Acceptabilité des traitements psychologiques pour les femmes en postpartum souffrant d'un trouble d'anxiété généralisée

Le trouble d’anxiété généralisée (TAG) en postpartum est une problématique très prévalente et ayant des conséquences importantes pour le système familial. Malgré cela, peu d’études ont porté sur son traitement et les rares interventions étudiées présentent des limites importantes, surtout en ce qui a trait à l’initiation et à l’adhérence à celles-ci. L’attrait des traitements en période postnatale et l’adhésion à ceux-ci sont des défis répandus compte tenu des obstacles à la consultation propres à cette période. Plusieurs études multiplient les adaptations des traitements à la réalité postnatale avec des résultats souvent prometteurs. Toutefois, il devient difficile de déterminer les adaptations qui sont les plus efficaces pour favoriser la dissémination de la consultation psychologique en postpartum et la majorité des études se sont centrées uniquement sur le traitement de la dépression postnatale. Comme l’acceptabilité d’un traitement est reconnue comme favorisant l’initiation et l’adhérence à celui-ci, il pourrait s’avérer judicieux de l’étudier en postpartum afin de mieux cibler les différents aspects d’un traitement qui peuvent le rendre plus ou moins acceptable pour les nouvelles mères. La présente thèse vise donc à documenter l’acceptabilité des traitements du TAG en postpartum. Pour y parvenir, un premier article explore l’acceptabilité de la thérapie cognitive-comportementale (TCC), l’acceptabilité de différentes stratégies thérapeutiques qui la composent ainsi que leurs liens avec différentes variables sociodémographiques, liées à la consultation et cliniques jugées pertinentes. Des nouvelles mères ont lu une mise en situation les invitant à s’imaginer souffrir des symptômes du TAG et ont évalué l’acceptabilité de la TCC et des stratégies thérapeutiques proposées. La comparaison des scores totaux moyens d’acceptabilité au point médian des instruments de mesure, indiquant une acceptabilité modérée, souligne que la TCC ainsi que la majorité des stratégies thérapeutiques étudiées sont au minimum modérément acceptables. Seule l’exposition in vivo ne présente pas une acceptabilité au minimum modérée pour les nouvelles mères. Les résultats des ANOVAs à mesure répétées effectuées à partir de l’acceptabilité des stratégies de traitement et le classement des stratégies en ordre de préférence soutiennent en général l’hypothèse selon laquelle la psychoéducation, la restructuration cognitive, l’activation comportementale et la résolution de problèmes apparaissent plus acceptables que l’entraînement à l’affirmation, l’exposition cognitive, l’exposition in vivo et les devoirs. Le deuxième article étudie de manière complémentaire l’acceptabilité de diverses modalités de traitement du TAG en postpartum chez les nouvelles mères ainsi que leurs liens avec des variables sociodémographiques, liées à la consultation et cliniques. La méthode utilisée était la même que pour l’étude précédente. La combinaison des résultats des tests t pour échantillons pairés et du choix forcé en fonction de la préférence indiquent que la thérapie individuelle est plus acceptable que la thérapie de groupe. Elle souligne aussi que l’inclusion du partenaire dans la thérapie est préférée à son exclusion, bien qu’il soit anticipé qu’elle présente plus d’effets négatifs. La combinaison des résultats d’une ANOVA de Friedman réalisée à partir des scores d’acceptabilité des modalités d’administration des traitements et du classement de ces modalités par ordre de préférence souligne que la thérapie au bureau du thérapeute est la modalité la plus acceptable, suivie de la thérapie à la maison, de la téléthérapie et de l’auto-traitement. Les résultats du choix forcé par rapport à certaines modalités de traitement indiquent une préférence des nouvelles mères pour un suivi de quatre à dix rencontres avec des séances d’une heure, hebdomadaires et en matinée. Les résultats d’une ANOVA effectuée à partir de l’acceptabilité des modalités de soins au bébé pendant les rencontres indiquent que de faire garder le bébé par une personne de son choix est plus acceptable que de bénéficier d’un service de garde sur place et que l’acceptabilité de conserver le bébé avec soi pendant la rencontre ne présente pas une acceptabilité différente des deux options précédentes. Dans les deux articles, les résultats des régressions linéaires effectuées à partir des variables présentant une corrélation significative avec les indices d’acceptabilité soulignent que certaines variables sociodémographiques, liées à la consultation et cliniques permettent de prédire l’acceptabilité. Les résultats de ces articles soulèvent différentes hypothèses quant aux éléments qui peuvent expliquer les variances observées quant à l’acceptabilité. Ils soulèvent aussi différentes pistes de recherche et applications cliniques qui visent ultimement à trouver un équilibre entre acceptabilité, efficacité et accessibilité dans l’élaboration d’un traitement du TAG adapté pour les nouvelles mères

