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Effectiveness of debriefing towards healthcare professionals’ nontechnical skills: a critical review
Full text linkThe importance of nontechnical skills among healthcare professionals is gaining widespread recognition as critical elements complementing technical skills that are used to improve patients’ safety. These skills are typically acquired through simulation training which has emerged as an effective way to complement clinical training. Effective simulation requires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of the effectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In this paper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcare professionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. The results of the review show a statistically significant improvement in the performance of nontechnical and technical skills across different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effective communication, decision-making, and situational awareness have improved significantly. In addition, integration of realism in simulation learning has begun to emerge as an effective technique of providing a real world experience. However, there was lack of detailed information on the length and type of debriefing conducted in the studies. These methods clearly require further research since the key to successful simulation learning is through debriefing which is the heart of simulation
Brain activation display functional asymmetry in response to action, background and tonal frequency during a pitch memory processing: an fMRI study
Full text linkIn this study, the asymmetry of the main effects of action, background and tonal frequency during a pitch memory processing were investigated by means of brain activation. Eighteen participants (mean age 27.6 years) were presented with low and high frequency tones in quiet and in noise. They listen, discriminate and recognize the target tone against the final tone in a series of four distracting tones. The main effects were studied using the analysis of variance (ANOVA) with action (to wring (rubber bulb) vs. not to wring), background (in quiet vs. in noise) and frequency (low vs. high) as the factors (and levels respectively). The main effect of action is in the right pre-central gyrus (PCG), in conformation with its contralateral behavior. The main effect of background indicated the bilateral primary auditory cortices (PAC) and is right lateralized, attributable to white noise. The main effect of frequency is also observed in PAC but bilaterally equal and attributable to low frequency tones. Despite the argument that the temporo-spectral lateralization dichotomy is not especially rigid as revealed by the main effect of frequency, right lateralization of PAC for the respective main effect of background clearly demonstrates its functional asymmetry suggesting different perceptual functionality of the right and left PAC
Assessing neuroplasticity using magnetoencephalography (MEG) in patient with left-temporo-parietal pilocytic astrocytomas treated with endoscopic surgery
Full text linkNeuroplasticity has been subjected to a great deal of research in the last century. Recently, significant emphasis has been placed on the global effect of localized plastic changes throughout the central nervous system, and on how these changes integrate in a pathological context. The present study aimed to demonstrate the functional cortical reorganization before and after surgery using magnetoencephalography (MEG) in a participant with brain tumor. Results of Visual Evoked Magnetic Field (VEF) based on functional MEG study revealed significantly different of MEG N100 waveforms before and after surgery. Larger and additional new locations for visual activation areas after the surgery were found suggesting neuroplasticity. The present study highlight a physiological plasticity in a teenage brain and the alterations regarding neural plasticity and network remodeling described in pathological contexts in higher-order visual association areas
Kepatuhan temujanji oleh pesakit di Klinik Optometri UKM
Full text linkKepatuhan temujanji pesakit merujuk kepada kebersediaan dan kebolehan pesakit untuk menghadiri temujanji yang telah ditetapkan. Kegagalan pesakit untuk berbuat demikian memberi pelbagai kesan terutamanya di klinik pengajaran seperti Klinik Optometri Universiti Kebangsaan Malaysia (UKM). Peratus kepatuhan temujanji oleh pesakit di Klinik Optometri UKM dianalisa dari September sehingga Disember 2015 dan dibahagikan mengikut jenis dan sesi klinik serta jantina dan etnik pesakit. Peratus kepatuhan temujanji adalah sekitar 60% untuk Klinik Optometri Primer. Kepatuhan meningkat ke sekitar 70% bagi klinik khas untuk pesakit bermasalah penglihatan seperti Klinik Penglihatan Terhad dan Klinik Penglihatan Pediatrik. Hari dan masa klinik tidak mempengaruhi kehadiran pesakit secara signifikan (p > 0.05). Jantina dan etnik pesakit tidak mempengaruhi kepatuhan temujanji secara signifikan tetapi pesakit berbangsa India secara konsisten menunjukkan peratus kehadiran temujanji terendah. Suatu protokol perlu dibangunkan untuk meningkatan kadar kepatuhan temujanji pesakit. Ini seterusnya dapat menambah produktiviti di kalangan kakitangan dan pelajar dan mengoptimumkan penggunaan sumber. Penerangan juga boleh diberikan kepada pesakit mengenai kos yang ditanggung oleh pihak pengurusan untuk setiap temujanji walaupun tiada sebarang caj dikenakan kepada pesakit
Simulation model algorithm for pre-hospital emergency care (PHEC) volunteers in Indonesia
Full text linkThe first responders who are often exposed to emergency condition play important roles in providing PHEC to victims with road accident trauma. Hence, empowerment of first responders is highly required to achieve the target of response time of less than 10 minutes to provide PHEC in order to minimize the numbers of deaths and disabilities caused by trauma. This study applied quasi-experimental design with static group comparison pattern using cross-sectional approach. A number of 40 samples of common people consisting of 20 samples in treatment group and 20 samples in control group were taken. The statistic test used in this research is t-test. The results reveals that simulation model using algorithm influences the improvement of traffic volunteers’ emergency management capabilities with p-value of < 0.05 and mean score difference of 34.5%, and the model is highly effective to be implemented to improve the capability of traffic assistant volunteers to manage trauma emergency with the mean score difference of 11.5%. Algorithm models for PHEC simulation have some strengths in real setting and effective interactive learning to evaluate the capabilities of first responders in managing pre-hospital emergency, and improve problem-solving skills, as well as their performance in such aspects as skill, knowledge, and attitude
Nutrient contents in tempe produced from five cottage industries in Selangor, Malaysia
Full text linkThis study aimed to determine the nutrient contents in tempe produced by five cottage industries in Selangor, Malaysia. Proximate contents were analysed by using standard methods of AOAC (1997) while carbohydrate content was calculated by difference. Mineral contents, total dietary fiber (TDF), total phenolic content and total isoflavone content were determined by Atomic Absorption Spectrophotometry (AAS), enzymatic-gravimetric (AOAC 985.29), Folin-Ciocalteu colorimetric and High Performance Liquid Chromatography (HPLC) respectively. Macronutrients were reported in 100 g sample and the results showed the average nutrient contents were as follow: 63.07 ± 3.18% moisture, 19.63 ± 1.50% protein, 0.65 ± 0.17% fat, 0.70 ± 0.06% ash and 15.95 ± 1.88% total carbohydrate. The average mineral content in 100 g samples (based on wet basis) were 29.45 ± 5.67 mg calcium, 13.28 ± 5.76 mg magnesium, 3.48 ± 1.09 mg sodium and 2.06 ± 0.33 mg ferum. The results showed that the average of TDF content was 8.05 ± 3.65%. Total phenolic content was 259.87 ± 22.62 mg of GAE/g. The total isoflavone content in 100 g samples (wet basis) was 41.94 ± 10.42 mg/100 g. This study had shown that total phenolic content was significantly correlated (p 0.05) in nutrient contents among tempe samples produced by five cottage industries located in Selangor, Malaysia. However, the mineral and isoflavone contents in the present study were lower compared to previous studies
Sintesis, penilaian biologi dan kajian dok sebatian auron ke atas enzim xantin oksidase
