Buxton Hospital

ABSTRACTBackgroundInvasive candidiasis (IC), life‐threatening fungal infections with high economic burden, are often treated first‐line with daily intravenous echinocandins. A new once weekly echinocandin, rezafungin, demonstrated statistically non‐inferior efficacy and numerically shorter intensive care unit (ICU) stay compared to caspofungin in clinical trials, offering potential for earlier discharge.ObjectiveTo assess the cost‐effectiveness of rezafungin versus daily echinocandins for the treatment of IC from a UK healthcare perspective.MethodsAn economic model was developed including a short‐term decision tree (treatment duration ≤ 30 days) and a long‐term Markov model (for lifetime outcomes). Considering the impact IC has on a patient's life expectancy and quality of life, a cost‐utility analysis was performed. A cost‐minimisation analysis assuming similar efficacy among echinocandins was included as scenario analysis. Treatment response was assessed at days 5/14 with nonresponders switching to second‐line treatment. Patients with negative repeat blood cultures could step down to oral fluconazole. Rezafungin's weekly administration was estimated to lead to early discharge for 16% of patients. Risk of death was included. Efficacy and resource use estimates were from pooled trial data. Unit costs, utilities, long‐term mortality were from published literature and UK databases.ResultsRezafungin was estimated to be cost‐saving compared to daily echinocandins (discounted incremental costs: −£6028 to −£6727 vs. daily echinocandins). Quality‐adjusted life‐years (QALYs) were similar (incremental QALY: 0.03 vs. daily echinocandins), resulting in rezafungin being cost‐effective. Results were most sensitive to varying mortality and ICU length of stay.ConclusionOnce weekly rezafungin is a cost‐saving and cost‐effective treatment option in IC from the UK healthcare perspective.

Mazkur maqola demokratik jamiyatda huquqiy madaniyatni yuksaltirish omillarining ijtimoiy-falsafiy tahliliga bag‘ishlanadi. “Jamiyatda huquqiy ong va huquqiy madaniyatni yuksaltirish tizimini tubdan takomillashtirish to‘g‘risida” 09.01.2019 yildagi PF-5618sonli O‘zbekiston Respublikasi Prezidentining farmoni, “Jamiyatda huquqiy madaniyatni yuksaltirish milliy dasturi to‘g‘risida” 29.08.1997 yildagi 466-I-sonli O‘zbekiston Respublikasi Oliy Majlisining qarorining ahamiyati tahlil etilgan. Ushbu normativ huquqiy hujjatlarda mamlakat demokratik rivojlanishi, huquqiy ong va huquqiy madaniyatning yuksalishi, huquqiy ta’lim va tarbiyaga bo‘lgan ehtiyojning har doimgiga nisbatan ortib borishi va ijtimoiy taraqqiyotga xizmat qilayotganligi yoritilgan. Shuningdek, maqolada huquqiy madaniyatning tarkibiy vositalari, asosiy yo‘nalishlari va uni rivojlantirish bo‘yicha davlat siyosatining va islohotlarining natijalari yoritib berilgan. Rivojlanish qonunlarining Yangi O‘zbekistonda ma’rifiy jamiyatni barpo etish, xalq farovonligini oshirish va huquqiy tarbiyaning samaradorligini ta’minlashga yo‘naltirilgan istiqbolli islohotlar mazmun-mohiyati ochib berilgan

To evaluate a novel elemental zinc bolus compared with a registered positive control zinc oxide bolus and assess serum zinc concentrations following concomitant treatment with a capsule containing copper oxide needles. Forty Romney-cross ewes were randomly allocated in a 2 × 2 factorial design study. On Day 0, 20 ewes received novel boluses containing elemental zinc (Investigational Veterinary Product, IVP) while 20 received a zinc oxide bolus (control; CP). Half the animals in each zinc treatment group (n=10) were treated with a copper oxide needle capsule [Copasure® - Ewe]. Weekly, from Day -7 to 56, all ewes were assessed for signs of photosensitization, and for 10 ewes from each zinc treatment groups, samples were collected for analysis of serum GGT activity, serum zinc concentrations, faecal zinc concentrations and on Days -7 and 56, liver copper concentrations. Multivariable random-effects models assessed the effects of zinc treatment, copper treatment, treatment interactions and time on all analytes. Regression models examined associations between serum and faecal zinc concentrations and GGT activity. Low spore numbers indicated low Pithomyces chartarum challenge. Serum zinc levels were significantly higher in the IVP than in the CP group [p < 0.0001] and varied by time [p < 0.001] and positively associated with faecal zinc concentration [p < 0.001]. Copper treatment did not affect serum zinc [p=0.82] or faecal zinc [p=0.92] concentrations. Liver copper concentrations did not differ between zinc treatment groups on Day -7 [p=0.6] or Day 56 [p=0.95]. Only the CP/no copper group had no increase in liver copper concentrations.

Peningkatan hasil belajar melalui model pembelajaran Problem Based Learning (PBL) dalam pembelajaran luring. Jenis penelitian ini adalah penelitian tindakan kelas (PTK) model spiral dari C. Kemmis dan Mc Taggart. Prosedur penelitian menggunakan 2 siklus, masing-masing siklus terdiri dari perencanaan, pelaksanaan tindakan, observasi, dan refleksi. Teknik pengumpulan data menggunakan teknik tes dan non tes. Instrumen penelitian berupa butir soal dan lembar observasi. Teknik analisis data yang digunakan adalah uji T dan uji N-Gain. Hasil penelitian menunjukkan bahwa penerapan model pembelajaran PBL dapat meningkatkan hasil belajar peserta didik pada pembelajaran tema 5 Pahlawanku. Kemudian hasil belajar peserta didik dalam penelitian ini juga mengalami peningkatan tiap siklusnya. Setelah diterapkan model pembelajaran PBL pada siklus I rata-rata nilai hasil belajar peserta didik 66,67% dan pada siklus II meningkat menjadi 88,89%. Berdasarkan hasil di atas, dapat disimpulkan bahwa model pembelajaran PBL berpengaruh terhadap hasil belajar pada peserta didik kelas IV Semester I di SD Negeri Bunton 02 tahun pelajaran 2021/2022. Kata Kunci: Hasil Belajar; Problem Based Learning; Motivasi Belajar.