PENDAMPINGAN KADER TERLATIH UNTUK MENINGKATKAN KEPATUHAN IBU HAMIL MENGKONSUMSI TABLET FE DI PUSKESMAS PEJAGOAN KABUPATEN KEBUMEN

Angka kejadian anemia kehamilan di Indonesia pada tahun 2018 dilaporkan sebanyak 48,9% dan prosentase paling banyak dialami oleh ibu hamil yang berumur 15-24 tahun (85,6%). Upaya yang dapat dilakukan petugas kesehatan harus mengikutsertakan kader terlatih sebagai pendamping ibu hamil dalam mengkonsumsi tablet Fe sehingga kepatuhannya meningkat.Tujuan penelitian ini adalah mengetahui pendampingan kader terlatih untuk meningkatkan kepatuhan ibu hamil mengkonsumsi tablet Fe di Puskesmas Pejagoan Kabupaten Kebumen. Jenis penelitian ini merupakan quasi experimental, dengan desain penelitian pretest-posttest with control group design. Sampel diambil dengan teknik purposive sampling didapatkan sejumlah 30 ibu hamil Trisemster II dan III yang terbagi menjadi 15 ibu kelompok kontrol dan 15 ibu kelompok intervensi.Hasil menunjukan skor akhir tingkat kepatuhan ibu hamil mengkonsumsi tablet Fe pada kelompok kontrol 5.47 dan pada kelompok intervensi skor tingkat kepatuhan ibu hamil mengkonsumsi tablet Fe post test 6.67. Antara kelompok kontrol dan kelompok intervensi skor tingkat kepatuhan mengalami perbedaan sebesar 1.200, dan setelah melalui uji independent t-test mendapatkan nilai p = 0,010 (p value < 0,05), Kesimpulan dari penelitian ini ada pengaruh pendampingan kader terlatih untuk meningkatkan kepatuhan ibu hamil mengkonsumsi tablet Fe di Puskesmas Pejagoan Kabupaten Kebumen. Rekomendasi Puskesmas Pejagoan diharapkan meningkatkan kegiatan promosi kesehatan tentang pentingnya konsumsi tablet Fe melalui program posyandu, kelas ibu hamil, kelas ibu balita rutin setiap bulan

Die Rolle der perineuralen Invasion (PNI) bezüglich der Überlebensprognose bei Plattenepithelkarzinomen der Haut im Kopf-Hals-Bereich (cHNSCC): eine systematische Review und Meta-Analyse

