Time to onset of antifracture efficacy and year-by-year persistence of effect of zoledronic acid in women with osteoporosis

Oral bisphosphonates reduce fracture risk in osteoporotic patients but are often associated with poor compliance, which may impair their antifracture effects. This post hoc analysis assessed the time to onset and persistence of the antifracture effect of zoledronic acid, a once-yearly bisphosphonate infusion, in women with osteoporosis. Data from 9355 women who were randomized in two placebo-controlled pivotal trials were included. Endpoints included reduction in the rate of any clinical fracture at 6, 12, 18, 24, and 36 months in the zoledronic acid group compared with placebo, and the year-by-year incidence of all clinical fractures over 3 years. Cox proportional hazards regression was used to determine the timing of onset of antifracture efficacy. A generalized estimating equation model was used to assess fracture reduction for the 3 consecutive years of treatment, thereby evaluating persistence of effect. Safety results from women in the two studies were collated. Zoledronic acid reduced the risk of all clinical fractures at 12 months (hazard ratio [HR] = 0.75, 95% confidence interval [CI] 0.61–0.92, p = 0.0050) with significant reductions maintained at all subsequent time points. Year-by-year analysis showed that zoledronic acid reduced the risk for all clinical fractures compared with the placebo group in each of the 3 years (year 1: odds ratio [OR] = 0.74, 95% CI 0.60–0.91, p = 0.0044; year 2: OR = 0.53, 95% CI 0.42–0.66, p < 0.0001; year 3: OR = 0.61, 95% CI 0.48–0.77, p < 0.0001). This antifracture effect was persistent over 3 years, with the reductions in years 2 and 3 slightly larger than in year 1 (p = 0.097). This analysis shows that zoledronic acid offered significant protection from clinical fractures as early as 12 months. When administered annually, its beneficial effects persisted for at least 3 years

Copayments for prescription medicines on a public health insurance scheme in Ireland

Purpose: We assessed the impact of the introduction of a €0.50 prescription copayment, and its increase to €1.50, on adherence to essential and less-essential medicines in a publicly insured population in Ireland. Methods: We used a pre-post longitudinal repeated measures design. We included new users of essential medicines: blood pressure lowering, lipid lowering and oral diabetic agents, thyroid hormone, anti-depressants, and less-essential medicines: non-steroidal anti-inflammatory drugs (NSAIDs), Proton Pump Inhibitors/H2 antagonists (PPIs/H2), and anxiolytics/hypnotics. The outcome was change in adherence, measured using Proportion of Days Covered. We used segmented regression with generalised estimating equations to allow for repeated measurements. Results: Sample sizes ranged from 7145 (thyroid hormone users) to 136111 (NSAID users). The €0.50 copayment was associated with reductions in adherence ranging from -2.1%[95% CI, -2.8 to -1.5] (thyroid hormone) to -8.3%[95% CI, -8.7 to -7.9] (anti-depressants) for essential medicines and reductions in adherence of -2%[95% CI, -2.3 to -1.7] (anxiolytics/hypnotics) to -9.5%[95% CI, -9.8 to -9.1] (PPIs/H2) for less-essential medicines. The €1.50 copayment generally resulted in smaller reductions in adherence to essential medicines. Anti-depressant medications were the exception with a decrease of -10.0% [95% CI, -10.4 to -9.6] after the copayment increase. Larger decreases in adherence were seen for most less-essential medicines; the largest was for PPIs/H2 at -13.5% [95% CI, -13.9 to -13.2] after the €1.50 copayment. Conclusion: Both copayments had a greater impact on adherence to less-essential medicines than essential medicines. The major exception was for anti-depressant medicines. Further research is required to explore heterogeneity across different socio-economic strata and to elicit the impact on clinical outcomes

Implementasi Manajemen Berbasis Sekolah Dalam Peningkatan Mutu Pendidikan Agama Islam (Studi Kasus di SMA Muhammadiyah 3 Surakarta Tahun 2011/2012)

