bluuebunny/crossref_metadata_2025 huggingface dataset:
IMPLEMENTATION OF THEORY OF CONSTRAINT ON WAITING TIME OF PRESCRIPTION SERVICE
Authors: Pertiwi Alissa Sita , Rochmah Thinni Nurul
Published: June 2019

Background: Medical services provided within the Indonesian National Health Insurance programme or Jaminan Kesehatan Nasional (JKN) have been continuously improving for the past several years. One of them is pharmaceutical service in the Pharmacy Store for JKN patients at one hospital with the highest number of visitors in Surabaya. However, one preliminary study points out that patient waiting time for prescription services in the Pharmacy Store for JKN patients is longer than the national standard.Aim: This study aims to investigate the causes for such delay in prescription services as one of pharmaceutical services in the Pharmacy Store for JKN patients at one hospital in Surabaya.Methods: This is an observational descriptive research with a reference to the Theory of Constraints. The research was conducted from August 2017 to February 2018. The data were obtained from observations, interviews with one pharmacist and four pharmacy technicians, and waiting time for prescription service.  Results: The study finds that the longer waiting time is caused by inefficient division of jobs and workers and the lack of worker’s discipline to work on time. The behaviors and habits of pharmacist and pharmacy technicians in drug preparation greatly affect patient waiting time, since the services still highly depend on manual human labor.Conclusions: Patient experience in prescription drug services is significantly influenced by the time spent waiting for the service provider. This study provides useful insights about constraint identification in pharmaceutical services, especially waiting time.Keywords: Pharmaceutical service, Theory of Constraints, Patient waiting time.
ROOT CAUSE ANALYSIS ON HOSPITAL STANDARDS AND JOINT COMMISSION INTERNATIONAL STANDARDS: A COMPARATIVE STUDY
Authors: Lanida Bella Putri , Yustiawan Tito , Dzykryanka Sylvy Medtasya
Published: June 2019

Background: Healthcare Associated Infections (HAIs) are infections that patients caught during medical treatment and health care. Prevention and control of infection will lead to patient safety, which ultimately has an impact on efficiency, management of health care facilities, and improvement of service quality. Infection can be controlled by identifying the causes. One method to achieve this goal is the Root Cause Analysis (RCA).Aim: This study aims to analyze the implementation of Root Couse Analysis (RCA) conducted by the Infection Prevention and Control Committee at the Mother and Child Hospital of Kendangsari MERR Surabaya.Method: This is a quantitative observational research that utilizes descriptive data analysis. This study is a cross sectional study and its results are presented narratively.Results: Results show that the Joint Commission International Standard 2015 version of RCA was not fully implemented at the Mother and Child Hospital of Kendangsari MERR Surabaya. Some methods, such as the fishbone and Plan-Do-Study-Action (PDSA), were not implemented. Limited resources became the contributing factor.Conclusion:  Infection Prevention and Control Committee at the Mother and Child Hospital of Kendangsari Merr Surabaya has implemented 9 out of 21 RCA steps of the Joint Commission International Standard 2015. The hospital needs to use other methods as an addition to the 5 Why’s in implementing RCA, such as fishbone diagrams and Plan-Do-Study-Action (PDSA), for problem solving planning. Keywords: Root Cause Analysis (RCA), HAIs, Infection prevention and control.
THE RELATIONSHIP OF STAFF JOB SATISFACTION AND INTENTION TO LEAVE AT A HOSPITAL
Authors: Mashuri Nimas Ayu , Maharani Diajeng Puspa Arum
Published: June 2019

Background: Job dissatisfaction arises as a result of a mismatch between expectation and reality in the employment conditions of employees in an organization. Job dissatisfaction can lead to the intention of to leave. Employees with Intention to leave have the opportunity to do turnover of their organization.Aims: The purpose of this study is to determine the relationship between job satisfaction variable and intention to leave variable.Methods: This study used quantitative method with cross-sectional design. The samples were 52 staffs of the Surabaya Orthopaedic and Traumatology Hospital who were still actively working until June 2012. Job satisfaction variable was measured using a questionnaire research instrument called Job Satisfaction Survey (JSS) by Spector while the intention to leave variable was measured using a questionnaire research instrument that is made by researchers.Results: The results of this study indicate that the level of staff work satisfaction of Surabaya Orthopaedic and Traumatology Hospital is relatively high while the intention to leave is moderate. The results of the Spearman Correlation show a number of -0.314 which shows a correlation that is not unidirectional and significant between the two variables. This means that job satisfaction and intention to leave have a negative relationship so that the higher the job satisfaction is, the lower the intention to leave is.Conclusion: It can be concluded from the study that job satisfaction has a significant relationship and is not in line with the intention to leave of the staffs. Therefore, it is important for the Surabaya Orthopaedic and Traumatology Hospital to improve their staff job satisfaction thus the staff loyalty can be formed. Keywords: Job satisfaction, Intention to leave, Hospital staff.
INSPECTING PRIMARY HEALTHCARE CENTERS IN REMOTE AREAS: FACILITIES, ACTIVITIES, AND FINANCES
Authors: Soewondo Prastuti , Johar Meliyanni , Pujisubekti Retno , Halimah Halimah , Irawati Dwi Oktiana
Published: June 2019

