bluuebunny/crossref_metadata_2025 huggingface dataset:
ISSU KESALAHAN PEMBERIAN OBAT TERKAIT KESELAMATAN PASIEN DI RUMAH SAKIT
Authors: Sari Esty Purnama
Published: November 2020

Keselamatan pasien (patient safety) adalah isu global dan nasional bagi rumah sakit yang memandang bahwa keselamatan merupakan hak bagi pasien dalam menerima pelayanan kesehatan dan komponen dari manajemen mutu (Kemenkes RI, 2011). Mengurangi kejadian yang membahayakan bagi pasien merupakan masalah dalam pelayanan kesehatan bagi setiap orang, dan terdapat banyak hal yang harus dipelajari dan dibagi antara negara-negara maju dengan negara-negara berkembang dan negara dalam transisi/konflik tentang masalah keselamatan pasien (WHO Collaborating Centre, 2009). Insiden keselamatan pasien yang meliputi Kejadian Tidak Diharapkan (KTD), Kejadian Nyaris Cedera (KNC) akan sering terjadi dan akan berakibat pada terjadinya cedera, kerugian, kerusakan dan bahkan kematian pasien. Isu keselamatan pasien melahirkan paradigma baru tentang mutu pelayanan. Bentuk-bentuk kesalahan yang terjadi di rumah sakit seperti kesalahan dalam pelayanan atau pengobatan yang dikarenakan kesalahan dalam mengidentifikasi pasien dengan benar, kesalahan dalam pemberian obat dikarenakan Look-Alike Sound-Alike, serta metode penggunaan obat yang terbukti tidak efektif. Penggunaan berlebihan juga menjadi masalah mutu karena pengobatan tertentu diberikan tanpa mengindahkan bukti bahwa pengobatan tersebut tidak efektif atau bahkan berbahaya. (Sharon, 2017:66). Rumah sakit secara kolaboratif mengembangkan suatu kebijakan dan/atau prosedur untuk membuat daftar obat-obat yang perlu diwaspadai berdasarkan data yang ada di rumah sakit. Kebijakan dan/atau prosedur juga mengidentifikasi area mana saja yang membutuhkan elektrolit konsentrat, seperti di IGD atau kamar operasi serta pemberian label secara benar pada elektrolit dan bagaimana penyimpanannya di area tersebut, sehingga membatasi akses untuk mencegah pemberian yang tidak disengaja/kurang hati-hati (Kemenkes R.I, 2011)
LAPORAN HARIAN KKLP ANI HAMRIANI
Authors: Hamriani Ani
Published: November 2020

Kuliah Kerja Lapang Plus (KKLP) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian pada masyarakat yang dilakukan oleh mahasiswa dalam jangka waktu tertentu. Oleh karena, sifatnya intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program Strata Satu (S1) harus mengikuti KKLP.
PERAN PERAWAT DALAM PENERAPAN SASARAN KESELAMATAN PASIEN DI RUMAH SAKIT
Authors: Lubis Sharima Chairunnisa
Published: November 2020

Keselamatan Pasien adalah suatu sistem yang membuat asuhan pasien lebih aman, meliputi asesmen risiko, identifikasi dan pengelolaan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya, serta implementasi solusi untuk meminimalkan timbulnya risiko. Tujuan dari tulisan ini ditujukan untuk perawat agar mampu mengimplementasikan sasaran keselamatan pasien terutama di Rumah Sakit. Penulisan ini dibuat menggunakan metode Literature Review , yang diambil dari beberapa jurnal serta e-book. Hasil dari tulisan ini diharapkan dapat menjadi acuan perawat dalam menerapkan sasaran keselamatan pasien di RS.
Proses Tahapan Pengambilan Keputusan Oleh Perawat Di Rumah Sakit
Authors: Zega Putri Meiyarny
Published: November 2020

Pengambilan keputusan dapat dianggap sebagai suatu hasil atau keluaran dari proses mental atau kognitif yang membawa pada pemilihan suatu jalur tindakan di antara beberapa alternatif yang tersedia. Setiap proses pengambilan keputusan selalu menghasilkan satu pilihan final. Keputusan dibuat untuk mencapai tujuan melalui pelaksanaan atau tindakan. Seorang perawat harus mempunyai keberanian untuk mengambil keputusan dan memikul tanggung jawab atas akibat dari resiko yang timbul sebagai konsekuensi dari keputusan yang telah diambilnya. Pada hakekatnya, pengambilan keputusan adalah suatu pendekatan yang sistematis terhadap hakekat suatu masalah yang difokuskan untuk memecahkan masalah secepatnya dimana individu harus memiliki kemampuan berfikir kritis dengan menggunakan pendidikan dan pengalaman yang berharga yang cukup efektif dalam pemecahan masalah.
Jurnal Harian Minggu 2 Samsinar
Authors: Samsinar
Published: November 2020

Kuliah Kerja Lapang Plus (KKLP) merupakan suatu kegiatan perkuliahan yang bersifat intrakurikuler dalam bentuk pengabdian kepada masyarakat selama waktu tertentu.Oleh karena sifatnya yang intrakurikuler sehingga setiap mahasiswa yang akan menyelesaikan studi di perguruan tinggi pada suatu program strata satu (S1) harus mengikuti KKLP.
faktor" yang mempengaruhi standar diagnosa keperawatan
Authors: Sitompul Samuel Pangihutan
Published: November 2020

