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Comparison Of Post Operative Length Of Stay And Mortality On-Pump And Off-Pump Coronary-Artery Bypass Grafting In The Cardiac Icu Of Haji Adam Malik Hospital Medan 棉兰哈吉亚当马利克医院心脏Icu有泵和无泵冠状动脉搭桥术术后住院时间和死亡率的比较
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13339
Mhd Abduh Rifai, A. Lubis, Tasrif Hamdi
Introduction: Coronary-Artery Bypass Grafting (CABG) is currently a heart bypass surgery procedure that is often performed and with developing technology. The most common CABG techniques are on-pump and off-pump. This difference in surgical technique affects the final postoperative outcome, namely the length of stay and mortality of patients in the cardiac ICU. On-pump CABG performed at cardiopulmonary bypass is one of the most commonly performed procedures and an excellent treatment for ischemic heart disease. However, the results of a recent retrospective study found that length of stay and postoperative mortality can be reduced when coronary artery bypass surgery is performed using the off-pump technique. Purpose: This study aims to compare the length of stay and mortality of postoperative on-pump and off-pump CABG patients in the cardiac ICU of Haji Adam Malik General Hospital, Medan. Methods: This study is an analytic study with a retrospective research method with secondary data sources obtained from cardiac ICU medical records for the period January 2016 – December 2021. Samples were on-pump and off-pump CABG postoperative patients undergoing treatment in the cardiac ICU who met the inclusion and exclusion criteria were collected by total sampling method. Results: It was found that the ICU stay after on-pump surgery was significantly longer than off-pump, with the median value for ICU stay in the on-pump surgical technique was 2 days while in the off-pump it was 1 day (Mean = 2.335; SE = 0.103 vs. Mean = 1.709; SE = 0.140) with p<0.05. There was no significant difference between on-pump and off-pump CABG postoperative mortality with p>0.05. Conclusion: The length of stay in the ICU after on-pump surgery is longer than off-pump. There was no difference in postoperative mortality between on-pump and off-pump CABG.
简介:冠状动脉旁路移植术(CABG)是目前常用的心脏搭桥手术,技术也在不断发展。最常见的CABG技术有开泵和关泵两种。这种手术技术的差异影响了最终的术后结果,即患者在心脏ICU的住院时间和死亡率。体外循环中进行的无泵冠状动脉搭桥是最常用的手术之一,也是缺血性心脏病的极好治疗方法。然而,最近的一项回顾性研究结果发现,使用非泵技术进行冠状动脉搭桥手术可以减少住院时间和术后死亡率。目的:比较棉兰哈吉·亚当·马利克总医院心脏ICU有泵和无泵CABG患者的住院时间和死亡率。方法:本研究采用回顾性研究方法,二手数据来源为2016年1月- 2021年12月心内科ICU病历。样本采用全抽样法收集在心脏ICU接受有泵和无泵CABG术后符合纳入和排除标准的患者。结果:有泵手术后ICU住院时间明显长于无泵手术,有泵手术后ICU住院时间中位数为2天,无泵手术后ICU住院时间中位数为1天(平均= 2.335;SE = 0.103, Mean = 1.709;SE = 0.140), p0.05。结论:有泵手术患者在ICU的住院时间明显长于无泵手术患者。有泵和无泵CABG术后死亡率无差异。
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引用次数: 0
A Self-Assessment: Stress and Teaching Health 自我评估:压力与教学健康
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13314
Reynaldo DC. del Rosario
- This study sought to assess if stress in teaching is present among Secondary Health Teachers in the Schools Division of the City of Meycauayan and determine its causes and consequences. It used a self-made survey questionnaire with interview questions to describe how teachers assess their stress levels and analyze how it affects their teaching performance as Health Teachers. The data gathered were analyzed through quantitative and qualitative methods. The percentage was used to describe the level of stress in teaching among Secondary Health Teachers, self-assessment of Health Teachers as to how stress is affecting their teaching performance and student achievement, and the facilitating and hindering factors that may influence their stay in the Department of Education or for them to leave DepEd due to stress. Word Statistics through the NVivo application was used to describe the qualitative data gathered from the interview of teachers. The quantitative and qualitative data gathered from this study both revealed that the Top 2 sources of stress in teaching among Health Teachers and the top 2 most valid reasons for them to leave the Department of Education were ‘Extra Paperwork or so much paper works’ and ‘Time Constraints for extra work’.
