38,431 research outputs found

    Evaluation of The COVID-19 Vaccination Program for the Elderly in the Rawalo Health Center With the CIPP (Context, Input, Process, And Product) Model

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    Rawalo sub-district had a relatively high number of COVID-19 cases compared to other sub-districts in Banyumas Regency. The government provides COVID-19 vaccination which aims to reduce the number of COVID-19 cases by forming Herd Immunity in the community. The elderly are a group at high risk of morbidity and mortality due to exposure to COVID-19. However, the coverage of COVID-19 vaccination for the elderly at the Rawalo Health Center is still relatively low. This study was aimed  to evaluate the program with the CIPP (Context, Input, Process, Product) model in a complex and comprehensive manner regarding how the implementation of the COVID-19 vaccination program in the elderly. This research was a qualitative study with a descriptive approach using observation and in-depth interview methods selected by purposive sampling technique. The research subjects as the main informants included the Head of the Puskesmas, the Head of the COVID-19 Vaccination Program Team, the COVID-19 Vaccination Coordinator and health cadres. Meanwhile, the elderly group and the Banyumas Regency Health Office as triangulation informants. The results showed that vaccination coverage in the elderly was still low, at 10% for dose 3. This was due to less thorough education, lack of human resources (vaccination officers), and ineffective coordination, there is data that is not synchronous or valid. There are technical and non-technical obstacles in recording and reporting. Thus, improvements need to be made to aspects that affect the vaccination implementation process and low coverage.

    International alliance of Urolithiasis (IAU) guideline on percutaneous nephrolithotomy

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    The International Alliance of Urolithiasis (IAU) would like to release the latest guideline on percutaneous nephrolithotomy (PCNL) and to provide a clinical framework for surgeons performing PCNL. These recommendations were collected and appraised from a systematic review and assessment of the literature covering all aspects of PCNLs from the PubMed database between January 1, 1976, and July 31, 2021. Each generated recommendation was graded using a modified GRADE methodology. The quality of the evidence was graded using a classification system modified from the Oxford Center for Evidence-Based Medicine Levels of Evidence. Forty-seven recommendations were summarized and graded, which covered the following issues, indications and contraindications, stone complexity evaluation, preoperative imaging, antibiotic strategy, management of antithrombotic therapy, anesthesia, position, puncture, tracts, dilation, lithotripsy, intraoperative evaluation of residual stones, exit strategy, postoperative imaging and stone-free status evaluation, complications. The present guideline on PCNL was the first in the IAU series of urolithiasis management guidelines. The recommendations, tips and tricks across the PCNL procedures would provide adequate guidance for urologists performing PCNLs to ensure safety and efficiency in PCNLs

    Serum creatinine and urea assays on Atellica® CH and Architect® ci4100: method comparison

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    Serum creatinine and urea are markers of renal function usually measured in conjunction. This study aims to evaluate the comparability of a new analyzer incorporated to our laboratory, Atellica® with the established analyzer, Architect ® ci 4100 in serum creatinine and urea assays. We ran 110 tests for creatinine and 107 for urea. In both analyzers, serum creatinine assay is based on the Jaffe reaction while urea measurement is based on the Roch-Ramel enzymatic reaction. Linear association between methods was evaluated using Pearson's correlation coefficient. Methods comparability was assessed using Passing-Bablok and Deming linear regression. Differences between analyzers were evaluated using Bland-Altman plot. For serum creatinine, regression equations are Atellica = 0.9721 x Architect - 2.7282 (Passing & Bablok) and Atellica = 0.8884 x Architect + 1.3456 (Deming). The mean difference between the two methods is -11.7 µmol/L as indicated by Bland-Altman plot. For urea, regression lines are expressed as Atellica = 1.0252 x Architect – 0.1609 (Passing-Bablok) and Atellica = 1.1424 x Architect – 0.9532 (Deming). Bland-Altman plot presented a mean difference of -0.1 mmol/L. These results could be described as a very good agreement between the two methods, the two analyzers could be used interchangeably. DOI: http://dx.doi.org/10.5281/zenodo.754215

