Development of Kampung Improvement Program in Surabaya, Indonesia

Abstract Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty. Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data. Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%. Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.

Download Full-text

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1717828 ◽

2020 ◽

Author(s):

George A. Beyer ◽

Karan Dua ◽

Neil V. Shah ◽

Joseph P. Scollan ◽

Jared M. Newman ◽

...

Keyword(s):

Quality Improvement ◽

Upper Extremity ◽

Free Flap ◽

Quality Improvement Program ◽

Readmission Rates ◽

Improvement Program ◽

Surgical Quality ◽

Flap Transfer ◽

Free Flap Transfer ◽

Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

Download Full-text

Blood Management in Total Knee Arthroplasty: A Nationwide Analysis from 2011 to 2018

The Journal of Knee Surgery ◽

10.1055/s-0040-1721414 ◽

2020 ◽

Author(s):

Jared A. Warren ◽

John P. McLaughlin ◽

Robert M. Molloy ◽

Carlos A. Higuera ◽

Jonathan L. Schaffer ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Platelet Count ◽

Knee Arthroplasty ◽

Categorical Variables ◽

Bleeding Disorders ◽

Blood Management ◽

Improvement Program ◽

Preoperative Anemia ◽

High Incidence ◽

Total Knee

AbstractBoth advances in perioperative blood management, anesthesia, and surgical technique have improved transfusion rates following primary total knee arthroplasty (TKA), and have driven substantial change in preoperative blood ordering protocols. Therefore, blood management in TKA has seen substantial changes with the implementation of preoperative screening, patient optimization, and intra- and postoperative advances. Thus, the purpose of this study was to examine changes in blood management in primary TKA, a nationwide sample, to assess gaps and opportunities. The American College of Surgeons National Surgical Quality Improvement Program database was used to identify TKA (n = 337,160) cases from 2011 to 2018. The following variables examined, such as preoperative hematocrit (HCT), anemia (HCT <35.5% for females and <38.5% for males), platelet count, thrombocytopenia (platelet count < 150,000/µL), international normalized ration (INR), INR > 2.0, bleeding disorders, preoperative, and postoperative transfusions. Analysis of variances were used to examine changes in continuous variables, and Chi-squared tests were used for categorical variables. There was a substantial decrease in postoperative transfusions from high of 18.3% in 2011 to a low of 1.0% in 2018, (p < 0.001), as well as in preoperative anemia from a high of 13.3% in 2011 to a low of 9.5% in 2016 to 2017 (p < 0.001). There were statistically significant, but clinically irrelevant changes in the other variables examined. There was a HCT high of 41.2 in 2016 and a low of 40.4 in 2011 to 2012 (p < 0.001). There was platelet count high of 247,400 in 2018 and a low of 242,700 in 201 (p < 0.001). There was a high incidence of thrombocytopenia of 5.2% in 2017 and a low of low of 4.4% in 2018 (p < 0.001). There was a high INR of 1.037 in 2011 and a low of 1.021 in 2013 (p < 0.001). There was a high incidence of INR >2.0 of 1.0% in 2012 to 2015 and a low of 0.8% in 2016 to 2018 (p = 0.027). There was a high incidence of bleeding disorders of 2.9% in 2013 and a low of 1.8% in 2017 to 2018 (p < 0.001). There was a high incidence of preoperative transfusions of 0.1% in 2011 to 2014 and a low of <0.1% in 2015 to 2018 (p = 0.021). From 2011 to 2018, there has been substantial decreases in patients receiving postoperative transfusions after primary TKA. Similarly, although a decrease in patients with anemia was seen, there remains 1 out 10 patients with preoperative anemia, highlighting the opportunity to further improve and address this potentially modifiable risk factor before surgery. These findings may reflect changes during TKA patient selection, optimization, or management, and emphasizes the need to further advance multimodal approaches for perioperative blood management of TKA patients. This is a Level III study.

Download Full-text

EVALUASI PROGRAM PEMODELAN DAN SIMULASI LABORATORIUM KIMIA PADA MAHASISWA CALON GURU

EDUSAINS ◽

10.15408/es.v8i2.4394 ◽

2019 ◽

Vol 8 (2) ◽

pp. 201-211

Author(s):

Yenni Kurniawati ◽

Yuni Fatisa

Keyword(s):

