Hambatan dalam Implementasi Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) di Kabupaten Badung

The family-centered safe birthing initiative (P4K) is aimed to reduce maternal and newborn mortality rates. The P4K program involves the distribution of promotional stickers by community health care workers. In 2011, the coverage of the P4K had reached 100% of villages, and 98.9% of expectant mothers had attached the promotional sticker on a visible section of their homes. However, the process is reported not implemented using standard procedures before placing the sticker on their homes. This study is aimed to explore the barriers to the implementation of P4K in Badung. This study was descriptive qualitative using phenomenology approach. Data were collected using focus group discussion (FGD) with 20 midwives and 10 cadres, in-depth interviews (with 6 expectant mothers and 3 husbands/family members) and participant observation of P4K implementation in community health centers. Secondary data was obtained through relevant P4K document analysis. Informants were purposively selected using the criteria of 1) midwives already trained in P4K, 2) cadres already trained in P4K and 3) P4K participating expectant mothers. Research findings indicate that knowledge, attitude and mother's and husband's behaviour impact negatively upon program implementation. There is also an evident of lack of logistical support including: P4K administrational forms, IEC pamphlets and transportation costs. Midwives and participating healthcare providers were having a very good knowledge; however, their behaviour does not demonstrate this. The poor governance of centres and high mobility of expectant mothers are also impacted upon program implementation. Future recommendations include program widening of scope and upscale, increased logistical support, continual monitoring and evaluation, research into program funding governance as well as upscale involvement of stakeholders

Control of deep lithospheric roots on crustal scale GOCE gravity and gradient fields evident in Gondwana reconstructions

The GOCE gravity field is globally homogeneous at the resolution of about 80km or better allowing for the first time to analyze tectonic structures at continental scale. Geologic correlation studies based on age determination and mineral composition of rock samples propose to continue the tectonic lineaments across continents to the pre-breakup position. Tectonic events which induce density changes, as metamorphic events and magmatic events, should then show up in the gravity field. Therefore gravity can be used as a globally available supportive tool for interpolation of isolated samples. Applying geodynamic plate reconstructions to the GOCE gravity field places today\u2019s observed field at the pre-breakup position. In order to test the possible deep control of the crustal features, the same reconstruction is applied to the seismic velocity models, and a joint gravity-velocity analysis is performed. The geophysical fields allow to control the likeliness of the hypothesized continuation of lineations based on sparse surface outcrops. Total absence of a signal, makes the cross-continental continuation of the lineament improbable, as continental-wide lineaments are controlled by rheologic and compositional differences of lithospheric mantle. It is found that the deep lithospheric roots as those found below cratons control the position of the positive gravity values. The explanation is that the deep lithospheric roots focus asthenospheric upwelling outboard of the root protecting the overlying craton from magmatic intrusions. The study is carried out over the African and South American continents. The background for the study can be found in the following publications where the techniques which have been used are described: Braitenberg, C., Mariani, P. and De Min, A. (2013). The European Alps and nearby orogenic belts sensed by GOCE, Boll. Bollettino di Geofisica Teorica ed Applicata, 54(4), 321-334. doi:10.4430/bgta0105 Braitenberg, C. and Mariani, P. (2015). Geological implications from complete Gondwana GOCE-products reconstructions and link to lithospheric roots. Proceedings of 5th International GOCE User Workshop, 25 - 28 November 2014. Braitenberg, C. (2015). Exploration of tectonic structures with GOCE in Africa and across-continents. Int. J.Appl. Earth Observ. Geoinf. 35, 88-95. http://dx.doi.org/10.1016/j.jag.2014.01.013 Braitenberg, C. (2015). A grip on geological units with GOCE, IAG Symp. 141, in press

Paran\ue1-Etendeka lithosphere modeling according to GOCE observations and geophysical constraints: improvement of PERLA project

One of the challenges of the European Space Agency (ESA) is to improve knowledge of physical properties and geodynamic processes of the lithosphere and the Earth\u2019s deep interior, and their relationship to the Earth-surface changes. PERLA project is a part of the challenge of ESA\u2019s Living Planet program to investigate the Solid Earth, and in particular the lithosphere of the Paran\ue1-Etendeka Large Igneous Province (LIP). At the present stage the study is focusing on the upper mantle, the source of the magma. The aim is to motivate the asymmetry of the shallow volcanic effusion of the Early Cretaceous tholeiitic magmatism, that in Paran\ue1 is wide, thick and represented by the basaltic layer of Serra Geral Formation, while in Etendeka it is rare and spanned. Viceversa the alkaline magmatism shows similar effusions along the region with dyke swarms and associated alkaline and alkaline-carbonatite complexes from Early Creataceous to Paleogene age. ESA\u2019s Living Planet program offers a suite of scientific satellites, the Earth Explorers, and in this context PERLA adopts the newest GOCE satellite mission products. The Marussi tensor field and especially its vertical component show a positive anomaly along the coastline sector of both the western and eastern Atlantic Ocean. Positive anomalies are also related to the deeper Moho under the northern part of Paran\ue1 basin, in South America (SAM) and the Etendeka continental part. Here we aim to define the detail of masses between crust and upper mantle by modeling the Marussi Tensor components and the invariants. The invariants are easier to understand because they are independent of the reference system. The forward model uses Tesseroids. The density model is compared with recent seismologic models, and is performed according to the results provided by the physical laws governing rock densities and seismic velocity of lithosphere in function of temperature and pressure combined with laboratory measurements of a great number of mineral samples. Also the age of the mantle is included, according to the standard petrological classification of mantle with the percentages of four lead minerals: Olivine, Orthopyroxene, Clinopyroxene and Garnet. Studying the GOCE gravimetric data with the integration of geophysical and also petrological constraints is useful to investigate the lithosphere and to improve the geodynamics of complex geologic areas like LIPs

