scholarly journals Persepsi Tenaga Kesehatan terhadap Praktik Kolaborasi Interprofesional dalam Terapi Antibiotik pada Bedah Ortopedi

2021 ◽  
Vol 8 (3) ◽  
pp. 296
Author(s):  
Ella Viani ◽  
Rika Yulia ◽  
Fauna Herawati

Kolaborasi interprofesional (Interprofessional Collaborative/IPC) menjadi strategi untuk menjawab kebutuhan akan pelayanan kesehatan yang terpadu. Dalam terapi antibiotik, praktik IPC yang efektif dapat meningkatkan ketepatan peresepan dan penggunaan antibiotik yang berdampak pada penurunan kejadian resistensi antibiotik. Agar tercipta praktik IPC yang efektif, perlu dilakukan identifikasi permasalahan yang ada dari persepsi tenaga kesehatan yang terlibat dalam IPC. Penelitian ini bertujuan menilai persepsi tenaga kesehatan terhadap praktik IPC dalam terapi antibiotik di unit bedah ortopedi. Penelitian ini merupakan penelitian observasional dengan pendekatan cross-sectional. Persepsi tenaga kesehatan dinilai menggunakan kuesioner Collaborative Practice Assessment Tool (CPAT) yang terdiri dari 8 domain dengan total 53 item pernyataan. Penelitian melibatkan 47 responden tenaga kesehatan di unit bedah ortopedi. Hasil penelitian menunjukkan terdapat perbedaan persepsi yang signifikan antara perawat dan tenaga kefarmasian terhadap domain hambatan tim dalam kolaborasi. Pada domain kepemimpinan terdapat perbedaan yang siginifikan antara tenaga kefarmasian dan dokter. Penelitian ini menyimpulkan secara umum, tenaga kesehatan menilai praktik IPC sudah berjalan dengan baik  (76,47% dari skor maksimum CPAT).Perawat menilai otonomi mereka dalam IPC masih terbatas ( 52% dari skor maksimum domain hambatan tim dalam kolaborasi), serta tenaga kefarmasian menilai masih adanya dominasi tenaga kesehatan lain dalam praktik IPC  (72% dari skor maksimum domain kepemimpinan)

2010 ◽  
Vol 25 (3) ◽  
pp. 189-195 ◽  
Author(s):  
Corinne Schroder ◽  
Jennifer Medves ◽  
Margo Paterson ◽  
Vaughan Byrnes ◽  
Christine Chapman ◽  
...  

2020 ◽  
Vol 90 (5-6) ◽  
pp. 535-552 ◽  
Author(s):  
Mahdieh Abbasalizad Farhangi ◽  
Mahdi Vajdi

Abstract. Backgrounds: Central obesity, as a pivotal component of metabolic syndrome is associated with numerous co-morbidities. Dietary factors influence central obesity by increased inflammatory status. However, recent studies didn’t evaluate the association between central obesity and dietary inflammation index (DII®) that give score to dietary factors according to their inflammatory potential. In the current systematic review and meta-analysis, we summarized the studies that investigated the association between DII® with central obesity indices in the general populations. Methods: In a systematic search from PubMed, SCOPUS, Web of Sciences and Cochrane electronic databases, we collected relevant studies written in English and published until 30 October 2019. The population of included studies were apparently healthy subjects or individuals with obesity or obesity-related diseases. Observational studies that evaluated the association between DII® and indices of central obesity including WC or WHR were included. Results: Totally thirty-two studies were included; thirty studies were cross-sectional and two were cohort studies with 103071 participants. Meta-analysis of observational studies showed that higher DII® scores were associated with 1.81 cm increase in WC (Pooled weighted mean difference (WMD) = 1.813; CI: 0.785–2.841; p = 0.001). Also, a non-significant increase in the odds of having higher WC (OR = 1.162; CI: 0.95–1.43; p = 0.154) in the highest DII category was also observed. In subgroup analysis, the continent, dietary assessment tool and gender were the heterogeneity sources. Conclusion: The findings proposed that adherence to diets with high DII® scores was associated with increased WC. Further studies with interventional designs are necessary to elucidate the causality inference between DII® and central obesity indices.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045550
Author(s):  
Zhigang Zhang ◽  
Guoqiang Wang ◽  
Yuchen Wu ◽  
Jin Guo ◽  
Nannan Ding ◽  
...  

