Perayaan Sejit Kongco Ceng Gwan Cin Kun di Kelenteng Tek Hay Kiong dalam Kacamata Fotografi

Chinese culture is one has formed the Indonesian culture nowadays and has become an integral part of the Indonesian culture. Although it is still originated from their ancestors, Chinese culture in Indonesia has become local and has had assimilation process with other local cultures. In order to preserve the physical structure, documentation in Digital Photography media is important so that this result in highly artistic and prime quality. Photography media is very effective to show visually the Chinese culture in Indonesia, especially in Tegal in details, as well as the artistic side in taking picture technique. It is an early step to introduce old and well preserved culture heritage, especially Chinese culture in Tegal

The contribution of age and time-to-death on health care expenditure for out-of-hospital services

Objectives: Controversy persists over the relationships between health care expenditure, time-to-death and age, undermining attempts to generate convincing predictions for policy. This paper explores the relationships between time-to-death (TTD), age and health care expenditure for Australian Medicare-funded, out-of-hospital services in the last five years of life, assessing if the relationship varies across different types of out-of-hospital services. Methods: Medicare Benefit Scheme claims for five years before death in Western Australia (1990 – 2004)pertaining to out-of-hospital primary care, specialist or diagnostic and therapeutic services were used to determine the total and mean per capita health care expenditure (HCE) according to age and TTD. Data were evaluated using univariate linear regression (age) and segmented time-trend regression analysis (time-to-death). Results: Changes to out-of-hospital HCE in the last five years of life did not consistently show a positive association with changes in the number of decedents. Only primary care services demonstrated a linear relationship for HCE and age. For TTD, a linear relationship was observed for all three service types within each retrospective period. Conclusions: This study has identified significant differences in the relationship between age, TTD and out-of- hospital HCE across service type, further highlighting potential shortcomings in methods that use single, all- service, all-cause models to predict future HCE. These results build on our previous study and suggest that such predictions should either use separate models, or models capable of accounting for the different relationships of HCE with TTD and age across types of services in order to predict future HCE more accurately

A questionnaire study of injections prescribed and dispensed for patients diagnosed with mild/moderate community-acquired pneumonia in Mongolia

Purpose. The study aimed to determine the extent of and factors influencing the prescribing of injections for the treatment of mild/moderate community acquired pneumonia (CAP) in Mongolia. Methods. Questionnaires were developed and administered to medication providers (34 Pharmacists, 27 pharmacy technicians) and prescribers (22 general doctors and 49 medical specialists) working in Mongolia. Results. Cefalosporins were prescribed for patients with mild pneumonia and doctors tended to prescribe injectable cefalosporins (cefazolin) rather than oral dosage forms. This was supported by the questionnaire study with pharmacists and pharmacy technicians. Additionally, 23 pharmacists and pharmacy technicians indicated that OTC injectable cefalosporins (37.7%) and injectable aminopenicillins (33,9%) were frequently sold by pharmacies for the treatment of mild/moderate CAP. Doctors and particularly pharmacists in the questionnaire studies indicated choosing an injection was to avoid non-compliance problems. Conclusion. High levels of injectable prescribing of antibiotics were found in non-hospitalized patients with CAP in Mongolia. This prevalence level indicated that inappropriate injection prescribing is a public health hazard for Mongolia and requires consideration by the appropriate authorities

Characterization and Reaction of an Analog of the Anticancer Drug Oxaliplatin

Oxaliplatin is an anticancer drug that reacts with DNA, RNA, and proteins both in vitro and in vivo. Our research focuses on synthesizing analogs of oxaliplatin and understanding how bulky ligand groups affect reaction with amino acids. (R,R)-N,N’-dimethyl-1,2-diaminocyclohexane platinum(II) oxalate or Pt(Me2dach)(ox) varies from oxaliplatin or Pt(dach)(ox) in that it has one methyl group attached to each platinum coordinated nitrogen. Nuclear Magnetic Resonance (NMR) spectroscopy has shown that the reactions of N-Acetylmethionine (N-AcMet) with Pt(Me2dach)(ox) and Pt(dach)(ox) proceed at similar rates suggesting that the methyl groups of Pt(Me2dach)(ox) have little effect on the initial reaction. Whereas the reaction of Pt(dach)(ox) and N-AcMet can form 1:1 or 1:2 complexes, Pt(Me2dach)(ox) with N-AcMet can form only 1:1 products. Depending on the Pt:N-AcMet ratios, Pt(dach)(ox) has the potential to form either a [Pt(dach)(N-AcMet-S)2] or [Pt(dach)(N-AcMet-S,N)] complex. The bis product is not found in Pt(Me2dach)(ox) reactions because the formation of a [Pt(Me2dach)(N-AcMet-S,O)]+ product hinders the coordination of a second N-AcMet. It has therefore been deduced that the additional methyl groups of Pt(Me2dach)(ox) limit reaction with N-AcMet to a 1:1 molar product

Voluntary Risk Taking By Young Bicyclists:A Case Study of University Students at Montreal

Young bicyclists in Montreal are taking voluntary risks such as bicycling without wearing helmet and braking system of bicycle although they are aware of the presence of danger. This article analyses the behaviour of young bicyclists taking voluntary risks. The university students in Montreal are considered as the case study since they are more risk takers and the bicycle is a favorite mode of transport among them. This study reveals that half of the respondents did not use helmets. They were also spontaneously taking a risk by high speeding, violating signals, bicycling in mixed traffic, ignoring protective equipment after dark, and avoiding the bicycle designated roads. They were taking voluntary risks based on their attitude, subjective norm and perceived behavioural control. They did not perceive the severity of risks since they experienced relevant and unremarkable minor injuries. The attractiveness of risk and accomplishing the risk activities encouraged the young bicyclists to take voluntary risks repeatedly. Increasing feelings of vulnerability among young bicyclists reduce voluntary risks taking attitude and physical and psychological sufferings of the victims of bicycle-related accidents. Findings of this study suggest that the City of Montreal as well as other cities consider the behaviour of bicyclists particularly the young people to avoid bicycle-related accidents along with other physical measures

Dairy food intake of Australian children and adolescents 2-16 years of age: 2007 Australian National Children's Nutrition and Physical Activity Survey

Dairy food consumption is important for Australian children as it contributes key nutrients such as protein and Ca. The aim of the present paper is to describe dietary intake from dairy foods for Australian children aged 2–16 years in 2007. Secondary analysis of a quota-sampled survey using population-weighted, 1 d (24 h) dietary recall data. Australian national survey conducted from February to August 2007. Children (n 4487) aged 2–16 years. Most Australian children consumed dairy foods (84–98 %), with the proportion consuming tending to decrease with age and males consuming significantly more than females from the age of 4 years. Milk was the most commonly consumed dairy food (58–88 %) and consumed in the greatest amount (243–384 g/d). Most children consumed regular-fat dairy products. The contribution of dairy foods to total energy intake decreased with age; from 22 % of total energy at age 2–3 years to 11 % at age 14–16 years. This trend was similar for all nutrients analysed. Dairy food intake peaked between 06.00 and 10.00 hours (typical breakfast hours) corresponding with the peak in dairy Ca intake. Australian children (older than 4 years) did not reach recommendations for dairy food intake, consuming ≤2 servings. The under-consumption of dairy foods by Australian children has important implications for intake of key nutrients and should be addressed by multiple strategies.Danielle L Bairda, Julie Syrette, Gilly A Hendrie, Malcolm D Riley, Jane Bowen and Manny Noake

Sequential learning of psychomotor and visuospatial skills for laparoscopic suturing and knot tying – study protocol for a randomized controlled trial “The shoebox study”

