10 research outputs found
DESIGNING A MOBILE APPLICATION TO MANAGE AND REDUCE COMMON MENTAL HEALTH PROBLEMS DURING THE COVID-19 PANDEMIC
No full textAlongside the expanding dispersal of data on the number of instances of death because of the Coronavirus outbreak, a large part of the data introduced by the media unveils the more stressed and causes a mental effect, in particular a psychological problem that causes a psychosomatic issue. The plan of this application is to assist individuals with overseeing and lessen sensations of stress or sadness in overabundance by doing contemplation that should be possible even at home and to expand the utilization of the application, the gamification technique is utilized to inspire clients to seek after existing objectives and structure new schedules for the client to rehash the action until the new propensity is shaped. The aftereffects of the assessment utilizing the ease of use testing imply that they are at a moderate level dependent on the principle markers. Along these lines, it tends to be reasoned that the plan of the arrangement gives a positive discernment as far as client experience and convenience
LUKISAN EKSPRESIONISTIK DAVAREZA : Ekspresi Wajah dan Gerakan Anak dalam Penciptaan Karya Lukis
No full textGambaran sosok anak sering diartikan alami, polos, ceria, aktif dan unik. Karakter seorang anak cenderung spontan dengan tingkat luapan emosional yang sangat tinggi dan berakhir dengan cara yang tiba-tiba. Ekspresi pikiran, perasaan dan keinginan seorang anak secara visual seperti tertawa, menangis, marah, serta gerakan ekspresif anak menjadi karakter sangat lucu, unik, dan menggemaskan. Pada karya penciptaan lukisan ini penulis terinspirasi dari ketertarikan penulis terhadap perilaku anak-anak di lingkungan penulis sendiri dan sebagai bentuk kasih sayang yang sangat besar terhadap anaknya Davareza. Penulis mencoba mengabadikan kebersamaan serta keunikan berekspresi Davareza ke dalam sebuah karya lukisan, ekspresi wajah dan gerakan spontan anak dijadikan subject matter dalam sebuah karya lukisan, serta kepolosan anak dalam meluapkan emosi perasaannya melalui ekspresi wajah dan gerakan menjadi keunikan karakter pada anak. Dengan tujuan memvisualisasikan berbagai ekspresi wajah dan gerak tubuh anak ke dalam penciptaan lukisan dalam tugas akhir ini, penulis menggunakan metode penciptaan karya yang dilakukan dengan beberapa tahapan yaitu, proses pengolahan ide, kontemplasi dan stimulasi, sampai proses kreasi dan teknik berkarya. Visual yang ditampilkan dalam lukisan yaitu ekspresi wajah yang mewakili perasaan emosional anak dalam berekspresi serta gerak spontan anak dengan visual gerakan menggunakan efek sapuan kuas tegas. Selain itu, warna latar pada lukisan disesuaikan dengan suasana hati anak ketika berekspresi. Hasil karya berupa enam buah karya lukisan ekspresi wajah dan gerak anak yang dibuat dengan berbagai ukuran dengan objek anak bernama Davareza, semoga hasil karya penciptaan ini diharapkan dapat menambah semangat apresiasi berkesenirupaan dan motivasi dalam berkarya seni lukis bagi pendidikan seni rupa maupun masyarakat umum.
Kata Kunci : Ekspresi dan Gerak Anak, Seni Lukis.
Image of a child often means natural, plain, cheerful, active and unique. The character of a child tends to spontaneous emotional overflow level is very high and ends in a way that suddenly. Expression of thoughts, feelings and desires of a child visually like laughing, crying, angry, and expressive movement into character very funny kid, unique, and adorable. In this painting the author's creative work inspired by the author's interest on the behavior of children in the author's own and as a form of very great affection towards his son Davareza. The author tries to perpetuate the unity and uniqueness of expression Davareza into a masterpiece painting, facial expressions and movement of children spontaneously used the subject matter in a work of painting, and the innocence of a child in the vent emotions feelings through facial expressions and movements into a unique character in children. With the aim of visualizing various facial expressions and gestures of children into the creation of paintings in this thesis, the author uses the method of creating the work done by several stages, namely, the processing of ideas, contemplation and stimulation, through the process of creation and engineering work. Visually displayed in the painting that facial expressions that represent feelings in the child's emotional expression and spontaneous motion using the motion of children with visual effects firm brush strokes. In addition, the background color in the painting adapted to the child's mood when expression. The work of six paintings in the form of facial expressions and gestures made by the child objects of various sizes with a child named Davareza, hopefully the work of creation is expected to add to the spirit of appreciation berkesenirupaan and motivation in the work of art for art education and the general public.
