ROLE OF COMMUNITY PHARMACIST AND NUTRITIONISTS IN OBESITY MANAGEMENT: A LITERATURE REVIEW

The idea of engaging community pharmacists and nutritionists in weight management services has been well accepted by the community, as both can help to improve behavior and knowledge regarding obesity among obese patients. The aim of this study is to summarize research findings from developed and developing countries as well as from Pakistan regarding role of community pharmacists and nutritionists in obesity management. A total of 38 studies were reviewed regarding trends in obesity management. The review concluded that the role of community pharmacists and nutritionists in obesity management is not well acknowledged in most of the developing countries including Pakistan. Limited data are available on a number of nutritionists and type of services provided by them for weight management in these countries. There is urgent need to identify the barriers and gaps to further enhance the effectiveness of obesity management. Beside this intervention studies involving multi-disciplinary health- care professionals must be designed to control current obesity crisis worldwide.Keywords: Community pharmacists, Counseling, Nutritionists, Obesity, Weight management program

A Short Review on Renewable Energy in the Asia Pacific

The Asia Pacific energy consumption in 2018 has increased by 37.5% from 4077 to 5606 Mtoe since 2008. Four countries make up 80% of the Asia Pacific primary energy consumption. China 54.7%, India 13.5%, Japan 7.6% and South Korea 5.0%. At a rate of -0.2% per annum and -12.3% per decade, Japan is the only country in the Asia Pacific, reducing its energy consumption. Each country has a different mix of (economic-dependent) sources. China & Indonesia have major coal mix, Thailand has a major natural gas mix, while Japan & Malaysia have balance coal and natural gas mix. Renewable energy mix in the Asia Pacific countries has an average of 14.3%, with China the highest and South Korea & Taiwan the lowest. To strategically reaching each RE target, individual country should consider the Levelized Cost of Energy (LCOE) which economically assess the average total cost to build and operate a power-generating asset over its lifetime divided by the total energy output of the asset over that lifetime

Elucidating the role of mTOR complexes (mTORC1 and mTORC2) in normal haemopoiesis and in Chronic Lymphocytic Leukaemia

Mechanistic target of rapamycin (mTOR) functions within a complex signalling cascade, through its activity in two unique complexes mTORC1 and mTORC2, to promote a multitude of different cellular functions including autophagy, protein synthesis and survival. The exact role of these complexes during leukaemia initiation/maintenance remains to be elucidated. Here, using transgenic knockout (KO) mouse models, we determine the individual roles of mTORC1 (targeting Raptor) and mTORC2 (targeting Rictor) in normal haemopoiesis and in CLL initiation/maintenance. Our results demonstrate that mice carrying a targeted KO of Raptor at the haemopoietic stem cell (HSC) stage (Vav-Raptor KO) do not survive post birth. This is due to anaemia resulting from a significant decrease in Ter119+ population, a significant decrease in Klf1 and Klf2 gene expression, and a significant increase in the megakaryocyte-erythroid progenitor (MEP) population, suggesting a block at the MEP stage in Vav-Raptor KO foetal liver (FL). While mTORC1 plays a fundamental role in RBC development, we show that mTORC2 plays a potential role in RBC regulation, as Rictor-deficient HSPCs exhibit an increase in RBC colony formation ex vivo. Conditional KO (cKO) of Raptor (Mx1-Raptor cKO) in adult mice results in splenomegaly accompanied by increased spleen organ cellularity. Furthermore, there is a significant decrease in B cell lineage commitment, with a block in B cell development at the Lin-Sca-1+CD117+ (LSK) stage in the BM. mTORC2, on the other hand regulates late B cell maintenance as indicated by a significant decrease in transitional B cells (T1/T2), marginal zone progenitor (MZP), and follicular 1 (fol1) cells in Vav-Rictor KO mice compared to controls. To address the role of mTORC1 and mTORC2 in CLL initiation/maintenance in vitro, BM-derived haemopoietic progenitor cells (HPCs) isolated from control (cre-), Raptor-deficient (Mx1-Raptor cKO) or Rictor-deficient (Vav-Rictor KO) mice were retrovirally-transduced with a kinase dead PKCα (PKCαKR) construct to induce an aggressive CLL-like disease. Raptor-deficient BM progenitors exhibited reduced proliferation and failed to generate a CLL-like disease, due to a block in B cell lineage commitment in vitro. However, there was an increase in cell cycling and migration in PKCαKR CLL-like cells with Rictor-deficiency suggesting a role of mTORC2 in disease maintenance. To determine a role for mTORC1 in disease maintenance in vivo, NSG mice were transplanted with Mx1-Raptor control or Mx1-Raptor cKO PKCαKR transduced BM cells. Once disease was established in vivo, cKO was induced and disease load and progression was monitored. Our data demonstrate a decrease in disease load with Raptor cKO, together with a significant increase in survival. Additionally, host mice transplanted with CD19-Raptor KO PKCαKR cells exhibited a significant increase in survival. However, these mice eventually died of disease due to limitations of the KO model. Lastly, to test the translational capacity of mTOR inhibitors, efficiency of AZD2014 (dual mTOR inhibitor), ibrutinib and a combination of the two drugs was assessed in reducing PKCαKR CLL-like disease load in host mice. AZD2014 was as efficient at reducing disease load as ibrutinib, however combination therapy of these drugs was not as efficient compared to single agents. Interestingly, we demonstrate that a more aggressive PKCαKR CLL-like disease (in secondary transplants) is more mTORC1 dependent than in primary transplants, as indicated by the superiority of rapamycin (allosteric mTORC1 inhibitor) in markedly decreasing disease load as compared to AZD2014 in host mice. Taken together, mTORC1 plays an essential role in haemopoiesis, with Raptor-deficiency causing a block in RBC and B cell development at the MEP and LSK stage respectively. In comparison, Rictor-deficiency regulates later B cell lineages and promotes RBC colony formation, potentially through mTORC1 activation. Importantly, CLL-like cells lacking mTORC2 have increased cell cycling and migration whereas mTORC1 deficiency causes a decrease in disease load. Therefore, mTORC1 and mTORC2 play distinct/complementary roles in haemopoietic development and leukaemia initiation/progression. These studies provide a strong foundation for further studies testing novel mTOR inhibitors for CLL in our models

