bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of arrhythmic effects of clarithromycin usage in patients with acute coronary syndrome via new parameters of 12 lead electrocardiography
Authors: GÖÇER Hakan , TÜRKYILMAZ Erdem , ÜNLÜ Ahmet , DURUKAN Ahmet Barış
Published: August 2019

Aim: Clarithromycin is a widely used
macrolide antibiotic with arrhythmic effects causing torsade de pointes by
elongating QT interval. Clarithromycin was used to treat acute coronary syndrome. we aimed to determine the
acute effects of short-term clarithromycin treatment on novel ECG parameters in
patients with acute coronary syndrome.Material and Methods: The study we conducted in
2002 evaluated the effects of clarithromycin on endothelial functions and QTdispersion.
We recently analyzed these patients’ ECGs performed before and one week after
of 1000 mg/day clarithromycin treatment. We analyzed newly recognized parameters; Tp–e interval, Tp-e/QTc ratio,
maximum QTc, minimum QTc, QTc dispersion values, P-maximum, P-minimum and P-wave
dispersion to indicate the
risk of atrial and ventricular arrhythmias. Results: There were 40 patients included where 20 were treated with
clarithromycin and 20 not. In the clarithromycin group, mean age of the
patients was 53.2±8.0 and in control group 58.9±11.6. Demographic characteristics of patients were
similar. All ECG parameters were comparable prior to clarithromycin treatment.
However, following therapy, all parameters including max QTc, min QTc, QTc
dispersion, Tp-e interval, TP-e/QTc, Pmax, Pmin, and P-wave dispersion were
statistically significantly higher in clarithromycin treated group (p<0.05
for each).

Conclusion:Clarithromycin treatment not only affects QT
parameters but also novel ECG parameters Tp–e interval and Tp-e/QTc
ratio showing the
risk of ventricular arrhythmias. It also affects P-wave parameters and dispersion
that shows risk of atrial arrhythmias. We may conclude that clarithromycin
treatment increases both ventricular and atrial arrhythmic risk during acute
coronary syndromes.
Diyabetik hastalarda uyku kalitesi ile anksiyete ve depresyon durumlarının değerlendirilmesi
Authors: Emre Nilüfer
Published: August 2019

Amaç: Diyabetes mellitus (DM) dünyada ve ülkemizde giderek artmakta olan morbidite ve mortalitesi yüksek kronik bir hastalıktır. Depresyon ve anksiyete gibi ruhsal hastalıklar ve uyku bozukluğu da bu hastalıkla birlikte sık görülmektedir. Bu çalışmada Tip 2 DM’li hastalarda uyku kalitesi ile anksiyete ve depresyon durumlarının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Araştırma İlçe Devlet Hastanesi dahiliye polikliniğinde takipli tip 2 DM tanılı hastalara uygulanan uyku kalitesi ve ruhsal durum ölçeklerinin sonuçlarının ve hastaların sosyo-demografik verilerinin retrospektif olarak değerlendirilmesi ile yapıldı.Bulgular: Çalışmaya dahil olan 49 kişiden 25’i erkek,  24’ü kadındı. Katılımcıların yaş ortalaması 62±9,9 idi. PUKİ puanları değerlendirildiğinde hastaların %59,2’sinde uyku kalitesi kötüydü. PUKİ puanları, sosyodemografik özellikler ile karşılaştırıldığında kadınların erkeklere göre uyku kalitesi daha kötüydü ve istatistiksel olarak anlamlı bulundu (p=0,027). Ancak yaş, medeni durum ve eğitim açısından istatistiksel olarak anlamlı ilişki bulunmadı. Katılımcıların HAD ölçeğine göre, anksiyete düzeyi %22,4 kişide, depresyon düzeyi %26,5 kişide eşik üstü değerde bulundu. HAD ölçeği açısından kadınların erkeklere göre anksiyete eşik üstü değeri anlamlı derecede yüksekti (p=0,013).Sonuç: Sonuç olarak, uykunun hem beden hem de ruh sağlığını etkileyen bir kavram olduğu göz önünde alındığında, diyabet gibi kronik hastalıklarda medikal tedavilerin yanı sıra uyku kalitesi ve ruhsal durumların da detaylı değerlendirilmesi gerekmektedir.
Determined Action to Tackle Health Determinants: A Collaborative Response to the Challenge of Climate Change Mitigation in Practice Settings
Authors: Morgan Roslyn Elizabeth
Published: August 2019

The physical environment has long been understood as a major determinant of health and well-being. In recent years, the relationship between health and the environment has become particularly pronounced, with the impacts of climate change identified as having the potential to reverse the last 50 years of public health advancement (Watts et al., 2015). Increasingly, professional bodies within health care are called upon to frame climate change as a health issue. Despite this, studies have found that nurses report feeling ill-equipped to respond to environmental changes and the resulting health impacts (Anaker, Nilsson, Holmner, & Elf, 2015; Lewis, 2018; Polivka, Chaudry, & Mac Crawford, 2011). This article recognizes some of the barriers facing concerned healthcare professionals who wish to introduce climate mitigation activities within their sphere of professional operation. The Australian Nursing and Midwifery Federation (Victorian Branch) was approached by nurses, midwives, and carers, to become more involved in policy debates surrounding climate change and to provide stronger support to members in responding to environmental issues. The result is top-down and bottom-up responses working in synergy for climate change mitigation, by empowering nurses to make changes to their professional practice.
Planetary Health: The Next Frontier in Nursing Education
Authors: Potter Teddie
Published: August 2019

