EFEKTIFITAS PEMBERIAN SEDUHAN DAUN SUNGKAI (PERONEMA CANESCENS JACK) TERHADAP PERUBAHAN TEKANAN DARAH PADA LANSIA HIPERTENSI DI WILAYAH UPT PUSKESMAS PAHANDUT PALANGKA RAYA

Salah satu terapi pengobatan non farmakologis untuk hipertensi yaitu dengan pemberian seduhan daun sungkai. Daun sungkai (Peronema Canescens Jack) merupakan etnobotani Indonesia dari suku Dayak Kalimantan. Daun sungkai mengandung senyawa flavonoid dan fenolik yang dapat menurunkan tekanan darah dan mempengaruhi kerja dari Angiotensin Converting Enzym (ACE) yang dapat vasodilatasi. Seduhan daun sungkai dapat dijadikan salah satu terapi komplementer berbasis kearifan lokal yang dapat untuk menurunkan tekanan darah, dengan meminum rutin seduhan daun sungkai diperkirakan dapat menyebabkan terjadinya penurunan tekanan darah. Penelitian ini untuk mengetahui Efektifitas Pemberian Seduhan Daun Sungkai terhadap Perubahan Tekanan Darah Pada Lansia Hipertensi. Desain penelitian menggunakan Quasy Eksperimental dengan rancangan Time Series Design. Teknik sampling menggunakan purposive sampling. Populasi penelitian ini lansia hipertensi yang berada di wilayah Puskesmas UPT Puskesmas Pahandut Palangka Raya. Sampel dalam penelitian ini berjumlah 25 responden terdiri satu kelompok eksperimen yaitu lansia hipertensi pada posyandu lansia berusia 45-74 tahun. Analisis uji statistik Wilcoxon, didapatkan hasil penelitian tekanan darah sebelum dan setelah diberikan seduhan daun sungkai menunjukkan angka sig .(2-tailed) dengan nilai p value = 0,000 < ? 0,01 menunjukkan bahwa seduhan daun sungkai efekttif untuk menurunkann tekanan darah pada lansia hipertensi. Dari penelitian ini dapat disimpulkan bahwa pemberian seduhan daun sungkai efektif terhadap perubahan tekanan darah yang mampu menurunkan tekanan darah pada lansia hipertensi. Salah satu terapi pengobatan non farmakologis untuk hipertensi yaitu dengan pemberian seduhan daun sungkai. Daun sungkai (Peronema Canescens Jack) merupakan etnobotani Indonesia dari suku Dayak Kalimantan. Daun sungkai mengandung senyawa flavonoid dan fenolik yang dapat menurunkan tekanan darah dan mempengaruhi kerja dari Angiotensin Converting Enzym (ACE) yang dapat vasodilatasi. Seduhan daun sungkai dapat dijadikan salah satu terapi komplementer berbasis kearifan lokal yang dapat untuk menurunkan tekanan darah, dengan meminum rutin seduhan daun sungkai diperkirakan dapat menyebabkan terjadinya penurunan tekanan darah. Penelitian ini untuk mengetahui Efektifitas Pemberian Seduhan Daun Sungkai terhadap Perubahan Tekanan Darah Pada Lansia Hipertensi. Desain penelitian menggunakan Quasy Eksperimental dengan rancangan Time Series Design. Teknik sampling menggunakan purposive sampling. Populasi penelitian ini lansia hipertensi yang berada di wilayah Puskesmas UPT Puskesmas Pahandut Palangka Raya. Sampel dalam penelitian ini berjumlah 25 responden terdiri satu kelompok eksperimen yaitu lansia hipertensi pada posyandu lansia berusia 45-74 tahun. Analisis uji statistik Wilcoxon, didapatkan hasil penelitian tekanan darah sebelum dan setelah diberikan seduhan daun sungkai menunjukkan angka sig .(2-tailed) dengan nilai p value = 0,000 < ? 0,01 menunjukkan bahwa seduhan daun sungkai efekttif untuk menurunkann tekanan darah pada lansia hipertensi. Dari penelitian ini dapat disimpulkan bahwa pemberian seduhan daun sungkai efektif terhadap perubahan tekanan darah yang mampu menurunkan tekanan darah pada lansia hipertensi

Effect of initial sugar concentration on the production of L (+) lactic acid by simultaneous enzymatic hydrolysis and fermentation of an agro-industrial waste product of pineapple (Ananas comosus) using Lactobacillus casei subspecies rhamnosus