The role of mTOR-mediated signals during haemopoiesis and lineage commitment

The serine/threonine protein kinase mechanistic target of rapamycin (mTOR) has been implicated in the regulation of an array of cellular functions including protein and lipid synthesis, proliferation, cell size and survival. Here, we describe the role of mTOR during haemopoiesis within the context of mTORC1 and mTORC2, the distinct complexes in which it functions. The use of conditional transgenic mouse models specifically targeting individual mTOR signalling components, together with selective inhibitors, have generated a significant body of research emphasising the critical roles played by mTOR, and individual mTOR complexes, in haemopoietic lineage commitment and development. This review will describe the profound role of mTOR in embryogenesis and haemopoiesis, underscoring the importance of mTORC1 at the early stages of haemopoietic cell development, through modulation of stem cell potentiation and self-renewal, and erythroid and B cell lineage commitment. Furthermore, the relatively discrete role of mTORC2 in haemopoiesis will be explored during T cell development and B cell maturation. Collectively, this review aims to highlight the functional diversity of mTOR signalling and underline the importance of this pathway in haemopoiesis

Simulation of vortex induced vibration of a bluff body structure

Understanding Vortex induced vibration (VIV) phenomenon is essential as it plays important role in designing marine risers which used in oil extraction from the seabed to the offshore platforms were exposed to external flows that may trigger dangerous VIV oscillations. The present two-dimensional numerical simulations of circular bluff body is a continuation of previous efforts trying to study the effect of frequency and amplitudes of the cylinder oscillation that is confined in the cross-flow and inline flow separately. The k-ε turbulence model is used to simulate the turbulent flow to evaluate the drag and lift coefficient of circular towards the flow characteristics which used time independent test (transient) and tested at different Reynolds number between 10000 and 100000 with uniform velocities of 1.35m/s and 13.5m/s. Results from dynamic response of a cylinder bluff body vibrating at frequencies variation of 1.48 Hz, 2.77 Hz and 3 Hz within 0.3m, 0.5m and 0.7m amplitudes variation were observed in this study. It is shown that for inline flow, the vibration at 0.3m amplitude is significantly low for drag and lift coefficient value for Re at 100000 compared to Re at10000. Meanwhile for the cross flow value it is observed that gives high percentages with 39% of drag coefficient and with 59% of lift coefficient compare to inline flow at high amplitude. However at low mode amplitude the cross flow contributes more with 19% of drag coefficient and 11% for lift coefficient compare to inline flow. The result also show that the cylinder oscillate higher at frequency shedding value with higher magnitude for the cross flow compare to the inline flow. Consequently, in order to get better performance, the vortex modes in the wake of oscillating cylinder have been found to be dependent on the amplitude distribution along the length of the model. The results concludes that in order to avoid inevitable vibration it is advisable by increasing damping or splitter when designing marine riser to generate more stable vortex shedding frequency

Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration

OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety.OBJETIVO Identificar percepciones de los liderazgos acerca de las dimensiones de la cultura de seguridad del paciente en el cotidiano de hospitales de distintos perfiles administrativos: públicos, organizaciones sociales y privados, y realizar la correlación entre las instituciones participantes, de acuerdo con las dimensiones de la cultura de seguridad del paciente utilizadas. MÉTODO Estudio transversal de aspecto cuantitativo obtenido por medio de la aplicación del instrumento Self Assessment Questionnaire 30, traducido a la lengua portuguesa. Los datos fueron tratados con análisis de varianza (ANOVA), además de las estadísticas descriptivas, considerando como de significación estadística valores de p-valor ≤ 0,05. RESULTADOS Según la percepción de los participantes del estudio, las dimensiones significativas para la cultura de seguridad del paciente fueron Ambiente de Seguridad del Paciente y Aprendizaje Organizativo, con poder explicativo del 81%. El promedio de respuestas obtenidas evidenció que en las organizaciones privadas hubo mayores valores atribuidos a las cuestiones, sin embargo la correlación entre las dimensiones fue más fuerte en las organizaciones públicas. CONCLUSIÓN Las dimensiones de la cultura de seguridad del paciente tienen valores distintos en las diferentes organizaciones hospitalarias y su investigación posibilita identificar cuáles necesitan introducirse o perfeccionarse para una mayor seguridad del paciente.OBJETIVO Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. MÉTODO Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. RESULTADOS Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de Segurança do Paciente e Aprendizado Organizacional, com poder explicativo de 81%. A média de respostas obtidas evidenciou que nas organizações privadas houve maiores valores atribuídos às questões, porém a correlação entre as dimensões foi mais forte nas organizações públicas. CONCLUSÃO As dimensões da cultura de segurança do paciente têm valores distintos nas diferentes organizações hospitalares e a sua investigação possibilita identificar quais necessitam ser introduzidas ou aprimoradas para maior segurança do paciente

Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration

OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety.OBJETIVO Identificar percepciones de los liderazgos acerca de las dimensiones de la cultura de seguridad del paciente en el cotidiano de hospitales de distintos perfiles administrativos: públicos, organizaciones sociales y privados, y realizar la correlación entre las instituciones participantes, de acuerdo con las dimensiones de la cultura de seguridad del paciente utilizadas. MÉTODO Estudio transversal de aspecto cuantitativo obtenido por medio de la aplicación del instrumento Self Assessment Questionnaire 30, traducido a la lengua portuguesa. Los datos fueron tratados con análisis de varianza (ANOVA), además de las estadísticas descriptivas, considerando como de significación estadística valores de p-valor ≤ 0,05. RESULTADOS Según la percepción de los participantes del estudio, las dimensiones significativas para la cultura de seguridad del paciente fueron Ambiente de Seguridad del Paciente y Aprendizaje Organizativo, con poder explicativo del 81%. El promedio de respuestas obtenidas evidenció que en las organizaciones privadas hubo mayores valores atribuidos a las cuestiones, sin embargo la correlación entre las dimensiones fue más fuerte en las organizaciones públicas. CONCLUSIÓN Las dimensiones de la cultura de seguridad del paciente tienen valores distintos en las diferentes organizaciones hospitalarias y su investigación posibilita identificar cuáles necesitan introducirse o perfeccionarse para una mayor seguridad del paciente.OBJETIVO Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. MÉTODO Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. RESULTADOS Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de Segurança do Paciente e Aprendizado Organizacional, com poder explicativo de 81%. A média de respostas obtidas evidenciou que nas organizações privadas houve maiores valores atribuídos às questões, porém a correlação entre as dimensões foi mais forte nas organizações públicas. CONCLUSÃO As dimensões da cultura de segurança do paciente têm valores distintos nas diferentes organizações hospitalares e a sua investigação possibilita identificar quais necessitam ser introduzidas ou aprimoradas para maior segurança do paciente

Patient safety in organizational culture as perceived by leaderships of hospital institutions with different types of administration

OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety.OBJETIVO Identificar percepciones de los liderazgos acerca de las dimensiones de la cultura de seguridad del paciente en el cotidiano de hospitales de distintos perfiles administrativos: públicos, organizaciones sociales y privados, y realizar la correlación entre las instituciones participantes, de acuerdo con las dimensiones de la cultura de seguridad del paciente utilizadas. MÉTODO Estudio transversal de aspecto cuantitativo obtenido por medio de la aplicación del instrumento Self Assessment Questionnaire 30, traducido a la lengua portuguesa. Los datos fueron tratados con análisis de varianza (ANOVA), además de las estadísticas descriptivas, considerando como de significación estadística valores de p-valor ≤ 0,05. RESULTADOS Según la percepción de los participantes del estudio, las dimensiones significativas para la cultura de seguridad del paciente fueron Ambiente de Seguridad del Paciente y Aprendizaje Organizativo, con poder explicativo del 81%. El promedio de respuestas obtenidas evidenció que en las organizaciones privadas hubo mayores valores atribuidos a las cuestiones, sin embargo la correlación entre las dimensiones fue más fuerte en las organizaciones públicas. CONCLUSIÓN Las dimensiones de la cultura de seguridad del paciente tienen valores distintos en las diferentes organizaciones hospitalarias y su investigación posibilita identificar cuáles necesitan introducirse o perfeccionarse para una mayor seguridad del paciente.OBJETIVO Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. MÉTODO Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. RESULTADOS Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de Segurança do Paciente e Aprendizado Organizacional, com poder explicativo de 81%. A média de respostas obtidas evidenciou que nas organizações privadas houve maiores valores atribuídos às questões, porém a correlação entre as dimensões foi mais forte nas organizações públicas. CONCLUSÃO As dimensões da cultura de segurança do paciente têm valores distintos nas diferentes organizações hospitalares e a sua investigação possibilita identificar quais necessitam ser introduzidas ou aprimoradas para maior segurança do paciente

