Studi Kebijakan Pengendalian Schistosomiasis di Kabupaten Poso dan Kabupaten Sigi Provinsi Sulawesi Tengah Tahun 2012

Schistosomiasis merupakan salah satu penyakit parasit terpenting dalam kesehatan masyarakat. Di Indonesiaschistosomiasis disebabkan oleh cacing Schistosoma japonicum dengan hospes perantara keong Oncomelaniahupensis lindoensis. Penyakit ini hanya ditemukan di Provinsi Sulawesi Tengah di dua kabupaten yaitu Kabupaten Posodan Sigi. Selama ini pengendalian yang dilakukan masih bersifat rutin yaitu pengobatan, survei fokus keong,pengumpulan tinja, dan pengadaan tool kit. Belum pernah dilakukan penelitian dari aspek kebijakan pemerintah daerahdalam pengendalian schistosomiasis. Penelitian ini secara umum bertujuan untuk memberikan opsi kebijakan bagipemerintah daerah dalam pengendalian schistosomiasis. Tujuan khusus yang ingin dicapai adalah menilai persepsistakeholder mengenai pengendalian schistosomiasis, menilai kebijakan yang selama ini dilakukan oleh pemerintahdaerah dalam pengendalian schistosomiasis dan merumuskan suatu opsi kebijakan. Metode penelitian yang dipakaiadalah studi kualitatif dengan wawancara mendalam kepada stakeholder di Kabupaten Poso, Kabupaten Sigi, danpemerintah daerah Provinsi Sulawesi Tengah. Penentuan sampel dilakukan secara purposive sampling dimana sampeladalah stakeholder yang berkompeten mengeluarkan kebijakan tentang pengendalian schistosomiasis. Data primerdikumpulkan dengan wawancara mendalam, sedangkan data sekunder diperoleh dengan mengumpulkan dokumendokumenyang terkait dengan kebijakan pengendalian schistosomiasis. Hasil wawancara mendalam menunjukkanbahwa pada umumnya semua stakeholder sudah tahu kalau schistosomiasis adalah penyakit spesifik lokal yang diIndonesia cuma ada di Provinsi Sulawesi Tengah, apa penyebabnya dan bagaimana cara pengendaliannya. Tindaklanjut dari surat keputusan yang sudah dikeluarkan oleh Gubernur Sulawesi Tengah yang membentuk tim terpadupengendalian schistosomiasis sampai sekarang belum ada gerakan. Satuan Kerja Perangkat Daerah (SKPD) yangdiharapkan terlibat, belum tahu apa yang akan dikerjakan. Perlu dilakukan pertemuan koordinasi lintas sektor agarpengendalian schistosomiasis dapat terpadu, saling mendukung, bersinergi dan dapat menghasilkan tujuan yangdiharapkan yaitu eliminasi di bawah 1%. Kesimpulan dari penelitian ini adalah persepsi stakeholder mengenaipengendalian schistosomiasis cukup baik, mereka pada umumnya mengerti apa itu schistosomiasis, apa penyebabnyadan cara pengendaliannya. Kebijakan yang selama ini dilakukan oleh pemerintah daerah dalam pengendalianschistosomiasis sudah mendapat dukungan dari Gubernur Sulawesi Tengah. Opsi kebijakan yang mendukung TimTerpadu Pengendalian Schistosomiasis adalah perlunya dibuatkan Peraturan Daerah sebagai regulasi agarimplementasi di lapangan mendapat dukungan penuh dari semua SKPD yang terlibat dalam memberikan bantuannyabaik itu sumbangan pemikiran, sumber daya maupun dana. Masyarakat juga harus diberikan hukuman adat, berupadenda potong sapi dari tokoh adat jika tidak berperilaku hidup bersih dan sehat di wilayah endemis serta harusmendukung program pemerintah daerah dalam pengendalian schistosomiasis.Kata kunci: Opsi kebijakan, stakeholder, schistosomiasisAbstractSchistosomiasis is one of the most important parasitic diseases in public health. In Indonesia schistosomiasis caused byworms Schistosoma japonicum in Oncomelania hupensis snail intermediate host lindoensis. The disease is only found inStudi Kebijakan Pengendalian ¦ (Ahmad Erlan, Muh. Junaidi, Ni Nyoman Veridiana, Puryadi, Octaviani)43Central Sulawesi province in two districts of Poso district and Sigi. This control is performed during routine is still thetreatment, the survey focused snails, stool collection, and procurement tool kit. There was no study have ever beencarried out regarding the government policy to eradicate schistosomiasis. This study generally aims to provide policyoptions for local governments in the control of schistosomiasis. Specific objectives to be achieved are to assessstakeholder perceptions regarding the control of schistosomiasis, appraise the policy that has been used by the localgovernment in the control of schistosomiasis and formulate a policy option. The research method used is a qualitativestudy with in-depth interviews to stakeholders in Poso district, Sigi, and Central Sulawesi provincial government. Thepurposive samples were stakeholders who are competent to issue a policy on the control of schistosomiasis. Primarydata were collected by in-depth interviews, and secondary data were obtained by collecting documents related toschistosomiasis control policies. The results of in-depth interviews showed that in general all the stakeholders alreadyknew that schistosomiasis is a disease in specific local Indonesian and only found in Central Sulawesi, besides, they alsounderstand the cause and how to control the disease. As a follow-up of the decree issued by the Governor of CentralSulawesi, an integrated team of schistosomiasis control was established, however, no activities have been carried out bythe team up to now. There was no clear guidelines have been set up. There is a need to conduct inter-sectoral meetingin order to eliminate the cases below 1%. The study conclude that the stakeholders perception on schistosomiasis, whatthe cause of it, and how to control them are relatively good. The Governor supported the policy of local districtgovernment in eradication of schistosomiasis. However, lack of operational guidelines made these activities did notoperate very well. The propose policies option among others is to established a regulation that all related infrastructuresshould support the schistosomiasis eradication process by providing resources and funds including contributing ideasand measures to achieve the objectives. Communities should also involves and be responsible in the process includingcarry out sanctions to community members who do not comply with the regulation through community punishment. Tothose who do not comply with the rule to keep their environmental clean and sanitary should be given a sanctions suchas to cut their cow/livestock. Supporting Team Integrated Control of Schistosomiasis is needed for a regulation as theregulation on the ground that the implementation of the full support of all SKPDs involved in providing assistance bothcontribute ideas, resources and funds. People should be given the customary penalties, such as fines cut a cow fromtraditional leaders behave otherwise clean and healthy living in endemic areas and the need to support local governmentprograms in the control of schistosomiasis.Keywords : policy options, stakeholders, schistosomiasi

