Pola Dan Logika Nikah Sirri Dalam Kultur Masyarakat Madura

Sirri marriage does not seem to be a problem in Maduran society, even when the women are often harmed during or after the marriage. This apparent indifference can be explained by analyzing the cultural logic of Maduran society, among them through the patriarchal relations where women are ignorant of public administration issues, the view that women must be protected, herded and made into an asset of men's pride. The paradigms regarding virginity (parabhan) and spinsters, and the fiqh-based religious reasoning apparent in Maduran society exacerbates the problem. There are several explanations for the patterns of sirri marriages in Madura: poverty, ignorance or lack of information on behalf of the women, the practice of arranged marriages (ajuduagi) and polygamy. Sirri marriages in Madura leads to child laborers supporting families, underage widows due to incapacity of handling domestic conflicts and hindrances for women from accessing their rights in many aspects due to their dependence on men

The Investigation of Polarization Diversity in MIMO System at 2.4 GHz

This paper describes the concept of multiple input multiple output (MIMO) system using polarization diversity that can enhance the channel capacity and increased the data output performance of the system. The microstrip antenna array is designed, fabricated and measured at the desired operating frequency for this measurement. Computer Simulation Technology (CST) software is used to design and simulate the microstrip antenna array. The simulation and measurement data results are compared and discussed. The fabricated microstrip antenna is used to develop the Radio Frequency (RF) MIMO test bed system. The system measurement has been conducted in Microwave Laboratory at Faculty of Electronic and Computer Engineering, University Technical Malaysia Melaka at the operating frequency of 2.4 GHz. The spatial diversity and polarization diversity are applied in measurement campaign to investigate the performance of the wireless MIMO channel. The data obtained from the measurement is processed using MATLAB software in order to calculate the MIMO channel capacity. The analysis has been focused on the effect of the MIMO channel capacity due to the proposed measurement setup configurations. The channel capacity is increased from 0.03 b/s/Hz to 0.09 b/s/Hz when polarization diversity is applied at both transmitter and receive

Modelling and Control of seven DOF Ride Model Using Hybrid Controller Optimized By Particle Swarm Optimization

In this study, a seven degree of freedom (DOF) ride model of armored vehicle is employed in control system to control the vehicle ride performance especially in body acceleration, body pitch acceleration and body roll acceleration due to extreme road profile and disturbance using Hybrid control structure optimized by Particle Swarm Optimization (PSO) algorithm. The seven DOF ride model parameters are obtained from CARSIM software by selecting heavy vehicle High Mobility Multipurpose Wheeled Vehicle (HMMWV) as benchmark. The performance of the Hybrid control structure without optimization were compared to the performance of a simple PID control structure and passive 7 DOF vehicle ride model. Lastly, the performance of Hybrid control structure without optimization were compared to the performance of Hybrid control structure optimized by PSO algorithm

Effect of early clinical skills teaching on 3rd year medical students' learning: The student perspective

AbstractObjectivesThe main purpose of the early introduction of Clinical Skills Learning (CSL) to pre-clinical years is to allow medical students to gain experience in clinical examination skills, basic medical procedures, history-taking and clinical communication. The objective of this study was to determine the effectiveness of the early teaching of clinical skills in preparing medical students for their clinical years.MethodsA validated questionnaire assessing the value of CSL on students in their first clinical year was distributed to 3rd year medical students. The questionnaire consisted of 8 items with a five-point Likert scale and one open-ended question.ResultsThe response rate to the questionnaire was approximately 62%. Nearly 97 (70.8%) students suggested that CSL was a favourable teaching strategy. A high percentage of students (90.5%) agreed that CSL was a useful pre-clinical module to prepare them for their clinical years. The students gave positive feedback on the teaching of history-taking and physical examination, exposure to the hospital environment and acquisition of communication skills with supervisors and patients. No student perceived the CSL module as poor.ConclusionsEarly CSL was well-perceived by students in preparing them for their clinical years. CSL is a vital part of the pre-clinical curriculum and should be further enriched with frequent hospital visits to enhance students' confidence level and performance when interacting with patients during their clinical years

Responses of haptoglobin and serum amyloid A in goats inoculated intradermally with C. pseudotuberculosis and mycolic acid extract immunogen