    Precision MRI Phenotyping Enables Detection of Small Changes in Body Composition for Longitudinal Cohorts

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    Longitudinal studies provide unique insights into the impact of environmental factors and lifespan issues on health and disease.Here we investigate changes in body composition in 3,088 free-living participants, part of the UK Biobank in-depth imagingstudy. All participants underwent neck-to-knee MRI scans at the first imaging visit and after approximately two years (secondimaging visit). Image-derived phenotypes for each participant were extracted using a fully-automated image processing pipeline,including volumes of several tissues and organs: liver, pancreas, spleen, kidneys, total skeletal muscle, iliopsoas muscle,visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), as well as fat and iron content in liver, pancreasand spleen. Overall, no significant changes were observed in BMI, body weight, or waist circumference over the scanninginterval, despite some large individual changes. A significant decrease in grip strength was observed, coupled to small, butstatistically significant, decrease in all skeletal muscle measurements. Significant increases in VAT and intermuscular fat in thethighs were also detected in the absence of changes in BMI, waist circumference and ectopic-fat deposition. Adjusting fordisease status at the first imaging visit did not have an additional impact on the changes observed. In summary, we showthat even after a relatively short period of time significant changes in body composition can take place, probably reflecting theobesogenic environment currently inhabited by most of the general population in the United Kingdom

