Bantuan Australia kepada Kiribati melalui Program Kiribati Australia Nursing Initiative (KANI)

Kiribati merupakan salah satu negara yang terletak di Kepulauan Pasifik yang rentan dengan banjir karena kenaikan permukaan air laut dan diperkirakan akan tenggelam pada tahun 2050. Selain itu, Kiribati juga dihadapkan oleh permasalahan domestik, seperti pengangguran dan kemiskinan. Untuk mengatasi masalah tersebut, pemerintah Kiribati berupaya untuk membentuk kebijakan yang dikenal dengan “migration with dignity” dengan meningkatkan program pendidikan dan keterampilan. Untuk mendukung kebijakan tersebut, pemerintah Australia sebagai negara tetangga Kiribati, memberikan bantuan berupa beasiswa kepada masyarakat Kiribati dalam bentuk program beasiswa pendidikan geratis di bidang keperawatan dan memberikan kesempatan bagi masyarakat Kiribati yang telah lulus program tersebut untuk bekerja langsung di Australia. Bantuan beasiswa ini dikenal dengan Kiribati Australia Nursing Initiative (KANI). Penelitian ini menjawab pertanyaan faktor-faktor yang menjadi motif Australia dalam membantu Kiribati. Penelitian ini berupa studi kepustakaan dengan menggunakan metode kualitatif, mengumpulkan data dari buku, internet, dan artikel ilmiah. Hasil penelitian menunjukkan bahwa KANI merupakan program beasiswa yang tidak saja menguntungkan Kiribati sebagai negara penerima, tetapi juga menguntungkan Australia sebagai negara pemberi bantuan luar negeri. Self-interest Australia yang dominan dalam program KANI adalah kebutuhannya pada kekurangan tenaga kerja pada sektor kesehatan akibat terbatasnya sumber daya manusia dalam memenuhi kebutuhan tersebut, sekaligus untuk memenuhi tugas regional Australia sebagai ‘big brother’ di Pasifik. Kata kunci: Australia, bantuan luar negeri, KANI, Kiribati Kiribati is a nation in the Pacific Island that is exposed to flooding due to rising sea levels and is expected to sink by 2050. In addition, Kiribati is also faced domestic problems such as unemployment and poverty. To solve the problems, Kiribati government seeks to establish a policy known as "migration with dignity" by improving education and skills programs. To support this policy, Australian government as a neighboring country of Kiribati, provides scholarship assistance to the Kiribati community in the form of free education scholarship programs in the field of nursing and provides opportunities for kiribati citizen who have passed the program to work directly in Australia. This scholarship assistance is known as Kiribati Australia Nursing Initiative (KANI). This study answers the question of Australia's motive in helping Kiribati. This research is in the form of literature studies using qualitative methods, collecting data from books, the internet, journals and scientific articles. The result showed that KANI is a scholarship program that not only benefits Kiribati as a receiving country, but also benefits Australa as a foreign aid provider. Australia's dominant self-interest in KANI program is its need for workforce shortages in the health sector due to limited human resources in meeting those needs, as well as to fulfill Australia's regional duty as a 'big brother' in the Pacific. Keywords: Australia, foreign aid, KANI, Kiribat

Gaps to bridge: Misalignment between perception, reality and actions in obesity

Aims Despite increased recognition as a chronic disease, obesity remains greatly underdiagnosed and undertreated. We aimed to identify international perceptions, attitudes, behaviours and barriers to effective obesity care in people with obesity (PwO) and healthcare professionals (HCPs). Materials and methods An online survey was conducted in 11 countries. Participants were adults with obesity and HCPs who were primarily concerned with direct patient care. Results A total of 14 502 PwO and 2785 HCPs completed the survey. Most PwO (68%) and HCPs (88%) agreed that obesity is a disease. However, 81% of PwO assumed complete responsibility for their own weight loss and only 44% of HCPs agreed that genetics were a barrier. There was a median of three (mean, six) years between the time PwO began struggling with excess weight or obesity and when they first discussed their weight with an HCP. Many PwO were concerned about the impact of excess weight on health (46%) and were motivated to lose weight (48%). Most PwO (68%) would like their HCP to initiate a conversation about weight and only 3% were offended by such a conversation. Among HCPs, belief that patients have little interest in or motivation for weight management may constitute a barrier for weight management conversations. When discussed, HCPs typically recommended lifestyle changes; however, more referrals and follow‐up appointments are required. Conclusions Our international dataset reveals a need to increase understanding of obesity and improve education concerning its physiological basis and clinical management. Realization that PwO are motivated to lose weight offers an opportunity for HCPs to initiate earlier weight management conversations

Preventing recurrence of thromboembolic events through coordinated treatment in the District of Columbia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87024/1/j.1747-4949.2011.00654.x.pd

Type II Heat-Labile Enterotoxins from 50 Diverse Escherichia coli Isolates Belong Almost Exclusively to the LT-IIc Family and May Be Prophage Encoded

Some enterotoxigenic Escherichia coli (ETEC) produce a type II heat-labile enterotoxin (LT-II) that activates adenylate cyclase in susceptible cells but is not neutralized by antisera against cholera toxin or type I heat-labile enterotoxin (LT-I). LT-I variants encoded by plasmids in ETEC from humans and pigs have amino acid sequences that are ≥95% identical. In contrast, LT-II toxins are chromosomally encoded and are much more diverse. Early studies characterized LT-IIa and LT-IIb variants, but a novel LT-IIc was reported recently. Here we characterized the LT-II encoding loci from 48 additional ETEC isolates. Two encoded LT-IIa, none encoded LT-IIb, and 46 encoded highly related variants of LT-IIc. Phylogenetic analysis indicated that the predicted LT-IIc toxins encoded by these loci could be assigned to 6 subgroups. The loci corresponding to individual toxins within each subgroup had DNA sequences that were more than 99% identical. The LT-IIc subgroups appear to have arisen by multiple recombinational events between progenitor loci encoding LT-IIc1- and LT-IIc3-like variants. All loci from representative isolates encoding the LT-IIa, LT-IIb, and each subgroup of LT-IIc enterotoxins are preceded by highly-related genes that are between 80 and 93% identical to predicted phage lysozyme genes. DNA sequences immediately following the B genes differ considerably between toxin subgroups, but all are most closely related to genomic sequences found in predicted prophages. Together these data suggest that the LT-II loci are inserted into lambdoid type prophages that may or may not be infectious. These findings raise the possibility that production of LT-II enterotoxins by ETEC may be determined by phage conversion and may be activated by induction of prophage, in a manner similar to control of production of Shiga-like toxins by converting phages in isolates of enterohemmorhagic E. coli

MicroRNAs as Biomarkers for Myocardial Infarction

MicroRNAs (miRs) are short non-coding RNA molecules involved in post-transcriptional gene regulation by binding to the 3′ untranslated region of a messenger RNA (mRNA), thereby inhibiting the translation or inducing mRNA destabilization. MiRs are generally considered to act as intracellular mediators essential for normal cardiac function, and their deregulated expression profiles have been associated with cardiovascular diseases. Recent studies have revealed the existence of freely circulating miRs in human peripheral blood, which are present in a stable nature. This has raised the possibility that miRs may be released in the circulation and can serve as novel diagnostic markers for acute or chronic human disorders, including myocardial infarction (MI). This review summarizes the recent findings of miRs that fulfill the criteria of candidate biomarkers for MI

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research