Open Science Journal (OSJ)
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Selective Outsourcing of IT Functions is the best option
Get PDFThe current research indicates that selective outsourcing is still the norm, however, outsourcing are becoming more complex. There are many perceived and hidden benefits and risks of outsourcing. The current research covers Full In-sourcing, Selective Outsourcing and Full outsourcing. This article provides an overview of Selective outsourcing of IT Functions, further, it traces the evolution of outsourcing and discusses the enabling role of information technology in outsourcing. Additionally, the research talks about process, management, and benefits of selective outsourcing
Diagnosis and Management of Hoarseness in Developing Country
Get PDFBackground: Hoarseness/dysphonia of voice is the most common symptom of laryngeal disorder regardless of its pathology.This study aimed at determining the sociodemographic profile, aetiology, predisposing factors, clinical profile and management of hoarseness.Materials and Methods: This study was a prospective study carried out on all patients who presented hoarseness of voice via the Ear, Nose, and the Throat at the department of a tertiary institution in Nigeria.The study was carried out between October 2015 to September 2017. Data were obtained from patients who gave consent by using pre tested interviewer assisted questionnaire. All the data obtained were analyzed using SPSS version 16.0.Results: Prevalence of hoarseness was 2.4%. There were 58.4% males with male to female ratio being 1.5:1. Housewives were involved 27.6%, Singers 21.5%, Teachers 17.3%, and Clergy 13.1%. Main causes were 96.3% organic causes and 2.8% neurological causes. Common organic causes were 36.4% acute laryngitis, 30.8% chronic laryngitis, and 15.0% vocal nodules.Main predisposing factors were Upper respiratory tract infections 50.5%, Voice abuse 33.6%, and Laryngopharyngeal reflux 29.4%. Commonest duration of the hoarseness prior to presentation were >12 months in 29.4% and 6–9 months in 27.1%. Main clinical features were hoarseness 78.5%, catarrh/cold 73.4%, sensation of lump in the throat 62.6%, and cough 55.6%. Prior medications before presentation to otorhinolaryngologist were local herb 84.6%, over the counter medication 48.6%, and health care center 38.3%. Specialist care was conservative/medical treatment 77.6%, surgical intervention 20.1%, and referral 2.3%.Conclusion: Prevalence of hoarseness of voice was high with associated presentation to the specialist. Organic causes are the commonest with predominant inflammatory origin. Laryngeal neoplasm with associated malignancy was significant in a numbers of patients
Correction of a Severely Rotated Mandibular Canine in an Adult Patient Using Invisalign: A Case Report
Get PDFIntroduction: The Invisalign system has been used in the orthodontic treatment of numerous types of malocclusions. However some clinicians have reported difficulty incorrecting rotations particularly in canines and premolars using the Invisalign appliance system. This case report describes the orthodontic treatment of an adult patient with severe canine rotation (more than 45°) and crowding on upper and lower tooth.Methods: The clinical examination included extra-oral and intra-oral photographs, panoramic radiographic, lateral cephalometric, stone casts, and upper and lower arch analysis obtained from ClinCheck 3.0.The treatment planning was resolved the crowding in both upper and lower arches and the severe rotation of 33 tooth (46°) using Invisalign system as well as the canine and molar relationship, dental verticalization, adequate over jet, overbite and dental midline using the same system. The duration of the treatment was approximately eight months.Results: In Post-treatment extra oralphotographs, no significant changes were observed at the end of the treatment. Intraoral photographs showed an important and notable improved aesthetics. The canine relationship improved slightly and molar Class Irelationship was maintained. An increase in transverse diameter was observed at the level of first premolars, second premolars and first molars. The overbite was improved. The crowding and the severe canine rotation were corrected. No obvious root resorption was radiographically evident and slight cephalometric changes.Conclusion: The treatment with the Invisalign system resolved the complaint of our patient so this system could be considered as an option that offered good results in the treatment of upper and lower crowding of arches involving severe canine rotation
Efficacy of Methotrexate in Combination with Antioxidant Vitamins (A, C & E) versus Methotrexate alone in the Treatment of Rheumatoid Arthritis
Get PDFBackground: There is evidence that oxidative stress plays an important role in autoimmune diseases, such as rheumatoid arthritis (RA). Despite the supporting evidence for a beneficial effect of antioxidants on clinical characteristics of RA, the right balance for optimal effectiveness of antioxidants is largely unknown. A study was designed to determine the potential beneficial effects of antioxidant intervention on clinical parameters of RA.Methods: Randomized clinical trial of 152 patients with positive rheumatoid factor (RF) and a Disease Activity Score (DAS 28) higher than 3.2 were enrolled in the study. Patients were divided into two groups (Group A and Group B) randomly and group A received methotrexate and antioxidant vitamins (A, C and E in a fixed dose) and group B methotrexate only. They were followed up for three visits (baseline, 10th week and 14th week). The intervention was stopped after 10 weeks and was followed by a ‘wash-out’ period of 4 weeks. At baseline, 10th week and 14th week patient’s condition were assessed by means of DAS-28 score. P- Value less than <0.05 was considered significant.Results: The numbers of swollen and tender joints were significantly reduced and general health was improved reflected by improved DAS-28 score at 10th week.The antioxidant effect was considered beneficial as compared to the scores of 1st visit at baseline; the DAS-28 score was significantly reduced at 2nd visit at 10th week. Increment of the DAS-28 score among the group A patients who were on antioxidant up to10 weeks, after the “wash-out period” of four weeks i.e. at 14th week confirmed a significant relation between changes in clinical condition and antioxidants.Conclusion: This study was designed to assess the potential beneficial effect of antioxidants (Vitamin A, C and E) in combination with methotrexate in the treatment of RA
Proof of Concept trial of diagnostic ultrasound in the orthopaedic triage setting.
