Upaya Pemerintah Kota Banda Aceh dalam Melindungi Anak Penyandang Disabilitas (Banda Aceh City Government's Efforts to Protect Children with Disabilities)

Children with disabilities are vulnerable to poor treatment and the growth will be very difficult in a community environment. Therefore, it must be a child with a disability given the attention of the local government to provide protection for the child's disability. This research is categorized as field research Research) and Library Research, is a type of qualitative research. The results of this research show, based on data obtained from the social service city of Banda Aceh, currently the city of Banda Aceh there are 467 children with disabilities with the category of 7 types of disabilities, of the 7 types of disability that most of the levels are Tuna Runggu and Tuna. In the management of children with disabilities, the Government of Banda Aceh carried out several activities in terms of social assistance fund Rp. 4 million (four million rupiahs) per year, the establishment of a disabled child Family Communication Forum (FKKADK) and the provision of disability aids for children with disabilities according to their degree of disability. The efforts of the activities undertaken by the Government of Banda Aceh are in accordance with the provisions of article 8 of the Candy PPPA number 4 year 2017 about special protection for children with disabilities who said that the implementation of special protection for children with disabilities in the form of activities to be a reference for the area in drafting the action plan is adjusted to the condition, the situation, needs, and capabilities of the area and with the appropriate implementation on the article with article 90 of law number 8 year 2016 social rehabilitation, social protection, social empowerment, and social security. In the implementation of child protection with disabilities in Banda Aceh in accordance with the provisions of Islamic law relating to maqasid sharia

Development and prioritization of socio-economic strategies to elevate public participation in natural resource management using TOPSIS approach; Case Study: Chaharmahal and Bakhtiari Province (Iran)

Proper implementation of the participatory projects to conserve national natural resources has become much more important over the recent decades. This socio-economic research seeks developing effective strategies to increase public participation in experts' opinions of Chaharmahal and Bakhtiari Province (Iran), in order to achieve sustainable and integrated management of natural resources. In the first step, the literature review led to the identification of 57 social parameters influencing public participation in the province. In the second step, from the parameters identified, with the help of the Delphi technique, 15 parameters were finalized by experts. This led to the formulation of the effective socioeconomic strategies in the study area. The next step was to prioritize these parameters. For this purpose, the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used in Topsis solver software. The study’s statistical population was comprised of the executive experts of Chaharmahal and Bakhtiari Province. The results of the prioritization indicated that the strategy of "the development of alternative livelihoods (A6)" ranks first with normal weight of 0.31, followed by "focus on profitable projects (A2)" with the normal weight of 0.2, and "strengthening social cohesion and trust (A7 )" with the normal weight of 0.12, as the most important strategies to increase public participation. The results of this study can be used by managers and executive decision-makers to protect natural resources and increase feasibility of management activities in Chaharmahal and Bakhtiari Province.Keywords: Strategies effective on public participation, Delphi technique, Executive experts, TOPSIS, Chaharmahal and Bakhtiari Provinc

Pengaruh Perendaman Dengan Filtrat Abu Jerami Padi (FAJP) Terhadap Lignin Dan Serat Kasar Tongkol Jagung

