126 research outputs found

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

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    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

    Understanding Link Dynamics in Wireless Sensor Networks with Dynamically Steerable Directional Antennas

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    Abstract. By radiating the power in the direction of choice, electronicallyswitched directional (ESD) antennas can reduce network contention and avoid packet loss. There exists some ESD antennas for wireless sensor networks, but so far researchers have mainly evaluated their directionality. There are no studies regarding the link dynamics of ESD antennas, in particular not for indoor deployments and other scenarios where nodes are not necessarily in line of sight. Our long-term experiments confirm that previous findings that have demonstrated the dependence of angleof-arrival on channel frequency also hold for directional transmissions with ESD antennas. This is important for the design of protocols for wireless sensor networks with ESD antennas: the best antenna direction, i.e., the direction that leads to the highest packet reception rate and signal strength at the receiver, is not stable but varies over time and with the selected IEEE 802.15.4 channel. As this requires protocols to incorporate some form of adaptation, we present an intentionally simple and yet efficient mechanism for selecting the best antenna direction at run-time with an energy overhead below 2 % compared to standard omni-directional transmissions.

    Antibiotic-resistant salmonellae in pet reptiles in Saudi Arabia

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    We investigated the occurrence rate of antibiotic-resistant salmonellae in exotic pet reptiles in Saudi Arabia. Salmonellae samples were collected from eight different genera of pet reptiles (snakes and lizards). Selective enrichment and selective plating procedures were carried out in order to detect salmonellae. Isolated bacteria were identified using biochemical tests, API 20E strips, and the VITEK compact system. Antimicrobial susceptibility testing was performed using the disc diffusion method. Salmonella spp. belonging to subspecies I (Salmonella enterica ssp. enterica) were detected in 29.2% of the samples. All of the detected salmonellae showed multidrug resistance (p<0.001, χ2 ). The results demonstrated that pet reptiles in private households could present health hazards to humans. Therefore, these animals should be carefully handled to avoid infection. To the best of our knowledge, this is the first report regarding the occurrence rate of antibiotic-resistant salmonellae in pet reptiles in Saudi Arabia. The detected Salmonella serovars should be subjected to further in-depth molecular analyses in order to understand the overall epidemiology of salmonellosis in Saudi Arabia.We investigated the occurrence rate of antibiotic-resistant salmonellae in exotic pet reptiles in Saudi Arabia. Salmonellae samples were collected from eight different genera of pet reptiles (snakes and lizards). Selective enrichment and selective plating procedures were carried out in order to detect salmonellae. Isolated bacteria were identified using biochemical tests, API 20E strips, and the VITEK compact system. Antimicrobial susceptibility testing was performed using the disc diffusion method. Salmonella spp. belonging to subspecies I (Salmonella enterica ssp. enterica) were detected in 29.2% of the samples. All of the detected salmonellae showed multidrug resistance (p<0.001, χ2 ). The results demonstrated that pet reptiles in private households could present health hazards to humans. Therefore, these animals should be carefully handled to avoid infection. To the best of our knowledge, this is the first report regarding the occurrence rate of antibiotic-resistant salmonellae in pet reptiles in Saudi Arabia. The detected Salmonella serovars should be subjected to further in-depth molecular analyses in order to understand the overall epidemiology of salmonellosis in Saudi Arabia

    Enabling comparison of UrQMD with Geant4 hadronic models

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    Geant4 has an abundant set of physics models that handle the diverse interaction of particles with matter across a wide energy range. However, there are also many well established reaction codes currently used in the same fields where Geant4 is applied. One such code is the Ultra-relativistic Quantum Molecular Dynamics (UrQMD) model. In order to take advantage of the UrQMD code, we create a tool to enable comparisons among UrQMD and Geant4 hadronic models. This tool allows a user to process the output file of UrQMD through Geant4 toolkit, while at the same time, can choose among different Geant4 hadronic model generators. As an example, the UrQMD model is compared with the HARP-CDP experimental data and with the Binary and FRITIOF generators, in the framework of Geant4. It is shown that the UrQMD model can better reproduce charged pion production for p+Cu and Pb interactions at 3, 8 and 15 GeV/c, and is a good candidate for Geant4 hadronic models.Comment: 17 pages, 5 Figure

    Practice of wound closure techniques among emergency physicians and surgeons in Makkah City Hospitals in Saudi Arabia

