Evaluasi Penggunaan Antibiotik Profilaksis Pada Pasien Bedah Apendisitis Di RSUD Dr M Ashari Pemalang Pada Tahun 2011

Apendisitis merupakan infeksi bakteria dan penyebab abdomen akut yang paling sering. Penatalaksanaan standar untuk apendisitis adalah operasi (apendiktomi) oleh sebab itu penggunaan antibiotik profilaksis diperlukan karena terbukti dapat mencegah atau mengurangi kejadian infeksi. Ketidaktepatan pemilihan antibiotik, indikasi dosis, cara pemberian, frekuensi dan lama pemberian menjadi penyebab tidak akuratnya pengobatan infeksi dengan antibiotik. Oleh karena itu, penelitian mengenai evaluasi penggunaan antibiotik profilaksis pada bedah apendisitis sangat diperlukan untuk mengetahui kesesuaian dan ketepatan penggunaan antibiotik profiliksis tersebut dalam mencegah terjadinya infeksi setelah bedah apendisitis. Penelitian ini bersifat observasional (non eksperimental) yang dilakukan secara retrospektif dan dianalisis dengan metode deskriptif. Pengambilan sampel dengan metode purposive sampling. Sampel penelitian pasien dewasa yang menjalani bedah apendisitis di RSUD Dr M Ashari pemalang pada tahun 2011 yang mendapatkan antibiotik profilaksis dan sesuai dengan kriteria inklusi. Data dibandingkan dengan Standar Pengobatan Medis RSUD Dr M Ashari Pemalang, lalu dievaluasi yang meliputi ketepatan obat, ketepatan pasien, ketepatan dosis. Pada 89 kasus pasien dengan 89 peresepan antibiotik diketahui sebanyak 77 peresepan (86,5%) tepat obat, 84 peresepan (94,4%) tepat pasien dan 89 peresepan (100%) tepat dosis. Tingginya ketepatan obat, ketepatan pasien, dan ketepatan dosis dikarenakan rumah sakit sudah menggunakan antibiotik yang sudah sesuai dengan SPM

Establishment of Unit-Based Council Using a Shared Governance Toolkit for Surgical clinics

Practice Problem: Shared governance (SG) is an organizational framework that empowers healthcare professionals by granting them authority over their own professional practice. The absence of a unit-based council (UBC) has been identified as hindering collaborative decision-making and problem-solving approaches. PICOT: In four surgical clinics requiring a Unit Based Counsel (UBC) structure (P), what is the impact of implementing a Shared Governance (SG) toolkit (I) compared to not implementing an SG toolkit (C) over eight weeks? (T) Evidence: The existing literature strongly indicates that shared governance (SG) empowers nurses to collaborate as equal partners with nursing leaders within the organization, fostering a collective effort in problem-solving and seeking effective solutions. Intervention: The Evidence-Based Practice (EBP) change management project encompassed several key steps, including the formation of a unit-based council (UBC) for Shared Governance (SG) through the utilization of an SG toolkit for education. To assess the success of SG, the Index of Professional Nursing Governance (IPNG) was employed to measure relevant elements both before and after the intervention. Outcome: The EBP change project was clinically significant in establishing a unit-based council (UBC) as part of the Shared Governance (SG) structure. A notable finding was the difference between male and female nurses regarding their perceptions of SG within the UBC. Female nurses reported significantly higher perceptions of shared governance in personnel matters compared to their male counterparts. Interestingly, although not statistically significant, male nurses reported higher perceptions of shared governance in other subscales except for goals. Conclusion: Shared Governance (SG) is crucial in healthcare organizations as it fosters shared decision-making among nurses. Ultimately, SG serves as the cornerstone for cultivating a culture of clinical and nursing excellence within high-performing healthcare organizations

