Potential Conflict Between the Malay and the Dayak Ethnic Groups in the Hinterland Region of West Kalimantan

This research was conducted in two villages in the hinterland region of West Kalimantan. The two villages are separated only by a small stream, and they are inhabited by two different ethnic groups. Seen from the upstream of the river, the left side of the riverbank is where the Dayak lived, while at the right side of the riverbank is where the Malay ethnic resided. The Malay, as Muslims, led their live according to Islamic teaching, while the Dayak is oblivious to theirneighbor's Islamic way of life. This in turn had fostered seeds of tensions with a potential for a conflict in the social relation between the two groups. Fortunately, the potential for conflict has not erupted into an open confrontation between them. The objective of this study is to find out the background issues that breed the potency of conflict between these two ethnic groups, the Malay and the Dayak, and why it never erupted into an open confrontation

Festival 1000 Tumpeng: Komodifikasi Tradisi, Pariwisata, Dan ‘Territoriality'di Gunung Kelud

This research explains how tradition can be modified for tourism and political purposes. The tradition that will be elaborated in this essay is "Festival 1000 Tumpeng Kelud". This festival adapts tradional Javanese cultural ceremony. The commodification of tradition is associated with the development of tourism in the area of Kelud Mountain, East Java. Furthermore, tourims activity in Kelud Mountain is part of strategy to defend particular territory in a disputed area. This is ethnography research with qualitative data and descriptive analysis, located in Sugihwaras village. Key informants of this research are special figure in society whom considered as person who can communicate with Kelud Mountain, society representative, BMKG officers, and Village officials. This essay concludes that there are three layers purposes of convening "Festival 1000 Tumpeng" initiated by the government of Kediri namely preservation of traditions and gratitude expression to God, tourism promotion, and politics of territoriality related to disputed area with Blitar Regency

Cold temperature tolerance of the alien Indo-Pacific damselfish Neopomacentrus cyanomos from the Southern Gulf of Mexico

The abundance of the alien, Indo-Pacific damselfish Neopomacentrus cyanomos on an oil-loading platform in the southwest Gulf of Mexico indicates that widely distributed platforms could facilitate the expansion of its geo- graphic range across the western and northern fringes of the Gulf. From there it likely will spread to other areas of the Greater Caribbean. The lionfish example demonstrates that it eventually happens, and can do so rapidly. Reduced temperature effects on the physiology of this species were examined to better predict its survivability in the northern Gulf during winter, when sea surface temperatures fall as low as 15 °C along the coast. Overall, our results show that when the degree of experimental temperature decline was large and rapid, no compensation occurred and the stress response observed mostly reflected cellular processes that minimized damage. Integrated biomarker response values were significantly different between fish rapidly exposed to colder vs. warmer temperatures (declines of −4 °C each day, from 26 to 14 °C), reflected in higher values of blood metabolites and routine metabolic rates observed in fish exposed to 14 and 18 °C respectively, and lower activity of all enzymes, lower protein carbonylation, and higher oxidative damage to lipids in fish exposed to 14 °C. While the phy- siological proxies responded to minimize damage during the rapid-decrease experiment, the same proxies re- flected the consequences of compensation when fish were thermally challenged after a 45 days acclimation at 18 °C. In this case, lower values of blood metabolites and high antioxidant levels and indicators of damages underpinned its pejus lower range. Based on the results of the present work, it seems clear that low winter SSTs in the northern Gulf will slow down the colonization of the inshore area of N. cyanomos. We suggest that the use of physiological cellular stress markers on specimens acquired at the beginning of an invasion should be im- plemented in new standardized experimental protocols, including both rapid increases/decreases of temperature and post-acclimation temperature challenges, to assess the invasiveness potential of aquatic species such as this

The impact of a social norms approach onreducing levels of misperceptions aroundsmokefree hospital entrances amongstpatients, staff, and visitors of a NHShospital: a repeated cross-sectional surveystudy