Haptoglobin (Hp) and Serum Amyloid A (SAA) are a group of blood proteins whose concentrations in animals can be influenced by infection, inflammation, surgical trauma or stress. Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis (CLA), and Mycolic acid is a virulent factor extracted from C. pseudotuberculosis. There is a dearth of sufficient evidence on the clinical implication of MAs on the responses of Hp and SAA in goats. Therefore, this study was conducted to evaluate the potential effects of Mycolic acid (MAs) and C. pseudotuberculosis on the responses of Hp and SAA in female goats. A total of 12 healthy female goats was divided into three groups; A, B and C each comprising of 4 goats and managed for a period of three months. Group (A) was inoculated with 2 mL of sterile phosphate buffered saline (as a negative control group) intradermally, while group (B) and (C) were inoculated intradermally with 2 ml each of mycolic acid and 1‏ × 109 cfu of active C. pseudotuberculosis respectively. The result of the study showed that the Hp concentration in goats inoculated with C. pseudotuberculosis was significantly increased up to 7-fold (1.17 ± 0.17 ng/L) while MAs showed a 3-fold increased (0.83 ± 0.01 ng/L) compared with the control. Whereas SAA concentration in C. pseudotuberculosis and MAs groups showed a significant 3-fold (17.85 ± 0.91 pg/mL) and 2-fold (10.97 ± 0.71 pg/mL) increased compared with the control. This study concludes that inoculation of C. pseudotuberculosis and MAs have significant effects on Hp and SAA levels, which indicates that MAs could have a role in the pathogenesis of caseous lymphadenitis

Relationship between the learning styles preferences and academic achievement

The individual learning differences that have been much explored relate to differences in personality, learning styles, strategies and conceptual of learning. This article studies the learning style profile exhibited by students towards the academic achievement in Malaysian Polytechnic. The relationship between learning styles of Polytechnic students and their academic achievement based on VARK learning styles model. The target population was international business students of Malaysian Polytechnic. By means of randomly sampling method, 103 students were selected as sample of research. By descriptive - survey research method and a questionnaire adapted from VARK Learning Style Index, required data were collected. According to the results, no significantly difference between learning style and academic achievement of students. Students academic achievement was quite similar to their individual learning styles. These facts reveal that each learning style has its own strengths and weaknesses

Public understanding of rip current and beach safety at Teluk Cempedak Recreational Beach in Pahang, Malaysia

Rip currents are known to be a global public health issue and have been extensively contributed to the coastguard rescues and drowning cases at recreational beaches. Most studies in Malaysia have focused on the physical control of rip currents, with little emphasis on social factors. This study aims to assess the public knowledge of rip currents and beach safety at Teluk Cempedak Recreational Beach (TCRB) in Pahang, Malaysia. A convenience sampling technique was used to conduct a cross-sectional study among 300 beachgoers in TCRB. All data was collected using a self-administered questionnaire. Bivariable and multivariable logistic analyses were computed to identify factors associated with satisfactory knowledge of rip current and beach safety. More than half of the respondents were females (51%) and residents of Kuantan (62%). Out of 300 respondents, 160 (53.3%) had a satisfactory knowledge of rip currents, while a higher number of respondents (n = 221, 73.7%) had an unsatisfactory knowledge of beach safety. Those aged 35 and up, females, and those who had never had difficulty with water activities at the beach were more likely to have satisfactory knowledge of rip currents. The only factor found to be significantly related to satisfactory beach safety knowledge was age (35 years old). In conclusion, the respondents were concerned about rip currents, but they had inadequate knowledge of beach safety. Therefore, the development of effective beach safety education programmes is needed in Malaysia

Pendampingan Kelompok Tani Desa Sidomukti Kecamatan Kenduruan Kabupaten Tuban: Kajian Partisipatory Action Research (PAR)

The purpose of the research and assistance carried out in Sidomukti Village, Kenduruan Sub-District, Tuban District was to make farmers independent for seed sovereignty, production sovereignty, and market sovereignty. The method used was Participatory Action Research. The results obtained are that agriculture is a very crucial field in the lives of Indonesian people. Therefore, the number of innovations and assistance carried out to build or increase agricultural capacity is absolutely necessary. In addition, collaboration between parties will be very helpful in the process of independence in the agricultural sector, both in the fields of seeds, production, and markets. For further researchers and assistants, it is hoped that they can carry out more in-depth research, this is because the research and assistance carried out is only in a fairly short time, so that the implementation evaluation process cannot be carried out optimally. In addition, collaboration from multi stakeholders continues to provide further assistance, especially in collaboration with government agencies, where one of the missions carried out by the current Regent is to increase the added value of the agricultural sector widely, where one of the work programs is one village. one priority, village cooperation, logistical support, and strengthening food security. So that multi-stakeholder cooperation will be established in Sidomukti Village. &nbsp

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation