Factors Related to Doctors’ and Nurses’ Perceptions of Evidence-Based Practice and Information - Communication Technology

Evidence-based practice (EBP) that is supported by the availability of the best literature can improve the quality of health services. Information and communication technology (ICT) usage may provide the evidence in timely-manner. However, literature on the factors related to EBP and ICT of doctors and nurses in Indonesia is scant. This study aimed to describe the factors related to the doctors’ and nurses’ EBP perception and ICT. This survey was conducted in November 2017–January 2018 at one general hospital, five private hospitals, eleven public health centers, and five private clinics. A total of 85 doctors and 271 nurses selected by proportional probability sampling were given online questionnaires. Each questionnaire consisted of 12 items about access to information and 24 items about perception of EBP adopted from the evidence-based practice questionnaire Upton & Upton. Pearson correlation, independent t-test analysis, and one-way ANOVA results found education and role were related to the doctors’ EBP. Education, role, age, and experience were related to the doctors’ ICT. There was a relationship between age and education with the nurses EBP. These two factors and working experience were related to the nurses’ ICT. EBP intervention through ICT may take into account the nature of experienced senior doctors and young inexperience nurses with higher education in the ICT platform. Advocacy is needed to increase the use of ICTs for EBP and professional development. Further research related to the need of knowledge translation through ICT should be conducted.  Abstrak  Faktor-faktor yang Berhubungan dengan Persepsi Dokter dan Perawat terhadap Praktik Klinis Berbasis Bukti dan Teknologi Informasi dan Komunikasi. Praktik klinis berbasis bukti (PKBB) yang ditunjang dengan ketersediaan literatur terbaik dapat meningkatkan kualitas pelayanan kesehatan. Penggunaan Teknologi Informasi dan Komunikasi (TIK) menyediakan bukti ilmiah dalam waktu yang singkat. Namun, literature tentang faktor-faktor yang berhubungan dengan PKBB dan TIK dokter dan perawat di Indonesia masih sedikit. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan persepsi PKBB dan TIK dokter dan perawat. Survei ini dilaksanakan pada November 2017–Januari 2018 di satu rumah sakit umum, lima rumah sakit swasta, sebelas puskesmas, dan lima klinik swasta. Sebanyak 85 dokter dan 271 perawat yang dipilih dengan sampel proportional probability diberikan kuesioner daring. Kuesioner terdiri dari 12 pertanyaan tentang akses informasi dan 24 pernyataan tentang persepsi PKBB yang diadopsi dari evidence-based practice questionnaire Upton & Upton. Hasil analisis Pearson correlation, independent T-test dan one-way ANOVA menemukan hubungan antara pendidikan dan peran dengan PKBB dokter, serta pendidikan, peran, usia dan pengalaman kerja berhubungan dengan TIK dokter. Ada hubungan antara umur dan pendidikan dengan PPKB perawat. Kedua faktor dan pengalaman kerja ini terkait dengan TIK perawat. Intervensi PPKB melalui TIK dapat mempertimbangkan karakter dokter senior berpengalaman dan perawat muda yang pendidikan tinggi namun belum berpengalaman dengan platform TIK. Advokasi diperlukan untuk meningkatkan pemanfaatan TIK untuk PPKB dan pengembangan profesional. Penelitian lebih lanjut terkait kebutuhan penerjemahan pengetahuan melalui TIK harus dilakukan. Kata Kunci: dokter, perawat, persepsi, praktik klinis berbasis ilmiah, teknologi informasi komunikas

Medication risk communication with cancer patients in a Middle East cancer care setting

Purpose: Cancer treatments are frequently associated with adverse effects, but there may be a cultural reluctance by care providers to be forthcoming with patients regarding these risks for fear of promoting nonadherence. Conversely, research in a number of countries indicates high levels of patient desire for this information. We sought to explore cancer patient experiences, satisfaction, and preferences for medication risk communication in a Middle East care setting. Methods: We developed and administered a ten-item questionnaire (Arabic and English) to a convenience sample of consenting adult patients receiving treatment at the National Center for Cancer Care and Research in Qatar. Results: One hundred and forty-three patients were interviewed. Most (88%) stated that the level of side effect information they received was sufficient, with physicians (86%) followed by pharmacists (39%) as the preferred sources. The majority (97%) agreed that knowing about possible side effects would help them recognize and manage the reaction, and 92% agreed that it would help them understand how to minimize or prevent the risks. Eighteen percent indicated that this information would make them not want to take treatment. Two-thirds (65%) had previously experienced intolerance to their cancer treatment regimen. Conclusion: Most patients surveyed expressed preference for the details of possible side effects they may encounter in their treatment. However, one in five considered such information a factor for nonadherence, indicating the need for patient-specific approaches when communicating medication risks.Undergraduate Research Experience Program award (UREP 14-001-3-001) from the Qatar National Research Fund (a member of Qatar Foundation)

Risk communication with Arab patients with cancer: a qualitative study of nurses and pharmacists

Objectives To explore pharmacist and nurse views and experiences in educating patients regarding their treatment safety and tolerability as well as the roles of other professions in this regard. Design In this qualitative study, six focus group discussions were conducted. Setting The National Center for Cancer Care and Research in Qatar. Participants Eleven pharmacists and 22 nurses providing direct patient care. Results Concepts related to three key themes were drawn from the seeding questions and included factors for determining the level of risk they communicated: the specific treatment regimen in question; the patient; and their assessment of the patient. Patient-related considerations arose from additional subthemes; both nurses and pharmacists described aspects related to the perceived psychological health status of the patient, as well as anticipated comprehension, as ascertained by demonstrated education and language abilities. In all discussions, it was noted that physician and family non-disclosure of cancer diagnosis to the patient profoundly influenced the nature of information they provided. While a high level of cohesion in safety communication prioritisation among these two health disciplines was found, a number of pharmacists asserted a more formal role compared to informal and repeated teaching by nurses. Conclusions Nurses and pharmacists in this Middle East healthcare environment were not reluctant to discuss treatment side effects with patients and draw on similar professional judgements in prioritising treatment risk information. We found that they did not always recognise each other's informal educational encounters and that there are opportunities to explore increased collaboration in this regard to enhance the patient care experience.Undergraduate Research Experience Program award (UREP 14-001-3-001) from the Qatar National Research Fund (a member of Qatar Foundation)

Methylglyoxal-Modified Albumin Effects on Endothelial Arginase Enzyme and Vascular Function

Advanced glycation end products (AGEs) contribute significantly to vascular dysfunction (VD) in diabetes. Decreased nitric oxide (NO) is a hallmark in VD. In endothelial cells, NO is produced by endothelial NO synthase (eNOS) from L-arginine. Arginase competes with NOS for L-arginine to produce urea and ornithine, limiting NO production. Arginase upregulation was reported in hyperglycemia; however, AGEs’ role in arginase regulation is unknown. Here, we investigated the effects of methylglyoxal-modified albumin (MGA) on arginase activity and protein expression in mouse aortic endothelial cells (MAEC) and on vascular function in mice aortas. Exposure of MAEC to MGA increased arginase activity, which was abrogated by MEK/ERK1/2 inhibitor, p38 MAPK inhibitor, and ABH (arginase inhibitor). Immunodetection of arginase revealed MGA-induced protein expression for arginase I. In aortic rings, MGA pretreatment impaired acetylcholine (ACh)-induced vasorelaxation, which was reversed by ABH. Intracellular NO detection by DAF-2DA revealed blunted ACh-induced NO production with MGA treatment that was reversed by ABH. In conclusion, AGEs increase arginase activity probably through the ERK1/2/p38 MAPK pathway due to increased arginase I expression. Furthermore, AGEs impair vascular function that can be reversed by arginase inhibition. Therefore, AGEs may be pivotal in arginase deleterious effects in diabetic VD, providing a novel therapeutic target

Factors Related to Doctors’ and Nurses’ Perceptions of Evidence-Based Practice and Healthcare Information Access Through Information and Communications Technology

