Issue: IeJSME 2015 9(1)

Interprofessional learning in nursing – a review

Authors: Mini Rani Mary Beth, Pek Hong Lim, Chitra Rathina Pandi.

ABSTRACT

Interprofessional learning (IPL) promotes collaboration among healthcare professionals in providing quality healthcare. For the IPL to have a positive influence on inter-professional collaboration, opportunities must be made available for the healthcare students to learn together. Attitudinal factors have been identified as the major factor hindering the implementation of IPL. In Malaysia, little is known about attitudes of healthcare students towards IPL. Students from different health disciplines often have poor conception of each other’s roles as a member of the healthcare team. IPL increases this knowledge and gives students an understanding of the interpersonal skills needed for liaison and communication. Students from different disciplines who learn together develop interpersonal and teamwork skills, and gain knowledge of how other professionals work. IPL has been shown to create teams that work together better and improve patient experience. In general, IPL aims to improve patient safety, enhance patient satisfaction, and increase levels of innovation in patient care, and increase staff motivation, well-being and retention. There has been increasing emphasis on the important role that interprofessional education (IPE) must play in educating and developing present and future healthcare professionals. This review aims to examine how learning outcomes are articulated in the field of IPE and includes the benefits, importance, ethical concepts and application of IPL in nursing.

Keywords: Interprofessional learning, Nursing education, experiential learning, ethical competency.

Citation: IeJSME 2015 9(1): 9-20

DOI: https://doi.org/10.56026/imu.9.1.9

Oily fish, liquid wax esters and keriorrhoea – a review

Authors: Peter Michael Barling, Yi Huan Foong.

ABSTRACT

Keriorrhoea is the involuntarily passing of orange oil per rectum. One of us (PMB) had the misfortune to experience this symptom, together with considerable gastrointestinal disturbances for a prolonged period of time after consumption of a deep sea fish, orange roughy, which is rich in liquid wax esters (LWEs). This paper presents a summary of available evidence concerned with the physiology and pathology of ingestion of LWEs, which can enter the human diet in substantial amounts from consumption of several species of deep-sea fish. LWEs are poorly digested and absorbed by the human body. They generally cause keriorrhoea when ingested deliberately or accidentally. Jojoba oil, which is a plant LWE, together with certain nutritional products (e.g. olestra) and medical (e.g. Orlistat) which are not LWEs may mimic the effects of LWEs, and cause similar gastrointestinal disturbances. This paper discusses the potential effects of LWEs as components of gastrointestinal micelles, and predicts that the orange oil which is leaked from a bout of keriorrhoea may contain considerable volumes of triacylglycerols (TAGs).

Keywords: keriorrhoea; liquid wax esters; orange roughy; escolar; oilfish; lipase; 2-monoglyceride.

Citation: IeJSME 2015 9(1): 21-25

DOI: https://doi.org/10.56026/imu.9.1.21

Influence of rice and added sugar intakes on fasting plasma glucose and triacylglycerol levels amongst a population sample of Malaysian adults

Authors: Zhi Yee Lee, Joshua Chuan Yung Foo, Mei Qian Lim, Zheng Xian Koh, Wendy Hui Yi Wong, Tony Kock Wai Ng.

ABSTRACT

Introduction: A recently published meta-analysis showed that each additional serving of rice increased risk of type 2 diabetes mellitus (DM) by an alarming 11%. We investigated whether this phenomenon is seen in the Malaysian population by studying the effect of rice intake and added sugar consumption on fasting plasma glucose (FPG) and fasting triacylglycerol (TAG).

Methods: Ninety subjects (60 females, 30 males, aged 30-70 years), adequate to detect a weak-to-moderate Pearson correlation of r=0.26 at a=0.05 and power=0.80, were recruited by convenience sampling from six communities in the Klang Valley, Malaysia. Fasting blood samples were collected by finger-prick and analysed for FPG (AccuCek, Roche) and TAG (Accutrend, Roche). Macronutrient intakes, including rice, were obtained by a single interview using a previously-evaluated food frequency questionnaire (FFQ) and quantitated as grams by the DietPLUS V2 programme. Added sugar intakes by subjects were estimated using an Added Sugar Intake excel programme.

