Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to de...Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.展开更多
Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are ...Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.展开更多
The Alvalade＇s neighborhood （Lisbon, Portugal）, 1945, as a paradigm of Portuguese urbanism, can be distinguished by different housing cells that define it, as well as the different urban models, which relied on. It...The Alvalade＇s neighborhood （Lisbon, Portugal）, 1945, as a paradigm of Portuguese urbanism, can be distinguished by different housing cells that define it, as well as the different urban models, which relied on. It is possible to identify distinct occupational stains within the neighborhood, specifically in the cell one in this article, as a pioneer construction, due to housing dimension that corresponds to different housing typologies, residents and daily use areas, equipment. The objective is therefore, to understand how these three factors are reflected inside the cell, managing occupational stains which differ in space appropriation. How those different occupational stains that derive from the housing and urban morphology, may result in the occupation and experience of its inhabitants, not invalidating a cohesive structure of the neighborhood？展开更多
Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Meth...Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Methods: A total of 20 midwives and public health nurses were selected as participants. Teaching materials and anonymous self-administered questionnaires were distributed, and the participants were asked to view the teaching materials and fill in the questionnaires. Retrieval was done by mail. The teaching materials included digital content, such as videos, sounds, and characters, which incorporated dangerous situations, preventions, and innovations in ablution and bathing procedures. The analysis was conducted by simple tabulation for each survey item. The free description was coded to preserve anonymity. This study was conducted with the approval of the Research Ethics Review Board of the authors’ affiliated university. Results: The teaching materials were found to be appropriate in terms of suitability to purpose, degree of difficulty of content, ease of viewing the videos, validity of time, appropriateness of expression, and usability. Conclusions: Ablution teaching materials that are used at the present time do not focus on dangers, and to date, no resources on bathing have been used as teaching materials. The created teaching materials in this study can be viewed multiple times, and mothers and family members who are unfamiliar with ablution and bathing can acquire knowledge regarding dangers and danger prevention. The addition of specific preventive measures and countermeasures for the occurrence of danger, along with practice, would result in the development of further appropriate teaching materials to reduce danger and alleviate anxiety.展开更多
CDMOs are emerging as critical drivers of innovation within the pharmaceutical and biotech industries. As the pharmaceutical industry continues to evolve, we can expect to see CDMOs play an increasingly important role...CDMOs are emerging as critical drivers of innovation within the pharmaceutical and biotech industries. As the pharmaceutical industry continues to evolve, we can expect to see CDMOs play an increasingly important role in drug development and manufacturing. Many companies within these sectors are now leveraging the expertise of CDMOs through technology transfers to foster innovation and enhance the development of new drug products. In the extensive field of drug development, technology transfer plays a crucial role at multiple stages, ranging from preclinical phases to commercialization. By working closely with drug developers, CDMOs can ensure that technologies are transferred seamlessly between phases of drug development, allowing for a more efficient and cost-effective development process. CDMOs also bring a wealth of experience in various areas of drug development, including process development, analytical testing, quality control, and manufacturing. This expertise, combined with a focus on innovation, can help drug developers to overcome technical challenges and optimize their drug development programs. CDMOs can provide drug developers with various manufacturing capabilities, from small-scale clinical trials to large-scale commercial production. This flexibility allows drug developers to focus on their core competencies while relying on CDMOs to provide the necessary infrastructure and support for drug manufacturing. The critical role of CDMOs in advancing pharmaceutical innovation in phase-appropriate technology transfer where there will be a lot of effort and patience with strong technical expertise is required. This article explores the various types of Technology transfer from preclinical to commercial stages and successful strategies to foster innovation.展开更多
Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the del...Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the delivery of immunization services extremely challenging. Vaccinators needed a long walk through the hilly terrain to reach outreach sites. Community mobilizers were unable to go house to house to inform the caregivers to bring children to the site for vaccination. Caregivers were unaware when the vaccinators arrive at the site. As a result, many children missed vaccination or were not vaccinated timely. Age-appropriate vaccination coverage (according to national immunization schedule) in the Sirmaur district was the lowest in the state. Thinking out-of-box to address the communication barriers with the caregivers, the traditional drum beating was used, for the first time in India, in two blocks of the Sirmaur district (Rajpura and Shillai). The initiative was planned and implemented by the district health system with the support of the local community leaders. An exit interview was conducted to know the reach of the drum beating to caregivers, and a baseline and end line household survey was conducted to know the outcome of the initiative on age-appropriate vaccination coverage. Analysis of exit interviews data indicated a very high reach of a drum beating to the caregivers;more than 97% of caregivers in Rajpura and 100% in Shillai heard drum beating, and almost 95% of caregivers in Rajpura and 98% in Shillai knew the purpose of drum beating. Analysis of immunization data from baseline and end line surveys showed improvement in age-appropriate vaccination coverage for all vaccines in Rajpura (by 2.2% for BCG, 15.3% for Pentavalent 1, 14.9% for Pentavalent 2, 14.1% for Pentavalent 3, and 6.5% for Measles/MR). In Shillai, age-appropriate vaccination coverage improved for Pentavalent 1 (by 3.4%), Pentavalent 2 (by 5%) and Measles/MR (by 1.7%). In addition, dropout rates were reduced in both the blocks, particularly in Rajpura Pentavalent 1 to Measles dropout rate was reduced by 13.5%. Both health workers and community leaders had positive perceptions of the drum beating initiative. However, another important lesson learned from the initiative was that both the access and demand-side barriers need to be addressed for the desired improvement of age-appropriate immunization coverage. In Shillai, there was lower coverage improvement and a reduction in dropout rates attributed to vacant positions of vaccinators that caused an issue with access to immunization services to people.展开更多
文摘Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.
