Data Collection Form Research Articles

A crisis awareness chain warning management model for patients with difficulties cooperating with magnetic resonance examinations.

This case-control study tested a crisis awareness-based chain warning management model for patients with difficulties cooperating with magnetic resonance imaging (MRI) examinations. All participants experienced difficulties cooperating with MRI examinations and underwent cranial magnetic resonance spectroscopy (MRS) and MRI at the same hospital in China. The control group (n = 1233) underwent examinations from January to June 2023 and received routine nursing care (pre-examination safety notification, instructions on cooperating during the examination, post-examination observation). A crisis awareness chain warning management model was implemented for the intervention group (n = 1352), who underwent examinations from July to December 2023. The groups were compared on average time for examination completion, quality of care and occurrence of complications. Data were collected using a self-devised data collection form. The average length of time to complete MRS and MRI was shorter for intervention group patients than for control group patients. The intervention group showed better pre-examination preparation, examination success rate, image quality attainment rate, and one-time examination success rate, and lower incidence of examination-related complications. This management model could increase MRI examination efficiency, improve quality of care, reduce complications and increase nurses' understanding of nursing continuity and crisis awareness.

The relationship between nurses' burnout status and their intention to leave during the COVID-19 pandemic process.

The aim of this research is to determine the relationship between nurses' burnout status and their intention to leave the job during the COVID-19 pandemic. The population of the descriptive study, which seeks a relationship, consists of nurses working in State Hospital, the sample consists of 213 nurses who agreed to participate in the research between April 2021 and August 2021. Data were collected using the 'Personal Data Collection Form', 'Burnout Scale' and 'Intention to Leave Scale'. Ethics committee approval was obtained for the study. Of the participants, 75.6% were women, 91.1% cared for patients with a diagnosis of COVID-19. The participants' Burnout Scale mean score was 4.34 ± 1.10, and the Intention to Leave Scale mean score was 2.94 ± 1.04. The relationship between burnout and age, gender, marital status, income status, unit of work, professional experience, choosing the profession voluntarily, being happy to do the joband caring for a patient with COVID-19 was found to be statistically significant (p < 0.05). It has been concluded that age, income status, unit of work, professional experience, choosing the profession willingly and being happy to do the job affect the intention to leave the job. A positive and significant relationship was found between the mean scores of the Burnout Scale and the mean scores of the Intention to Leave Scale. This study determined that as nurses' burnout level increased, their intention to quit their jobs increased.

Halth Workers' Knowledge about The Use of Electronic Medical Records: A Literature Review

Introduction: The knowledge of health workers will affect their skills in carrying out the quality of medical records. The development of knowledge is so fast that health workers will quickly fall behind if they do not take advantage of various things to update the latest developments. The purpose of this study was to identify the knowledge of health workers about the use of electronic medical records (EMR).Methods: This study used a literature review design with a qualitative approach to the data obtained in the form of literature review study data collection. Researchers collected 15 articles or scientific journals that have been published to analyze the knowledge of health workers in using EMR.Results: The percentage of health workers who knew about the use of EMR was more than 50% in 10 articles and less than 50% in 5 articles.Conclusion: The percentage of health workers who know about the use of EMR is relatively high. The level of knowledge is still low due to the lack of training and computer skills for officers and the lack of understanding by officers regarding the benefits of EMR for health facilities.

A machine learning approach to determine the risk factors for fall in multiple sclerosis

BackgroundFalls in multiple sclerosis can result in numerous problems, including injuries and functional loss. Therefore, determining the factors contributing to falls in people with Multiple Sclerosis (PwMS) is crucial. This study aims to investigate the contributing factors to falls in multiple sclerosis using a machine learning approach.MethodsThis cross-sectional study was conducted with 253 PwMS admitted to the outpatient clinic of a university hospital between February and August 2023. A sociodemographic data collection form, Fall Efficacy Scale (FES-I), Berg Balance Scale (BBS), Fatigue Severity Scale (FSS), Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), and Timed 25 Foot Walk Test (T25-FW) were used for data collection. Gradient-boosting algorithms were employed to predict the important variables for falls in PwMS. The XGBoost algorithm emerged as the best performed model in this study.ResultsMost of the participants (70.0%) were female, with a mean age of 40.44 ± 10.88 years. Among the participants, 40.7% reported a fall history in the last year. The area under the curve value of the model was 0.713. Risk factors of falls in PwMS included MSIS-29 (0.424), EDSS (0.406), marital status (0.297), education level (0.240), disease duration (0.185), age (0.130), family type (0.119), smoking (0.031), income level (0.031), and regular exercise habit (0.026).ConclusionsIn this study, smoking and regular exercise were the modifiable factors contributing to falls in PwMS. We recommend that clinicians facilitate the modification of these factors in PwMS. Age and disease duration were non-modifiable factors. These should be considered as risk increasing factors and used to identify PwMS at risk. Interventions aimed at reducing MSIS-29 and EDSS scores will help to prevent falls in PwMS. Education of individuals to increase knowledge and awareness is recommended. Financial support policies for those with low income will help to reduce the risk of falls.

