From 78 pts. (87,6%) treated with artesunate intravenous, 13 pts. (16,7%) died, mostly have three or more complications. Nine pts. (10,1%) treated with artemether i.m., 1 pts. with 2 complications died (11%). Only 1 pts. with 2 complications (2,3%) treated with quinine i.v and survive.Conclusion: Mortality of severe malaria in Manado is 15,7% which is comparable to the SEAQUAMAT study. Jaundice and acute renal failure are the commonest complications. Four or more complications have worst prognosis.
This longitudinal research examined the relationship direction between burnout components (exhaustion and disengagement) within the context of personal resources measured by self-efficacy and social support. In line with the conservation of resources theory we hypothesized that exhaustion may trigger a spiral loss of personal resources where self-efficacy declines and subsequently, social support also declines and in turn predict disengagement. Participants in Study 1 were mental healthcare providers (N = 135) working with U.S. military personnel suffering from trauma. Participants in Study 2 were healthcare providers, social workers, and other human services professionals (N = 193) providing various types of services for civilian trauma survivors in Poland. Baseline and 6-month follow-up measurements included burnout components, burnout self-efficacy and perceived social support. The path analysis showed consistent results for both longitudinal studies; exhaustion measured at Time 1 led to disengagement at Time 2, after controlling for baseline disengagement levels. Across Study 1 and Study 2 these associations were mediated by self-efficacy change: Higher exhaustion led to greater decline in self-efficacy which in turn explained higher disengagement at the follow-up. Social support, however, did not mediate between self-efficacy and disengagement. These mediating effects were invariant across Studies 1 and 2, although the mean levels of burnout and personal resources differed significantly. The results contribute to a discussion on the internal structure of job burnout and a broader understanding of the associations between exhaustion and disengagement that may be explained by the underlying mechanism of change in self-efficacy.
Additive manufacturing (AM), also known as three-dimensional (3D) printing, enables fabrication of custom-designed and personalized 3D constructs with high complexity in shape and composition. AM has a strong potential to fabricate oral tablets with enhanced customization and complexity as compared to tablets manufactured using conventional approaches. Despite these advantages, AM has not yet become the mainstream manufacturing approach for fabrication of oral solid dosage forms mainly due to limitations of AM technologies and lack of diverse printable drug formulations. In this review, AM of oral tablets are summarized with respect to AM technology. A detailed review of AM methods and materials used for the AM of oral tablets is presented. This article also reviews the challenges in AM of pharmaceutical formulations and potential strategies to overcome these challenges.
The authors present a short summary of the current state of malaria vaccine development and the perspectives for the availability of a malaria vaccines for travellers from non-endemic countries. There is currently no commercially available malaria vaccine for travellers. The efficacy of the RTS,S/AS01 vaccine is limited and differs dramatically from the effects of other vaccines administered in travel medicine. In the current recommendations, the use of repellents is deemed the most important measure to prevent malaria infection, and in the high-risk destinations, chemoprophylaxis is strongly advised. Many questions in malaria vaccinology remain unanswered.
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