238 research outputs found
MEMAHAMI PENERAPAN HUMAN CAPITAL MANAGEMENT DI BHINEKA MUDA
Nowadays, every business unit need to improve the operational performance in order to be able to compete with other businesses. One of the important components is the role of human resources, through the implementation of HCM that proper to that business. The purpose of this study was to understanding the implementation of HCM in one of the coffee shop business, namely Bhineka Muda. In this study using qualitative and quantitative data types, using data collection techniques through the interviewing, observation, and documentation. The results of this study, it can be concluded that the implementation of HCM in Bhineka Muda is fairly simple in the concept and implementation. By carrying out the concept of "warung", this business don’t want to make every things complicated in the internal business management and human resource management. It can be seen from several aspects such as the provisions for employee recruitment, training and development methods for employee, the service from employee to customers, division of work fields, and the work shift system
Kemampuan Penalaran Klinis Mahasiswa Perawat Tahun Keempat Pada Masalah Keperawatan Medikal Medah
Penalaran klinis merupakan sebuah kemampuan pengambilan keputusan, pemecahan masalah, berpikir kritis, dan penilaian klinis. Penalaran klinis yang baik pada mahasiswa keperawatan akan menghasilkan sebuah keputusan klinis yang tepat dan asuhan keperawatan yang efektif. Tujuan dari penelitian ini adalah untuk mengetahui kemampuan penalaran klinis mahasiswa perawat tahun keempat pada masalah keperawatan medikal bedah. Desain penelitian yang digunakan adalah studi deskriptif. Populasi dalam penelitian ini adalah mahasiswa keperawatan tahun keempat STIKES Bina Usada Bali dengan sampel sebanyak 103, yang ditentukan dengan teknik sampling purposive. Pengumpulan data menggunakan Nursing Clinical Reasoning Assessment Tools. Analisa data menggunakan univariat. Hasil penelitian menunjukkan sebagian besar responden memiliki kemampuan penalaran klinis pada kategori competent 49(48%), diikuti dengan sejumlah 35(34%) responden dengan kemampuan penalaran klinis advanced beginner, sebanyak 14(13%) responden profecient, yang diikuti sejumlah 5(5%) mahasiswa memiliki kemampuan penalaran klinis novice. Temuan penelitian ini mengindikasikan perawat pendidik untuk mengambil peran aktif dan menjadi lebih kreatif dengan mengembangkan keterampilan penalaran klinis
PENGARUH CORPORATE SOCIAL RESPONSIBILITY TERHADAP PERILAKU WORD OF MOUTH POSITIF DAN CITRA MEREK AQUA
Penelitian ini memiliki tujuan membahas pengaruh corporate social responsibility terhadap word of mouth positif, membahas pengaruh corporate social responsibility terhadap citra merek AQUA. Melalui metode non probability sampling, sampel ditentukan sebanyak 140 responden. Kota Denpasar dipilih sebagai tempat studi dengan teknik analisis data regresi linier sederhana. Hasil analisis menemukan corporate social responsibility berpengaruh signifikan terhadap word of mouth positif. Corporate social responsibility berpengaruh signifikan terhadap citra merek AQUA. Ini terbukti dari nilai t hitung lebih besar dari nilai t tabel
Spontaneous Splenic Rupture: A Rare Complication of Acute Pancreatitis in a Patient with Crohn's Disease
Crohn's disease (CD) is an idiopathic inflammatory bowel disease which can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon and the anorectum. Although rare, acute pancreatitis as a complication of CD involving the duodenum has been described in the literature. We describe a 37-year-old male with CD presenting with acute pancreatitis and spontaneous splenic rupture. The potential mechanisms associated with acute pancreatitis along with spontaneous rupture of the spleen in this patient population and its treatment will be discussed. Common complaints such as upper abdominal pain in a patient with CD should undergo workup to exclude less commonly involved sites such as the pancreas and spleen. Close monitoring in the critical care setting is recommended in carefully selected and hemodynamically stable patients with splenic rupture. Surgical treatment is considered as the standard of care in hemodynamically unstable patients
Global Transcriptome Profiling of the Pine Shoot Beetle, Tomicus yunnanensis (Coleoptera: Scolytinae)
Background: The pine shoot beetle Tomicus yunnanensis (Coleoptera: Scolytinae) is an economically important pest of Pinus yunnanensis in southwestern China. Developed resistance to insecticides due to chemical pesticides being used for a long time is a factor involved in its serious damage, which poses a challenge for management. In addition, highly efficient adaptation to divergent environmental ecologies results in this pest posing great potential threat to pine forests. However, the molecular mechanisms remain unknown as only limited nucleotide sequence data for this species is available. Methodology/Principal Findings: In this study, we applied next generation sequencing (Illumina sequencing) to sequence the adult transcriptome of T. yunnanensis. A total of 51,822,230 reads were obtained. They were assembled into 140,702 scaffolds, and 60,031 unigenes. The unigenes were further functionally annotated with gene descriptions, Gene Ontology (GO), Clusters of Orthologous Groups (COG), and Kyoto Encyclopedia of Genes and Genome (KEGG). In total, 80,932 unigenes were classified into GO, 13,599 unigenes were assigned to COG, and 33,875 unigenes were found in KO categories. A biochemical pathway database containing 219 predicted pathways was also created based on the annotations. In depth analysis of the data revealed a large number of genes related to insecticides resistance and heat shock protein genes associated with environmental stress. Conclusions/Significance: The results facilitate the investigations of molecular resistance mechanisms to insecticides an
