The Influence of Clinically Meaningful Factors on the Performance of the Recommended Annual Diabetic Foot Screening

Background: Diabetic foot ulcers are the result of multiple complications from hyperglycemia and lead to poor quality of life and high healthcare costs. The annual diabetes foot screening exam (ADFSE) and prevention interventions can reduce DFUs up to 75%. In 2015, 71% of the US population received the ADFSE. Objectives: The main objectives of this dissertation were: 1) to determine the association between adherence to diabetes self-management behaviors and the ADFSE, 2) to determine the association between concordant and discordant comorbidities and the ADFSE and 3) to determine the association between the performance of diabetes preventive care processes, number of office visits for diabetes and the completion of the ADFSE. Methods: Three cross-sectional studies used data from the 2015 Behavioral Risk Factor Surveillance System. Logistic regression models were evaluated to assess the association between the self-management behaviors and the ADFSE. Structural equation modeling (SEM) was used to assess the simultaneous, direct effects of concordant and discordant comorbidity loads on the ADFSE and the performance of diabetes preventive care processes and the number of office visits for diabetes care on the ADFSE. Results: In 2015, between 78.2% and 80.4% of the US population with diabetes received the ADFSE. Performance of the ADFSE was 77% less likely (OR: 0.33, 95%CI: 0.25-0.44) in those who do not perform self-foot inspections and 40% (OR: 0.59, 95%CI: 0.45-0.76) less likely in those who have never received the pneumococcal vaccination. Receiving the ADFSE was 50-80% less likely in patients who do not self-monitor blood glucose at least one time per day, depending on insulin use and receipt of diabetes education. Neither concordant comorbidities (β=0.226, p=0.086) nor discordant comorbidities (β=0.080, p=0.415) had a direct association with the performance of the ADFSE. The collection of preventive care processes demonstrated a 7% (OR: 1.07, 95% CI: 1.05-1.10) increase in the likelihood the ADFSE was performed Conclusions: Performance of the ADFSE may be improved through multiple types of interventions. Patient-based interventions to increase adherence to self-management behaviors is one route. Programs to improve overall diabetes care in the clinical setting may also help to further improve completion of the ADFSE

Hubungan antara Lingkungan Belajar dan Minat Belajar dengan Prestasi Belajar Geografi

The aims of this research is to investigate whether there is significant correlation between students' achiviement at the XI social class of the SMAN 1 Belalau in academic year 2012 – 2013. The method used correlation method. The population of this research is the students in XI IPS as many as 77 students. The writer collected the data by using questionnaire, observation, and documentation. Hypothesis are analyzed by product moment. The result of this research are : (1) there is significant correlation between learning environment and students' achiviement. (2) There is significant correlations between students' interest and their achiviement.Penelitian bertujuan untuk mengetahui tentang hubungan lingkungan belajar dan minat belajar dengan prestasi belajar siswa kelas XI IPS SMAN 1 Belalau Tahun Pelajaran 2012-2013. Penelitian menggunakan metode korelasional. Populasi penelitian siswa kelas XI IPS SMAN 1 belalau sebanyak 77 siswa. Pengumpulan data menggunakan teknik observasi, dokumentasi dan kuesioner. Analisis data untuk uji hipotesis menggunakan korelasi product moment. Hasil penelitian : (1) ada hubungan yang positif dan signifikan antara lingkungan belajar dengan prestasi belajar siswa, semakin baik lingkungan belajar siswa maka prestasi belajar siswa akan meningkat. (2) Ada hubungan yang positif dan signifikan antara minat belajar dengan prestasi belajar siswa, semakin tinggi minat belajar siswa maka akan tinggi pula prestasi belajar siswa

The Implementation of Diseases Control for Acute Respiratory Infection (DC-ARI) Program's at Sungai Pakning's Public Health Centre, Bengkalis Regency

Disease control program for Acute Respiratory Infection is a program for infectious diseases. Aims of this program is to lowering the number of toddler's pain and death  that caused by Acute Respiratory Infection or Pneumonia. The implementation program of this program at Sungai Pakning's Community Health Centre, Bengkalis Regency, was still not effective. It shown that pneumonia discovery was still low          ( 2,64%) and it's still far from the target of national policy for pneumonia control (100%). Aim of this study was to know how is the implementation program of diseases control for acute respiratory infection at Sungai Pakning's Community Health Centre, Bengkalis Regency, based on indicators of achievement process (intensification program, improvement and development of human resources, and partnerships). This research was qualitative study. There were eight persons as a sample consists of Head of Disease Control Program for Acute Respiratory Acute, Head of Community Health Centre, Doctor, Nurse, midwife of Integrated Management of The Sick Toddler, Cadre of Health, Community Leader, and Religious Figures. It used triangulation of sources, method, and data. The results shown that there's no fund for disease control program of ISPA, less human resources is caused the lack of trained personnel for Pneumonia implication thru integrated management of the sick toddler nor verbal autopsy. Then the partnership of cross program or sectoral was not so good. Even the internal of Community Health Centre has policy to used BPJS services as a scape goat to rise the fund. Availability of facilities and infrastructure of integrated management of the sick toddler policlinic should be completed. Increases of human resources capacity by given a training for integrated management of the sick toddler and verbal autopsy. Building partnership and involving the community participation in the middle of disease control program for acute respiratory infection

Protection of Galvanized steel from corrosion in salt media using sulfur nanoparticles

