Comparative Analysis of Actual Cost and INA CBG Rate in Diabetic Gangrene Inpatients

Background: Diabetic gangrene is a complication of diabetes mellitus that imposes a substantial financial burden on patients and their families as well as the health care system. Objective: To determine the total cost of disease, and the difference between real cost and INA CBG rate for diabetic gangrene inpatients from January - December 2017 at Universitas Airlangga Hospital, Surabaya Methods: The study was conducted retrospectively by using a total sampling method. The perspective used was the hospital perspective. This study's direct medical costs were laboratory, drug and consumable medical device costs, medical equipment rental, radiology examination, red cross, oxygen, service, and room costs. Data analysis was performed using an independent samples t-test. Results: The results showed that 148 patients met the inclusion criteria. The total real cost of diabetic gangrene inpatients at Universitas Airlangga Hospital in 2017 was IDR 1,339,949,381, and the total INA CBG rate for inpatients with diabetic gangrene was IDR 1,365,047,500. The difference was (p = 0.000) between real cost and INA CBG rate. Conclusion: There is a difference between the actual cost and the INA CBG rate for diabetic gangrene inpatients.

Issues in specifying contrast in building elements for people with a visual disability

BACKGROUND: Standards writers, national and international, have used different contrast calculations to set requirements in building elements for people with visual impairments. On the other hand, they have typically set a single requirement (30%) for specifying the minimum contrast. The systems are not linearly related and 30%means something rather different in each system. OBJECTIVE: To provide a comparison of the various scales in order to illustrate the differences caused by multiple scales with a single compliance value, recommend a single scale for universal adoption and, if a new measure is problematic for implementation, to recommend the most perceptually uniform of the present methods. METHODS: We use the contrast between combinations of 205 paint colours to illustrate the relationships between the measures. We use an internationally accepted scale, with equal perceptual steps, as a “gold standard” to identify the most perceptually uniform measurement scale in the existing methods. RESULTS: We show that Michelson contrast is the most perceptually uniform of the existing measurement scales. We show the contrasts in the proposed method that equate to the various current requirements. CONCLUSIONS: We propose that CIE Metric Lightness could be used as the contrast measure. Alternatively, Michelson contrast is the most perceptually linear of the current measurement scales.

Electronic records management at the coal face: Testing a behaviour search model for EDRMS

<p>The main objective of this proposed research is to test the reliability and validity of the information search model presented by Joseph, Debowski & Goldschmidt (2013a) which relates to searching in EDRMS. In order to do this, the search behaviour of employees using the EDRMS eDOCS Hummingbird in a New Zealand local authority will be compared with the model. Another research objective is to gain information about current search behaviour in relationship to the design of the new EDRMS system Objective which will soon be installed in the test organisation. As the literature review shows, introducing an EDRMS to a workplace is difficult, requiring a major change to the way that employees have managed their information, (Maguire, 2005). The last objective is to gain insights from the search behaviour in regards to training for the new system.</p>

Electronic records management at the coal face: Testing a behaviour search model for EDRMS

<p>The main objective of this proposed research is to test the reliability and validity of the information search model presented by Joseph, Debowski & Goldschmidt (2013a) which relates to searching in EDRMS. In order to do this, the search behaviour of employees using the EDRMS eDOCS Hummingbird in a New Zealand local authority will be compared with the model. Another research objective is to gain information about current search behaviour in relationship to the design of the new EDRMS system Objective which will soon be installed in the test organisation. As the literature review shows, introducing an EDRMS to a workplace is difficult, requiring a major change to the way that employees have managed their information, (Maguire, 2005). The last objective is to gain insights from the search behaviour in regards to training for the new system.</p>

An introduction to the industrial town’s safety management (ITSM) system

BACKGROUND: In industrial towns, the dangers of each industry also poses a threat to other industries due to the proximity of different industries to each other. So there is a need for a safety management system. OBJECTIVE: This study was conducted to introduce a management system for managing the safety of industrial towns. METHODOLOGY: This cross-sectional and qualitative study was conducted in three main phases: (1) Identify the elements of the safety management systems using literature review, (2) Screening and determining useful elements using Delphi technique and (3) Determining the structure of safety management system. RESULTS: Participation of the industries and their compliance with the standards were considered as the system foundation. The networks of safety information of the industries, accident’s database, safety training, contractors, emergency management and management of the changes were placed on the foundation as the system columns. The Industrial Town’s Safety Management (ITSM) system as the system roof was placed on the columns. This structure was placed within a two-line framework including the trade secrets and program audit. CONCLUSIONS: The ITSM system consists of a set of factors that can help manage the safety of the industrial towns. This system will increase the safety level of industrial towns by incorporating some safety principles. However, the safety management of an industrial town is very complex and requires a great deal of efforts.

Mathematical modeling of the chest, its funnel-shaped deformation and thoracoplasty

The most common method of treating of the congenital funnel-shaped chest is thoracoplasty method by D. Nuss. During this surgery, a significant mechanical effect is created on the ribs, sternum, spinal column, which act instantly and continuously for a long time and create new biomechanical conditions for the «chest – rib – spine» system. Objective. To construct a functional model of the chest with a spinal column, which takes into account the movements in the costal-vertebral joints, it allows modeling the funnel-shaped deformation in conditions close to the reality, its operative correction, predicting the results and choosing the optimal parameters of thoracoplasty. Methods. Normal and funnel-shaped chest models based on the articular connection of the ribs to the spine were created using SolidWorks. The main calculations were made using the ANSYS program. To estimate the stress-strain state (SSS), stresses are selected by Mises. Results. The created dynamic mathematical model of the chest makes it possible to conduct a reliable analysis of the biomechanical interaction of the plate with the chest, to analyze the stress-strain state of the constructed models in the norm, with and without taking into account the movements in the costal-vertebral joints. In addition, it allows to simulate the operation by D. Nuss and to study the biomechanical changes in conditions close to reality, occurring in the «chest – rib – spine» system, to determine the areas of maximum loads and safety boundaries. Conclusions. The reproduction of articular ribs rotation in the dynamic model changes the picture of the SSS distribution. In the case of modeling the correction of funnel-shaped deformation of the chest by the method by D. Nuss, the largest zone of stress concentration was found on the outer posterior surface of the sixth pair of ribs. The most tense vertebrae were ThV– ThVI, but the maximum values did not exceed the permissible values. In the case of a lower plate conduction, the correction is achieved with better SSS values in the higher elements of the «chest – ribs – spine» system.