Much has been said about the severe health impacts of climate change for individuals and societies. The nursing profession has done significant work educating practicing nurses about climate change (Health Care Without Harm, 2018; Letters, Smith, Hut-fling, McDermott-Levy, & Sattler, 2016), promoting policy changes (Letters & Butterfield, 2018), and leading effective actions and practice changes (Alliance of Nurses for Healthy Environments, 2019). However, climate change is only one symptom of an emerging and potentially catastrophic multisystem failure. Failing to take a systems approach and addressing only one symptom at a time can lead to unintended consequences, ineffective use of resources, and activist burnout. The severity and urgency of global environmental issues requires a paradigm shift from understanding health solely in human terms, to a deep awareness that human health and environmental health are inseparable. This article discusses the emerging interdisciplinary field of planetary health and the potential impact of nursing leadership. Modifications to nursing education are required so that future nurses are ready to lead transformative planetary health initiatives.
Addressing Food Insecurity and Overweight/Obesity in Hospitalized Low-Income Latino Patients
Authors: Gipson-Jones Trina Lorraine , Davis Bertha L. , Harris Ché Matthew
Published: August 2019

Food insecurity (Fl), the limited or unreliable availability of safe and nutritious food, is a pressing public health concern affecting millions of U.S. citizens. Unfortunately, FI tends to impact those who are most vulnerable (e.g., low-income minorities) and potentially increases obesity risks, diet-sensitive disease risks (e.g., hypertension and type 2 diabetes), and hospital utilization. Low-income Latino patients may be particularly sensitive to adverse outcomes based on unaddressed socioeconomic needs. Nurses are in a prime position to assess and address FI in these patients. Our article will discuss how nurses can be advocates in combating FI in Latino patients with overweight/obesity.
Climate Change and Schools: Implications for Children's Health and Safety
Authors: Chalupka Stephanie , Anderko Laura
Published: August 2019

The predicted impacts of climate change are fast becoming a reality and are already adversely affecting human health and health systems. Events such as flooding, hurricanes, tornadoes, and wildfires are challenging communities to re-evaluate whether their schools provide a safe, healthy environment. Among the populations most vulnerable to the impacts of our changing climate are our children. Nurses are key to supporting mitigation and adaptation efforts to promote more resilient school environments, using approaches based on values of the common good and social justice.
In Nightingale's Footsteps—Individual to Global: From Nurse Coaches to Environmental and Civil Society Activists
Authors: Beck Deva-Marie , Dossey Barbara Montgomery
Published: August 2019

Florence Nightingale (1820–1910), the famous “lady with the lamp,” is indeed the world's most well-known nurse. In our times, now for nearly six decades, the same environmental and social issues that were of concern to Nightingale are understood as key factors in achieving global development and global health. In Nightingale's footsteps, Nurse Coach leaders and all nurses are 21st century Nightingales who are coaching, informing, and educating for healthy people to be living on a healthy planet.
Bazı Biyoinsektisitlerin Myzus persicae (Sulzer) (Hemiptera: Aphididae)’ye Etkileri
Authors: Kurşuncu Şahin Gülsüm , Karaca İsmail
Published: August 2019

Bu çalışmada 4 farklı biyopestisit (Bio-Catch®, Bio-Magic®, Nostalgist® ve Priority®) ile bitkisel ekstraktlı bir preparat (Nimbedicine) ve karşılaştırma ilacı olarak Chlorpyrifos-ethyl etken maddeli preparat laboratuvar koşullarında Myzus persicae (Sulzer) (Hemiptera: Aphididae)’ye püskürtme şeklinde firmaların önerdiği dozlarda uygulanmıştır. Çalışmalar Süleyman Demirel Üniversitesi, Ziraat Fakültesi, Bitki Koruma Bölümü, Biyolojik Mücadele Araştırma ve Uygulama Laboratuvarı’nda petri ve saksı denemeleri şeklinde yürütülmüştür. Preparatlar petriye yerleştirilmiş biber yaprakları üzerine ve saksılardaki biber bitkilerine püskürtme şeklinde uygulanmıştır. Uygulamalardan 10 dakika sonra her bir petriye 10 birey, her bir saksıdaki bitkinin bir yaprağına 5 birey olmak üzere toplamda 3 yaprağa 15 birey bulaştırılmıştır. Petri denemeleri 10, saksı denemeleri 4 tekerrürlü olarak kurulmuştur. Uygulamalardan sonra sayımlar petri denemelerinde 1., 3., 5. ve 7. günlerde, saksı denemelerinde sadece 7. günde yapılmıştır. Sayımlarda canlı ve ölü bireyler kayıt altına alınmıştır. Çalışma sonucunda, petri denemelerinde 7. günün sonunda Bio-Catch®, Bio-Magic®, Nostalgist®, Priority®, Nimbedicine ve Chlorpyrifos-ethyl’in M. persicae’ye Abbott’a göre etkileri sırasıyla %39, %35, %47, %39, %68 ve %100 olarak bulunmuştur. Saksı denemelerinde ise bu etki yine 7. günde sırasıyla %44.44, %42.59, %53.70, %37.04, %68.52 ve %100.00 olarak saptanmıştır. Sonuç olarak, gerek petri denemelerinde gerekse saksı denemelerinde M. persicae’ye en etkili Chlorpyrifos-ethyl bulunmuş, bunu Nimbedicine izlemiştir. Biyoinsektisitlerin etkileri ise birbirine yakın bulunmuştur.
SPATIAL STATISTICAL ANALYSIS OF PARTICIPANTS IN THE INDIVIDUAL PENSION SYSTEM OF TURKEY
Authors: YILDIRIM Vural , MERT KANTAR Yeliz
Published: August 2019