Diagnosiskeperawatanmerupakanpenilaianklinisterhadappengalamanatauresponindividu,keluarga,dankomunitaspadamasalahkesehatanpadaresikomasalahkesehatanataupadaproseskehidupan.Diagnosiskeperawatanmerupakanbagianvitaldalammenentukanasuhankeperawatanyangsesuaiuntukmembantuklienmencapaikesehatanyangoptimal.Mengingatpentingnyadiagnosiskeperawatandalammemberianasuhankeperawatan,makadibutuhkanstandardiagnosiskeperawatanyangdapatditerapkandiindonesia.
Laporan KKLP allu' tarowang ismawati
Authors: Ismawati
Published: November 2020

Kuliah kerja lapang plus merupakan program studi yang dilakukan mahasiswa setiap semester 7 untuk melaksanakan tugas sebagai mahasiswa
News Sharing on Social Media: Mapping the Ideology of News Media, Politicians, and the Mass Public
Authors: Eady Gregory , Bonneau Richard , Tucker Joshua A , Nagler Jonathan
Published: November 2020

This article examines the information sharing behavior of US politicians and the mass public by mapping the ideological sharing space of political news on social media. As data, we use the near-universal currency of online information exchange: web links. We introduce a methodological approach and statistical software to unify the measurement of ideology on social media platforms by using sharing data to jointly estimate the ideology of news media organizations, politicians, and the mass public. Empirically, we investigate the electoral incentives that members of Congress have to share ideologically polarizing information online. We show that the more competitive an election is, the less likely politicians are to share ideologically polarizing information. This finding has important implications for our understanding of the role of election pressures as constraints on sharing behavior in our highly polarized information ecosystem.
Peran Perawat dalam Penerapan Sasaran Keselamatan Pasien di Rumah Sakit
Authors: Asyla Jihan
Published: November 2020

AbstrakPenerapan keselamatan pasien dapat diwujudkan dengan menetapkan standar, sasaran dan langkah menuju keselamatan pasien dengan tujuan akhir yaitu memberikan asuhan pasien yang lebih aman. Upaya keselamatan pasien merupakan bagian tak terpisahkan dari proses asuhan keperawatan. Keselamatan pasien (patient safety) adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman, mencegah terjadinya cidera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil
Pembuatan batas kelurahan
Authors: hastuti
Published: November 2020

Kuliah kerja lapang plus adalah salah satu kegiatan perkuliahan yang wajib dilaksanakan oleh mahasiswa dal jangka waktu tertentu
PENTINGNYA PERENCANAAN KEPERAWATAN DALAM PEMBERIAN ASUHAN KEPERAWATAN
Authors: Barus Clara Vincensia br
Published: November 2020

Setiap organisasi perlu melakukan suatu perencanaan dalam setiap kegiatan organisasina, baik perencanaan produksi, perencanaan rekrutmen karyawan, baru, program penjualan produk baru, maupun perencanaan anggarannya. Perencanaan (Planning) merupakan proses dasar bagi organisasi untuk memilih sasaran dan menetapkan bagaimana cara mencapainya. Oleh karena itu, organisasi harus menetapkan tujuan dan sasaran yang hendak dicapai sebelum melakukan proses perencanaan. Perencanaan diperlukan dan terjadi dalam bentuk organisasi, sebab perencanaan ini merupakan proses dasar manajemen di dalam mengambil suatu keputusan atau tindakan. Perencanaan diperlukan dalam jenis kegiatan baik kegiatan organisasi, perusahaan meupun kegiatan di masyarakat, dan perencanaan ada dalam setiap fungsi-fungsi manajemen, karena fungsi-fungsi tersebut hanya dapat melaksanakan keputusan-keputusan yang telah ditetapkan dalam perencanaan, Perencanaan merupakan tahapan paling pentingdari suatu fungsi manajemen, terutama dalam menghadapi lingkungan eksternal yang berubah dinamis. Dalam era globalisasi ini, perencanaan harus lebih mengandalkan prosedur yang rasional dan sistematis dan bukan hanya pada intuisi dan firasat (dugaan). Sama halnya dalam pemberian asuhan keperawatan. Perencanaan keperawata termasuk dalam proses dlam pemberian asuhan keperwatan oleh perawat kepada klien/pasien. Perencanaan Keperawatan merupakan suatu proses penyusunan berbagai intervensi keperawatan yang dibutuhkan untuk mencegah, menurunkan, atau mengurangi masalah-masalah klien. Perencanaan ini merupakan langkah ketiga dalam membuat suatu proses keperawatan. Perencanaan adalah merupakan bagian dari fase pengorganisasian dalam proses keperawatan sebagai pedoman untuk mengarahkan tindakan keperawatan dalam usaha membantu, meringankan, memecahkan masalah atau untuk memenuhi kebutuhan klien.Suatu perencanaan yang tertulis dengan baik akan memberi petunjuk dan arti pada asuhan keperawatan karena perencanaan adalah sumber informasi bagi semua yang terlibat dalam asuhan keperawatan klien. Perencanaan merupakan suatu petunjuk tertulis yang menggambarkan secara tepat rencana tindakan keperawatan yang dilakukan terhadap klien sesuai dengan kebutuhannya berdasarkan diagnosis keperawatan.
Gagasan Teknokratik Pembangunan Keagamaan
Authors: Murtadlo Muhamad
Published: November 2020