تم دراسة خصائص الكبريت النانوي بوساطة  جهاز مجهر القوة الذري. أظهرت قياسات مجهر القوة الذرية الحجم الكلي للكبريت النانوي المحضر بوساطة مزج ثايوسلفات الصوديوم مع مستخلص نبات  اليقطين مساويا 93.62نانومتر .تم دراسة حماية التاكل لمعدن الكلفانك ستيل  في الوسط الملحي وبمختلف درجات الحرارة بوساطة الكبريت النانوي وتم الحصول على افضل نتائج ثرموديناميكية  للمعدن بوجود الكبريت النانوي حيث كفاءة التثبيط ومقاومة لتاكل للمعدن تعطي اعلى قيمة عند اعلى درجة حرارية بوجود المثبط بلمقارنة بغيابة .كذلك سرعة التاكل تقل عند زيادة درجة الحرارة بوجود الكبريت النانوي, القيم الموجة للدالة الحرارية بوجود وبعدم وجود الكبريت النانوي تدل على انه التفاعل ماص للحرارة . لذا يقترح ان الكبريت النانوي مثبط جيد لمعدن الكالفانك ستيل في الوسط الملحي                The characteristics of sulfur nanoparticles were studied by using atomic force microscope (AFM) analysis. The atomic force microscope (AFM) measurements showed that the average size of sulfur nanoparticles synthesized using thiosulfate sodium solution through the extract of cucurbita pepo extra was 93.62 nm. Protecting galvanized steel from corrosion in salt media was achieved by using sulfur nanoparticles in different temperatures. The obtained data of thermodynamic in the presence of sulfur nanoparticles referred to high value as compares to counterpart in the absence of sulfur nanoparticles, the high inhibition efficiency (%IE) and corrosion resistance were at high temperature, the corrosion rate or weight loss decreased with increasing temperature in the presence of sulfur nanoparticles. The positive value of enthalpy ∆H* for galvanized steel with and without sulfur nanoparticles indicates that the reaction was endothermic. Therefore, the sulfur nanoparticles can be suggested as good inhibitor for galvanization in salt media

Psychosocial factors of caregiver burden in child caregivers: results from the new national study of caregiving

Background Over 50 million informal caregivers in the United States provide care to an aging adult, saving the economy hundreds of billions of dollars annually from costly hospitalization or institutionalization. Despite the benefits associated with caregiving, caregiver stress can lead to negative physical and mental health consequences, or “caregiver burden”. Given these potential negative consequences of caregiver burden, it is important not only to understand the multidimensional components of burden but to also understand the experience from the perspective of the caregiver themselves. Therefore, the objectives of our study are to use exploratory factor analysis to obtain a set of latent factors among a subset of caregiver burden questions identified in previous studies and assess their reliability. Methods All data was obtained from the 2011 National Study of Caregiving (NSOC). Exploratory factor analysis (EFA) was performed to identify a set of latent factors assessing four domains of caregiver burden in “child caregivers”: those informal caregivers who provide care to a parent or stepparent. Sensitivity analysis was also conducted by repeating the EFA on demographic subsets of caregivers. Results After multiple factor analyses, four consistent caregiver burden factors emerged from the 23 questions analyzed: Negative emotional, positive emotional, social, and financial. Reliability of each factor varied, and was strongest for the positive emotional domain for caregiver burden. These domains were generally consistent across demographic subsets of informal caregivers. Conclusion These results provide researchers a more comprehensive understanding of caregiver burden to target interventions to protect caregiver health and maintain this vital component of the US health care system

Examen anatomo-pathologique du placenta: ses indications, ses lésions chez la femme drépanocytaire

Dans cet article, les auteurs rappellent les principales indications de l'examen anatomopathologique du placenta. Ils essaient d'élucider, au vue de la littérature l'atteinte placentaire en cas de drépanocytose, marquée par le faible poids, les infarctus,la sclérose des villosités, la présence des érythrocytes en faucilles et des dépôts de fibrines dans l'espace intervilleux. Mots cles: pathologie, placenta, drépanocytose Clinics in Mother and Child Health Vol. 1(1) 2004: 9-1

A case report of a giant fallopian tube leiomyoma mimicking a mesenteric tumor.

Leiomyomas are benign tumors usually found in the uterus although other organs such as the vagina and the ovaries can be involved. The most common etiology of tubal disorders is infection, but tubal leiomyomas remain a rare possibility. We hereby present a case-report of fallopian tube leiomyoma undiagnosed preoperatively despite the technological progress in radiologic imaging. The diagnosis was only made at laparotomy. In this case report, diagnostic measures and the difficulties encountered are discussed.KEY WORDS: Abdominal mass- Fallopian tube fibroid - Diagnosis

Quenched autoligation probes allow discrimination of live bacterial species by single nucleotide differences in rRNA

Quenched autoligation (QUAL) probes are a class of self-reacting nucleic acid probes that give strong fluorescence signal in the presence of fully complementary RNAs and selectivity against single nucleotide differences in solution. Here, we describe experiments designed to test whether QUAL probes can discriminate between bacterial species by the detection of small differences in their 16S rRNA sequences. Probes were introduced into live cells using small amounts of detergent, thus eliminating the need for fixation, and fluorescence signal was monitored both by microscopy and by flow cytometry without any washing steps. The effects of probe length, modified backbone, probe concentration and growth state of the bacteria were investigated. The data demonstrate specific fluorescence discrimination between three closely related bacteria, Escherichia coli, Salmonella enterica and Pseudomonas putida, based on single nucleotide differences in their 16S rRNA. Discrimination was possible with cells in mid-log phase or in lag phase. These results suggest that QUAL probes may be useful for rapid identification of microorganisms in laboratory and clinical settings