Background: Progress towards health-for-all must be supported by quality health facilities that are available to everyone. However, health care facilities in remote and underdeveloped areas, borderland, and outlying islands or Daerah Terpencil, Tertinggal, Perbatasan dan Kepulauan (DTPK) are facing some constraints to have access to health coverage.Aim: This study aimed to provide a comprehensive picture of the readiness of primary healthcare centers or puskesmas as the main provider of primary health services located in remote areas.Methods: Observations were taken from 18 primary healthcare centers in locations that had been identified by the government as remote and underdeveloped areas, borderland, and outlying islands in 3 provinces: Bengkulu, Nusa Tenggara Timur (East Nusa Tenggara), and South Sulawesi.Results: The findings reveal that many facilities in primary healthcare centers are still insufficient. In particular, roads to primary healthcare centers are in poor physical conditions, operational hours are too short, and doctors and lab technicians are unavailable. The good news is that primary healthcare centers have managed to run many indoor and outdoor activities, such as health education classes and detection of priority diseases in the community. Regarding primary healthcare centers’ finances, they largely depend on public funding to support their increasing expenses to provide health services, pay worker salaries, and run indoor and outdoor activities.Conclusions: Overall, some constraints faced by the primary healthcare centers in DTPK include difficult access to facilities and temporary health personnel. All of this information provides valuable inputs to policymakers in building a health infrastructure and human resources for health in DTPK. Keywords: Remote area, Human resources for health, Primary healthcare center.
Improvement of Internal Stability of Alluvial Clay from Famagusta Bay, Cyprus, Using Copolymer of Butyl Acrylate and Styrene
Authors: Golhashem Mohammad Reza , Uygar Eris
Published: June 2019

The internal stability of alluvial clays may be significantly compromised during a heavy rainfall due to infiltration of surface water causing sudden inundation, softening, and loss of erosion resistance or mechanical strength. Most of the available stabilization methods for clay soils employ pozzolanic or other cementitious binders, creating a chemically bound clay-admixture matrix. These admixtures commonly require a curing period after placement and compaction. Alternatively, aqueous polymers can be used in diluted form without any need for a curing period. Aqueous polymers can form agglomerations of clay particles enclosed in a matrix of polymer chains, held together by electrostatic and hydrogen bonding, improving erosion resistance. In this research, an aqueous polymer, namely, copolymer of butyl acrylate and styrene (CBAS), is mixed with alluvial clay sampled from Famagusta Bay, Cyprus, and the clay stability test is performed as a basis for assessing the degree of improvement on erosion resistance. A time-dependent approach for the evaluation of test results is followed to increase the accuracy of the analysis of the actual behavior observed during the test. A significant improvement in the erosion resistance is observed in treated test specimens. The mode of collapse of specimens during the clay soil stability test when aqueous polymer is used also changed from being gradual cracking and slaking to explosive. The swelling behavior and the effect of drying on the erosion resistance are also observed in the testing program. X-ray diffraction analysis and Fourier transform infrared spectroscopy are performed for observation of the effect of CBAS on microstructural interactions, such as electrostatic bonding and changes in soil fabric.
Women geographers and the International Geographical Union
Authors: Droogleever Fortuijn Joos
Published: June 2019

This article reports the under representation of women in the discipline of geography in the world and focuses on the position of women in the global geography community of the International Geographical Union IGU. First, it gives an overview of the underrepresentation of women in geography in different parts of the world, demonstrating that women are particularly underrepresented in positions of power and prestige. Second, it summarizes factors that explain the underrepresentation of women in geography. Finally, it analyzes the position of women in the governance of the IGU. It concludes that women geographers are still underrepresented in the IGU in the same way as in geography departments all over the world. The participation of women in the governance of the IGU reflects the gendered nature of subdisciplines in geography as an integrative natural sciences-social sciences-humanities discipline, with a higher share of female representation in human geography than in physical and technical subdisciplines. Female representation is more often from high-income countries in Europe, North-America and Oceania and from Latin-America than from Asia and Africa.
Effect of Confinement and Well Interference on SAGD Performance: An Analytical Assessment
Authors: Zargar Zeinab , Farouq Ali S. M.
Published: June 2019

In this paper, we introduce, for the first time, an analytical approach for evaluating the effect of confinement and well interference on the SAGD process and achieving a better understanding of the situation. In the well-confinement stage of SAGD, there is adjacent-chamber interference, the effective head of drainage decreases, and the heat-loss rate decreases or, in a conservative design, remains constant. Our objectives were to predict the oil-production rate, steam-injection rate, thermal efficiency, steam-chamber velocity, unsteady temperature profile, heat distribution, and the cumulative steam/oil ratio (CSOR). In this approach, heat transfer was coupled with fluid flow. The governing equations were Darcy's law, volumetric balance, and heat conduction—constitutive equations indicating the temperature dependence of some physical properties. Our model was developed on the basis of a moving-boundary problem.

The predicted oil rate remained constant during the sideways-expansion phase, while the steam-injection rate had to be constantly increased. After a determined confinement time, the oil rate started to decline with time because the decreasing steam-chamber interface length was offset by a decreasing head. The unsteady temperature profiles from the model showed that lower temperatures were predicted ahead of the interface owing to the confinement effect. Also, the model showed that, for a small lateral well spacing, confinement occurred earlier and heat loss started decreasing sooner, resulting in a lower CSOR than for a large spacing. It was shown that, even though the oil rate declined faster in a confined model rather than in an unconfined model, the reservoir depleted faster, just like the angle between the steam-chamber interface and the horizon. The results were validated using experimental data reported in the literature.
Vitamin D status and its relation with insulin resistance and VDR-FokI polymorphism in Iranian non-melanoma skin cancer (NMSC) patients: a case-control study
Authors: Rezaiian Fatemeh , Davoodi Sayed Hossein , Nikooyeh Bahareh , Ehsani Amir Houshang , Kalayi Ali , Shariatzadeh Nastaran , Zahedirad Maliheh , Neyestani Tirang R.
Published: June 2019

Background

Sunlight exposure, the main source of endogenous vitamin D synthesis, may increase the risk of non-melanoma skin cancer (NMSC) development. Vitamin D receptor (VDR) polymorphisms are associated with 25(OH)D levels, cancer development and insulin resistance.

