PEMBANGUNAN APLIKASI PEMBELAJARAN ANATOMI TUBUH MANUSIA BERBASIS MULTIMEDIA

Human anatomy is one of the subject matter of biology which deals with human body parts. Students need a picture to explain the material object. Therefore, should made in a medium of learning that makes the material easy to understand, such as by using the facilities that already exist by using computer technology. This thesis aims to overcome this problem, ranging from providing visual object that is not boring in teaching and learning through the interactive nature of which is given to teachers can easily convey the material. The author uses Macromedia Flash 8 media in making the application. In addition, the system development methodology that author use is Waterfall methodology. Applications are also tested and evaluated using questionnaires. Based on the questionnaire, the respondents agreed that the application meets user needs. The author hopes that the application can become an alternative media in the learning process for students and teachers can find a solution to overcomethe problem of learning in the classroom by using the advanced and innovative media in accordance with current technological developments

Characterising extant technology related barriers & enablers for streamlined delivery of BP@home in North Central London: Report for NCL LTC Clinical Network

Report objectives: This report summarises the key findings of a place-based evaluation to identify barriers and enablers to the streamlined use of digital tools to support successful implementation of BP@home in North Central London (NCL). Specifically, we characterised the IT landscape in NCL, investigated the views and experiences of HCPs regarding the use of place-based IT solutions and processes, and synthesised a list of evidence-based recommendations for the consideration of NCL leadership team. Methods: We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focus groups, action research, data analysis, synthesis and reporting. Results: The evaluation showed that there was a lack of standardisation across IT systems, internal processes and templates in PCNs in NCL, leading to challenges in implementing and using digital tools to support BP@home. These challenges were not unique to NCL. AccurX and the locally created NCL template are the most widely used IT tools to support the program in NCL. Other digital platforms being tested in NCL include Suvera, each with unique strengths and weaknesses. Other digital tools, such as Omron Connect, could be considered to support management of hypertension and other chronic conditions. HCPs faced challenges with patient engagement, data quality, IT system integration and resource allocation, but generally felt that the current approach works. Basic requirements for the use and adoption of IT tools and systems include adequate resources, stakeholder engagement, user-friendly interfaces, and interoperability between different systems. We proposed 16 actionable insights and recommendations that could be implemented to help improve the delivery of BP@home in NCL. These include standardising IT systems, improving patient engagement, providing adequate training and support, and promoting the benefits of remote monitoring. Conclusion: On balance, we recommend that NCL continues to deliver BP@home using the current standard IT offer that facilitates asynchronous engagement with patients (i.e., AccurX). Embedding a quality improvement approach to identify mechanisms to continually improve the BP@home offer in NCL is recommended. Clinical leadership could also review the evaluation findings of alternative tools currently being tested locally (e.g., pilot using Suvera across one PCN) to drive evidence-based commissioning decision as the BP@home initiative becomes even more embedded in routine general practice

BP@home Pan-London Evaluation: Report Presented to NHSE I & LCEG (London)

Report objectives: This report summarises the key findings of a Pan-London evaluation to assess levels of implementation and identify key barriers and enablers to the streamlined implementation of the BP@home program across London. Specifically, we mapped the reception and distribution of BP@home monitors, investigated the views and experiences of primary care workers involved in the implementation of the programme, and quantify changes in outcomes using SNOMED codes. This data was synthesised and used to develop a list of evidence-based recommendations for the consideration of NHSE leadership team. Methods: We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focus groups, action research, data analysis, synthesis and reporting. Results: The evaluation showed that there are different levels of readiness and implementation across the 5 London ICSs. The roll-out of BP@home programme has been challenging due to a number of key factors across the pathway, including the limited IT infrastructure, insufficient human and financial resources, and the lack of adequate and specific SNOMED codes. These challenges were further increased by the competing demands on limited capacity in Primary Care, especially during the Covid-19 pandemic. However, respondents also identified some facilitators, including the onboarding material provided by NHSE, the inclusion of the UCLP criteria the EHR and the provision of conditional incentives in certain ICSs. A more structured and holistic approach to onboarding patients is needed to ensure high quality compliance and satisfactory results for patients. Another key recommendation devised by respondents was to offer BP monitors on prescription, along with the creation of specific SNOMED codes. Conclusion: At the time of redaction of this report, there are local evaluation plans in each ICS & a national evaluation of @Home programme was recently commissioned by NIHR. There is an urgent need to develop & use system-wide codes to track activity as well as carry additional research especially regarding patients’ experience and perspectives as recipients of the BP@home programme

Développement d'un outil chronostratigraphique pour les archives climatiques : datations absolues (K/Ar,⁴⁰Ar/³⁹Ar) et paléomagnétisme appliqués aux laves