The impact of limited English proficiency on oncological outcomes in the United States: A systematic review.

The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes. To assess the effects of LEP compared to English proficiency (EP) for oncological outcomes in adult cancer patients in the United States. We searched MEDLINE (Ovid), the Cochrane Library (Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials), PsycINFO, CINAHLand Scopus from data inception to 26 January2023. We also searched the reference lists and cited lists of included studies. Studies were limited to the UnitedStatesand the English language. We included retrospective and cross-sectional studies that analyzed one or more clinical outcomes (survival, readmission, length of stay, complicationsand discharge disposition) in LEP and EP cancer patients. Studies were eligible if they assessed cancer patients in the United Stateswho were 18 years and older. Using a piloted, standardized data collection form, two non-blinded, independent reviewers extracted data in duplicate from studies meeting our inclusion criteria. Reviewers resolved discrepancies through discussion. We then performed a qualitative assessment of the findings. We retrieved 2425 records from the database searches. We screened 1496 records by title and abstract and reviewed the full text of eight records. We retrieved 347 records from additional search methods and reviewed the full text of six records. We included 14 papers in total for analysis. The studies included 55,141 total patients and assessed outcomes in brain, oesophageal, head and neck, pancreaticand skin cancer. Our qualitative assessment demonstrated limited information on whether LEP impacted survival, complicationsand discharge disposition. We found no significant association between LEP and readmission or length of stay. Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.

THE RELATIONSHIP BETWEEN BODY MASS INDEX AND ABDOMINAL CIRCUMFERENCE WITH INTRAABDOMINAL ORGAN INJURY IN HIGH ENERGY BLUNT TRAUMA PATIENTS

ABSTRACT Objective: The aim of this study was to determine the impact of body mass index (BMI) and abdominal circumference on intra-abdominal organ injury in high energy blunt trauma patients presenting to the emergency department. Materials and Methods: This prospective, cross-sectional, and analytical study included patients who presented to the Ankara Bilkent City Hospital Emergency Medicine Clinic between June 15, 2022, and December 31, 2022, due to high-energy blunt trauma and underwent contrast-enhanced abdominal computed tomography (CT). Patient demographics, vital signs, height, weight, BMI, mechanism of injury, abdominal injuries, injuries to other systems, abdominal circumference measurements, emergency department outcomes, and laboratory results were recorded in the data collection form. CT images were evaluated by a single radiology specialist, and abdominal circumference and subcutaneous fat tissue thickness were measured. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Statistical significance was assessed using the p-value, and a significance level of p

Understanding pediatric snakebites: Clinical and epidemiological insights from a healthcare center in Bihar, India.

Snakebites are a common medical emergency and occupational hazard for children in India, particularly in rural areas where poverty is prevalent. However, there is limited data on the epidemiology of snakebites on the Indian subcontinent. This cross-sectional, observational study aims to investigate the epidemiology, major clinical manifestations, and outcomes of snakebites in children under the age of 15 who were admitted to a tertiary care center in Bihar, a state in East India, and draw attention to this public health concern. A cross-sectional observational study was conducted at the Department of Paediatrics, Patna Medical College and Hospital, Patna. The study included all cases of snakebites with features of envenomation involving patients less than 15 years of age who were brought to the department over a 2-year period. Data were collected using a data collection form and analyzed using the Statistical Package for the Social Sciences, version 11.0 (SPSS Inc., Chicago, IL, USA). A total of 59 cases were recorded, with 62.71% (n = 37) being male and 37.28% (n = 22) being female. Kraits were responsible for 38.9% (n = 23) of cases, vipers for 42.3% (n = 25), and cobras for 5% (n = 3). Fang marks were present in 67.7% (n = 40) of cases, and the majority of bites (84.7%, n = 50) occurred on a lower limb during the day. The age distribution showed that 16.9% (n = 10) were below 5 years old, 44% (n = 26) were between 5 and 10 years old, and 22% (n = 13) were above 10 years old. Traditional treatment was used in 44.7% (n = 22) of cases, with the most common treatments being local incision + tourniquet (22%, n = 13) and no traditional treatment (55.9%, n = 33). The highest number of cases occurred during July-September (35.5%, n = 21). Snakebites are a significant public health issue in Bihar, India, with the majority of cases occurring in rural areas. The study highlights the importance of increased awareness and preparedness among healthcare providers and the general public, particularly during the monsoon season. Early hospital transfer, prehospital management, and prevention should be promoted through regular public health initiatives.

