132 research outputs found
Pengelolaan Bank Sampah dan Pembuatan Pupuk Kompos di Kelurahan Baru ilir Kecamatan Balikpapan Barat
The waste bank management program aims to help the residents' economy and maintain environmental cleanliness by processing waste in the environment. The improvement of the residents' economy is done by selling inorganic/plastic waste that has economic value and converting organic waste into compost. Because of this background, the waste bank program was chosen as a community service activity for 2022 ITK by considering the appropriate location and partners. RT 56 Kelurahan Baru Ilir, West Balikpapan District is a densely populated area with the majority of its residents making seasonal livelihoods such as washermen and construction workers, so with the aim of helping the residents' economy, we decided to make RT 56 a partner for the waste bank program. The waste bank program is implemented in stages, namely coordination with the local government, socialization, waste collection, waste weighing, recording, selling waste and payments to customers. The processing of organic waste consists of refining organic waste, mixing in composting, ripening, harvesting compost. The Waste Bank program was implemented for 3 months, namely in March-May 2022 and obtained 23 customers with total customer funds reaching Rp564,324.00. The organic waste treatment program is carried out by making a composting prototype made from drums that is able to reduce the unpleasant odor produced during the composting process, so that in 1 month, ready-to-use organic fertilizer can be produced.The waste bank management program aims to help the residents' economy and maintain environmental cleanliness by processing waste in the environment. The improvement of the residents' economy is done by selling inorganic/plastic waste that has economic value and converting organic waste into compost. Because of this background, the waste bank program was chosen as a community service activity for 2022 ITK by considering the appropriate location and partners. RT 56 Kelurahan Baru Ilir, West Balikpapan District is a densely populated area with the majority of its residents making seasonal livelihoods such as washermen and construction workers, so with the aim of helping the residents' economy, we decided to make RT 56 a partner for the waste bank program. The waste bank program is implemented in stages, namely coordination with the local government, socialization, waste collection, waste weighing, recording, selling waste and payments to customers. The processing of organic waste consists of refining organic waste, mixing in composting, ripening, harvesting compost. The Waste Bank program was implemented for 3 months, namely in March-May 2022 and obtained 23 customers with total customer funds reaching Rp564,324.00. The organic waste treatment program is carried out by making a composting prototype made from drums that is able to reduce the unpleasant odor produced during the composting process, so that in 1 month, ready-to-use organic fertilizer can be produced
“I Can’t See How People Could Walk Through That Exhibit and Not Be Forever Changed”: A Qualitative Analysis Exploring the Use of Art in Research Dissemination
Background: Art can be a strong advocacy tool; it can be used to amplify the voices of marginalized communities and can change people’s perceptions of the world and others in it. In 2018, an art exhibit at Jefferson University included the cardboard signs of people who panhandle in Philadelphia as well as excerpts from in-depth interviews with those who panhandle to highlight their lived experiences. While the team published an article about this work, the purpose of this follow-up study is to explore the lasting impact of the exhibit experience on attendees’ perceptions of people who panhandle.
Methods: Fourteen attendees of the “Signs of Humanity” exhibit were interviewed 18 months later to explore their recollection of their visit and perceptions of the panhandling community. Interviews were recorded, transcribed, and thematic codes were developed in two ways: a priori codes based on literature, and through line-by-line reading of transcripts.
Results: Directed content analysis showed three main areas in which the exhibit resonated with participants: emotional, behavioral, and educational resonance, in addition to a cross-cutting “sticky” theme, referring to the memorable long-term value of the exhibit.
