Evaluation of Hypertensive Clinical Significance in a Primary Care Setting with Veterans with Diabetes

Analyses of hypertensive confounding factors were identified by looking retrospectively at patient demographics, medications, recent blood pressure and the medical history of hypertensive patients with diabetes. The data trends found in this database highlighted potential areas for improvement with regards to the care of patients with this co-morbidity in the outpatient setting. All prescription anti-hypertensives prescribed for the 102 patients followed the National Joint Committee (JNC-8) Hypertension Guideline Algorithm. Of 102 adult males (over the age of 18), 22 patients had a blood pressure that is out of control (over 140/90). Within this group of patients, 33.3% of the patients are overweight with a body mass index between 25.0 and 29.9. Patients were obese 60.8% of the time with a BMI of 30.0 and above. Half of the patients (51 of 102) have an active diagnosis of obstructive sleep apnea. There is a need for continued aggressive treatment of hypertension in order to keep blood pressure below the recommended 140/90mmHg per the JNC-8 Hypertension Guidelines for hypertensive and diabetic patients. Several evidence-based practice recommendations were provided to address the clinically significant findings mentioned above

Perencanaan Penggantian Jembatan Juwet Kabupaten Pemalang

Juwet Bridge is located approximately one kilometer to the south of Comal Bridge Pemalang District is one of the alternative bridges used when the Comal Bridge collapsed. In this final Juwet Bridge which has a width of only 3 meters is designed with a larger capacity and functioned as an alternative pathway Comal Bridge. Planning on aspects of traffic using a design life of 20 years with the growth of the vehicle based on a linear regression of 642 veh / year and using two scenarios, there are normal conditions (2 Comal Bridge function) and incidental conditions (only 1 Comal Bridge functioning). Initial planning, the alternative pathway using a type 2/2 UD. In normal conditions, the distribution of traffic flow 70% for Comal Bridge and 30% for Juwet Bridge produce a degree of saturation (DS) under 0.75 over the life of the plan. In the incidental conditions, the distribution of traffic flow 60% for Comal Bridge and 40% for Juwet Bridge, DS value is 0.81. Assuming then use 2/2 type UD with 8 meters wide still used. New Juwet Bridge continue to use steel as the structure and the upper structure of reinforced concrete for the structure underneath. Planned implementation within 8 months at a cost of Rp. 36.4 billion. In this final project scope of the planned bridge elements include work for the overall structure of the bridge and approach bridge. Given this new Juwet Bridge when congestion occurs on the Pantura line around Comal Bridge, the bridge is able to be an alternative pathway in servicing and reducing the burden of most of the traffic flow on the Pantura line

Perencanaan Alternatif Desain Jembatan Jurang Gempal Kabupaten Wonogiri

Pokoh and Jurang Gempal bridge are the bridges that are located on Wonogiri – Ngadirojo roads crossing over Bengawan Solo river connecting Wonogiri Regency and Ponorogo Regency/Pacitan Regency. But in the past 10 years, only one bridge operates and that is Pokoh Bridge. This is caused by the condition of Jurang Gempal Bridge that is no longer adequate since it was built in the colonial era, some parts of the construction aren\u27t function properly. With only one bridge that is operating, it oftenly lead to a high traffic density on traffic hours. Thus, the re-operating of Jurang Gempal Bridge can be the solution of this traffic density problem that occurred. However, there is a need to do a total change on the bridge construction by seeing the existing condition and the age of the bridge that is already too old. Jurang Gempal Bridge was planned to be located in the existing location that is 2x60 meter in bridge length. The upper structure of this bridge is using steel frame that is 9.0 meter in width (2x3.5 meter vehicle floor and 2x1.0 meter sidewalk) and 6.0 meter in height. Meanwhile, the sub-structure of this bridge is using an abutment that the height is 7.0 meter and a pier that is 9.0 meter in height. The hard soil that is positioned in 10 meter depth is the kind of a sand soil so the Bored Pile is used as the foundation of this Jurang Gempal Bridge