Objective

This study aimed to examine the associations among vitamin D status, VDR FokI polymorphism, insulin resistance and NMSC.

Methods

This case-control study included 73 diagnosed cases of NMSC and 72 healthy controls from dermatology clinics at Razi Hospital, Tehran, Iran. A questionnaire was used to assess sunlight exposure. The extracted DNA from whole blood samples were genotyped. Fasting serum 25-hydroxyvitaminD (25(OH)D)), lipid profile, glucose, and insulin were measured. To evaluate insulin resistance, HOMA-IR formula was used.

Results

We found a significant higher duration of cumulative sunlight exposure in cases compared with controls (p<0.001). However, 25(OH)D concentrations were not significantly different between cases and controls (30±15 vs. 29±15 ng/mL, p=0.78). Higher levels of insulin (p = 0.004) and HOMA-IR score (p= 0.019) were observed in Ff and ff genotype of FokI. We did not observe any significant increased risk of NMSC due to f allele, as compared with FF (OR =2.33, 95% CI 0.81-6.75, p=0.12). The components of lipid profile, fasting serum glucose, iPTH and anthropometric measures did not differ significantly across VDR genotypes.

Conclusion

In conclusion, sunlight exposure was associated with NMSC risk. VDR FokI polymorphisms appears to influence insulin resistance in the NMSC patients.
Acanthamoeba keratitis related to contact lens in a tertiary hospital in China
Authors: Li Weiwei , Wang Zhiqun , Qu Jinghao , Zhang Yang , Sun Xuguang
Published: June 2019

Backgroud To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens in a tertiary hospital in China. Methods In this retrospective study, medical results of 61 cases of AK related to contact lens were reviewed from January 2000 to December 2017. The data included patients’ demographics, lens type, history, risk factors, the disease stages, reports of corneal scrapings and culture, treatment. Moreover, the genotype identification of part of these isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. Results There were 64 eyes included in the study. And 32.8% of cases wore soft contact lenses, 67.2% of patients used overnight orthokeratology. In the cases (20eyes) of early stage, 65% (13 eyes) had positive results in Giemsa stained smears, trophozoites were seen in 7 eyes (35%) in 0.9% sodium chloride (NaCl) wet mounts. Six eyes (30%) were diagnosed by confocal microscopy together with clinical sign. In the orthokeratology patients, 87.8% (36/41) of cases rinsed the lenses and/or cases with tap water, while 55% of soft lens wearers wore their lens during showering. The genotype of 9 isolates was determined, all the strains belonged to genotype T4. In the orthokeratology related cases, patients required therapeutic penetrating keratoplasty after 2005 were less than before 2005 (Chi-square test, χ2= 4.209，P = 0.04). Conclusions More than two thirds of cases were associated with orthokeratology. The examinations of Giemsa stained smears, 0.9% NaCl wet mounts and confocal microscopy should be done for the highly suspected cases of early stage to help the early diagnosis. The rate of therapeutic keratoplasty was decrease after 2005 compare with before 2005 in the cases of orthokeratology.
A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery
Authors: Temel Mehmet Emrah , TOTOZ Tolga , ERKALP KEREM , TEMEL Gulen Safiye , SELCAN Aysin
Published: June 2019

Background: Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS, by ultrasound assessment.
Methods: Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after the orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before the anaesthesia induction) and postoperatively (before the extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in the subgroup analyses according to the surgery type. Pearson correlation analysis was performed to assess correlations between the variables.
Results: AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05). Patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively (p < 0.05).
Conclusions: The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in an elective NS. It is therefore a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.
Thermodynamics of the metal-insulator transition in the extended Hubbard model
Authors: Schüler Malte , van Loon Erik , Katsnelson Mikhail , Wehling Tim
Published: June 2019

In contrast to the Hubbard model, the extended Hubbard model, which
additionally accounts for non-local interactions, lacks systemic studies
of thermodynamic properties especially across the metal-insulator
transition. Using a variational principle, we perform such a systematic
study and describe how non-local interactions screen local correlations
differently in the Fermi-liquid and in the insulator. The thermodynamics
reveal that non-local interactions are at least in parts responsible for
first-order metal-insulator transitions in real materials.
Determinants of microbiological quality of drinking water in refugee camps and host communities in Gambella Region, Ethiopia
Authors: Mekonnen Getachew Kabew , Mengistie Bezatu , Sahilu Geremew , Mulat Worku , Kloos Helmut
Published: June 2019

Inadequate improved water supply and sanitation, particularly in refugee camps contribute to the spread of infectious diseases. The study objective was to assess determinants of microbiological quality of drinking water in refugee camps and host communities in Gambella Region, Ethiopia. A cross-sectional study was conducted from September to December 2016 based on structured questionnaire-based interviews and testing household water using the portable Potatest+ water quality testing kit. Data were analyzed and P values <0.05 with 95% confidence interval (CI) were considered statistically significant. Results showed there were significant differences in fecal coliform count (P value = 0.009) and free residual chlorine concentration (P value = 0.01) between the source and stored water samples. Surface water source, water shortages in the previous month, and unavailability of free residual chlorine and caregivers without formal education were the main determinants of microbiological quality of stored water. Stored water was contaminated in many households in both the refugee and host communities. Designing and implementing appropriate community education and effective hygiene promotion programs are essential in improving community knowledge of water contamination and reducing diarrhea prevalence among under-five children in refugee camps and host communities in Gambella Region.
Ketalar Anesthesia in Surgical Operations: An Experience of Sierra Leone
Authors: ALİMOĞLU Orhan , LEBLEBİCİ Metin , ATAK Tuba , SAĞIROĞLU Jülide , YILMAZ Yadigar , TOMBALAK Ercüment , DEMİRCİ Elif , KARAMAN Muhammet İhsan
Published: June 2019

Introduction      High dose of
ketamine is administered in general anesthesia and low dose is used to induce
analgesia. Intravenous ketamine is usually used for hernia repair as well as
cutaneous interventions in general surgery, for dilatation and curettage in
gynecology, and hydrocele repair in urology.Materials and
Methods      This study
reports the outcomes of 49 patients who had been operated by volunteering
surgical team of Doctors Worldwide in Sierra Leone during 10th to 16th
of March 2014. Demographic features of all patients and surgical methods were
recorded. All patients were operated on under ketamine anesthesia.Results      Five female and
44 male patients with mean age of 36.8+17.8 were operated. One patient
had umbilical, 1 had epigastric, and 35 had giant inguinal hernias. Umbilical
and epigastric hernias underwent primary repair. Inguinal hernias were right
sided in 19, and left sided in 16 patients. Twenty-eight patients had indirect
hernias, while 6 had direct and 1 had bilateral hernias. None of the patients
appeared with either obstruction or strangulation. Four patients in pediatric
age with hernia underwent high ligation. In adult age group, 28 patients were
operated by wall darn repair, and 3 had Bassini repair. Four patients had been
diagnosed with right sided, and 4 left sided giant hydroceles all of which
underwent Winkelmann procedure. One patient had orchiectomy for a right sided
testicular mass; 1 had resection of an inguinal tumor; 1 excision of lipoma in
the neck, and 1 excision of a solid mass in the left labium majus. None of the
patients had complications related to anesthesia.Conclusion

      Safe and
effective sedation by low dose intravenous administration of ketamine and
midazolam is beneficial in surgical procedures, especially in field conditions
where general anesthesia is not applicable.
Ayrık Otuna Yer Açmak: Geleneksel Tıp ve Hasta-Hekim İlişkisi Üzerine
Authors: KARA Mahmut Alpertunga
Published: June 2019

Amaç Bu çalışmada hasta–hekim ilişkisinde potansiyel fayda ve zararları yeterince araştırılmamış olan geleneksel tıp metotlarına karşı uygun bir yaklaşım belirlemek amaçlanmıştır.Gereç ve Yöntemler Türkiye’de ve dünyada geleneksel tıp metotlarına olan genel yönelim, bitkisel tedavilerin klinik tedavilerle etkileşimi ve bunun muhtemel sonuçları ile ortalama hastanın bu konudaki tavrı incelenip tartışılarak mantıki sonuçlara varılmıştır.BulgularDünyada ve Türkiye’de geleneksel tıp metotlarının kullanımı giderek yaygınlaşmaktadır. Halkın, medyanın ve özel sektörün bu metotların kullanımına sıcak baktığı gerçeği göz önüne alındığında bu tersine çevrilebilir bir süreç gibi görünmemektedir. Hekimler ise konu hakkında yeterince bilgi ve farkındalık sahibi değildir.Tartışma ve SonuçBu gidişat halk sağlığını olumsuz etkileyebilir. Sorun çok yönlü olduğu için, çok yönlü bir çözüm stratejisine ihtiyaç vardır. Bu gibi yapısal sorunların çözümü uzun zaman alabilir; ancak hekimlerin konuya yapıcı yaklaşması pratik bir çözüm olarak durumu iyiye götürebilir.
Bir Tıp Fakültesi Hastanesinin Çocuk Acil Servisine Başvuran Hastaların Özellikleri
Authors: TEMİZKAN Ramazan Cahit , BÜYÜK Nursel , KILIÇASLAN Önder , ANKARALI Handan , KOCABAY Kenan
Published: June 2019

Amaç: Acil servisler hastanelerin her tür acil hasta ve yaralıya
kesintisiz hizmet veren en önemli birimlerindendir. Bu çalışmada Düzce Üniversitesi
Tıp Fakültesi Çocuk Acil Servisi’ne belli bir dönemde başvuran hastaların çeşitli
özelliklerini ve dağılımlarını ortaya koymak ve elde edilen bulgular doğrultusunda
performansı yüksek, iş gücü kaybı en aza indirilmiş, kaliteli hizmet veren ve
hasta memnuniyetini önemseyen bir acil servis modeli çizmek amaçlanmıştır. Gereç ve Yöntemler: 1.01.2012—31.12.2016 döneminde başvuran toplam
116.172 hastanın kayıtları elektronik ortamda retrospektif olarak incelendi.
Kayıtlarda hastaların yıl içinde kaç kez acil polikliniğine başvurduğuna, başvuru
zamanına ve nedenlerine, aldığı tanıya ve hizmet çeşi­dine, ve yaş, cinsiyet ve
sosyoekonomik özellerine dair bilgiler yer almakta idi. Bulgular: Çocuk Acil Servisi’ne başvuran hasta sayısının 2012–2016 yıllarında
sırasıyla 11.336 (%9,75), 15.453 (%13,3), 23.944 (%20,6), 28.695 (%24,7) ve
36.744 (%31,6) olduğu ve yıllar içinde başvuran hasta sayısında anlamlı bir artış
kaydedildiği görüldü.