Mixed Method ◽

Random Sampling ◽

Sample Selection ◽

Product Evaluation ◽

Thinking Skills ◽

Laboratory Simulation ◽

Input Process ◽

Improvement Program ◽

Chemistry Students ◽

Process Product

Abstract Modeling and laboratory simulation can help overcome of cost obstacle, time, safety and other constraints in laboratory experiments. Many skills also had the opportunity to be fostered and promoted, especially in connection with the construction of thinking skills. However, the implementation of this program required an evaluation, in order to decided whether the program will be continuing or not, in addition its needed to found the focused of on overall quality of learning in order to make a recommendation in the decision making. This research was conducted by the mixed-method approached with triangulation design, in order to evaluate the effectiveness, problems or any obstacles of the implementation of the program. The population in this study was the third semester of pre-service chemistry students at UIN Syarif Kasim Sultan Riau, which was supported by lecturers, assistant laboratory and staf. The sample selection was done using random sampling techniques. Program evaluation in this study was conducted by the CIPP model (Context, Input, Process, Product). The results showed that the program was running quite effective when viewed from the overall average grades. The evaluation about context, inputs, processes and products had the good and very good score, in which the evaluation score of context and input, get the better score than process and product evaluation. This study recommends to be a continuing improvement program of modeling and simulation laboratories, both as an exercise before the experiments or replace the real experiments. Keywords: modeling; simulation lab; chemistry experiment Abstrak Pemodelan dan simulasi laboratorium dapat membantu mengatasi kendala biaya, waktu, alasan keselamatan dan kendala lainnya dalam praktikum di laboratorium kimia. Beragam kemampuan lain juga berkesempatan untuk ditumbuh-kembangkan terutama dalam kaitannya dengan konstruksi berfikir. Meskipun demikian, implementasi pelaksanaan program ini memerlukan evaluasi, guna memutuskan apakah program ini layak dilanjutkan ataukah tidak, selain karena diperlukannya penemuan terhadap fokus peningkatan kualitas pembelajaran secara menyeluruh guna menghasilkan rekomendasi dalam menentukan keputusan. Penelitian ini dilakukan dengan menggunakan pendekatan mixed-method desain triangulasi, guna mengevaluasi sebab-sebab efektifitas, kendala ataupun kegagalan pelaksanaan program. Populasi dalam penelitian ini adalah mahasiswa semester III jurusan Pendidikan Kimia UIN Sultan Syarif Kasim Riau, yang didukung oleh dosen, asisten laboratorium dan laboran dan pemilihan sampel dilakukan menggunakan teknik random sampling. Evaluasi program dalam penelitian ini dilakukan menggunakan model CIPP (Context, Input, Process, Product). Hasil penelitian menunjukkan bahwa program ini berjalan cukup efektif jika dilihat dari rata-rata keseluruhan nilai, mulai dari context, input, proses dan produk yang berada pada skor baik dan sangat baik, di mana skor evaluasi context dan input, lebih baik dibanding proses dan produk. Penelitian ini memberikan rekomendasi untuk terus meningkatkan penggunaan pemodelan dan simulasi laboratorium kimia, baik sebagai latihan sebelum praktikum maupun menggantikan praktikum yang sesungguhnya. Kata Kunci: pemodelan; simulasi laboratorium; praktikum kimia Permalink/DOI: http://dx.doi.org/10.15408/es.v8i2.4394

Download Full-text

Indonesian Language Learning and Teacher Innovation for Foreigners and Instructors for Foreign Language for Employees in Bali

International Journal of Contemporary Research and Review ◽

10.15520/ijcrr/2018/9/10/612 ◽

2018 ◽

Vol 9 (10) ◽

pp. 21087-21095

Author(s):

Ni Putu Nita Anggraini ◽

Ni Luh Gede Yogi Arthani ◽

I Putu Yuria Mendra

Keyword(s):

Foreign Language ◽

Language Learning ◽

Financial Management ◽

Teaching Method ◽

Positive Impact ◽

Development Program ◽

Language Teachers ◽

Improvement Program ◽

Counseling Training ◽

Language Instructors

The group of foreign language instructors and Indonesian language instructors for foreigners initially had problems in the fields of HR, legality, marketing and management. The implementation of the community partnership program (PKM) funded by the Ministry of Research and Technology's Research and Development Program aims to solve partner problems through entrepreneurship building. The method applied is in the form of knowledge transfer in the form of counseling, training, simulation and diffusion of science and technology about teaching methods, mentoring financial management and marketing and managing agency permits. The teaching method quality improvement program is carried out through workshops and workshops with the theme of teaching Indonesian and multimedia-based foreign languages. The resulting output is in the form of certificates and the quality of teaching increases. The problem of business management and enlargement has been solved through mentoring by management experts so that partners know the tips of building a small business. To build a language teaching business, the team helped partners manage the Business Course and Training (LKP) business license in a notary and operational permits in the Badung District Education Office. From the marketing aspect, the team has helped partner market course service products through the creation of signboards, business cards and websites with the domain www.gepbali.com . The implementation of all these activities has been running 70% while the draft article and seminar papers are still in draft form. This activity has had a positive impact on providing employment for language teachers and improving language skills for the community.

Download Full-text