PENGARUH EKSTRAK RIMPANG TEMULAWAK (Curcuma xanthorrhiza Roxb.) TERHADAP PERKEMBANGAN EMBRIO PRAIMPLANTASI MENCIT (Mus musculus) SWISS WEBSTER

Berdasarkan hasil berbagai penelitian, temulawak (Curcuma xanthorrhiza Roxb.) dipercaya memiliki berbagai macam khasiat dan manfaat pada bidang kesehatan. Temulawak juga diketahui memiliki potensi sebagai anti proliferasi, anti implantasi dan anti fertilitas. Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak rimpang temulawak terhadap perkembangan embrio praimplantasi, terbentuknya embrio abnormal dan ukuran diameter blastokista mencit (Mus musculus) Swiss Webster. Ekstrak rimpang temulawak didapatkan melalui proses ekstraksi air. Ekstrak rimpang temulawak diberikan secara gavage setiap hari dengan dosis 0 mg/kg BB, 140 mg/kg BB, 280 mg/kg BB atau 700 mg/kg BB pada enam mencit dara untuk setiap dosisnya atau 24 ekor untuk seluruhnya. Perlakuan tidak dilakukan secara serentak, namun hanya dilakukan pada mencit yang telah ditemukan vaginal plug sekitar 1-3 ekor per harinya. Perkembangan embrio praimplantasi diamati pada usia kebuntingan ke 3,5 hari setelah dikawinkan secara alami dengan metode flushing menggunakan larutan Phosphate Buffered Saline (PBS) untuk proses koleksi embrionya. Hasil pengamatan terhadap embrio praimplantasi yang didapatkan menunjukkan terjadinya hambatan perkembangan embrio tahap blastokista pada tahap morula dan terbentuknya embrio abnormal di setiap dosisnya. Pemberian ekstrak dengan dosis 280 mg/kg BB atau 700 mg/kg BB secara signifikan (p<0,05) menurunkan jumlah embrio yang akan mencapai tahap blastokista dibandingkan dengan kontrol. Sementara itu, pemberian ekstrak rimpang temulawak dosis 700 mg/kg BB juga secara signifikan (p<0,05) meningkatkan jumlah embrio abnormal dibandingkan dengan kontrol. Selain itu, pemberian ekstrak rimpang temulawak dosis 140 mg/kg BB memiliki ukuran diameter horizontal blastokista yang lebih kecil secara signifikan (p<0,05) dibandingkan kontrol. Pemberian ekstrak dosis 140 mg/kg atau BB 280 mg/kg BB memiliki ukuran diameter vertikal blastokista yang lebih kecil secara signifikan (p<0,05) dibandingkan kontrol. Berdasarkan hasil penelitian ini, ekstrak rimpang temulawak menyebabkan terjadinya hambatan perkembangan embrio praimplantasi, terbentuknya embrio abnormal dan menyebabkan ukuran diameter blastokista lebih kecil jika dibandingkan dengan kontrol. Kata Kunci : Temulawak, Embrio Praimplantasi, Embrio Abnormal, Diameter Blastokista, Mencit. Based of many researches, Temulawak (Curcuma xanthorrhiza Roxb.) has been believed of a great advantages for human health. Temulawak is also known exhibit an effect of anti proliferation, anti implantation and anti fertility. In the present study, an attempt has been made to analyze the effects of temulawak rhizome extract in embryo preimplantation development, the abnormality and blastocyst diameter measurement of virgin mice (Mus musculus L.) Swiss Webster. Temulawak rhizome extract was extracted by aquous extraction method. The extract was given in six virgin mice for each doses or in 24 mice for all doses, these are 0 mg/ kg b.wt. (as a control), 140 mg/ kg b.wt., 280 mg/ kg b.wt. and 700 mg/ kg b.wt. which given by gavage method everyday. The treatment were doing while vaginal plug was found after natural conception, it’s about 1-3 mice in a day. The embryo preimplantation development was analyzed at the 3,5 day of pregnancy. The embryo was collected by flushing method with PBS solution. The temulawak rhizome extract was arrested the development of embryo preimplantation in each doses at morula stage. The extract was significantly (p<0,05) decreased the total number of blastocyst at 280 mg/ kg b.wt. and 700 mg/ kg b.wt. dose toward the control. The extract was significantly (p<0,05) induced the development of abnormal embryo at 700 mg/ kg b.wt. dose toward the control. In addition, the blastocyst diameter measurement at 140 mg/ kg b.wt. for horizontal diameter was significantly (p<0,05) smaller than control and at 140 mg/ kg b.wt. and 280 mg/ kg b.wt for vertical diameter too. Thus, the results in present study indicate that the temulawak rhizome extract has the effects to induce arresting of embryo preimplantation development, increasing of the total of abnormal embryo and changing of blastocyst diameter. . Keywords : Temulawak, Embryo Preimplantation, Abnormal Embryo, Blastocyst Diameter, Mice