The individual pension system is known as the personal future investment system that allows participants to regularly save for their retirements. Thus, the role of this system among incomes in retirement has significantly grown in the last decade in Turkey as in other countries. In Turkey, the participation in the individual pension system has been voluntary since the beginning of this system. Thus, it is important to study the factors affecting the participants of the individual pension system and also the distribution of the participants in Turkey. In this study, participants’ data in the individual pension system of Turkey (2013), provided by the Pension Monitoring Center, is examined at provincial level by means of GIS and spatial statistics tools. Firstly, spatial distribution, spatial local and global clustering for the participation rate have been researched. Also, the participant rate in Turkey with the effects of variables measured at provincial level (the labor rate, unemployment rate, sex ratio, urbanization rate, deposit rate, illiteracy rate and human development index) is studied by using the spatial econometrics models. The result shows that there are global and local spatial autocorrelations between the participation rates in Turkey and also the spatial lag model provides better results than the classical regression model and some other spatial models in terms of all criteria.
DAYA TERIMA DAN KANDUNGAN GIZI DIM SUM YANG DISUBSTITUSI IKAN PATIN (Pangasius sp.) DAN PURE KELOR (Moringa oleifera) SEBAGAI SNACK BALITA
[Acceptance and Nutrient Values of Dim Sum Substituted by Patin Fish (Pangasius sp.) and Moringa Puree (Moringa oleifera) as Snack for Under Five Children]

Authors: Ardhanareswari Ni Putu
Published: August 2019

Under five age is golden period where growth and development occurs rapidly, therefore nutrition support are important. Patin fish and Moringa leaves are foods that high in energy, and protein, which are needed in childrens growth. The purpose of this study was to analyze the infl uence of Patin fi sh (Pangasius sp.) and Moringa leaves puree (Moringa oleifera) substitution toward the acceptance and nutrient content (energy and protein) of dim sum as healthy snack for under fi ve children. This was a true experimental study with completely randomized design. Untrained panelists in this study were 30 pairs of mother and their children at integrated health post Kartini 5D to assess the acceptance of color, taste, fl avor, and texture of dim sum. Dim sum wrappers formula was F0 (0% Moringa fl our) while F1, F2, and F3 (4% Moringa fl our, 96% wheat fl our). Formula for dim sum fi lling was F0 (100% Spanish mackerel), F1 (100% patin fi sh, 0% fresh moringa leaves), F2 (90% patin fi sh, 10% fresh moringa leaves), and F3 (85% patin fi sh, 15% fresh moringa leaves). Kruskal Wallis test result on fl avor, taste, and color showed no signifi cant difference among all dim sum formulas (p>0.05), while for texture there was a signifi cant difference (p<0.037). Mann Whitney test showed that texture in control formula and modifi cation formula have signifi cant differences (p<0.05), but result the test among modifi cation formulas had no signifi cant difference. (p>0.05). Formula F2 was the best formula that can be accepted in terms of color, taste, fl avor, and texture with energy value 234 kcal, and protein 7.9 g/100 g dim sum.
ASUPAN ZAT GIZI MAKRO DAN STATUS GIZI MAHASISWA ASING DI SURABAYA, INDONESIA
[Macronutrient Consumption and Nutritional Status of International Students in Surabaya, Indonesia]

Authors: Levina Airin , Sumarmi Sri
Published: August 2019

Nutrient intake is one of the factors affect nutritional status. International students who live in other countries face different environment from their own country. The differences affects food habits, nutritional adequacy level, and nutritional status of international students. This study aimed to analyze the correlation of nutrition intake and nutritional status among international students in Surabaya. This cross-sectional study included 30 respondents. Food consumption was collected by Semi-Quantitative Food Frequency Questionnaire. Nutritional status determined by body weight and height. Chi-square test was used to analyze the correlation variables. The average energy intake of international students were 1,888 ± 379 kcal per day. The percentage of overweight international students were 20% and underweight were 16.7%. The results showed low correlation between energy (r=0.370) and protein (r=0.380) adequacy level with nutritional status, moderate correlation between fat adequacy level (r=0.410) and nutritional status, and no correlation between carbohydrate adequacy level (r=-) with nutritional status. The conclusion was lower macronutrient intake causes inadequacy energy level which causes one third of international students didn’t have normal nutritional status. Therefore, international students need to increase macronutrient intake by increasing meal-portion, choosing balanced food, and not skipping meal time.
HUBUNGAN ASUPAN ZAT BESI, PROTEIN, VITAMIN C DAN POLA MENSTRUASI DENGAN KADAR HEMOGLOBIN PADA REMAJA PUTRI DI SMAN 1 MANYAR GRESIK
[Correlation Between Intake of Iron, Protein, Vitamin C and Menstruation Pattern with Haemoglobin Concentration among Adolescent Girl in Senior High School 1 Manyar Gresik]

Authors: Sholicha Cynthia Almaratus , Muniroh Lailatul
Published: August 2019

One of nutrition problem that needs to get high attention is anemia. Anemia is a condition that develops when healthy red blood cells below normal. Inadequate intake of nutrient, menstruation, infectious diseases, and lack of knowledge can caused anemia. Monthly menstruation and growth period drive adolescent girls pronen to anemia. The purpose of this study was to analyze correlation between intake of iron, protein, vitamin C and menstruation patterns with anemia among adolescent girls. This study used cross sectional design. Population of this study was adolescent student grade X and XI at SMAN 1 Manyar Gresik. Sixty two students were selected using proportional random sampling . Data were collected with semi quantitative food frequency questionnaire, structured questionnaire, and digital haemoglobinmeter. Data were analyzed using Spearman correlation test and Chi-square test. Results showed intake of iron (r=0.635; p=0.000), protein (r=0.663; p=0.000), and vitamin C (r=0.780; p=0.000) was correlated with haemoglobin concentration similiar with menstruation pattern which also had signifi cant correlation with anemia (p=0.002). Lower intake of iron, protein and vitamin C, caused lower haemoglobin concentration. Thus, anemia incidence will be higher. Adolescent girl are expected to increase food consumption of food source of iron and consume iron supplement routinely to replace iron that lost during menstruation.
KUALITAS SENSORI, UKURAN PORI, INDEKS GLIKEMIK, DAN BEBAN GLIKEMIK ROTI TAWAR SUBSTITUSI TEPUNG SINGKONG (MANIHOT ESCULENTA) DAN TEPUNG TEMPE
[Sensory Quality, Pore Size, Glycemic Index, and Glycemic Load of White Bread with Cassava Flour (Manihot esculenta) and Tempeh Flour Substitution]