Menteri Perencanaan Pembangunan Nasional telah mengeluarkan peraturan No. 5 tahun 2019 yang menghendaki penyusunan rancangan pembangunan semua kementerian dan lembaga negara ke depan menggunakan pendekatan teknokratik. Tuntutan ini harus diterjemahkan dalam dokumen renstra 2020-2024, permasalahannya bagaimana rancangan teknokratik itu diterjemahkan dalam pembangunan bidang keagamaan. Tulisan ini mencoba memaknai secara positif dari pendekatan teknokratik ini, didasarkan pertimbangan bahwa pemerintah wajib melakukan pembangunan yang terukur keberhasilannya. Tuntutan keterukuran pembangunan juga berlaku di bidang keagamaan. Tulisan ini merekomendasi pengukuran di bidang pembangunan budi pekerti (karakter); pengukuran di bidang moderasi beragama dan pengukuran peran agama dalam meningkatkan daya saing bangsa.
UPAYA MENINGKATKAN PENGETAHUAN PERAWAT DALAM PERENCANAAN KEPERAWATAN
Authors: Lubis Sharima Chairunnisa
Published: November 2020

Perencanaan keperawatan merupakan suatu aspek yang penting dalam proses keperawatan. Perencanaan keperawatan adalah bagian dari fase pengorganisasian dalam proses keperawatan sebagai pedoman untuk mengarahkan tindakan keperawatan, oleh sebab itu sebagai seorang perawat, hal ini tidak boleh diabaikan. Tulisan ini dibuat untuk meningkatkan pengetahuan tenaga kesehatan terutama perawat untuk meningkatkan pengetahuan dalam perencanaan keperawatan dengan baik. Tulisan ini menggunakan metode literature review yang diambil dari beberapa sumber yaitu jurnal . Dengan dibuatnya tulisan ini, diharapkan semua tenaga kerja kesehatan di Rumah Sakit dapat mengaplikasikan pengetahuannya dengan baik.
Jurnal Harian/Mingguan KKLP Yuliana 9173770410408
Authors: Yuliana
Published: November 2020

Kuliah Kerja Lapangan Pengganti (KKLP) adalah Kegiatan akademik sebagai pengganti matakuliah Kuliah Kerja Lapangan (KKLP) yang dilaksanakan oleh kelompok mahasiswa berupa penyusunan laporan hasil review dari satu atau beberapa bidang pekerjaan industri/ instansi atau menghasilkan suatu karya baik berupa alat atau hasil.
PERSEPSI RESIKO DAN KEMUNGKINAN HAZARD PSIKOLOGIS BAGI SEORANG PERAWAT
Authors: Imanda Ihdina
Published: November 2020

AbstrakPengertian “sehat” senantiasa digambarkan suatu kondisi fisik, mental dan sosial seseorang yang tidak saja bebas dari penyakit atau gangguam kesehatan melainkan juga menunjukkan kemampuan seseorang untuk berinteraksi dengan lingkungan dan pekerjaannya. Kesehatan kerja bertujuan untuk promosi dan pemeliharaan tingkat tertinggi kesehatan fisik, mental dan sosial dari pekerjaan dalam berbagai jenis pekerjaan, mencegah penyakit yang diakibatkan dari kondisi pekerjaan mereka ditempat kerja dari risiko yang diakibatkan faktor-faktor yang mengganggu kesehatan; menempatkan dan memelihara lingkungan pekerjaan pekerja baik kemampuan fisiologis maupun psikologis pekerja dan menerapkannya kepada pekerja disetiap pekerjaannnya. Menurut A.M. Sugeng Budiono, dalam artikelnya “hazards” yang sering disebut potensi bahaya merupakan sumber resiko yang potensial mengakibatkan kerugian baik material, lingkungan maupun manusia.
Pengambilan Keputusan Dalam Asuhan Keperawatan
Authors: Sabrina Adelia
Published: November 2020

Proses pengambilan keputusan merupakan sebuah refleksi dari perawat ataupun klien, pengambilan keputusan klinis keperawatan harus ada interaksi antara perawat-klien, pengambilan keputusan klinis keperawatan dapat dilakukan dalam setiap proses keperawatan, tugas perawat pada saat proses pengambilan keputusan ini adalah sebagai fasilitator untuk memberikan fasilitas dan dukungan pada klien, pengambilan keputusan klinis dengan melibatkan klien akan meningkatkan tingkat kemandirian bagi klien, pengambilan keputusan klinis diperlukan kemampuan berpikir kritis bagi perawat
Tren dan Isu Keselamatan Pasien
Authors: Zebua Mega Ceria Purnama
Published: November 2020

Latar Belakang: Latar belakang penelitian ini adalah bahwa setiap tindakan medis menyimpan potensi resiko. Keselamatan pasien menjadi isu yang sangat disukai oleh khalayak umum. Karena keselamatan pasien salah satu indikator penilaian terhadap suatu rumah sakit.
Pentingnya Kelengkapan dan Keakuratan Dokumentasi Keperawatan Beserta Manfaatnya
Authors: Azhari Raihanah
Published: November 2020

Pentingnya Kelengkapan dan Keakuratan Dokumentasi Keperawatan Beserta Manfaatnya
Dampak Sektor Pariwisata bagi Perekonomian Indonesia
Authors: Ihsan Fauzan Saiful
Published: November 2020