    EVALUACIÓN ANALGÉSICA PERIOPERATORIA DEL ACETAMINOFÉN EN PERRAS SOMETIDAS A OVARIOHISTERECTOMÍA ELECTIVA

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    Tesis de doctorado que evalúa el efecto analgésico del acetaminofén en perras ovarihisterectomizadas.La administración de analgésicos antiinflamatorios no esteroidales (AINES) para el control del dolor post-quirúrgico en perros es una práctica común, debido a sus efectos analgésicos, antiinflamatorios y antipiréticos. En el presente trabajo se realizaron dos estudios. En el experimento 1, el objetivo fue evaluar la analgesia post-operatoria del acetaminofén (paracetamol) a través de la utilización de las escalas de reconocimiento clínico del dolor DIVAS (Escala Dinámica e Interactiva Analógica Visual) y UMPS (Escala de la Universidad de Melbourne), en perras sometidas a ovariohisterectomía electiva. Además de valorar la seguridad y eficacia clínica del uso del acetaminofén en perros mediante pruebas de funcionamiento hepático y renal en el post-operatorio inmediato. Para ello, se utilizaron 30 perras de diferentes razas que fueron asignadas aleatoriamente a uno de los tres grupos de tratamiento: acetaminofén [GACET; n=10, 15 mg kg-1 intravenoso (IV)], carprofeno (GCARP; n=10, 4 mg kg-1 IV) y meloxicam (GMELOX; n=10, 0.2 mg kg-1 IV). Todos los tratamientos se administraron 30 minutos antes de la cirugía y posterior a esta durante 48 horas. En este período el acetaminofén se administró por vía oral cada 8 horas (15 mg kg-1); el carprofeno (4 mg kg-1) y el meloxicam (0.1 mg kg-1) se administraron por vía IV cada 24 horas. Durante el postoperatorio, los sistemas de puntuación del dolor DIVAS y UMPS fueron medidos a las 1, 2, 4, 6, 8, 12, 16, 20, 24, 36 y 48 horas post-cirugía. Para evaluar la seguridad clínica de los tratamientos, se recolectaron muestras de sangre de la vena yugular para realizar la medición de enzimas ALT, AST, ALP, y los metabolitos bilirrubina directa, bilirrubina indirecta, bilirrubina total, creatinina, urea, albúmina y glucosa. Esto fue realizado en T0 (pre-anestesia; TBASAL), 48 y 96 horas después de la cirugía (T48, T96). Los resultados indican que en la evaluación clínica del dolor de todos los grupos de estudio, hubo una reducción gradual en la percepción del mismo durante el postoperatorio en ambos sistemas de puntuación; no obstante, también fue observado que ninguna escala difirió significativamente entre los tres grupos de tratamiento (P>0.05) en cada momento de evaluación durante las 48 horas post-cirugía. En cuanto a los parámetros bioquímico séricos, sólo la ALT aumentó significativamente en T96 en el GACET y GCARP con respecto a los valores basales (P<0.01). El resto de los analitos séricos evaluados se mantuvo en rangos normales. En el experimento 2 bajo el mismo diseño experimental de tratamientos administrados, el objetivo fue evaluar el efecto analgésico perioperatorio del acetaminofén 2 administrado pre y post-quirúrgicamente en perras sometidas a ovariohisterectomía electiva a través de la medición del índice de la actividad del tono parasimpático (PTA). Este parámetro hemodinámico fue medido 60 minutos antes de la cirugía (TBASAL) y durante el transquirúrgico en la aplicación de estímulos nociceptivos: colocación de las pinzas de campo backhouse (TPINZ), incisión de piel y abordaje quirúrgico primario (TINC), ligadura y extracción de pedículo ovárico izquierdo (TOVI) y derecho (TOVD), ligadura y transfixión del cuello uterino (TLIGUT), sección quirúrgica del cuello uterino (TCUT), reconstrucción de peritoneo y planos anatómicos musculares (TMUSC) y sutura de piel (TSUT). Durante el postoperatorio, el índice PTA fue valorado a las 1, 2, 4, 6, 8, 12, 16, 20, 24, 36 y 48 horas, en los mismos tiempos en que fueron evaluadas las escalas de reconocimiento de dolor DIVAS y UMPS. Los resultados obtenidos en la medición del índice PTA basal para GACET fue 65 ± 8, para GCARP 65 ± 7 y para GMELOX 62 ± 5. Durante los diferentes tiempos transquirúrgicos, los valores promedio de índice PTA indican que GACET (76 ± 14) y GMELOX (72 ± 18) muestran tendencia a manifestar mayores niveles en comparación con GCARP (62 ± 13) desde el inicio del procedimiento quirúrgico sin que esto pudiera comprobarse estadísticamente, ya que no hubo diferencias significativas entre grupos de tratamiento ni entre los tiempos quirúrgicos evaluados (P>0.05). En el postoperatorio, el índice PTA fue de 65 ± 9 en el GACET, 63 ± 8 en el GCARP y 65 ± 8 en el GMELOX. Los resultados tampoco mostraron diferencias estadísticamente significativas con los valores basales o entre los tratamientos (P>0.05). El índice PTA postoperatorio mostró una sensibilidad del 40%, especificidad del 98.46% y valor predictivo negativo del 99.07% con respecto a la escala validada de UMPS. En conclusión, el acetaminofén puede considerarse una herramienta para el tratamiento efectivo del dolor perioperatorio agudo en perros, ya que mostró la misma eficacia clínica que el meloxicam y el carprofeno para la analgesia postquirúrgica en perras sometidas a ovariohisterectomía electiva. Además, la evidencia del uso de este medicamento no condujo a reacciones adversas o cambios en los parámetros evaluados, lo que indica su seguridad clínica. Finalmente, destacar que el índice PTA representa una medición objetiva del comfort y analgesia postoperatoria, por lo que es una herramienta que podría ayudar a predecir las respuestas hemodinámicas asociadas con el dolor

    Building body identities - exploring the world of female bodybuilders

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    This thesis explores how female bodybuilders seek to develop and maintain a viable sense of self despite being stigmatized by the gendered foundations of what Erving Goffman (1983) refers to as the 'interaction order'; the unavoidable presentational context in which identities are forged during the course of social life. Placed in the context of an overview of the historical treatment of women's bodies, and a concern with the development of bodybuilding as a specific form of body modification, the research draws upon a unique two year ethnographic study based in the South of England, complemented by interviews with twenty-six female bodybuilders, all of whom live in the U.K. By mapping these extraordinary women's lives, the research illuminates the pivotal spaces and essential lived experiences that make up the female bodybuilder. Whilst the women appear to be embarking on an 'empowering' radical body project for themselves, the consequences of their activity remains culturally ambivalent. This research exposes the 'Janus-faced' nature of female bodybuilding, exploring the ways in which the women negotiate, accommodate and resist pressures to engage in more orthodox and feminine activities and appearances
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