Authors: Hamidah Nanik , Riyanto Riyanto , Uji Endang Taat
Published: August 2019

Bread is alternative food made by wheat fl our that can be used as one of carbohydrates sources. Bread is classifi ed as high glycemic index food. Cassava is one of carbohydrate source contain high resistant starch which has low glycemic index, meanwhile tempeh has high protein value. Substitution of wheat fl our with cassava and tempah fl our is predicted can give lower glycemic index and higher protein content of white bread. Purpose for this research was to analyse the effect of cassava fl our tempeh fl our substitution to sensory, pore size, glycemic index, and glycemic load of white bread. Research method were used true experimental with complete randomized design. Proportion of cassava and tempeh fl our were respectively P1 (0%), P2 (2.4%;0.8%), P3 (4.8%;1.6%), P4 (7.3%;2.4%) and P5 (9.7%;3.2%). Sensory quality and pore size were analysed by Kruskall Wallis followed by ranking difference test. Glycemic index test were done only for the best formula (P2) based on sensory test treatment. Result of this study showed substitution of cassava and tempeh fl our gave signifi cant infl uences toward sensory quality including texture (p=0.003), fl avour (p=0.0001), colour [crumb, crust (p=0.0001)], taste (p=0.012), and size of pore (p=0.0001). Glycemic Index (IG) and Glycemic Load (BG) test of formula P2 showed 132.32 and 53,32 which belong to high category. Substitution of wheat fl our with cassava and soybean tempeh fl our changed the sensory quality, pore size, IG and BG high category
HUBUNGAN TINGKAT KECUKUPAN ENERGI DAN ZAT GIZI MAKRO DENGAN KETAHANAN PANGAN SISWA SEKOLAH DASAR DARI KELUARGA PETANI
[Correlation of Energy and Macronutrient Adequacy Level and Food Security among Elementary School Children from Farmers Family]

Authors: Fatimah Nur , Nindya Triska Susila
Published: August 2019

Food security is an underlying cause of malnutrition in children. Food security affects children’s quality and quantity of food consumption. Food quantity are refl ected by energy and macronutrient adequacy level (protein, fat, carbohydrate). This study aimed to analyze the association between the energy and macronutrient adequacy level with food security among elementary school children from farmer family. Study was a cross sectional study with simple random sampling. Total samples are 60 elementary school students from grade 1 to 6 at SDN Jombatan 1, SDN Jombatan 2, and SDN Jombatan 3 Jombatan Village, Kesamben Sub-district, Jombang Regency, and their parents are paddy rice farmers. Data collected by samples characteristics questionnaire, 2x24 hours food recall form, and United States – Household Food Security Survey Modul (US-HFSSM) questionnaire. Spearman correlation test were used to analyze the correlation between variables. Most of school children had insuffi cient energy and macronutrients adequacy level energy (91.7%), protein (54.2%), fat (84.8%), and carbohydrate (86.4%) respectively. More than half of farmer family were included in food insecurity without hunger (58.3%). There was signifi cant association between energy adequacy level with food security among elementary school students from farmer family (p=0.039). Nonetheless, there were no signifi cant correlation between macronutrient adequacy level such as protein (p=0.931), fat (p=0.189), and carbohydrate (p=0.104) with food security among elementary school student from farmer family. Family food security associated with the quantity of family food consumption. Increasing food security to increase energy adequacy level can be done by increasing income from non-agricultural sector.
ASUPAN GIZI, AKTIVITAS FISIK, PENGETAHUAN GIZI, STATUS GIZI DAN KEBUGARAN JASMANI GURU OLAHRAGA SEKOLAH DASAR
[Nutritient Intake, Physical Activity, Nutrition Knowledge, Nutritional Status, and Physical Fitness of Elementary School Sport Teacher]

Authors: Yunitasari Andini Retno , Sinaga Tiurma , Nurdiani Reisi
Published: August 2019

Sport teacher are central fi gure for attitude, behaviour, and healthy lifestyle change of student, especially at primary school level. This research aimed to analyze nutrition intake, physical activity, nutrition knowledge, nutritional status, and physical fi tness of sport teacher in Jagakarsa subdistrict ptimary school, South Jakarta. Design of this study was cross sectional, with total subject are 53 subjects. Collected data were characteristics of subjects, weight and height, nutritional knowledge, food consumption, physical activity, and physical fi tness (YMCA step test). Data were collected using direct interview, questionnaires, anthropometric measurements, and body fi tness measurement throught YMCA test. Result showed that most of sport teacher in Jagakarsa subdistrict have obesity nutritional status (41.5%), high percentage of body fat (64.1%), light physical activity (45.3%), suffi cient physical fi tness level (47.2%), and nutrition knowledge level was moderate (52%). Energy adequacy level (43.4%) and protein adequacy level (26.4%) of subject classifi ed into severe defi cits, while fat adequacy levels (39.6%) and carbohydrate adequacy levels (73.6%) classifi ed into defi cits. Spearman correlation test showed signifi cant correlation (p<0.05) between carbohydrate intake and body mass index, also signifi cant correlation (p<0.05) between body fat percentage and fi tness level based on pulse rate. Sport teacher need to care about nutritional status, food intake, and physical activity referring to balanced nutrition guidelines in order to prevent increasing obesity problem.
Penyelenggara Dana Perlindungan Pemodal Bagi Investor Dalam Transaksi Saham Pada Pasar Modal
Authors: Attijani Mohammad Solehodin
Published: August 2019