The understanding of climatic mechanisms and rapid climate changes requires a high-resolution, robust, and precise timescale which allows long-distance and multi-archives correlations.An appropriate tool to construct such a timescale is provided by the Earth magnetic field (EMF). The EMF is independent from climatic variations and its past evolution, global at the surface of the Earth, is recorded by most of the geological/climatic archives. Sedimentary sequences provide continuous records of relative intensities of the EMF on timescales usually based on ice core age models or orbital tuning. Lavas, though discontinuously emitted through time, record the absolute intensity of the EMF during their cooling at the surface of the Earth. Lavas are dated using 2 complementary methods: ⁴⁰Ar/³⁹Ar and K-Ar, both independent from climatic parameters. Lavas have therefore the potential to deliver tie-points (age-paleointensity couples) enabling the time calibration of sedimentary sequences and their transfer onto absolute intensity scale and chronological time scale. This timescale can then be transferred to other climatic archives. The present study focusses on the last 200 ka with lavas sampled from young volcanoes of Ardèche (South Massif Central, France) and recent phases of volcanism in the Canary Islands.Lava flows from Ardèche provided unexploitable paleointensity results and ages with large uncertainties. Therefore, they failed to provide suitable tie-points. However, our geochronological results evidence how crucial the combination of both the K-Ar and 40Ar/39Ar methods is to test the accuracy and geological meaning of the ages. Ardèche lavas have abundant mantellic and crustal xenoliths, potential carriers of excess ⁴⁰Ar*. Our study suggests that the argon excess is located in sites that decrepitate at low temperature (<600°C). Because ⁴⁰Ar/³⁹Ar ages are not affected by excess ⁴⁰Ar*, they provide reliable results. The new age dataset indicates that the volcanic activity of Ardèche can be divided in 3 phases: the oldest one (180±30 ka) took place in the northern part of the studied area and 2 younger phases are expressed in the South (31±4 ka and 24±8 ka).The study of the Canarian lavas produced 14 tie-points (9 out of 14 dated combining K-Ar and ⁴⁰Ar/³⁹Ar results). These data have been added to the available ones for the same time period. The published data have been selected on the basis of robust analytical protocols and accuracy. The 51 data finally selected are compared to available sedimentary stacks. Over the last 80 ka, the volcanic data corroborate the calibration of GLOPIS-75, initially based on volcanic and archeomagnetic data between 10-20 ka and the low intensity observed in the Laschamp excursion. Three newly produced data, dated between 45 and 60 ka, extend the database initially used to older periods and they are also consistent with the initial calibration of GLOPIS-75. Between 80 and 140 ka, though volcanic data have significant uncertainties (in age and/or paleointensity), they are consistent with available sedimentary records and validate their calibration level on the long-term. At a shorter time scale, volcanic data corroborate the intensity low reached during the older phase of the Blake excursion (120 ka) by PISO-1500, whereas this low does not appear in SINT-2000. For ages older than 140 ka, not only the volcanic data are scattered, but also the sedimentary records are different from one another and no conclusions could be drawn. Finally, 2 of our data suggest a brief geomagnetic event around 155 ka. Such an event cannot be seen on available global sedimentary stacks or models, even though some individual studies report a local geomagnetic event around 150 ka (Austria, Russia, and China Sea).Développer une échelle de temps à haute résolution temporelle et commune aux différentes archives climatiques est une étape importante afin de quantifier avec précision les rapides variations climatiques passées et pour les placer dans un cadre chronologique unifié facilitant leurs inter-comparaisons et la quantification d’éventuels déphasages entre évènements, marqueurs ou archives climatiques.Le champ magnétique terrestre (CMT) regroupe l’ensemble des caractéristiques désirées pour développer un tel outil chronostratigraphique (expression dipolaire globale à la surface du globe, enregistrement dans diverses archives, variations en intensité indépendantes des variables climatiques). Bien que porteurs d’enregistrements continus, les sédiments ne donnent accès qu’aux variations relatives d’intensité du CMT. De plus, quand leur échelle de temps ne peut plus être placée sur celle des glaces polaires, elle est généralement obtenue par forçage orbital. Les laves, émises sporadiquement, enregistrent l’intensité absolue du CMT et sont datables par méthodes ⁴⁰Ar/³⁹Ar et K-Ar (indépendantes des variables climatiques). Elles fournissent ainsi des couples âge-paléointensité (A-PI) permettant de calibrer les enregistrements sédimentaires et de les transférer sur des échelles de temps et d’intensité absolues. L’échelle de temps ainsi obtenue est par la suite transférable à diverses archives climatiques. Cette étude se focalise sur les derniers 200 ka. Les laves étudiées proviennent des jeunes volcans d’Ardèche et des phases récentes du volcanisme canarien. Les laves ardéchoises ont délivré des résultats de paléointensité non exploitables et des incertitudes trop importantes sur les âges. Aucun couple A-PI pertinent n’a donc été obtenu. Cependant, nos résultats géochronologiques démontrent l’importance de combiner les 2 méthodes de datation K-Ar et ⁴⁰Ar/³⁹Ar pour tester l’exactitude et la signification géologique des âges obtenus. Pour ces laves, porteuses d’indices de contamination crustale et mantellique, nous suggérons que l’excès d’argon est situé dans des sites de rétention basses températures (<600°C). Les âges ⁴⁰Ar/³⁹Ar obtenus, apparemment non affectés par l’excès d’argon, décomposent l’activité volcanique en 3 phases : 1 au Nord (180±30 ka) et 2 au Sud (31±4 ka et 24±8 ka).Les laves canariennes ont produit 14 nouveaux couples A-PI (dont 9 datés conjointement en K-Ar et ⁴⁰Ar/³⁹Ar). Ces données ont été combinées à celles disponibles et triées de manière à ne garder que celles issues de protocoles d’analyses robustes et suffisamment précises. Les 51 données retenues ont été comparées aux courbes sédimentaires disponibles afin d’obtenir de nouvelles contraintes temporelles sur 0-200 ka. Sur 0-80 ka, les données confirment la bonne calibration de GLOPIS-75 initialement basée le minimum d’intensité de l’excursion du Laschamp et sur l’évolution du CMT entre 20 et 10 ka. En particulier, 3 de nos données réparties entre 45 et 60 ka sont cohérentes avec l’évolution du signal magnétique présentée par GLOPIS-75, complétant ainsi le jeu de contraintes sur cet intervalle. De 80 à 140 ka, les données retenues, bien qu’ayant des incertitudes temporelles parfois importantes, sont cohérentes avec les courbes sédimentaires validant ainsi leur niveau moyen de calibration sur cette période. Ces données confirment également la baisse d’intensité lors de l’épisode ancien du Blake à 120 ka, baisse d’intensité bien documentée par PISO-1500 mais très lissée sur SINT-2000. Avant 140 ka, les données sédimentaires et volcaniques disponibles sont trop incohérentes : aucune calibration n’a donc été entreprise sur cette période. Enfin, 2 données produites suggèrent un évènement géomagnétique bref vers 155 ka. Un tel événement n’est pas observé dans les courbes sédimentaires globales et les modèles disponibles vers 155 ka mais quelques études individuelles mentionnent localement un évènement géomagnétique vers 150 ka (Autriche, Russie et Mer de Chine)