Anorexia nervosa and reproduction: connecting brain to gonads

Anorexia nervosa (AN) is a psychiatric disorder that predominantly affects young women and is characterized by low caloric intake and a major dissatisfaction with one’s body image. It is often overlooked and, while patients and family seek medical help, emaciation and nutritional misbalances may become extreme and potentially life threatening. Among the many somatic complications, an accumulation of early endocrine adaptations occurs, leading to functional amenorrhea and impaired reproduction as a result of dysfunction of the hypothalamic-pituitary-ovarian axis. Even though these conditions are reversible, long-term consequences may affect the fertility of women with AN and can lead to maternal and fetal complications during pregnancy and birth. This review presents the clinical particularities of reproduction in the context of AN, along with the possible pathophysiological mechanisms involved

Pairing of Anaerobic and Aerobic Treatment of Petroleum Wastewater

The objective of this project was to treat petroleum refinery wastewater using a combination of anaerobic and aerobic processes, namely an Up-flow Anaerobic Sludge Blanket (UASB) reactor paired with a Rotation Algae Biofilm Reactor (RABR), respectively, to produce a treated effluent. The treatment method developed needed to produce a cost-effective and efficient way to decrease nitrogen, phosphorous, total suspended solids (TSS), and COD concentrations to below State of Utah limitations. It was demonstrated that RABR treatment was capable of reducing effluent concentrations of nitrogen, phosphorus, and TSS to State of Utah limitations. RABR treatment did not significantly reduce COD from the wastewater. The COD reduction requirement, however, was met through anaerobic digestion of the wastewater. Therefore, our system proved effectual at the treatment of the wastewater and met all design criteria

Algae-Based Biofilm Productivity and Treatment of Dairy Wastewater: Effects of Temperature and Organic Carbon Concentration

Production of dairy and associated products is a source of millions of gallons of wastewater every year. Water used in cleaning feeding stalls as well as the liquid component of the animal waste are two of the major volumetric components of this wastewater. This water is nutrient rich, often limiting the viability as a land applied fertilizer. However, these same nutrients could be used as an inexpensive feedstock for the cultivation of algae, which can then be used to produce downstream products including animal feed and aquaculture. As part of this study, algal biomass was cultivated on dairy wastewater from the Utah State University Caine Dairy. A Rotating Algal Biofilm Reactor (RABR) system was used to grow the biomass. The RABR is a biofilm technology designed and developed at Utah State University and has been applied to the treatment of municipal wastewater. In this study, the RABR was adapted for use in a dairy wastewater stream. The RABR was operated at temperatures ranging from 7-27 °C, and organic carbon levels in the wastewater ranged from 300-1200 mg/L of Total Organic Carbon (TOC). Areal algal biofilm growth rates were calculated, and statistical analysis showed that both increasing temperature and levels of organic carbon contributed to an increase in biomass growth and an increase in nutrient removal. Equations were then developed using a linearization method and corresponding constants and equations were generated that can be used to evaluate algal biomass productivity and nutrient removal rates in future experiments and designs for dairy wastewater

The Slash Between

In this Plan B thesis, I wrote a braided essay accompanied by a critical introduction. The essay moves between three different topics: Salt Lake Comic Con; the journal of James Holmes, the shooter in the Aurora theatre massacre; and my father’s incarceration. Through the interaction among these three topics, or strands, I explore the lines we construct as human beings as a way of defining and controlling our world. I investigate such dichotomies as normal/abnormal, inside/outside, good/bad, and fantasy/reality. By the end, the strands reveal the fragility of the lines we draw and the futility of attempting to construct them. As much as we try to sort and categorize, life falls into the area between lines—both normal and abnormal, inside and outside, good and bad, fantasy and reality. Rather than trying to reestablish my own lines and boundaries after the trauma of my father’s incarceration, I conclude that he falls in the space between categories, hovering the border. And ultimately, so do we all

Relaciones interculturales al interior de los grupos escolarizados en contextos de pobreza

