Faktor-faktor yang Memengaruhi Anggota Organisasi Kepemudaan Alumni Budi Mulia (Album-medan) terhadap Donor Darah di Pmi Medan Tahun 2012

Many factor affecting the members of youth organizations Budi Mulia (Album- Medan) to donate blood in medan red cross 2012. The importance of the availability of blood is to meet the need for blood transfusions that could occur anytime such as for accident victims, cesarean section and for patients with blood diseases such as hemophilia and thalassemia. Therefore, it is very important to know what are the factors that could affect members of youth organization such as ALBUM-Medan to donate their blood. The purpose of this study was aimed to determine the factors that affect members of youth organization ALBUM-Medan to donate blood. The factors were characteristics, sources of information, knowledge, social capital, attitude, reference groups, intentions and actions of members of youth organization ALBUM-Medan to donate blood at Medan Red Cross in 2012. This research used descriptive quantitative. The number of respondents in this study amounted to 62 people with total sampling as the sampling technique, where the respondent was a person who members of youth organizations ALBUM-Medan that register in 2009-2011. The results are presented in frequency distribution table. This is the result of the research, 33,9 % is 18th years old, 59,7% is male. The catagorized of youth's sources of information is medium or 71,0%. The catagorized of youth's knowledge is medium or 67,7%. And for the catagorized of the social capital is medium or 50,0%. The attitude of the responden considered good or 88,7%. The intention of the respondents considered good or 67,7% and for the youth's action considered bad or 88,7%

Faktor-faktor yang Mempengaruhi Perilaku Ibu Nifas dalam Mengkonsumsi Tuo Nifarö di Kecamatan Lotu Kabupaten Nias Utara

Tuo nifarö istypicalofNiasdrink that contains alcohol that resulted from distillation of cocoa. Tuo nifarö can be utilizedfor many purposes, one of them usedfor post-partum period treatment. The aim of this research is to knowing the determinant of post-partum mother's behavior who consumedtuonfaroin Lotu, District of North Nias. This kind of researchis descriptivequantitative andqualitative approachto completethe required datawith a sample of 52 people. The resultsof research onthe characteristics ofrespondents,59.6% were25-35years and61.5% of respondentshavea loweducation level. 61.5% of post-partummothers have the moderate trust levelson benefit ofconsumingtuo nifarö. In terms ofnormativebelief, theconsumptionof alcoholic beveragessuch astuo nifarö for post-partum mothers is affected bythe role offamiliesand communitiesthatinfluence the post-partum mothersto act. Attitudetowardconsumption of tuo nifarö 53.8% wereatmoderatelevels. In terms ofaction, 55.8% of respondentsconsumealcoholic beveragespostpartum, where82.8% had a loweducational level, 48.3% have the confidenceandgood judgment, and 58.6% at a moderate level, 100% supportedbyfamiliesand89.7% are supportedby the community. 72.4% of respondentshadconsumedblack beer as a substitutefor various reasons. This occasion should be maintained with regard to alcohol content, and health workers need to explore the benefits of taking tuo nifar

Family Support and its Association with The Risk of Lung Tuberculosis in Subulussalam, Aceh

Background: Tuberculosis (TB) remains a major public health problem in developing countries. This study aimed to examine the association between family support and the risk of lung TB in Subulussalam, Aceh. Subjects and Method: This was a cross sectional study conducted at Pus¬kes-mas (Community Health Center) Penanggalan in Subulussalam, Aceh. A sample of 30 patients was selected for this study. The dependent variable was lung TB. The independent variables were family support, sex, and knowledge. Data on tuberculosis diagnosis status was obtained from the medical record. The other data we¬re collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: The risk of lung TB was positively associated with weak family support (OR= 4.28; 95% CI= 2.15 to 6.60; p= 0.027), after adjusting for the effects of sex and knowledge. Conclusion: The risk of lung TB is positively associated with weak family sup-port after adjusting for the effects of sex and knowledge. Keywords: lung tuberculosis, family support, sex, knowledge