Acute Aerobic Exercise Reduces 24-H Ambulatory Blood Pressure Levels in Long-Term-Treated Hypertensive Patients

BACKGROUND: Even with anti-hypertensive therapy, it is difficult to maintain optimal systemic blood pressure values in hypertensive patients. Exercise may reduce blood pressure in untreated hypertensive, but its effect when combined with long-term anti-hypertensive therapy remains unclear. Our purpose was to evaluate the acute effects of a single session of aerobic exercise on the blood pressure of long-term-treated hypertensive patients. METHODS: Fifty treated hypertensive patients (18/32 male/female; 46.5±8.2 years; Body mass index: 27.8±4.7 kg/m²) were monitored for 24 h with respect to ambulatory (A) blood pressure after an aerobic exercise session (post-exercise) and a control period (control) in random order. Aerobic exercise consisted of 40 minutes on a cycle-ergometer, with the mean exercise intensity at 60% of the patient's reserve heart rate. RESULTS: Post-exercise ambulatory blood pressure was reduced for 24 h systolic (126±8.6 vs. 123.1±8.7 mmHg, p=0.004) and diastolic blood pressure (81.9±8 vs. 79.8±8.5 mmHg, p=0.004), daytime diastolic blood pressure (85.5±8.5 vs. 83.9±8.8 mmHg, p=0.04), and nighttime S (116.8±9.9 vs. 112.5±9.2 mmHg, p<0.001) and diastolic blood pressure (73.5±8.8 vs. 70.1±8.4 mmHg, p<0.001). Post-exercise daytime systolic blood pressure also tended to be reduced (129.8±9.3 vs. 127.8±9.4 mmHg, p=0.06). These post-exercise decreases in ambulatory blood pressure increased the percentage of patients displaying normal 24h systolic blood pressure (58% vs. 76%, p=0.007), daytime systolic blood pressure (68% vs. 82%, p=0.02), and nighttime diastolic blood pressure (56% vs. 72%, p=0.02). Nighttime systolic blood pressure also tended to increase (58% vs. 80%, p=0.058). CONCLUSION: A single bout of aerobic exercise reduced 24h ambulatory blood pressure levels in long-term-treated hypertensive patients and increased the percentage of patients reaching normal ambulatory blood pressure values. These effects suggest that aerobic exercise may have a potential role in blood pressure management of long-term-treated hypertensive