Pemberian kewenangan penuh kepada sekolah dan guru dalam mengatur, merencanakan, mengorganisasi, mengawasi, mempertanggungjawabkan, dan memimpin sumber daya insani serta barang-barang untuk membantu pelaksanaan pembelajaran yang sesuai dengan tujuan sekolah merupakan inti dari konsep manajemen berbasis sekolah (MBS). SMA Muhammadiyah 3 Surakarta adalah salah satu lembaga pendidikan swasta yang saat ini sudah menerapkan manajemen berbasis sekolah. hal ini didasari dengan adanya partisifasi masyarakat yang bertujuan untuk meningkatkan kualitas sekolah pada umumnya, dan peningkatan mutu pendidikan Agama Islam pada khususnya. Dari latar belakang tersebut, penulis tertarik untuk meneliti lembaga ini dengan tujuan untuk mengetahui penerapan manajemen berbasis sekolah dan peningkatan mutu pendidikan agama Islamnya. Bagaimanakah manajemen diterapkan dalam peningkatan mutu pendidikan agama Islamnya, serta adakah faktor pendukung dan penghambat dalam pelaksanaan manajemen berbasis sekolah dan peningkatan mutu pendidikan agama Islam. Jenis penelitian ini termasuk penelitian lapangan, adapun pendekatan dalam penelitian ini adalah pendekatan kualitatif. Dalam pengumpulan data penulis menggunakan metode observasi, interview, dan dokumentasi. Adapun penelitian ini dianalisis dengan pendekatan kualitatif deskriptif. Hasil dari penelitian ini menunjukkan bahwa SMA Muhammadiyah 3 Surakarta adalah lembaga pendidikan swasta yang sangat menonjolkan sekolah yang berasaskan Islam yaitu memadukan kurikulum nasional dengan diniyyah, sarana prasarana yang cukup baik, manajemen tenaga kependidikan dalam perekrutan guru pendidikan agama Islam, menerapkan syarat-syarat dan tes, serta yang berbasic lulusan pesantren, dll. Lembaga tersebut juga telah memiliki pola manajerial yang baik dan sesuai dengan kosep manajemen berbasis sekolah. dibuktikan dengan adanya kelengkapan komponen manajemen sekolah serta konsep kepemimpinan yang terbuka dan demokratis. Faktor pendukung diantaranya adalah dari masyarakat, hal ini dengan banyaknya animo masyarakat untuk memasukan putra-putrinya manjadi siswa di lembaga tersebut. Meskipun demikian dalam pelaksanaan manajerialnya terdapat beberapa kekurangan yang harus di perbaiki, diantaranya adalah kurang sumber dana dan dukungan orang tua dan siswa

Syntactic mistakes and errors in students’ conversation at Boarding School Babussalam Islamic Education Center

This thesis is entitled “Syntactic Mistakes and Errors in students Conversation at Boarding School Babus Salam Islamic Education Center”. The research has been conducted based on the researcher’s interest in syntactic mistakes and errors, which are frequently produced by students in conversation at Babus Salam Boarding School. The purposes of conducting this research are to describe the syntactic mistakes and errors that occurred in its syntactic function and to know the most frequent occurrence between syntactic mistakes and errors. The method used in this research is descriptive method. Qualitative research is used for data collecting through conversation, recording and crossing check the transcripts of every participant that consist of eight students in second grade of senior high school level from different classes; four students are male and four students are female. The results of the study show that syntactic errors occurs in the function of subject, verb, object, and complement, while syntactic mistakes occurs in the function of verb and object. Syntactic errors also occurred for lack of subject, verb and object. The syntactic mistakes also occurred for lack of subject and verb. From the total number of sentences, syntactic errors appears more than syntactic mistakes, syntactic errors are contained in 126 sentences, and syntactic mistakes are contained in 58 sentences

The Role of Marine Sponges in Carbon and Nitrogen Cycles of Coral Reef and Nearshore Environments