Sustainable Product Design Education: An International Review

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2009Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2009Sanayi Devrimi’nin ardından, endüstriyel tasarımın bir meslek olarak yükselişiyle, mesleğe ilişkin tartışmalar başlamıştır. Bu süreçte çevre ve etik konulara yönelik iki ana kavram; sürdürülebilirlik ve sürdürülebilir tasarım öne çıkmıştır. Terimler çeşitlenerek kullanılsa da, hepsinin ana teması, en geniş anlamıyla “tasarım”ın, Dünyamız’a etkisi gerçeğidir. Sonuçta bugün gerçekleşen tasarım pratiği gelecekte izlenebilir küçük veya büyük izler bırakır. Sürdürülebilirliğin amacı dünyanin korunması ve tüm birey ve kurumlarin dünyaya ilişkin olumsuz etkilerinin olabilecek en azda tutulmasıdır. Burada sürdürülebilir tasarım, endüstriyel tasarımın bir meslek olarak yeniden tanımlanmasıyla, hangi ürünlerin üretileceği, nasıl üretildikleri ve kullanıldıkları üzerindeki önemli etkisiyle, kilit bir role sahiptir. Sürdürülebilir tasarım eğitimi konu olarak belirlendiğinde, sadece ürün tasarımıyla değil, birçok alanla ilişkilidir ve ele alınması için daraltılması gerekmiştir. Fakat sürdürülebilir tasarımın disiplinlerarası doğası sınırlandırmayı güçleştirmiştir. Sonuçta konunun sınırları endüstri ürünleri tasarımı geçmişi ile ulaşılabilir şekilde çizilmiştir. Bu nedenlerle konu temel olarak endüstriyel tasarım, ürün ve ürün-hizmet-sistemleri tasarımına odaklanan, “sürüdülebilir ürün tasarımı eğitimi” olarak daraltılmıştır. Tezin amacı sadece sürdürülebilir tasarımın hayatlarımızdaki önemini vurgulamak değil ayrıca eğitimin, sürdürülebilir tasarımın, hem akademik hem de profesyonel anlamda, temelini oluşturduğu gerçeğininin altını çizmektir. Araştırmada, sürdürülebilir ürün tasarımı eğitiminin net bir resmini çizebilmek için konu dört safhaya bölünmüştür. Birinci bölümde sürdürülebilir ürün tasarımı geçmişi ve gelişimi incelenirken, ikincide konunun eğitim boyutunda bugününe yoğunlaşılmış; dünyada bölüm ve ders seviyesinde eğitim veren kurumlar araştırılmıştır. Üçüncü bölümde ise birçok akademisyen ve profesyoneli kapsayan ilgili eğitimin evrimi araştırılmıştır. Son bölümde, bulgular yukarıdaki üç bölümde anlatıldıktan sonra araştırmanın değerlendirilmesi yapılmış, sürdürülebilir ürün tasarımı eğitiminin gelecek yönelimleri konu almıştır.After the industrial revolution, industrial design has started to rise as a profession; simultaneously the arguments have begun. Accordingly, two main issues have come up with regard to environmental and ethical concerns; sustainability and sustainable design. However the term is used the main concern of all is the impact of “design” among our World. In the end, the design action that occurs now has a smaller or bigger trace through the future. Hence, the purpose of sustainability is to sustain the world and keep these traces in minimum. Sustainable design, re-definition of the industrial design profession, has a key role with a huge impact on what and how is produced. Sustainable product design education includes an enormous field. Therefore, the topic is determined as sustainable product design education focusing on education for industrial design as well as product and product-service-system design. The aim of this study is not only to express the importance of sustainable design, but also articulate the reality that education creates the basis of sustainable design both academically and professionally. The research is divided into four phases to provide a clear picture of sustainable product design education. Initially, the evolution of sustainable product design and later, in the second, the present situation of sustainable product design education is researched. In the third phase, the history and evolution of the topic is explored. Consequently, the future directions of sustainable product design education and future of sustainability issues in industrial design education is discussed in the final part.Yüksek LisansM.Sc

Electric vehicles as distribution grid batteries:a reality check

Abstract The current transition towards electric mobility implies that a significant portion of electricity is drawn by and stored in the electric vehicle’s (EV) batteries. Vehicle-to-grid (V2G) technologies can potentially give distribution system operators access to such energy to provide ancillary services, while remunerating the vehicle owners for their availability to participate. Although the benefits of stabilization and grid efficiency improvements are clear, is it appealing and lucrative for the vehicle owners to participate in such services? In this work, we answer this question by modelling the V2G system and performing economic projections of the possible benefits for EV owners. In particular, we present a novel way of parametrizing the electric vehicle driving profile and the V2G energy transfer to compute battery degradation costs. A profit model is developed to evaluate the profit earned by the vehicle owners offering their batteries. The profit is estimated on the basis of the owner’s inclination to buy and sell energy from the grid based on the electricity price. Using data of the German electricity market, we estimate a profit of 662 €/EV/Year for a vehicle with 100 kWh capacity, 95% battery round trip efficiency and driving 52 km per day. The remuneration is meaningful and can have the potential to encourage EV owners to participate in V2G service

PENGARUH GLOBALISASI TERHADAP PENGGUNAAN BAHASA INDONESIA

ABSTRAK Penelitian ini merupakan penelitian kuantitatif dengan metode survei deskriptif. Penelitian ini bertujuan untuk mengetahui bahwa globalisasi mempengaruh penggunaan bahasa Indonesia. Populasi penelitian ini adalah para generasi milenial dan zilenial yang aktif menggunakan media sosial. Dalam pengambilan sampel menggunakan non-probability sampling, dengan teknik quota sampling yang merupakan sebuah teknik pengambilan sampel dari sebuah populasi hingga memenuhi jumlah kuota yang diinginkan. Adapun beberapa kriteria dalam pengambilan sampel dalam penelitian ini adalah; a) Remaja dengan rentang usia 15-27 tahun; b) aktif menggunakan&nbsp; media sosial; c) pernah berinteraksi dengan warga negara asing. Hasil penelitian menunjukkan bahwa adanya globalisasi mempenggaruh penggunaan bahasa Indonesia pada kalangan generasi milenial dan zilenial. Berdasarkan diagram batang penggunaan bahasa Indonesia yang baik dan benar, nilai rata-rata keseluruhan dari 50 responden adalah 52,6, dengan nilai median (nilai yang sering muncul) adalah 50. Selain itu, berdasarkan data diagram batang minat bahasa yang digunakan dan dipelajari oleh generasi milenial, mayoritas sangat minat mempelajari dan menggunakan bahasa Inggris dan bahasa asing daripada bahasa Indonesia. Hal ini dapat diartikan bahwa di era globalisasi 4.0, eksistensi bahasa Indonesia di kalangan generasi milenial dan zilenial menggalami penurunan. Kata kunci: Globalisasi, Dampak Perkembang, Teknologi Komunikasi, Bahasa. ABSTRACT This research is a quantitative study with a descriptive survey method. This research aims to find out that globalization influences the use of Indonesian. The population of this research are millennials and zilenials who are actively using social media. In the sample sampling using a non-sampling technique that is a sample sampling technique from a population to meet the desired quota. As for some criteria in this research sampling are; A) teenagers with a span of 15-27 years; B) actively using social media; C) have interacted with foreign nationals. The result of the research indicates hat globalization has cultivated the use of Indonesian among millennials and zilenial generations. Based on the correct and proper English usage bar diagram, the overall average of 50 respondents is 52.6, with the median (often established value) is 50. Furthermore, based on the data of the foreign-language tool-interest diagram used and studied by the millennials, the vast majority were interested in learning and using English and foreign languages rather than Indonesian. It can be argued that in the age of globalization 4.0, the existence of the Indonesian language among millennials and zilenial generations has been spawned a decline. Keyword: Globalization, Impact of Development, Communication Technology, Language. &nbsp; &nbsp