Background: Smoking is a cause of avoidable morbidity and mortality. In the United Kingdom (UK) the national smoking ban inside hospital buildings is widely adhered to. There is a perception it has led to smokers congregating around hospital entrances (Selbie D. 2016, It’s time for a truly smokefree NHS. Public Health Matters Blog. Public Health England). Efforts to shift social norms and create positive smokefree environments might be strengthened by delivering social norms messages. This study explored the impact of a social norms approach campaign to reduce levels of misperceptions surrounding support for smokefree hospital entrances. Method: Repeated cross sectional study design. Staff, patients, and hospital visitors at Pinderfields National Health Service (NHS) Hospital (Wakefield, United Kingdom (UK)) completed a survey before and after implementation of a public health social norms campaign (n = 481 surveyed before; n = 459 surveyed after). The main outcome measure was difference between perceived and reported levels of support for smokefree hospital entrances. Results: There were high levels of support for smokefree hospital entrances. The majority of participants agreed that patients (n = 849, 90% agreed), staff (n = 863, 92% agreed), and visitors (n = 850, 90% agreed) should not smoke in the hospital entrance. Participants underestimated the proportion of others who self-reported keeping the entrance smokefree. Over 90% of respondents reported not smoking in the hospital entrance, but the perception was that between 50 to 75% of hospital staff, patients, and visitors did not smoke in the hospital entrance. The mean percentage of hospital staff, patients, and visitors who respondents thought did not smoke in entrances was higher for respondents responding after, compared to those responding before, the campaign. There was an overall significant effect of time on attitudes towards smoking in the entrances; in all instances the mean percentage of hospital staff, patients, and visitors the participants believed agreed that hospital entrances should be smokefree was higher for those responding after, compared with before, the campaign. Conclusions: People hold misperceptions of the proportion of people who choose to smoke in the hospital entrance. The social norms approach campaign was associated with a strengthening of positive social norms. Such campaigns should be considered by Trusts as one evidence-based based tactic to denormalise smoking, increase support for smokefree policies

Impact of Covid-19 on Mental Health among Healthcare Workers in India: A Mixed-Methods Systematic Review

Healthcare workers (HCWs) experienced significant mental health challenges during the COVID-19 pandemic. This review aimed comprehensively assess the impact of the COVID-19 pandemic on the mental health of HCWs in India. A mixed-methods review adopted a results-based convergent approach incorporating quantitative and qualitative data. A comprehensive literature search was conducted in relevant databases: PubMed-MEDLINE, CINAHL, Web of Science, and ProQuest. All available full-text studies in the English language that assessed the mental health outcomes (anxiety, stress, depression) of HCWs during the pandemic and published till February 28, 2022, were included. A total of 31 studies were included in this review (27 quantitative studies, three qualitative studies, and one mixed-method study). The pooled prevalence of depression, anxiety, and stress was 32.96%, 29.49%, and 33.47 %, respectively among the HCWs in India. The qualitative analysis resulted in the themes: challenges faced, and coping strategies used during the COVID-19 pandemic. Integration of quantitative and qualitative findings using social determinants of health framework resulted in various contributing factors and coping strategies. There is a need for a supportive work environment, mental health support, and mental health policies for HCWs in India

Robotic-assisted surgery compared with laparoscopic resection surgery for rectal cancer: the ROLARR RCT