Sponges and their microbial consortia can alter the water quality of the surrounding environment through animal and hosted microbial chemical transformations resulting from their dynamic pumping, water filtration, and respiration processes. The goal of this dissertation was to quantify the role of these organisms in the cycles of carbon (C) and nitrogen (N) on reefs and representative environments of Florida Bay and describes five principle findings: 1) the abundant coral reef sponge Xestospongia muta satisfies the bulk of its respiration oxygen (O2) demand through uptake of dissolved organic carbon, and this species removed C in excess of O2 demand which is presumed to be reserved for cellular maintenance, growth, and the generation of reproductive materials. 2) Respiration activities in this species yielded a tremendous flux of dissolved inorganic nitrogen (DIN), and the rate of this N release appeared to be broadly conserved between Floridian and Bahamian reefs. 3) The magnitude and speciation of exhalent DIN from species tested in Florida Bay showed similar rates of N efflux as those on the reef, yet the remineralization of particulate organic matter appears to be the dominant feedstock for the observed N release. 4) The N released from these species represented a dominant source of N to a budget calculated for an offshore basin in Florida Bay (Mystery Basin). 5) Bloom conditions swept through Mystery Basin decimating sponge populations and water column N, and yielded significant and lasting changes to the chemical and ecological structure of the system. These results indicated that sponges have the capacity to alter local water quality through the observed C and N transformations mediated by the holobiont (sponge and associated microbiome), and further suggests that they can drastically impact ecosystems where their populations dominate.Doctor of Philosoph

Nobody Whups Me Now : Emancipation and Slave Identity in Mississippi

Long before the CIvil War drew to a close, slaves had been looking steadfastly towards the day they would be set free. Like Abe McKlennan, who anticipated the arrival of his freedom many years before it came, Dora Franks similarly recalled one day when she overheard her master telling his wife, Emmaline, dat dey was gwinter have a bloody war and he was afeared dat all de slaves would be took away. Dora heard Emmaline declare that if this were true she feel lak jumpin\u27 in de well, and although Dora hated to hear her mistress say such things, she reported, from dat minute I started prayin\u27 for freedom and all de rest of de women did de same thing

Analisis Kandungan Serat Pangan (Dietary Fiber) Dan Iodium Mie Basah Rumput Laut (Eucheuma Cottonii) Di Ukm Sri Tanjung Dan Ukm Tiga Putra

Salah satu permasalahan kesehatan yang terjadi di Indonesia adalah kurangnya pengetahuan masyarakat terhadap kandungan gizi makanan khususnya mie. Padahal, mie merupakan makanan yang sering dikonsumsi oteh masyarakat Indonesia setelah nasi. Adapun jenis mie yang beredar di masyarakat Indonesia adalah mie dengan bahan baku utama yaitu tepung terigu dengan komposisi kimia pada umumnya sedikit mengandung iodium serta rendah kandugan serat pangannya (Dietry fiber). Dari penjelasan tersebut ada korelasi antara tingginya tingkat konsumsi mie dengan gangguan yang disebabkan oleh kandungan mie dengan jumlah iodium dan serat pangan (Dietry fiber) yang rendah. Guna memenuhi kebutuhan gizi masyarakat Indonesia UKM Sri Tanjung dan UKM Tiga Putra melakukan inovasi dengan mensubtitusikan tepung ruput laut kedalam pembuatan mie basah tetapi kandungan gizinya belum diketahui. Tujuan penelitian ini adalah untuk mengetahui kandungan serat pangan (Dietry fibe) dan iodium pada rumput laut Eucheuma cottonii di UKM Sri Tanjung Kecamatan Wongsorejo Kabupaten Banyuwangi dan UKM Tiga Putra Kecamatan Pasirian Kecamatan Lumajang Provinsi Jawa Timur. Metode penelitian ini merupakan penelitian deskriptif. Penelitian deskriptif merupakan metode penelitian yang berusaha menggambarkan dan menginterpretasi objek sesuai dengan apa adanya. Penelitian ini juga sering disebut noneksperimen, karena pada penelitian ini tidak melakukan control dan manipulasi variable penelitian. Hasil Peneliti kadar serat pangan UKM Sri Tanjung Lebih Tinggi dari pada UKM Tiga Putra dengan kadar serat pangan yaitu 20.003%, kadar 'odium 2,63% dan kadar karbohidrat 20,033% sedangkan kadar serat pangan UKM Tiga Putra yaitu 18,475%, kadar iodium 2,41 dan kadar karbohidrat 19,97%. Kesimpulan dari penelitian ml yaitu Kandungan serat pangan (dietary fiber) dan iodium pada mie yang di produksi oleh UKM Sri Tanjung dan UKM Tiga Putra memiliki kandungan yang relatif sama dimana kadar serat pangan yaitu 20.003%, kadar iodium 2,63% dan kadar karbohidrat 20,033% sedangkar kadar serat pangan UKM Tiga Putra yaitu 18,475%, kadar 'odium 2,41 dan kada karbohidrat 19,97%. Saran pada penelitian analisis kandungan serat pangal (dietary fiber) dan iodium mie basah rumput taut Eucheum cottonii di UKM Tanjung dan UKM Tiga Putra diharapkan untuk penelitian selanjutnya tertebi dahulu dilakukan pengujian terhadap bahan baku dasar yaitu tepung rumput tat dan dilanjutkan dengan pengujian mutu produk