Results: Rice contributed to 85% of dietary carbohydrates, accounting for 41.8 % kcal of the average 1750-kcal diet. Rice intakes or added sugar consumption did not have a significant correlation (p>0.05) with FPG nor fasting TAG. Added sugar consumption, which averaged 44g/person/day (5% kcal) was markedly lower than the 137g/person/day reported elsewhere for the Malaysian population.

Conclusion: High consumption of rice as a risk factor of type 2 DM was not indicated in the present study. Since white rice consumption varied 10-fold in the present subjects, the reduction in daily intake of this staple food represents a feasible option for cutting back on calorie intake for overweight or obese individuals.

Keywords: Rice intake, added sugar, fasting plasma glucose, triacylglycerol.

Citation: IeJSME 2015 9(1): 26-31

DOI: https://doi.org/10.56026/imu.9.1.26

Is there a correlation between co-morbidities and initial severity score of pneumonia in patients admitted with community acquired pneumonia? – a retrospective study

Authors: Vaani Valerie Visuvanathan, Hui Min Chong, Shien Yee Ng, Chen Nee Ch’ng, Juliana Shook Shin Tan, Sree Viknaraja Arun Kumar, Ming Wai Wan.

ABSTRACT

Background: Community-acquired pneumonia (CAP) is the most important cause of hospitalisation in Malaysia and the 6th most important cause of mortality in patients aged 65 years and above. CAP is a lower respiratory tract infection that includes signs and symptoms like cough, fever, dyspnoea, the presence of new focal chest signs and new radiographic shadowing with no prior cause. To assist clinical judgement in deciding whether to admit the patient for in-ward treatment or otherwise, the severity of CAP is most commonly graded using the CURB-65 score as the components are more readily accessible in the Accidents and Emergency Department. We believe that cardiopulmonary diseases, immunosuppressive diseases like HIV infection or diabetes mellitus and other co-morbidities may affect the severity of CAP and are thus aspects of a patients’ history that should play a more significant role in influencing a clinician’s judgement of CAP severity. The general objective of the study is therefore to identify the relationship between co-morbidities and initial severity assessment of a patient admitted for community acquired pneumonia. The 3 specific objectives are i) to determine if presence of co-morbidities affects initial severity assessment in a patient admitted with CAP ii) To identify which co-morbidities affects initial severity
assessment and iii) to determine whether having multiple co-morbidities increases initial severity assessment.

Methodology: A retrospective study was carried out from the month of February 2013 to July 2013 at Hospital Tuanku Ja’afar, Seremban (HTJS). Patients admitted to the four Medical wards – 6A, 6B, 7A, and 7B – from July 2012 to December 2012 and have been diagnosed with CAP were chosen. A checklist was used as a survey instrument. Using statistical analysis, the severity of CAP in patients was compared in patients with different factors like gender, different co-morbidities and the number of co-morbidities.

Results: A total of 63 patients in the control group had no co-morbidities and 54 patients were of low risk, 7 patients had moderate risk, and 2 patients had high risk CAP. Of the remaining 337 patients in the sample population, 124 patients had one co-morbidity, while 213 patients had multiple co-morbidities. Among those with a single co-morbidity, 100 patients had low risk, 19 patients had moderate risk, and 5 patients had high risk CAP. For the group with multiple co-morbidities, 135 patients had low risk, 58 patients had moderate risk, and 20 patients had high risk CAP. This study found that the presence and number of co-morbidities present in a patient affected the severity of CAP. Co-morbidities like diabetes mellitus, hypertension and asthma had significant correlation to the severity of CAP in patients. The gender of the patient had no significant correlation to the severity of CAP.

Conclusion: The presence and number of co-morbidities present in a patient increases the severity of CAP. Hypertension, diabetes mellitus, and asthma are comorbidities that are prerequisites for increased caution and alert when judging the severity of CAP in patients. Comparison of patients with single and multiple comorbidities showed that patients in the latter group present with higher severity scores (p-value = 0.004).

Keywords: Co-morbidities, CURB-65 risk score, Community Acquired Pneumonia, retrospective, random sampling.

Citation: IeJSME 2015 9(1): 32-37

DOI: https://doi.org/10.56026/imu.9.1.32