294 research outputs found

    Analisa Pembangunan Manusia Dan Pengaruhnya Terhadap Kesejahteraan Penduduk Di Kabupaten Mimika

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    Tujuan dari penelitian ini adalah untuk mengetahui : a) bagaimana korelasi IPM dengan komponen-komponen pembentuk IPM, b) faktor apa yang paling besar membentuk IPM, dan c). seberapa besar pengaruh IPM terhadap Pendapatan Per Kapita, dan Kemiskinan.Data yang digunakan dalam penelitian adalah Indeks Pembangunan Manusia, Pendapatan Per Kapita dan Tingkat Kemiskinan Kabupaten Mimika kurun waktu tahun 2005 – 2013. Metode analisis yang digunakan dalam menjawab tujuan penelitian di atas adalah menggunakan analisis korelasi dan analisis regresi sederhana. Hasil analisis menunjukkan bahwa seluruh komponen pembentuk IPM mempunyai korelasi yang sangat kuat dan signifikan terhadap IPM, dengan rata-rata angka koefisien korelasi lebih dari 0,90 atau 90% ke atas.Diantara keempat komponen tersebut, Angka Harapan Hidup (AHH) dan Pengeluaran Per Kapita (PPP) keduanya mempunyai koefisien korelasi yang paling tinggi dan sama besar terhadap variabel IPM yakni 0,980 untuk AHH, dan 0,986 untuk PPP. Ini berarti kedua komponen tersebut dapat dikatakan sebagai pembentuk yang paling dominan terhadap IPM. Sehingga cepat lambatnya perkembangan IPM sangat tergantung kepada hasil pembangunan kesehatan dan pembangunan ekonomi daerah. Hasil analisis lainya menunjukkan bahwa kenaikan IPM Kabupaten Mimika sebesar 1 point akan menurunkan tingkat kemiskinan sebesar 3,8225 persen atau 4 persen, selain itu kenaikan IPM akan meningkatkan pendapatan per kapita masyarakat Kabupaten Mimika sebesar Rp. 717.414,40.Kata Kunci : Indeks Pembangunan Manusia, Pendapatan Per kapita, Tingkat Kemiskina

    Drug wastage among the elderly living in old aged homes in Hong Kong

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    The extend of drug wastage among elderly living in old aged homes was never investigated. Upon the completion of the previous study on pharmaceutical services provided to elderly living in old aged homes, the amount of drugs wasted from 3,020 residents in one of the delegated pharmacies over a 4-month period were counted and their costs were calculated. The total cost of wasted drugs amounted to be HKD96,924,withdrugsactingonthecentralnervoussystemcontributedtothehighestcostofHKD96,924, with drugs acting on the central nervous system contributed to the highest cost of HKD26,872 (27.7%), followed by respiratory drugs of HKD23,875(24.623,875 (24.6%) and alimentary tract & metabolism of HKD22,965 (23.7%). The results showed that for health institutes dispensing prescriptions of long duration to the elderly could lead to considerable amount of drug wastage and this issue should be addressed.link_to_subscribed_fulltex

    The pharmaceutical services to the elderly in the old aged homes in Hong Kong: a scope exercise

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    Various models of pharmaceutical services have been provided by pharmacists to old aged home residents, however, these models have never been summarised and compared. The aim of this scoping exercise is to identify different kinds of pharmaceutical services currently available to the old aged home residents, by means of systemic literature review, qualitative in-depth interviews with service providers in order to understand their models and qualitative semi-structured interviews with non-pharmaceutical service users in an attempt to investigate reasons why some homes do not subscribe to these services. The results showed that none of the pharmaceutical services currently available can uproot the causes of medication errors, and there is a need to elaborate the roles of pharmacists in a primary care setting.link_to_subscribed_fulltex

    Perbandingan Nilai Agregasi Trombosit Pada Pasien Hipertensi Yang Diberi Aspirin Dan Tidak Diberi Aspirin Di Rsup. Prof. Dr. R. D. Kandou Manado

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    : Thrombocyte hyperaggregation occurs in hypertensive patients. Thrombocyte accumulates and thrombi formation caused by hyperaggregation are important factors in pathogenesis of cardiovaskular and cerebrovascular disease. Around 50 million people consume aspirin everyday to treat or to prevent cardiovascular or cerebrovascular disease. The use of aspirin known can increase bleeding risk especially when trauma occurs or intraoperative, but inhypertensive patients50 or over 50 years old, the benefit of aspirin can be greater then the bleeding risk it carries. Method: This study used comparative study, which compared thrombocyte aggregation value in hypertensive patients with aspirin and without aspirin. The tools that used for thrombocyte aggregation examination is an aggregometer and the data analysis is done by using SPSS software. Result: The difference value of thrombocyte aggregation in hypertensive patients with aspirin and without aspirin used T 2 independent samples test gave significant for ADP 10 µM and 5 µM(p <0.05), respectively 0.001 and 0.01. Conclusion: There is a difference between thrombocyte aggregation value in hypertensive patients with aspirin and without aspirin. Mean value ofthrombocyte aggregation in hypertensive patients with aspirin is lower than hypertensive patients without aspirin

    Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: an analysis of sales data from 70 middle-income and high-income countries

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    Background The 2017 WHO Model List of Essential Medicines for Children (EMLc) groups antibiotics as Access, Watch, or Reserve, based on recommendations of their use as first-choice and second-choice empirical treatment for the most common infections. This grouping provides an opportunity to review country-level antibiotic consumption and a potential for stewardship. Therefore, we aimed to review 2015 levels of oral antibiotic consumption by young children globally. Methods We analysed wholesale antibiotic sales in 70 middle-income and high-income countries in 2015. We identified oral antibiotic formulations appropriate for use in young children (defined as child-appropriate formulations [CAFs]) using wholesale data from the IQVIA-Multinational Integrated Data Analysis System database, and we estimated 2015 antibiotic consumption in reference to the 2017 WHO EMLc Access, Watch, Reserve (AWaRe) antibiotic groups. We used three metrics for assessment of intra-country patterns: access percentage, defined as the number of CAF standard units of Access antibiotics divided by the total number of CAF standard units; amoxicillin index, defined as the number of amoxicillin CAF standard units divided by the total number of CAF standard units; and access-to-watch index, defined as the ratio of Access-to-Watch CAF standard units. Findings The overall median volume of CAF antibiotic standard units sold in 2015 per country was 74·5 million (IQR 12·4–210·7 million). The median access percentage among the 70 countries was 76·3% (IQR 62·6–84·2). The amoxicillin index was low (median 30·7%, IQR 14·3–47·3). The median access-to-watch index was 6·0 (IQR 3·1–9·8). CAF antibiotic consumption patterns were highly variable between the 70 countries, without a clear difference between high-income and middle-income countries. Interpretation Antibiotics in the Access group have a key role in treating young children globally. A simple combination of metrics based on the AWaRe groups can be informative on individual countries' patterns of antibiotic consumption and stewardship opportunities. These metrics could support countries in the development of programmes to improve access to core Access antibiotics, particularly amoxicillin. Funding Global Antibiotic R&D Partnership (German Federal Ministry of Health, Médecins Sans Frontières, Netherlands Ministry of Health, Welfare and Sport, and UK Department for International Development)

    Comparative efficacy and safety of statin and fibrate monotherapy: A systematic review and meta-analysis of head-to-head randomized controlled trials

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    OBJECTIVE: To assess whether in adults with dyslipidemia, statins reduce cardiovascular events, mortality, and adverse effects when compared to fibrates. METHODS: Systematic review and meta-analysis of head-to-head randomized trials of statin and fibrate monotherapy. MEDLINE, EMBASE, Cochrane, WHO International Controlled Trials Registry Platform, and ClinicalTrials.gov were searched through October 30, 2019. Trials that had a follow-up of at least 28 days, and reported mortality or a cardiovascular outcome of interest were eligible for inclusion. Efficacy outcomes were cardiovascular mortality and major cardiovascular events. Safety outcomes included myalgia, serious adverse effects, elevated serum creatinine, and elevated serum alanine aminotransferase. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using the Mantel-Haenszel fixed-effect model, and heterogeneity was assessed using the I2 statistic. RESULTS: We included 19 eligible trials that directly compared statin and fibrate monotherapy and reported mortality or a cardiovascular event. Studies had a limited duration of follow-up (range 10 weeks to 2 years). We did not find any evidence of a difference between statins and fibrates for cardiovascular mortality (OR 2.35, 95% CI 0.94-5.86, I2 = 0%; ten studies, n = 2657; low certainty), major cardiovascular events (OR 1.15, 95% CI 0.80-1.65, I2 = 13%; 19 studies, n = 7619; low certainty), and myalgia (OR 1.32, 95% CI 0.95-1.83, I2 = 0%; ten studies, n = 6090; low certainty). Statins had less serious adverse effects (OR 0.57, 95% CI 0.36-0.91, I2 = 0%; nine studies, n = 3749; moderate certainty), less elevations in serum creatinine (OR 0.17, 95% CI 0.08-0.36, I2 = 0%; six studies, n = 2553; high certainty), and more elevations in alanine aminotransferase (OR 1.43, 95% CI 1.03-1.99, I2 = 44%; seven studies, n = 5225; low certainty). CONCLUSIONS: The eligible randomized trials of statins versus fibrates were designed to assess short-term lipid outcomes, making it difficult to have certainty about the direct comparative effect on cardiovascular outcomes and mortality. With the exception of myalgia, use of a statin appeared to have a lower incidence of adverse effects compared to use of a fibrate