Keywords: Expression and Motion Child, Art
PELAKSANAAN LAYANAN BIMBINGAN KELOMPOK DENGAN TEKNIK SELF- INSTRUCTION DALAM MENGEMBANGKAN KEPERCAYAAN DIRI PESERTA DIDIK DI SMK NEGERI 5 BANDAR LAMPUNG
No full textABSTRAK
Kepercayaan diri adalah suatu proses yang sangat penting dalam
pengembangan diri, yang dapat dicapai ketika seseorang memiliki
tekad yang kuat untuk menunjukkan kreativitas serta kemampuan yang
dimilikinya. Kepercayaan diri ini bukan sekadar perasaan positif, tetapi
merupakan keyakinan yang muncul dari dalam diri individu, mencakup
berbagai aspek, seperti emosional, perilaku, dan spiritual. Di sisi lain,
bimbingan kelompok adalah layanan konseling yang memberikan
kesempatan kepada sekelompok peserta didik untuk belajar dan
berinteraksi bersama melalui dinamika kelompok Melalui proses
bimbingan ini, peserta didik memiliki kesempatan untuk
mendiskusikan berbagai topik yang bermanfaat, seperti keterampilan
sosial, manajemen stres, dan perencanaan karier, yang tidak hanya
meningkatkan pemahaman mereka, tetapi juga kualitas kehidupan
sehari-hari. Bimbingan kelompok ini juga berfungsi untuk mendukung
perkembangan diri peserta didik, baik sebagai individu maupun sebagai
pelajar. Dalam lingkungan yang mendukung ini, mereka dapat
mengembangkan kemampuan interpersonal dan empati, belajar untuk
bekerja sama, serta meningkatkan rasa saling percaya di antara teman
teman sebaya. Dengan demikian, kepercayaan diri dan bimbingan
kelompok saling berhubungan erat, di mana proses bimbingan dapat
berkontribusi secara signifikan terhadap peningkatan kepercayaan diri
peserta didik, sehingga mereka siap menghadapi tantangan di masa
depan dengan lebih percaya diri dan proaktif.
Jenis penelitian yang digunakan adalah dengan pendekatan
kualitatif. Jenis penelitian yang digunakan peneliti bersifat deskriptif
naratif, Jenis penelitian yang digunakan peneliti bersifat deskriptif
naratif, karena peneliti bermaksud mendeskripsikan, mengambil, dan
menganalisis kesimpulan secara umum. Penelitian deskriptif
(descrptive research) ditujukan untuk mendeskripsikan suatu keadaan
atau fenomena-fenomena apa adanya. Teknik pengumpulan data
kualitatif dikumpulkan melalui natural setting dengan teknik
wawancara pengamatan dan dokumentasi. Dalam penelitian ini peneliti
i
menggunakan teknik analisis data bahwa aktivitas dalam analisis data
kualitatif dilakukan secara interaktif dan berlangsung secara terus dan
tuntas.
Berdasarkan hasil penelitian dan pembahasan yang telah penulis
lakukan, kondisi kepercayaan diri peserta didik menunjukkan
perkembangan yang baik dan optimal. Peserta didik mulai
memperlihatkan perubahan positif secara bertahap dalam sikap dan
perilaku mereka. Mereka yang sebelumnya merasa kurang percaya diri
dan tidak yakin akan kemampuan diri mulai menunjukkan keberanian
untuk tampil di depan kelas, berpartisipasi aktif dalam diskusi, dan
menyampaikan pendapat mereka tanpa rasa ragu. Perubahan ini sangat
signifikan dan berdampak positif pada proses belajar, karena peserta
didik menjadi lebih terbuka untuk berdiskusi dan bertanya, yang pada
gilirannya meningkatkan pemahaman mereka terhadap materi
pelajaran. Peningkatan kepercayaan diri ini juga berkontribusi pada
prestasi akademik mereka, karena mereka lebih termotivasi untuk
berusaha dan menghadapi tantangan di kelas. Penulis menyimpulkan
bahwa guru Bimbingan Konseling (BK) telah menjalankan perannya
dengan cukup baik dan profesional dalam memberikan layanan
bimbingan kelompok. Guru BK berhasil menciptakan suasana yang
mendukung dan aman, sehingga peserta didik merasa nyaman untuk
berpartisipasi. Pelaksanaan kegiatan bimbingan kelompok dilakukan di
dalam kelas, mengikuti empat tahapan utama yang terdiri dari tahap
pembentukan, tahap peralihan, tahap kegiatan, dan tahap
pengakhiran.Pada tahap pembentukan, sebagian besar peserta didik
tampak antusias dan bersemangat untuk terlibat, meskipun masih ada
beberapa yang merasa malu dan belum berani mengungkapkan
permasalahan pribadi mereka. Dengan demikian, kegiatan bimbingan
kelompok ini tidak hanya meningkatkan kepercayaan diri, tetapi juga
menciptakan rasa kebersamaan dan saling mendukung di antara peserta
didik.
Kata Kunci : Bimbingan Kelompok, Kepercayan diri, Peserta
didik
ii
ABSTRACT
Self-confidence is a very important process in self
development, which can be achieved when someone has a strong
determination to show their creativity and abilities. This self
confidence is not just a positive feeling, but is a belief that arises from
within the individual, covering various aspects, such as emotional,
behavioral and spiritual. On the other hand, group guidance is a
counseling service that provides an opportunity for a group of students
to learn and interact together through group dynamics. Through this
guidance process, students have the opportunity to discuss various
useful topics, such as social skills, stress management, and career
planning, which not only improves their understanding, but also the
quality of everyday life. This group guidance also functions to support
students' personal development, both as individuals and as students. In
this supportive environment, they can develop interpersonal skills and
empathy, learn to work together, and increase mutual trust among
peers. Thus, self-confidence and group guidance are closely related,
where the guidance process can contribute significantly to increasing
students' self-confidence, so that they are ready to face future
challenges more confidently and proactively.
The type of research used is a qualitative approach. The type
of research used by researchers is descriptive narrative. The type of
research used by researchers is descriptive narrative, because the
researcher intends to describe, draw and analyze general conclusions.
Descriptive research is aimed at describing a situation or phenomena
as they are. Qualitative data collection techniques were collected
through natural settings with observation and documentation interview
iii
techniques. In this study, the researcher used data analysis techniques,
namely that activities in qualitative data analysis were carried out
interactively and took place continuously and completely.
Based on the results of research and discussions that the author
has conducted, the condition of students' self-confidence shows good
and optimal development. Students begin to show gradual positive
changes in their attitudes and behavior. Those who previously felt less
confident and unsure of their abilities began to show the courage to
appear in front of the class, participate actively in discussions, and
express their opinions without hesitation. This change is very
significant and has a positive impact on the learning process, because
students become more open to discussing and asking questions, which
in turn increases their understanding of the subject matter. This
increase in self-confidence also contributes to their academic
performance, as they are more motivated to try and face challenges in
class. The author concludes that the Guidance Counseling (BK) teacher
has carried out his role quite well and professionally in providing group
guidance services. The guidance and counseling teacher succeeded in
creating a supportive and safe atmosphere, so that students felt
comfortable participating. The implementation of group guidance
activities is carried out in the classroom, following four main stages
consisting of the formation stage, transition stage, activity stage, and
ending stage. At the formation stage, the majority of students seemed
enthusiastic and eager to be involved, although there were still some
who felt embarrassed and do not dare to reveal their personal
problems. Thus, this group guidance activity not only increases self
iv
confidence, but also creates a sense of togetherness and mutual support
among students.