Effects of Doula Care on Mother and Infant Health Outcomes in Al-Ahsa Region, Saudi Arabia: A Retrospective Cohort Study.

Introduction Continued supportive care during childbirth may be the key to preventing unfavorable outcomes for both mother and child. It is important to assess and comprehend the sources of assistance available during pregnancy in order to enhance the birthing process and promote favorable outcomes. Objectives The current study aimed to assess the impact of ongoing doula support on mother and infant health outcomes compared to standard care. Methods A retrospective cohort study using both medical records and direct interviews based on information in the data collection form was carried out in the Eastern Province of Saudi Arabia, Al-Ahsa Region. The data that were collected included demographic information, obstetric history, delivery data, and postpartum outcome. Results A total of 50 pregnant women receiving doula care and 100 pregnant women receiving standard care were included. Regarding the mode of delivery, 43 (86%) of the doula group had vaginal deliveries compared to 73 (73%) of the standard care group, while CSs were needed for seven (14%) and 27 (27%), respectively (P = 0.78). Only seven (14%) neonates in the doula group required neonatal intensive care unit admission, versus 22 (22%) in the standard care group (P = 0.246). Additionally, initial breastfeeding within the golden hour occurred in 27 (54%) of the doula group compared to 16 (16%) of the standard care group, while exclusive breastfeeding was reported in 32 (64%) of the doula group compared to 26 (26%) of the standard care group (P < 0.001). Conclusion The current study showed more advantageous delivery and postpartum outcomes among doula care women and their infants compared to standard care, mainly for increasing the rate of initiated breastfeeding within the golden hour, exclusive breastfeeding, and reducing postpartum depression.

Using Comics as Data Collection and Training Tools to Understand and Prevent Provider-Enacted HIV Stigma.

Comic storyboards that participants co-create can function as generative data collection tools when integrated into interviews or focus groups in a qualitative-rhetorical study. As a preliminary stage of a study, user testing comic storyboards can help ensure that they are generative and participant-informed, the latter being especially important when researching issues related to participant vulnerability, such as stigma. This article discusses the exigency, user testing, adaptation, and affordances of comic storyboards as data collection or story elicitation tools in a study of provider-enacted HIV stigma. Our user testing of comics storyboards enabled us to implement more responsive, participant-centered, and participatory forms of data collection. Given that the goal of this study is to develop anti-stigma provider training materials in the form of comics, participants' contributions through user testing not only helped us improve our data collection in the main study, but also generated input that informed our conceptualization and drafting of provider training comics.

Assessment of taste alteration and its correlation with nutritional status and quality of life among cancer patients undergoing chemotherapy

BackgroundChemotherapy is the most commonly utilized therapeutic strategy among the numerous cancer treatments. These chemotherapeutic agents have a variety of adverse reactions, one of which is taste alteration (TA), which substantially influences the patients nutritional status and quality of life (QoL). ObjectiveThe study aims to assess TAs, associated factors, and the nutritional status and QoL of cancer patients undergoing chemotherapy. MethodsAn observational cross-sectional study was carried out for 6 months, among cancer patients diagnosed with TA. Data was collected using a chemotherapy-induced taste alteration scale (CiTAS). Demographic details of the patients, factors associated with TA, details regarding chemotherapeutic agent used, number of current chemotherapy cycles etc, were recorded using a self-designed data collection form. Nutritional status and QoL on cancer patients were collected using Mini nutritional assessment – short form (MNA-SF) and EuroQol 5 dimension 5 levels (EQ5D5L), respectively, and statistical package for the social sciences (SPSS) software version 29 was used for the analysis of data. ResultsA significant association was observed between TA and QoL. There was also a significant association between TA and predisposing factors such as nausea and dry mouth, which was obtained from the Chi-square test. Male patients were found to have higher TA than female patients. TA has also affected various aspects of QoL, such as mobility, pain, and discomfort. Patients experiencing mouth dryness or xerostomia had higher TA than others. A negative association was seen between TAs and nutritional status. ConclusionThis study shows a significant relationship between gender and TA, dry mouth, nausea, and TA. Several QoL factors like mobility, pain/discomfort, and TA were also observed. Despite this study not observing any statistical association between nutritional status and TA, clinically, most of the patients with higher TA were malnourished. This study concluded that there was a relationship between TA and QoL and that nausea and dry mouth are the predisposing factors for TA.

