Differences in Disability among Older Women and Men in Egypt and Tunisia

[Excerpt] Research on child survival and health has indicated disparities between boys and girls in selected Middle Eastern countries. Health disparities in later life are understudied in this region. In this article, we examine differences between women and men in later-life activity limitation in Egypt and Tunisia. Difficulty executing physical tasks is more common for women than for men in both study sites, although differences are smaller after adjustment for underlying illness. Differences in the difficulty of executing physical tasks also are sensitive to environmental controls in variable ways across the study sites. The findings caution against the sole use of reported disability in comparative studies of gender and agin

Aktivitas Mikroorganisme Tanah Pada Tanah Bekas Kebakaran Hutan Di Kabupaten Samosir

Forest fire affect chemical, physical and biological properties of the soils. In the biological properties of the soil, forest fire also affects number of microorganisms and activity of microorganisms. The purpose of this research is calculate the value of soil microorganism with various periods of forest fires. The measure of the activities of microorganism using jar and titrimetri methods.The result of this research showed that value of respiration in unburn soil is 11,99. Value of respiration from forest fire soil in 2010 is 6,43. Value of respiration from forest fire soil in 2011 is 10,28. Value of respiration from forest fire soil in 2012 is 16,28. Value of respiration from forest fire soil in 2013 is 11,14. Value of respiration from forest fire soil in 2014 is 8,14. Activity of microorganisms is almost the same between the occurrence of fire with soil unburn

Clinical practice guidelines for the foot and ankle in rheumatoid arthritis: a critical appraisal

Background: Clinical practice guidelines are recommendations systematically developed to assist clinical decision-making and inform healthcare. In current rheumatoid arthritis (RA) guidelines, management of the foot and ankle is under-represented and the quality of recommendation is uncertain. This study aimed to identify and critically appraise clinical practice guidelines for foot and ankle management in RA. Methods: Guidelines were identified electronically and through hand searching. Search terms 'rheumatoid arthritis', 'clinical practice guidelines' and related synonyms were used. Critical appraisal and quality rating were conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: Twenty-four guidelines were included. Five guidelines were high quality and recommended for use. Five high quality and seven low quality guidelines were recommended for use with modifications. Seven guidelines were low quality and not recommended for use. Five early and twelve established RA guidelines were recommended for use. Only two guidelines were foot and ankle specific. Five recommendation domains were identified in both early and established RA guidelines. These were multidisciplinary team care, foot healthcare access, foot health assessment/review, orthoses/insoles/splints, and therapeutic footwear. Established RA guidelines also had an 'other foot care treatments' domain. Conclusions: Foot and ankle management for RA features in many clinical practice guidelines recommended for use. Unfortunately, supporting evidence in the guidelines is low quality. Agreement levels are predominantly 'expert opinion' or 'good clinical practice'. More research investigating foot and ankle management for RA is needed prior to inclusion in clinical practice guidelines

UJI DAYA HAMBAT DAUN SIRIH MERAH (PIPER CROCATUM) TERHADAP BAKTERI MYCOBACTERIUM TUBERCULOSIS

Penyakit tuberculosis adalah penyakit yang sangat berbahaya dan menular khususnya di daerah Sumatera Utara. Penyakit ini disebabkan oleh bakteri patogen yaitu Mycobacterium tuberculosis. Tuberculosis adalah penyakit yang menyerang paru-paru terutama parenkim paru-paru yang dapat menyebabkan infeksi dalam waktu jangka panjang. Mycobacterium tuberculosis merupakan patogen obligat yang memiliki kemampuan bertahan pada hostnya dalam jangka panjang serta termasuk sebagai basil tahan asam (BTA). Kemampuan daun sirih merah (Piper crocatum) dalam menghambat pertumbuhan bakteri Mycobacterium tuberculosis diakui dan telah diteliti sangat manjur dan efektif. Zat bahan kimia alami yang terkandung dalam daun sirih merah (Piper crocatum) ini adalah minyak atsiri, flavonoid, tanin, alkaloid dan fenol. Penelitian ini bertujuan untuk mengetahui kemampuan daya hambat dari daun sirih merah (Piper crocatum) terhadap pertumbuhan bakteri Mycobacterium tuberculosis. Penelitian menggunakan metode pra eksperimen one grup pre dan post test. Penelitian ini menggunakan populasi penelitian yang sudah positif Mycobacterium tuberculosis di Rumah Sakit Santa Elisabeth Medan. Hasil penelitian menunjukkan terdapat zona daya hambat dari daun sirih merah (Piper crocatum) yaitu pada konsentrasi 20% adalah 4,63 mm, dan konsentrasi 100%  adalah 22,16 mm yang menunjukkan bahwa kategori resisten ditemukan pada konsentrasi terkecil yaitu 20%, sedangkan kategori kuat ditemukan pada konsentrasi terbesar yaitu 100%. Hal ini dapat disimpulkan bahwa uji daya hambat konsentrasi tertinggi pada daun sirih merah (Piper crocatum) yaitu 100% sangat kuat dalam menghambat pertumbuhan bakteri Mycobacterium tuberculosis

The systematic guideline review: method, rationale, and test on chronic heart failure

Background: Evidence-based guidelines have the potential to improve healthcare. However, their de-novo-development requires substantial resources-especially for complex conditions, and adaptation may be biased by contextually influenced recommendations in source guidelines. In this paper we describe a new approach to guideline development-the systematic guideline review method (SGR), and its application in the development of an evidence-based guideline for family physicians on chronic heart failure (CHF). Methods: A systematic search for guidelines was carried out. Evidence-based guidelines on CHF management in adults in ambulatory care published in English or German between the years 2000 and 2004 were included. Guidelines on acute or right heart failure were excluded. Eligibility was assessed by two reviewers, methodological quality of selected guidelines was appraised using the AGREE instrument, and a framework of relevant clinical questions for diagnostics and treatment was derived. Data were extracted into evidence tables, systematically compared by means of a consistency analysis and synthesized in a preliminary draft. Most relevant primary sources were re-assessed to verify the cited evidence. Evidence and recommendations were summarized in a draft guideline. Results: Of 16 included guidelines five were of good quality. A total of 35 recommendations were systematically compared: 25/35 were consistent, 9/35 inconsistent, and 1/35 un-rateable (derived from a single guideline). Of the 25 consistencies, 14 were based on consensus, seven on evidence and four differed in grading. Major inconsistencies were found in 3/9 of the inconsistent recommendations. We re-evaluated the evidence for 17 recommendations (evidence-based, differing evidence levels and minor inconsistencies) - the majority was congruent. Incongruity was found where the stated evidence could not be verified in the cited primary sources, or where the evaluation in the source guidelines focused on treatment benefits and underestimated the risks. The draft guideline was completed in 8.5 man-months. The main limitation to this study was the lack of a second reviewer. Conclusion: The systematic guideline review including framework development, consistency analysis and validation is an effective, valid, and resource saving-approach to the development of evidence-based guidelines