Hintergrund: Die perineurale Invasion (PNI) beim Plattenepithelkarzinom (PEK) der Haut im Kopf- und Halsbereich wird in der Literatur oft als Risikofaktor mit einer schlechten Überlebensprognose in Zusammenhang gebracht. Ziele: Durchführung einer systematischen Review und Metaanalyse mit allen verfügbaren Studien, die seit 1984 publiziert wurden und den Einfluss der PNI auf das Gesamtüberleben (OS), das krankheitsspezifische Überleben (DSS), das krankheitsfreie Überleben (DFS) und die loko-regionäre Kontrolle (LRC) untersuchten. Datenquellen und Auswahlkriterien: In den Datenbanken PubMed, OVID und Cochrane-Database wurde mit einer vordefinierten Suchstrategie nach englisch- und deutschsprachigen Studien gesucht, die zwischen 1984 und dem 31.12.2019 publiziert wurden. Mindestens 10 Teilnehmer mussten in einer Überlebensanalyse (OS, DSS, DFS und LRC) im Zusammenhang mit PNI untersucht worden und die Ergebnisse als Hazard Ratios (HR) bzw. Kaplan-Meier Überlebenskurven dargestellt sein, damit die Studie inkludiert werden konnte. Sekundärtumore, nicht-PEK Entitäten und Tierstudien wurden nicht inkludiert. Datenextraktion: Unter Nutzung der PRISMA-Guidelines haben zwei voneinander unabhängige Reviewer, Daten wie Studien- und Tumorcharakteristiken, Follow-Up, Behandlungen und Ergebnisse der Überlebensanalysen aus den inkludierten Studien extrahiert. Die Metaanalyse wurde mit dem Zufallseffekt-Modell (random effects model) durchgeführt. Endpunkte: Als primärer Endpunkt wurde OS und als sekundäre Endpunkte DSS, DFS und LRC definiert. Ergebnisse: 16 Studien mit 2681 Patienten (744 davon PNI-positiv) erfüllten unsere Inklusionskriterien und wurden eingeschlossen. Es zeigte sich, dass die PNI ein statistisch signifikanter Risikofaktor war, der das OS (HR 2,039 [95% KI: 1,201-3,462] p=0,008), DSS (HR 2,355 [95% KI 1,553-3,570] p<0,001), DFS (HR 1,752 [95% KI 1,164-2,636] p=0,007) und LRC (HR 2,072 [95% KI 1,429-3,002] p<0,001) negativ beeinflusste. Schlussfolgerung: Die Ergebnisse der Metaanalyse zeigten, dass Patienten mit PEK der Haut mit positivem PNI-Status einem hohen Risiko mit reduziertem OS, DSS, DFS und LRC ausgesetzt sind. Weitere Untersuchungen mit prospektiven Kohortenstudien, unter anderem auch in frühen Tumorstadien, sind notwendig, um die Qualität zukünftiger Metaanalysen zu verbessern.Importance: Perineural invasion (PNI) has often been associated with poor outcomes in survival analyses in cutaneous squamous cell carcinomas of the head and neck (cHNSCC). There is a need to summarize systematically the available quantity of data into a meta-analysis. Objektives: To conduct a systematic review and meta-analysis of published studies on PNI, as risk factor for overall survival (OS), disease specific survival (DSS), disease free survival (DFS) and loco-regional control (LRC). Data sources: PubMed, OVID and Cochrane Database were searched for papers in German and English languages, published between 1984 and 31 of December 2019. Study selection: Inclusion criteria were studies with at least 10 patients reporting about cHNSCC; analyzing the effect of PNI on OS, DSS, DFS or LRC and reporting them as Cox-regression model (hazard ratios) or Kaplan-Meier survival curves. Studies reporting non-cutaneous SCC, secondary tumors and animal studies were excluded. Data extraction and synthesis: Two reviewers abstracted the data independently using the PRISMA guidelines. The extracted data included study and tumor characteristics, follow-up, performed treatments and survival outcomes. Meta-analysis was performed using the random effects model. Main outcomes and measures: OS was defined as primary endpoint. Secondary endpoints were DSS, DFS and LRC. Results: A total of 16 studies containing 2681 patients (744 PNI-positive) with data collection between 1970 and 2018, were identified and included. PNI was a significant risk factor worsening the outcomes for OS (HR 2.039; 95% CI, 1.201-3.462; p=0.008), DSS (HR, 2.355; 95% CI, 1.553-3.570; p<0.001), DFS (HR, 1.752; 95% CI, 1.164-2.636; p=0.007) and LRC (HR, 2.072; 95% CI, 1.429-3.002; p<0.001). Conclusion and relevance: Patients with positive PNI-status in cHNSCC are at increased risk for poor outcomes in OS, DSS, DFS and LRC. Further investigations with more prospective studies, especially in early tumor stages are needed to perform high quality meta-analyses.Paralleltitel laut Übersetzung des VerfassersMedizinische Universität Wien, Diplomarbeit, 2020(VLID)510265

Post-harvest changes in cell walls of mango fruits

Comparative work on the structure of the cell walls of red kidney bean hypocotyls and mesocarp from unripe and ripe mango fruits showed significant differences. Cell-wall fractions from each were obtained using solvent extraction (water, alkali and acid) and enzymic (endopolygalacturonase) degradation procedures. The monosaccharide composition of each fraction was determined after TFA-hydrolysis by TLC-analysis. Greatest variation in monosaccharide compositions was observed in the water-soluble fractions which accounted for 18%, 48% and 11% of the cell walls of the bean, unripe and ripe mango, respectively. Water-soluble carbohydrates present in the mango pulp were examined by TLC, gel-filtration and ion-exchange methods. Only sucrose, fructose, glucose and high-MW polysaccharides were detected. The ripe mango contained 8 times more soluble polysaccharide than the unripe. In the ripe fruit the approximate MW of the polysaccharide fraction, which was rich in uronic acid was 40,000. In the unripe fruitpolysaccharides with MW's ranging from 40,000 to > 300,000 were detected. These polymers contained much smaller proportions of uronic acid than those from the ripe mesocarp. A crude 3 M LiCl enzyme extract from the cell walls of the ripe mango was able to solubilize 14% of prepared cell walls from the unripe fruit. The mechanism of this process was investigated. Endo-enzymes involved could not be identified. The involvement of b-galactosidase in cell-wall degradation was examined. Using p-nitrophenyl-b-D-galactopyranoside as substrate, 3 wall-bound forms of the enzyme were found in the ripe fruit and 2 in the unripe. Four soluble forms which were different from the wall-bound forms were observed in the ripe fruit. Three of these were present in the unripe fruit. The action of the enzyme forms on mango pectin and cell walls was examined. There was no evidence that any were directly implicated in cell-wall degradation. Wall-bound exopolygalacturonase was detected for the first time in the mango fruit. <p

СУЩНОСТЬ ГАСТРОНОМИЧЕСКОГО ТУРИЗМА И ОСОБЕННОСТИ ГАСТРОНОМИЧЕСКИХ ТУРОВ

Длинная информационная статья с определениями и понятиями на тему гастрономического туризма. Текст очень подробный, так как раскрывает все понятия и приводит примеры

Application possibilities of climate controlled greenhouse sheep and goat barns in Bursa region

Bu çalışmada, Bursa bölgesi koyun-keçi yetiştiriciliği işletmelerinin mevcut durumu ve yapısal özellikleri belirlenerek var olan sorunları ortaya koyulmaya çalışılmış ve elde edilen veriler eşliğinde bölgeye uygun sera tipi koyun ağıllarının geliştirilmesine yönelik önerilerde bulunulmuştur. Bursa bölgesi Damızlık Koyun-Keçi Yetiştiriciliği Birliğine bağlı faaliyet gösteren işletmeler ve bu işletmelerin üretim yapıları araştırma materyalini oluşturmaktadır. Çalışmanın birinci bölümünü oluşturan arazi çalışmaları damızlık birliğine bağlı farklı kapasite ve özelliğe sahip 17 adet koyunculuk işletmesine ait ağılda yürütülmüştür. Bu işletmelerin % 70,5'i kapalı tip, % 29,5'i sundurma tipi ağıllardır. İşletmelerin ağıl kapasiteleri 20-100 baş % 17, 100-249 baş % 47, 250-1 000 baş % 24 olarak değişmektedir. Bir adet işletmede (% 6) 1000 baştan fazla koyun olduğu ve bir adet işletmede (% 6) de hiç hayvan bulunmadığı gözlenmiştir. Hazırlanan anket ve yapılan ölçümlerle işletme yapılarının genel durumu ve planlama hataları değerlendirilmiştir. Ayrıca barınak içi çevre koşullarını değerlendirebilmek amacıyla kısa süreli anlık ölçümler yapılmıştır. İkinci bölümünde ise, bölge koşullarına uygun düşük maliyetli, iklim denetimli sera tipi koyun ağıllarının modellenmesi çalışılmıştır.The aim of this study is to determine the structural characteristics and general conditions of sheep-goat barns in Bursa region and to give some suggestions to develop appropriate new greenhouse sheep barns for the region according to the obtained data. The materials of this study are sheep-goat enterprises and their production facilites which are the members of Bursa Sheep-Goat Breeders Society.. The first part of the study is field works. Field works were carried on 17 sheep barns which have different capacities and types. Of these 17 sheep barns, 70,5% are closed type, 29,5% are shed type. It is observed that 6% of investigated barns have no sheep, 17% have 20-100 sheep, 47% have 100-249 sheep, 24% have 250-1000 sheep, and 6% have more than 1000 sheep. General conditions and planning failures of barns were evaluated by the field surveys and measurements. Additionally, short term instant measurements were carried out to determine indoor environmental conditions of the barns. Modelling of the climate controlled low cost greenhouse sheep barns is the second part of the study