Assessment of antimicrobial stewardship programmes and antibiotic use among children admitted to two hospitals in Sierra Leone: a cross-sectional study

IntroductionAntimicrobial resistance (AMR) is a global public health concern and irrational use of antibiotics in hospitals is a key driver of AMR. Even though it is not preventable, antimicrobial stewardship (AMS) programmes will reduce or slow it down. Research evidence from Sierra Leone has demonstrated the high use of antibiotics in hospitals, but no study has assessed hospital AMS programmes and antibiotic use specifically among children. We conducted the first-ever study to assess the AMS programmes and antibiotics use in two tertiary hospitals in Sierra Leone.MethodsThis was a hospital-based cross-sectional survey using the World Health Organization (WHO) point prevalence survey (PPS) methodology. Data was collected from the medical records of eligible patients at the Ola During Children’s Hospital (ODCH) and Makeni Regional Hospital (MRH) using the WHO PPS hospital questionnaire; and required data collection forms. The prescribed antibiotics were classified according to the WHO Access, Watch, and Reserve (AWaRe) classification. Ethics approval was obtained from the Sierra Leone Ethics and Scientific Review Committee. Statistical analysis was conducted using the SPSS version 22.ResultsBoth ODCH and MRH did not have the required AMS infrastructure; policy and practice; and monitoring and feedback mechanisms to ensure rational antibiotic prescribing. Of the 150 patients included in the survey, 116 (77.3%) were admitted at ODCH and 34 (22.7%) to MRH, 77 (51.3%) were males and 73 (48.7%) were females. The mean age was 2 years (SD=3.5). The overall prevalence of antibiotic use was 84.7% (95% CI: 77.9% – 90.0%) and 77 (83.8%) of the children aged less than one year received an antibiotic. The proportion of males that received antibiotics was higher than that of females. Most (58, 47.2 %) of the patients received at least two antibiotics. The top five antibiotics prescribed were gentamycin (100, 27.4%), ceftriaxone (76, 20.3%), ampicillin (71, 19.5%), metronidazole (44, 12.1%), and cefotaxime (31, 8.5%). Community-acquired infections were the primary diagnoses for antibiotic prescription.ConclusionThe non-existence of AMS programmes might have contributed to the high use of antibiotics at ODCH and MRH. This has the potential to increase antibiotic selection pressure and in turn the AMR burden in the country. There is need to establish hospital AMS teams and train health workers on the rational use of antibiotics.

Health Literacy Levels of Vocational School of Health Services Students and Related Factors

Introduction: The concept of health literacy requires individuals to have basic health knowledge in order to use health services correctly and effectively, and this is very important. Considering that research in the field of health literacy in our country is not yet at a sufficient level, it was aimed to determine the level of the concept of health literacy, which is gaining importance, among students of vocational schools of health services and related factors. Methods: The research is a descriptive cross-sectional type, and the population of the research consists of students studying at vocational schools of health services at Izmir Tinaztepe University, Ege University, Pamukkale University and Bolu Abant Izzet Baysal University. Individual Introduction Form and Health Literacy Scale were used as data collection forms. Results: 1370 students participated in the research. The average age of the students is 20.29±2.86 years, 78.5% are female and 21.5% are male. It was determined that 24.6% of the students smoked and 22.4% consumed alcohol. The proportion of students participating in the research who read books frequently is only 31.4%. It was determined that 46.7% of the students in the research group knew the concept of health literacy. It was determined that the average score of the students in the research group on the health literacy scale was 110.24±12.22. In addition, it was determined that the average of the subscales, the access to information dimension, was 21.93±2.96, the average of the information understanding dimension was 31.17±3.58, the average of the evaluation/evaluation dimension was 35.40±4.57, and the average of the application/use dimension was 21.74±3.13. According to the findings of the research, it was determined that there was a statistically significant difference between the health literacy scale scores of the students according to their gender, family structure and literacy level, income level, smoking status, book reading frequency and general health status (p

Professional Development as a Selected Factor Influencing Succession in Family Businesses

Theoretical background: Professional development plays a key role in succession in family businesses. Succession in family businesses means transferring control and ownership of the company from one generation to the next, and choosing the right successor is very important for the future of the company. Therefore, professional development can be a significant factor influencing this decision. Purpose of the article: The article presents professional development as a selected factor that affects succession in family businesses. Research methods: The primary research method chosen for data collection was a survey in the form of a questionnaire. The survey was done through a free online questionnaire – Google Form. This was intended to reach a wider audience from all over the country, so that the respondents would be as representative group as possible. The respondents were contacted through social media messaging and e-mail. This form of data collection was motivated by the desire to obtain responses primarily from young people. While 402 respondents participated in the survey, 305 responses were considered for analysis. Main findings: The following article presents the results of a survey on awareness of the importance of building a career path and professional development and the actual status of the implementation of plans. The survey also addresses issues of satisfaction with respondents’ current working conditions. The current shortage of workers in the labour market and the deepening demographic decline may cause a situation in which a successor does not become a single member of the immediate family. The best effect can be achieved by linking succession planning with the conscious and thorough construction of a career path and professional development based on the family business. The results of the paper relate to research analysing the career decisions of future managers, take into account the impact of the career path on professional development, and contribute to the understanding of the factors analysed in the succession process.

Incidence, diagnosis, and management of orofacial pain among new patients receiving tertiary care in Thailand: A 6-year retrospective study comparing before and during the COVID-19 outbreak.

There is insufficient data on orofacial pain related to the COVID-19 outbreak in Thailand. To investigate the incidence, diagnosis and management of orofacial pain among new patients over the last 6 years, before and during the COVID-19 outbreak. Medical records from new patients who first visited Chulalongkorn Dental Hospital between 2017 and 2022 were retrospectively investigated. The sample size was determined, and proportional stratified random sampling was employed to distribute the sample number proportionally across each year. The hospital number of each patient was randomised using online software as a sampling strategy. A data collection form was developed and used to gather information from the digital data system. At the first visit, 770 out of 1359 patients (56.7/100 people, 95% CI: 54.0-59.3) reported orofacial pain defined as acute, chronic and unclassified pain. The most common chief complaints based on the AAOP classification were odontogenic pain (90.00%) and temporomandibular disorders (6.10%). The top three provisional modified ICD-10-TM diagnoses among these patients were pulp diseases (21.95%), impacted teeth (20.65%) and dental caries (9.09%). 81.87% of dental students' provisional diagnoses matched the final diagnoses given by dental specialists. Only 63.38% of orofacial pain patients were completely managed during the COVID-19 pandemic with common procedures being surgical removal, extraction and root canal therapy. Half of Thai dental patients seeking tertiary care at a university dental hospital reported orofacial pain, which was not impacted by the COVID-19 pandemic. In contrast, dysfunction-related problems in the orofacial area significantly increased during the pandemic.

A STUDY TO EVALUATE THE TYPE AND CAUSE OF BLINDNESS/LOW VISION IN APPLICATIONS FOR BLINDNESS CERTIFICATE PRESENTING IN CHAMBA DISTRICT OF HIMACHAL PRADESH

Objective: This study aims to assess the prevalence, causes, and socio-economic impacts of visual impairment in the Chamba District of Himachal Pradesh, India. It seeks to identify the major factors contributing to visual disability and the role of literacy and employment status in influencing the lives of the visually impaired. Methods: A cross-sectional, hospital-based study was conducted over a period of one year, enrolling patients from the outpatient department of ophthalmology who were applying for visual disability certification. The study utilized a randomized sampling method and a semi-structured interview along with an examination form for data collection. Ethical approval was obtained, and the study adhered to ICMR and Helsinki Declaration guidelines. Participants underwent comprehensive ophthalmic evaluations, and data were analyzed using SPSS version 17.0. Results: Among the 270 participants evaluated, a higher prevalence of visual impairment was observed in males (n=149) compared to females (n=121), particularly within the age group of 21-40 y. The leading causes of visual disability included Corneal Opacity (16.25%), Retinitis Pigmentosa (15.83%), and Congenital Malformation (14.17%). Furthermore, literacy played a crucial role in employment opportunities, with 75.83% of the literate participants being employed, indicating a significant impact on the socio-economic status. Conclusion: The study highlights the multifaceted nature of visual impairment in the Chamba District, emphasizing the need for integrated public health strategies to address the identified challenges. Enhancing preventive measures, improving access to healthcare, and supporting rehabilitation services are essential steps towards mitigating the burden of visual impairment.

Validation of the newly proposed Brighton Collaboration case definition for vaccine-induced immune thrombocytopenia and thrombosis

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a newly recognized syndrome mediated by anti-platelet factor 4 antibodies induced by Covid-19 adenovirus-vectored vaccines including ChAdOx1 nCoV-19 and Ad26.COV2.S. This study validated a proposed Brighton Collaboration case definition for VITT. A data collection form was developed and used to capture the variations in VITT criteria and assess their level of diagnostic certainty from adjudicated positive VITT case datasheets in Germany (n = 71), UK (n = 220), Australia (n = 203), and Taiwan (n = 56). We observed high prevalence of each component of the proposed VITT definition in positive cases (84%–100%), except for the occurrence of thrombosis or thromboembolism criterion in only 34% of VITT cases in Taiwan. The sensitivity of this proposed definition was 100% for Germany and UK, 92% for Australia, and 89% for Taiwan cases. These findings support the validity of this case definition for VITT.

Economic burden of psoriasis in Southern Iran in 2022

IntroductionPsoriasis is a common, chronic, and non-contagious skin disease that has no known cause or treatment. Various medical costs for skin disorders, including psoriasis, can be expensive and lifelong. The purpose of the present study was to determine the economic burden of psoriasis in patients admitted to general hospitals affiliated with Shiraz University of Medical Sciences, Iran in 2022.Materials and methodsThis research was a descriptive, cross-sectional, cost of illness study from a societal perspective. All psoriasis patients (N = 118) admitted to the hospitals affiliated with Shiraz University of Medical Sciences in 2022 were examined. 7 participants refused to cooperate and were excluded from the study and, the information of 111 patients was collected. A researcher-made data collection form was used to collect data. A prevalence-based approach was used to prepare cost data, and the costing approach was bottom-up. The productivity lost due to the absenteeism of patients and their companions was estimated using the human capital approach. Microsoft Excel ® 2016 was applied to analyze the data.ResultsThe mean annual cost per psoriasis patient was estimated to be US$ 30,374.21. Its highest and lowest share was related to direct medical costs (88.61%), direct non-medical costs (7.3%) and indirect costs (4.09%), respectively. Also, the highest mean direct medical, direct non-medical, and indirect costs per patient were related to those of medicine (93.11%), transportation (51.65%), and absenteeism of the patients’ companions due to patient care (71.73%).ConclusionConsidering that the major contributor in the direct medical cost of treating psoriasis patients was related to medicine, designing appropriate mechanisms for insurance coverage, and allocating government subsidies for the purchase of medicine, are suggested. The result of the current study has important implications for policymakers in developing guidelines for early diagnosis of this disease and reducing the health economic burden.

Implementasi Inovasi Program Multiple Intelligences Research (MIR) di Sekolah Dasar Inklusi Ponorogo

The educational tendency in Indonesia to equalize intelligence standards between students through formal tests can kill students' potential intelligence, interests and talents. Minimal awareness of the concept of multiple intelligences (multiple intelligences) educational institutions in Indonesia need more innovative solutions so that efforts to improve the quality of education can be more optimized. The MIR program innovation initiated by Munif Chatib is the right solution so that the concept of different student intelligence can be understood and appreciated as a basis for determining methods and styles in learning activities. The research method used in this research is descriptive qualitative research with a case study type of research (case study). The data collection technique used is an in-depth interview (indepth interview), participatory observation and documentation processed using Miles, Huberman and Saldana's interactive model data analysis technique which consists of four stages in the form of data collection, data condensation, data presentation and data verification. The location of this research was carried out at SD Immersion Ponorogo as a school with branding inclusion. This research aims to analyze the process of spreading MIR program innovation so that it can become a new breakthrough in the world of education to better appreciate and develop students' various intelligences. The research results show that the process of spreading innovation is carried out in line with Everett M Roger's theory of innovation diffusion which consists of innovation, communication channels, time period and social systems as an effective and efficient dissemination strategy. The MIR program is used as a reference for teachers in determining students' learning styles and models at Immersion Elementary School according to their multiple intelligences more effectively and efficiently. The learning styles used include: storry telling, brainstorming, tape recording, journal writing, fieldtrip, and project based learning.