Salah satu penyumbang devisa negara terbesar di Indonesia adalah dari sektor pariwisata. Selain itu sektor ini memiliki dampak langsung bagi masyarakat yang terlibat dalam kegiatan pariwisata dengan harapan dapat mewujudkan current account deficit semakin menurun dan meningkatkan lapangan kerja serta menggerakkan usaha mikro, kecil, dan menengah (UMKM).
ZOOSEMIOTICS
Authors: JISH ELS
Published: November 2020

Language is the medium to communicate with others. Rahman stated in his journal article that “Literature as an identity is referred to as ethno-literature.” (Rahman, 2020). In another article Rahman stated that “Literature is a source of learning and entertainment for readers.” (Rahman, Amir P., & Tammasse, 2019). The impact of communication is very important. Sahib in her journal article stated that “The desire and effort to improve forestry has not shown a delightful or wonderful result.” (Sahib, Rahman, Duli, & Asba, 2019). The point is how to put attention to nature
turnamen takraw
Authors: Jumrawatimuhktar
Published: November 2020

AlasanDiadakannyaagar pemuda danmasyarakat setempatkedepannya bersifatpositifdengan olahragadenganMotoNarkobaNOOlahragaYESdanjunjungtinggi sportifitasberolahraga.
PENGANTAR PROSES KEPERAWATAN
Authors: intan
Published: November 2020

Latar BelakangPerawatan adalah sesuatu yang esensial dan sangat penting yang diberikan oleh perawat terhadap individu, keluarga dan masyarakat yang bertujuan untuk menyelesaikan masalah dan memenuhi kebutuhan pasien. Pelayanan yang diberikan adalah upaya untuk meningkatkan derajat kesehatan semaksimal mungkin sesuai dengan kemampuan yang dimiliki dalam menjalankan kegiatan promotif, kuratif, preventif dan rehabilitatif dengan menggunakan proses keperwatan. Layanan asuhan keperawatan dilaksanakan oleh tenaga keperawatan yang bekerja sama dengan tenaga kesehatan lainnya dalasm mencapai kesehatan yang optimal ( Effendy, 1995). Perawat sebagai profesi yang memiliki hubungan lebuh dekat dengan pasien dalam pemenuhan kebuthannya, dibutuhkan suatu pendekatan dengan metode ilmiah dan sistematis sehingga mempermudah pemecahan masalah pasien. Metode tersebut adalah proses keperawatan (Haryanto, 2008).
Rebutting Pedro J. Silva’s article in Biophysical Chemistry supporting Mitchell-Boyer’s ideas on bioenergetics and advocating murburn concept as a viable explanation for aerobic respiration and oxygenic photosynthesis
Authors: Manoj Kelath Murali
Published: November 2020

Over the last three years, I had pointed out the untenable nature of the proton-centric ‘chemiosmosis driven rotary ATP-synthesis (CRAS)’ explanation for Oxidative Phosphorylation (OxPhos). Recently, Pedro J. Silva (PJS) [Chemiosmotic misunderstandings (2020). Biophys. Chem. 264, 106424] afforded a part of our work his critical attention, but overlooked the large volume of evidence against CRAS and supporting the oxygen-centric murburn mechanism of OxPhos. In his article, PJS also posed some queries on our bioenergetics model. When I offered my rebuttal, the Editor of Biophysical Chemistry refused to publish it. Therefore, I have no other option than to publish the rebuttal as a preprint. Herein, I demonstrate the flaws and lacunae in PJS’s defense of CRAS hypothesis and answer his specific queries and defend the murburn explanation of mOxPhos. The current scientific discourse is crucial for correcting major historical errors in mitochondrial physiology and understanding oxygen’s crucial role in the powering chemistry of life.
Upaya perawat dalam melaksanakan diagnosa keperawatan
Authors: Gulo Nadya Duta Haga
Published: November 2020

Diagnosa keperawatan adalah penilaian klinik tentang respons individu, keluarga, atau komunitas terhadap masalah kesehatan/proses kehidupan yang aktual atau potensial. Diagnosa keperawatan memberikan dasar untuk pemilihan inter vensi keperawatan untuk mencapai hasil yang merupakan tanggung jawab perawat (Disetujui oleh anggota North Nursing Association (NANDA), Konferensi IX, Maret 1990), Perumusan diagnosa keperawatan meliputi beberapakomponen penting, yaitu: Problem (P), Etiologi (E), Sign dan symptom (5). Seorang perawat pada saat merumuskan diagnosa keperawatan didasarkan pada masalah yang dialami klien. Problem atau masalah merupakan gambaran dari keadaan klien agar perawat secara tepat dapat memberikan tindakan keperawatan.
Research Ethics Beyond the IRB: Selection Bias and the Direction of Innovation in Applied Economics
Authors: Michler Jeffrey D , Masters William A. , Josephson Anna
Published: November 2020

Principles for ethical behavior in the context of research are codified into rules that may change over time to meet peoples’ needs in specific institutions, including universities and professional associations. This paper aims to spark discussion about a set of ethical choices beyond those addressed by an IRB or recent association policy statements. Our specific focus is topic selection, and the role of researchers’ interests and incentives in determining the kinds of research that we do. Using the principle of induced innovation, we show how changing incentives can influence the direction of research effort and thereby affect the kinds of policies or technologies that are supported by available evidence. With this paper, we hope to generate discussion among applied economists about selection bias in research, and how we can use insights from economics itself to guide topic selection.
Motivations to decrease and cease substance use in third-level students: A scoping review.
Authors: whelan eadaoin , Dockray Samantha , Dick Samantha , Davoren Martin , Heavin Ciara , Linehan Conor , Byrne Michael
Published: November 2020