PENGARUH PERBANDINGAN ETANOL, ASAM SITRAT DAN AIR PADA EKSTRAKSI ZAT WARNA KULIT JENGKOL (PITHECELLOBIUM JIRINGAN) TERHADAP RENDEMEN DAN KARAKTERISTIK ZAT WARNA YANG DIHASILKAN

Penelitian ini bertujuan untuk mengetahui pengaruh perbandingan etanol, asam sitrat dan air pada ekstraksi zat warna kulit jengkol terhadap rendemen dan karakteristik zat warna yang dihasilkan. Penelitian terdiri dari dua tahap yaitu tahap I adalah ekstraksi zat warna kulit jengkol dengan pelarut campuran etanol, asam sitrat dan air (5:1:25; 10:1:20; 15:1:15; 20:1:10 dan 25:1:5). Penelitian tahap I ini menggunakan Rancangan Acak Lengkap (RAL) faktor tungal dengan 3 kali ulangan. Data dianalisa menggunakan statistik ANOVA dan dilanjutkan dengan uji lanjut Duncan’s New Multiple Range Test (DNMRT) dengan taraf 5%. Parameter pengujian yang digunakan adalah analisa konsentrasi antosianin, intensitas warna, analisa pH ekstrak, rendemen, analisa sisa pelarut dan penentuan perlakuan terbaik. Penelitian tahap II. Stabilitas pigmen antosianin kulit jengkol terhadap pengaruh pH, kadar gula, kadar garam, suhu pemanasan dan lama pemanasan. Hasil penelitian tahap I menunjukkan bahwa perlakuan terbaik adalah pada perlakuan perbandingan etanol : asam sitrat : air = 25 : 1 : 5 dengan pH ekstrak 2,7 dan polaritas 33,7 menghasilkan ekstrak warna dari kulit jengkol (konsentrasi antosianin) tertinggi yaitu 15,5665 mg/L. Hasil penelitian tahap II, menunjukkan bahwa ekstrak warna dari kulit jengkol stabil pada kondisi pH 3 – 5, terjadi penurunan stabilitas seiring dengan bertambahnya konsentrasi gula, masih stabil pada kadar garam sampai 8%, terjadi penurunan stabilitas pada pemanasan sampai suhu 80°C, masih stabil pada lama pemanasan sampai 30 menit, namun mengalami penurunan stabilitas pada lama pemanasan lebih dari 30 menit

PENERAPAN ART OF DAKWAH UNTUK MENINGKATKAN MOTIVASI SISWA BELAJAR AGAMA ISLAM DI EKK MAN 1 CIANJUR

Currently, visual content spread worldwide often contains conspiracies serving the interests of certain groups to control humans, focusing their attention and belief on films and shows that promote disbelief. Therefore, the implementation of the Art of Da'wah to increase students' motivation to learn religion at MAN I Cianjur serves as a learning approach to convey Islamic messages and values to students. The purpose of this study is to facilitate students in learning Islam through art presented in digital form to dominate their daily habits. To build student motivation, there must be both internal (intrinsic) and external (extrinsic) encouragement. This study uses a descriptive quantitative method with a sample size of 47 people taken from a total population of about 88 people. Data collection techniques in this study include questionnaires, observations, interviews, and documentation. Data analysis uses SPSS with correlation formulas and Microsoft Excel assistance. The results of this study show an average value of 44.72 for the application of the Art of Da'wah, with an increase in motivation of 44.31, which can be interpreted as a high category. The degree of influence of X on Y is 0.89 or equivalent to 79.5%. The hypothesis proposed by the author: "If the application of the Art of Da'wah is used in learning, it will produce good motivation" is proven to be true