Conclusion: This study demonstrates that integrating art into the dissemination phase of research is effective in imbuing long-lasting emotional/behavioral responses in a way that is both accessible and provocative for the lay and scientific communities. This study adds to the body of evidence supporting the efficacy of art as an education tool and supports its use as a way to amplify the voices of marginalized communities
Incentive payments are not related to expected health gain in the pay for performance scheme for UK primary care: cross-sectional analysis
Background: The General Medical Services primary care contract for the United Kingdom financially rewards performance in 19 clinical areas, through the Quality and Outcomes Framework. Little is known about how best to determine the size of financial incentives in pay for performance schemes. Our aim was to test the hypothesis that performance indicators with larger population health benefits receive larger financial incentives. Methods: We performed cross sectional analyses to quantify associations between the size of financial incentives and expected health gain in the 2004 and 2006 versions of the Quality and Outcomes Framework. We used non-parametric two-sided Spearman rank correlation tests. Health gain was measured in expected lives saved in one year and in quality adjusted life years. For each quality indicator in an average sized general practice we tested for associations first, between the marginal increase in payment and the health gain resulting from a one percent point improvement in performance and second, between total payment and the health gain at the performance threshold for maximum payment. Results: Evidence for lives saved or quality adjusted life years gained was found for 28 indicators accounting for 41% of the total incentive payments. No statistically significant associations were found between the expected health gain and incentive gained from a marginal 1% increase in performance in either the 2004 or 2006 version of the Quality and Outcomes Framework. In addition no associations were found between the size of financial payment for achievement of an indicator and the expected health gain at the performance threshold for maximum payment measured in lives saved or quality adjusted life years. Conclusions: In this subgroup of indicators the financial incentives were not aligned to maximise health gain. This disconnection between incentive and expected health gain risks supporting clinical activities that are only marginally effective, at the expense of more effective activities receiving lower incentives. When designing pay for performance programmes decisions about the size of the financial incentive attached to an indicator should be informed by information on the health gain to be expected from that indicator
Immune modulation by group B Streptococcus influences host susceptibility to urinary tract infection by uropathogenic Escherichia coli
Urinary tract infection (UTI) is most often caused by uropathogenic Escherichia coli (UPEC). UPEC inoculation into the female urinary tract (UT) can occur through physical activities that expose the UT to an inherently polymicrobial periurethral, vaginal, or gastrointestinal flora. We report that a common urogenital inhabitant and opportunistic pathogen, group B Streptococcus (GBS), when present at the time of UPEC exposure, undergoes rapid UPEC-dependent exclusion from the murine urinary tract, yet it influences acute UPEC-host interactions and alters host susceptibility to persistent outcomes of bladder and kidney infection. GBS presence results in increased UPEC titers in the bladder lumen during acute infection and reduced inflammatory responses of murine macrophages to live UPEC or purified lipopolysaccharide (LPS), phenotypes that require GBS mimicry of host sialic acid residues. Taken together, these studies suggest that despite low titers, the presence of GBS at the time of polymicrobial UT exposure may be an overlooked risk factor for chronic pyelonephritis and recurrent UTI in susceptible groups, even if it is outcompeted and thus absent by the time of diagnosis
Association of alpha-aminoadipic acid with cardiometabolic risk factors in healthy and high-risk individuals
IntroductionPlasma levels of the metabolite alpha-aminoadipic acid (2-AAA) have been associated with risk of type 2 diabetes (T2D) and atherosclerosis. However, little is known about the relationship of 2-AAA to other cardiometabolic risk markers in pre-disease states, or in the setting of comorbid disease.MethodsWe measured circulating 2-AAA using two methods in 1) a sample of 261 healthy individuals (2-AAA Study), and 2) in a sample of 134 persons comprising 110 individuals with treated HIV, with or without T2D, a population at high risk of metabolic disease and cardiovascular events despite suppression of circulating virus, and 24 individuals with T2D without HIV (HATIM Study). We examined associations between plasma 2-AAA and markers of cardiometabolic health within each cohort.Results and discussionWe observed differences in 2-AAA by sex and race in both cohorts, with higher levels observed in men compared with women, and in Asian compared with Black or white individuals (P<0.05). There was no significant difference in 2-AAA by HIV status within individuals with T2D in the HATIM Study. We confirmed associations between 2-AAA and dyslipidemia in both cohorts, where high 2-AAA associated with low HDL cholesterol (P<0.001) and high triglycerides (P<0.05). As expected, within the cohort of people with HIV, 2-AAA was higher in the setting of T2D compared to pre-diabetes or normoglycemia (P<0.001). 2-AAA was positively associated with body mass index (BMI) in the 2-AAA Study, and with waist circumference and measures of visceral fat volume in HATIM (all P<0.05). Further, 2-AAA associated with increased liver fat in persons with HIV (P<0.001). Our study confirms 2-AAA as a marker of cardiometabolic risk in both healthy individuals and those at high cardiometabolic risk, reveals relationships with adiposity and hepatic steatosis, and highlights important differences by sex and race. Further studies are warranted to establish molecular mechanisms linking 2-AAA to disease in other high-risk populations
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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
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