AbstractInvestors who want to invest in the capital market in Indonesia, which include securities in the form of shares, need to have a good knowledge of investment objects because basically all investments contain risk and there is no guarantee of getting profits. Investor protection fund operators have the main goal of forming investor protection funds to increase protection and trust that investors’ assets are safe without being worried about the inability of securities companies to fulfill their obligations. The capital market can fail due to loss of investor distrust caused by the failure or bankruptcy of securities companies, resulting in a systemic effect that can reduce the reliability of the capital market industry. Through the organizer of the protection fund investors will provide compensation claims to investors who are victims of violations and securities crimes, not from loss of personal transactions. Investors whose assets receive investor protection funds are investors who meet the requirements set by the financial services authority.Keywords  :  Organizers of Investor Protection Funds, Investor Compensation Claims AbstrakInvestor yang ingin berinvestasi pada pasar modal di Indonesia, yakni antara lain surat berharga berbentuk saham, perlu memiliki pengetahuan yang baik mengenai obyek investasi karena pada dasarnya semua investasi mengandung risiko dan tidak ada jaminan pasti mendapatkan keuntungan. Penyelenggara dana perlindungan pemodal mempunyai tujuan utama membentuk dana perlindungan pemodal untuk meningkatkan perlindungan dan kepercayaan bahwa aset investor aman tanpa dihinggapi rasa khawatir atas ketidakmampuan perusahaan efek dalam memenuhi kewajibannya. Pasar modal dapat mengalami kegagalan akibat hilangnya ketidakpercayaan pemodal yang disebabkan kegagalan atau kebangkrutan perusahaan efek, sehingga menimbulkan efek sistemik yang dapat menjatuhkan kridibilitas industri pasar modal. Melalui penyelenggara dana perlindungan pemodal akan memberikan klaim ganti rugi kepada investor yang menjadi korban dari pelanggaran dan kejahatan sekuritas, bukan dari kerugian transaksi pribadi. Investor yang asetnya mendapat dana perlindungan pemodal adalah investor yang memenuhi persyaratan yang telah ditentukan otoritas jasa keuangan.Kata Kunci :  Penyelenggara Dana Perlindungan Pemodal, Klaim Ganti Rugi Investor
Asas Itikad Baik Dalam Memorandum Of Understanding Sebagai Dasar Pembuatan Kontrak
Authors: Daniella Margaretha Donda , Putra William Tandya , Widjaja Erich Kurniawan
Published: August 2019

Memorandum of Understanding (MoU) merupakan salah satu bentuk dari perjanjian pendahuluan yang digunakan sebagai pendahuluan untuk mengadakan perjanjian selanjutnya yang lebih rinci dan pasti yang termasuk kedalam fase prakontrak. Pada prinsipnya MoU tidak memiliki kekuatan mengikat sebagaimana kontrak pada umumnya, sehingga para pihak diwajibkan untuk menerapkan prinsip itikad baik dalam pembuatan dan pelaksanaan MoU, karena prinsip itikad baik ini memandang bahwa MoU merupakan tahap penting untuk ditindaklanjuti. Prinsip-prinsip dasar dalam MoU ialah prinsip kebebasan berkontrak, prinsip konsensualisme, prinsip daya mengikat kontrak (pacta sunt servanda) dan prinsip itikad baik. Substansi dari MoU ialah berisi kesepakatan para pihak tentang hal-hal yang bersifat umum, dan bukannya berisi hak dan kewajiban para pihak. Jika substansi MoU memuat hak dan kewajiban para pihak, maka MoU tersebut telah kehilangan esensinya sebagai perjanjian pendahuluan dan mengakibatkan MoU tersebut mengikat para pihaknya dan memiliki kekuatan hukum, sehingga segala bentuk pelanggaran dari MoU dapat diajukan gugatan atas perbuatan wanprestasi ataupun perbuatan melanggar hukum. Akan tetapi terhadap MoU sebagai perjanjian pendahuluan tidak dapat diajukan gugatan wanprestasi karena dalam MoU tersebut tidak memuat hak dan kewajiban sehingga tidak ada janji yang diingkari, akan tetapi dapat diajukan gugatan perbuatan melanggar hukum atas kerugian yang diderita oleh pihak yang dirugikan akibat pengingkaran dari MoU tersebut.
PERBEDAAN HASIL BELAJAR SISWA MENGGUNAKAN MODEL PEMBELAJARAN KOOPERATIF TIPE THINK PAIR SHARE (TPS) DENGAN TIPE TWO STAY TWO STRAY (TSTS) PADA KELAS XI IPA SMA NEGERI 4 BANJARMASIN
Authors: Rozaiah Nazua , Wati Mustika , Mastuang Mastuang
Published: August 2019

Telah dilakukan penelitian tentang perbedaan hasil belajar siswamenggunakanmodel pembelajaran kooperatif tipe Think Pair Share (TPS) dengantipe Two Stay Two Stray (TSTS) pada kelas XI IPA SMA Negeri 4 Banjarmasin. Penelitian ini bertujuan untuk mengetahui apakah terdapat perbedaan hasil belajar siswa dalam pembelajaran fisika pokok bahasan fluida dinamis antara yang menggunakan model pembelajaran kooperatif tipe Think Pair Share (TPS) dengan tipe Two Stay Two Stray (TSTS) pada kelas XI IPA SMA Negeri 4 Banjarmasin. Metode penelitian adalah kuasi eksperimen.Populasi penelitian adalah siswa kelas XI IPA SMAN Negeri 4 Banjarmasin tahun ajaran 2015/2016 yang berjumlah 83 siswa.Sampel diambil secara cluster random samplingsebanyak dua kelas dari tiga kelas di SMA Negeri 4 Banjarmasin. Kelas eksperimen I yang berjumlah 26 siswa diberi perlakuan dengan menggunakan pembelajaran tipe Think Pair Share (TPS) dan kelas eksperimen II berjumlah 26 siswa diberi perlakuan dengan menggunakan model pembelajaran tipe Two Stay Two Stray (TSTS). Teknik pengumpulan data menggunakan teknik tes.Teknik analisis data menggunakan statistik parametrik teknik t-test independent sampel. Pengujian hipotesis menunjukan bahwa nilai t hitung lebih besar daripada ttabel  dansignifikansi (2-tailed) yang diperoleh lebih kecil dari 0,05 (0,01 < 0,05) sehingga terdapat perbedaan hasil belajar yang signifikan antara kelas eksperimen I yang diberi perlakuan menggunakan tipe TPS dengan kelas eksperimen II yang diberi perlakuan menggunakan tipe TSTS.
Analysis of Understanding of First-Year Chemistry Education Students on Molecular Forces Topic
Authors: Musawwa Muhammad Miqdam , Wulan Febriana Beta , Normalia Arlianty Widinda
Published: August 2019

This research aims to investigate the concept understanding of first year students of study program chemistry education, faculty of mathematics and natural sciences, Universitas Islam Indonesia Yogyakarta, Indonesia. The sample used in this study was 49 students. Data collection instruments used are multiple choice questions.  The results of the study show that there are still many students who have difficulty in determining the example of the force between molecules that occurs in several molecules. Students also have difficulty in determining the molecuar forces between molecules from the example case given. The level of student understanding in the material concept of moleculecular forces is classified intermediate.
Study on the main drugs and drug combinations of patient-controlled analgesia based on text mining
Authors: Jin Xing , Wu Ying , Hou Lei
Published: August 2019

Background

In recent years, with the continuous understanding of pain knowledge and the continuous improvement of quality of life requirements, patient-controlled analgesia (PCA) has been widely used in a variety of pain patients. In the treatment of PCA, more and more patients use multimodal analgesia (MMA). In this study, text mining technology was used to analyze relevant literatures, try to find out the main drugs of PCA, classify the drugs, and dig out the important drug combination rules.

Methods

PCA literatures were retrieved from Pubmed database in recent 10 years, and the bibliographic information of the literatures was taken as mining samples. First, the names of the drugs in the sample is identified by MetaMap package, then Bicomb software was used to extract high-frequency drugs for word frequency analysis and to construct a drug-phrase matrix. Finally, ‘hclust’ package and ‘arules’ package of R were used for cluster analysis and association analysis of drugs.

Results

39 main PCA drugs were screened out, Morphine, Dexmedetomidine and Fentanyl were the top three drugs. Through cluster analysis, these drugs are divided into two clusters, one containing 26 common drugs and the other containing 13 core drugs. The association analysis of these drugs was carried out and 22 frequent itemsets and 6 association rules were obtained. The maximum frequent 1-itemsets were {Morphine} and the maximum frequent 2-itemsets were {Morphine, Ropivacaine}.

Conclusions

The research results have certain guidance and reference value for clinicians and researchers. In addition, it provides a way to study the relationship between drugs from the perspective of text mining.
Factors associated with death in patients with tuberculosis in Brazil: survival analysis with competitive risks
Authors: Viana Paulo Victor de Sousa , Paiva Natalia Santana , Villela Daniel Antunes Maciel , Bastos Leonardo Soares , Bierrenbach Ana Luiza de Souza , Basta Paulo Cesar
Published: August 2019

Background: This study aimed to analyze the factors associated with deaths caused by TB, TB-related causes and deaths from other causes. Methods: A retrospective, population-based cohort study of the causes of death, using a survival regression model in the presence of competitive risk in a cohort of patients in treatment for TB was performed using records of patients that started TB treatment in Brazil and death certificates from 2008 to 2013. Results: In this cohort, 39,997 individuals (14.1%) died, out of a total of 283,508 individuals. Of these, 8,936 deaths due to TB (22.4%), 3,365 deaths to associated TB (8.4%), revealing a high rate of lethality. 27,696 deaths (69.2%) were from other causes. From our analysis, factors strongly associated with death from TB were male gender (sHR = 1.33, 95% CI: 1.26-1.40), older than 60 years (sHR = 9.29, 95% CI: 8.15-10.60), illiterate schooling (sHR = 2.33, 95% CI: 2.09-2.59), black (sHR = 1.33, 95% CI: 1.26-1.40) and brown color/race (sHR = 13, 95% CI: 1.07-1.19), from the southern region (sHR = 1.19, 95% CI: 1.10-1.28), mixed forms (sHR = 1.91, 95% CI: 1.73 -2.11) and alcoholism (sHR = 1.90, 95% CI: 1.81-2.00). Also, HIV positive serology was strongly associated with death due to TB (sHR = 62.78; 95% CI: 55.01 - 71.63). Conclusions: We believe that specific active surveillance strategies and early case finding could reduce mortality among tuberculosis patients, leading to a more timely detection and treatment.
Diet, Physical Activity, and Emotional Health: What Works, What Doesn’t, and Why We Need Integrated Solutions for Total Worker Health
Authors: Syed Iffath Unissa
Published: August 2019