Acute aerobic exercise reduces 24-h ambulatory blood pressure levels in long-term-treated hypertensive patients

BACKGROUND: Even with anti-hypertensive therapy, it is difficult to maintain optimal systemic blood pressure values in hypertensive patients. Exercise may reduce blood pressure in untreated hypertensive, but its effect when combined with long-term anti-hypertensive therapy remains unclear. Our purpose was to evaluate the acute effects of a single session of aerobic exercise on the blood pressure of long-term-treated hypertensive patients. METHODS: Fifty treated hypertensive patients (18/32 male/female; 46.5±8.2 years; Body mass index: 27.8±4.7 kg/m²) were monitored for 24 h with respect to ambulatory (A) blood pressure after an aerobic exercise session (post-exercise) and a control period (control) in random order. Aerobic exercise consisted of 40 minutes on a cycle-ergometer, with the mean exercise intensity at 60% of the patient's reserve heart rate. RESULTS: Post-exercise ambulatory blood pressure was reduced for 24 h systolic (126±8.6 vs. 123.1±8.7 mmHg, p=0.004) and diastolic blood pressure (81.9±8 vs. 79.8±8.5 mmHg, p=0.004), daytime diastolic blood pressure (85.5±8.5 vs. 83.9±8.8 mmHg, p=0.04), and nighttime S (116.8±9.9 vs. 112.5±9.2 mmHg,

Situasi Filariasis Setelah Pengobatan Massal Tahun Ketiga di Kabupaten Mamuju Utara

Mass Drug Administration (MDA) of lymphatic filariasis has been carried out for three years in North of Mamuju District. However, achievement of efficacy of this programme was unknown. The implementation of mass treatment to filariasis have been conducted for three years in the District of North Mamuju, but achievement of efficacy of this activity were not known yet. To determine the change of filarial situation as well as knowledge, attitude and behavior of the people to filariasis, after three years mass drug treatment, studies were conducted in March-November 2015, the activities were to collect mass blood fingerprick and interview to the local community. The blood fingerprick was conducted to two selected villages do to age 5 years up old (≥ 5 years), and interviewed was conducted to thirty selected villages do to age 15 years up old (≥ 15 years). The results showed that microfilaria rate in North Mamuju district was 1,39%, and the species was Brugiamalayi. Interviewed to 1,586 respondents indicated that knowledge of filariasis disease and the mass treatment it self were low, similary with the behavior related prevention to drug consumption. On the other hand their behave to prevention, control and filariasis treatment were positif. Microfilaria rate was still higher than 1%, as well as knowledge, attitude and behavior related to prevention and mass drug consumption were particularly still low, those indicated that after three years of mass drug treatment implementation the result did not showed as excpected. It suggested that mass drug implementation in North Mamuju need to be continued until five years,with right procedures and seriously monitoring to the area with chronic and microfilaria positive cases

Supplementation of carotenoids from peach palm waste (Bactris gasipaes) obtained with an ionic liquid mediated process displays kidney anti-inflammatory and antioxidant outcomes

Sustainable extraction processes based on alternative solvents to recover bioactive compounds of different raw materials have been highlighted as excellent alternatives to supply the needs of society towards a bioeconomy strategy. Little is known about the safety and biological effect of compounds extracted by these processes. In this work, carotenoids from Bactris gasipaes wastes obtained by an IL-based process were investigated in terms of safety, anti-inflammatory and, antioxidant activity in a high-fat-diet animal model on the kidney. Wistar rats were supplemented or not by carotenoids extracted with IL or VOS. The animals supplemented with carotenoids had lower weight than control and high-fat diets. In the animals supplemented with carotenoids, the group IL improved anti-inflammatory and antioxidant activity compared with carotenoids obtained by VOS. Also, the group HFD-VOS showed moderate-severe injuries on the kidney. Then, ILs could represent a novel tool for natural pigments safely applied to food industry.publishe