PurposeTo translate and adapt the Chelsea Critical Care Physical Assessment Tool (CPAx) into Chinese version (‘CPAx-Chi’), test the reliability and validity of CPAx-Chi, and verify the cut-off point for the diagnosis of intensive care unit-acquired weakness (ICU-AW).Study designCross-sectional observational study.MethodsForward and back translation, cross-cultural adaptation and pretesting of CPAx into CPAx-Chi were based on the Brislin model. Participants were recruited from the general ICU of five third-grade class-A hospitals in western China. Two hundred critically ill adult patients (median age: 53 years; 64% men) with duration of ICU stay ≥48 hours and Glasgow Coma Scale ≥11 were included in this study. Two researchers simultaneously and independently assessed eligible patients using the Medical Research Council Muscle Score (MRC-Score) and CPAx-Chi.ResultsThe content validity index of items was 0.889. The content validity index of scale was 0.955. Taking the MRC-Score scale as standard, the criterion validity of CPAx-Chi was r=0.758 (p<0.001) for researcher A, and r=0.65 (p<0.001) for researcher B. Cronbach’s α was 0.939. The inter-rater reliability was 0.902 (p<0.001). The area under the receiver operating characteristic curves of CPAx-Chi for diagnosing ICU-AW based on MRC-Score ≤48 were 0.899 (95% CI 0.862 to 1.025) and 0.874 (95% CI 0.824 to 0.925) for researcher B. The best cut-off point for CPAx-Chi for the diagnosis of ICU-AW was 31.5. The sensitivity was 87% and specificity was 77% for researcher A, whereas it was 0.621, 31.5, 75% and 87% for researcher B, respectively. The consistency was high when taking CPAx-Chi ≤31 and MRC-Score ≤48 as the cut-off points for the diagnosis of ICU-AW. Cohen’s kappa=0.845 (p=0.02) in researcher A and 0.839 (p=0.04) for researcher B.ConclusionsCPAx-Chi demonstrated content validity, criterion-related validity and reliability. CPAx-Chi showed the best accuracy in assessment of patients at risk of ICU-AW with good sensitivity and specificity at a recommended cut-off of 31.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ning An ◽  
Ji Sheng Lin ◽  
Qi Fei

Abstract Background To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM). Methods A cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results There were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value. Conclusions Both BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.


2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Patrícia Amaro Andrade ◽  
Carolina Araújo dos Santos ◽  
Heloísa Helena Firmino ◽  
Carla de Oliveira Barbosa Rosa

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.


2010 ◽  
Vol 34 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Kim Hitchings ◽  
Terry Capuano ◽  
Joanna Bokovoy ◽  
Janet Houser

2021 ◽  
pp. appi.ps.2020007
Author(s):  
Ekaterina Smali ◽  
Rachel M. Talley ◽  
Matthew L. Goldman ◽  
Harold Alan Pincus ◽  
David Woodlock ◽  
...  

2021 ◽  
Author(s):  
Samira Arbabi Jam ◽  
Shahab Rezaeian ◽  
Farid Najafi ◽  
Behroz Hamze ◽  
Ebrahim Shakiba ◽  
...  

Abstract Background: Dietary factors and inflammation are associated with most non-communicable diseases (NCDs). The Dietary Inflammatory Index (DII) is a developed validated assessment tool. This study was conducted to assessed association of DII with the hypertension and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional analysis was performed on 9,811 participants of 35 to 65 years of the base-line phase data of Ravansar Non-Communicable Diseases (RaNCD) cohort study. The DII was calculated using 31 parameters food of food frequency questionnaire (FFQ). The estimates were performed using univariable and multivariable logistic regression.Results: The mean DII scores in healthy participants was -2.32± 1.60, in participant with T2DM, hypertension and both were -2.23± 1.59, -2.45± 1.60 and -2.25± 1.60, respectively (P= 0.011). Pre-inflammatory diet was significantly higher in male compared to female (P<0.001). In the most pro-inflammatory diet was significantly higher BMI (body mass index), triglyceride, energy intake, smokers; and was significantly lower socio-economic status (SES), physical activity and HDL-C compared to the most anti-inflammatory diet. Participants with T2DM, hypertension and comorbidity had a significantly higher mean of anthropometry indices (P<0.001) and lipid profile compared to healthy subjects (P<0.001). After adjustment for age, sex and physical activity, the odds of T2DM in the fourth quartile of DII was 1.48 (95% CI: 1.19, 1.85) times higher compared to the first quartile of DII. Conclusions: Pro-inflammatory diet was weak associations with hypertension. Pro-inflammatory diet was significant associations with increasing T2DM and its related risk factors. Modification of diet and lifestyle is suggested to reduce inflammation.


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