Esta línea de investigación al interior del programa: Confrontaciones y entrecruzamientos de perspectivas en el trabajo grupal: un análisis cualitativo se plantea como objetivo central pensar en la constitución de estos grupos escolarizados en contextos de pobreza, a partir de las relaciones interculturales que establecen desde una perspectiva etnográfica educativa. La educación es una "construcción histórico social, un campo de mediación entre el desarrollo y la socialización, entre la naturaleza y la historia". De esta manera el sistema educativo tiene zonas de fronteras originadas por el choque de contradicciones, a partir de las cuales se posibilita la creación de un espacio político pedagógico. Las prácticas educativas son pensadas como un espacio que se construye por las interrelaciones que se establecen en un orden social, siendo ese lugar el entrecruzamiento con las demás prácticas, en donde los actores sociales de la educación se comprometen con la ciencia, la cultura, la política y la ideología. La enseñanza se concibe como un práctica socialmente construida, contextuada sociohistoricamente, cargada de valores, intenciones, por lo cual no puede analizarse desde la racionalidad técnica, sino desde los significados, condicionantes e intereses que la determinan. Estos grupos escolarizados que cursan el octavo año del tercer ciclo de la Educación General Básica -concurren a una escuela ubicada en la periferia de la ciudad de Rosario (Argentina). Son niños y jóvenes provenientes de migraciones internas, es decir de otras provincias argentinas desplazados de sus lugares de origen por causas relacionadas con el trabajo de sus padres; de asentamiento relocalizados dentro de la misma ciudad; de migraciones campo - ciudad y/o de países limítrofes (paraguayos, bolivianos y peruanos, entre otras). Dolores Juliano aporta para una mejor compresión del lugar que ocupa la escuela en las actuales coyunturas y como es la relación de esta institución con las minorías étnicas y la diversidad cultural. Dice que "afecta a todas las escuelas aún aquellas en las que no hay hijos de inmigrantes, pues de las opciones que se realicen al respecto dependerán en cierta medida, las características que tome la convivencia en el futuro" (Juliano, D 1993). En el campo educativo estas relaciones interculturales adquieren mayor importancia ya que en la escuela la institución a la que el Estado a dado el mandato -ley mediante- la transmisión de la cultura hegemónica. En relación a lo planteado nos propusimos utilizar una metodología aportada por el paradigma cualitativo. El trabajo de campo y la utilización del método etnográfico hacen que la tarea del investigador tenga un carácter "vivencial" en tanto el principio básico de esta tarea es su inserción en la realidad que constituye su objeto de estudio

Critical analysis of interpersonal trust determinants in virtual teams, working in capability planning in the identification of capability gaps or needs, to provide required future military capability in the UK’s MOD

