treat all cases of type 2 diabetes mellitus (T2DM) in India. Many interventions can reduce the burden of this disease. However, health care resources are limited; thus, interventions for diabetes treatment should be prioritized. The present study assesses the cost-effectiveness of antidiabetic drugs in patients with T2DM from Mumbai, India.
Methods: A prospective cross-sectional study was performed to assess the cost-effectiveness of antidiabetic drugs in patients with T2DM. Face-to-face interviews were conducted by using a validated questionnaire in a total of 152 (76 males, 76 females) patients with T2DM from F-North Ward, Mumbai, India. Cost-effectiveness was determined on the basis of cost of antidiabetic drug/s, efficacy, adverse drug reactions, safety of administration, frequency of administration, and bioavailability.
Results: For treatment of T2DM in non-obese participants, Glimepiride+Pioglitazone costed least (`3.7) per unit of effectiveness followed by Glimepiride (`6.6), Gliclazide (`8.1), Repaglinide (`24.5), and Vildagliptin (`45.2). For treatment of T2DM in obese participants, Metformin cost least (` 6.7) per unit of effectiveness followed by Glimepiride + Metformin (`5.9) and Repaglinide (`24.5).
Conclusions: In case of non-obese participants, cost effectiveness and prescribed treatments did not show a match, while for obese participants prescribed treatments were in line with cost effectiveness.
Objective: To determine the distribution of symptoms of post-stroke depression (PSD) in relation to some predisposing factors in an African population.
Relevance: Environment is a key determinant of behavior, and varied socio-cultural contexts must have implications for modifiable characteristics (age, duration of the stroke, marital status, type of employment, gender, the location of cerebral lesion and complications) of individuals vulnerable to PSD, which may be targeted to enhance recovery.
Method: This was a cross-sectional observational study of 50 (22 females and 28 males) stroke survivors (mean age=54.76±8.79 years), at the physiotherapy department, the University of Nigeria teaching hospital, Enugu, selected using convenience sampling technique. Data were collected using Becks Depression Inventory and analyzed using Z-score, Chi-square test and univariate logistic regression, at p<0.05.
Results: PSD was more prevalent in females (45.45%); young(100%); middle-age(60%) adults(27-36/47-56 years respectively); living with spouse (45%); left cerebral lesions (40.74%); complications(45%); cold case >3 years(47.05%); self-employed and unemployed (66.67%), respectively. Age was significantly associated with depression (χ2 =4.92,df=1,p=0.03), and was related to the risk of PSD (3.7[1.1-12.0], p=0.03, φ = +0.31, φ2=0.1).
Conclusion: Age could be a risk factor for PSD, which was more prevalent in the elderly than young/middle-age adults, female gender, left cerebral lesion, complications, cold case; those living with a spouse, self-employed and unemployed.
Der Bachelorstudiengang „Bibliotheks- und Informationsmanagement“ der Hochschule für den öffentlichen Dienst in Bayern (HföD) zeichnet sich durch seinen starken Praxisbezug aus. Mit der spezifischen Ausrichtung auf die wissenschaftlichen Bibliotheken, dem mehrstufigen Auswahlverfahren der Studierenden, der Gestaltung der beiden Praxismodule, der Konzeption des theoretischen Unterrichts und den begleitenden Veranstaltungen sowie den Strukturen, in die der Studiengang eingebunden ist, werden in dem vorliegenden Aufsatz die wichtigsten Elemente für diese starke Praxisbezogenheit vorgestellt.
Objective
We aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.
Methods
Patients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994–2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were included. Data on periods of payment came from the Finnish Centre for Pensions, and death data from Statistics Finland. Multivariate logistic regression analyses assessed factors associated with NRTW 1 year after IS, and lasagna plots visualized the proportion of patients returning to work over time.
Results
We included a total of 769 patients, of whom 289 (37.6%) were not working at 1 year, 323 (42.0%) at 2 years, and 361 (46.9%) at 5 years from IS. When adjusted for age, sex, socioeconomic status, and NIH Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.
Conclusions
NRTW is a frequent adverse outcome after IS in young adults with mild to moderate IS. Clinical variables available during acute hospitalization may allow prediction of NRTW.