ANALISIS BIAYA STANDAR UNTUK PENGENDALIAN BIAYA PRODUKSI PADA CV MAHAKARYA EXPORT

PUTRI ANISA MALYA, NIM: 1908205126, “ANALISIS BIAYA STANDAR UNTUK PENGENDALIAN BIAYA PRODUKSI PADA CV MAHAKARYA EXPORT”,2023 CV. Mahakarya Export merupakan perusahaan manufaktur yang memproduksi furniture rotan.Namun, CV. Mahakarya Export ini hanya memproduksi ketika ada pesananan. Tujuan penelitian ini yaitu untuk menganalisis penerapan biaya standar sebagai pengendalian biaya produksi pada CV. Mahakarya Export Majalengka dan menyesuaikan biaya standar CV. Mahakarya Export dengan menggunakan metode satu selisih. Penelitian ini merupakan penelitian kualitatif deskriptif dengan menggunakan data biaya produksi sesungguhnya dan biaya produksi standar dengan perhitungan analisis penyimpangan model dua selisih. Teknik pengumpulan data dengan observasi, wawancara dan dokumentasi. Wawancara dilakukan dengan tiga subjek yaitu bagian keuangan, bagian administrasi dan bagian produksi CV. Mahakarya Export serta di dukung dengan 2 informan yaitu karyawan CV. Mahakarya Export Pengabsahan data yang digunakan adalah triangulasi sumber dan metode. Analisis data yang digunakan yaitu pengumpulan data, reduksi data, penyajian data, dan menarik kesimpulan. Hasil penelitian ini menunjukkan bahwa penerapan biaya standar pada CV. Mahakarya Export mengalami selisih bahan baku menguntungkan sebesar Rp.24.695.000. Pada biaya tenaga kerja langsung dan biaya overhead pabrik tidak mengalami penyimpangan ini dikarenakan CV. Mahakarya Export masih melakukan pencatatan di waktu lalu. Kata Kunci: Biaya produksi, biaya standar, dan selisih

Tackling the grassroots: appraisal of career choice and prospects of the students at a medical school in Tanzania

Tanzania has one of the world’s worst doctor-to-population ratio. Ironically, the number of medical graduates who do not practice medicine remains very high. Lack of interest and commitment of the young doctors may greatly contribute to the huge number of non-practicing doctors. We assessed medical students’ career views from interest and choice during childhood, their current learning motivations, future career expectations and interest to work in the academia. One hundred and ninetyfive students halfway their first year of medical school complete a self-administered questionnaire with a verbal consent sought from each respondent. Four in every ten students had made their decision to become a doctor before or during primary school. Over 5 out of 10 students made their choice during secondary school. Majority chose medicine due to altruistic and humanity reasons and would prefer work in clinical practice in the hospital. Very few would prefer a faculty job. Knowing about the human body, controlling and managing diseases are the main motivating factors. ‘Too much to learn’ and ‘tight schedules’ were the most aspect and deterrent factors during the medical school and the medical profession in general. Attaining a higher academic honour such as a professorship would not inspire students into the academia. Majority of students make their medical career choice early in life driven by altruistic reasons. Poor learning environments disenchant them from the passion for the career. More studies are needed to assess and improve the training in medicine.Keywords: Medical students, motivation, career prospects, Tanzani

Jejunogastric Intussusception: A Rare Complication of Gastric Surgery

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of Billroth II operation diagnosed by computed tomography. At emergent laparotomy, an efferent loop type JGI was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful

Practice and Prevalence of Antibiotic Self-Medication among Undergraduate Students at Kilimanjaro Christian Medical University College, Tanzania

Background: Antibiotic self-medication has been on the rise in different parts of the world. Antibiotic self-medication causes excessive antibiotic exposure to humans which is associated with many health risks including antibiotic resistance. The objective of this study was to assess practice and determine the prevalence of antibiotic self-medication among undergraduate students.Methodology: This was a descriptive cross-sectional study conducted at Kilimanjaro Christian Medical University College. A self-administered questionnaire was used to assess the practice and knowledge of antibiotic self-medication among undergraduate students. A total of 300 undergraduate students were purposively sampled. The association between categorical predictors and antibiotic self-medication waspresented as Odds Ratios (OR) with 95% Confidence Intervals (95% CIs) using logistic regression.Result: The prevalence of antibiotic self-medication among undergraduate students is 191(63.7%) with amoxicillin 103(53.9%) being the most used antibiotic for treatment of respiratory disorders 109(57.1%) and gastrointestinal disorders 50(26.2%). Pharmacy is the major source of antibiotics used for self-medication 165(86.4%). Delayed/queue in seeking hospitals services was the main reason for practicing antibiotic self-medication 74(38.7%).Conclusion: The study observed a high prevalence of antibiotic self-medication among undergraduate students. This calls for immediate implementation of public health programs aimed at increasing awareness of consequences that may results from antibiotic self-medication. At the policy-making level, there is an urgent need to legislate and enforce laws restricting access to antibiotics in Tanzania

EDUKASI KESEHATAN REPRODUKSI TERPADU DALAM PROGRAM PEMBERDAYAAN MASYARAKAT BERBASIS MASJID DI KOTA YOGYAKARTA

Telah dilakukan usaha pemberdayaan masyarakat dalam bentuk edukasi kesehatan reproduksi (KR) padakelompok dewasa dan lansia oleh Tim Pelaksana di RW 6, Cokrodiningratan, Yogyakarta. Tujuan dari programpemberdayaan adalah meningkatkan pengetahuan, kesadaran dan ketrampilan berperilaku sesuai KR yang baikpada masyarakat kelompok sasaran. Pelaksanaan program pemberdayaan dilakukan selama 2 bulan. Sebagaipusat aktivitas program pemberdayaan berlokasi di Masjid Nurul Iman Jetisharjo. Aktivitas pemberdayaanmenggunakan beberapa pendekatan sesuai target. Tim Pelaksana pemberdayaan adalah dosen bersamamahasiswa yang telah mendapatkan pelatihan dan modul materi pemberdayaan. Tahapan pelaksanaan programpemberdayaan adalah persiapan, perencanaan dan pelaksanaan. Telah dilakukan 6 kegiatan edukasi KR.Ceramah umum dalam rangka Maulid Nabi Muhammad SAW berisi tentang pola asuh anak berdasar jeniskelamin dan peran keluarga sebagai sarana pencegahan penyimpangan perilaku seksual. Kegiatan sapa anakkost telah digunakan untuk melakukan penyuluhan kelompok tentangKR bagi para warga kost. Kegiatanpelatihan berbasis kasus, role play serta cerdas cermat sebagai upaya meningkatkan pengetahuan danketrampilan pencegahan kekerasan seksual. Penyuluhan pada kegiatan senam lansia tentang pencegahanosteoporosis. Berdasarkan serangkaian program edukasi KR ini telah menumbuhkan kesadaran tentangpentingnya edukasi KR secara benar, pentingnya agama dan masjid sebagai basis pencegahan perilaku seksualmenyimpang