Production of lactic acid by fermentation process has been studied from glucose solutions and other sources because of many important reasons: biotechnological production is cheaper than chemical synthesis; production of biodegradable materials from L (+) lactic acid and, the use of nutrient-rich agro-industrial wastes as raw material, which helps to reduce the environmental impact. The goal of this study was to evaluate the effect of sugar concentration of a pineapple liquid waste as the carbon source on the capacity of Lactobacillus casei subspecies rhamnosus to produce lactic acid by simultaneous enzymatic hydrolysis and fermentation. Three different pineapple waste concentrations were evaluated (60, 80 and 100% v/v) from a pineapple juice with 11.3% (m/v) of sugars (sucrose, fructose and glucose). L. casei was able to consume all sugars present within the levels tested, and converted all into lactic acid, showing efficient yields of 0.91 g lactic acid/g sugars. Final lactic acid concentration increased significantly (p<0.05) with the increase of pineapple waste percentage. Maximum lactic acid concentration (102g/L) was achieved with 100% pineapple waste medium. The highest total productivity (4.0g/h) and maximum productivity (4.48 g/L*h) were obtained with 60% pineapple waste medium and it decreased significantly (p<0.05) when 100% was used. Fermentation time increased with the increment of sugars, but it increased considerably with the medium composed of 100% of pineapple waste in comparison with the other two mediums. Pineapple waste represents a good alternative as a cheap carbon source for bacteria growth and production of L (+) lactic acid

Mapping and Managing Organization Objectives: A Case Study of the Alto Maipo Hydroelectric Project in Chile

This study presents a process that uses the method of alliances, conflicts, tactics, objectives, and recommendations (MACTOR) to inform integrated water resources management (IWRM) strategies for complex, multiorganization hydroelectric projects. This process is applied to the Alto Maipo Hydroelectric Project (AMHP) in Chile. The process enabled qualitative and quantitative insight on the interconnected aspects of alignment and conflict between AMHP organizations by mapping the battlefield on which they converge or diverge based on their organizational objectives and relative levels of influence. Study findings reveal environmental protection and water provision as the core objectives around which conflicts center. Study findings also point to a nuanced power struggle between state and local organizations that undermines project productivity. Project recommendations focus on improving communication and collaboration between aligned yet siloed organizations and on improving the mechanisms for information flow and advocacy for the local community and governmental organizations. These findings demonstrate the utility of the MACTOR approach—as it is applied within the proposed process—as a way to inform IWRM strategies for multiorganization hydroelectric projects from a systems perspectiv

Le discours organisationnel et la construction de la responsabilité sociale d’entreprise : une comparaison d’entreprises chiliennes et canadiennes

Cette recherche se propose d’étudier, d’un point de vue ethnométhodologique, la manière dont des entreprises de deux pays (le Chili et le Canada) et trois secteurs productifs (Banque, télécommunications et forestier) construisent leur responsabilité sociale à partir de leur discours, c’est à dire à la manière dont elles s’auto-positionnent par rapport à cette question. Sans vouloir généraliser, la comparaison des entreprises canadiennes et chiliennes a pour objectif de savoir dans quelle mesure des entreprises établies dans des pays représentant différents degrés de développement construisent des discours différents ou similaires par rapport à la question de leur responsabilité sociale. Pour tenter de répondre à cette question, nous étudierons ce sujet à travers l’analyse du message ou de la lettre du Président Directeur Général (PDG) présentées sur leurs rapports de responsabilité sociale, ce qui nous permettra de montrer comment les entreprises construisent et s’auto-positionnent, dans leur discours officiel, par rapport à la question de leur responsabilité sociale. En nous basant sur ces analyses, nous discuterons des similitudes et des différences identifiées et nous montrerons ainsi dans quelle mesure la responsabilité sociale est construite sur des références globales plus larges, ou sur des contingences qui émergent du contexte.This research’s objective is to study, from an ethnomethodological perspective, how firms of two countries (Chile and Canada) and three productive areas (Bank, telecommunications and forestry) construct their social responsibility from their discourse, that is, the way they position themselves in relation to this topic. Even we do not want to generalize, this comparison between Canadian and Chilean firms aims to know to what extent firms established in countries representing different degrees of development construct different or similar discourses in relation with the question of their social responsibility. In order to address this question, we will study this subject by analyzing the CEOs’ messages or letters introducing their social responsibility reports, which will allow us to understand how firms construct and position themselves in relation with the question of their social responsibility. Based on these analyses, we discuss the similarities and differences identified and clarify so to what extent social responsibility is constructed on global references, or on the contingencies that appear from the various contexts in which these discourses are produced

Functional characterization of HMGN5 in chromatin architecture and gene expression

The modulation of higher order structure of chromatin has profound implications in the regulation of nuclear processes, like transcription, replication, recombination or DNA repair. Those processes require accessible DNA to recruit large protein complexes to function. In humans, the architectural proteins of the “high mobility group nucleosomal binding domain” (HMGN) family participate in the opening of chromatin structure and the regulation of gene expression. HMGN proteins bind the nucleosome particle through a conserved nucleosomal binding domain (NBD) and compete with H1 for the binding to chromatin. Of all HMGN family members, HMGN5 has the biggest effect on transcriptional regulation in mouse and human cells. Moreover, HMGN5 is also able to induce large-scale chromatin decondensation in vivo. In the present work we study the functional role of HMGN5 in the opening of higher-order structure of chromatin and gene expression by biochemical and genome-wide methods. We identified a novel and specific RNA binding domain overlapping with the NBD of HMGN5. Moreover, by in vitro competition assays we demonstrated that HMGN5 exhibits exclusive binding to nucleosomes or to RNA. Furthermore, we showed that the RNA binding activity is a feature of other HMGN members as well, highlighting a novel function for those proteins. The overexpression and knockdown of HMGN5 in human cell lines affect the expression of about 3000 genes respectively, with 1287 overlapping target genes. ChIP-seq analysis of HMGN5 revealed that HMGN5 mainly associates with active regulatory genomic regions, like promoters and CpG islands, and it localizes to DNase I hypersensitive sites (DHSs). Moreover, we found that the actively regulated target genes belong to the group of genes involved in RNA metabolic processes. HMGN5 binding overlaps with RNA polymerase II binding sites. CLIP-seq analysis of HMGN5-bound RNAs revealed that HMGN5 is able to bind nascent transcripts. In the light of the biochemical results, we propose that HMGN5 participates in the regulation of RNA metabolism by a dual mechanism that enables HMGN5 binding either chromatin or RNA since the HMGN5-bound RNAs have no functional relationship with the chromatin function of HMGN5. Interestingly, by using quantitative mass spectrometry we identified CTCF, BANF1 and seven proteins associated with the pre-ribosomal RNA processing. Strikingly, our ChIP-seq data revealed that HMGN5 co-localizes with HMGN5. As CTCF constitutes the major organizer of chromatin architecture, the results presented here suggest a cooperative role of both proteins in the organization of higher-order structure of chromatin. Further functional characterization of the potential HMGN5-CTCF complex, may shed light on the regulation of higher-order chromatin organization

Diseño de un plan de acción para la atención de los factores de riesgo psicosocial y el estrés laboral en el personal de Equipos Básicos de Atención Integral en Salud (EBAIS) del área de salud de Florencia (ASF), San Carlos, Alajuela, Costa Rica