Background: Depletion of ovarian hormone in postmenopausal women has been associated with changes in the locomotor apparatus that may compromise walking function including muscle atrophy/weakness, weight gain, and bone demineralization. Therefore, handgrip strength (HGS), bone mineral density (BMD) and body composition [percentage body fat mass (%BFM), fat mass (FM), Fat-free mass (FFM) and body mass index (BMI)], may significantly vary and predict WB in postmenopausal women. Consequently, the study sought to 1. Explore body composition, BMD and muscle strength differences between premenopausal and postmenopausal women and 2. Explore how these variables [I.e., body composition, BMD and muscle strength] relate to WB in postmenopausal women.
Method: Fifty-one pre-menopausal (35.74 + 1.52) and 50 postmenopausal (53.32 + 2.28) women were selected by convenience sampling and studied. Six explanatory variables (HGS, BMD, %BFM, FFM, BMI and FM) were explored to predict WB in postmenopausal women: Data collected were analyzed using multiple linear regression, ANCOVA, independent t-test and Pearson correlation coefficient at p < 0.05.
Result: Postmenopausal women had higher BMI(t = + 1.72; p = 0.04), %BFM(t = + 2.77; p = .003), FM(t = + 1.77; p = 0.04) and lower HGS(t = − 3.05; p = 0.001),compared to the premenopausal women. The predicted main effect of age on HGS was not significant, F(1, 197) = 0.03, p = 0.06, likewise the interaction between age and %BFM, F(1, 197) = 0.02, p = 0.89; unlike the predicted main effect of %BFM, F(1, 197) = 10.34, p = .002, on HGS. HGS was the highest predictor of WB (t = 2.203; β=0.3046) in postmenopausal women and combined with T-score right big toe (Tscorert) to produce R2 = 0.11;F (2, 47)=4.11;p = 0.02 as the best fit for the predictive model. The variance (R2) change was significant from HGS model (R2 = 0.09;p = 0.03) to HGS + Tscorert model (R2 = 0.11;p = 0.02). The regression model equation was therefore given as: WB =5.4805 + 0.1578(HGS) + (− 1.3532) Tscorert.
Conclusion: There are differences in body composition suggesting re-compartmentalization of the body, which may adversely impact the (HGS) muscle strength in postmenopausal women. Muscle strength and BMD areassociated with WB, although, only contribute to a marginal amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.
Library of Congress Subject Headings (LCSH) are popular for indexing library records. We studied the possibility of assigning LCSH automatically by training classifiers for terms used frequently in a large collection of abstracts of the literature on hand and by extracting headings from those abstracts. The resulting classifiers reach an acceptable level of precision, but fail in terms of recall partly because we could only train classifiers for a small number of LCSH. Extraction, i.e., the matching of headings in the text, produces better recall but extremely low precision. We found that combining both methods leads to a significant improvement of recall and a slight improvement of F1 score with only a small decrease in precision.
Background: Discovery of antibiotics have helped to manage the devastating diseases. Presently, the antibiotic era is threatened by the emergence of high level of antibiotic resistance of important pathogens. Misuse of antibiotics poses a serious risk to infectious disease control. It is necessary to improve public awareness to bring a change in the behavior of consumers. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. 300 students were approached to participate in the study of which 250 agreed to participate (males: 117; females: 133). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Substantial number (33% and 40%) participants were unaware about the differences in antibiotic-anti-inflammatory drugs and antibiotic-antipyretics respectively. 28% of the participants thought it is right to stop antibiotics only based on symptoms improvement. Sixty eight percent and seventy nine percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively.
Conclusions: Participants demonstrated poor knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention can be introduced to make them aware about rational antibiotic practices.
Background: Pharmacovigilance (PV); also known as drug safety surveillance, is the science of enhancing patient care and patient safety regarding the use of medicines by collecting, monitoring, assessing, and evaluating information from healthcare providers and patients. Pharmacists are pivotal players in adverse drug event (ADE) monitoring and reporting. However, most pharmacists are unaware or not knowledgeable about the guidelines used by their respective countries’ drug regulatory bodies. It is the need of the hour to train pharmacy students on the concept of pharmacovigilance.
Methods: A cross-sectional study was carried out among pharmacy students from Mumbai University, India during May-June 2017. On the basis of the eligibility criterion 352 students were selected for the present study. Four hundred students were approached to participate in the study of which 201 agreed to participate (males: 179; females: 173). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Overall pharmacovigilance knowledge (44%) and perception (58%) was low among the participants of the present study. Seventy four percent of the participants felt that adverse drug reaction (ADR) reporting should be made compulsory for healthcare professionals. And only 21% agreed that the topic of Pharmacovigilance is well covered in pharmacy curriculum.