The United Kingdom’s Ministry of Defence (MOD) balances defence policy aspirations and available resources through the capability planning process. Arguably, the cornerstone of this process is the cross-functional integration of skills and capabilities across defence. This is realised through a construct of Virtual Teams (VTs) called Capability Planning Groups (CPGs). Literature on the topic of interpersonal trust in VTs highlights the development of trust as a key element, if not the most significant, in pursuing desired outcomes. Furthermore, literature on this topic, in a defence context, is scarce. This thesis undertakes a specific research approach, in accordance with its aim: To develop a critical analysis of interpersonal trust determinants in VTs, working in capability planning for the identification of capability gaps or needs, to provide required future military capability. Consequently, three research questions are investigated: What are the pertinent determinants of interpersonal trust in the CPG?; What, if any, are the issues surrounding those determinants within the CPG?; and, What risks are there, beyond the interpersonal relationships, which could influence the trust behaviour of CPG members? A critical review of pertinent literature is followed by the development of a research methodology under a phenomenological paradigm. Building from this, fieldwork was undertaken in two phases. As a result of semi-structured interviews to the members of a number of CPGs, the way in which interpersonal trust is generically perceived was conceptualised, and confirmation of the interpersonal trust determinants considered in an adapted model of interpersonal trust in CPGs was provided. In addition, a cross-case analysis allowed the integration of the data gathered, in order to identify target areas to be covered in the second wave of data collection. Subsequently, in Phase II, information was gathered through a survey questionnaire addressed to the whole population under consideration, in order to increase the robustness of the study, by confirming and providing further insights about key issues identified, as well as underpinning more powerful conclusions. From this, interpersonal trust determinants pertaining to the CPGs, as well as the issues and risks regarding interpersonal trust, were asserted. A major finding was the conceptualisation of these issues and risks, because they are critical in determining if a specific behaviour will be taken. Moreover, as highlighted in the Defence Reform Report (2011), some of these are already identified as very real concerns, and appear as structural or enduring problems at MOD level. These elements are deemed a central focus for future research, because of their significance as contextual variables that have to be addressed in order to stimulate interpersonal trust and, consequently, improve performance in the CPGs. As the use of VTs is considered most likely to increase over time in MOD organisations, the findings from this research will be useful to all personnel involved in capability planning, and other cross-functional activities. In particular, it could inform the design of organisational processes and systems as capability management is taken forward. Finally, the issues and risks associated with such virtual trust are asserted as not believed to be a manifestation of dysfunctional strategic planning because defence organisations can have clarity of purpose, can have clear direction, and yet still send competing messages. Paradoxically, that is the weakness of being strong. The analysis suggests that action has to be taken in order to stimulate interpersonal trust, because it is important to avoid or mitigate negative effects of contextual variables influencing CPGs. To this end, it is crucial to understand the role that interpersonal trust plays in the cross-functional work that is critical for the successful integration of skills and capabilities, and to ensure that people involved in capability planning and other cross-functional activities are assisted in understanding the nature of this challenging and complex context

PENGARUH EARNING PER SHARE (EPS) TERHADAP HARGA SAHAM LQ-45 DI BURSA EFEK INDONESIA (BEI)

Tujuan penelitian adalah untuk mengetahui pengaruh Earning Per Share (EPS) terhadap harga saham LQ-45 di Bursa Efek Indonesia (BEI) periode 2007-2011. Jumlah perusahaan LQ-45 yang menjadi sampel pada penelitian ini adalah sebanyak 13 emiten. Metode penelitian yang digunakan dalam menganalisis mengenai pengeruh earning per share (EPS) terhadap harga saham LQ-45 di BEI adalah dengan menggunakan uji analisis regresi sederhana dan uji (one-sample T Test). Hasil yang diperoleh dari penelitian ini menunjukan bahwa terdapat pengaruh yang signifikan antara earning per share (EPS) terhadap harga saham LQ-45 di BEI. kesimpulan dari penelitian ini adalah earning per share (EPS) memiliki pengaruh terhadap harga saham perusahaan yang terdaftar dalam LQ-45 di BEI

Ceftiofur-loaded PHBV microparticles: A potential formulation for a long-acting antibiotic to treat animal infections

Indexación: Web of Science; ScieloBackground: The infectious diseases in the livestock breeding industry represent a significant drawback that generates substantial economic loss and have led to the indiscriminate use of antibiotics. The formulation of polymeric microparticles loaded with antibiotics for veterinary use can: reduce the number of required doses; protect the drug from inactivation; and maintain a sustained-release of the antibiotic drug at effective levels. Accomplishing all of these goals would have a significant economic and animal health impact on the livestock breeding industry. Results: In this work, we formulated ceftiofur-loaded PHBV microparticles (PHBV-CEF) with a spherical shape, a smooth surface and diameter sizes between 1.65 and 2.37 μm. The encapsulation efficiency was 39.5 ± 1.1% w/w, and we obtained a sustained release of ceftiofur in PBS-buffer (pH 7.4) over 7 days. The antibacterial activity of ceftiofur was preserved after the encapsulation procedure, and toxicity of PHBV-CEF microparticles evaluated by MTS was represented by an IC50 > 10 mg/mL. Conclusions: Our results suggest that PHBV-CEF particles have a potential application for improving the treatment of infectious diseases in the livestock breeding industry. Keywords: ceftiofur, drug delivery, livestock breeding industry, PHBV, polymeric microparticle