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    Background: Wound suturing is a procedure performed by medical and surgical specialists. While there are many different suturing techniques and materials used to treat patients, the choice of which to employ depends on different variables that affect the outcome of the procedure.Design and Methods: This is a cross-sectional study conducted to provide descriptive data regarding the practice of wound closure techniques, and to develop an awareness of scar formation factors. A total of 172 general surgery (GS) surgeons and emergency (EM) physicians in Makkah city hospitals in Saudi Arabia participated in the study.Results: More than 50% of the practitioners favored the simple interrupted technique for the treatment of all types of studied wounds. The other most common techniques among participants were the subcuticular and vertical mattress methods, respectively, while the use of a stapler was limited to certain wound types. Regarding suturing material, polyglycolic acid was the most frequent material used by 50.1% of participants, whereas only 22% of the participants selected nylon material for wound suturing. However, this study showed a good level of awareness among participants, with significant p-values (p<0.05) of strongly agree and agree regarding the essential factors affecting wound healing and scar formation.Conclusions: The result provides insight into the most common suture techniques and materials used in wound closure. There are wide variations in selecting these techniques and materials among the participants. Also, we found that there is good awareness among participants about factors that lead to scar formation

    Neurite outgrowth inhibitory levels of organophosphates induce tissue transglutaminase activity in differentiating N2a cells: evidence for covalent adduct formation

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    Organophosphate compounds (OPs) induce both acute and delayed neurotoxic effects, the latter of which is believed to involve their interaction with proteins other than acetylcholinesterase. However, few OP-binding proteins have been identified that may have a direct role in OP-induced delayed neurotoxicity. Given their ability to disrupt Ca2+ homeostasis, a key aim of the current work was to investigate the effects of sub-lethal neurite outgrowth inhibitory levels of OPs on the Ca2+-dependent enzyme tissue transglutaminase (TG2). At 1–10 µM, the OPs phenyl saligenin phosphate (PSP) and chlorpyrifos oxon (CPO) had no effect cell viability but induced concentration-dependent decreases in neurite outgrowth in differentiating N2a neuroblastoma cells. The activity of TG2 increased in cell lysates of differentiating cells exposed for 24 h to PSP and chlorpyrifos oxon CPO (10 µM), as determined by biotin-cadaverine incorporation assays. Exposure to both OPs (3 and/or 10 µM) also enhanced in situ incorporation of the membrane permeable substrate biotin-X-cadaverine, as indicated by Western blot analysis of treated cell lysates probed with ExtrAvidin peroxidase and fluorescence microscopy of cell monolayers incubated with FITC-streptavidin. Both OPs (10 µM) stimulated the activity of human and mouse recombinant TG2 and covalent labelling of TG2 with dansylamine-labelled PSP was demonstrated by fluorescence imaging following SDS-PAGE. A number of TG2 substrates were tentatively identified by mass spectrometry, including cytoskeletal proteins, chaperones and proteins involved protein synthesis and gene regulation. We propose that the elevated TG2 activity observed is due to the formation of a novel covalent adduct between TG2 and OPs

    A standardised template for reporting lower limb kinematic waveform movement compensations from a sensor-based portable clinical movement analysis toolkit

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    Objectives To develop a standardised template to support physiotherapist reporting of lower limb kinematic waveform data Design Within and between user agreement identification of movement compensation strategies. Setting University Health Board Physiotherapy Department Participants Fourteen individuals with anterior cruciate ligament reconstruction performed overground gait, double-leg squat, and stair ascent wearing body-worn sensors. Six users viewed 252 kinematic waveforms of hip, knee and ankle joint angles in the sagittal and frontal planes. Main outcome measures Between and within-user observed agreement and themes from movement analysis reports Results Between-user observed agreement for presence of a movement compensation was 0.6–0.9 for the sagittal plane and 0.75–1.0 for the frontal place. Within-user observed agreement was 0.57–1.00 for the sagittal plane and 0.71–1.00 for the frontal plane. Three themes and seven categories were identified from the waveform interpretations: Amount (qualitative and quantitative description), timing (phase, discrete time point, cycle), and nature (peak, range of motion, timing) of the compensation. Conclusion There was good agreement between users at identifying the presence of movement compensation from the kinematic waveforms, but there was variation in how movement compensations were described. An interactive report, a standardised template for interpretation of kinematic waveforms, and training to support the clinical application of a movement analysis toolkit are proposed