Background: Illicit substance use by third-level students is associated with depressive symptoms, health risk, relationship strain, and legal ramifications. Prevention and intervention programmes have often been grounded in information exchange, aimed at education of students about the associated risks. However, these interventions produce only small to moderate effect sizes in promoting reduction or cessation of substance use in third-level students. Understanding what motivates third-level students to change their substance use behaviour is essential in the planning of effective behaviour change programmes. The aim of this scoping review was to determine factors that relate to student motivations to reduce or stop their illicit use of substances, and to increase understanding of the factors that may be pertinent in behaviour change interventions for substance use in this population. Method: We searched 8 databases in August 2018 using search terms based on ‘students’, ‘illicit substance use’, and ‘motivations’. We identified 86 research articles that reported on third-level students’ illicit substance use, and included reasons or motives for their usage. Results: After full-text screening, only three studies were eligible for inclusion in the qualitative synthesis. The majority of studies were excluded as they described motives for abstention, but did not describe motivation for reducing or stopping current patterns of use of illicit substances. Conclusion: Few efforts have been made to identify motivations of third-level students to decrease or cease substance use. Promising avenues for future research on motivations to change in relation to substance use include the social contextual factors, perceptions of effects on social relationships, and actions of friends and family members to prompt contemplations of change.
A year in the social life of a teenager: Within-person fluctuations in stress, phone communication, and anxiety and depression
Authors: Rodman Alexandra M , Vidal Bustamante Constanza M. , Dennison Meg , Flournoy John Coleman , Coppersmith Daniel D.L. , Nook Erik C , Worthington Steven , Mair Patrick , McLaughlin Katie A
Published: November 2020

Stressful life events (SLEs) are strongly associated with the emergence of adolescent anxiety and depression, but the underlying mechanisms remain poorly understood, especially at the within-person level. We investigated how adolescent social communication (i.e., frequency of calls and texts) following SLEs relates to changes in internalizing symptoms in a multi-timescale intensive year-long study (N=30; n=355 monthly observations; n=~5,000 experience-sampling observations). Within-person increases in SLEs were associated with receiving more calls than usual at both monthly- and momentary-levels, and making more calls at the monthly-level. Increased calls were prospectively associated with worsening internalizing symptoms at the monthly-level only, suggesting that SLEs rapidly influences phone communication patterns, but these communication changes may have a more protracted, cumulative influence on internalizing symptoms. Finally, increased incoming calls prospectively mediated the association between SLEs and anxiety at the monthly-level. We identify adolescent social communication fluctuations as a potential mechanism conferring risk for stress-related internalizing psychopathology.
Association of coping strategies with mental health trajectories during the first twenty-one weeks of COVID-19 lockdown
Authors: Fluharty Meg , Bu Feifei , Steptoe Andrew , Fancourt Daisy
Published: November 2020

The negative impact of the COVID-19 pandemic on mental health is well evidenced. However, there is little research on how individuals’ coping strategies during the pandemic were related to changes in mental health over time. The current study used data from the COVID-19 Social Study (N=26,505) to explore whether particular coping strategies (problem-focused, emotion-focused, avoidant, and supportive) were associated with (i) better mental health as lockdown was introduced, and (ii) faster recovery from symptoms across 21 weeks. People with greater use of problem-focused, avoidant, and supportive coping displayed more mental health symptoms, while greater use of emotion-focused coping was associated with fewer mental health symptoms. Symptoms decreased over time for all coping strategies, but only supportive coping was associated with a faster decrease in anxiety and depressive symptoms, indicating a potential protective effect of social support on psychological distress.
Treatment Utility of Clinical Assessment
Authors: Hopwood Christopher James , Kamphuis Jan Henk , Noordhof Arjen
Published: November 2020

The extent to which clinical assessment enhances subsequent treatment benefits for patients has long been controversial, and we suggest specifying and examining more closely the conditions by which assessment can – or cannot - contribute to treatment process and ultimately patient benefit. We argue that this can contribute to more informative research on this very important question, and provide illustrative examples from clinical assessment practice.
The Mediterranean World and the ‘Turk’ in Shakespeare’s Representation of the British Empire
Authors: HALIL Houria , Riche Bouteldja
Published: November 2020

This research explores Shakespeare’s representation of the so-called British Empire in its contact with other jostling empires, most notably the Ottoman Empire in the Mediterranean. To this end, four of Shakespeare’s Mediterranean plays Othello, the Moor of Venice (1603), The Merchant of Venice (1596), The Tempest (1611), and Cymbeline (1611) are taken understudy. By considering the Postcolonial historicist approach developed by literary scholars such as Stephen Greenblatt and Edward Said, the research argues that the issues of imperial relationships in Shakespeare are not solely centered on the transatlantic colony of Virginia, but it was also extended to the Mediterranean basin. The latter, during Tudor England and, later, Stuart Britain had much more trade and diplomatic activity than on the Atlantic seaboard. This economic activity created a cosmopolitan zone of contact wherein people of the Orient elbowed people from the West. This encounter gave rise to a pre-modern form of Orientalism, which is reflected in Shakespeare’s celebration of marital-cum-political endogamous relationships in his four plays mentioned earlier.
Junto Diaz’s The Brief Wondrous Life of Oscar Wao: A Narrative of Identity and Diaspora
Authors: Almutairi Samirah
Published: November 2020

Junto Diaz’s novel The Brief Wondrous Life of Oscar Wao raises the question of the identity formation for the Caribbean in diaspora. Diasporic Caribbean people struggle with understanding their difference and recognizing the important of assimilating to other people’s lives and cultures when they leave their home country. The struggle of the main character, Oscar Wao, in the novel is established perfectly well through apparent identity crisis that is manifested in his cultural displacements, childhood memories, real-life situations, and unsuccessful relationship with the other sex. It is a problem that Oscar creates his passage towards constructing a national identity, which ends in a tragic death. Caribbean people should privilege a hybrid identify if they want to live outside the West Indies. The present article aims to analyze from a postcolonial perspective Oscar’s futile search for national identity in diaspora and its consequences. This is clarified through a discussion of migration, the results of living in diaspora on the identity formation for the main character, relationships with women, and the concept of a return to the homeland.
Challenges faced by dental professionals during COVID-19- A cross sectional survey
Authors: Gupta Swati , Hrishi Thayyil Sivaraman , Gupta Sumeet , Kumar Sanjana , Javadi Hamid , Gupta Richa
Published: November 2020

Background: At the time of pandemics like COVID-19, dental professionals being one of the frontline workers must face a lot of challenges in workplace bringing about a lot of anxiety and stress. The purpose of this survey was to assess the physiological well-being of the dental professionals, the majority of challenges faced by them, , how they are dealing with it and what changes in their opinion could be implemented to be prepared in the wake of any future adversity.

Methodology: We conducted a cross sectional survey via an online questionnaire that was sent to dentists in 4 different countries- India, US, UK, and Iran. The questionnaire comprised of closed ended questions grouped in broad categories of demographics, physiological well-being of dentists, Changes in dental practice during COVID-19 and Changes to be implemented post Covid-19. Descriptive analysis was performed to summarize the data with SPSS-19 software.

Results: A total of 312 dentists (181 Males and 131 Females) from four countries responded to the study. Most of them (56.4 %) were in the age group of 30 to 40 years, 27.9 % in 25- 30 years, and 7.1% above 50 years. 47.5% dentists reported suffering from stress and anxiety due to the shutting down of their private dental practices. 72.5% dentists reported that they are worried about the operational and financial challenges to run their practice during Covid-19. 60% of the dentists had concerns due to the shortage of personal protective equipment. Most of the dental professionals (73.9%) are of the opinion that management of medical emergencies should be included in the dental curriculum, so that dentists can volunteer their services at the time of crisis and also can be well-prepared to take care of their patients.

Conclusion: During the COVID-19 pandemic, dentists like medical professionals must face a lot of ethical and moral dilemma along with dealing with the operational challenges. The present study draws our attention to the fact that despite having faced pandemics like SARS, health professions like dentistry still need a lot of preparedness and requires modifications to face any such challenges in future.
COVID-19: Is herd immunity the answer?
Authors: Robinson Jared , Banerjee Indrajit , Sathian Brijesh
Published: November 2020

The current global figures of COVID-19 is still rising. Many countries have enforced lockdowns to safeguard its citizens, however in most cases this has been to the dire detriment of the economy. Most leaders and governments have been holding out and looking to the development of a vaccine to be the answer to this COVID-19 pandemic, however at this point in time and for the foreseeable future a viable and widely available vaccine is not likely to be developed. In juxtaposition to the conventional methods countries such as Singapore, Israel, Iceland, Portugal, The Netherlands, Sweden, Hong Kong, Japan, South Korea, Indonesia, Taiwan and Turkey have adopted the concept of herd immunity. It is there for poignant and of the upmost importance that an alternate stratagem is developed and exercised to best facilitate the re-ignition of the country’s economy as well to best protect its citizens from the virus. Models such as herd immunity or a model based thereon are the most logical solution to attain this goal.

At this time in the development of the global COVID-19 pandemic it is too early to conclude as to whether a fully-fledged lockdown is more effective and useful than the establishment of herd immunity. In order to achieve the goal of safeguarding the lives of a countries citizens as well as its economy, a mixed method of lockdown and herd immunity is advised. Individuals who are economically active and less susceptible to the virus should adopt the herd immunity model, whereas those who are elderly with concomitant comorbidities should exercise self-isolation and follow the lockdown model. The application of using both models simultaneously, will both capitalize on the advantages of either and negate the drawbacks thereof. This ultimately decreasing the loss of lives whilst still inducing a degree of herd immunity within the general populous.
PENGARUH MEDIA CERITA BERGAMBAR TERHADAP KEMAMPUAN LITERASI AWAL ANAK USIA 4-5 TAHUN
Authors: Farodhy Thea Yesika , Utami Novianti Retno
Published: November 2020