-本研究旨在评估Meycauayan市学校部门的中学保健教师是否存在教学压力,并确定其原因和后果。本研究采用自制的问卷调查和访谈问题来描述教师如何评估他们的压力水平,并分析压力水平如何影响他们作为健康教师的教学绩效。收集到的数据通过定量和定性方法进行分析。该百分比用于描述中学卫生教师在教学中的压力程度、卫生教师对压力如何影响其教学表现和学生成绩的自我评估,以及可能影响他们留在教育部或因压力而离开教育部的促进和阻碍因素。通过NVivo应用软件Word Statistics来描述从教师访谈中收集的定性数据。从这项研究中收集的定量和定性数据都表明,卫生教师在教学中最大的两个压力来源和他们离开教育部的两个最有效的理由是“额外的文书工作或太多的文书工作”和“额外工作的时间限制”。
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引用次数: 0
Comparison of the Effect Administration Ketamine-Propofol (Ketofol) With Ketamin Single On The Quality Score Of Recovery In Patients Post Intravenous General Anesthesia As Measured By Qor-40 In Patients Undergoing Gastrointestinal Endoscopic Procedure 氯胺酮-异丙酚(酮酚)与单氯胺酮对经胃肠道内镜手术患者静脉全身麻醉后恢复质量评分(Qor-40)的影响比较
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13336
Samawi Husein Ramud, D. W. Wijaya, Yutu Solihat
Introduction: Gastrointestinal endoscopy procedures cause discomfort to patients. Administration of sedation to relieve anxiety and discomfort, improve the results of the examination, and reduce the patient's memory of the event. Effective sedation can be judged by how well the drug achieves rapid onset of sedation, hemodynamic stability and fast recovery time. Ketamine maintains hemodynamic stability and sufficient depth of sedation during EGI procedures. Administering ketamine prevents bradycardia, hypotension and achieves sufficient and prolonged sedation.. Objective : This study aims to compare the effect of giving ketamine-propofol (ketofol) with ketamine alone on the recovery quality score of patients after intravenous general anesthesia as measured by QoR-40 in patients undergoing gastrointestinal endoscopy procedures. Methods : This study is a randomized blinded clinical trial. This research was conducted from July to September 2022. A total of 30 research subjects who underwent gastrointestinal endoscopy were divided into 2 groups. Group A (n=15) was given intravenous sedation Ketamine 0.5 mg/KgBW + Propofol 0.5 mg/KgBW, group B (n=15) was given Ketamine 1 mg/KgBW. The patient's recovery score was measured using the QoR-40 questionnaire 60 minutes after the endoscopy procedure was completed. Data were analyzed by univariate and bivariate. Bivariate data were analyzed by Chi-Square test, Independent T-Test and Mann-Whitney.. Results : The assessment of the safety score and the total score in this study found significant differences between the two groups with a p value <0.05. No significant difference was found in the assessment of feelings, support for patients, physical independence and pain scores with a p>0.05. Conclusion : The Ketamine-Propofol group on the comfort score and total score had higher scores than the single ketamine group, whereas on feelings, patient support, physical independence and pain scores there was no difference between the two groups.