    Phenyl Saligenin Phosphate Induced Caspase-3 and c-Jun N-Terminal Kinase Activation in Cardiomyocyte-Like Cells

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    At present, little is known about the effect(s) of organophosphorous compounds (OPs) on cardiomyocytes. In this study we have investigated the effects of phenyl saligenin phosphate (PSP), two organophosphorothioate insecticides (diazinon and chlorpyrifos) and their acutely toxic metabolites (diazoxon and chlorpyrifos oxon) on mitotic and differentiated H9c2 cardiomyoblasts. OP-induced cytotoxicity was assessed by monitoring MTT reduction, LDH release and caspase-3 activity. Cytotoxicity was not observed with diazinon, diazoxon or chlorpyrifos oxon (48 h exposure; 200 μM). Chlorpyrifos-induced cytotoxicity was only evident at concentrations >100 μM. In marked contrast, PSP displayed pronounced cytotoxicity towards mitotic and differentiated H9c2 cells. PSP triggered the activation of JNK1/2, but not ERK1/2, p38 MAPK or PKB, suggesting a role for this pro-apoptotic protein kinase in PSP-induced cell death. The JNK1/2 inhibitor SP 600125 attenuated PSP-induced caspase-3 and JNK1/2 activation, confirming the role of JNK1/2 in PSP-induced cytotoxicity. Fluorescently labelled PSP (dansylated PSP) was used to identify novel PSP binding proteins. Dansylated PSP displayed cytotoxicity towards differentiated H9c2 cells. 2D-gel electrophoresis profiles of cells treated with dansylated PSP (25 μM) were used to identify proteins fluorescently labelled with dansylated PSP. Proteomic analysis identified tropomyosin, heat shock protein β-1 and nucleolar protein 58 as novel protein targets for PSP. In summary, PSP triggers cytotoxicity in differentiated H9c2 cardiomyoblasts via JNK1/2-mediated activation of caspase-3. Further studies are required to investigate whether the identified novel protein targets of PSP play a role in the cytotoxicity of this OP, which is usually associated with the development of OP-induced delayed neuropathy

    Maternal Serum Macrophage Inhibitory Cytokine-1 as a Biomarker for Ectopic Pregnancy in Women with a Pregnancy of Unknown Location

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    Ectopic pregnancy (EP) occurs in 1-2% of pregnancies, but is over-represented as a leading cause of maternal death in early pregnancy. It remains a challenge to diagnose early and accurately. Women often present in early pregnancy with a 'pregnancy of unknown location' (PUL) and the diagnosis and exclusion of EP is difficult due to a lack of reliable biomarkers. A serum biomarker able to clearly distinguish between EP and other pregnancy outcomes would greatly assist clinicians in diagnosing and safely managing PULs. This study evaluates the ability of maternal serum macrophage inhibitory cytokine-1 (MIC-1) levels to differentiate between EP and other pregnancy outcomes in women with a PUL.Sera were collected from 120 women with a PUL at first clinical presentation and assayed for MIC-1 by ELISA. Results were classified according to ultimate pregnancy outcome and the discriminatory ability of MIC-1 to diagnose EP was assessed.Serum MIC-1 levels were lower in women with histologically confirmed (definite) EP (dEP) (median 552 ng/mL; interquartile range (IQR) 414-693 ng/mL) compared to women with definite viable intra-uterine pregnancies (dVIUPs) (722 ng/mL; IQR 412-1122 ng/mL), and higher when compared to women with definite non-viable intra-uterine pregnancies (dNVIUPs) (465 ng/mL; IQR 341-675 ng/mL). MIC-1 levels were significantly higher in women with dEP compared to women whose PULs resolved without medical intervention (srPUL) (401 ng/mL; IQR 315-475 ng/mL) (p<0.003). There were no women with an ectopic pregnancy where serum MIC-1>1000 ng/mL.Serum MIC-1 levels in PUL were not able to categorically diagnose EP, however, MIC-1 could distinguish women with an EP that required medical intervention and those women whose PULs spontaneously resolved. A single serum MIC-1 measurement also excluded EP at levels above 1000 ng/mL. MIC-1 may play a role in the development of a combined assay of biomarkers for the diagnosis of EP
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