Sustainable Development of Poverty Impacts in Industrial Region with Local Competency Approach in Central Java Province

The poverty of industrial areas is interesting to be studied because the industrial area should be a potential that will bring benefits to the region concerned. However, in reality, many industrial areas with poor community conditions. The problem of sustainability of poverty alleviation efforts that have been done so far is dependent on the availability of the budget and depends on the government’s commitment as the implementer of poverty eradication program. This happens because there are many factors that cause less optimal contribution of local competence in poverty alleviation efforts in Central Java Province. In its existence, local competencies that grow and develop in society can not be separated from aspects of geographical, historical, and socio-political conditions. The number and condition of poverty in industrial areas can not be separated from the rate of industrialization that is not based on the empowerment of local residents and the lack of attention of stakeholders to local competence in the community. This research uses descriptive research type with qualitatif approach.     Keywords: Poverty, Local Competence, Industrial Area, Region Potential and Central Jav

PESQUISA PARTICIPATIVA DE BASE COMUNITÁRIA (PPBC): UMA METODOLOGIA PARA ESTUDOS DE PARTICIPAÇÃO DE ADOLESCENTES

O estudo objetiva apresentar a Pesquisa Participativa de Base Comunitária (PPBC) como metodologia utilizada em estudo de participação com adolescentes. A metodologia adotada aborda questões relacionadas ao estudo e a intervenção em determinado grupo de pessoas, a comunidade a ser estudada, que nesse estudo são os adolescentes. Para tanto, alguns princípios devem ser seguidos para que as vantagens do método sejam evidentes. A pesquisa, nesse estudo relatada, enfatizou a temática participação na promoção da saúde do adolescente em uma perspectiva mais abrangente, sendo desenvolvida com um grupo de adolescentes que vivenciaram momentos educativos/participativos, baseados nos princípios da PPBC. A pesquisa abrangeu seis encontros, cada um foi planejado juntamente com os adolescentes. A avaliação do processo realizou-se mediante a observação e percepções colhidas através de registros escritos e verbais, além das manifestações não verbais. Destacaram-se como pontos positivos na implementação da metodologia a consecução de autonomia e vínculo entre a comunidade estudada e a científica (adolescentes e pesquisadores), e o aprendizado de temas realizados a promoção da saúde do público adolescente. Evidenciou-se que esse tipo de metodologia adequou-se ao estudo com adolescentes, tendo em vista que os passos foram seguidos para o alcance do objeto do estudo

Decreased mortality risk due to first acute coronary syndrome in women with postmenopausal hormone therapy use

Objectives: The role of postmenopausal hormone therapy (HT) in the incidence of acute coronary syndrome (ACS) has been studied extensively, but less is known of the impact of HT on the mortality risk due to an ACS. Study design and main outcome measures: We extracted from a population-based ACS register, FINAMI, 7258 postmenopausal women with the first ACS. These data were combined with HT use data from the National Drug Reimbursement Register; 625 patients (9%) had used various HT regimens. The death risks due to ACS before admission to hospital, 2-28, or 29-365 days after the incident ACS were compared between HT users and non-users with logistic regression analyses. Results: In all follow-up time points, the ACS death risks in HT ever-users were smaller compared to non-users. Of women with FIT ever use, 42% died within one year as compared with 52% of non-users (OR 0.62, p = 5 year FIT use (OR 0.54, p <0.001) died as compared to 43% of the non-users. Age 60 years at the HT initiation was accompanied with similar reductions in ACS mortality risk. Conclusions: Postmenopausal HT use is accompanied with reduced mortality risk after primary ACS. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

Development of a preoperative risk score on admission in surgical intermediate care unit in gastrointestinal cancer surgery

DSAIPA/DS/0042/2018 UID/DTP/00617/2019Background: Gastrointestinal cancer surgery continues to be a significant cause of postoperative complications and mortality in high-risk patients. It is crucial to identify these patients. Our study aimed to evaluate the accuracy of specific perioperative risk assessment tools to predict postoperative complications, identifying the most informative variables and combining them to test their prediction ability as a new score. Methods: A prospective cohort study of digestive cancer surgical patients admitted to the surgical intermediate care unit of the Portuguese Oncology Institute of Porto, Portugal was conducted during the period January 2016 to April 2018. Demographic and medical information including sex, age, date from hospital admission, diagnosis, emergency or elective admission, and type of surgery, were collected. We analyzed and compared a set of measurements of surgical risk using the risk assessment instruments P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score according to the outcomes classified by the Clavien-Dindo score. According to each risk score system, we studied the expected and observed post-operative complications. We performed a multivariable regression model retaining only the significant variables of these tools (age, gender, physiological P-Possum, and ACS NSQIP serious complication rate) and created a new score (MyIPOrisk-score). The predictive ability of each continuous score and the final panel obtained was evaluated using ROC curves and estimating the area under the curve (AUC). Results: We studied 341 patients. Our results showed that the predictive accuracy and agreement of P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score were limited. The MyIPOrisk-score, shows to have greater discrimination ability than the one obtained with the other risk tools when evaluated individually (AUC = 0.808; 95% CI: 0.755-0.862). The expected and observed complication rates were similar to the new risk tool as opposed to the other risk calculators. Conclusions: The feasibility and usefulness of the MyIPOrisk-score have been demonstrated for the evaluation of patients undergoing digestive oncologic surgery. However, it requires further testing through a multicenter prospective study to validate the predictive accuracy of the proposed risk score.publishersversionpublishe

Risk factors for major adverse cardiovascular events after the first acute coronary syndrome

Aims To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients. Methods We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993-2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199). Results Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 x 10(-7)), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 x 10(-15)), higher Charlson index (p = 1.56 x 10(-19)) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication. Conclusion Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.Peer reviewe

Root causes and outcomes of postoperative pulmonary complications after abdominal surgery: A retrospective observational cohort study

FCT project IPOscore (DSAIPA/DS/0042/2018).Background: Postoperative pulmonary complications (PPCs) contribute significantly to overall postoperative morbidity and mortality. In abdominal surgery, PPCs remain frequent. The study aimed to analyze the profile and outcomes of PPCs in patients submitted to abdominal surgery and admitted in a Portuguese polyvalent intensive care unit. Methods: From January to December 2017 in the polyvalent intensive care unit of Hospital Garcia de Orta, Almada, Portugal, we conducted a retrospective, observational study of inpatients submitted to urgent or elective abdominal surgery who had severe PPCs. We evaluated the perioperative risk factors and associated mortality. Logistic regression was performed to find which perioperative risk factors were most important in the occurrence of PPCs. Results: Sixty patients (75% male) with a median age of 64.5 [47-81] years who were submitted to urgent or elective abdominal surgery were included in the analysis. Thirty-six patients (60%) developed PPCs within 48 h and twenty-four developed PPCs after 48 h. Pneumonia was the most frequent PPC in this sample. In this cohort, 48 patients developed acute respiratory failure and needed mechanical ventilation. In the emergency setting, peritonitis had the highest rate of PPCs. Electively operated patients who developed PPCs were mostly carriers of digestive malignancies. Thirty-day mortality was 21.7%. The risk of PPCs development in the first 48 h was related to the need for neuromuscular blocking drugs several times during surgery and preoperative abnormal arterial blood gases. Median abdominal surgical incision, long surgery duration, and high body mass index were associated with PPCs that occurred more than 48 h after surgery. The American Society of Anesthesiologists physical status score 4 and COPD/Asthma determined less mechanical ventilation needs since they were preoperatively optimized. Malnutrition (low albumin) before surgery was associated with 30-day mortality. Conclusion: PPCs after abdominal surgery are still a major problem since they have profound effects on outcomes. Our results suggest that programs before surgery, involve preoperative lifestyle changes, such as nutritional supplementation, exercise, stress reduction, and smoking cessation, were an effective strategy in mitigating postoperative complications by decreasing mortality.publishersversionpublishe

Topographical change caused by moderate and small floods in a gravel bed ephemeral river-a depth-averaged morphodynamic simulation approach

In ephemeral rivers, channel morphology represents a snapshot at the end of a succession of geomorphic changes caused by floods. In most cases, the channel shape and bedform migration during different phases of a flood hydrograph cannot be identified from field evidence. This paper analyses the timing of riverbed erosion and deposition of a gravel bed ephemeral river channel (Rambla de la Viuda, Spain) during consecutive and moderate- (March 2013) and low-magnitude (May 2013) discharge events, by applying a morphodynamic model (Delft3D) calibrated with pre- and post-event surveys by RTK-GPS points and mobile laser scanning. The study reach is mainly depositional and all bedload sediment supplied from adjacent upstream areas is trapped in the study segment forming gravel lobes. Therefore, estimates of total bedload sediment mass balance can be obtained from pre- and post-field survey for each flood event. The spatially varying grain size data and transport equations were the most important factors for model calibration, in addition to flow discharge. The channel acted as a braided channel during the lower flows of the two discharge events, but when bars were submerged in the high discharges of May 2013, the high fluid forces followed a meandering river planform. The model results showed that erosion and deposition were in total greater during the long-lasting receding phase than during the rising phase of the flood hydrographs. In the case of the moderate-magnitude discharge event, deposition and erosion peaks were predicted to occur at the beginning of the hydrograph, whereas deposition dominated throughout the event. Conversely, the low-magnitude discharge event only experienced the peak of channel changes after the discharge peak. Thus, both type of discharge events highlight the importance of receding phase for this type of gravel bed ephemeral river channel