文摘Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.
文摘The Alvalade＇s neighborhood （Lisbon, Portugal）, 1945, as a paradigm of Portuguese urbanism, can be distinguished by different housing cells that define it, as well as the different urban models, which relied on. It is possible to identify distinct occupational stains within the neighborhood, specifically in the cell one in this article, as a pioneer construction, due to housing dimension that corresponds to different housing typologies, residents and daily use areas, equipment. The objective is therefore, to understand how these three factors are reflected inside the cell, managing occupational stains which differ in space appropriation. How those different occupational stains that derive from the housing and urban morphology, may result in the occupation and experience of its inhabitants, not invalidating a cohesive structure of the neighborhood？
文摘Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Methods: A total of 20 midwives and public health nurses were selected as participants. Teaching materials and anonymous self-administered questionnaires were distributed, and the participants were asked to view the teaching materials and fill in the questionnaires. Retrieval was done by mail. The teaching materials included digital content, such as videos, sounds, and characters, which incorporated dangerous situations, preventions, and innovations in ablution and bathing procedures. The analysis was conducted by simple tabulation for each survey item. The free description was coded to preserve anonymity. This study was conducted with the approval of the Research Ethics Review Board of the authors’ affiliated university. Results: The teaching materials were found to be appropriate in terms of suitability to purpose, degree of difficulty of content, ease of viewing the videos, validity of time, appropriateness of expression, and usability. Conclusions: Ablution teaching materials that are used at the present time do not focus on dangers, and to date, no resources on bathing have been used as teaching materials. The created teaching materials in this study can be viewed multiple times, and mothers and family members who are unfamiliar with ablution and bathing can acquire knowledge regarding dangers and danger prevention. The addition of specific preventive measures and countermeasures for the occurrence of danger, along with practice, would result in the development of further appropriate teaching materials to reduce danger and alleviate anxiety.
文摘CDMOs are emerging as critical drivers of innovation within the pharmaceutical and biotech industries. As the pharmaceutical industry continues to evolve, we can expect to see CDMOs play an increasingly important role in drug development and manufacturing. Many companies within these sectors are now leveraging the expertise of CDMOs through technology transfers to foster innovation and enhance the development of new drug products. In the extensive field of drug development, technology transfer plays a crucial role at multiple stages, ranging from preclinical phases to commercialization. By working closely with drug developers, CDMOs can ensure that technologies are transferred seamlessly between phases of drug development, allowing for a more efficient and cost-effective development process. CDMOs also bring a wealth of experience in various areas of drug development, including process development, analytical testing, quality control, and manufacturing. This expertise, combined with a focus on innovation, can help drug developers to overcome technical challenges and optimize their drug development programs. CDMOs can provide drug developers with various manufacturing capabilities, from small-scale clinical trials to large-scale commercial production. This flexibility allows drug developers to focus on their core competencies while relying on CDMOs to provide the necessary infrastructure and support for drug manufacturing. The critical role of CDMOs in advancing pharmaceutical innovation in phase-appropriate technology transfer where there will be a lot of effort and patience with strong technical expertise is required. This article explores the various types of Technology transfer from preclinical to commercial stages and successful strategies to foster innovation.
文摘Sirmaur district in the state of Himachal Pradesh in India is a hard-to-reach area situated in the western Himalayas having an extreme landscape with snow-laden mountains and extensive river systems that makes the delivery of immunization services extremely challenging. Vaccinators needed a long walk through the hilly terrain to reach outreach sites. Community mobilizers were unable to go house to house to inform the caregivers to bring children to the site for vaccination. Caregivers were unaware when the vaccinators arrive at the site. As a result, many children missed vaccination or were not vaccinated timely. Age-appropriate vaccination coverage (according to national immunization schedule) in the Sirmaur district was the lowest in the state. Thinking out-of-box to address the communication barriers with the caregivers, the traditional drum beating was used, for the first time in India, in two blocks of the Sirmaur district (Rajpura and Shillai). The initiative was planned and implemented by the district health system with the support of the local community leaders. An exit interview was conducted to know the reach of the drum beating to caregivers, and a baseline and end line household survey was conducted to know the outcome of the initiative on age-appropriate vaccination coverage. Analysis of exit interviews data indicated a very high reach of a drum beating to the caregivers;more than 97% of caregivers in Rajpura and 100% in Shillai heard drum beating, and almost 95% of caregivers in Rajpura and 98% in Shillai knew the purpose of drum beating. Analysis of immunization data from baseline and end line surveys showed improvement in age-appropriate vaccination coverage for all vaccines in Rajpura (by 2.2% for BCG, 15.3% for Pentavalent 1, 14.9% for Pentavalent 2, 14.1% for Pentavalent 3, and 6.5% for Measles/MR). In Shillai, age-appropriate vaccination coverage improved for Pentavalent 1 (by 3.4%), Pentavalent 2 (by 5%) and Measles/MR (by 1.7%). In addition, dropout rates were reduced in both the blocks, particularly in Rajpura Pentavalent 1 to Measles dropout rate was reduced by 13.5%. Both health workers and community leaders had positive perceptions of the drum beating initiative. However, another important lesson learned from the initiative was that both the access and demand-side barriers need to be addressed for the desired improvement of age-appropriate immunization coverage. In Shillai, there was lower coverage improvement and a reduction in dropout rates attributed to vacant positions of vaccinators that caused an issue with access to immunization services to people.