Objectives: Current research advocates lifestyle factors to manage workers’ health issues, such as obesity, metabolic syndrome, and type II diabetes mellitus, among other things (World Health Organization (WHO), 2000; WHO, 2016), though little is known about employees’ lifestyle factors in high-stress, high turnover environments, such as in the long term care (“LTC”) sector. Methods: Drawing on qualitative single-case study in Ontario, Canada, this paper investigates an under-researched area consisting of the health practices of health care workers from high-stress, high turnover environments. In particular, it identifies LTC worker’s mechanisms for maintaining physical, emotional, and social wellbeing. Results: The findings suggest that while particular mechanisms were prevalent, such as through diet and exercise, they were often conducted in group settings or tied to emotional health, suggesting important social and mental health contexts to these behaviors. Furthermore, there were financial barriers that prevented workers from participating in these activities and achieving health benefits. Conclusion: Accordingly, this study advocates integrated, total worker health (TWH) initiatives that consider social determinants of health approaches, recognizing the wider socio-economic impacts of workers’ health and wellbeing.
The effect of early antenatal booking on adherence to Iron/folic acid supplementation among antenatal care attendees in Libo kemkem district, Ethiopia
Authors: liyeh Tewachew Muche , Goshu Yitayal Ayalew , Ayele Amare Simegn , Abebe Yibeltal
Published: August 2019

Background

Iron and folic acid supplementation is the feasible and cost effective strategy to control and prevent anemia in pregnancy. Pregnant women are vulnerable for iron deficiency anemia due to increased nutrient requirement during pregnancy. In Ethiopia, the national data suggests that from all pregnant women supplemented with these tablets, only 5.1% consumed more than 90 tablets during their pregnancy time. The factors for this low adherence are not clearly known.
Objective: To assess factors associated with adherence to iron-folic acid supplementation among pregnant women attending antenatal care service in Libo Kemkem district, Ethiopia 2017.

Method: Hospital based cross sectional study was conducted using quantitative methods on 406 pregnant women attending antenatal care at Libo Kemkem district public health institutions. Systematic random sampling method was used. An interview with pre tested semi structured questionnaire was carried out. The collected data was entered in Epi data 4.1 and analyzed with SPSS version 20. Bivariate and multivariable logistic regression model were used. Odds ratio with 95% interval was computed and P- value <0.05% considered as level of significance.

Result: About 406 respondents were included in the study. The adherence rate of iron-folic acid supplementation was 49.3% (95% CI= 44.3%-54.2%). Factors significantly associated with adherence to iron-folic acid utilization were urban residence (AOR =4.8, 95% CI=1.82-12.79), women aged 21-30 (AOR = 4.3, 95% CI=1.60-11.42) ,women aged 31-40 (AOR =4.2, 95% CI=1.33-13.41),early ANC booking (AOR =4.1, 95% CI=1.80-9.30) and getting medical advice (AOR = 2.5, 95% CI = 1.04 – 6.16). Fear of side effects, forgetfulness and too many pills were the major reasons for missing the doses of tablets.

Conclusion: adherence rate of iron and folic acid supplementation was low. Residence, maternal age, early ANC booking and getting medical advice were significantly associated with adherence to iron and folic acid.

Key Words: Iron-folic acid, pregnant women and adherence
Prevalence and predictors of self-medication among University students in Ethiopia: A systematic review and Meta-analysis
Authors: Fetensa Getahun , Tolossa Tadesse , Ebi Werku Etafa
Published: August 2019

Background

Self-medication is the global issue especially on those having access and education about medication irrespective of its side effect. It has a significant impact on resistance and medication-related complication. There are limited and inconsistent studies regarding self-medication practice in Ethiopia. The aim of this systematic review and meta-analysis was to estimates the pooled prevalence of self-medication and its predictors among Ethiopian university students.

Method

A systematic review and meta-analysis were conducted to assess the prevalence and predictors of self-medication among university students in Ethiopia. We searched literature from the databases of Medline, Hinari, Scopes, PubMed CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library, the Web of Science, Google Scholar and manual search. A total of nine studies reporting the prevalence of self-medication among university students were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, I2 test was used since the included studies exhibit high heterogeneity, a random effect meta-analysis model was computed to estimate the pooled prevalence of self-medication. In another way, the association between predictor variables, and self-medication practice were examined.

Result

A total of 3513 study respondents from nine studies in Ethiopia published between 2010-2017 were included in the study. The result of our study reveals that a pooled prevalence of self-medication among university students was 45.61% (95%CI: 30.66, 60.57). Included studies have a sample size ranged from 250 to 548 with lowest prevalence (19.81%) of self-medication from University of Gondar, whereas the highest prevalence (77.01%) recorded in a study conducted at Arsi University.

Conclusion

Prevalence of Ethiopian university students was 45.61%, which is very high with the current global health problem with Anti-microbial resistance increment and other toxicity. In addition to this in this study, the association between self-medication and year of study was insignificant and statistically significant with the sex of participants and income level.

Systemic review registration

PROSPERO International prospective register of systematic reviews: CRD42018099975
Metabolic alterations provide insights into Stylosanthes roots responding to phosphorus deficiency
Authors: Luo Jiajia , Liu Yunxi , Zhang Huikai , Wang Jinpeng , Chen Zhijian , Luo Lijuan , Liu Guodao , Liu Pandao
Published: August 2019

Background

Low phosphorus (P) availability is a major constraint on the growth of plants, especially in acid soils. Stylosanthes (stylo) is a pioneer tropical legume with several adaptive strategies to cope with P deficiency, but its metabolic reprogramming during P limitation remain poorly understood.