Get PDFPurpose: This study aims to investigate the benefits of Point of Care (POC) ultrasound and Scheduled Ultrasound Clinics using a Proof of Concept approach in the orthopaedic triage setting.Materials and Methods: The trial ran for a six week period sourcing all patients referred to the orthopaedic triage service. The trial collected three measurable outcomes i.e. two Patient Reported Outcome Measures: MSK-HQ and The Care Measure, and a Proof of Concept clinician survey via Survey Monkey. These were completed by the clinicians and patient cohort during the scheduled clinic and POC clinical contact.Results: A total of 135 patients received a diagnostic ultrasound scan over the six week trial period. 34 patients received a diagnostic ultrasound scan from the Extended Scope Practitioner (ESP) Physiotherapist in a Scheduled Care setting. 101 patients received a diagnostic ultrasound scan from the ESP Podiatrist in orthopaedic triage over the six week period (74 in Scheduled care clinics and 27 at Point of Care). The outcome measure suggest that patients recieved a rapid diagnosis (n.135), implementation of appropriate treatment pathway (86.36%), a positive impact on Referral to Treatment (88.55%), appropriate implementation of conservative treatment (91.11%) and had excellent co-production during the trial with an 88% average CARE Measure Score. The MSK-HQ results suggested a wide variety of muscuoskeletal conditions were asseessed during the trial with a mean MSK-HQ score of 27.6 with a Standard Deviation of 12.Conclusion: Results from clinician sourced Survey Monkey data, The CARE Measure and MSK HQ suggest that POC ultrasound and Scheduled care clinics offer a positive benefit for the patient’s care pathway, are beneficial clinically and suggest adequate demand for the service
Municipal Solid Waste (MSW) characterization for possible Waste-to-Energy (WtE) conversion in Zambia
Get PDFCoal has traditionally been relied upon as a good source of bulk energy in many pyro processes especially in cement manufacturing and thermal power generation. In Zambia, cement manufacturing, a key and growing industry, uses coal as the main source of energy for the pyro process in the cement kiln that converts raw materials to a semi-finished product called clinker. Despite the advantages that coal has over other sources of energy in this market including its high energy content and its easy accessibility, burning coal has significant known and documented disadvantages especially towards the environment and human health that give way to dissenting views on its continued use. In attempts to address the environmental effects of coal usage in cement manufacturing and consequently contribute to the lowering of production costs, Cement manufacturing companies have been pursuing the possibilities of coal substitution with Municipal Solid Waste (MSW). The MSW should however; conform to certain standards before it can be used in the substitution in order not to affect the quality of cement produced. This paper sought to characterize the Municipal Solid Waste in Lusaka to ascertain its conformity to internationally recognized standards in order to be used in coal substitution. The results show that the characterization of MSW showed that it could be a viable substitute for coal burning in cement manufacturing in Zambia. Apart from the high moisture content in the rainy season, the other readings were all favorable to its use as an alternate energy source. The high moisture content meant that during the pre-treatment for possible use in the cement manufacturing, pretreatment processes could be employed to help align the moisture content before its use as the substitute for coal in cement manufacturing
Integration of Bourdieu’s Habitus into Bernstein’s Code
Get PDFThis paper aims to sketch dialectically two great sociologists’ views, those of Bernstein and Bourdieu on one canvas so as to increase the transparency in three specialized aspects of education. First, Bernsteinian sociolinguistic dimension of habitus and its relation to cultural reproduction is delineated; second, the educational knowledge and its transmission in accordance with habitus is provided; finally, providing a draft to an interdisciplinary curriculum regarding Bernstein’s verticality and Bourdieu’s subjectivity of knowledge is given. The answer to why it is possible to juxtapose Bernsteinian pedagogy and habitus in one plateau is that while habitus provides a lens for understanding practice and knowledge within the social milieu (Costa and Stahl, 2015), Bernstein explains how this knowledge is classified, and transmitted (1977). Although habitus is a social subjectivity, the integrated curriculum, and not the collected one, provided by Bernstein can supposedly pave the way for this subjectivity to develop in the social milieu of school. Bernstein holds that his work is “complementary” to that of Bourdieu, seeing Bourdieu’s work as an explanation of the “structure of reproduction” and his as the “process of transmission” (1977, p. 14). Complementarily, habitus allows for the study of individual and collective dispositions and also shows how individuals’ perspectives, values, actions, conceptions of hierarchies and social positions are formed (Costa, 2015). Habitus folds and unfolds itself outside and inside school. Accordingly, both these views put an effort to analyse pedagogic pupil
Ecological Indices of the Heavy Metals in the Soil of Shewasoor Sub-Basin, Kirkuk NE Iraq
Get PDFThe current research aimed to assess contamination levels in the soil of study area by heavy metals. Eight sites were selected for the collection of soil samples. The eight heavy metals namely As, Pb, Cd, Cr, Co, Cu, Ni, and Zn were analyzed in each soil samples by using ICP-MS technology. The measured concentrations of heavy metals were compared with Geochemical Background values, EPA Sediment Quality Guidelines, Ecological Screening values, and WHO Guidelines. The spatial distribution maps of ecological indices were performed using ArcGIS software (version 10.2), which provides an idea of the geographical distribution of heavy metals contamination levels in the soil of Shewasoor sub-basin. The soil contamination by heavy metals assessed using Potential Ecological Risk Index (RI), Nemerow Pollution Index (P_N), Hazard Index (HI), and Cancer Risk. The RI showed there are high risk of heavy metals in soil and according to P_N the soil has been moderate to severely contaminated by heavy metals. The hazard index of all soil samples was within acceptable range for adults and showed unacceptable risk for children. While the total cancer risk values of As and Cr were within acceptable limits, whereas of Pb, Cd, Co, and Ni were lower than acceptable risk range at all sites for adults and children. Ecological indices which are used to assess the contamination levels in the soil by heavy metals refers to the soil of study area was contaminated moderate to heavily by heavy metals, this attributed to the natural and anthropogenic pollution sources around and within the study area
The effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases: A critically appraised topic
Get PDFObjectives: To conduct a critical appraisal of peer reviewed articles on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases.Methods: This study critically appraised peer-reviewed article on the effectiveness of telemedicine on stigmatization and treatment burden in patients with health compromising lifestyles and chronic diseases. Treatments included e-health interventions, information and communication technologies used in health care, internet-based interventions for diagnosis and treatments that encouraged collaborative care for patients with chronic diseases. This paper critically appraised the full text of each relevant peer-reviewed article adapting the Occupational Therapy Critically Appraised Topics (CATs) template while using the Oxford Centre for Evidence-based Medicine- Levels of Evidence (2011) model to assess for best evidence or quality. Results: Initial internet search using Psychinformation; PubMed; Medline; ProQuest; CINAHL; OT seeker and the Cochrane Library generated over 1450 titles/abstracts. Following abstract appraisal, 30 articles were selected for full text assessment. Five of the final articles selected for this critical appraisal alluded to the effectiveness of telemedicine in reducing the treatment burden of stigmatization on patients with chronic diseases. Majority of the appraised articles indicated the effectiveness of telemedicine in changing behaviours.Conclusions: All the appraised articles alluded to the effectiveness of telemedicine in curbing some of the treatment burdens of stigmatization for patients with health compromising lifestyles and chronic diseases. However, it is evident that the use of other intervention methods such as government policy, public education and patient empowerment in conjunction with telemedicine would better reduce the effect of stigmatization and facilitate the medical interventions for patients with chronic diseases
Success Indicators of the Philippine National Aquasilviculture Program (PNAP) - Mangrove Rehabilitation Project in Davao del Sur, Southern Philippines
Get PDFThe study was conducted to evaluate success indicators of the Philippine National Aquasilviculture Program (PNAP) – Mangrove Rehabilitation Project in Davao del Sur. The growth increment of mangroves(cm/day) and survival and the physico-chemical parameters of the different project sites were recorded. A questionnaire was employed to gather in socio-demographic profile, best practices employed, benefits and institutional factors. The study employed one shot sampling. The growth increments of mangroves in Punta Biao (0.0032 cm/day) was comparable with Bucana (0.0031 cm/day) but were significantly higher than the rest of the project sites.Sto. Rosario exhibited the lowest growth increment of 0.0007 cm/day. In terms of survival, Bucana and Punta Biao showed the highest survival rate of 96.87% and 99.62%respectively, while San Isidro obtained the lowest mean value of 13.71%. Two (2) types of area orientation found in the different project sites, midland and tidal/mud flats. Soil types were clay loam and sandy clay. High survival and high growth increment were observed in midland area with clay loam substrate while low survival observed in seaward areas with sandy clay substrate. The pH ranged from 6.46-7.23 while salinity ranged from 23ppt-35ppt. Some of the contributing factors that influenced higher survival rate of PNAP Mangrove Rehabilitation Project in Davao del Sur include the used of matured mangrove propagates, staking prior to mangrove planting, regular monitoring at least every other day and carefully scraping epiphytes (e.g. barnacles and oysters) during mangrove’s early stage. This practices observed in all project sites regardless of percentage rate recorded.