Consensus-based care recommendations for adults with myotonic dystrophy type 1

Purpose of review Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects between 1 in 3,000 and 8,000 individuals globally. No evidence-based guideline exists to inform the care of these patients, and most do not have access to multidisciplinary care centers staffed by experienced professionals, creating a clinical care deficit. Recent findings The Myotonic Dystrophy Foundation (MDF) recruited 66 international clinicians experienced in DM1 patient care to develop consensus-based care recommendations. MDF created a 2-step methodology for the project using elements of the Single Text Procedure and the Nominal Group Technique. The process generated a 4-page Quick Reference Guide and a comprehensive, 55-page document that provides clinical care recommendations for 19 discrete body systems and/or care considerations. Summary The resulting recommendations are intended to help standardize and elevate care for this patient population and reduce variability in clinical trial and study environments. Described as “one of the more variable diseases found in medicine,” myotonic dystrophy type 1 (DM1) is an autosomal dominant, triplet-repeat expansion disorder that affects somewhere between 1:3,000 and 1:8,000 individuals worldwide.1 There is a modest association between increased repeat expansion and disease severity, as evidenced by the average age of onset and overall morbidity of the condition. An expansion of over 35 repeats typically indicates an unstable and expanding mutation. An expansion of 50 repeats or higher is consistent with a diagnosis of DM1. DM1 is a multisystem and heterogeneous disease characterized by distal weakness, atrophy, and myotonia, as well as symptoms in the heart, brain, gastrointestinal tract, endocrine, and respiratory systems. Symptoms may occur at any age. The severity of the condition varies widely among affected individuals, even among members of the same family. Comprehensive evidence-based guidelines do not currently exist to guide the treatment of DM1 patients. As a result, the international patient community reports varied levels of care and care quality, and difficulty accessing care adequate to manage their symptoms, unless they have access to multidisciplinary neuromuscular clinics. Consensus-based care recommendations can help standardize and improve the quality of care received by DM1 patients and assist clinicians who may not be familiar with the significant variability, range of symptoms, and severity of the disease. Care recommendations can also improve the landscape for clinical trial success by eliminating some of the inconsistencies in patient care to allow more accurate understanding of the benefit of potential therapies

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches

Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations

Crop pests and predators exhibit inconsistent responses to surrounding landscape composition

The idea that noncrop habitat enhances pest control and represents a win–win opportunity to conserve biodiversity and bolster yields has emerged as an agroecological paradigm. However, while noncrop habitat in landscapes surrounding farms sometimes benefits pest predators, natural enemy responses remain heterogeneous across studies and effects on pests are inconclusive. The observed heterogeneity in species responses to noncrop habitat may be biological in origin or could result from variation in how habitat and biocontrol are measured. Here, we use a pest-control database encompassing 132 studies and 6,759 sites worldwide to model natural enemy and pest abundances, predation rates, and crop damage as a function of landscape composition. Our results showed that although landscape composition explained significant variation within studies, pest and enemy abundances, predation rates, crop damage, and yields each exhibited different responses across studies, sometimes increasing and sometimes decreasing in landscapes with more noncrop habitat but overall showing no consistent trend. Thus, models that used landscape-composition variables to predict pest-control dynamics demonstrated little potential to explain variation across studies, though prediction did improve when comparing studies with similar crop and landscape features. Overall, our work shows that surrounding noncrop habitat does not consistently improve pest management, meaning habitat conservation may bolster production in some systems and depress yields in others. Future efforts to develop tools that inform farmers when habitat conservation truly represents a win–win would benefit from increased understanding of how landscape effects are modulated by local farm management and the biology of pests and their enemies

Source patterns of potentially toxic elements (PTEs) and mining activity contamination level in soils of Taltal city (northern Chile)

Mining activities are among the main sources of potentially toxic elements (PTEs) in the environment which constitute a real concern worldwide, especially in developing countries. These activities have been carried out for more than a century in Chile, South America, where, as evidence of incorrect waste disposal practices, several abandoned mining waste deposits were left behind. This study aimed to understand multi-elements geochemistry, source patterns and mobility of PTEs in soils of the Taltal urban area (northern Chile). Topsoil samples (n = 125) were collected in the urban area of Taltal city (6 km2) where physicochemical properties (redox potential, electric conductivity and pH) as well as chemical concentrations for 35 elements were determined by inductively coupled plasma optical emission spectrometer. Data were treated following a robust workflow, which included factor analysis (based on ilr-transformed data), a new robust compositional contamination index (RCCI), and fractal/multi-fractal interpolation in GIS environment. This approach allowed to generate significant elemental associations, identifying pool of elements related either to the geological background, pedogenic processes accompanying soil formation or to anthropogenic activities. In particular, the study eventually focused on a pool of 6 PTEs (As, Cd, Cr, Cu, Pb, and Zn), their spatial distribution in the Taltal city, and the potential sources and mechanisms controlling their concentrations. Results showed generally low baseline values of PTEs in most sites of the surveyed area. On a smaller number of sites, however, higher values concentrations of As, Cd, Cu, Zn and Pb were found. These corresponded to very high RCCI contamination level and were correlated to potential anthropogenic sources, such as the abandoned mining waste deposits in the north-eastern part of the Taltal city. This study highlighted new and significant insight on the contamination levels of Taltal city, and its links with anthropogenic activities. Further research is considered to be crucial to extend this assessment to the entire region. This would provide a comprehensive overview and vital information for the development of intervention limits and guide environmental legislation for these pollutants in Chilean soils

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead