Manajemen Asuhan Kebidanan Intranatal pada Ny. "R" Gestasi 37 Minggu 5 Hari dengan KPD di RSUD H. Padjonga Dg. Ngalle Kab. Takalar 27 Mei 2013

xiii, 90 hlm.; 28,5 cm

Photochemistry and Anion-Controlled Structure of Fe(III) Complexes with an α‑Hydroxy Acid-Containing Tripodal Amine Chelate

The tripodal amine chelate with two pyridyl groups and an α-hydroxy acid (AHA) group, Pyr-TPA-AHA, was synthesized. Different Fe­(III) complexes form with this chelate depending upon the counterion of the Fe­(III) source used in the synthesis. A dinuclear complex, Fe­(III)₂(Pyr-TPA-AHA)₂(μ-O), <b>1</b>, and mononuclear complexes Fe­(III)­(Pyr-TPA-AHA)­X (X = Cl^– or Br^–, <b>2</b> and <b>3</b>, respectively) were synthesized. <b>2</b> can be easily converted to <b>1</b> by addition of silver nitrate or a large excess of water. The structure of <b>1</b> was solved by X-ray crystallography (C₃₂H₃₄N₆O₇Fe₂·13H₂O, <i>a</i> = 14.1236(6) Å, <i>b</i> = 14.1236(6) Å, <i>c</i> = 21.7469(15) Å, α = β = γ = 90°, tetragonal, P4₂2₁2, <i>Z</i> = 4). <b>2</b> and <b>3</b> each have simple quasireversible cyclic voltammograms with <i>E</i>_1/2 (vs aqueous Ag/AgCl) = +135 mV for <b>2</b> and +470 for <b>3</b> in acetonitrile. The cyclic voltammogram for <b>1</b> in acetonitrile has a quasireversible feature at <i>E</i>_1/2 = −285 mV and an irreversible cathodic feature at −1140 mV. All three complexes are photochemically active upon irradiation with UV light, resulting in cleavage of the AHA group and reduction of the iron to Fe­(II). Photolysis of <b>1</b> results in reduction of both Fe­(III) ions in the dinuclear complex for each AHA group that is cleaved, while photolysis of <b>2</b> and <b>3</b> results in reduction of a single Fe­(III) for each AHA cleavage. The quantum yields for <b>2</b> and <b>3</b> are significantly higher than that of <b>1</b>

Interventions to improve system-level coproduction in the Cystic Fibrosis Learning Network

Background Coproduction is defined as patients and clinicians collaborating equally and reciprocally in healthcare and is a crucial concept for quality improvement (QI) of health services. Learning Health Networks (LHNs) provide insights to integrate coproduction with QI efforts from programmes from various health systems.Objective We describe interventions to develop and maintain patient and family partner (PFP) coproduction, measured by PFP-reported and programme-reported scales. We aim to increase percentage of programmes with PFPs reporting active QI work within their programme, while maintaining satisfaction in PFP-clinician relationships.Methods Conducted in the Cystic Fibrosis Learning Network (CFLN), an LHN comprising over 30 cystic fibrosis (CF) programmes, people with CF, caregivers and clinicians cocreated interventions in readiness awareness, inclusive PFP recruitment, onboarding process, partnership development and leadership opportunities. Interventions were adapted by CFLN programmes and summarised in a change package for existing programmes and the orientation of new ones. We collected monthly assessments for PFP and programme perceptions of coproduction and PFP self-rated competency of QI skills and satisfaction with programme QI efforts. We used control charts to analyse coproduction scales and run charts for PFP self-ratings.Results Between 2018 and 2022, the CFLN expanded to 34 programmes with 52% having ≥1 PFP reporting active QI participation. Clinicians from 76% of programmes reported PFPs were actively participating or leading QI efforts. PFPs reported increased QI skills competency (17%–32%) and consistently high satisfaction and feeling valued in their work.Conclusions Implementing system-level programmatic strategies to engage and sustain partnerships between clinicians and patients and families with CF improved perceptions of coproduction to conduct QI work. Key adaptable strategies for programmes included onboarding and QI training, supporting multiple PFPs simultaneously and developing financial recognition processes. Interventions may be applicable in other health conditions beyond CF seeking to foster the practice of coproduction