Adequacy of postoperative pain relief after discharge

Day care surgery has shown a remarkable development over the last two decades, comprising approximately 60-70% of all surgical procedures. Therefore major proportions of surgical patients are recovering at home and have little or no assessment of the adequacy of their pain relief. The aim of our audit was to compare suggested postoperative pain indicators with targets for best practice. This audit was done at the Aga Khan University Hospital day care unit for a period of three months. On the day of surgery patients having the contact numbers were informed about the telephone call 24 hrs after the surgery inquiring about their pain relief. Patients were shown and explained the visual analogue score from 0 to 10. The data was collected by one of the investigators on the day of surgery. We could assess 63.3% of day care patients. All patients were discharged with analgesia. Only three percent reported severe pain after 24 hrs which is according to the proposed standard for best practice that is \u3c 5 %. Sixty percent of patients had mild or no pain which is less than the proposed standard (\u3e85%) and 84.2% were satisfied which is almost borderline (\u3e85%) according to the standard of best practice

Implementasi Micro Teaching Kaitannya Dengan Keterampilan Mengajar Pada Program Pengalaman Lapangan (PPL) Bagi Mahasiswa Program Studi PGSD FKIP UMS Tahun 2013/2014

Penelitian ini bertujuan untuk mengetahui pengelolaan laboratorium micro teaching FKIP UMS, mengetahui kegiatan micro teaching yang dilakukan mahasiswa Program Studi PGSD, dan mengetahui pelaksanaan micro teaching kaitannya dengan keterampilan mengajar mahasiswa dalam Pelaksanaan Program Pengalaman Lapangan (PPL). Penelitian ini termasuk jenis penelitian deskriptif kualitatif. Subjek penelitian ini adalah pengelola laboratorium micro teaching yang diwakilkan oleh petugas administrasi laboratorium micro teaching, dosen mata kuliah micro teaching, guru pamong dalam kegiatan Program Pengalaman Lapangan (PPL), dan mahasiswa semester VII FKIP PGSD UMS. Metode pengumpulan data dilakukan melalui wawancara mendalam, observasi, dan studi dokumentasi. Untuk menjamin keabsahan data, digunakan teknik triangulasi sumber. Dalam melakukan analisis data, penelitian ini menggunakan teknik analisis deskriptif model interaktif. Berdasarkan data yang terkumpul, kemudian dideskripsikan dan dianalisis, penulis dapat mengambil kesimpulan bahwa: Pengelolan laboratorium micro teaching sudah baik, peralatan atau fasilitas yang ada juga sudah mendukung kegiatan praktik micro teaching. Dengan adanya peralatan yang sudah mendukung kegiatan praktik micro teaching tersebut, mahasiswa juga dapat melatih keterampilan mengajar yang mereka miliki. Pelaksanaan micro teaching sangat efektif kaitannya dengan keterampilan mengajar yang dimiliki oleh mahasiswa dan dengan keterampilan yang mereka miliki mahasiswa dapat mengimplementasikannya pada saat kegiatan Program Pengalaman Lapangan (PPL)

Identify cmy-2 Incompatibility Groups in Salmonella Multidrug Resistance Plasmids

Many Gram negative bacteria including Salmonella enterica species exhibit evolving multi-drug resistance coded for on their chromosome and on mobile genetic elements. Salmonella species carrying multi-drug resistance plasmids can potentially disperse the cmy-2 gene conferring β- lactam resistance to new Salmonella species as well as to other enteric bacteria commonly found in the human and animal gut. Objective: This study seeks to identify the numbers and incompatibility types of plasmids carried by six different Salmonella clinical isolates. Design: Raw whole genome and DNA fragment (contig) sequence secondary data analyses were conducted using the Center for Genomic Epidemiology (Lyngby, Denmark) open source internet databases plasmid Multilocus Sequence Typing (pMLST) and Resistance Finder (ResFinder). Method: Nucleic acid sequences were separated into files, labeled by contig, and uploaded to the consensus databases for analysis against known Salmonella resistance genes and plasmid types. Results were returned in table format and identified specific resistance, susceptibility, and incompatibility groups present with greater than 90% homology between known and analyzed DNA sequences. Results: Results of this analysis show that these bacterial strains carry plasmids which confer multi-drug resistance and that multiple incompatibility groups are present across some but not all analyzed Salmonella strains. Conclusions: The researchers continue to analyze the data and have not yet formed conclusions as to their significance. This study will advance our understanding about how bacteria develop multiple antibiotic resistances and could ultimately help design more effective drugs with greater potential to combat and prevent bacterial diseases

Relative effectiveness of mindfulness and cognitive behavioral interventions for anxiety disorders: Meta-analytic review

Increasingly popular mindfulness intervention innovations seem demonstrably effective in alleviating anxiety among people with anxiety disorders. However, the basis of such primary and synthetic evidence has, for the most part, been comparisons with non-active comparison conditions such as waiting lists. The longest-standing and strongest evidence-informed practices in this field have been cognitive behavioral interventions (CBI). This meta-analysis synthesized evidence from nine randomized trials of the relative effectiveness of mindfulness interventions compared to CBIs (i.e., active control groups) in treating anxiety disorders. The sample-weighted synthesis found no statistically or practically significant differences between the two groups on anxiety alleviation: Cohen’s d = - 0.02 (95% confidence interval = - 0.16, 0.12). Both groups enjoyed large clinical benefits. However, because mindfulness methods may require less professional training and take less time for both workers and clients to master, they are probably less expensive to provide. As they are probably less expensive, but equally effective, it seems that, in a cost-beneficial sense, mindfulness interventions may be more practically effective. These review-generated meta-analytic findings and inferences may be best thought of as developed hypotheses for future research testing. These and other future research needs are discussed

Dynamics of Birth Spacing in Pakistan

In recent years the study of birth spacing has emerged as an area of demographic interest. This is because of its close linkage with the timing and tempo of fertility relative to other measures. At the same time, marital fertility in Pakistan and the duration of breastfeeding have shown a decline (Khan 1985). Thus, the study of birth spacing becomes an important area for examining changes in the components of fertility. The paper's major objectives are to study: (I) Changes in spacing between births if any. (2) Differentials in birth spacing by residence in major 'urban', 'other urban’ and 'rural' areas to see if there is a gradation in birth spacing by levels of urbanization. (3) And differentials in birth spacing by age at marriage, urbanization, education, work pattern and contraceptive use

Second Order Corrections to QED Coupling at Low Temperature

We calculate the second order corrections to vacuum polarization tensor of photons at low temperatures, i.e; T $\le 10^{10}$ K ($T << m_e$). The thermal contributions to the QED coupling constant are evaluated at temperatures below the electron mass that is $T< m_e$ . Renormalization of QED at these temperatures has explicitly been checked. The electromagnetic properties of such a thermal medium are modified. Parameters like electric permittivity and magnetic permeability of such a medium are no more constant and become functions of temperature.Comment: 8 latex pages and 1 figure (to appear in IJMP

Effectiveness of stretching and strengthening exercises in shoulder impingement syndrome

BACKGROUND : Being the most flexible joint in the human body, the shoulder is prone to injuries and dislocation that is usually very painful. Impingement syndrome occurs when the tendons of rotator cuff and the sub acromial bursa are compressed between the bones of the shoulder. Impingement syndrome is a common cause of shoulder pain especially during over head activities. AIM AND OBJECTIVES : To find out the effect of stretching exercises in shoulder muscles using Hug a tree stretch, door way stretch, back of shoulder stretch etc. exercises in shoulder impingement syndrome. To find out the effect of strengthening exercises in shoulder muscles using shoulder shrugs, towel squeezes, supine press, and biceps curls etc. in shoulder impingement syndrome. METHODS : Fifteen subjects are selected based on the inclusion criteria. All the subjects will be treated in single group. The duration of the study was eight weeks. Pre test and post test evaluation was done using SPADI. RESULT : This study revealed significant difference in pain and functional disability after stretching and strengthening exercises. CONCLUSION : The results indicate that stretching and strengthening exercises reduces pain and improves functional ability

Mending the Gaps: An Exercise in Identifying and Understanding Diverse and Multicultural Team Faultlines

The Faultlines Exercise, an experiential activity, introduces students to concepts of diversity attributes (surface and deep levels), social identity, and team faultlines. Through individual reflection and team discussion, students apply these concepts to their own diverse multicultural class teams with the goals of (a) preventing negative outcomes that may develop from faultlines and (b) improving team performance. Plenary class discussions reinforce key learning points that can be applied to teamwork throughout the course. Students in both face-to-face and online classes report that the exercise helps improve team performance and helps to identify and resolve problems. Instructions for facilitating classroom discussion and student handouts are provided, as are suggestions for adapting the exercise to other constructs