A focus group study of patient’s perspective and experiences of type 2 diabetes and its management in Jordan

Background

Diabetes is increasingly becoming a major health problem in Jordan and glycemic goals are often not achieved.

Interactive design of cellular manufacturing systems,optimality and flexibility

Optimal design and flexible manufacturing are two objectives that have to be achieved in cellular manufacturing systems. Achieving both objectives will optimize the inter-cell movements of parts which will lead to a minimum number of voids and exceptions. The main problem in designing cellular manufacturing systems is cell formation. In the process of forming such manufacturing cells, the designer is faced with the constraint of limited number of cells, therefore the designer needs to specify the number of cells in advance. A number of heuristic methods have been developed in the literature to come up with acceptable but not optimal results due to the complexity of these optimization problems. In this paper a special case algorithm for generating a two-cell formation will be developed with unbounded cell size based on Stirling number. The aim of the proposed 2-cell algorithm is to obtain exact and optimal solutions, and to give flexibility to the system designer in order to decide and choose among alternative optimal solutions for machine-part incidence matrix. The superiority of the proposed algorithm for designing cellular manufacturing systems is to develop an approach that not only specifies the number of cells in advance but also determines all the possible ways to form p-cells from n-machines. To demonstrate the merits of the proposed 2-cell algorithm in designing machine-part matrix, the researcher borrows industrial problems cited in the literature to show that the developed algorithm offers designers better if not the same clusters as compared with known methods. The proposed approach is interactive in the sense that the designer can choose the suitable 2-cell design for a given scenario. Further, when the optimization routine is linked to automated cell layout software, the designer can interactively compare alternative cell designs and layouts and choose the most appropriate.     

Prevalence of Torsades de Pointes inducing drugs usage among elderly outpatients in North Jordan Hospitals

Background

Torsade de Pointes (TdP) is an abnormal cardiac rhythm associated with a prolongation of QT interval. Although in most cases it spontaneously returns to the normal rhythm, TdP can lead to sudden cardiac death. Medications are the main cause of QT-prolongation and subsequent TdP flare, even though the exact mechanism of why some people evoke TdP but others do not is still unknown. It is evident that elderly patients are more susceptible to experience drug's side effects especially with chronically used medications.

Impact of pharmaceutical care on health outcomes in patients with COPD

Background Chronic obstructive pulmonary disease (COPD) treatment goals are often not achieved despite the availability of many effective treatments. Furthermore, clinical pharmacist interventions to improve clinical and humanistic outcomes in COPD patients have not yet been explored and few randomized controlled trials have been reported to evaluate the impact of pharmaceutical care on health outcomes in patients with COPD. Objective The aim of the present study was to evaluate the impact of pharmaceutical care intervention, with a strong focus on self-management, on a range of clinical and humanistic outcomes in patients with COPD. Setting Outpatient COPD Clinic at the Royal Medical Services Hospital. Method In a randomised, controlled, prospective clinical trial, a total of 133 COPD patients were randomly assigned to intervention or control group. A structured education about COPD and management of its symptoms was delivered by the clinical pharmacist for patients in the intervention group. Patients were followed up at 6?months during a scheduled visit. Effectiveness of the intervention was assessed in terms of improvement in health-related quality of life, medication adherence, disease knowledge and healthcare utilization. Data collected at baseline and at the 6?month assessment was coded and entered into SPSS^? software version 17 for statistical analysis. A P value of <0.05 was considered statistically significant. Main outcome measure The primary outcome measure was health-related quality of life improvement. All other data collected including healthcare utilization, COPD knowledge and medication adherence formed secondary outcome measures. Results A total of 66 patients were randomized to the intervention group and 67 patients were randomized to the control group. Although the current study failed to illustrate significant improvement in health-related quality of life parameters, the results indicated significant improvements in COPD knowledge (P?<?0.001), medication adherence (P?<?0.05), medication beliefs (P?<?0.01) and significant reduction in hospital admission rates (P?<?0.05) in intervention patients when compared with control group patients at the end of the study. Conclusion The enhanced patient outcomes as a result of the pharmaceutical care programme in the present study demonstrate the value of an enhanced clinical pharmacy service in achieving the desired health outcomes for patients with COPD.