Karakterisasi Senyawa Hasil Isolasi Dari Ekstrak Etil Asetat Daun Namnam (Cynometra Cauliflora L.) Yang Memiliki Aktivitas Antibakteri

Namnam is known as a plant family of fabacea that contains phenolic compounds with diverse biological activities including antibacterial. The aim of this study was to isolate and characterize the antibacterial activity of compounds isolated from ethyl acetate extract of the leaves namanam (Cynometra cauliflora L.). Extraction was done by maceration, fractionation by column chromatography, antibacterial essay by disc diffusion method, and characterization of compounds with UV-Vis, FTIR spectroscopy and LCMS. Ethyl acetate extracts have antibacterial activity with inhibition zone respectively 12.25 and 6.00 mm to Escherecia coli and Stapilococcus aureus at a concentration of 100,000 ppm. The results of column chromatography fractions 23-30 yielded three isolates with Rf 0.20 cm; 0.33 cm and 0.87 cm. Characteristics of antibacterial active compounds in isolates 2 (Rf 0.33 cm) is based on the analysis results are UV-Vis absorption at λmaks 206.93 nm, 268.40 nm, 328.58 nm, 383.98 nm and 386.98 nm , FTIR (KBr) showed -OH group 3415.68 cm-1, CH 2958.10 cm-1, C = C aromatic 1651.18 cm-1, C-OH cyclic 1019.88 cm-1 and CH aromatic 694.56 cm-1 and LCMS produce three main peak at a retention time of 4.82; 6.87 and 7.64 which is thought to be the compound 2-isopropyl-5-metilsikloheksil 2-hidroksipropanoat, Cuelure, and 2-[(2-Hydroxycyclohexyl) oxy] cyclohexanecarboxylate

The effects of laryngeal mask airway passage simulation training on the acquisition of undergraduate clinical skills: a randomised controlled trial

Background\ud Effective use of the laryngeal mask airway (LMA) requires learning proper insertion technique in normal patients undergoing routine surgical procedures. However, there is a move towards simulation training for learning practical clinical skills, such as LMA placement. The evidence linking different amounts of mannequin simulation training to the undergraduate clinical skill of LMA placement in real patients is limited. The purpose of this study was to compare the effectiveness in vivo of two LMA placement simulation courses of different durations. \ud \ud Methods\ud Medical students (n = 126) enrolled in a randomised controlled trial. Seventy-eight of these students completed the trial. The control group (n = 38) received brief mannequin training while the intervention group (n = 40) received additional more intensive mannequin training as part of which they repeated LMA insertion until they were proficient. The anaesthetists supervising LMA placements in real patients rated the participants' performance on assessment forms. Participants completed a self-assessment questionnaire. \ud \ud Results\ud Additional mannequin training was not associated with improved performance (37% of intervention participants received an overall placement rating of > 3/5 on their first patient compared to 48% of the control group, $X^2$ = 0.81, p = 0.37). The agreement between the participants and their instructors in terms of LMA placement success rates was poor to fair. Participants reported that mannequins were poor at mimicking reality. \ud \ud Conclusions\ud The results suggest that the value of extended mannequin simulation training in the case of LMA placement is limited. Educators considering simulation for the training of practical skills should reflect on the extent to which the in vitro simulation mimics the skill required and the degree of difficulty of the procedure. \ud \u

Validation of “Care of the Dying Evaluation” in emergency medicine (CODEEM): pilot phase of End-of-life Management Protocol Offered Within Emergency Room (EMPOWER) study

Background: An increasing number of patients who present to emergency departments are at their endof-life phase and have significant palliative care needs such as in symptom control for pain and dyspnoea. Evaluating quality of care provided is imperative, yet there is no suitable tool validated in the emergency and Asian settings. We aim to examine the face and construct validity, and reliability of a newly developed questionnaire, Care of the Dying Evaluation - Emergency Medicine, for measuring the quality of end-of-life care in an Asian emergency context. Methods: A mixed methods pilot study was conducted. Participants composed of the next-of-kin to thirty dying patients who presented to the emergency departments of three public hospitals in Singapore. Qualitative evaluation, using cognitive "think-aloud" interviews, and quantitative analysis were employed. Percentage agreement and κ statistic were measured to evaluate temporal stability of the questionnaire. Cronbach's α and item-total correlations were used to assess internal consistency within the constructs. Confirmatory factor analysis was performed for construct validity. Results: All participants reported clear understanding of the questionnaire with no ambiguity; a minority felt the questions caused emotional distress (7/30, 23.3%). The questions showed moderate to good testretest reliability. Internal consistencies within the constructs were good for "ENVIRONMENT" and "CARE", and moderate for "COMMUNICATION". Factor loadings range from 0.40 to 0.99. Conclusions: The Care of the Dying Evaluation - Emergency Medicine questionnaire may be valid and reliable for use in an Asian emergency setting. Our prospective multicentre study using this evaluation tool may provide more insight on the quality of care rendered to dying patients and identify areas for improvement. Trial registration: ClinicalTrials.gov (NCT03906747)

Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department

10.1186/cc11456Critical Care164R14

Knowledge of signs and symptoms of heart attack and stroke among Singapore residents

10.1155/2014/572425BioMed Research International201457242

Supporting the utilization of community-based primary health care implementation research in Ghana

From Crossref journal articles via Jisc Publications RouterItem not available in this repository.Ever since the 1990s, implementation research in Ghana has guided the development of policies and practices that are essential to establishing community-based primary health care. In response to evidence emerging from this research, the Community-based Health Planning and Services (CHPS) policy was promulgated in 1999 to scale-up results. However, during the first decade of CHPS operation, national monitoring showed that its pace of coverage expansion was unacceptably slow. In 2010, the Ghana Health Service launched a five-year plausibility trial of CHPS reform for testing ways to accelerate scale-up. This initiative, known as the Ghana Essential Health Intervention Program (GEHIP), included a knowledge management component for establishing congruence of knowledge generation and flow with the operational system that GEHIP evidence was intended to reform. Four Upper East Region districts served as trial areas while seven districts were comparison areas. Interventions tested means of developing the upward flow of information based on perspectives of district managers, sub-district supervisors, and community-level workers. GEHIP also endeavored to improve procedures for the downward flow and utilization of policy guidelines. Field exchanges were convened for providing national, regional, and district leaders with opportunities for participatory learning about GEHIP implementation innovations. This systems approach facilitated the process of augmenting the communication of evidence with practical field experience. Scientific rigor associated with the production of evidence was thereby integrated into management decision-making processes in ways that institutionalized learning at all levels. The GEHIP knowledge management system functioned as a prototype for guiding the planning of a national knowledge management strategy. A follow-up project transferred its mechanisms from the Upper East Regional Health Administration to the Policy Planning Monitoring and Evaluation Division of the Ghana Health Service in Accra.Funder: Doris Duke Charitable Foundation; FundRef: 10.13039/100000862; Grant(s): 201610737pubpub