Conclusions: Pharmacy council of India, pharmacy teacher’s association and respective pharmacy college should take necessary steps to increase the knowledge and create awareness regarding pharmacovigilance and adverse drug reaction reporting among pharmacy students.
Background: Epilepsy is a chronic disorder of the brain that affects people worldwide. The overall prevalence (3.0-11.9 / 1,000) and incidence (0.2-0.6/1,000) of epilepsy in India are comparable to the rates of high-income countries. The high prevalence of negative attitudes towards epilepsy has been highlighted by several studies. Pharmacy students represent a better-educated section of society regarding drugs and have the potential to create awareness, and influence attitudes towards the disease. Thus, it is important that they have the appropriate and updated knowledge and appropriate attitude towards epilepsy and antiepileptic drugs. Objective of the present study was to determine the Mumbai University pharmacy student’s awareness about epilepsy, so as to know the kind of education and awareness strategies that would be applicable to them.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Two hundred and fifty students were approached to participate in the study of which 213 agreed to participate (males: 107; females: 106). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: Response rate for this study was 85.2% (213/250). Ninety six percent (204/213) of the participants had heard or read about epilepsy. Overall knowledge was poor (40.2%) and attitude was fair (75.3%). None of the participants were aware about recent research regarding hereditary nature of epilepsy. Only 2 (0.98%) students were aware how to perform the first aid in epilepsy. Only 6.8% participants felt that epileptics should participate in sports.
Conclusions: The findings of this study show that, even with extensive curriculum covering diseases, drugs and relevant laws of land, the knowledge and attitude scores were low. There is a need to have focused education and campaigns to increase the knowledge and attitude towards epilepsy.
Medical devices are health care products distinguished from drugs for regulatory purposes in most countries based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect. Developing new medical devices requires clinical investigations and approval process goes through similar process like drugs. Medical device approvals in the period of 2010 to 2014 were searched from USFDA website. Disease burden data in the similar period was searched from centers for disease control and prevention website. Collected data was analyzed to know number of approved devices, top therapy areas, and mechanism of action of these devices. Out of a total of 200 medical devices approvals in the time period of 2010 to 2014, maximum number of devices (51; 25.5%) were approved in the year 2011, cardiovascular (78; 39%) was the top therapy area. Highest number (180; 90%) of approved medical devices belonged to the category III and maximum number (73; 36.5%) of approved medical devices had ―mechanical‖ mechanism of action. The top 3 causes of deaths in USA during 2010 to 2014 were heart disease, cancer and followed by respiratory infection. There was a match between the top diseases and the medical device approvals for top 2 diseases in USA i.e. heart disease, and cancer. With respect to respiratory infections and ailments which was the 3rd leading cause of death only one device was approved out of 200 approvals in total.
Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) that may cause cervical cancer and other malignancies including those of the vulva, anus, vagina, penis, head and neck. In most Asian countries including India, cervical cancer is the second most common cancer in women. Awareness about HPV and cervical cancer, use of vaccines can be very helpful in prevention, control and early diagnosis of cervical cancer. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May - June 2017. Two hundred students were approached to participate in the study of which 142 were selected to participate (males: 54; females: 88). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Participants had fair knowledge (61% average) about HPV, whereas knowledge about symptoms, prevention and spread of HPV was very poor i.e. 18%. Knowledge about HPV vaccine was 50% and 78% participants had positive attitude for HPV vaccine. Conclusions: This study showed the lacunas in the pharmacy curriculum and urgent need to create awareness of HPV among bachelor of pharmacy students from Mumbai University.
Background: Oral cancer is among the top three types of cancers in India. Severe alcoholism, use of tobacco in the form of cigarettes, smokeless tobacco, and betel nut chewing are the most common risk factors for oral cancer. Often individuals with pre cancer even notice the alterations, such as reduced mouth opening in oral submucous fibrosis (OSMF), but they are not aware about the causes and consequences of these changes. Awareness about causes and features of oral cancers can be very helpful in prevention, control and early diagnosis of oral cancer.
Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Five hundred students were approached to participate in the study of which 400 agreed to participate. Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23.
Results: There were 199 (49%) males and 201 (50%) females in the study and response rate was (80%). Respondents had good knowledge about oral cancer. Seventy four percent (268/362) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost all (96%; 348/362) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Seventy two percent (260/362) respondents believed that oral cancer is curable. Significantly higher number of male (98%) compared to female participants answered correctly to questions regarding spread of disease and occurrence of oral cancer in AIDS patients.