This is the final version. Available from NIHR Journals Library via the DOI in this recordData-sharing statement: All available data can be obtained by contacting the corresponding author.Background Robotic rectal cancer surgery is gaining popularity, but there are limited data about its safety and efficacy. Objective To undertake an evaluation of robotic compared with laparoscopic rectal cancer surgery to determine its safety, efficacy and cost-effectiveness. Design This was a multicentre, randomised trial comparing robotic with laparoscopic rectal resection in patients with rectal adenocarcinoma. Setting The study was conducted at 26 sites across 10 countries and involved 40 surgeons. Participants The study involved 471 patients with rectal adenocarcinoma. Recruitment took place from 7 January 2011 to 30 September 2014 with final follow-up on 16 June 2015. Interventions Robotic and laparoscopic rectal cancer resections were performed by high anterior resection, low anterior resection or abdominoperineal resection. There were 237 patients randomised to robotic and 234 to laparoscopic surgery. Follow-up was at 30 days, at 6 months and annually until 3 years after surgery. Main outcome measures The primary outcome was conversion to laparotomy. Secondary end points included intra- and postoperative complications, pathological outcomes, quality of life (QoL) [measured using the Short Form questionnaire-36 items version 2 (SF-36v2) and the Multidimensional Fatigue Inventory-20 (MFI-20)], bladder and sexual dysfunction [measured using the International Prostatic Symptom Score (I-PSS), the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI)], and oncological outcomes. An economic evaluation considered the costs of robotic and laparoscopic surgery, including primary and secondary care costs up to 6 months post operation. Results Among 471 randomised patients [mean age 64.9 years, standard deviation (SD) 11.0 years; 320 (67.9%) men], 466 (98.9%) patients completed the study. Data were analysed on an intention-to-treat basis. The overall rate of conversion to laparotomy was 10.1% and occurred in 19 (8.1%) patients in the robotic-assisted group and in 28 (12.2%) patients in the conventional laparoscopic group {unadjusted risk difference 4.12% [95% confidence interval (CI) –1.35% to 9.59%], adjusted odds ratio 0.61 [95% CI 0.31 to –1.21]; p = 0.16}. Of the nine prespecified secondary end points, including circumferential resection margin positivity, intraoperative complications, postoperative complications, plane of surgery, 30-day mortality and bladder and sexual dysfunction, none showed a statistically significant difference between the groups. No difference between the treatment groups was observed for longer-term outcomes, disease-free and overall survival (OS). Males were at a greater risk of local recurrence than females and had worse OS rates. The costs of robotic and laparoscopic surgery, excluding capital costs, were £11,853 (SD £2940) and £10,874 (SD £2676) respectively. Conclusions There is insufficient evidence to conclude that robotic rectal surgery compared with laparoscopic rectal surgery reduces the risk of conversion to laparotomy. There were no statistically significant differences in resection margin positivity, complication rates or QoL at 6 months between the treatment groups. Robotic rectal cancer surgery was on average £980 more expensive than laparoscopic surgery, even when the acquisition and maintenance costs for the robot were excluded. Future work The lower rate of conversion to laparotomy in males undergoing robotic rectal cancer surgery deserves further investigation. The introduction of new robotic systems into the market may alter the cost-effectiveness of robotic rectal cancer surgery.National Institute for Health Research (NIHR

Early evolution of the extraordinary Nova Del 2013 (V339 Del)

We determine the temporal evolution of the luminosity L(WD), radius R(WD) and effective temperature Teff of the white dwarf (WD) pseudophotosphere of V339 Del from its discovery to around day 40. Another main objective was studying the ionization structure of the ejecta. These aims were achieved by modelling the optical/near-IR spectral energy distribution (SED) using low-resolution spectroscopy (3500 - 9200 A), UBVRcIc and JHKLM photometry. During the fireball stage (Aug. 14.8 - 19.9, 2013), Teff was in the range of 6000 - 12000 K, R(WD) was expanding non-uniformly in time from around 66 to around 300 (d/3 kpc) R(Sun), and L(WD) was super-Eddington, but not constant. After the fireball stage, a large emission measure of 1.0-2.0E+62 (d/3 kpc)**2 cm**(-3) constrained the lower limit of L(WD) to be well above the super-Eddington value. The evolution of the H-alpha line and mainly the transient emergence of the Raman-scattered O VI 1032 A line suggested a biconical ionization structure of the ejecta with a disk-like H I region persisting around the WD until its total ionization, around day 40. It is evident that the nova was not evolving according to the current theoretical prediction. The unusual non-spherically symmetric ejecta of nova V339 Del and its extreme physical conditions and evolution during and after the fireball stage represent interesting new challenges for the theoretical modelling of the nova phenomenon.Comment: 14 pages, 9 figures, 3 tables, accepted for Astronomy and Astrophysic

The detection of airborne transmission of tuberculosis from HIV-infected patients, using an in vivo air sampling model

