Translating international HIV treatment guidelines into local priorities in Indonesia

Objective: International guidelines recommend countries to expand antiretroviral therapy (ART) to all HIV-infected individuals and establish local-level priorities in relation to other treatment, prevention and mitigation interventions through fair processes. However, no practical guidance is provided for such priority-setting processes. Evidence-informed deliberative processes (EDPs) fill this gap and combine stakeholder deliberation to incorporate relevant social values with rational decision-making informed by evidence on these values. This study reports on the first-time implementation and evaluation of an EDP in HIV control, organised to support the AIDS Commission in West Java province, Indonesia, in the development of its strategic plan for 2014–2018. Methods: Under the responsibility of the provincial AIDS Commission, an EDP was implemented to select priority interventions using six steps: (i) situational analysis; (ii) formation of a multistakeholder Consultation Panel; (iii) selection of criteria; (iv) identification and assessment of interventions’ performance; (v) deliberation; and (vi) selection of funding and implementing institutions. An independent researcher conducted in-depth interviews (n = 21) with panel members to evaluate the process. Results: The Consultation Pa

Challenges and opportunities in resuming spirometry services in England post-pandemic with potential to adopt Artificial Intelligence decision support software: a qualitative study

Background: Spirometry services to diagnose and monitor lung disease in primary care are restarting post-pandemic in England, identified as a priority in the NHS Long Term Plan, however evidence regarding best practice is limited.Aims: To explore perspectives on spirometry provision in primary care, and the potential for Artificial Intelligence (AI) decision support software to aid quality and interpretation.Design and Setting: Semi-structured interviews with stakeholders in spirometry services in primary care.Methods: Semi-structured interviews were conducted with key stakeholders in spirometry services across England. Participants were recruited by snowball sampling. Interviews explored the pre-pandemic delivery of spirometry, restarting of services and perceptions of the role of AI. Transcripts were analysed thematically.Results: 28 participants (mean [SD], 21.6 [9.4, range 3-40] years’ clinical experience) were interviewed between April and June 2022. Participants included clinicians (n=25) and commissioners (n=3); eight held regional and/or national respiratory network advisory roles. Four themes were identified: 1) Historical challenges in spirometry provision; 2) Inequity in post-pandemic spirometry provision and challenges to restarting spirometry in primary care; 3) Future delivery closer to patients’ homes by appropriately trained staff; 4) The potential for AI to have supportive roles in spirometry.Conclusion: Stakeholders highlighted historic challenges and the damaging effects of the pandemic contributing to inequity in provision of spirometry, which must be addressed. Overall stakeholders were positive about the potential of AI to support clinicians in quality assessment and interpretation of spirometry. However, it was evident that validation of the software must be sufficiently robust for clinicians and healthcare commissioners to have trust in the process

Translating international HIV treatment guidelines into local priorities in Indonesia

Contains fulltext : 189873.pdf (publisher's version ) (Open Access

Studi tentang ragam hias pada masjid sultan suriansyah di kota Banjarmasin Kalimantan Selatan

Ragam hias masjid ini bermotif kaligrafi dengan huruf arab dan diambil dari ayat-ayat al quran. HAl ini namapk pada rintu, dinding, ventilasi dan mimbar. Selain itu digunakan motif flora bunga melati yang bermakna kehidupan yang suci. Motif buah manggis bermakna kehidupan pahit di luar dan manis di dalam ada pada tangga serambi. PAda tiang diterapkan motif tali. Dari motif terbut disimpulkan bahwa di dalamnya mengaut motif flora, geometris dan motif fauna

Studi Tentang Ragam Hias Pada Masjid Sultan Suriansyah Di Kodya Banjarmasin Kalimantan Selatan

Kedekatan masyarakat dengan alam menjadi bahan utama dalam mewujudkan ragam hias dengan motif-motifnya yang distilir. Adanya ragam hias tradisional dapat mendukung penampilan masjid yang diterapkan pada elemen-elemen bangunan masjid terse-but. Dari uraian diatas membuahkan rumusan masalah yaitu jenis ragam hias apa saja, makna dari ragam hias tersebut, clan penerapan ragam hias tersebut. Berangkat dari permasalahan tersebul penulis memilih jenis penelitian deskriptif dan dibahas dengan analisis kualitatif. Dari hasil penelitian ragam hias pada Masjid Sultan Suriansyah terdiri dari ragam hias motif kaligra Arab yang diambil dari ayat suci Al Qur’an diterapkan pada pintu, dinding, hiasan dinding, ventilasi, dan mimbar. Motif ora seperti logam (melati dan mawar) lambang kesucian dan percintaan atau bermakna suatu harapan kehidupan, diterapkan pada kandang rasi, pintu, kaki tiang, dan jendela. Motif daunjaragju sebagai lambang “tolak bala” bermakna kesuburan dengan warna hijaunya, diterapkan pada pintu, jendela, ventilasi, dan hiasan dinding. Motif buah manggis bermakna walaupun kehidupan pahit diluar namun manis didalam, diterapkan pada tangga pagar serambi. Motif pilinan tali bermakna tali persaudaraan diterapkan pacla tiang bangunan induk dan lisplang dinding. Ragam hias jamang dengan motif stilisasi buntut ayam jago bermakna kekuatan diterapkan pada ujung atap masjid. Motif hiris gagaras bagi orang Banjar bermakna cantik dan tidak bosan dipandang diterapkan pada lisplang pinggiran atap dan kaki tiang soko guru. Ragam hias puraka dengan motif stiliran burung anggang, be-rmakna kasih sayang, stiliran buntut ayam jago bermakna kekuatan,dan stiliran buah waloh bermakna hasil kesuburan dan kejayaan dongan warnanya. Motif sulur-suluran ora berupa batang, daun, dan bunga bermakna kesuburan diterapkan pada gerbang masjid dan lisplang dinding. Terakhir adalah motif-motif lain seperti kipas, sebagai lambang matahari yang bermakna mendapat kehidupan yang layak dan memberi sinar terang kepada masyarakat. Kesimpulan dari ragam hias pada Masjid Sultan Suriansyah menerapkan motif ora, motif geometris, dan motif fauna sebagai pongaruh buclaya sotempat yang distilir, untuk menghindari kemusyrikkan sebab Islam melarang bentuk atau gambar makhluk hidup. Dari semua ragam hias yang diterapkan sebagai hasil kebudayaan sewajarnya dijaga dan dilestarikan baik individu, masyarakat, institusi dan pemerintah

Simulation of HAZ sub-zone microstructures in P92 steel.

Australian Institute for Non-Destructive Testing (AINDT

Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework

Contains fulltext : 153730.pdf (publisher's version ) (Closed access)BACKGROUND: Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement. METHODS: We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung). RESULTS: We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting. CONCLUSIONS: To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework

Effect of Eel Biscuit Supplementation on Height of Children with Stunting Aged 36–60 Months: A Pilot Study

Background. Stunting is a major health problem in developing countries. Animal-based supplements can increase the height of children with stunting. This study was aimed at determining the effect of eel biscuit supplementation on increase in the height of children with stunting aged 36–60 months. Methods. A pilot study with pretest-post-test design. The study was conducted in two villages in the Priangan Region, West Java Province, Indonesia. The participants were divided into two groups: intervention group (10 supplemented eel biscuit pieces) and control group (biscuits from the government’s biscuit programme). A total of 56 children aged 36–60 months with the height-for-age z-score of <−2 SD were recruited voluntarily for sampling. Results. The initial height-for-age z-score of the intervention group was −3.45 SD and that of the control group was −3.11 SD. After 3 months of supplemented eel biscuit consumption, the height-for-age z-score of the intervention group changed to −2.52 SD and that of the control group changed to −2.51 SD. The average shift of the height-for-age z-score after 3 months of supplemented eel biscuit consumption was 0.93 SD in the intervention group and 0.6 SD in the control group. There were significant differences in delta and percent increase in the height-for-age z-score between both groups. Conclusions. Consumption of supplemented eel biscuits for 3 months increased the height-for-age z-score of children with stunting aged 36–60 months by 0.93 SD

Comparing performance of primary care clinicians in the interpretation of SPIROmetry with or without Artificial Intelligence Decision support software (SPIRO-AID): a protocol for a randomised controlled trial

Peer reviewed: TrueAcknowledgements: We thank our patient and public involvement members for their contribution to the overall grant application and involvement in trail management meetings. We acknowledge Asthma+Lung UK for their contribution and support with this work.Funder: National Institute for Health and Care Research; FundRef: http://dx.doi.org/10.13039/501100000272; Grant(s): Phase 3- Application: Grant number AI_AWARD02204.IntroductionSpirometry is a point-of-care lung function test that helps support the diagnosis and monitoring of chronic lung disease. The quality and interpretation accuracy of spirometry is variable in primary care. This study aims to evaluate whether artificial intelligence (AI) decision support software improves the performance of primary care clinicians in the interpretation of spirometry, against reference standard (expert interpretation).Methods and analysisA parallel, two-group, statistician-blinded, randomised controlled trial of primary care clinicians in the UK, who refer for, or interpret, spirometry. People with specialist training in respiratory medicine to consultant level were excluded. A minimum target of 228 primary care clinician participants will be randomised with a 1:1 allocation to assess fifty de-identified, real-world patient spirometry sessions through an online platform either with (intervention group) or without (control group) AI decision support software report. Outcomes will cover primary care clinicians’ spirometry interpretation performance including measures of technical quality assessment, spirometry pattern recognition and diagnostic prediction, compared with reference standard. Clinicians’ self-rated confidence in spirometry interpretation will also be evaluated. The primary outcome is the proportion of the 50 spirometry sessions where the participant’s preferred diagnosis matches the reference diagnosis. Unpaired t-tests and analysis of covariance will be used to estimate the difference in primary outcome between intervention and control groups.Ethics and disseminationThis study has been reviewed and given favourable opinion by Health Research Authority Wales (reference: 22/HRA/5023). Results will be submitted for publication in peer-reviewed journals, presented at relevant national and international conferences, disseminated through social media, patient and public routes and directly shared with stakeholders.Trial registration numberNCT05933694.</jats:sec