Full text linkPerencatan aktiviti xantin oksidase (XO) merupakan satu pendekatan terapeutik yang berkesan dalam rawatan penyakit seperti gout dan hiperurikemia. Selain itu, penggunaan perencat XO juga dapat diluaskan kepada rawatan kecederaan contohnya reperfusi iskemia di pelbagai organ seperti jantung, hati dan buah pinggang. Dalam kajian ini, sebanyak 7 sebatian auron telah disintesis dan diuji ke atas XO dan dibandingkan dengan kawalan positif allopurinol. Sebatian 5e dikenalpasti sebagai sebatian yang paling berpotensi dan mampu merencatkan separuh daripada aktiviti XO pada 33.23 μM diikuti oleh sebatian 5f pada 210.22 μM dan sebatian 5d pada 302.0 μM. Kajian dok molekul telah dijalankan untuk memahami interaksi penting antara auron yang terpilih dengan tapak aktif XO
Willingness to pay for outpatient services user fees: Malaysian community perspective
Full text linkHealth care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure
Association between tooth loss and body mass index among older adults in Kuala Pilah, Negeri Sembilan
Full text linkLoss of teeth can affect masticatory efficiency in older adults. This may result in avoidance or modifications in food choices and lead to lower intake of important nutrients among older individuals. The aim of this study was to determine the association between tooth loss and body mass index, BMI, among older adults in Kuala Pilah, Negeri Sembilan. A cross-sectional study was carried out on 428 older adults aged 50 years and above from selected villages in district of Kuala Pilah. Respondents were interviewed to collect information on their demographic characteristics. Number of tooth loss was determined through oral assessment, followed by anthropometric assessment to calculate the BMI of respondents. Findings showed that majority of the respondents were overweight and obese, 40.4% and 19.9% respectively, while only a small proportion was underweight, 3.9%. The proportion of edentulism (total tooth loss) was 18.3% and majority of the older adults had lost more than 12 teeth (77.1%) and less than 4 pairs of occluding posterior teeth (86.0%). Total and partial tooth loss was found to be not significantly associated with BMI. In relation to the arrangement of teeth, older adults with reduced number of posterior occluding pairs of teeth were more likely to experience unsatisfactory BMI (OR = 3.61, 95% CI: 1.48, 8.76). This may suggest that functional arrangement of the tooth in the oral cavity is more important than the number of tooth loss alone. Thus, maintaining an optimum number of teeth for chewing is essential for maintenance of ideal BMI
Persepsi pelajar tingkatan lima terhadap kerjaya dalam bidang Sains Kesihatan
Full text linkBidang Sains Kesihatan kurang diceburi berbanding program kompetitif seperti perubatan, farmasi, dan pergigian. Kajian ini bertujuan untuk menilai persepsi pelajar Tingkatan Lima terhadap kerjaya dalam bidang Sains Kesihatan berkenaan dengan empat dimensi, iaitu ciri-ciri kerjaya yang dinilai sebagai “penting” dalam pemilihan kerjaya, tahap pengetahuan terhadap kerjaya dalam bidang kesihatan, persepsi pelajar terhadap kerjaya dalam bidang kesihatan, dan profesion kesihatan yang dipertimbangkan sebagai kerjaya. Satu kajian keratan rentas terhadap 188 orang pelajar daripada 10 buah sekolah menengah kebangsaan di sekitar Kuala Lumpur telah dijalankan. Hasil kajian menunjukkan responden mementingkan ciri kerjaya yang “memberi kepuasan pekerjaan” (97.8%), “mempunyai jaminan pekerjaan” (96.8%), “menarik” (95.2%), “membantu orang lain” (92.4%), “melakukan sesuatu perkara yang bermanfaat terhadap masyarakat” (92.1%) dan “dibayar gaji tinggi” (88.6%). Dari segi tahap pengetahuan, Perubatan (93.1%) merupakan kerjaya profesional yang paling diketahui dalam kalangan responden, diikuti Farmasi (84.0%), Pergigian (76.6%), Kejururawatan (74.8%), dan Sains Forensik (71.3%). Responden mempunyai pengetahuan yang paling kurang tentang bidang Terapi Pertuturan-Bahasa (28.0%), Audiologi (27.0%), dan Terapi Carakerja (19.3%). Perbezaan dari segi jantina dan etnik turut dikenalpasti melalui dapatan kajian ini. Persepsi responden terhadap sesuatu profesion dipengaruhi oleh faktor pengetahuan, etnik, dan jantina. Responden mempunyai tahap pengetahuan yang rendah dan tidak tepat bagi profesion yang kurang dikenali dan hal ini mempengaruhi pertimbangan responden dalam pemilihan kerjaya