Pengaruh Komunikasi Terapeutik Perawat Terhadap Kepuasan Pasien Di Rawat Jalan RSUD Jogja

The Objective of this study is to know influence of nurse therapeutic communication to satisfaction of patients satisfaction in RSUD Yogyakarta. The study was a quantitative research methods such as surveys of descriptive inferential research with cross sectional approach. Number of samples in this research is 285 sample in inpatient and 140 in emergency room. The instrument used a questionnaire. Analysis of data using multiple linear regression. This study show that there is the influence of therapeutic communication nurse to satisfaction of outpatients and Emergency room in RSUD Yogyakarta, and orientation phase is a phase that most influence on patient satisfaction. The most influential to therapeutic communication is termination stage

An Isolable NHC-Stabilized Silylene Radical Cation: Synthesis and Structural Characterization

The silyl-substituted silylene–NHC complex bis­(tri-<i>tert</i>-butylsilyl)­silylene–(1,3,4,5-tetramethylimidazol-2-ylidene) [(^<i>t</i>Bu₃Si)₂Si:←NHC^Me, <b>2</b>] was synthesized and isolated as air- and moisture-sensitive orange crystals by reductive debromination of the dibromosilane (^<i>t</i>Bu₃Si)₂SiBr₂ (<b>1</b>) with 2.0 equiv of KC₈ in the presence of NHC^Me. In addition, the silylene–NHC complex <b>2</b> cleanly underwent one-electron oxidation with 1.0 equiv of Ph₃C⁺·Ar₄B^– (Ar₄B^– = tetrakis­[4-(<i>tert</i>-butyldimethylsilyl)-2,3,5,6-tetrafluorophenyl]­borate) in benzene to afford the NHC-stabilized silylene radical cation [(^<i>t</i>Bu₃Si)₂Si←NHC^Me]^•+·Ar₄B^– (<b>3</b>). The radical cation <b>3</b> was isolated as air- and moisture-sensitive yellow crystals and structurally characterized by X-ray crystallography and electron paramagnetic resonance spectroscopy, which showed that <b>3</b> has a planar structure with a π-radical nature

An Isolable NHC-Stabilized Silylene Radical Cation: Synthesis and Structural Characterization

The silyl-substituted silylene–NHC complex bis­(tri-<i>tert</i>-butylsilyl)­silylene–(1,3,4,5-tetramethylimidazol-2-ylidene) [(^<i>t</i>Bu₃Si)₂Si:←NHC^Me, <b>2</b>] was synthesized and isolated as air- and moisture-sensitive orange crystals by reductive debromination of the dibromosilane (^<i>t</i>Bu₃Si)₂SiBr₂ (<b>1</b>) with 2.0 equiv of KC₈ in the presence of NHC^Me. In addition, the silylene–NHC complex <b>2</b> cleanly underwent one-electron oxidation with 1.0 equiv of Ph₃C⁺·Ar₄B^– (Ar₄B^– = tetrakis­[4-(<i>tert</i>-butyldimethylsilyl)-2,3,5,6-tetrafluorophenyl]­borate) in benzene to afford the NHC-stabilized silylene radical cation [(^<i>t</i>Bu₃Si)₂Si←NHC^Me]^•+·Ar₄B^– (<b>3</b>). The radical cation <b>3</b> was isolated as air- and moisture-sensitive yellow crystals and structurally characterized by X-ray crystallography and electron paramagnetic resonance spectroscopy, which showed that <b>3</b> has a planar structure with a π-radical nature

Optimisation of the analysis of anti-influenza drugs in wastewater and surface water

<div><p>We optimised the simultaneous analysis of four analytes, namely three anti-influenza drugs (oseltamivir (OS), zanamivir (ZAN) and amantadine (AMN)) and one metabolite of OS (oseltamivir carboxylate (OC)), in sewage treatment plant (STP) influent and effluent by verifying the types and conditions of solid phase extraction (SPE) appropriate for LC-MS/MS analysis. In summary, these target analytes were extracted from aqueous samples (30–50 mL) by using strong cation-exchange SPE cartridges (500 mg adsorbent) under acidic conditions (pH 3–4). After washing of the cartridges with acidified water (pH 3.0, 3 mL) and methanol (3 mL), the analytes were eluted with a mixed solvent (2 mL) of 10% (v/v) triethylamine in a 1:1 (v/v) mixture of acetone and water. Application of this technique to the target compounds should yield a comprehensive understanding of the occurrence and fate of anti-influenza drugs in the water environment.</p></div

Modeling the Photochemical Attenuation of Down-the-Drain Chemicals during River Transport by Stochastic Methods and Field Measurements of Pharmaceuticals and Personal Care Products