Media cerita bergambar adalah perpaduan antara media cerita dan media gambar yang berkaitan dengan cerita yang disajikan, sehingga perpaduan dari media cerita dan gambar dapat menjadi satu kesatuan yang saling mendukung. Tujuan dari penelitian ini yaitu untuk menguji pengaruh media cerita bergambar terhadap literasi awal anak usia 4-5 tahun. Hipotesis yang diajukan yaitu media cerita bergambar efektif dalam meningkatkan kemampuan literasi awal anak usia 4-5 tahun. Metode yang digunakan  dalam penelitian ini yaitu metode penelitian quasi experiment, the one group pretest-posttest design. Subyek dalam penelitian ini adalah 19 anak usia 4-5 tahun di BA Aisyiyah Banyudono 1. Teknik pengumpulan data dalam penelitian ini menggunakan tes literasi awal anak menggunakan instrumen Get Ready To Read. Teknik analisis data dalam penelitian ini menggunakan Uji Wilcoxon untuk melihat tingkat signifikansi hasil literasi awal anak sebelum dan sesudah dilakukan perlakuan. Hasil penelitian menunjukkan asymp.sig. (2 tailed) 0,000. Nilai sig 0,000 > 0,05 maka media cerita bergambar efektif dalam meningkatkan kemampuan literasi awal anak usia 4-5 tahun
Application of an Evaluation Framework for Extra-Organizational Communities of Practice: Assessment and Refinement
Authors: McKellar Kaileah A. , Berta Whitney , Cockerill Rhonda , Cole Donald C. , Saint-Charles Johanne
Published: November 2020

Abstract: Communities of practice (CoPs) are groups of people who work together on an ongoing basis and share knowledge and expertise. CoPs exist both within and outside of organizations, although extra-organizational CoPs have received less evaluation attention. The primary objective of this study was to assess the applicability of a multi-level, multiple-value evaluation framework for extra-organizational CoPs. Qualitative interviews were conducted with an extra-organizational CoP—the Canadian Community of Practice in Ecosystems Approaches to Health (CoPEH-Canada). The evaluation framework oriented both the member interview guide and the deductive content analysis. The findings showed that the evaluation framework was sufficiently comprehensive to capture the values generated. Following reflection on these findings, challenges in its application and suggested revisions to the framework are provided; also discussed are limitations and strengths, evaluation research next steps, and the opportunities for future applications.
Antidiabetic Efficacy of Nigella sativa Linn. in Alloxan-induced Diabetic Rabbits
Authors: F Ikram , F Hussain
Published: November 2020

Introduction: Diabetes mellitus (DM) is the most common metabolic disease worldwide. Multiple medications and side effects, the most significant and prevalent themes in diabetes mellitus ultimately determine novel directions and avenues in drug discovery. The present study was conducted to investigate antidiabetic efficacy of extracts of Nigella sativa Linn. seeds (NS). Methods: Alloxan-induced diabetic rabbits (n = 28) were divided into four groups, including diabetic control. Two groups were treated with NS methanol (NSM) and ethanol (NSE) extracts, and one group were given glibenclamide. Serum glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were measured by kit methods. Results: NS demonstrated hypoglycaemic and hypolipidaemic activities. Although NS treatments decreased blood glucose, TC, TG and LDL-C and increased HDL-C in diabetic groups, it was unable to normalize all the parameters. NS extracts did not regenerate β-cells of islet of the pancreas. Glibenclamide showed significant (P<0.05) decline in hyperglycaemia and hyperlipidaemia as well as prominent renewal of β-cells of islets of Langerhans. Few surviving beta cells of islet of the pancreas were apparent in NSM treated group. Standard drug glibenclamide showed a significant decline in hyperglycaemia and hyperlipidaemia as well as prominent renewal of beta cells. Conclusion: N. sativa L. extracts have curative effects in terms of diabetes-induced disturbances of glucose and lipids. Further investigations are suggested to ascertain the therapeutic role of NS on islet histopathology in diabetes mellitus.
A pilot study of the primary care management of knee osteoarthritis in the Northern States of Malaysia
Authors: A Arshad , R Rashid
Published: November 2020

Introduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA.
Knowledge, attitude and practice on breastfeeding in Klang, Malaysia
Authors: KL Tan
Published: November 2020

Introduction: In Klang, a district in the state of Selangor in Peninsular Malaysia, the effects of westernization and urbanization in recent years have had an impact on infant feeding. The objective of this study was to evaluate the practice, knowledge and attitude to breastfeeding and to assess factors associated with breastfeeding among women in Klang, Malaysia. Materials & Methods: A cross-sectional study was carried out between June and October 2006 involving 220 women with infants aged six months from two randomly selected health clinics were selected and interviewed. Data on socio-demographic, infant factors, infant feeding in the first six months of life, knowledge and attitude towards breastfeeding were collected. Results: Exclusive breastfeeding was reported by 32.8%, mixed feeding was reported by 14.5% and infant formula feeding was reported by 52.7% of the respondents. Chinese women were more likely not to practice exclusive breastfeeding compared to Malay women (odds ratio 18.27, 95% CI: 3.95, 84.54) while working women were more likely not to practice exclusive breastfeeding compared to non working women (odds ratio 3.75, 95% CI: 1.64, 8.55). Positive association with not exclusive breastfeeding included women with high household income and women with male infants. Malaysian women had a positive attitude but work place and short maternity leave had a negative impact on breastfeeding. Conclusion: Women of Chinese ethnicity, working, from high family income and with male infants were less likely to exclusively breastfeed. Adopting facilitatory measures at hospitals and work place could increase the rate of exclusive breastfeeding.
Giant Intracranial Aneurysmal bone cyst: Case Report and literature Review
Authors: Vargas Alejandro
Published: November 2020

We present the case of a 13-year-old male patient with a two-month clinical picture of global headache and progressive decrease in visual acuity. Neuroimaging showed a well-defined giant left frontal lesion, hypointense in T1, with heterogenous signal in T2 and intense enhancement after gadolinium. The patient was treated with surgical resection and the lesion confirmed pathologically as Cavernous Hemangioma with focal component of aneurysmal bone cyst. The aneurysmal bone cyst is a benign lesion of rapid growth and very destructive, which commonly occurs in metaphysics of long bones or axial skeleton, requiring radical treatment. It was first described in 1942, as an injury that occurred mostly in people under 20 years of age with a peak between 12 and 13 years, but very rarely occurs in the head and neck, mostly involving the occipital bone. The case is presented below together with a review on the subject of Aneurysmal Bone Cyst, through databases such as EMBASE, PubMed and COCHRANE, selecting 70 articles that covered relevant aspects of its physiopathology, clinical and radiological manifestations and surgical approach.
The Voluntary Nature of Ethical-Moral Behavior in the 21st Century (Or In Any Other): A Personal Perspective
Authors: Spears Tom
Published: November 2020

Increasingly in the modern research world there are questions raised about actions taken by academics who do now have full control of their choice of action. In the laboratory setting, graduate students, postdoctoral fellows and even junior professors are often compelled to follow courses of action that are determined by their supervisors or senior members of their departments. So the question of moral determinism derives from the more fundamental question of what actions are voluntary, and to what degree — a question that has informed the thought of philosophers as far back as Aquinas and Duns Scotus. What follows is a personal reflection on currents in this line of inquiry.
Hyper Eosinophilia and Dementia
Authors: Cusack Paul T E
Published: November 2020

In this brief paper, we consider how the Herpes Virus could possibly be the culprit when the body responds to a latent infection causing dementia. The over production of white blood cells passing through he Blood-Brain- Barrier leads to death of nerve cells. This is the path toward dementia.
The Ethics of Pricing and Access to Healthcare: A Social Justice Issue
Authors: Boudreau Richard
Published: November 2020

In most countries in the developed world, healthcare is considered a right, not a privilege. Access to appropriate medical services, including pharmaceuticals, is viewed as a natural part of the commitment of the government to its people.
Polypharmacy: volume or value, quantity or quality? The high quantity originates low quality. There is no adequate and valuable polypharmacy
Authors: Turabian Jose
Published: November 2020

All patients, especially elderly patients, those with certain pathologies, those with multimorbidity, or those who live in institutions, are exposed to polypharmacy. The prevalence of polypharmacy is high (18-30%) and the prevalence of excessive polypharmacy (10+ drugs) is 12%. Polypharmacy affects between 40% and 50% of all older adults. The incidence rate of polypharmacy is 20% person-years, ranging from 17% in individuals aged 65–74 years to 33% in those aged ≥95 years. From this point of view, polypharmacy seems to be a concept of quantity or volume of prescriptions. It can lead to serious adverse events related to a wide variety of drug-drug interactions (DDIs) and adverse drug reactions (ADRs): the frequency of ADR is 6% when a patient takes two medications, 50% when he takes five and almost 100% when he takes eight or more medications. Of every 100 courses of drug treatment, there are 20 adverse drug ADRs, between 5 and 25 of clinically observable DDIs and between 15 and 50 potential DDIs, which arrive to 100 in geriatric patients. But on the other hand, low-quality pharmacological care reports are not uncommon. About 60% of patients may be exposed to at least one potentially inappropriate medication: benzodiazepines, psychotropics, proton pump inhibitors, analgesics (including opiates), laxatives, NSAIDs, antacids, etc. Adverse health outcomes related to inappropriate medications for the population, and especially the elderly, include falls, strokes, delirium and death. The quantity of drugs as a defining concept of polypharmacy implies poor quality. The more drugs that are prescribed to a patient, not only there are more possibilities of inappropriate prescriptions or of little value, but even suitable prescriptions tend to lose their indication, and from a certain level of quantity or volume of prescriptions, the increase IDDs and ADRs makes their value decrease in such prescriptions, and they begin to be inappropriate and give rise to poor quality. In other words, there is no adequate and valuable polypharmacy; the high quantity originates low quality.
A Case Report of Cortisol-Secreating Adrenal Adenoma Causing Cushing Syndrome
Authors: Radhi Husain
Published: November 2020

Cushing syndrome is a state of prolonged exposure to excess cortisol production. Causes can be varied ranging from exogenous intake or endogenous production from a pituitary source due to overproduction of adrenocorticotropic hormone (ACTH) or due to over secretion from unilateral or bilateral adrenal glands. Cushing syndrome in an adult can present with proximal muscle weakness, facial plethora, wasting of the extremities with increased fat in the abdomen and face, wide purplish striae, bruising with no obvious trauma, and supraclavicular fat pads. Here, we report a 38 year old male who presented with suspicion of having Cushing syndrome due to his clinical manifestations and high cortisol levels. He presented to the clinic with new onset diabetes, severe hypertension, chronic abdominal pain and distension which was being investigating by different specialties. The patient underwent CT scan of the abdomen which show right adrenal adenoma and on examination, he was found to have proximal weakness and purple striae. Laboratory data showed high morning cortisol, 24 urine free cortisol and ACTH levels which were strongly suggestive of ACTH independent Cushing syndrome.