Keywords: Group Guidance, Self-confidence, Student
Enhancement of as-sputtered silver-tantalum oxide thin film coating on biomaterial stainless steel by surface thermal treatment
No full textKnitting Indonesian Unity in the Momentum of Mohammad Natsir's Integral Motion: Studi analyses
No full textUnity is an important aspect of a state institution. Unity can be a strength for a nation and state. One of the historical moments that seeks to unite Indonesia after the proclamation is Natsir's Integral Motion. The concept promoted by Indonesian Muslim political figure Mohammad Natsir succeeded in uniting Indonesia into the Republic of Indonesia from the previous RIS (United Republic of Indonesia). This article will discuss the role of Mohammad Natsir with his integral motion in building unity and integrity in Indonesia. This research is library research and the data source used consists of primary data sources of Mohammad Natsir's works related to the Integral Movement and Indonesian Unity, and is assisted by secondary data sources, namely books, which are relevant to this research to strengthen arguments and to complete the data from the research results. The data analysis technique used by the author in this research is content analysis. The results that the author got from this study are that Natsir's Integral Motion has a big and important influence on Indonesia. Not only does it unite Indonesia, but it also has a significant influence in the fields of politics, economics, education and international relations. Based on these findings, the author hopes that there will be further studies on Natsir's integral motion, so that it can become material for reflection and discussion together
IMPLEMENTATION OF VIRTUAL TOUR USING IMAGE STITCHING AS AN INTRODUCTION MEDIA OF SMPN 1 KARANGKOBAR TO NEW STUDENTS
No full text“During the pandemic, the education sector experienced a decline where students and teachers had to do online learning due to the increasingly widespread Covid-19 outbreak. Therefore, the Indonesian government decided to reduce activities that cause crowds in order to prevent the transmission of Covid-19 in Indonesia. With such problems, the author can provide a solution by using a Virtual Tour which is used as a medium to introduce Karangkobar 1 State Junior High School to students who want to register when PPDB takes place. Virtual Tour in the form of 360-degree panoramic images provided with a hotspot and several features such as popups such as images and information that appear in real time. In the functional testing of the Espensaka Virtual Tour application, it was carried out using the Blackbox Testing method on eight different smartphones which produced functions that could run well but had problems with the Gyroscope which could not run on laptops and computers. Then the test using the SUS (System Usability Scale) method with 90 respondents who filled out 10 questions on the questionnaire resulted in an average value of 73.8 which the score according to the System Usability Scale Grade was included in a good rating. From the results of testing using the method on the application, it can be concluded that the Espensaka Virtual Tour application can be run well but has problems with the Gyroscope which cannot be run on laptops and computers. The Espensaka Virtual Tour application can still be used by making an improvement on the recommended hotspot
LEBIH PRODUKTIF DI ERA NEW NORMAL DENGAN LOKA SMART TABLE
No full textIn Indonesia, waste is a serious problem and has a negative impact on various groups. Seeing this
problem, the author thought of making a work table & study table that applies the theme of eco design
& sustainable design, where 50% of the material is made from processed HDPE plastic waste and
other environmentally friendly materials. This theme was chosen so that every product that is made
remains constant. environmentally friendly and has a good impact on the environment. In addition to
the theme, this table also has a modern minimalist visual concept with a touch of eco living so that
this table sticks to its original goal of reducing waste in Indonesia. In addition, this table also
presents several IOT-based smart home features such as Bluetooth Speakers, 3 12v Charging Ports +
3 USB Ports, and LED Light which can be controlled using electronic devices such as Cellphones &
Laptops. This feature is embedded so that users can be more productive during WFH (Work From
Home) & SFH (Study From Home).
Keywords : Waste, New Normal, Loka Smart Table, Sustainable Desig
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Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021
No full textBackground Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories.
Methods We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens.
Findings Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2.18 million deaths (1.98-2.36), or 27.7 deaths (25.1-29.9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97.9 million (92.1-104.0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46.4 million [43.6-49.3] episodes) and Mycoplasma spp (25.3 million [23.5-27.2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41.7% (35.9-46.9), from 56.5 deaths (51.3-61.9) to 32.9 deaths (29.9-35.4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated nonpharmaceutical interventions, we estimated a 16.0% (13.1-18.6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71.8% (63.8-78.9) decline in the number of influenza deaths and a 66.7% (56.6-75.3) decline in the number of RSV deaths.
Interpretation Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textAbstract: Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd
Efficacy and adverse events profile of videolaryngoscopy in critically ill patients: subanalysis of the INTUBE study
No full textBackground: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated. Methods: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy. Results: Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P<0.001). In adjusted analyses, videolaryngoscopy increased the probability of first-pass intubation success, with an OR of 1.40 (95% confidence interval [CI] 1.05–1.87). Videolaryngoscopy was not significantly associated with risk of major adverse events (odds ratio 1.24, 95% CI 0.95–1.62) or cardiovascular events (odds ratio 0.78, 95% CI 0.60–1.02). Conclusions: In critically ill patients, videolaryngoscopy was associated with higher first-pass intubation success rates, despite being used in a population at higher risk of difficult airway management. Videolaryngoscopy was not associated with overall risk of major adverse events. Clinical trial registration: NCT03616054