Background: Laparoscopy training has become an integral part of surgical education. Suturing and knot tying is a basic, yet inherent part of many laparoscopic operations, and should be mastered prior to operating on patients. One common and standardized suturing technique is the C-loop technique. In the standard training setting, on a box trainer, the trainee learns the psychomotor movements of the task and the laparoscopic visuospatial orientation simultaneously. Learning the psychomotor and visuospatial skills separately and sequentially may offer a more time-efficient alternative to the current standard of training. Methods: This is a monocentric, two-arm randomized controlled trial. The participants are medical students in their clinical years (third to sixth year) at Heidelberg University who have not previously partaken in a laparoscopic training course lasting more than 2 hours. A total of 54 students are randomized into one of two arms in a 1:1 ratio to sequential learning (group 1) or control (group 2). Both groups receive a standardized introduction to the training center, laparoscopic instruments, and C-loop technique. Group 1 learn the C-loop using a transparent shoebox, thus only learning the psychomotor skills. Once they reach proficiency, they then perform the same knot tying procedure on a box trainer with standard laparoscopic view, where they combine their psychomotor skills with the visuospatial orientation inherent to laparoscopy. Group 2 learn the C-loop using solely a box trainer with standard laparoscopic view until they reach proficiency. Trainees work in pairs and time is recorded for each attempt. The primary outcome is mean total training time for each group. Secondary endpoints include procedural and knot quality subscore differences. Tertiary endpoints include studying the influence of gender and video game experience on performance. Discussion: This study addresses whether the learning of the psychomotor and visuospatial aspects of laparoscopic suturing and knot tying is optimal sequentially or simultaneously, by assessing total training time, procedural, and knot quality differences between the two groups. It will improve the efficiency of future laparoscopic suturing courses and may serve as an indicator for laparoscopic training in a broader context, i.e., not only for suturing and knot tying. Trial registration: This trial was registered on 12 August 2015 with the trial registration number DRKS00008668

Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study

BACKGROUND: African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE: To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN: Prospective cohort. PARTICIPANTS: 1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication. MAIN MEASURES: Blood pressure was the average of three seated measurements. Dementia was diagnosed using a two-stage design, with a screening evaluation every 2 to 3 years followed by a comprehensive in-home clinical evaluation for those with a positive screen. Laboratory, inpatient and outpatient encounter data, coded diagnoses and procedures, and medication records were derived from a health information exchange. KEY RESULTS: Of the 1236 hypertensive participants without dementia at baseline, 114 (9%) developed incident dementia during follow-up. Individuals prescribed any antihypertensive medication (n = 816) were found to have a significantly reduced risk of dementia (HR = 0.57, 95% CI 0.37-0.88, p = 0.0114) compared to untreated hypertensive participants (n = 420). When this analysis was repeated including a variable indicating suboptimally treated blood pressure (> 140 mmHg systolic or >90 mmHg diastolic), the effect of antihypertensive medication was no longer statistically significant (HR = 0.65, 95% CI 0.32-1.30, p = 0.2217). CONCLUSIONS: Control of blood pressure in older adult African American patients with hypertension is a key intervention for preventing dementia, with similar benefits from most of the commonly available antihypertensive medications

Treatment patterns for cancer in Western Australia: does being Indigenous make a difference?

Objective: To examine whether hospital patients with cancer who were identified as Indigenous were as likely to receive surgery for the cancer as non-Indigenous patients. Design, setting and patients: Epidemiological survey of all Western Australian (WA) patients who had a cancer registration in the state-based WA Record Linkage Project that mentioned cancer of the breast (1982–2000) or cancer of the lung or prostate (1982–2001). Main outcome measures: The likelihoods of receiving breast-conserving surgery or mastectomy for breast cancer, lung surgery for lung cancer, or radical or non-radical prostatectomy for prostate cancer were compared between the Indigenous and non-Indigenous populations using adjusted logistic regression analyses. Results: Indigenous people were less likely to receive surgery for their lung cancer (odds ratio [OR], 0.64; 95% CI, 0.41–0.98). Indigenous men were as likely as non- Indigenous men to receive non-radical prostatectomy (OR, 0.69; 95% CI, 0.40–1.17); only one Indigenous man out of 64 received radical prostatectomy. Indigenous women were as likely as non-Indigenous women to undergo breast-conserving surgery (OR, 0.86; 95% CI, 0.60–1.21). Conclusions: These results indicate a different pattern of surgical care for Indigenous patients in relation to lung and prostate, but not breast, cancer. Reasons for these disparities, such as treatment choice and barriers to care, require further investigation