Existing stochastic models for predicting concentrations of down-the-drain chemicals in aquatic environments do not account for the diurnal variation of direct photolysis by sunlight, despite its being an important factor in natural attenuation. To overcome this limitation, we developed a stochastic model incorporating temporal variations in direct photolysis. To verify the model, we measured 57 pharmaceuticals and personal care products (PPCPs) in a 7.6-km stretch of an urban river, and determined their physical and biological properties in laboratory experiments. During transport along the river, 8 PPCPs, including ketoprofen and azithromycin, were attenuated by >20%, mainly owing to direct photolysis and adsorption to sediments. The photolabile PPCPs attenuated significantly in the daytime but persisted in the nighttime. The observations were similar to the values predicted by the photolysis model for the photolabile PPCPs (i.e., ketoprofen, diclofenac and furosemide) but not by the existing model. The stochastic model developed in this study was suggested to be a novel and useful stochastic model for evaluating direct photolysis of down-the-drain chemicals, which occurs during the river transport

Synchronous Dynamics of Observed and Predicted Values of Anti-influenza drugs in Environmental Waters during a Seasonal Influenza Outbreak

Time-dependent dynamics in the concentrations of four anti-influenza drugs (oseltamivir, oseltamivir carboxylate, zanamivir, and amantadine) in environmental waters collected from the Yodo River basin, Japan, were monitored for the first time over a 1 year period (July 2010 to June 2011). The clear, convex dynamic profiles of oseltamivir, oseltamivir carboxylate, and zanamivir during a 3 month seasonal influenza outbreak (January to March 2011) were synchronized well with that of the numbers of influenza patients treated with the drugs. The highest levels in sewage treatment plants (STPs) and river waters were, respectively, 177 and 60 ng/L (oseltamivir), 827 and 288 ng/L (oseltamivir carboxylate), and 30 and 15 ng/L (zanamivir). Fixed levels of amantadine were detectable year-round (100–200 ng/L in the STPs and 10–30 ng/L in river waters). The predicted convex profiles of oseltamivir, oseltamivir carboxylate, and zanamivir in both STPs and river waters were significantly correlated (0.714 < <i>R</i> < 0.932) with the observed values. The profiles were predicted successfully by simple mathematical principles, taking the number of influenza patients, quantities of Tamiflu and Relenza used, dilution by drainwaters passing through STPs, removal rates at STPs, dilution rates in river effluents, and attenuation rates in rivers into consideration

Ozone treatment process for the removal of pharmaceuticals and personal care products in wastewater

<p>This study investigated the degradability of pharmaceuticals and personal care products (PPCPs) by ozonation for the treatment of secondary effluent of a municipal wastewater treatment plant. A set of experiments were conducted in a laboratory using a pilot-scale process consisting of three flow-through reactors in series, by varying the ozone dose (1–9 mg L⁻¹), the hydraulic retention time (5–15 min), and the concentration of ozone injected into the reactors (14–42 mg L⁻¹). Thirty-seven PPCPs were detected in the secondary effluent, which belongs to the use categories of antibiotics, analgesics, antiarrhythmic agents, anticonvulsants, vasodilators, lipid modifying agents, anti-itch drugs, anti-psychotic drugs, insect repellents, bronchodilators, diuretics, peptic ulcer drugs, NMDA receptor antagonists, antifungal drugs, antimicrobial drugs, and antineoplastic agents. These PPCPs were broadly classified into five groups ranging from “sensitive” to ozone (O₃) or “unstable” in the ozonation process, to the group of “insensitive” to O₃ or “very stable” in the ozonation process. These groups are based on the PPCP concentrations after the ozone treatment and their limit of detection (LOD). Furthermore, this study examined comparatively the effects of the ozone dose, the retention (reaction) time, and the concentration of O₃ supplied to the reactors on the degradability of the PPCPs.</p

Comparison of straight and shuttle running velocites for the same VO₂ demands.

<p>VO<b>₂</b>, oxygen consumption.</p

Comparison of physiological responses and RPE while running at different velocities.

<p>Relationship between turn frequency and oxygen consumption (A), heart rate (B), and RPE (C), while running at different velocities. HR, heart rate; RPE, rating of perceived exertion; VO_2, gross oxygen consumption.</p

Comparison of turn cost for different data points.

<p>There was strong correlation (r = 0.99994, p<0.00001) between the slopes of regression lines drawn using two data points and five data points to evaluate the energy cost of a COD. The slope of the regression line of gross VO₂ and the graded COD frequency test indicates the energy cost of a COD while running. COD, change of direction; VO<b>₂</b>, gross oxygen consumption.</p