Proyecto de graduación (Maestría en Salud Ocupacional con Énfasis en Higiene Ambiental) Instituto Tecnológico de Costa Rica, Escuela de Ingeniería en Seguridad Laboral e Higiene Ambiental, 2020.Este proyecto cumple con el objetivo número 3 de la Agenda 2030 de Desarrollo Sostenible (ODS): “Asegurar una vida sana y promover el bienestar de todas las personas en todas las edades” con la meta c: "Aumentar sustancialmente la financiación de la salud y la contratación, el desarrollo, la capacitación y la retención del personal sanitario en los países en desarrollo, especialmente en los países menos adelantados y los pequeños Estados insulares en desarrollo”.La Comisión de Salud Ocupacional del área de salud de Florencia, reportó entre 2016 y 2019 un creciente número de trabajadores aquejando problemas de salud relacionados a estrés en su trabajo. Por tal motivo se planteó un estudio para identificar riesgos psicosociales en el trabajo y magnitud del estrés, con el fin de desarrollar un plan de acción ajustado a su realidad. Para lograr un plan de acción conjunto, se utilizó un diseño de investigación acción participativa, donde se combinaron métodos cuantitativos y cualitativos simultáneamente. Primero se hizo un diagnóstico (Fase I) con una encuesta validada en Colombia sobre riesgos psicosociales y estrés laboral a 43 trabajadores de los siete Equipos Básicos de Atención Integral en Salud del área de Salud de Florencia. Después del diagnóstico (Fase II), se desarrollaron las actividades para elaboración del plan con tres grupos de tres Equipos Básicos de Atención Integral en Salud seleccionados al azar, conformados con representantes de los diferentes perfiles que participaron en el diagnóstico (registros médicos, farmacia, técnicos de farmacia, medicina y enfermería) y con informantes clave conformados por personas con experiencia y reconocimiento por haber trabajado con diferentes funciones en los quipos Básicos de Atención Integral en Salud involucrados en el plan. En esta fase, usando los resultados del diagnóstico, se interactuó con los trabajadores para entender, profundizar y desarrollar el plan de intervención. En el análisis de la situación actual (fase I) se observó una fuerza laboral de predominio femenino, casados, con estabilidad laboral y antigüedad mayor a un año. Los factores de riesgo intralaborales que predominaron fueron riesgo alto principalmente en el dominio de demanda mientras que en los extralaborales predominó el nivel de riesgo bajo. De las categorías epidemiológicas, solo el grupo de edad de 40 a 62 años resultó asociado a un riesgo alto total (intra y extralaboral) con una significancia de 0,03 y RP 2,0 IC 95% (1,1-3,8). La prevalencia de estrés fue de 91 % sin diferencias significativas en los niveles de riesgo total. Las Alternativas de solución (fase II), se consensuaron con los participantes y se procedió a la elaboración del plan de intervención, basado en su experiencia vivida y razonando los resultados del método cuantitativo. Se propusieron acciones en todos sus ámbitos. La acción más importante identificada fue incentivar el reconocimiento de la labor realizada, mediante un reforzamiento positivo que corresponde al dominio recompensa. Todas las acciones sugeridas por los grupos focales fueron compartidas con las jefaturas, quienes a su vez indicaron recomendaciones que complementaron el plan inicial realizado por los grupos focales. El plan de acción final fue entregado a la Comisión de Salud Ocupacional para ser incorporado en la gestión del área de salud de Florencia De esta experiencia se desprende la importancia de los planes de acción conjuntos, ya que no sólo se trabajó en problemas estratégicos, sino que además se buscaron soluciones y consecuentemente las principales acciones desde la perspectiva de los trabajadores. Al realizarse este trabajo durante la pandemia del COVID-19, se puso de manifiesto la necesidad de prepararse mejor para emergencias de esta magnitud. De la misma manera, incluir en la planificación el desarrollo de mecanismos de afrontamiento para fortalecer la resiliencia, así como un enfoque en salud mental para evitar enfermedades crónicas secundarias al estrés, como el síndrome de burnout. Además del plan, se preparó un panfleto informativo que contiene información sobre efectos negativos del estrés, consejos basados en un libro de crecimiento personal para aumentar la resiliencia y recomendaciones para reducir el estrés.The Occupational Health Commission of "Florencia" health area (ASF), reported, between 2016 and 2019, a growing number of workers suffering from health problems related to stress at work. For this reason, a study was proposed to identify the psychosocial risks factors at work and the magnitude of stress in order to develop an action plan adjusted to their reality. To develop the action plan, a participatory-action-research (PAR) design was used, where quantitative and qualitative methods were combined simultaneously. To achieve this, a diagnosis (Phase I) was put in place through a survey validated in Colombia on psychosocial risks and work stress was applied to 43 workers from the seven EBAIS (Basic Team for Global Health Care) of the Florencia Health Area (ASF). After the diagnosis (Phase II), a series of activities followed to develop a plan with three groups of three randomly selected EBAIS who were representatives of the different professions participants in the study (medical records, pharmacy, pharmacy technicians, medicine and nursing), plus key informants with experience and recognition for having worked with different functions in the EBAIS involved in the plan. In this phase, using the results of the diagnosis, they interacted with the workers to understand, deepen, and develop the intervention plan. In the analysis of the current situation (phase I), a predominantly female workforce, married, with job stability and seniority greater than one year was observed. The Occupational risk factor that predominated were high risk, mainly in the demand domain, while in non-occupational risk factor, the low risk level predominated. Of the epidemiological categories, only the age group 40 to 62 years, was associated with a total high risk (Occupational and non-occupational) with a significance of 0,03 and PR 2,0 95% CI (1,1-3,8). The prevalence of stress was extremely high at 91% with no significant differences in the levels of total risk. The alternative solutions (phase II), a consensus among the participants ideas was reached, and the intervention plan was drawn up, based on the explanations that validated the data from the quantitative method. Actions were proposed in all areas. The most important action identified was to encourage recognition of the work performed, through positive reinforcement that corresponds to the reward domain. All the actions were shared with the headquarters and aspects not contemplated were incorporated. The agreed plan was delivered to the headquarters to be incorporated into the planning of the ASF EBAIS and to be used as a basis for the Occupational Health Commission. This experience shows the importance of joint action plans since not only did were they worked on strategic problems, but also solutions were sought and consequently the main actions from the work’s perspective. Conducting this work during the COVID-19 pandemic underscored the need to better prepare for emergencies of this magnitude. It was also planned to include the development of coping mechanisms to strengthen resilience, as well as a focus on mental health to avoid chronic diseases secondary to stress, such as burnout syndrome. In addition to the plan, an informative pamphlet containing information on negative effects of stress, tips based on a personal growth book for increasing resilience, and tips to reduce stress