Signatures of spin in the n=1/3 Fractional Quantum Hall Effect

The activation gap Delta of the fractional quantum Hall state at constant filling n =1/3 is measured in wide range of perpendicular magnetic field B. Despite the full spin polarization of the incompressible ground state, we observe a sharp crossover between a low-field linear dependence of Delta on B associated to spin texture excitations and a Coulomb-like behavior at large B. From the global gap-reduction we get information about the mobility edges in the fractional quantum Hall regime.Comment: 4 pages, 3 figure

A framework for P2P application development

Although Peer-to-Peer (P2P) computing has become increasingly popular over recent years, there still exist only a very small number of application domains that have exploited it on a large scale. This can be attributed to a number of reasons including the rapid evolution of P2P technologies, coupled with their often-complex nature. This paper describes an implemented abstraction framework that seeks to aid developers in building P2P applications. A selection of example P2P applications that have been developed using this framework are also presented

Macroscopic fluctuations theory of aerogel dynamics

We consider the thermodynamic potential describing the macroscopic fluctuation of the current and local energy of a general class of Hamiltonian models including aerogels. We argue that this potential is neither analytic nor strictly convex, a property that should be expected in general but missing from models studied in the literature. This opens the possibility of describing in terms of a thermodynamic potential non-equilibrium phase transitions in a concrete physical context. This special behaviour of the thermodynamic potential is caused by the fact that the energy current is carried by particles which may have arbitrary low speed with sufficiently large probability.Comment: final versio

Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity. A pilot study

Pouchitis is the most common complication following proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis (UC). To provide a standardized definition of pouchitis clinical, endoscopic and histological markers were grouped and weighted in the pouch disease activity index (PDAI). However, the delay in the assessment of the final score due to the time requested for histological analysis remains the main obstacle to the index implementation in clinical practice so that the use of modified-PDAI (mPDAI) with exclusion of histologic subscore has been proposed. We tested the ability of calprotectin measurement in the pouch endoluminal content to mimic the histologic score as defined in the PDAI, the index that we adopted as gold standard for pouchitis diagnosis. Calprotectin was measured by ELISA in the pouch endoluminal content collected during endoscopy in 40 consecutive patients with J-pouch. In each patient PDAI and mPDAI were calculated and 15% of patients were erroneously classified by mPDAI. ROC analysis of calprotectin values vs. acute histological subscore 3 identified different calprotectin cut-off values with corresponding sensitivity and specificity allowing the definition and scoring of different range of calprotectin subscores. We incorporated the calprotectin score in the mPDAI obtaining a new score that shows the same specificity as PDAI for diagnosis of pouchitis and higher sensitivity when compared with mPDAI. The use of the proposed new score, once validated in a larger series of patients, might be useful in the early management of patients with symptoms of pouchitis

Numerical Implementation of lepton-nucleus interactions and its effect on neutrino oscillation analysis

We discuss the implementation of the nuclear model based on realistic nuclear spectral functions in the GENIE neutrino interaction generator. Besides improving on the Fermi gas description of the nuclear ground state, our scheme involves a new prescription for $Q^2$ selection, meant to efficiently enforce energy momentum conservation. The results of our simulations, validated through comparison to electron scattering data, have been obtained for a variety of target nuclei, ranging from carbon to argon, and cover the kinematical region in which quasi elastic scattering is the dominant reaction mechanism. We also analyse the influence of the adopted nuclear model on the determination of neutrino oscillation parameters.Comment: 19 pages, 35 figures, version accepted by Phys. Rev.

Mild cognitive impairment: a systematic review

MCI is a nosological entity proposed as an intermediate state between normal aging and dementia. The syndrome can be divided into two broad subtypes: amnestic MCI ( aMCI) characterized by reduced memory, and non- amnestic MCI ( naMCI) in which other cognitive functions rather than memory are mostly impaired. aMCI seems to represent an early stage of AD, while the outcomes of the naMCI subtypes appear more heterogeneous - including vascular dementia, frontotemporal dementia or dementia with Lewy bodies- but this aspect is still under debate. MCI in fact represents a condition with multiple sources of heterogeneity, including clinical presentation, etiology, and prognosis. To improve classification and prognosis, there is a need for more sensitive instruments specifically developed for MCI as well as for more reliable methods to determine its progression or improvement. Current clinical criteria for MCI should be updated to include restriction in complex ADL; also the diagnostic and prognostic role of behavioral symptoms and motor dysfunctions should be better defined. A multidisciplinary diagnostic approach including biological and neuroimaging techniques may probably represent the best option to predict the conversion from MCI to dementia. In this review we discuss the most recent aspects related to the epidemiological, clinical, neuropathological, neuroimaging, biochemical and therapeutic aspects of MCI, with specific attention to possible markers of conversion to dementia