    Estimating global trends in total and childhood antibiotic consumption, 2011-2015

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    Introduction Understanding patterns of antibiotic consumption is essential to ensure access to appropriate antibiotics when needed and to minimise overuse, which can lead to antibiotic resistance. We aimed to describe changes in global antibiotic consumption between 2011 and 2015. Methods We analysed wholesale data on total antibiotic sales and antibiotics sold as child-appropriate formulations (CAFs), stratified by country income level (low/middle-income and high-income countries (LMICs and HICs)). The volume of antibiotics sold per year was recorded for 36 LMICs and 39 HICs, measured in standard units (SU: 1 SU is equivalent to a single tablet, capsule or 5 mL ampoule/vial/oral suspension) and SU per person, overall and as CAFs. Changes over time were quantified as percentage changes and compound annual growth rates in consumption per person. Analyses were conducted separately for total sales, sales of antibiotics in the Access and Watch groups of the WHO’s Essential Medicines List for children 2017, for amoxicillin and amoxicillin with clavulanic acid. Results Antibiotic consumption increased slightly between 2011 and 2015, from 6.85×1010 SU to 7.44×1010 SU overall and from 1.66×1010 SU to 1.78×1010 SU for CAFs. However, trends differed between countries and for specific antibiotics; for example, consumption of amoxicillin as CAFs changed little in LMICs and HICs, but that of amoxicillin with clavulanic acid increased by 6.8% per year in LMICs and decreased by 1.0% per year in HICs. Conclusions As measured in standard units in sales data, the rate of increase in global antibiotic consumption may be slowing. However, the trends appear to differ between countries and drugs. In the absence of routine surveillance of antibiotic use in many countries, these data provide important indicators of trends in consumption which should be confirmed in national and local studies of prescribing

    The association between dementia and the risk of hypoglycaemia events among patients with diabetes mellitus: a propensity-score matched cohort analysis

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    Background: Hypoglycaemia commonly occurs in patients diagnosed with diabetes mellitus (DM) and dementia. The impact of dementia on hypoglycaemic events is controversial. Thus, we evaluated whether dementia increases the risk of hypoglycaemic events in older patients diagnosed with DM. Design: A retrospective cohort study. Setting: We used the IQVIA Medical Research Data (IMRD-UK) database (formerly known as the THIN database). Participants: All patients aged ≥55 years and diagnosed with DM who were prescribed at least two prescriptions of antidiabetic medication between 2000 and 2017. Two groups of patients, dementia and non-dementia group, were propensity-score (PS) matched at 1:2. The risk of hypoglycaemia was assessed through a Cox regression analysis. Main outcome and measures: Hypoglycaemic events were determined during the follow-up period by Read codes. Results: From the database, 133,664 diabetic patients were identified, with a mean follow-up of 6.11 years. During the study period, 7,762 diabetic patients diagnosed with dementia were matched with 12,944 diabetic patients who had not been diagnosed with dementia. The PS-matched Cox regression analysis showed that patients diagnosed with dementia were at a 2-fold increased risk for hypoglycaemic events compared with those not diagnosed with dementia (hazard ratio [HR], 2.00; 95% CI, 1.63–2.66). A similar result was shown for a multivariable analysis using all patient data (adjusted HR, 2.25; 95% CI, 2.22–2.32). Conclusion: Our findings suggest that diabetic patients with a diagnosis of dementia have a statistically significant higher risk of experiencing hypoglycaemia
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