Background. Nosocomial transmission of tuberculosis remains an important public health problem. We created an in vivo air sampling model to study airborne transmission of tuberculosis from patients coinfected with human immunodeficiency virus (HIV) and to evaluate environmental control measures. Methods. An animal facility was built above a mechanically ventilated HIV‐tuberculosis ward in Lima, Peru. A mean of 92 guinea pigs were continuously exposed to all ward exhaust air for 16 months. Animals had tuberculin skin tests performed at monthly intervals, and those with positive reactions were removed for autopsy and culture for tuberculosis. Results. Over 505 consecutive days, there were 118 ward admissions by 97 patients with pulmonary tuberculosis, with a median duration of hospitalization of 11 days. All patients were infected with HIV and constituted a heterogeneous group with both new and existing diagnoses of tuberculosis. There was a wide variation in monthly rates of guinea pigs developing positive tuberculin test results (0%–53%). Of 292 animals exposed to ward air, 159 developed positive tuberculin skin test results, of which 129 had laboratory confirmation of tuberculosis. The HIV‐positive patients with pulmonary tuberculosis produced a mean of 8.2 infectious quanta per hour, compared with 1.25 for HIV‐negative patients with tuberculosis in similar studies from the 1950s. The mean monthly patient infectiousness varied greatly, from production of 0–44 infectious quanta per hour, as did the theoretical risk for a health care worker to acquire tuberculosis by breathing ward air. Conclusions. HIV‐positive patients with tuberculosis varied greatly in their infectiousness, and some were highly infectious. Use of environmental control strategies for nosocomial tuberculosis is therefore a priority, especially in areas with a high prevalence of both tuberculosis and HIV infection

Governance tools for board members : adapting strategy maps and balanced scorecards for directorial action

The accountability of members of the board of directors of publicly traded companies has increased over years. Corresponding to these developments, there has been an inadequate advancement of tools and frameworks to help directorial functioning. This paper provides an argument for design of the Balanced Scorecard and Strategy Maps made available to the directors as a means of influencing, monitoring, controlling and assisting managerial action. This paper examines how the Balanced Scorecard and Strategy Maps could be modified and used for this purpose. The paper suggests incorporating Balanced Scorecards in the Internal Process perspective, ‘internal’ implying here not just ‘internal to the firm’, but also ‘internal to the inter-organizational system’. We recommend that other such factors be introduced separately under a new ‘perspective’ depending upon what the board wants to emphasize without creating any unwieldy proliferation of measures. Tracking the Strategy Map over time by the board of directors is a way for the board to take responsibility for the firm’s performance. The paper makes a distinction between action variables and monitoring variables. Monitoring variables are further divided on the basis of two considerations: a) whether results have been met or not and b) whether causative factors have met the expected levels of performance or not. Based on directorial responsibilities and accountability, we take another look at how the variables could be specified more completely and accurately with directorial recommendations for executives

Hepatitis C virus (HCV) RNA profiles among chronic HIV/HCV-coinfected individuals in ESPRIT; spontaneous HCV RNA clearance observed in nine individuals.

OBJECTIVES: Studies have shown that hepatitis C virus (HCV) RNA levels remain stable over time in HIV/HCV-coinfected individuals taking combination antiretroviral therapy (cART), while spontaneous clearance of HCV RNA during the persistent infection phase has been documented only rarely among those with the CC interleukin (IL)-28B genotype. This study describes HCV RNA profiles and factors associated with changes over time in HCV RNA levels in the ESPRIT study. METHODS: HIV/HCV-coinfected individuals positive for HCV RNA were included in the study. Follow-up was counted from the first HCV RNA positive test and censored at the initiation of interferon-based treatment. HCV RNA and IL-28B measurements were performed in the same reference laboratory. Random effects mixed models were used to analyse changes over time in HCV RNA. RESULTS: A total of 312 ESPRIT patients were included in the study (151 in the arm receiving subcutaneous recombinant IL-2 and 161 in the control arm). Most of the patients were white (89%) and male (76%), and they had a median of 5 HCV RNA measurements per person [interquartile range (IQR) 3-6; range 1-9]. Median follow-up was 5 years (IQR: 2-6 years). At baseline, 96% of patients were taking cART and 93% had undetectable HIV RNA. Mean HCV RNA levels decreased by 13% per year over the study period [95% confidence interval (CI) 8-18%; P < 0.0001]. Baseline HCV RNA levels and the change over time in HCV RNA did not differ by randomization arm (P = 0.16 and P = 0.56, respectively). Nine individuals spontaneously cleared HCV RNA during follow-up [IL-28B genotypes: CC, five patients (56%); CT, four patients (44%)]. CONCLUSIONS: HCV RNA levels decreased over time in this population with well-controlled HIV infection. Spontaneous clearance of HCV RNA was documented in five individuals with IL-28B genotype CC and four with the CT genotype