Ionic liquid-mediated recovery of carotenoids from the bactris gasipaes fruit waste and their application in food-packaging chitosan films

In this work, a process for the extraction and purification of carotenoids from the fruit Bactris gasipaes was developed. Ethanolic and aqueous solutions of ionic liquids (ILs) and surfactants were evaluated on the extraction of these pigments. Thus, we developed an optimized sustainable downstream process mediated by the best solvent with further isolation of the carotenoids and the recyclability of the IL used. The process was characterized not only in terms of efficiency but also regarding its environmental impact. The recyclability of the solvents as well as the high efficiency (maximum yield of extraction of carotenoids = 88.7 ± 0.9 μgcarotenoids·gdried biomass–1) and the low environmental impact of the integrated process developed in this work were demonstrated. In the end, in order to incorporate functional activity for an alternative food-packaging material, carotenoids were successfully applied on the preparation of chitosan-based films with excellent results regarding their mechanical parameters and antioxidant activity.publishe

Isolation and functional characterization of proinflammatory acidic phospholipase A2 from Bothrops leucurus snake venom

AbstractIn the present study, an acidic PLA2, designated Bl-PLA2, was isolated from Bothrops leucurus snake venom through two chromatographic steps: ion-exchange on CM-Sepharose and hydrophobic chromatography on Phenyl-Sepharose. Bl-PLA2 was homogeneous on SDS-PAGE and when submitted to 2D electrophoresis the molecular mass was 15,000Da and pI was 5.4. Its N-terminal sequence revealed a high homology with other Asp49 acidic PLA2s from snake venoms. Its specific activity was 159.9U/mg and the indirect hemolytic activity was also higher than that of the crude venom. Bl-PLA2 induced low myotoxic and edema activities as compared to those of the crude venom. Moreover, the enzyme was able to induce increments in IL-12p40, TNF-α, IL-1β and IL-6 levels and no variation of IL-8 and IL-10 in human PBMC stimulated in vitro, suggesting that Bl-PLA2 induces proinflammatory cytokine production by human mononuclear cells. Bothrops leucurus venom is still not extensively explored and knowledge of its components will contribute for a better understanding of its action mechanism

Intensive nursing care to older adults with delirium: a protocol of scoping review

Objetivo: explorar sistematicamente a literatura quanto aos cuidados de enfermagem prestados aos idosos internados com delirium, em unidades de terapia intensiva, sejam eles para prevenção, sejam eles para manejo do delirium. Método: protocolo de revisão de escopo, estruturado pelas recomendações do Manual do Instituto Joanna Briggs, utilizando as seguintes bases de dados: PubMed via MEDLINE, Scopus, Embase, Web of Science e Google Scholar. A bibliografia encontrada será organizada através do gerenciador EndNote. Após a exclusão dos estudos duplicados, as citações serão transferidas para o software Rayyan. Em seguida, será iniciada a triagem das referências por dois pesquisadores independentes. O processo da seleção de estudos será exibido no fluxograma adaptado do Checklist PRISMA-ScR. Os dados serão extraídos dos estudos através de uma planilha desenvolvida no programa Microsoft Excel pelos próprios autores, avaliando e interpretando as informações de acordo com o objetivo proposto. Os dados serão organizados em tabelas, quadros e fluxogramas, com discussão narrativa.Objective: To systematically explore the literature regarding the nursing care provided to the older adult hospitalized with delirium in intensive care units for the prevention or management of delirium. Method: scoping review protocol, structured by the recommendations of the Joanna Briggs Institute manual, utilizing the following database: MEDLINE via PubMed, Scopus, Embase, Web of Science, and Google Scholar. We will organize the citations found through the EndNote manager. After the exclusion of duplicated studies, we will transfer the citations to the Rayyan software. Afterward, two independent researchers will begin the screening of titles/ abstracts. We will present the selection process of studies in the Checklist PRISMAScR adopted flowchart. The authors will extract the data of the studies through a spreadsheet developed in the Microsoft Excel, evaluating and interpreting the information according to the objective of the study. We will organize the data in charts, tables, and flowcharts with a narrative discussion.info:eu-repo/semantics/publishedVersio