Good Homosexual Behaviour Decrease Prevalence of Sexual Transmitted Dissease

Introduction: The homosexual behaviour were become indicators of sexually transmitted diseases\u27s (STDs) prevalencies. Prevalence of sexually transmitted diseases in homosexual community was very high but until recently study it was conducted sporadically. The objective of this study was to analyze the correlation of homosexual behaviour with prevalence of sexually transmitted diseases (STDs) in Mobile Clinic Community Centre of IGAMA collaborating with Public Health Centre Sumberpucung of Malang Regency. Method: Analytic design with cross sectional methode was used in this study. The population were all visitors of Mobile Clinic Community Centre of IGAMA collaborating with Public Health Centre Sumberpucung of Malang Regency (353 people). Sample were 40 people who met to the inclusion criteria. The independent variable was homosexual behaviour and the dependent variable was prevalence of sexually transmitted diseases (STDs). Data for homosexual behaviour were collected by using questionnaire and indhept interview with content analyze and data for prevalence of sexually transmitted diseases (STDs) were collected by using laboratorium test for STDs. Result: The research result was presented in the form diagram, table of cross tabulation and analyzed by using Spearman Rho with significance level ρ=0.005. The result showed that there was correlation of homosexual knowledge (ρ=0.001), attitude (ρ=0.000) and practice (ρ=0.000) with prevalence of STDs. Dsicussion: It can be concluded that the better knowledge, attitude and practice of homosexual could be decrease prevalence of STDs. Futher studies are recomended to analyze the correlation between homosexual behaviour and prevalence of STDs with Health Believe approach

Bending experiment on a novel configuration of composite system using rebar as shear connectors with partially encased cold-formed steel built-up beams

In order to achieve greater ductility and strength, as well as to produce a more economical design, a novel composite beam and floor system have been developed to achieve higher strength and ductility, as well as to yield a more economical design purpose. This paper has put focus on this newly developed composite beam system which consists of a profiled metal decking slab made with self-compacting concrete (SCC). It has been joined cold-formed steel (CFS) built-up beams. These beams have been infilled with SCC by means of U-shaped rebar used as shear connectors. The researcher, in order to construct an open section, put together two CFS C-lipped channel sections in a back-to-back formation, and to construct a closed section, the formation was made to be toe-to-toe. The flexural behaviour of the partly encased composite beam was evaluated through experimentation by the researchers. So that the researchers could observe the failure modes and flexural capacity of the construction, a four-point bending test procedure was performed on two samples taking into consideration both closed and open built-up beam sections. The results of the test demonstrated that the open sections were able to exhibit a 24 percent higher ultimate moment capacity as well as greater stiffness and higher vertical deflection. As can be seen from the results of the experimental bending test, the built-up design had a great impact on the capacity and deflection of the section, and the section that was encased was able to reach the ultimate strength when the proposed shear connector was placed in the composite action. In order to validate the present test results, the design and analysis of the new composite beams have been evaluated

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Kondisi Mental Wasit dalam Memimpin Pertandingan Semifinal dan Final Liga Pemuda Volleyball di Provinsi Jawa Timur 2020

. Mental wasit sangat berpengaruh untuk memimpin setiap pertandingan. Sebab apabila seorang wasit memiliki mental yang baik, maka akan berpengaruh terhadap kinerja dan produktivitasnya. Penelitian ini bertujuan untuk mengetahui kondisi mental wasit memimpin pertandingan semifinal dan final liga remaja bolavoli Provinsi Jawa Timur tahun 2020. Metode yang digunakan dalam penelitian ini adalah kuantitatif deskriptif. Populasi dalam penelitian ini adalah wasit bolavoli yang memimpin pertandingan semifinal dan final liga remaja bolavoli provinsi Jawa Timur tahun 2020 yang berjumlah delapan orang. Berdasarkan hasil perhitungan angket yang telah diisi oleh wasit bolavoli yang bertugas menjadi wasit pertama dan wasit kedua pada pertandingan semifinal dan final menghasilkan Kondisi mental subjek MH semakin baik saat memimpin pertandingan final. Sama dengan MH, subyek NW, HA dan RF juga memiliki kondisi mental yang semakin baik saat memimpin pertandingan final. Lain halnya dengan subyek MH, NW, HA dan RF, subyek AR, KD, HK dan IP memiliki kondisi mental yang menurun saat memimpin pertandingan final. Hasil penelitian ini menunjukkan bahwa kondisi mental wasit sangat dipengaruhi oleh beberapa faktor yaitu kelelahan, suasana amarah, perasaan siap, energik dan penuh tenaga, ketegangan, penilaian diri, suasana bingung dan depresi. Semakin besar skor pada faktor kelelahan, suasana amarah, ketegangan, suasana bingung dan depresi semakin rendah kondisi mentalnya. Sedangkan untuk faktor perasaan siap energik, dan penuh tenaga dan penilaian diri semakin besar faktornya semakin tinggi pula kondisi mentalnya. Dari penelitian ini dapat disimpulkan kondisi mental wasit yang memimpin pertandingan semifinal dan final liga remaja bolavoli Provinsi Jawa Timur tahun 2020 rata-rata dalam keadaan baik

Experimental study on flexural behaviour of partially encased cold-formed steel composite beams using rebar as shear connector

This paper focuses on the composite action of two samples each consisting of two composite beams and a composite slab with bent up rebar as a shear connector. The specimens were knowingly adapted to have different shear transfer capacities along the interfaces with different geometries of the composite beams. By using the four-point bending tests of the two full-scale specimens, the authors experimentally evaluated the flexural behaviour of the partially encased composite beams. Therefore, this paper presents experimental works on the structural performance of composite beams consisting of cold-formed steel (CFS) section with self-compacting concrete (SCC) by means of the shear connection mechanism of the proposed using deformed reinforcement bar. "The results have shown that the theoretical value of flexural capacities designed agrees well enough with the experimental results. Based on the present beam tests results it was realised that the new composite system showed slightly higher results than predicted with ultimate moment ratios between 0.89-0.91% and 0.83-1.08% for the 250 mm and 150 mm beam respectively. According to the experimental bending test results, the composite section can reach the ultimate strength without compression buckling failure or local shear when the proposed shear connector was presented in the composite action. Analysis and design of composite beams are studied to validate the present test results.

Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up

Background: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. Methods: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. Results: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). Conclusion: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)