Identifying technology related barriers & enablers to streamlining delivery of BP@home in NCL

Report objectives: This report summarises the key findings of a place-based evaluation to identify barriers and enablers to the streamlined use of digital tools to support successful implementation of BP@home in North Central London (NCL). Specifically, we characterised the IT landscape in NCL, investigated the views and experiences of HCPs regarding the use of place-based IT solutions and processes, and synthesised a list of evidence-based recommendations for the consideration of NCL leadership team. Methods: We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focus groups, action research, data analysis, synthesis and reporting. Results: The evaluation showed that there was a lack of standardisation across IT systems, internal processes and templates in PCNs in NCL, leading to challenges in implementing and using digital tools to support P@home. These challenges were not unique to NCL. AccurX and the locally created NCL template are the most widely used IT tools to support the program in NCL. Other digital platforms being tested in NCL include Suvera, each with unique strengths and weaknesses. Other digital tools, such as Omron Connect, could be considered to support management of hypertension and other chronic conditions. HCPs faced challenges with patient engagement, data quality, IT system integration and resource allocation, but generally felt that the current approach works. Basic requirements for the use and adoption of IT tools and systems include adequate resources, stakeholder engagement, user-friendly interfaces, and interoperability between different ystems. We proposed 16 actionable insights and recommendations that could be implemented to help improve the delivery of BP@home in NCL. These include standardising IT systems, improving patient engagement, providing adequate training and support, and promoting the benefits of remote monitoring. Conclusion: On balance, we recommend that NCL continues to deliver BP@home using the current standard IT offer that facilitates asynchronous engagement with patients (i.e., AccurX). Embedding a quality improvement approach to identify mechanisms to continually improve the BP@home offer in NCL is recommended. Clinical leadership could also review the evaluation findings of alternative tools currently being tested locally (e.g., pilot using Suvera across one PCN) to drive evidence-based commissioning decision as the BP@home initiative becomes even more embedded in routine general practice

Is mammographic density differentially associated with breast cancer according to receptor status? A meta-analysis.

Mammographic density (MD) is a strong marker of breast cancer risk, but it is debated whether the association holds, and is of a similar magnitude, for different subtypes of breast cancer defined by receptor status or gene expression profiles. A literature search conducted in June 2012 was used to identify all studies that had investigated the association of MD with subtype-specific breast cancer, independent of age. 7 cohort/case-control and 12 case-only studies were included, comprising a total of >24,000 breast cancer cases. Random effects meta-analysis models were used to combine relative risks (RR) of MD with subtype-specific breast cancer for case-control studies, and in case-only studies to combine relative risk ratios (RRR) of receptor positive versus negative breast tumors. In case-control/cohort studies, relative to women in the lowest density category, women in the highest density category had 3.1-fold (95 % confidence interval [CI] 2.2, 4.2) and 3.2-fold (1.7, 5.9) increased risk of estrogen receptor positive (ER+) and ER- breast cancer, respectively. In case-only analyses, RRRs of breast tumors being ER+ versus ER- were 1.13 (95 % CI 0.89, 1.42) for medium versus minimal MD. MD remained associated with screen-detected ER+ tumors, despite the expectation of this association to be attenuated due to masking bias and overdiagnoses of ER+ tumors. In eight contributing studies, the association of MD did not differ by HER2 status. This combined evidence strengthens the importance of MD as a strong marker of overall and of subtype-specific risk, and confirms its value in overall breast cancer risk assessment and monitoring for both research and clinical purposes

Public libraries to promote public health and wellbeing: A cross-sectional study of community-dwelling adults

Purpose of research: To explore the potential of libraries as community hubs to promote mental and physical health and wellbeing. Design: Cross-sectional online survey and interview-based study with community-dwelling adults and library staff. Methods: We analysed data from 605 respondents using a 14-item electronic survey and conducted interviews with 12 library users and staff to gauge perceptions. Descriptive statistics and thematic analysis were used to identify key trends and emergent themes. Results: Libraries remain popular and are considered a'safe place' by members of the community, irrespective of whether they are frequent users of services. Library users' lack of awareness of community-facing services could act as a hurdle to improving community health and wellbeing. Targeted engagement with residents is needed to increase awareness of libraries' services, including community interventions to help tackle loneliness and inequalities in digital and health literacy. Library staff often did not feel involved in important decision-making. Various barriers, drivers and practical recommendations were identied to leverage libraries as hubs to promote community health and wellbeing. Conclusion: Libraries already offer a variety of resources that either directly or indirectly support the health and wellbeing of community-dwelling adults and young people, but public awareness of these services is limited. As we navigate postpandemic recovery, libraries can serve as platforms for community engagement, fostering resilience, mental health support, and reducing social isolation. Recognising libraries' untapped potential can lead to healthier communities and improved wellbeing

Coloured petri nets como apoyo a la gestión de proyectos de continuidad del negocio

Las tecnologías de la información son clave en el éxito de las organizaciones. Su utilización requiere complejas infraestructuras que incluyen gran número de componentes (aplicaciones, servidores, etc.). Esto implica que los impactos y riesgos motivados por fallas o indisponibilidades crecen con cada nueva aplicación, mejora de la red o actualización de los mismos. COBIT, ITIL e ISO 27000 plantean la necesidad de conocer los riesgos que puedan afectar la continuidad del negocio y contar con planes adecuados y alineados con los objetivos de la organización. Se debe asegurar que los servicios críticos estén disponibles ante cualquier evento que pueda afectar la organización. El Análisis de Impacto al Negocio (BIA) es el punto de partida de todo proyecto de Continuidad de Negocio. En este artículo se presenta como representar la infraestructura utilizando Coloured Petri Nets. Se describe como aplicar esta representación en el BIA para conocer los recursos involucrados en los servicios.Eje: Workshop de seguridad informática (WSI)Red de Universidades con Carreras en Informática (RedUNCI

Coloured petri nets como apoyo a la gestión de proyectos de continuidad del negocio

Las tecnologías de la información son clave en el éxito de las organizaciones. Su utilización requiere complejas infraestructuras que incluyen gran número de componentes (aplicaciones, servidores, etc.). Esto implica que los impactos y riesgos motivados por fallas o indisponibilidades crecen con cada nueva aplicación, mejora de la red o actualización de los mismos. COBIT, ITIL e ISO 27000 plantean la necesidad de conocer los riesgos que puedan afectar la continuidad del negocio y contar con planes adecuados y alineados con los objetivos de la organización. Se debe asegurar que los servicios críticos estén disponibles ante cualquier evento que pueda afectar la organización. El Análisis de Impacto al Negocio (BIA) es el punto de partida de todo proyecto de Continuidad de Negocio. En este artículo se presenta como representar la infraestructura utilizando Coloured Petri Nets. Se describe como aplicar esta representación en el BIA para conocer los recursos involucrados en los servicios.Eje: Workshop de seguridad informática (WSI)Red de Universidades con Carreras en Informática (RedUNCI