Results

To shed light on the acclimation of stylo roots to low P stress, morphophysiological and metabolic response were investigated in this study. After 15 days of low P treatment, shoot dry weight and total P concentration were markedly hampered, whereas root growth, root APase activity, root antioxidant activity were markedly enhanced. Corresponding investigation of metabolic profiling showed that a total of 256 metabolites with differential accumulation in response to P deficiency were identified in stylo roots, mainly including sugars, organic acids, amino acids, nucleotides, phenylpropanoids and their derivatives. P deficiency leads to significant reduction in the levels of phosphorylated sugars and nucleotides, indicates that the known strategies of P scavenging from P-containing metabolites are observed. The metabolisms of organic acids and amino acids were also remodeled by P limitation, which suggests that P-deficient stylo roots redistribute their carbohydrates in responding P deprivation, by releasing organic acids into the rhizosphere to mobilize phosphate from P complexes and employing amino acids as alternative carbon resource for energy metabolism. In phenylpropanoid metabolism pathway, the increased accumulation flavonoids, as well as up-regulated expression of involved genes SgF3H, SgF3’H, SgFLS, might contribute to enhance the antioxidant activity of stylo roots, especially kaempferol, quercetin, dihydromyricetin. The enhanced accumulation isoflavonoids with differential expression of related genes (SgHID and SgUGT) supported the opinion of isoflavonoids secreted to function with rhizosphere microbes in responding to P deficiency condition, especially daidzein and rotenone.

Conclusions

This study provides valuable insights generated from stylo roots into the various adaptation responses to Pi-starvation, identified candidate genes and metabolites will make some contributions to detect potential target region for future developing Pi-efficiency breeding research.
Assessing Anticoagulation Management and Shared Decision-Making Documentation from Providers Participating in the SUPPORT-AF Study
Authors: Hoque Laboni , Amroze Azraa , Gilvaz Vinit , Abraham Sonu , Lal Amos , Mishra Ajay , Crawford Sybil , Mazor Kathleen , McManus David , Kapoor Alok
Published: August 2019

Background We previously tested an intervention featuring educational outreach with modified academic detailing (AD) to increase anticoagulation (AC) use in patients with atrial fibrillation (AF). Currently, we compare providers receiving and not receiving AD in terms of inclusion of our AD educational topics and shared decision-making elements in documentation. Methods Physicians reviewed themes discussed with providers during AD and evaluated charts for evidence of shared decision-making. We then compared frequency of documentation of individual items for providers receiving AD compared with non-AD providers. To understand baseline documentation practices of AD providers, we also randomly selected encounters of AD providers before their AD participation. Results There were 113 eligible encounters in the four months after AD - 36 from AD providers and 77 from non-AD providers. We also identified 35 encounters from AD providers before participating in the intervention. Providers infrequently documented many reviewed items (% documenting): AC mentioned (44%), multiple options for AC (5%), CHA2DS2-VASc score (11%), bleeding risk factors (2%). Compared with non-AD providers, AD providers had statistically significant higher percentages for the following items: mention of AC (64% versus 35%), stroke risk (11% versus 0%), AC benefits (8% versus 0%), patient involvement (70% versus 0%). There was no improvement, however, for AD providers compared with baseline documentation percentages. Conclusions Providers infrequently documented important items in AC management and shared decision-making. AD participation did not improve documentation. Improving adoption of AD educational items may require more prolonged interaction with providers. Improving shared decision-making may require an intervention more focused on it and its documentation. Trial Registration The trial was registered as NCT03583008 on Clinicaltrials.gov on July 11, 2018.
Diffusion-weighted imaging in normal pancreas: Apparent diffusion coefficient test-retest repeatability
Authors: Chen Shiyue , Liu Ri , Ma Chao , Bian Yun , Li Jing , Yang Panpan , Wang Minjie , Lu Jianping
Published: August 2019

Background

The assessment of apparent diffusion coefficient (ADC) repeatability is important to body diffusion weighted imaging (DWI). However, data onto evaluating the repeatability of ADC values for normal pancreas are limited. The aim of this study was to evaluate the ADC test-retest repeatability of the normal pancreas.Methods

Twenty-six healthy volunteers (mean 47.6 years; 13 men) were included and scanned twice with reposition using a DWI sequence at 3.0-T. ADCs of the pancreatic head, body and tail for two DWIs were measured by two readers. The mean ADCs of the pancreatic head, body and tail were calculated as the global pancreatic ADC. Test-retest repeatability and agreement of ADC measurement were evaluated by the Bland-Altman analysis, intra-class correlation coefficient (ICC) and coefficient of variation (CV).Results

The global pancreatic ADC showed the best test-retest repeatability (mean difference ± limits of agreement were 0.05 ± 0.25×10 -3 mm 2 /s; ICC, 0.79; CV, 6%). Test-retest repeatabilities for ADC of pancreatic head, body or tail were scattered, with mean difference ± limits of agreement between two tests were 0.03 ± 0.47, 0.05 ± 0.42 and 0.06 ± 0.31 (×10 -3 mm 2 /s), respectively (ICCs, 0.81, 0.52 and 0.68; CVs, 9%, 8% and 8%). Both intra-observer repeatability and inter-observer reproducibility were acceptable for whole pancreas between ADC measurements of the two DWIs.Conclusions

ADC values of the pancreas are technically challenging and repeatability is variable. Cautions should be taken when interpreting longitudinal clinical changes in ADC values of the normal pancreas because the measurements do have an inherent variability by locations.