胃肠内窥镜检查会给患者带来不适。给予镇静以缓解焦虑和不适,改善检查结果,减少患者对事件的记忆。有效的镇静可通过药物在多大程度上实现快速起效、血流动力学稳定性和快速恢复时间来判断。氯胺酮在EGI过程中维持血流动力学稳定性和足够的镇静深度。给予氯胺酮可预防心动过缓、低血压,并达到充分和持久的镇静作用。目的:比较氯胺酮-异丙酚(酮酚)与单独氯胺酮对胃肠内镜手术患者静脉全身麻醉后恢复质量评分(QoR-40)的影响。方法:采用随机、盲法临床试验。该研究于2022年7月至9月进行。将30例行胃肠内镜检查的研究对象分为两组。A组(n=15)给予氯胺酮0.5 mg/KgBW +异丙酚0.5 mg/KgBW静脉镇静,B组(n=15)给予氯胺酮1 mg/KgBW。在内镜检查完成后60分钟,使用QoR-40问卷测量患者的恢复评分。数据采用单因素和双因素分析。双变量数据采用卡方检验、独立t检验和Mann-Whitney检验。结果:本研究安全性评分及总分评定两组间差异有统计学意义,p值为0.05。结论:氯胺酮-异丙酚组在舒适评分和总分上均高于单氯胺酮组,而在感觉评分、患者支持评分、身体独立性评分和疼痛评分上,两组差异无统计学意义。
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引用次数: 0
Comparison Of P/F Ratio In Ventilated ARDS Patients Using Driving Pressure Strategy And Conventional Lung-Protective Strategy Method In ICU H. Adam Malik Hospital Medan 棉兰亚当马利克医院ICU采用驱动压力策略与常规肺保护策略对通气性ARDS患者肺功能比的比较
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13334
Jul Hendri, B. Lubis, M. Ihsan
Backgrounds: The progression of ARDS causes significant patient morbidity and mortality, with hypoxia being the basic mechanism of organ failure. Therefore, it is necessary to measure the P/F ratio to identify hypoxia as early as possible. Objectives: To compare the P/F ratio values in ventilated ARDS patients using driving pressure strategy method versus conventional lung-protective strategy in ICU of H. Adam Malik General Hospital Medan. Methods: This study was a randomized controlled trial conducted at ICUH. Haji Adam Malik General Hospital Medan of ventilated ARDS patients who were treated in ICU who met inclusion and exclusion criteria and were selected by consecutive sampling method. The value of the P/F ratio is determined by the driving pressure strategy method and the conventional lung protective strategy method. To analyze the difference in the P/F ratio between two intervention groups, the Mann-Whitney test was used. A confidence interval with an ap value of 0.05 is considered to be significantly significant. Results: The mean value of the P/F ratio in the lung protective group on the first day was 178.18 ± 46.5 and in the Driving pressure group was 164.81 ± 44.5 (p=0.608). On the second day, the mean P/F ratio in the lung protective group was 166.1 ± 30.8 and in the driving pressure group was 169.5 ± 12.8 (p=0.815). On the third day, the mean P/F ratio in the lung protective group was 177.2 ± 27.4 and in the driving pressure group was 175 ± 35 (p=0.726). Conclusion: There was no significant difference found in the P/F ratio value as measured by the lung protective strategy method and the driving pressure strategy method either from the first, second or third day.
背景:急性呼吸窘迫综合征(ARDS)的进展可引起显著的患者发病率和死亡率,缺氧是器官衰竭的基本机制。因此,有必要测量P/F比,以尽早识别缺氧。目的:比较棉兰Adam Malik总医院ICU采用驱动压策略与常规肺保护策略治疗通气性ARDS患者的P/F值。方法:本研究是在ICUH进行的随机对照试验。采用连续抽样的方法,选取棉兰哈吉总医院ICU收治的符合纳入和排除标准的呼吸性ARDS患者。P/F值由驱动压力策略法和常规肺保护策略法确定。采用Mann-Whitney检验分析两干预组间P/F比的差异。ap值为0.05的置信区间被认为是显著显著的。结果:肺保护组第1天P/F平均值为178.18±46.5,驱动压组P/F平均值为164.81±44.5 (P =0.608)。第2天,肺保护组P/F均值为166.1±30.8,驱动压组P/F均值为169.5±12.8 (P =0.815)。第3天,肺保护组P/F平均值为177.2±27.4,驱动压组P/F平均值为175±35 (P =0.726)。结论:肺保护策略法与驱动压策略法测定的P/F值在第1天、第2天、第3天均无显著差异。
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引用次数: 0
Patient Centered Care to Reduce Surgical Site Infection in Geriatric Patients : A Scooping Review Protocol 以患者为中心的护理减少老年患者手术部位感染:一项综述方案
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13330
Y. D. Indriani, E. M. Rosa
- Objective: The objectives of this scooping review are to analysis of Patient Centered Care (PCC) implementation on Surgical Site Infection (SSI) reduction in geriatric patients. The results of this scooping review are expected to provide information related to the implementation of PCC to reduce the incidence of SSI in geriatric patients. Introduction: There are at least 234 million operations every year, with the frequency of occurrence of SSI reaching more than 20% in the world. During the last decade, the incidence of SSI has increased very rapidly each year, about 500,000 patients experiencing SSI. Age has been confirmed as a risk factor for SSI after surgery. Currently the geriatric population is increasing rapidly throughout the world. The advancement of health care is an important factor in efforts to prolong life. This phenomenon in turn becomes a challenge for the health service system. Health workers who are in charge of caring for patients required to provide good health services. Currently PCC is emerging as the main approach in patient care. Inclusion criteria: The review will include published papers that discuss changes in the incidence of SSI in geriatrics by applying PCC. Methods: Search will be carried out to identify literature published between 2012 and 2021. The databases that will be used to search for related journals are: PubMed, Scopus, and EBSCO. The PRISMA protocol will be used in this study. Literature is selected in accordance with the inclusion criteria and then will be critical appraisal and analyzed. Result: From several studies it was found that there was a decrease in the Surgical Site Infection rate in the intervention group that applied a multidisciplinary team approach or used bundle care in the implementation of Patient Centered Care. The application of PCC is even more significant to reduce SSI in patients who have higher ASA (The American Society of Anesthesiologists) levels, including patients with old age. Conclusion: Geriatric population has unique physiological and social demands. Collaborative care models lead to better outcomes and care for patients and also offer cost savings in healthcare systems.
目的:本综述的目的是分析以患者为中心的护理(PCC)在减少老年患者手术部位感染(SSI)方面的实施情况。本综述的结果有望为实施PCC以减少老年患者SSI的发生率提供相关信息。导读:每年至少有2.34亿例手术,全球SSI的发生频率达到20%以上。在过去的十年中,SSI的发病率每年都在快速增长,大约有50万患者经历过SSI。年龄已被证实是术后SSI的危险因素。目前,全世界的老年人口正在迅速增加。提高保健水平是努力延长生命的一个重要因素。这种现象反过来又成为卫生服务系统的挑战。负责照顾需要提供良好保健服务的病人的卫生工作者。目前,PCC正在成为患者护理的主要方法。纳入标准:本综述将包括讨论应用PCC改变老年SSI发生率的已发表论文。方法:检索2012 - 2021年间发表的文献。将用于搜索相关期刊的数据库有:PubMed、Scopus和EBSCO。本研究将使用PRISMA协议。根据纳入标准选择文献,然后进行批判性评价和分析。结果:通过多项研究发现,在实施以患者为中心的护理中,采用多学科团队方式或采用捆绑护理的干预组手术部位感染率有所下降。对于ASA (The American Society of Anesthesiologists)水平较高的患者,包括老年患者,PCC的应用对于降低SSI更为重要。结论:老年人群具有独特的生理和社会需求。协作式护理模式可以为患者带来更好的结果和护理,并为医疗保健系统节省成本。
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引用次数: 0
Evaluation of consonant development following cleft palate surgery: Comparison of Isolated Cleft Palate Versus Pierre Robin sequence 腭裂术后辅音发育的评价:孤立性腭裂与Pierre Robin序列的比较
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13326
Malka Jayathilake, D. Silva, R. Gunasekera
: The optimal management of Cleft palate patient from birth to completion of the treatment continue to present a formidable challenge the professionals of the multidisciplinary cleft clinic (MDCC) specially children with Pierre Robin Sequence (PRS) than the children with Isolated cleft palate (ICP). The children with PRS have more challenge to develop normal articulation of consonants (Speech sounds except vowels) than ICP due to they are associated with congenital sequence of multiple anomalies, which cause to occur delayed surgery procedures.