Tartışma ve
Sonuç: Çocuk acil servislerine gelen hastaların sosyodemografik ve klinik özellikleri
tespit edilerek bir veri tabanı oluşturulması, bu servisler için yapılacak çalışma
ve gelecek plan­ları açısından çok önemlidir.
Tıp Öğrencilerinin Üreme Sağlığı ve Aile Planlaması Konusundaki Bilgi Düzeyinin Değerlendirilmesi
Authors: İKİIŞIK Hatice , ARI Alpaslan , BAŞIBÜYÜK Hatice Feyza , BIYIK Kübra , ERDEM Ali Emre , MARAL İşıl
Published: June 2019

Amaç: Bu çalışmada 2. ve 5. sınıf tıp öğrencilerinin
üreme sağlığı ve aile planlaması konusundaki bilgi düzeyini değerlendirmek amaçlanmıştır.
Gereç ve Yöntemler: İstanbul’da bir tıp fakültesinin tüm ikinci sınıf öğrencilerinin
121’ine (%81,7), tüm beşinci sınıf öğrencilerinin 88’ine (%79,2) olmak üzere,
araştırma kapsamında toplam 209 öğrenciye ulaşılmıştır. Veriler,
sosyodemografik özellikleri, üreme sağlığı ve aile planlaması ko­nusundaki
bilgi ve tutumları değerlendirmeye yönelik 17 sorudan oluşan bir anket formu
aracı­lığıyla toplanmıştır. Bulgular: Öğrencilere aile planlamasının tanımı sorulmuş ve 2. sınıf öğrencilerinin
107’sinden (%88,4), 5. sınıf öğrencilerinin ise 67’sinden (%76,1) “ailenin
bakabileceği ve yetiştirebileceği ka­dar çocuk sahibi olmak” yanıtı alınmıştır
(p<0,05). Öğrencilerden aile planlaması hakkındaki bilgi durumlarını
kendilerinin değerlendirmesi istenmiş, ikinci sınıfların 51’i (%42,1), beşinci
sınıfların 64’ü (%72,2) aile planlaması yöntemleri hakkında yeterli bilgiye
sahip olduğunu söylemiştir. Her iki sınıfta da kondom 185 (%88,5) en çok,
spermisitler ise 89 (%42,6) en az bilinen aile planlaması yöntemi idi. En az
bilinen cinsel yolla bulaşan enfeksiyon 106 öğrenci (%50,7) ile Trikomonas
vaginalis enfeksiyonu, en çok bilinen ise 207 öğrenci (%99) ile HIV
enfeksiyonuydu. Öğrencilere, “Lisede yeterli düzeyde cinsel sağlık eğitimi aldınız
mı?” sorusu da sorulmuş, ikinci sınıfların 102’si (%84,3), beşinci sınıfların
ise 78’i (%88,6) “Hayır” cevabı vermiştir.

Tartışma ve Sonuç: Tıp fakültesi 2. ve 5. sınıf
öğrencilerinin aile planlaması yöntemleri, cinsel yolla bulaşan hastalıklar,
acil kontrasepsiyon ve acil kontraseptif yöntemler hakkındaki bilgi dü­zeylerinin
farklı olduğu saptanmıştır.
Dimethyloxallyl Glycine-Incorporated Borosilicate Bioactive Glass Scaffolds for Improving Angiogenesis and Osteogenesis in Critical-Sized Calvarial Defects
Authors: Jin Xiangyun , Han Dan , Tao Jie , Huang Yinjun , Zhou Zihui , Zhang Zheng , Qi Xin , Jia Weitao
Published: June 2019

Background:

In the field of bone tissue engineering, there has been an increasing interest in
biomedical materials with both high angiogenic ability and osteogenic ability. Among various osteogenesis
materials, bioactive borosilicate and borate glass scaffolds possess suitable degradation rate
and mechanical strength, thus drawing many scholars’ interests and attention.

Objective:

In this study, we fabricated bioactive glass scaffolds composed of borosilicate 2B6Sr using
the Template-Method and incorporated Dimethyloxalylglycine (DMOG), a small-molecule angiogenic
drug possessing good angiogenic ability, to improve bone regeneration.

Methods:

The in-vitro studies showed that porous borosilicate bioactive glass scaffolds released slowly,
a steady amount of DMOG and stimulated the proliferation and osteogenic differentiation of human bone
marrow stromal cells hBMSCs.

Results:

In-vivo studies showed that the borosilicate bioactive glass scaffolds could significantly promote
new bone formation and neovascularization in rats’ calvarial bone defects.

Conclusion:

These results indicated that DMOG-incorporated bioactive glass scaffold is a successful
compound with excellent angiogenesis-osteogenesis ability, which has favorable clinical prospects.
An Epidemiological Review on Emerging and Re-Emerging Parasitic Infectious Diseases in Malaysia
Authors: Alasil Saad M. , Abdullah Khairul A.
Published: June 2019

Emerging infectious diseases are infections that have recently appeared in a population over a defined period of time whereas, re-emerging infectious diseases are those that were once a health problem in a particular region or a country and are now emerging again. Parasitic infectious diseases represent a serious health problem in many developing countries and recently have started spreading to developed nations via international traveling or immigration. Malaysia is facing many challenges caused by various parasitic pathogens. The lack of awareness among disadvantaged populations such as the Orang Asli community and the dependency on foreign workers has led to an influx of immigrants to Malaysia from countries endemic to various parasitic diseases. Understanding the social and economic dynamics of such diseases can help anticipate and subsequently control their emergence. Raising public awareness, developing robust public health infrastructure and implementing point-of-care diagnostics will help curb the spread of such diseases. This review provides epidemiological insights into the reported emerging and re-emerging parasitic infectious diseases in Malaysia over the past two decades.
Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children
Authors: Zaki Maysaa , El-Halaby Hanan , Elmansoury Eman , Zeid Mayada , Khaled Khaled , Nomir Manal
Published: June 2019

Background:

Treatment failure of sepsis caused by Escherichia coli (E. Coli) is a leading cause of death of infants and children in intensive care units.

Objective:

To detect the prevalence of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-genes between E. coli isolates from infants and children with septicemia and to identify their antibiotic sensitivity pattern.

Methods:

This is a cross-sectional study performed on 88 patients with sepsis. The isolated E. coli were identified by Gram stain and biochemically by the Microscan automated system. ESBL and carbapenemase producing E. coli were isolated on double disk diffusion and EDTA double disk, respectively. Polymerase chain reaction for ESBL and carbapenemase producing E. coli genes were performed. Bacterial susceptibility to antibiotics was tested. The initial results were measured through the 30-days of hospital admission. IRB approved the study.

Results:

Of 88 patients with sepsis, 49 and 30 strains were ESBL producing and carbapenemase producing E. coli; respectively. Neither risk factors for infection nor clinical picture can differentiate between ESBL and carbapenemase producing E. coli. The most frequently detected gene of ESBL producing E. coli was SHV, it was more sensitive to Piperacillin/Tazobactam (90%) and cefepime (86.7%) while for carbapenemase-producing E. coli; IMP was the most frequent, its sensitivity was high to Piperacillin/Tazobactam and Ciprofloxacin (52.6% each).

Conclusion:

The commonest gene of ESBL producing E. coli is SHV whereas for carbapenemase-producing E. coli is IMP. Piperacillin/Tazobactam is the candidate drug to start in children with septicemia and suspected ESBL or carbapenemase-producing E. coli infection.
Antibiotic Susceptibility Pattern of Enterobacteriaceae Isolated from Raw Meat and Ghanaian Coin Currencies at Cape Coast Metropolis, Ghana: The Public Health Implication
Authors: Anning Alberta S. , Dugbatey Arnold A. , Kwakye-Nuako Godwin , Asare Kwame K.
Published: June 2019

Introduction:

The emergence and upsurge of Multiple Antibiotic Resistant (MDR) Enterobacteriaceae in the environment is a cause of concern as this can result in an outbreak and spread to healthcare settings. MDR Enterobacteriaceae have been associated with high morbidity and mortality due to delay in selecting and delivering active therapy in time.

Aims & Objectives:

The study was conducted to investigate the level of contamination of raw meat and Ghanaian coins in circulation at Cape Coast Metropolis. In all, 10 raw meat were sampled each from chevron and beef from Kotokuraba market, and 400 Ghanaian coin currencies retrieved from food vendors, students, transport operators and banks were used in this study.

Materials & Methods:

The Enterobacteriaceae species isolated were tested for their susceptibility to Ampicillin, Tetracycline (TET), Gentamicin (GEN), Cotrimoxazole (COT), Cefuroxime (CRX), Cefixime (CXM), Cefotaxime (CTX), Penicillin (PEN), Cloxacillin (CXC), Erythromycin (ERY) and Amikacin (AMK) antibiotics using Mueller-Hinton agar antibiotic diffusion technique. Of the isolated Enterobacteriaceae, 30% and 62% from chevron and beef respectively and 14.17%, 13.75% and 10.63% from food vendors, students and transport operators respectively showed resistance to some of the antibiotics tested.

Results & Discussion:

8.6% of the Escherichia coli (E. coli) isolated from chevon were resistant to CRXr-CHLr-AMPr-COTr-GEMr and 15.5% of CRXi-CHLi-AMPr-TETr-COTr from beef. 40.0% of E. coli isolated from coin currencies were resistant to CRXr-CHLr-AMPr-TETr-CTXr, 50.0% of Enterobacter spp to CRXr-CHLr-AMPr-TETr-CTXr, 16.67% of Proteus spp to CRXi-CHLi-AMPr-TETr-AMKi, 40% Pseudomonas spp to CRXr-AMPr-TETr-AMKi and 100% of Enterobacter spp to CRXr-AMPr-TETi-CTXr.

Conclusion:

The multidrug-resistant Enterobacteriaceae isolates from circulating Ghanaian coins and raw meats in the Cape Coast metropolis is an indication of an impending danger which requires immediate attention to prevent a possible outbreak and spread from the society to the hospital setting.
Construct Validity Of Rorschach Space Responses
Authors: Rosso Anna Maria , Camoirano Andrea
Published: June 2019

Background:

The diagnostic meaning of the Space response, a Rorschach variable, is far from established. Previous studies on Rorschach Space responses suggested that different figure-ground relationships, shown in the three subtypes of Space responses (Integration, Reversal, and Fusion), could indicate different psychological processes.

