DIET SEHAT DAN GIZI SEIMBANG PADA PENDERITA HIPERTENSI

Hipertensi merupakan gangguan pada   pembuluh darah yang dapat mengakibatkan suplai oksigen dan juga nutrisi yang dibawa oleh darah terhambat sampai ke jaringan tubuh yang membutuhkannya. Hipertensi disebabkan oleh beberapa faktor seperti usia, jenis kelamin, riwayat keluarga, kebiasaan merokok, konsumsi  garam  yang berlebihan, kurang aktifitas fisik, dan  berat badan yang berlebih. Komplikasi dari hipertensi dapat berupa infark miokardium, stroke, gagal ginjal dan gagal jantung. Cara menghindari dan mencegah terjadinya hipertensi baik yang telah berulang sebaiknya merubah pola hidup seperti mengatur pola makan. Kegiatan pengabdian masyarakat dilakukan dengan memberikan edukasi tentang diet sehat dan gizi seimbang pada penderita hipertensi dengan peserta sebanyak 20 orang. Modifikasi pola asupan makanan sehari-hari merupakan salah satu komponen perubahan gaya hidup yang mempunyai peran paling besar dalam menurunkan tekanan darah. Modifikasi pola asupan makanan yang dimaksud adalah mengikuti pedoman umum gizi seimbang juga sesuai dengan dietary approach to stop hypertension (DASH), yaitu tinggi sayuran dan buah, bahan makanan tinggi serat, susu rendah lemak, daging, dan kacang- kacangan dan yang menjadi perhatian juga adalah asupan energi, jumlah dan jenis protein, serta komponen lemak dan karbohidrat. Bahan makanan kaya akan mineral dan vitamin, serta nutrien spesifik, seperti asam lemak tak jenuh omega-3 mempunyai peran dalam pencegahan dan penatalaksanaan hipertensi. Pada akhir kegiatan dilakukan evaluasi kepada seluruh peserta dan hasilnya seluruh peserta mampu memahami dan menjelaskan diet sehat dan gizi seimbang pada penderita hipertensi. &nbsp

Studies on Viruses in Water

A new procedure for the detection of viral antigens in fecal material was developed. The test is performed by first diluting a fecal sample with phosphate buffered saline to give a liquid consistency. The pH is then adjusted to 8.5-9.0 and the solids are allowed to settle for five minutes. Supernatant fluid from above the fecal sediment is placed on the upper surface of a well of an inverted Immulon microtiter plate and incubated for one hour at 37 degrees C to allow virus to adsorb to the plastic. The Immulon plate is then washed three times with a Tween 20 solution and dried. Adsorbed virus is stained with fluorescein labled antiviral antibody containing Evan\u27s Blue dye. The stained preparations are examined by epi-fluorescence microsopy for the presence of viral aggregates and virus-containing cellular membranes. The test is applied in a continuous water monitoring procedure that can be used to upplement methods in which infectious viruses are isolated from water. In another study a protamine sulfate procedure for concentrating and an immunofluorescent cell procedure for assaying infectious virus (IV, reovirus that is infectious without proteolytic enzyme treatment), and potentially infectious virus (PIV, enzyme enhanceable reovirus) from polluted waters have been developed. The presence of PIV inthe environment had not previously been investigated. In following these procedures, protamine sulfate concentratiosn of 0.005 percent for the first precipitation of the sample, and 0.0025 percent for the second were used. With these protamine concentrations and 0.25 percent fetal bovine serum, IV and PIV are concentrations over 500-fold from river water inoculated with virus. Virus recoveries are between 80 and 100 percent. The IV and PIV fractions are assayed respectively before and after treatment with 200 ug fo chymotrypsin per millileter. When PIV is precipitated from river water, and the precipitate is dissolved and stored at 20 degrees C as a protamine-virus concentrate, only 5 percent of the viral infectivity is lost after 14 days. Therefore, reovirus can be precipitated from water at the sampling site, and only the protamine concentrate needs to be taken to the laboratory to be examined for virus content. When reoviruses are treated with chlorine, PIV is more resistant to inactivation thatn IV, and PIV appears to be at least as resistant to chlorination as poliovirus and coxsackievirus A-2. Granular media filtration systems (i.e., sand, anthracite coal and sand; anthracite coal; sand and garnet) are ineffectual in the removal of the acteriophage MS 2 from water when used as in-line direct filters. Batch assays have indicated a 93 percent reduction of MS 2 can occur when polyelectrolytes are added to the water. In addition, alum concentrations of 20, 30, 40, and 50 mg/1 remove 80 to 98 percent of the virus by precipitation. No reduction of MS 2 was observed at alum concentrations from 1 to 10 mg/1

Mechanisms of Unexplained Anemia in the Nursing Home

To characterize anemia in elderly nursing home residents. Design : Prospective multiinstitutional cohort study. Setting : Five nursing homes. Participants : From retrospective analysis, residents found to be anemic using chart review were prospectively randomized. Of the 81 residents enrolled, 60 were anemic. Measurements : Chart review for medical history and factors related to treatment or history of anemia, extensive laboratory evaluation for causes of anemia, and classification of anemia by two hematologists. Results : Among the 60 anemic residents, the causes of anemia were idiopathic (n=27), iron-deficiency (n=14), anemia associated with chronic disease (n=8), anemia of renal insufficiency (n=6), and other (n=5). The eryrthropoietin (EPO) response to anemia was lower in residents with idiopathic anemia (IA) than in those with iron-deficiency anemia, and this correlated with renal function as estimated using calculated creatinine clearance. In this elderly population, advancing age was not correlated with lower EPO response. Conclusion : IA is common in nursing home residents. A lower EPO response contributes to the high prevalence of anemia in this setting and may be due, in part, to occult renal dysfunction.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65745/1/j.1532-5415.2004.52116.x.pd

Roundtable on teaching Work as an interdisciplinary first-year college seminar

This past year’s theme, “Work,” (2009-2010) asked students to interrogate the cultural construction of work from the early industrial revolution to our current economic moment, and to question how the new economy, as it develops, shapes the future conditions of work. Over the course of the year, we considered a number of overarching themes as we attempted to theorize “work” and its place in culture. For instance, we looked at terms we use to describe work (labor, career, job), personal and collective identities associated with work (unions; corporate culture; social and economic class positions; race, gender and ethnic identities), representations of work (photography, film, maps, music, literature), and theoretical interpretations of work (alienation from systems of production, gift economies)

CONservative TReatment of Appendicitis in Children – a randomised controlled feasibility Trial (CONTRACT)

Objective To establish the feasibility of a multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy in children with uncomplicated acute appendicitis.Design Feasibility randomised controlled trial with embedded qualitative study to inform recruiter training to optimise recruitment and the design of a future definitive trial.Setting Three specialist paediatric surgery centres in the UK.Patients Children (aged 4–15 years) with a clinical diagnosis of uncomplicated acute appendicitis.Interventions Appendicectomy or a non-operative treatment pathway (comprising broad-spectrum antibiotics and active observation).Main outcome measures Primary outcome measure was the proportion of eligible patients recruited. Secondary outcomes evaluated adherence to interventions, data collection during follow-up, safety of treatment pathways and clinical course.Results Fifty per cent of eligible participants (95% CI 40 to 59) approached about the trial agreed to participate and were randomised. Repeated bespoke recruiter training was associated with an increase in recruitment rate over the course of the trial from 38% to 72%. There was high acceptance of randomisation, good patient and surgeon adherence to trial procedures and satisfactory completion of follow-up. Although more participants had perforated appendicitis than had been anticipated, treatment pathways were found to be safe and adverse event profiles acceptable.Conclusion Recruitment to a randomised controlled trial examining the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy for the treatment of uncomplicated acute appendicitis in children is feasible.Trial registration number ISRCTN15830435

Conservative treatment for uncomplicated appendicitis in children:the CONTRACT feasibility study, including feasibility RCT

Background Whilst non-operative treatment is known to be effective for the treatment of uncomplicated acute appendicitis in children, comparative randomised trial data reporting important outcomes compared to appendicectomy are lacking.ObjectivesTo ascertain the feasibility of conducting a multi-centre randomised controlled trial (RCT) testing the effectiveness and cost-effectiveness of a non-operative treatment pathway compared to appendicectomy for the treatment of uncomplicated acute appendicitis in children.•DesignMixed methods study including: a feasibility RCT; embedded and parallel qualitative and survey studies; parallel health economic feasibility study; development of a core outcome set.Setting Three specialist NHS Paediatric Surgical Units in EnglandParticipants Children (aged 4-15 years) clinically diagnosed with uncomplicated acute appendicitis participated in the feasibility RCT. Children, their families, recruiting clinicians and other healthcare professionals involved in caring for children with appendicitis took part in the qualitative study. UK Specialist Paediatric Surgeons took part in the survey. Specialist Paediatric Surgeons, Adult General Surgeons who treat children, and children and young people who previously had appendicitis along with their families took part in the core outcomes set development.Interventions Participants in the feasibility RCT were randomised to a non-operative treatment pathway (broad-spectrum antibiotics and active observation) or appendicectomy.Main outcome measures Primary outcome measure was the proportion of eligible patients recruited to the feasibility trial.Data sourcesNHS casenotes, questionnaire responses, transcribed audio recordings of recruitment discussions and qualitative interviewsResults Overall, 50% (95%CI 40-59) of 115 eligible participants approached about the trial agreed to participate and were randomised. There was high acceptance of randomisation and good adherence to trial procedures and follow-up (follow rates of 89%, 85% and 85% at six weeks, three months and six months respectively). More participants had perforated appendicitis than had been anticipated.Qualitative work enabled us to: communicate about the trial effectively with patients and families; design and deliver bespoke training to optimise recruitment; and understand how to optimise design and delivery of a future trial.The health economic study, indicated that the main cost drivers are the ward stay cost and the cost of the operation, and has informed quality of life assessment methods for future work.A core outcome set for the treatment of uncomplicated acute appendicitis in children and young people was developed, containing 14 outcomes.There is adequate surgeon interest to justify proceeding to an effectiveness trial with 51% of those surveyed expressing a willingness to recruit with an unchanged trial protocol.LimitationsSince the feasibility RCT was only performed in three centres we cannot guarantee successful recruitment across a larger number of sites. However, our qualitative work has informed a bespoke training package to facilitate this. Although survey results suggest adequate clinician interest to make a larger trial possible, actual participation may differ, and equipoise may have moved over time.Conclusions A future effectiveness trial is feasible following limited additional preparation to establish appropriate outcome measures and case identification. We recommend a limited package of qualitative work be included to optimise recruitment at new centres in particular.Future work Prior to proceeding to an effectiveness trial we need to: develop a robust method for distinguishing children with uncomplicated acute appendicitis from those with more advanced appendicitis; reach agreement on a primary outcome measure and effect size that is acceptable to all stakeholder groups involved.Study registration ISRCTN15830435.Funding detailsNIHR HTA programm

Global Diversity of Brittle Stars (Echinodermata: Ophiuroidea)

This review presents a comprehensive overview of the current status regarding the global diversity of the echinoderm class Ophiuroidea, focussing on taxonomy and distribution patterns, with brief introduction to their anatomy, biology, phylogeny, and palaeontological history. A glossary of terms is provided. Species names and taxonomic decisions have been extracted from the literature and compiled in The World Ophiuroidea Database, part of the World Register of Marine Species (WoRMS). Ophiuroidea, with 2064 known species, are the largest class of Echinodermata. A table presents 16 families with numbers of genera and species. The largest are Amphiuridae (467), Ophiuridae (344 species) and Ophiacanthidae (319 species). A biogeographic analysis for all world oceans and all accepted species was performed, based on published distribution records. Approximately similar numbers of species were recorded from the shelf (n = 1313) and bathyal depth strata (1297). The Indo-Pacific region had the highest species richness overall (825 species) and at all depths. Adjacent regions were also relatively species rich, including the North Pacific (398), South Pacific (355) and Indian (316) due to the presence of many Indo-Pacific species that partially extended into these regions. A secondary region of enhanced species richness was found in the West Atlantic (335). Regions of relatively low species richness include the Arctic (73 species), East Atlantic (118), South America (124) and Antarctic (126)

Guinea pig models for translation of the developmental origins of health and disease hypothesis into the clinic

Over 30 years ago Professor David Barker first proposed the theory that events in early life could explain an individual\u27s risk of non-communicable disease in later life: the developmental origins of health and disease (DOHaD) hypothesis. During the 1990s the validity of the DOHaD hypothesis was extensively tested in a number of human populations and the mechanisms underpinning it characterised in a range of experimental animal models. Over the past decade, researchers have sought to use this mechanistic understanding of DOHaD to develop therapeutic interventions during pregnancy and early life to improve adult health. A variety of animal models have been used to develop and evaluate interventions, each with strengths and limitations. It is becoming apparent that effective translational research requires that the animal paradigm selected mirrors the tempo of human fetal growth and development as closely as possible so that the effect of a perinatal insult and/or therapeutic intervention can be fully assessed. The guinea pig is one such animal model that over the past two decades has demonstrated itself to be a very useful platform for these important reproductive studies. This review highlights similarities in the in utero development between humans and guinea pigs, the strengths and limitations of the guinea pig as an experimental model of DOHaD and the guinea pig\u27s potential to enhance clinical therapeutic innovation to improve human health. (Figure presented.)

Overview of the MOSAiC expedition - Atmosphere

With the Arctic rapidly changing, the needs to observe, understand, and model the changes are essential. To support these needs, an annual cycle of observations of atmospheric properties, processes, and interactions were made while drifting with the sea ice across the central Arctic during the Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) expedition from October 2019 to September 2020. An international team designed and implemented the comprehensive program to document and characterize all aspects of the Arctic atmospheric system in unprecedented detail, using a variety of approaches, and across multiple scales. These measurements were coordinated with other observational teams to explore cross-cutting and coupled interactions with the Arctic Ocean, sea ice, and ecosystem through a variety of physical and biogeochemical processes. This overview outlines the breadth and complexity of the atmospheric research program, which was organized into 4 subgroups: atmospheric state, clouds and precipitation, gases and aerosols, and energy budgets. Atmospheric variability over the annual cycle revealed important influences from a persistent large-scale winter circulation pattern, leading to some storms with pressure and winds that were outside the interquartile range of past conditions suggested by long-term reanalysis. Similarly, the MOSAiC location was warmer and wetter in summer than the reanalysis climatology, in part due to its close proximity to the sea ice edge. The comprehensiveness of the observational program for characterizing and analyzing atmospheric phenomena is demonstrated via a winter case study examining air mass transitions and a summer case study examining vertical atmospheric evolution. Overall, the MOSAiC atmospheric program successfully met its objectives and was the most comprehensive atmospheric measurement program to date conducted over the Arctic sea ice. The obtained data will support a broad range of coupled-system scientific research and provide an important foundation for advancing multiscale modeling capabilities in the Arctic