Rhodococcus equi venous catheter infection: a case report and review of the literature
<p>Abstract</p> <p>Introduction</p> <p><it>Rhodococcus equi </it>is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow) or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to <it>R. equi </it>infections of tunneled central venous catheters has rarely been described.</p> <p>Case presentation</p> <p>We report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to <it>R. equi </it>and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with <it>R. equi</it>.</p> <p>Conclusion</p> <p><it>R. equi </it>should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.</p
The Critical Richardson Number and Limits of Applicability of Local Similarity Theory in the Stable Boundary Layer
Measurements of atmospheric turbulence made over the Arctic pack ice during
the Surface Heat Budget of the Arctic Ocean experiment (SHEBA) are used to
determine the limits of applicability of Monin-Obukhov similarity theory (in
the local scaling formulation) in the stable atmospheric boundary layer. Based
on the spectral analysis of wind velocity and air temperature fluctuations, it
is shown that, when both of the gradient Richardson number, Ri, and the flux
Richardson number, Rf, exceed a 'critical value' of about 0.20 - 0.25, the
inertial subrange associated with the Richardson-Kolmogorov cascade dies out
and vertical turbulent fluxes become small. Some small-scale turbulence
survives even in this supercritical regime, but this is non-Kolmogorov
turbulence, and it decays rapidly with further increasing stability. Similarity
theory is based on the turbulent fluxes in the high-frequency part of the
spectra that are associated with energy-containing/flux-carrying eddies.
Spectral densities in this high-frequency band diminish as the
Richardson-Kolmogorov energy cascade weakens; therefore, the applicability of
local Monin-Obukhov similarity theory in stable conditions is limited by the
inequalities Ri < Ri_cr and Rf < Rf_cr. However, it is found that Rf_cr = 0.20
- 0.25 is a primary threshold for applicability. Applying this prerequisite
shows that the data follow classical Monin-Obukhov local z-less predictions
after the irrelevant cases (turbulence without the Richardson-Kolmogorov
cascade) have been filtered out.Comment: Boundary-Layer Meteorology (Manuscript submitted: 16 February 2012;
Accepted: 10 September 2012
Validity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational study
BACKGROUND: Currently, there is no standardised tool used to capture morbidity following abdominal aortic aneurysm (AAA) repair. The aim of this prospective observational study was to validate the Postoperative Morbidity Survey (POMS) according to its two guiding principles: to only capture morbidity substantial enough to delay discharge from hospital and to be a rapid, simple screening tool. METHODS: A total of 64 adult patients undergoing elective infrarenal AAA repair participated in the study. Following surgery, the POMS was recorded daily, by trained research staff with the clinical teams blinded, until hospital discharge or death. We modelled the data using Cox regression, accounting for the competing risk of death, with POMS as a binary time-dependent (repeated measures) internal covariate. For each day for each patient, ‘discharged’ (yes/no) was the event, with the elapsed number of days post-surgery as the time variable. We derived the hazard ratio for any POMS morbidity (score 1–9) vs. no morbidity (zero), adjusted for type of repair (endovascular versus open), age and aneurysm size. RESULTS: The hazard ratio for alive discharge with any POMS-recorded morbidity versus no morbidity was 0.130 (95 % confidence interval 0.070 to 0.243). The median time-to-discharge was 13 days after recording any POMS morbidity vs. 2 days after scoring zero for POMS morbidity. Compliance with POMS completion was 99.5 %. CONCLUSIONS: The POMS is a valid tool for capturing short-term postoperative morbidity following elective infrarenal AAA repair that is substantial enough to delay discharge from hospital. Daily POMS measurement is recommended to fully capture morbidity and allow robust analysis. The survey could be a valuable outcome measure for use in quality improvement programmes and future research
Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke
[EN] Background: Virtual and mixed reality systems have been suggested to promote motor recovery after stroke. Basing on the existing evidence on motor learning, we have developed a portable and low-cost mixed reality tabletop system that transforms a conventional table in a virtual environment for upper limb rehabilitation. The system allows intensive and customized training of a wide range of arm, hand, and finger movements and enables interaction with tangible objects, while providing audiovisual feedback of the participants' performance in gamified tasks. This study evaluates the clinical effectiveness and the acceptance of an experimental intervention with the system in chronic stroke survivors.