Conclusions: Participants showed good knowledge about oral cancer. Female participants showed lesser knowledge compared to male counterparts. Details about oral cancer should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
Background: Concerns about practice of self-medication (SM) world across are based on associated risks such as adverse reactions, disease masking, increased morbidity, wastage of resources and antibiotic resistance. SM is likely to differ between rural and urban areas of India. Systematically retrieved evidence on these differences are required in order to design targeted measures for improvement. Methods: We conducted a cross sectional study among the general population in urban (Matunga) and rural (Tala) areas of Maharashtra, India to explore SM practices and its associated factors. Face to face interviews were conducted using the validated study questionnaire. Data was analyzed by using descriptive and analytical statistical methods. Results: A total of 1523 inhabitants from 462 households were interviewed between [June/2015] and [August /2015], 778 (51%) of them in rural and 745 (49%) in urban areas. Overall self-medication prevalence was 29.1% (urban; 51.5%, rural; 7.7%, OR 12.7, CI 9.4-17.2) in the study participants. Participants having chronic disease (OR: 3.15, CI: 2.07-4.79) and from urban areas (OR:15.38, CI:8.49-27.85) were more likely to self-medicate. Self-medication practices were characterized by having old prescription (41.6%) as the main reason, fever (39.4%) as top indication and NSAIDs (Non-Steroidal Anti Inflammatory Agents) as the most self-medicated category of drugs (40.7%). Conclusions: The present study documented that the prevalence of self-medication is associated with place of residence, and health status of the study participants. Self-medication is still a major issue in western Maharashtra, India and is majorly an urban phenomenon. Status of implementation of existing regulations should be reconsidered.
Knowledge and attitude towards voluntary blood donation among students from Mumbai University
(2018)
Background: Blood is scarce; its demand far outweighs the supply. In addition to limited supply, the issue of safety especially with regard to the risk of transfusion transmissible infection is also an issue of utmost concern especially in the developing countries. Blood transfusion services in India have gained special significance in recent years and forms a vital part of national health care system. Voluntary Non-Remunerated Blood Donation (VNRBD) is the safest of all types of blood donations. One of the potential sources that can be tapped for blood donation is the young and physically fit students from educational institutions across India. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 201 agreed to participate (males: 104; females: 97). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: High number of participants agreed about encouraging general public about voluntary blood donation (96%; 193/201), lack of awareness about VBD in general public (82%; 164/201). But not a single participant was able to respond to the knowledge part of the questionnaire with 100% accuracy. Almost all the participants had correct knowledge about blood groups (98%; 196/201) and blood matching need (195/201; 97%). Conclusions: Participants showed good attitude but demonstrated poor knowledge about voluntary blood donation. Details about blood donation should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.
In diesem Beitrag werden Spezifika der Hochschulen und Ausbildungseinrichtungen, die in der KIBA organisiert sind, mit ihren Studiengängen, Weiterbildungsprogrammen, Forschungsschwerpunkten und didaktischen Konzepten vorgestellt. Es wird gezeigt, wie diese Einrichtungen mit ihrer Berufungs- und Einstellungspolitik, strategischen Allianzen und übergeordneten fachlichen und politischen Zusammenschlüssen sowie mit der Profilierung ihrer Studiengänge auf neue Anforderungen des Marktes und der Berufspraxis reagieren. Berücksichtigt werden dabei Positionen und Strategien zur Digitalisierung aus der Politik sowie ihren Beratungsgremien, in der sich die Inhalte bibliotheks- und informationswissenschaftlicher Ausbildung und Forschung verorten lassen. Insgesamt wird deutlich, wie schwierig es heute ist zu definieren, was die Bibliotheks- und die Informationswissenschaft im Kern ausmacht, um im Spannungsfeld der Herausforderungen an wissenschaftliche und öffentliche Bibliotheken, den Anforderungen der Wirtschaft im Bereich Informations- und Wissensmanagement, der Digitalisierung und Langzeitarchivierung von Kulturerbe, um nur einige Felder zu nennen, Ausbildungsprogramme bedarfsgerecht zu profilieren und die bibliotheks- und informationswissenschaftlichen Institute, Fachbereiche und Ausbildungseinrichtungen politisch abzusichern und ausreichend mit Ressourcen auszustatten.