Pemberdayaan Pelaku Ekonomi Sektor Melalui Peningkatan Pemahaman Konsep Wisata Syariah

The purpose of this dedication is to improve the understanding of the concept of sharia tourism for economic actors in the tourism sector, to improve services and to increase the income for economic actors in the tourism sector in Rokan Hulu regency, Riau province. The subject of this dedication is the economic actors in the tourism sector in the Great Islamic Center mosque in Rokan Hulu district. While the object is to increase the understanding of Islamic tourism. Empowerment methods are Participatory Learning and Action (PLA) Models, or Participatory Learning and Practical Processes by holding beginning and Final Competency Tests. Based on the results of dedication, it can be concluded that the knowledge and understanding of economic actors in the tourism sector at the Islamic Grand Mosque of Rokan Hulu district about the concept of sharia tourism is increased.  Tujuan pengabdian ini adalah meningkatkan pemahaman konsep wisata syariah bagi pelaku ekonomi sektor pariwisata, meningkatkan pelayanan di sektor pariwisata dan meningkatkan pendapatan bagi para pelaku ekonomi di sektor pariwisata di kabupaten Rokan Hulu provinsi Riau. Adapun subjek dari pengabdian ini adalah para pelaku ekonomi sektor pariwisata yang ada di mesjid Agung Islamic Centre kabupaten Rokan Hulu. Sedangkan Objeknya adalah peningkatan pemahaman tentang pariwisata syariah. Metode pemberdayaan adalah Model Pemberdayaan PLA (Participatory Learning and Action), atau Proses Belajar dan Praktek Secara Partisipatif dengan mengadakan Uji Kompetensi Awal dan akhir. Bedasarkan hasil pengabdian dapat disimpulkan bahwa Pengetahuan dan pemahaman pelaku ekonomi sektor pariwisata di Mesjid Agung Islamic centre kabupaten Rokan Hulu tentang konsep wisata syariah menjadi meningkat.   Kata Kunci : Pemberdayan, Pemahaman, Pelaku ekonomi, pariwisata syaria

mTORC1 activity is essential for erythropoiesis and B cell lineage commitment

Mechanistic target of rapamycin (mTOR) is a serine/threonine protein kinase that mediates phosphoinositide-3-kinase (PI3K)/AKT signalling. This pathway is involved in a plethora of cellular functions including protein and lipid synthesis, cell migration, cell proliferation and apoptosis. In this study, we proposed to delineate the role of mTORC1 in haemopoietic lineage commitment using knock out (KO) mouse and cell line models. Mx1-cre and Vav-cre expression systems were used to specifically target Raptorfl/fl (mTORC1), either in all tissues upon poly(I:C) inoculation, or specifically in haemopoietic stem cells, respectively. Assessment of the role of mTORC1 during the early stages of development in Vav-cre+Raptorfl/fl mice, revealed that these mice do not survive post birth due to aberrations in erythropoiesis resulting from an arrest in development at the megakaryocyte-erythrocyte progenitor stage. Furthermore, Raptor-deficient mice exhibited a block in B cell lineage commitment. The essential role of Raptor (mTORC1) in erythrocyte and B lineage commitment was confirmed in adult Mx1-cre+Raptorfl/fl mice upon cre-recombinase induction. These studies were supported by results showing that the expression of key lineage commitment regulators, GATA1, GATA2 and PAX5 were dysregulated in the absence of mTORC1-mediated signals. The regulatory role of mTOR during erythropoiesis was confirmed in vitro by demonstrating a reduction of K562 cell differentiation towards RBCs in the presence of established mTOR inhibitors. While mTORC1 plays a fundamental role in promoting RBC development, we showed that mTORC2 has an opposing role, as Rictor-deficient progenitor cells exhibited an elevation in RBC colony formation ex vivo. Collectively, our data demonstrate a critical role played by mTORC1 in regulating the haemopoietic cell lineage commitment