Analysis of interhospital emergency referrals despite safety concerns on the roads: Emergency referrals in Northwest Syria intraregional borders

Objectives This study aims to assess emergency patient referrals between hospitals in the northwestern region of Syria. In this way, determining the patient profiles referred in the region can help shed light on the reasons for avoidable referrals, reduce referrals, and reduce the risks associated with referrals. Methods This retrospective study investigated the patients who were referred to AAA Hospital, BBB Hospital, and CCC Hospital and from these facilities within the borders of the northwestern region of Syria between 01/01/2020-01/01/2021. Referral records of patients transferred between hospitals and ambulance stations were searched in files and computer records. Because there was no automation system in the healthcare facilities involved in the study, data were recorded manually on the data collection form and processed for statistical analysis. Statistical analyzes of the study were performed as descriptive statistics of variables are reported as mean∓standard deviation, median (min-max), and n(%). Statistical analyzes of categorical variables were performed using the chi-square test and Fisher Freeman Halton Exact test. Results The mean age of the patients of 899 patients included in the study was 33.68∓26.80 years, 530(59.0%) were male and 369(41.0%) were female. 27.3% of patients were trauma patients and of both sexes. Male trauma patients were approximately 2.5 times more common than female trauma patients. Among pediatric referrals, trauma was present in one out of every three patients. Patients were most frequently referred in February, March, and June and least frequently in January (p &lt; 0.05). It was found that the need for adult, newborn, and pediatric intensive care, the need for medical material and equipment, the need for further examination/treatment, followed by the need for treatment under the supervision neurosurgeon, obstetric and gynecologist, cardiology specialist, or pediatrician. It was also noted that referrals for COVID -19 (SARS-CoV-2 Coronavirus Disease 2019) service needs due to the impact of the COVID -19 outbreak during the study period were among the most common reasons. COVID -19, falls, respiratory distress, traffic accidents, and acute MI were the most common diagnoses in all referred age groups. Conclusion In northwestern Syria, emergency patients are most often referred from one hospital to another because they require all types of intensive care units, medical materials and equipment, advanced diagnostic treatment, and specialists in neurosurgery, obstetrics and gynecology, cardiology, and pediatrics. Increasing hospital capacity and qualifications of hospitals within the humanitarian response and increasing the number of specialists, may be considered to reduce inter-hospital referrals of emergency patients.

Safety and efficacy of vancomycin therapy in a tertiary care hospital: A prospective observational study

Abstract Background: Vancomycin is widely used to treat infections caused by Gram-positive organisms. However, its use results in several clinically significant side effects in human beings. This study focuses on the safety and clinical outcomes of vancomycin therapy and its judicious use in hospitalized patients. Materials and Methods: A prospective observational study was conducted over a period of 6 months in Lourdes Hospital, Ernakulam. Demographic and clinical details, including pertinent laboratory values of patients prescribed with vancomycin during hospitalization, were documented and analyzed using a specifically designed data collection form. Results: Positive clinical outcomes were observed in a study of 60 patients treated with vancomycin for various infections, although two died within 30 days. The average duration of therapy was 6.86 days, and the average length of hospital stay was 12.23 days. Nephrotoxicity was observed in 5% of patients, with 11.6% developing acute kidney injury network (AKIN) Stage 1 and 5% progressing to Stage 2. Laboratory results demonstrated recovery from infection (reflected by reduced neutrophil and erythrocyte sedimentation rate levels) alongside a slight increase in creatinine levels and a significant decrease in urea levels. Adverse drug reactions were reported in 19 patients (31.7%). Conclusion: This study assessed the safety and efficacy of vancomycin, highlighting nephrotoxicity in 16.6% of patients. Despite some adverse reactions, there were favorable responses in 90% of the cases. Doses were administered according to standard guidelines. The study’s findings contributed to developing proposed guidelines for vancomycin use in collaboration with the Nephrology Department.