Realidades de la práctica de la automedicación en estudiantes de la Universidad del Magdalena

La automedicación forma parte del autocuidado y es considerada como un recurso de salud pública primaria en el sistema de atención de la salud. Objetivo: Determinar la prevalencia y patrones de consumo que influyen en la automedicación de los estudiantes de la Universidad del Magdalena Métodos: El estudio corresponde a una investigación de carácter descriptivo, de corte transversal, y enfoque cuantitativo; la muestra se determinó por conglomerados, conformada por 312 estudiantes activos matriculados en pregrado de la Universidad del Magdalena de la ciudad de Santa Marta. Resultados: La práctica de la automedicación se vio reflejado en un 97%; los motivos por los cuales se automedican los estudiantes tienen relación con la aparición de síntomas tales como el dolor y síntomas gripales, los cuales son tratados a partir del consumo de medicamentos tipo analgésicos, antiinflamatorios, con una prevalencia del 84,26%. El principal motivo para automedicarse se relaciona con la levedad de los sintomas; el consejo de familiares en un 46,87% refleja su fuente de información; existe influencia por la publicidad especialmente televisión e internet; finalmente el 71% tiene conocimiento de las consecuencias que acarrea el automedicarse.Conclusiones: La práctica de la automedicación en la población universitaria es alta; los factores influyentes se relacionan con aparición de sintomas, el consejo de familiares, la influencia de la publicidad, la levedad de los sintomas y la falta de tiempo para visitar al médico. Self-medication is part f self-care and is considered as a primary public health resource in the health care system. Objective: To determine the prevalence and consumption patterns that influence the automation of the students of the Universidad del Magdalena. Methods: The study corresponds to a descriptive cross-sectional and quantitative approach investigation; the sample was determined by conglomerates, made up of 312 active students enrolled in undergraduate studies at the Universidad del Magdalena the city of the Santa Marta. Results: The practice of self-medication was reflected in 97%; the reasons for which the students self-medicate are related to the appearance of symptoms stories, such as pain and flu-like symptoms, which are treated from the consumption at analgesic, anti-inflammatory drugs with prevalence of 84,26%.The main reason for self-medication is related to the mildness of the symptoms; the council of relatives in 46,87% reflects their source of information; there is influence by advertising especially television and internet; finally 71% are aware of the consequences of self -medication. Conclusions: The practice of self-medication in the University population is high; influencing factors are related to the appearance of symptoms the advice of relatives, the influence of advertising the mildness of symptoms and lack of the time to visit the doctor.

Use of cannabidiol as a therapeutic method in epilepsy

Introduction: Cannabis sativa has several therapeutic properties and has been used for millennials for healing purposes. Among its benefits are analgesic, antiemetic and tranquilizing effects, acting strongly on the nervous system. Objective: This study aims to emphasize the importance of Cannabidiol as a therapeutic purpose for epilepsy, especially in Brazil, where its use is still controlled. Method: A systematic literature review, using bibliographic searches carried out in the electronic databases LILACS, PubMed and SciELO with the descriptors “cannabidiol” and “epilepsy”. Of 1645 searches found, 06 were used in the study. Results: Epileptic seizures can be generalized or partial and are determined by the affected area. The treatment for epilepsy are drugs that decrease the arousal capacity of neural tissue and a significant percentage of individuals cannot control them with traditional drugs alone. Endocannabinoids work in response to epileptiform activity, to activate CB1 receptors for excitatory neurons, to contain excess neuronal activity, which occurs during seizures. It is proven that patients who use it do not have toxic adverse effects. Conclusions: In Brazil, Cannabis is a controlled drug and the fact that it is imported, interfere in the treatment, who is interrupted while patient waits the new dosage. The importance of cannabidiol as a target for research and studies is verified, as it has ample potential in the treatment of epilepsy and reduces brain damage caused by it. In order that patients with epilepsy, have improvements in their quality of life.

Detection of Biofilm and Siderophore Encoding Genes Implicated in the Pathogenesis of Klebsiella pneumoniae Isolated from Different Clinical Specimens

Background: Biofilm and siderophores protect K. pneumoniae, making them resistant to antimicrobials and increase the ability to evade immune system. Objective: The aim of the present study was to detect some of the virulence genes responsible for biofilm formation and siderophore production implicated in the pathogenesis of K. pneumoniae. Methodology: Crystal violet method was used to detect biofilm phenotypically, hypermucoviscosity by string test and virulence genes were detected by PCR. Results: Phenotypically, biofilm formation was positive in 76% and negative in 24%. Genotypically, FimH and ycfm were detected in 100% of isolates while mrkD in 98%. Kfu, entB and iutA were found in 100%, 68% and 34% respectively. Phenotypically by string test 66% of isolates were classified as hypermucoviscous, while 34% as classical. rmpA gene was detected in 52% of isolates. Conclusion: FimH, mrkD, ycfm, Kfu and iutA genes are implicated in multisystemic infection of K. pneumoniae. Enterobactin gene is more predominant than other siderophore genes.