腭裂患者从出生到治疗结束的最佳管理对多学科腭裂临床(MDCC)的专业人员,特别是皮埃尔·罗宾序列(PRS)儿童比孤立性腭裂(ICP)儿童面临着巨大的挑战。与ICP相比,PRS患儿在发展正常辅音发音(元音以外的语音)方面面临更大的挑战,因为它们与先天的多重异常序列有关,导致手术延迟。
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引用次数: 0
Influence of International Humanitarian Organizations on Food Security Among Rural Communities in Malakal County, South Sudan 国际人道主义组织对南苏丹马拉卡尔县农村社区粮食安全的影响
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13347
Akol Abiong Bol, P. K. Mutundu
Since the outbreak of the civil war in South Sudan in 2013, just 2 years after gaining independence from the larger Sudan, agricultural production and normal livelihood was disrupted for the locals in most affected region. In 2017 the UN declared that there was famine in South Sudan affecting more than 5.5 million people in the country. For a while now, a number of international organizations have been selling the message of hope to locals and to the international platforms appealing for more funds to aid in the situation of food security in South Sudan, they include the Oxfam, World Vision, CARE, Norwegian Refugee Council, UNICEF, Action Against Hunger, Sudan Relief Fund among other, some have been in the country since 2011. This study seeks to investigate the influence of international humanitarian organizations, on food security among rural communities in Malakal County, South Sudan.The study objectives will be (i) The influence of international humanitarian organizations on food availability among rural communities in Malakal County, South Sudan. (ii) The influence of international humanitarian organizations on access to food among rural communities in Malakal County, South Sudan. (iii) The influence of international humanitarian organizations on food utilization among rural communities in Malakal County, South Sudan. The study adopted a descriptive research design. It will have a sample of 307 respondents composed of 185 local beneficiaries and 107 locals non beneficiaries on food aid humanitarian assistance and 15 focus group discussion participants. The data will be collected through a blend of both quantitative and qualitative methods. Semi structured questionnaires will be used to collect field (primary) data on 185 aid assistance respondents using systematic sampling. Interviews will be carried out on surrounding with 10 Focus Group Discussions will be held with beneficiaries and 5 with non-beneficiaries’ members. The respondents will be sampled through purposive sampling. Secondary data will be gathered from published sources. The outcome of this research will give real understandings to legislators, developers, aid agencies and policymakers by what means towards reduction of poverty design programs which include securing food through agricultural means and fishing methods to boost the living condition of vulnerable households in Malakal County. Key TermsFood security, humanitarian organizations, county governments, Influence of international organizations Introduction According to Barrett & Lentz (2010), food security is both fundamentally and instrumentally significant, but it is inherently unobservable and difficult to describe. Food provides nutrients that humans require physiologically. As a result, food is an essential component of performance and well-being. Consequently, food security is a goal in many development programs, projects, and policies. Apart from its physiological requirement, food is also a source of enjoyment. It'
2013年,南苏丹脱离大苏丹独立仅2年,内战爆发以来,受影响最严重地区的农业生产和正常生活受到干扰。2017年,联合国宣布南苏丹发生饥荒,影响该国550多万人。一段时间以来,一些国际组织一直在向当地人和呼吁更多资金援助南苏丹粮食安全局势的国际平台传递希望的信息,其中包括乐施会,世界宣明会,援外社,挪威难民理事会,联合国儿童基金会,反饥饿行动,苏丹救济基金等,其中一些自2011年以来一直在该国。本研究旨在调查国际人道主义组织对南苏丹马拉卡尔县农村社区粮食安全的影响。研究目标将是:(i)国际人道主义组织对南苏丹马拉卡尔县农村社区粮食供应的影响。(二)国际人道主义组织对南苏丹马拉卡尔县农村社区获得粮食的影响。(三)国际人道主义组织对南苏丹马拉卡尔县农村社区粮食利用的影响。本研究采用描述性研究设计。它将有307名受访者的样本,其中包括185名当地受益人和107名当地非粮食援助人道主义援助受益人和15名焦点小组讨论参与者。数据将通过定量和定性相结合的方法收集。半结构化问卷将采用系统抽样的方式收集185名援助应答者的现场(主要)数据。访谈将围绕受益人和非受益人成员进行10次焦点小组讨论和5次焦点小组讨论。受访者将通过有目的抽样进行抽样。辅助数据将从已发表的资料中收集。这项研究的结果将为立法者、开发商、援助机构和决策者提供真正的理解,通过何种方式减少贫困设计方案,包括通过农业手段和捕鱼方法获得粮食,以改善马拉卡勒县弱势家庭的生活条件。关键术语粮食安全,人道主义组织,县政府,国际组织的影响介绍根据巴雷特和伦茨(2010),粮食安全具有根本性和工具性的重要意义,但它本质上是不可观察的,难以描述。食物提供人体生理所需的营养。因此,食物是表现和健康的重要组成部分。因此,粮食安全是许多发展计划、项目和政策的目标。除了生理上的需要,食物也是一种享受。很难确定精确的、可操作的粮食安全指标,因为不同社会之间和不同社会内部对食物的生物需求和对食物的情感满足存在巨大差异。此外,粮食安全不仅仅包括一个人目前的营养状况;它还包括对未来获得充足和合适食物的脆弱性(巴雷特,2002)。《国际科学与研究杂志》,第13卷第1期,2023年1月375 ISSN 2250-3153本出版物在知识共享署名CC BY下获得许可。http://dx.doi.org/10.29322/IJSRP.13.01.2023.p13347 www.ijsrp.org根据1996年世界粮食首脑会议商定的目前流行的定义,“所有人在任何时候都能在物质、社会和经济上获得充足、安全和有营养的食物,以满足其饮食需要和食物偏好,使其过上积极和健康的生活”,如果不满足这一标准,就会发生粮食不安全。当然,按照这个标准,世界只知道粮食不安全(Barrett & Lentz, 2010)。人道主义援助很重要,因为它是挽救生命的原因。当大量人口受到危机、灾害或冲突等灾难的影响时,各机构就会采取应对措施。援助的主要目的是防止生命损失,这也是南苏丹人道主义援助的主要目的。艾滋病通过向有需要的人提供粮食,在限制影响、减少生命损失和冲突造成的痛苦方面发挥着至关重要的作用。人道主义机构针对弱势群体的基本需求和支持他们恢复正常生活,开办和设立了许多项目。重要的是,任何受到任何灾难或冲突影响的人口都应得到人道主义援助。通过人道主义有效行动,灾害对社区的影响有很大可能减少。 人道主义援助有助于在危机爆发后大幅减少死亡人数。当援助资金充足时,响应机构在拯救生命方面发挥着至关重要的作用,这可能是艾滋病在第三世界国家至关重要的原因之一。南苏丹公民在从大苏丹独立后抱有很高的期望,其中包括南苏丹国家政府的效率和表现。这将反过来减少对人道主义援助及其有关活动的依赖程度。包括联合国机构在内的一些机构在2013年爆发冲突后热衷于应急反应,而不是国家建设的能力建设。马古利斯(2021)认为,“政权综合体是否存在增加或减少干预可能性的特征?粮食安全是由部分重叠的国际协议和政府间组织(IOs)管理的,这些协议和组织管理着如何在全球范围内生产、分配和获取粮食。这是一个复杂的制度,包括许多基本制度农业和粮食,人道主义援助,人权,国际贸易,气候变化,发展融资以及具有各种目标的国际组织”(马古利斯2013;Breitmeier et al. 2020)。从历史上看,联合国机构如粮农组织和世界粮食计划署负责全球粮食安全治理,其共同目标是消除饥饿(Shaw 2007)。“然而,粮食安全制度综合体现在包括具有更多样化使命和目标的国际组织,例如世界贸易组织(WTO),其主要目标是实现国际贸易自由化,以及联合国人权事务高级专员(OHCHR),其主要目标是促进和保护人权。虽然这些目标在某些情况下可能是互利的,但在其他情况下可能会相互矛盾”(马古利斯,2021)。索马里是非洲之角东部一个政治不稳定的国家,粮食不安全是灾难性的。2011年,由于干旱,索马里的庄稼和牲畜被毁,这场饥荒被称为人道主义灾难。随着干旱持续到2012年,粮食已成为一种稀有而昂贵的商品,导致粮食和水短缺,以及通货膨胀加剧和政治不稳定。饥荒对儿童和孕妇的伤害尤为严重。尽管农业条件有所改善,索马里也接受了外国援助,但仍有251万人没有粮食保障。海地是另一个面临粮食不安全的国家。在一个平均每人每天挣两美元的社会里,高通货膨胀导致食品价格上涨。此外,海地的大部分粮食是进口的,导致粮食价格上涨。许多人买不起食物,在最近肆虐该国的众多热带风暴过后,他们正在努力重建生活。由于历史上的腐败,许多政府组织对向海地提供援助犹豫不决,但该国确实得到了一些非政府组织(ngo)的援助。在粮农组织(2013年)进行的一项研究中,他们发现谷物,特别是小麦,是种植最广泛的作物,其次是大麦、水稻、棉花、蔬菜和果树。“在所有国家,牧草都是必不可少的,它们主要是用枣椰树间作。枣椰树、芒果、柑橘、葡萄和无花果、桑葚、石榴和橄榄等果树是树层中最普遍的园艺作物,所有这些都是土生土长的,很好地适应了沙漠和地中海的气候条件。大多数农业基础雄厚的国家都出口一些农产品。某些国家,如约旦,正在推行一项雄心勃勃的农业现代化议程,其中包括扩大灌溉面积和增加部门私有化。然而,市场营销和获得投入物和贷款等若干问题继续阻碍农业发展。2009年,谷物总量的国家级自给率在3%至81%之间,表明进口占该次区域可用粮食的主要份额”(粮农组织,2013年)。《国际科学与研究杂志》,第13卷第1期,2023年1月376 ISSN 2250-3153本出版物在知识共享署名CC BY下获得许可。http://dx.doi.org/10.29322/IJSRP.13.01.2023.p13347 www.ijsrp.org根据CSRF(未注明日期),马拉卡尔县是南苏丹少数几个采用大规模机械化农业的地区之一。尽管自2013年暴力事件爆发以来,这些行动一直受到阻碍。牛、山羊和绵羊由较富裕的家庭饲养。捕鱼主要是在雨季结束和旱季开始的湿地进行的。 牧民和他们的牛群在该地区的季节性迁徙可能是造成冲突的原因
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引用次数: 0
Comparison of 0.2% Chlorhexidine Mouthwash with 1% Povidone Iodine in Preventing the Incidence of Early Ventilator Acquired Pneumonia in the Intensive Care Unit of RSUP Haji Adam Malik Medan 0.2%洗必泰漱口水与1%聚维酮碘预防重症监护室早期呼吸机获得性肺炎的比较
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13337
F. Chandra, A. Hanafie, Tasrif Hamdi
Background: Intensive Care Unit (ICU) is a ward that is prone to nosocomial infections. Mechanical ventilation (MV) support is often required by 10-20% of patients admitted to the ICU, where there is always a risk of developed Ventilator-Acquired Pneumonia (VAP). Poor oral hygiene can lead to bacterial colonization of the oropharynx and aspiration of oropharyngeal secretions into the lower respiratory tract is a major factor in the occurrence of VAP. In addition, VAP is an important cause of morbidity, increased use of health resources, increased length of ICU stay and costs. Therefore, since 2003, various efforts have been made to reduce the incidence of VAP in the ICU, one of which is the use of antiseptic mouthwash which is expected to reduce the incidence of VAP. Objective: Obtain the results of chlorhexidine 0,2% mouthwash compared to povidone iodine 1% mouthwash in preventing the incidence of Early VAP in RSUP Haji Adam Malik Medan. Methods: The research design is randomized clinical trial with a single blind method. After obtaining approval from the Ethics Committee of the Faculty of Medicine, Universitas Sumatera Utara, Medan, 40 research samples were collected which, after fulfilling the inclusion criteria, were randomly divided into 2 groups. Group A received chlorhexidine 0,2% and group B received povidone iodine 1%. The research data obtained were tested using SPSS. Results: CPIS value < 6 at 48 hours was higher in the 0.2% chlorhexidine group than the 1% povidone iodine group, but not statistically significant (p = 0.170). The most common distribution of germs found were Acinetobacter baumanii and Pseudomonas aeruginosa. Conclusion: The incidence of Early VAP appeared to be less in the group receiving 0.2% chlorhexidine mouthwash compared to the 1% povidone iodine group but not statistically significant. In the 0.2% chlorhexidine group, the incidence of Early VAP was 22.5%. In the 1% povidone iodine group, the incidence of Early VAP was 32.5%. The distribution of germs obtained from the culture results shows that Acinetobacter baumanii and Pseudomonas aeruginosa are still the main causes of VAP in the ICU of Haji Adam
背景:重症监护病房(ICU)是院内感染的高发病房。10-20%入住ICU的患者通常需要机械通气(MV)支持,因为ICU总是存在发展为呼吸机获得性肺炎(VAP)的风险。口腔卫生不良可导致细菌在口咽部定植,口咽部分泌物吸入下呼吸道是VAP发生的主要因素。此外,VAP是发病率、卫生资源使用增加、ICU住院时间延长和费用增加的重要原因。因此,自2003年以来,人们采取了各种措施来降低ICU中VAP的发病率,其中一项措施是使用抗菌漱口水,有望降低VAP的发病率。目的:比较0.2%氯己定漱口水与1%聚维酮碘漱口水对急性呼吸道感染患者早期VAP的预防效果。方法:采用单盲随机临床试验设计。经棉兰苏门答腊北方大学医学院伦理委员会批准,收集研究样本40份,符合纳入标准后随机分为2组。A组0.2%氯己定,B组1%聚维酮碘。所得研究数据采用SPSS软件进行检验。结果:0.2%氯己定组48 h CPIS值< 6高于1%聚维酮碘组,但差异无统计学意义(p = 0.170)。最常见的细菌分布是鲍曼不动杆菌和铜绿假单胞菌。结论:0.2%氯己定漱口水组早期VAP发生率明显低于1%聚维酮碘组,但无统计学意义。0.2%氯己定组早期VAP发生率为22.5%。1%聚维酮碘组早期VAP发生率为32.5%。从培养结果中获得的细菌分布显示,鲍曼不动杆菌和铜绿假单胞菌仍然是Haji Adam ICU中VAP的主要原因
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引用次数: 0
The Main and Basic Differences between the Google Search and ChatGPT Application 谷歌搜索和ChatGPT应用程序之间的主要和基本区别
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13354
Ibrahim Ramadan
- This study aims to focus on two tools used by millions of user, Google Search and ChatGPT (Chat Generative Pre-trained Transformer), Google Search is a web search engine that allows users to search the internet for information, while ChatGPT is a natural language processing tool that allows users to communicate with a Chabot using natural language. Both tools use machine learning algorithms and natural language processing to understand and respond to user inputs, but they serve different purposes and are used in different ways.
-本研究旨在关注数百万用户使用的两个工具,谷歌搜索和ChatGPT(聊天生成预训练变压器),谷歌搜索是一个网络搜索引擎,允许用户在互联网上搜索信息,而ChatGPT是一个自然语言处理工具,允许用户使用自然语言与聊天机器人进行交流。这两种工具都使用机器学习算法和自然语言处理来理解和响应用户输入,但它们的目的和使用方式不同。
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引用次数: 1
The Implementation of Nine Values of Character Education in English Language Teaching at Bumi Cendekia Junior High School Yogyakarta 日惹Bumi Cendekia初中英语教学中品格教育九大价值观的实施
Pub Date : 2023-01-24 DOI: 10.29322/ijsrp.13.01.2023.p13333
Rizki Nurma Sari, Mursid Saleh, Fahrur Rozi
This study proposes to explain the students' and teachers' implementation and problems and solves character education, especially for the nine values of Bumi Cendekia. This study employed qualitative research in a descriptive case study design. One English teacher and three mornings English corner teachers from Bumi Cendekia Junior High School of Yogyakarta were observed and interviewed. The data were gathered through classroom observation, semi-structured interviews, and document analysis. This study revealed that all teachers had a good knowledge of character education, especially for the concept and implementation of Bumi Cendekia's nine values. They implemented those nine values of Bumi Cendekia using appropriate strategies and methods in English language lessons' teaching and learning process. All the results aligned with the teachers' perceptions of the interview and the data from classroom observation and document analysis. The most frequent is the mindful character, the second one is respectful, the third one is resilient, and the other characters from fourth to nine are compassionate, trustworthy, responsible, sincere global citizens
本研究旨在解释学生和教师的执行和问题,并解决品格教育,特别是对Bumi Cendekia的九大价值观。本研究采用定性研究的描述性案例研究设计。对日惹市Bumi Cendekia初中的1名英语老师和3名上午英语角老师进行了观察和访谈。通过课堂观察、半结构化访谈和文献分析收集数据。本研究发现,所有教师都对品格教育有较好的了解,特别是对Bumi Cendekia的九大价值观的概念和实施。他们运用适当的策略和方法,在英语教学过程中贯彻布米·肯德基亚的九项价值观。所有结果与教师对访谈的看法以及课堂观察和文献分析的数据一致。最常见的是正念性格,第二是恭敬性格,第三是坚韧性格,从第四到第九的其他性格是富有同情心、值得信赖、负责任、真诚的世界公民
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引用次数: 0
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International Journal of Scientific and Research Publications (IJSRP)
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