Methods: Thirty individuals with stroke were included in a reversal (A-B-A) study. Phase A consisted of 30 sessions of conventional physical therapy. Phase B consisted of 30 training sessions with the experimental system. Both interventions involved flexion and extension of the elbow, wrist, and fingers, and grasping of different objects. Sessions were 45-min long and were administered three to five days a week. The body structures (Modified Ashworth Scale), functions (Motricity Index, Fugl-Meyer Assessment Scale), activities (Manual Function Test, Wolf Motor Function Test, Box and Blocks Test, Nine Hole Peg Test), and participation (Motor Activity Log) were assessed before and after each phase. Acceptance of the system was also assessed after phase B (System Usability Scale, Intrinsic Motivation Inventory).
Results: Significant improvement was detected after the intervention with the system in the activity, both in arm function measured by the Wolf Motor Function Test (p < 0.01) and finger dexterity measured by the Box and Blocks Test (p < 0.01) and the Nine Hole Peg Test (p < 0.01); and participation (p < 0.01), which was maintained to the end of the study. The experimental system was reported as highly usable, enjoyable, and motivating.
Conclusions: Our results support the clinical effectiveness of mixed reality interventions that satisfy the motor learning principles for upper limb rehabilitation in chronic stroke survivors. This characteristic, together with the low cost of the system, its portability, and its acceptance could promote the integration of these systems in the clinical practice as an alternative to more expensive systems, such as robotic instruments.The authors wish to thank the staff and patients of the Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA for their involvement in the study. The authors also wish to thank the staff of LabHuman for their support in this project, especially Francisco Toledo and José Roda for their assistance. This study was funded in part by the Project TEREHA (IDI-20110844) and Project NeuroVR (TIN2013-44741-R) of the Ministerio de Economia y Competitividad of Spain, the Project Consolider-C (SEJ2006-14301/PSIC) of the Ministerio de Educacion y Ciencia of Spain, the "CIBER of Physiopathology of Obesity and Nutrition, an initiative of ISCIII", and the Excellence Research Program PROMETEO of the Conselleria de Educacion of Generalitat Valenciana (2008-157).Colomer Font, C.; Llorens Rodríguez, R.; Noé Sebastián, E.; Alcañiz Raya, ML. (2016). Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of NeuroEngineering and Rehabilitation. 13:1-10. https://doi.org/10.1186/s12984-016-0153-6S11013Fregni F, Pascual-Leone A. Hand motor recovery after stroke: tuning the orchestra to improve hand motor function. Cogn Behav Neurol. 2006;19(1):21–33.Patten C, Condliffe EG, Dairaghi CA, Lum PS. 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Cationic polyamines inhibit anthrax lethal factor protease
BACKGROUND: Anthrax is a human disease that results from infection by the bacteria, Bacillus anthracis and has recently been used as a bioterrorist agent. Historically, this disease was associated with Bacillus spore exposure from wool or animal carcasses. While current vaccine approaches (targeted against the protective antigen) are effective for prophylaxis, multiple doses must be injected. Common antibiotics that block the germination process are effective but must be administered early in the infection cycle. In addition, new therapeutics are needed to specifically target the proteolytic activity of lethal factor (LF) associated with this bacterial infection. RESULTS: Using a fluorescence-based assay to identify and characterize inhibitors of anthrax lethal factor protease activity, we identified several chemically-distinct classes of inhibitory molecules including polyamines, aminoglycosides and cationic peptides. In these studies, spermine was demonstrated for the first time to inhibit anthrax LF with a K(i )value of 0.9 ± 0.09 μM (mean ± SEM; n = 3). Additional linear polyamines were also active as LF inhibitors with lower potencies. CONCLUSION: Based upon the studies reported herein, we chose linear polyamines related to spermine as potential lead optimization candidates and additional testing in cell-based models where cell penetration could be studied. During our screening process, we reproducibly demonstrated that the potencies of certain compounds, including neomycin but not neamine or spermine, were different depending upon the presence or absence of nucleic acids. Differential sensitivity to the presence/absence of nucleic acids may be an additional point to consider when comparing various classes of active compounds for lead optimization
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