Objective:

The aim of the current study was to investigate the construct validity of Space responses in a nonclinical sample by exploring the association of the three different types of Space responses with (a) the observer-rated motor, emotional, and cognitive components of aggression; and (b) the direction and emotional regulation of aggression in socially frustrating situations.

Methods:

The Rorschach Inkblot Method and the Rosenzweig Picture-Frustration Study were administered to 151 volunteers from a nonclinical community sample. The Aggression Questionnaire was administered as an observer-rated version to the participants’ mothers. Correlation analyses were performed to investigate the associations between the three different Space responses, the scores reported on the Rosenzweig Picture-Frustration Study, and the observer-reported scores on the Aggression Questionnaire.

Conclusion:

This study offers support for differentiating the three types of mutually exclusive Space responses. Space reversal responses were found to be indicative of a propensity to direct aggression outward in the context of frustrating interpersonal situations, whereas Space fusion responses positively correlated with a greater amount of anger feelings and hostile thoughts associated with a deficit in anger and emotional regulation that may contribute to impair reality testing. As with previous studies, no association between S integration responses and anger or aggression was observed.
Nummular Contact Eczema: Presentation of a Pediatric Case
Authors: Bonamonte D , Filoni A , Gullo G , Vestita M
Published: June 2019

The etiopathogenesis of the nummular eczema is not fully known. Various causative factors have been proposed, and among these only a few studies investigate the relevance of contact allergy. Here, we present a case of nummular contact eczema in an 8-year-old allergic to perfumes. Since atopic dermatitis may also present with different clinical phenotypes, among which nummular eczema is quite frequent, the possible significant differences between non-atopic and atopic nummular diseases are considered. Based on the high incidence of contact sensitization in all cases of nummular eczema, it is recommended to perform patch tests for diagnostic-preventive purposes.
Structural Analysis of High-rise Buildings under Horizontal Loads: A Study on the Piedmont Region Headquarters Tower in Turin
Authors: Nitti Giuseppe , Lacidogna Giuseppe , Carpinteri Alberto
Published: June 2019

Background:

When a high-rise building is designed, the main aim is to limit transversal displacements. In addition, when vertical bracings, made up of thin open sections, are subjected to external torsion, warping and secondary torsional moment stresses arise which need to be evaluated using Vlasov’s Theory.

Objective:

This work analyzes the Piedmont Region Headquarters Tower, using an analytical formulation which enables the calculation of structural displacements and stresses.

Methods:

The analytical formulation used in the static and dynamic analysis of the structure was implemented using Matlab computation code. A computational model was also created using a commercial Finite Element Code to validate the results.

Results:

The results obtained with the analytical model were compared with those obtained with the FEM model. The transversal displacements, bending, torsional, and axial stresses in the vertical bracings were calculated, along with the principal natural frequencies of the structure.

Conclusion:

It has been proved that analytical calculation codes are a good tool for the preliminary design of a high-rise building. In particular, the proposed formulation, which has only three degrees of freedom per floor, provided results similar to those obtained using a FEM model. The great advantage of this analytical code is to speed up the computation time, which is proportional to the square of the degrees of freedom. In a FEM model, these have orders of magnitude greater than in the analytical model. Moreover, the proposed formulation allows the load distribution between the structural elements to be determined.
Association Between Endoscopic, Radiologic and Patient-reported Chronic Rhinosinusitis with Nasal Polyps
Authors: Luukkainen A. , Numminen J. , Rautiainen M. , Julkunen A. , Huhtala H. , Lampi J. , Markkola A. , Myller J. , Andiappan A.K. , Wang D.Y. , Toppila-Salmi S.
Published: June 2019

Objectives:

Chronic Rhinosinusitis without Nasal Polyps (CRSsNP) and with Nasal Polyps (CRSwNP) affect 10% and 1-4% of the general population respectively. Early detection and treatment of CRSwNP might prevent recalcitrant disease forms. The aim of this prospective controlled study was to evaluate association between endoscopic, radiologic, and self-reported CRSwNP, and a family history in defining CRSwNP.

Methods:

This study involved 73 CRS patients aged 18 years or over undergoing CRS-surgical consultation at the Tampere University Hospital. Data of sinus Computed Tomography (CT) scans and nasal endoscopy was obtained from patient records. Sixty controls ±allergic rhinitis underwent clinical examination. All subjects filled a questionnaire. Associations were analyzed by Chi square and adjusted regression models. The predictive performance of various parameters was assessed using the Area Under the Receiver Operating Characteristic curve (AUROC).

Results:

A total of 33% of CRSwNP patients reported not having Nasal Polyps (NPs), while 18% of CRSsNP patients reported having NPs (p < 0.001). Radiologic Nasal Polyp (NP) score differentiated CRSwNP from CRSsNP with an AUROC of 0.95 (95% CI 0.91-1.00). The AUROC value for Lund-Mackay (LM) score was 0.84 (0.75-0.94). Positive family history of NP did not differ significantly between CRS and control groups. Family history of allergy or asthma was given with certainty, whereas CRS patients had uncertainty of reporting NPs in family compared to controls (adjusted OR=6.02, 95% CI 1.98-18.30, p = 0.002).