ABSTRAK. Potensi tongkol jagung sebagai pakan ruminansia sangat besar, namun dibatasi penggunaannya karena kadar ligninnya yang tinggi. Penelitian ini bertujuan untuk menguji dan mengetahui hubungan antara kandungan lignin dan serat kasar tongkol jagung yang direndam dengan berbagai konsentrasi filtrat abu jerami padi (FAJP). Penelitian menggunakan rancangan acak lengkap (RAL) dengan empat macam perendaman, yaitu R1 = Tongkol jagung dengan hidrolisis FAJP konsentrasi 5%, R2 = Tongkol jagung dengan hidrolisis FAJP konsentrasi 10%, R3 = Tongkol jagung dengan hidrolisis FAJP konsentrasi 15%, R4 = Tongkol jagung dengan hidrolisis FAJP konsentrasi 20%. Setiap perlakuan diulang sebanyak empat kali. Hasil menunjukkan bahwa FAJP berpengaruh nyata terhadap penurunan kadar lignin dan serat kasar pada tongkol jagung (p0,05). Hubungan antara perlakuan dengan kadar lignin membentuk persamaan regresi Y = 9,29 -0,172X dengan R2 =0,92, sedangan antara serat kasar dan lignin memiliki hubungan yang sangat erat dengan nilai r =0,85. Perendaman tongkol jagung dengan FAJP 20% menghasilkan persentase lignin dan serat kasar yang paling rendah yaitu 5,88dan 32,03 %.Kesimpulan, penggunaan FSJP dengan konsentrasi 20% merupakan perlakuan yang terbaik.(The effect of soaked by rice straw ash filtrate on lignin and crude fiber content of corn cob)ABSTRACT. Utilization of corncobs as a ruminant feed is highly potential but its high lignin content may limit its use. The objective of this experiment was to investigate the effect of soaking in the water containing different concentration of rice straws ash filtrate (RSAF) on lignin and crude fiber contents of corncob. A completely randomized design was employed to compare 5 different treatments: R1 = corncob with RSAF hydrolysis 5%, R2 = corncob with RSAF hydrolysis 10%, R3 = corncob with RSAF hydrolysis 15%, and R4 = corncob with RSAF hydrolysis 20%. Each treatment was repeatedfour times (n=4). The result showed that RSAF had a significant effect (P0.05) in reducing lignin and crude fiber contents. The relationship between treatment and lignin content followed a regression equation: Y = 9.29 -0.172X with R2 =0.92, while crude fiber and lignin had a close relationship with r =0.85. Soaking corncobs with RSAF as much as 20% resulted the lowest lignin and crude fiber contents which were 5.88 and 32.03% respectively. It concluded that utilization of RSAF 20% was the best treatment

Collaborative water management through revitalizing social power relationships: a social network analysis of Qanat stakeholders in Iran

peer reviewedThe network relations of Qanat stakeholders in Iran as an ancient type of water-supply system were considered with the aim of clarifying the societal transformation through revitalizing power dynamics. The present network was highlighted by the interaction of three groups of new actors with the greatest social power: 1. those capable of developing trust and participation ties, 2. those with high control power and high mediation who link small family groups and play a role in empowering individuals, and 3. those who have high fame and are key players by leading thoughts and resolving conflicts. Meanwhile, Boolean Combination Index confirms the increase of various quantitative indicators, such as higher reciprocity and transitivity of relationships and shorter geodetic and diameter index. This study concluded that the revival of power relations in a social–ecological system can be effective in changing the social structure based on the recognition of internal social capitals

The monetary facilities payment for ecosystem services as an approach to restore the Degraded Urmia Lake in Iran.

peer reviewedThis study analyzed the potential use of Payment for Ecosystem Services (PES) as a strategy for improving water supply management. This study focused on the Siminehroud Sub-basin due to its high importance to the Basin of Urmia Lake (UL). Siminehroud is the second provider of water (by volume) to Urmia Lake. To evaluate the technical and economic feasibility of a PES scheme, the current land use map was extracted using satellite imagery. In addition, the two algorithms of Support Vector Machines (SVMs) and Maximum Likelihood (ML) are used for Landsat images classification, rather than analyzing the relationship between land use and ecosystem services. Then, the most relevant ecosystem services provided in the region were evaluated using the Benefit Transfer Method. In the last step, by designing and implementing a survey, on the one hand, the local farmers' Willingness to Accept (WTA) cash payments for reducing the area they cultivate, and on the other hand, the farmers' Willingness to Pay (WTP) for managing the water consumption were determined. The results illustrated that the WTA program is more acceptable among the beneficiaries. It is also notable that this program needs very high governmental funding. Furthermore, the results of the program indicate that the land area out of the cultivation cycle will gradually increase while the price of agricultural water will also increase

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC