Perilaku Inovasi Karyawan Ditinjau Dari Empat Kuadran Iklim Organisasi

Penelitian ini bertujuan untuk melihat hubungan antara iklim organisasi denganperilaku inovasi karyawan. Penelitian ini menggunakan pendekatan kuantitatif denganmetode korelasional, melibatkan 36 orang karyawan yang bekerja di harian Tribun Medandan teknik pengambilan sampel menggunakan nonrandom sampling yaitu conviniencesampling. Hasil penelitian menunjukkan bahwa iklim organisasi memiliki tiga kuadran yangberhubungan dengan perilaku inovasi yaitu kuadran human relation model, rational goalmodel dan open system model, sedangkan satu kuadran lainnya yaitu internal process modeltidak menunjukkan adanya pengaruh dengan perilaku inovasi. Berdasarkan hasil penelitianini dapat disimpulkan bahwa untuk meningkatkan perilaku inovasi karyawan di suatuperusahaan, maka pihak manajemen patut pula untuk memperhitungan iklim organisasi yangberkembang di Perusahaannya

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Levosimendan and Global Longitudinal Strain Assessment in Sepsis (GLASSES 1): a study protocol for an observational study

Introduction Cardiogenic shock is a condition of low cardiac output that represents the end stage of a progressive deterioration of cardiac function. The main cause is ischaemic heart disease, but there are several non-ischaemic causes, including sepsis. The use of levosimendan in cardiogenic shock during sepsis is still under debate.Methods We are conducting an observational, single-centre, not-for-profit study enrolling patients aged 18–80 years old admitted to the intensive care unit with a diagnosis of septic shock. Patients will be monitored with the EV1000/VolumeView device (Edwards Lifesciences, Irvine, USA). Patients with cardiac index (CI) values <2.5 L/min/m2 and/or stroke volume index (SVI) <30 mL/beat/m2 are considered eligible for the study. Enrolled participants will undergo an echocardiographic examination using the Vivid S6 ultrasound machine (General Electric, Northville, Michigan) and a 3.6 MHz cardiology probe through which the apical projections of chambers 2, 3 and 4 will be acquired; this is necessary to calculate the global longitudinal strain (GLS) using EchoPAC* Clinical Workstation Software (General Electric). A dobutamine infusion will be started in these patients; 24 hours later CI and SVI will be recalculated using EV1000/VolumeView and then a levosimendan infusion will begin for 24 hours. Once the infusion cycle of the calcium-sensitising drug has been carried out, the infusion of dobutamine will be reduced until it stops, and the CI, SVI, GLS and arterial elastance (Ea):Ventricular Elastance (Ees) will be re-evaluated. The primary endpoint is recovery of GLS ≥15% and the secondary endpoint is a relative reduction in mortality of 15%.Ethics and dissemination The investigators declare that the study will be conducted in full compliance with international regulations (EU Directive 2016/679/EC) and national implementation (DM 15 July 1997; 211/2003; 200/2007) regarding the clinical trial and the principles of the Declaration of Helsinki. Study results will be disseminated through peer-reviewed journals and conferences. Ethical approval for this study has been given by Comitato Etico Regione Toscana - Area Vasta Centro, Florence, Italy (ethical committee number: 13875_oss) on 25 May 2019 (Chairperson Professor Marco Marchi).Trial registration number NCT04141410

Deep sedation for nasal septal surgery: an observational retrospective study with an inverse probability weighting model

Abstract Background Septoplasty, a common surgical procedure to correct a deviated septum, can be performed under either general anesthesia or deep sedation anesthesia. The choice of anesthesia can influence the duration of anesthesia and surgical outcomes, impacting the feasibility of outpatient procedures. Methods The institutional review board approved the protocol, and we obtained written informed consent from all participants. This retrospective, single-center observational study analyzed data from 586 patients who underwent rhino septoplasty at Santo Stefano Hospital in Prato, Italy, from 2017 to 2021. Patients received either general anesthesia or deep sedation anesthesia. Propensity score matching and inverse probability weighting were used to balance patient characteristics. The main outcome variable was discharge time, with anesthesia time and surgical time as covariates. Statistical analysis was conducted using R software. Results Patients who received deep sedation anesthesia had a significantly shorter duration of anesthesia compared to those who received general anesthesia. A multivariate linear regression model showed that the type of anesthesia had a strong positive association with discharge time, while anesthesia time had a weaker negative association, although not statistically significant. Conclusions Deep sedation anesthesia is associated with a shorter duration of anesthesia compared to general anesthesia during nasal septal surgery, suggesting it could be a more feasible option for outpatient procedures. However, the choice of anesthesia should be tailored to individual patient factors and surgical requirements. Further research is needed to confirm these findings and explore the potential benefits of sedation anesthesia in outpatient nasal septal surgery. Question How do general anesthesia and deep sedation anesthesia compare in terms of duration of anesthesia and surgical outcomes during nasal septal surgery? Findings Our study found that deep sedation anesthesia was associated with a shorter duration of anesthesia compared to general anesthesia in patients undergoing nasal septal surgery. However, there were no significant differences in the duration of the surgical procedure. Meaning The findings suggest that deep sedation anesthesia could potentially make nasal septal surgery more feasible as an outpatient procedure

SOFA score.

<p>Mean and SD of SOFA scores cumulatively observed for the entire population at the baseline, and then at 6, 12, 24 and 48 hrs after HCO-CVVHD initiation; and at 24 and 48 hrs after HCO-CVVHD discontinuation (Panel A). In Panel B, SOFA scores are shown for each subgroup (Survivors and non-Survivors). * Value statistically different to the baseline through statistical test for pairs data. † Value statistically different between groups through statistical test for unpaired data.</p

HCO-CVVHD treatment parameters across the groups.

<p>HCO-CVVHD treatment parameters across the groups.</p

Circulating levels of inflammatory mediators.

<p>Concentrations of mediators are expressed in a logarithmic scale.</p

Clinical and biochemical parameters for both the overall population and the Survivors and non-Survivors subgroups.

<p>Clinical and biochemical parameters for both the overall population and the Survivors and non-Survivors subgroups.</p