Profile and differences in financial literacy: empirical evidence

The increasing cost of living in Malaysia has resulted in individuals and households being more mindful of their wealth management. Financial crises and world geopolitical issues have caused much volatility in returns and market volatility. These economic challenges have impacted the way Malaysians save, spend, manage risks and invest in order to preserve their livelihood. It is therefore vital to understand financial instruments and markets in order to better manage investments and wealth. This research aims to study the level of financial literacy among Malaysians across gender, income, age and ethnicity group. It applies a quantitative study method with a self-administered questionnaire to obtain relevant data. A total sample of 2000 respondents is obtained and results reveal that unfortunately, the majority of Malaysians possess only moderate level of financial literacy. In addition, there are significant differences in female, who are in the above the RM7000 income group, 30 to 39 years old and Chinese in terms of financial literacy. Findings from the study provide a better understanding of the level of Malaysians" financial literacy and implication on policy objectives to further strengthen this area through targeted sustainable financial education

Perencanaan Peningkatan Jalan Tembus Jl. Ambarawa- Jl. Soekarno Hatta, Bawen, Semarang

Highway with it's accessories are a mode of land transport infrastructure wich are essential to the flow of services and commodity that pass through the land. With the flow of commodity and services, it will affect the economic and social development around the existing road infrastructure. Semarang has a strategic location in the development of the Province of Central Java, because Semarang crossed by important lines that connect to the regional growth centers such as Semarang, Surakarta, and Yogyakarta and it's location close to the capital city of Central Java Province, wich is the center of economic activity, governance, social and cultural areas in Central Java. However, various problems of traffic jam occurs in the area of Semarang, this requiring an improvement road planning that will be an alternative way into the city of Semarang. Passageway of Jl. Ambarawa- Jl. Soekarno Hatta located between Ambarawa and Bawen with land use as residential areas, schools, fields, and forests. The main problem that occurred in this passageway are a pretty damage road caused by overload traffic flow and also because of pavement over time factor and because of the road capacity doesn't required yet to accommodate the current traffic load. The purpose and goal of this evaluation and improvement are to maximize road function as an alternative way, in the end it'll support a movement that can achieve economic growth of the area as well as reduce the problem, with a longer design time. The results of evaluation for the existing roads are gives several factors to improvement road. Due to the improvement and widening of road, it is automaticaly should redesign the geometry. The entire analysis and engineering calculations are based on the Highways Regulations and Indonesian National Standard. The results of improvement design it is carried one step of planning to widen this road in 2016, for a Rengas-Bawen segment, Gembol-Doplang segment and Harjosari-Doplang segment now widened into 7 m, for Rengas – Bawen segment before was 5 m of lane, and was 3 m for Gembol-Doplang and Doplang-Harjosari, three of them are design with 2/2 undevided lane, with new shoulder width 1 m. Design pavement used flexible ones and for the existing pavement need overlay with thick layer of 7 cm using Laston MS 454. For widening used surface course with thick layer of 10 cm using Laston MS 454, for base course using a class A crushed stone with a thickness of 20 cm CBR 100% and the subbase course using class B gravel CBR 50% with thick layer of 12 cm and lied on subgrade form browny red silty clay with sand in CBR 6%. Hope that this evaluation and improvement design can provide comfort services to road users during the specified design time of 10 years with a plan of speed 50 km / hour and a maximum slope of 9%

Perencanaan Jalan Lingkar Utara Kota Wonosari, Kabupaten Gunung Kidul, Provinsi Daerah Istimewa YOGYAKARTA

Economic development and growth in the City Wonosari relatively fast growing, giving rise to the high mobility of the impact on the increase in traffic flow, traffic volume and road network system. One effort to do that with the planned construction of the North Ring Road City Wonosari able to support the creation of a transportation system that is effective, efficient, provide smooth transport, and increasing the role and function of national roads which have an important role in the conduct of regional transport flows in the Province Central Java. From the analysis of the northern ring road planning Wonosari City in accordance with the volume of traffic survey determined the number of lanes is 2/2 UD. From the calculation of the northern ring road planning Wonosari City, at the intersection specified the use of rigid pavement while traffic along the ring road north of the City Wonosari using flexible pavements

Evaluasi Kelayakan Dan Peningkatan Kinerja Jalan Lingkar Kudus

Kudus Ring Road is a primary arterial road that connects traffic from the provincial capital of East Java's Surabaya to the provincial capital of Central Java's Semarang. This ring road was establised with the purpose to redirecting traffic without having to pass through the urban area, so it can reduced the traffic jam. First construction was started at 1997 and has several repairs or improvements. At an early age getting older, this ring road needs an evaluation for many fators such as traffic performance, road geometry, road pavement, drainage channel, and complement facility such as light lamp, road marker, and traffic's signs. The results of the evaluation are expected to improve the quality of this ring road in serving the traffic movements