Evidence-based practice (EBP) that is supported by the availability of the best literature can improve the quality of health services. Information and communication technology (ICT) usage may provide the evidence in timely-manner. However, literature on the factors related to EBP and ICT of doctors and nurses in Indonesia is scant. This study aimed to describe the factors related to the doctors’ and nurses’ EBP perception and ICT. This survey was conducted in November 2017–January 2018 at one general hospital, five private hospitals, eleven public health centers, and five private clinics. A total of 85 doctors and 271 nurses selected by proportional probability sampling were given online questionnaires. Each questionnaire consisted of 12 items about access to information and 24 items about perception of EBP adopted from the evidence-based practice questionnaire Upton & Upton. Pearson correlation, independent t-test analysis, and one-way ANOVA results found education and role were related to the doctors’ EBP. Education, role, age, and experience were related to the doctors’ ICT. There was a relationship between age and education with the nurses EBP. These two factors and working experience were related to the nurses’ ICT. EBP intervention through ICT may take into account the nature of experienced senior doctors and young inexperience nurses with higher education in the ICT platform. Advocacy is needed to increase the use of ICTs for EBP and professional development. Further research related to the need of knowledge translation through ICT should be conducted. Abstrak Faktor-faktor yang Berhubungan dengan Persepsi Dokter dan Perawat terhadap Praktik Klinis Berbasis Bukti dan Teknologi Informasi dan Komunikasi. Praktik klinis berbasis bukti (PKBB) yang ditunjang dengan ketersediaan literatur terbaik dapat meningkatkan kualitas pelayanan kesehatan. Penggunaan Teknologi Informasi dan Komunikasi (TIK) menyediakan bukti ilmiah dalam waktu yang singkat. Namun, literature tentang faktor-faktor yang berhubungan dengan PKBB dan TIK dokter dan perawat di Indonesia masih sedikit. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan persepsi PKBB dan TIK dokter dan perawat. Survei ini dilaksanakan pada November 2017–Januari 2018 di satu rumah sakit umum, lima rumah sakit swasta, sebelas puskesmas, dan lima klinik swasta. Sebanyak 85 dokter dan 271 perawat yang dipilih dengan sampel proportional probability diberikan kuesioner daring. Kuesioner terdiri dari 12 pertanyaan tentang akses informasi dan 24 pernyataan tentang persepsi PKBB yang diadopsi dari evidence-based practice questionnaire Upton & Upton. Hasil analisis Pearson correlation, independent T- test dan one-way ANOVA menemukan hubungan antara pendidikan dan peran dengan PKBB dokter, serta pendidikan, peran, usia dan pengalaman kerja berhubungan dengan TIK dokter. Ada hubungan antara umur dan pendidikan dengan PPKB perawat. Kedua faktor dan pengalaman kerja ini terkait dengan TIK perawat. Intervensi PPKB melalui TIK dapat mempertimbangkan karakter dokter senior berpengalaman dan perawat muda yang pendidikan tinggi namun belum berpengalaman dengan platform TIK. Advokasi diperlukan untuk meningkatkan pemanfaatan TIK untuk PPKB dan pengembangan profesional. Penelitian lebih lanjut terkait kebutuhan penerjemahan pengetahuan melalui TIK harus dilakukan. Kata Kunci: dokter, perawat, persepsi, praktik klinis berbasis ilmiah, teknologi informasi komunikas

Synthesis and antibacterial activity of novel 2-(arylimino)thiazolidin-4-one and 2-(benzylidenehydrazono)-3-arylthiazolidin-4-one derivatives

The ongoing spread of multidrug-resistant bacteria demands an intensive search for new antibacterial agents. In the present study, a series of new 1,3-thiazolidin-4-ones has been synthesized and investigated for its in vitro antibacterial activity. The most potent antibacterial compound 4c was found to be active, at low micromolar range, against Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and the pneumonic plague causative agent Yersinia pestis with minimum inhibitory concentrations of 5 µM, 2.5 µM, 2.5 µM and 5 µM, respectively. Compound 4c showed the ability to kill E. faecalis JH212 strain with a minimum bactericidal concentration of 5 µM. Furthermore, compounds 9b and 10a inhibited the biofilm formation in S. epidermidis, where they showed 70% to 80% inhibition at a concentration of 40 µM

Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms

Background The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. Objectives To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. Methods A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Results Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Conclusions Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience

Correlation Between Strain Distribution and Antibiotic Resistance Genes Pattern of Streptococcus agalactiae Group B from Patients in Taif, Saudi Arabia

The Group B Streptococcus (Streptococcus agalactiae) (GBS) is one of the natural flora bacteria in the female reproductive system. In the recent years, GBS has become the major bacterial infections throw the perinatal period causing many troubles. This study was undertaken to determine the prevalence and antibiotic genes of GBS colonization in pregnant women of obstetrics hospital in Taif, Saudi Arabia. Fourteen Streptococcus agalactiae isolates obtained after screening about 134 swabs samples from genitourinary tract specimens of women patients from obstetrics hospital in Taif governorate, Saudi Arabia. These isolates were studied for antibiotic resistance and virulence genes. All obtained isolates were identified as Streptococcus agalactiae by the 16S rDNA gene sequence. These strains were found by Disc diffusion method sensitive against Meropenem, Cefotaxime, Cefepime, Amoxicillin, Penicillin G, Daptomycin, Chloramphenicol, Linezolid and Levofloxacin. The highest resistance was for Tetracyclin (85.7%) whereas the lowest resistance was found for Vancomycin (21.4%). Resistance against Erythromycin and Clindamycin was 71.5%, and 28.5% respectively. PCR based detection revealed 50% of isolates were carrying the tetT genes, while 92.8% of isolates were carrying tetO and tetM genes associated with Tetracycline resistance. All isolates were harboring genes that associated with Erythromycin resistance like ErmB1, ErmB2, and Erm(A|TR) genes, but only 28.5% of isolates were carrying ErmTR gene. Molecular detection of virulence associated genes revealed that out of fourteen isolates of S. agalactiae, only one isolate was carrying the LinB gene, while all isolates were positive for MreA and VanA genes respectively. We can conclude that the GBS isolates were found sensitive to many antibiotic while most isolates were resistance to Tetracycline due to the existence of tetO and tetM genes. Resistance against Erythromycin and Clindamycin was 71.5%, and 28.5% respectively. The two erythromycin resistance genes (ErmB and ErmTR) were found in all isolates, while, the third erythromycin resistance gene Erm(A|TR) was found only in 25.8% of the isolates

Molecular Identification and Phylogenetic Analysis of Multidrug-resistant Bacteria using 16S rDNA Sequencing

In the present study, 30 multidrug-resistant bacterial samples were isolated from different hospitals in the Taif governorate in Saudi Arabia. Given its discriminating power as a universal phylogenetic marker, the 16S rDNA gene was sequenced in a comprehensive diversity study to determine the evolutionary and phylogenetic relationships among the bacterial isolates. The 16S rDNA genes of all isolates were successfully amplified using PCR, and comprehensive identification results were based on GenBank databases. Analysis revealed nucleotide identities ranging from 76% to 100% based on the consensus sequences of 21 species, namely, Bacillus cereus, Bacillus subtilis, Bacillus tequilensis, Caldimonas manganoxidans, Citrobacter freundii, Enterococcus faecium, Escherichia fergusonii, Klebsiella pneumoniae, Lactobacillus plantarum, Lactococcus garvieae, Leuconostoc mesenteroides, Myristica yunnanensis, Pantoea eucrina, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus capitis, Staphylococcus caprae, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus petrasii, and Staphylococcus saccharolyticus. We observed high variability in terms of DNA length and GC content between and within species. Phylogenetic analysis clustered the isolates into three groups. The number of sites ranged from 827 (S. aureus) to 1,219 (L. mesenteroides). Estimation of nucleotide diversity (ð) showed that all analyzed sequences were diverse site-wise and also exhibited high nucleotide diversity, with ð values ranging from 0.17 to 0.94. All isolates showed significantly conserved regions (P>0.05). In conclusion, the observed variations in the sequences of the target bacterial strains can be attributed to resistance to antibiotics and gene transfer among bacterial strains in the hospital environment. Further sequence analyses of antibiotic resistance genes are warranted