Los Desafíos de la Evaluación Institucional en Chile Herramientas Utilizadas y Nuevos Horizonte

El presente artículo tiene por objetivo mostrar los resultadosobtenidos a partir del Seminario de FLACSO patrocinado por la RELACen Noviembre del año 2009 titulado: “Evaluación y Contraloría Social:un imperativo democrático” y un segundo seminario organizado en Diciembre del 2010 por el Núcleo de Evaluación de Políticas Públicasde la Universidad de Chile en el marco del Diplomado de Evaluación enIntervenciones Sociales DEIS, patrocinado por la misma RELAC, titulado“Perspectivas de la evaluación pública”. En ambos espacios, se refl exionasobre el panorama en el cual se ha desarrollado la evaluación en Chile,desde sus organismos públicos, sectoriales, además de organizacionesinternacionales que realizan evaluación y organismos de la sociedadcivil, y los desafíos que la evaluación institucional presenta hoy endía dado los cambios en el contexto institucional y la necesidad deinnovación permanente de estrategias e instrumentos que permitanevaluar resultados y gastos, pero a su vez impactos cualitativos de lasintervenciones estatales. Lo anterior con la fi nalidad de abrir el debatehacia nuevas posibilidades y formas de evaluar que puedan mejorar elimpacto de las intervenciones sociales públicas en general

Developing a practical guide for teaching histology: an evaluation of the didactic components

The Didactic Guide is a valuable tool complementing and making learning more dynamic. It is done using creative didactic strategies that simulate the presence of the tutor and generate a dialogue in order to offer students different possibilities to improve their understanding and self-discovery learning.This way the student is the protagonist of his own learning process. In this context, is highly important to consider the self discovery learning as a goal facilitating significant learning. The use of practical guides enables students to manage their own time, goals, techniques, contents and evaluation. In medical histology teaching several models of didactic guides could be use, and they normally include numerous activities, text, questionnaires, pictures, and drawings that may enhance the effectiveness of this tool in the learning process. In this work we have evaluated the usefulnes of different sections of a histology didactic guide in order to determine the key sections that enhance the learning process in human histology. For this purpose, a practical histology guide was designed with different sections: message text, theoretical text, objectives, drawings, pictures, clinical cases, games, blank spaces for self notes and drawing and final self evaluation questions. First, a simple questionnaire was applied in 90 students enrolled in histology practical seccions to analyze the student´s perceptions and preferences related to the histology guide. Finally, for all questionnaires average results and standard deviations were calculated for each option and all participants, as well for each gender, separately. Comparisons were done for drawings vs drawing blank spaces, teoric content vs notes blank space, drawings vs pictures and for each gender separately using Mann-Whitney non-parametrical test. Our findings revealed that visual strategies such as images and pictures were considered to be more useful for learning histology in the practical session. Similary, the students rated the self evaluation questions and blank spaces for self notes and drawing to be more attractive to the students. However, texts with theoretical information, messages, objectives, and clinical cases revealed to be less useful for the students in the learning process of medical histology. Moreover, statistically significant differences between theoretical content vs notes blank space was observed. All these results point out the importance of including pictures and drawings in the practical guide accompained of blank spaces that allow the development of creativity and autonomy that lead the students into a self discovery learning. Interestingly the students do not appreciate the presence of theoretical background in the practical guide as relevant information for their academic formation in the practical session