Reduksi Kandungan Aflatoksin B1 (Afb1) pada Pembuatan Kacang Telur melalui Perebusan dalam Larutan Kapur (Reduction Of Aflatoxin B1 (Afb1) Content In The Egg Peanut By Boilling In Lime Solution)

Background: The harmful effect of aflatoxin B1 for human being because of its toxicity, as carcinogenic agent. The toxin is produced by the Aspergillus flavus which usually grows in grain and nuts. As the result that the grain, nuts and their product contaminated by the toxin. Egg peanut is one of peanut products which are widely consumed by the peoples. Consequently the egg peanut should be not containing the toxin. The modification of process of making peanut is one way to eliminate the toxin. Objectives: To eliminate the aflatoksin B1 content in the product of egg peanut through the preparation of raw peanuts by boiling the peanut in the boiled lime solution. The concentration of the lime solution in this research was 0.5 percent, and 1.5 percent for 10 minutes. Methods: There were two kinds of peanut egg, one was made from the raw peanuts which were already contaminated by the aflatoxin, and another one from the raw peanuts was not contaminated. The first product was to observe the influenced of boiling in the lime solution of peanuts to the content of aflatoxin. The second product was to observe the influenced of boiling in the lime solution of peanuts to the sensory of peanut eggs. Aflatoxin analysis was carried out by ELISA (Enzyme Linked Immunosorbent Assay). Results: The result of research showed that the preparation of the raw peanuts by boiling in lime solution was able to reduce the content of aflatoxin in peanut eggs. The percentage of reduction was increased by increasing the concentration of lime solution. In this study, the reduction of aflatoxin for the peanuts which was boiled in the 0.5 percent of lime solution was 27.8 percent. The reduction was increased becoming 29.5 percent when the peanuts boiled in the 1.5 percent of lime solution. The roasting of the peanut increased 44 percent the reduction of aflatoxin content. Conclusion: The modification process of making the egg peanut by boiling in lime solution could reduce the aflatoxin content, whereas the sensory of peanuts was not affected. The reduction content of aflatoxin was depending on the concentration of lime solution. [Penel Gizi Makan 2011, 34(1): 21-28

Pengurangan Aflatoksin B (AFB ) dengan Proses Fermentasi Menggunakan Rhizopus Oligosporus MK-1 pada Pembuatan Bumbu Pecel

Aflatoksin B adalah mikotoksin yang paling berbahaya untuk kesehatan manusia, karena bersifat racun, karsinogenik, teratogenik dan mutagenik. Aflatoksin adalah mikotoksin yang sering mencemari biji-bijian, kacang-kacangandan juga produk biji-bijian maupun kacang-kacangan seperti bumbu pecel. Bumbu pecel adalah bumbu yang digu- nakan bersama sayuran yang biasa disebut “pecel” yang sangat popular di Indonesia. Reduksi biologis aflatoksin adalah proses yang sangat penting untuk menurunkan kandungan aflatoksin selama fermentasi kacang oleh Rhizopus oligosporus MK-1. Penelitian ini terdiri dari 2 tahap yaitu modifikasi proses produksi bumbu pecel dan uji sensoris terhadap bumbu pecel yang telah dimodifikasi. Modifikasi proses meliputi perendaman biji, pengupasan kulit biji, pen- cucian, perebusan, fermentasi Rhizopus oligosporus MK-1 dan penyangraian. Analisis aflatoksin menggunakan ELISA (Enzym Linked Immunosorbent Assay). Hasil penelitian menunjukkan bahwa proses fermentasi menggunakan Rhizopus oligosporus MK-1 menurunkan kadar aflatoksin B sekitar 88,95 % selama 3 hari proses fermentasi. Semakin lama proses fermentasi, maka penurunan kadar aflatoksin juga semakin banyak dan berhubungan dengan pertumbuhanRhizopus oligosporus MK-1. Fermentasi selama 2 hari tidak berpengaruh terhadap karakter sensoris bumbu pecel

Impact of Motivational Interviewing by Social Workers on Service Users - a systematic review

Purpose: This systematic review was undertaken to determine the effectiveness of motivational interviewing (MI), by social workers, on service user outcomes. Methods: A literature search was undertaken between 2007 and 2018. All eligible studies were analyzed using the Critical Appraisal Skills Programme tool. As heterogeneity was high, a narrative synthesis approach was employed, using thematic analysis for categorizing data. Results: Eleven studies met the inclusion criteria and were included in this review. MI had a positive effect on service user experience, but this was not consistent. Training was variable, but the evidence suggests that practitioner’s need ongoing training, supervision, or coaching while providing MI. Discussion: There is a paucity of research examining the impact of MI on children, which was a limitation of this review. There is a need for more qualitative research to surface views and experience of service users to determine why MI is effective

Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

<p>Abstract</p> <p>Background</p> <p>Untreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods.</p> <p>Methods</p> <p>Eight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year.</p> <p>Results</p> <p>The average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system). All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient.</p> <p>Conclusion</p> <p>The results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation.</p> <p>Level of Evidence</p> <p>Therapeutic study, Level IV (case series [no, or historical, control group])</p

‘I wouldn't push that further because I don't want to lose her’: a multiperspective qualitative study of behaviour change for long-term conditions in primary care

Background: Health outcomes for long-term conditions (LTCs) can be improved by lifestyle, dietary and condition management-related behaviour change. Primary care is an important setting for behaviour change work. Practitioners have identified barriers to this work, but there is little evidence examining practices of behaviour change in primary care consultations and how patients and practitioners perceive these practices. Objective: To examine how behaviour change is engaged with in primary care consultations for LTCs and investigate how behaviour change is perceived by patients and practitioners. Design: Multiperspective, longitudinal qualitative research involving six primary health-care practices in England. Consultations between patients with LTCs and health-care practitioners were audio-recorded. Semi-structured interviews were completed with patients and practitioners, using stimulated recall. Patients were re-interviewed 3 months later. Framework analysis was applied to all data. Participants: Thirty-two people with at least one LTC (chronic obstructive pulmonary disease, diabetes, asthma and coronary heart disease) and 10 practitioners. Results: Behaviour change talk in consultations was rare and, when it occurred, was characterized by deflection and diffidence on the part of practitioners. Patient motivation tended to be unaddressed. While practitioners positioned behaviour change work as outside their remit, patients felt uncertain about, yet responsible for, this work. Practitioners raised concerns that this work could damage other aspects of care, particularly the patient–practitioner relationship. Conclusion: Behaviour change work is often deflected or deferred by practitioners in consultations, who nevertheless vocalize support for its importance in interviews. This discrepancy between practitioners’ accounts and behaviours needs to be addressed within primary health-care organizations

Optimizing care for children with difficult-to-treat and severe asthma through specialist paediatric asthma centres:expert practical experience and advice

Severe asthma in children carries an unacceptable treatment burden, yet its rarity means clinical experience in treating it is limited, even among specialists. Practical guidance is needed to support clinical decision-making to optimize treatment for children with this condition. This modified Delphi convened 16 paediatric pulmonologists and allergologists from northern Europe, all experienced in treating children with severe asthma. Informed by interviews with stakeholders involved in the care of children with severe asthma (including paediatricians, nurses and carers), and an analysis of European guidelines, the experts built a consensus focused on the gaps in existing guidance. Explored were considerations for optimizing care for patients needing biologic treatment, and for selecting home or hospital delivery of biologics. This consensus is aimed at clinicians in specialist centres, as well as general paediatricians, paediatric allergologists and paediatric pulmonologists who refer children with the most severe asthma to specialist care. Consensus is based on expert opinion and is intended for use alongside published guidelines. Our discussions revealed three key facets to optimizing care. Firstly, early asthma detection in children presenting with wheezing and/or dyspnoea is vital, with a low threshold for referral from primary to specialist care. Secondly, children who may need biologics should be referred to and managed by specialist paediatric asthma centres; we define principles for the specialist team members, tests, and expertise necessary at such centres, as well as guidance on when homecare biologics delivery is and is not appropriate. Thirdly, shared decision-making is essential at all stages of the patient’s journey: clear, concise treatment plans are vital for patient/carer self-management, and structured processes for transition from paediatric to adult services are valuable. The experts identified the potential for specialist paediatric asthma nurses to play a significant role in facilitating multidisciplinary working. Through this project is agreed a framework of practical advice to optimize the care of children with severe asthma. We encourage clinicians and policymakers to implement this practical advice to enhance patient care.</p

Motivational Interviewing Versus Cognitive Behavioral Group Therapy in the Treatment of Problem and Pathological Gambling: A Randomized Controlled Trial

Pathological gambling is a widespread problem with major implications for society and the individual. There are effective treatments, but little is known about the relative effectiveness of different treatments. The aim of this study was to test the effectiveness of motivational interviewing, cognitive behavioral group therapy, and a no-treatment control (wait-list) in the treatment of pathological gambling. This was done in a randomized controlled trial at an outpatient dependency clinic at Karolinska Institute (Stockholm, Sweden). A total of 150 primarily self-recruited patients with current gambling problems or pathological gambling according to an NORC DSM-IV screen for gambling problems were randomized to four individual sessions of motivational interviewing (MI), eight sessions of cognitive behavioral group therapy (CBGT), or a no-treatment wait-list control. Gambling-related measures derived from timeline follow-back as well as general levels of anxiety and depression were administered at baseline, termination, and 6 and 12 months posttermination. Treatment showed superiority in some areas over the no-treatment control in the short term, including the primary outcome measure. No differences were found between MI and CBGT at any point in time. Instead, both MI and CBGT produced significant within-group decreases on most outcome measures up to the 12-month follow-up. Both forms of intervention are promising treatments, but there is room for improvement in terms of both outcome and compliance

Motivational engagement in first-time hearing aid users: a feasibility study

Objective: To assess (1) the feasibility of incorporating the Ida Institute’s Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures. Design: A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute’s Motivation Tools formed the basis for motivational engagement. Study sample: First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. Results: The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. Conclusions: There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users