Conclusion:

Our findings suggest that in situations where nasal endoscopy cannot be performed, early detection of CRSwNP could result from information obtained from sinus CT scans and patients, in comparison to family history which has lower predictive value. However validation studies with larger sample sizes are still needed.
Correlation of Some Trace Elements Serum Levels with Prostate Cancer Progression in Saudi Patients
Authors: Saleh Saleh A. K. , Adly Heba M. , A.Abdulkhaliq Altaf , M. Nassir Anmar
Published: June 2019

Background:

Trace elements, such as zinc, arsenic, cadmium and nickel are found naturally in the environment, and human exposure comes from a variety of sources, including air, drinking water, and food. Yet, there are a few studies of the association between trace element levels and prostate cancer in the country.

Objective:

This study aimed to investigate the changes in trace elements in prostate cancer patients with different levels of their prostate-specific antigen (PSA) values.

Methods:

The study included 58 patients with prostate cancer aged 70 years and older, divided into 3 different levels of PSA. Full history and clinical data were recorded for all subjects. Blood samples from all subjects and levels of Se, Zn, Cd and Cu were analyzed by inductively-coupled plasma mass spectrometry. The odds ratio of trace element levels was adjusted in accordance with socioeconomic data, family history and supplements intake.

Results:

Mean Se and Zn levels in serum were significantly low (p<0.05) in all prostate cancer patients. The levels of serum Se decreased by 56%, 67% and 70%, while the levels of serum Zn decreased by 35%, 41% and 47%, in subjects with PSA of 5-10 ng/ml, 11-20 ng/ml and > 20 ng/ml, respectively. Cu levels were increased significantly in prostate cancer patients, while Cd levels had no significant difference between control and prostate cancer groups.

Conclusion:

This study emphasizes the importance of minerals intake during prostate cancer management and follow-up period. This highlights the importance of trace elements Zn and Se intake as food supplements for prostate cancer patients.
Patient Alcohol Consumption and Knowledge of Safe Alcohol Use at Dr. George Mukhari Academic Hospital, Pretoria
Authors: Nashed Kamelia Kamel , Mabuza Langalibalele Honey
Published: June 2019

Background:

According to the World Health Organisation (WHO), there were 3.3 million deaths globally due to alcohol use in 2012. Establishing patients’ knowledge of safe alcohol use and practices regarding alcohol consumption could reform intervention policies.

Objectives:

The aim of this study was to assess patients’ knowledge of safe alcohol use and practices regarding alcohol consumption among patients attending the Family Practice Clinic at Dr. George Mukhari Academic Hospital (DGMAH) in Pretoria.

Methods:

The sample consisted of 300 patients (150 males; 150 females). Data relating to patients’ baseline characteristics, knowledge of safe alcohol use and practice were collected by means of a researcher administered questionnaire. The SAS, Release 9.3 was used for data analysis. The statistical level of significance was set at p < 0.05.

Results:

Majority of the respondents had lack of knowledge on safe quantities of alcohol use per day, for male and female individuals [268 (89.3%) vs 32 (10.7%); p < 0.0001] and [279 (93.0%) vs 21 (7.0%); p < 0.0001], respectively. Respondents mostly consumed alcohol on special occasions (152; 50.7%), and on weekends (100; 33.3%). Age groups ≥ 38 years consumed more alcohol per day (100; 33.3%). Majority of the respondents (179; 59.7%) were binge drinkers. Relatively less patients with higher levels of education were chronic harmful users of alcohol (p ≤ 0.001).

Conclusion:

The finding that majority of the patients lacked knowledge on safe quantities of alcohol use for males and females, and the unsafe use of alcohol, including binge drinking, warrant introduction of safe alcohol use awareness campaigns at primary health care, particularly targeting the middle aged and the elderly.
The Effect of Distraction with a Loved One’s Voice on Pain Reduction While Extracting the Chest Tube after Open Heart Surgery
Authors: Sheykhasadi Hakimeh , Abbaszadeh Abbas , Bonakdar Homira , Salmani Fatemeh , Tavan Asghar , Sedri Nadia
Published: June 2019

Background:

One of the forms of ost-operative care after open heart surgery is controlling the pain resulting from chest tube insertion. Management of pain is considered vital and requires the awareness of health care providers. One of the main responsibilities of nurses is to prepare patients for invasive procedures such as the removal of the chest tube. This study was designed to analyze the impact of a loved one’s voice for distraction in patients undergoing open heart surgery.

Methods:

This study was a clinical trial. The research sample was randomly selected from patients undergoing open heart surgery. In this study, the number of samples for each group was considered to be 64 people, where the total number of samples was 128 people. The data collection tools included Visual Analog Scale (VAS) assessment tool and a researcher-made questionnaire. After selecting the eligible samples and obtaining the informed consent, each patient was randomly assigned to one of the two groups (intervention group and control group). The pain was measured before, immediately, and 10 minutes after removing the chest tube.

Results:

The findings of this study indicated that the two groups had no statistically significant differences in pain before chest tube removal. The mean pain during chest tube removal and 10 minutes later in both groups indicated a significant difference based on Mann-Whitney test (P<0.001).

Conclusion:

This study showed that a loved one’s voice is effective in reducing pain during chest tube removal after open heart surgery.
Nieuw musea in de stad: Tussen kunst en kitsch
Authors: Van Aalst Irina
Published: June 2019

Veel steden hebben de laatste jaren geïnvesteerd in nieuwe of de uitbreiding van bestaande musea. De vraag dringt zich op welke motieven ten grondslag liggen aan de recente museumgolf. Zijn kunstinhoudelijke argumenten doorslaggevend of spelen plaatspromotie en stedelijk imago een belangrijke rol?