The Influence of Pregnancy on the Recurrence of Cutaneous Malignant Melanoma in Women

Objective. The aim of this study was to determine whether pregnancy increases the recurrence risk of cutaneous malignant melanoma (CMM) in women with a history of stage I CMM. Methods. The electronic medical databases of Medline and Embase were explored. All 1084 obtained articles were screened on title and abstract using predetermined inclusion and exclusion criteria. A critical appraisal of relevance and validity was conducted on the remaining full text available articles. Results. Two studies were selected. Both studies revealed no significant difference in disease-free survival between women with stage I CMM and the control population. Conclusion. Pregnancy does not increase the recurrence risk of CMM in women with a history of stage I CMM

PENGUATAN NILAI – NILAI PANCASILA MELALUI PROFIL PELAJAR PANCASILA DI SD NEGERI 008 SILAM DAN SD NEGERI 022 SILAM DESA SILAM KECAMATAN KUOK KABUPATEN KAMPAR

Profil pelajar pancasisila adalah bentuk penguatan nilai - nilai pancasila melalui profil yang ideal dalam membentuk karakter peserta didik dalam dunia pendidikan. Profil pelajar pancasila merupakan suatu upaya dalam memperkuat karakter siswa - siswi melalui nilai-nilai yang terdapat di dalam Pancasila. Pengenalan terhadap profil pelajar pancasila kepada peserta didik di setiap jenjang pendidikan harus dilaksanakan. Sosialisasi dilakukan oleh Tim Kukerta Universitas Riau dengan melakukan presentasi melalui PowerPoint dengan tema Pentingnya Profil Pelajar Pancasila. Sosialisasi ini bertujuan untuk meningkatkan dan mengembangkan pengetahuan Siswa SD Negeri 008 Silam dan SD Negeri 022 Silam terkait program Profil Pelajar Pancasila bagi pendidik dan peserta didik. Kegiatan sosialisasi ini didukung oleh beberapa peralatan seperti laptop, LCD, WI-FI, speaker dan lain sebagainya. Pengabdian masyarakat dilakukan pada hari Jum’at, 22 Juli 2022 dan Selasa, 26 Juli 2022 secara luring. Kegiatan sosialisasi ini diikuti oleh siswa kelas 4-6 dan didampingi beberapa Guru. Kegiatan pengabdian ini dilaksanakan dengan izin sekolah dan diketahui oleh Dosen Pembimbing Lapangan (DPL)

Climate Change, Growth, and California Wildfire

Large wildfire occurrence and burned area are modeled using hydroclimate and landsurface characteristics under a range of future climate and development scenarios. The range of uncertainty for future wildfire regimes is analyzed over two emissions pathways (the Special Report on Emissions Scenarios [SRES] A2 and B1 scenarios); three global climate models (Centre National de Recherches Météorologiques CM3, Geophysical Fluid Dynamics Laboratory CM21 and National Center for Atmospheric Research PCM2); a mid‐range scenario for future population growth and development footprint; two model specifications related to the uncertainty over the speed and timing with which vegetation characteristics will shift their spatial distributions in response to trends in climate and disturbance; and two thresholds for defining the wildland‐urban interface relative to housing density. Results were assessed for three 30‐year time periods centered on 2020, 2050, and 2085, relative to a 30‐year reference period centered on 1975. Substantial increases in wildfire are anticipated for most scenarios, although the range of outcomes is large and increases with time. The increase in wildfire area burned associated with the higher emissions pathway (SRES A2) is substantial, with increases statewide ranging from 57 percent to 169 percent by 2085, and increases exceeding 100 percent in most of the forest areas of Northern California in every SRES A2 scenario by 2085. The spatial patterns associated with increased fire occurrence vary according to the speed with which the distribution of vegetation types shifts on the landscape in response to climate and disturbance, with greater increases in fire area burned tending to occur in coastal southern California, the Monterey Bay area and northern California Coast ranges in scenarios where vegetation types shift more rapidly.National Oceanic and Atmospheric Administration (NOAA) Regional Integrated Science and Assessment Program for California, United StatesCalifornia Climate Change Center/[CEC-500-2009-046-F]//Estados UnidosUnited States Department of Agriculture (USDA) Forest Service Pacific Southwest Research Station///Estados UnidosNational Oceanic and Atmospheric Administration (NOAA) Regional Integrated Science and Assessment Program for California///Estados UnidosUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones Geofísicas (CIGEFI

Behavioral adaptation to climate change in wildfireâ prone forests

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146375/1/wcc553.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146375/2/wcc553_am.pd

The structure of quality systems is important to the process and outcome, an empirical study of 386 hospital departments in Sweden

<p>Abstract</p> <p>Background</p> <p>Clinicians, nurses, and managers in hospitals are continuously confronted by new technologies and methods that require changes to working practice. Quality systems can help to manage change while maintaining a high quality of care. A new model of quality systems inspired by the works of Donabedian has three factors: structure (resources and administration), process (culture and professional co-operation), and outcome (competence development and goal achievement). The objectives of this study were to analyse whether structure, process, and outcome can be used to describe quality systems, to analyse whether these components are related, and to discuss implications.</p> <p>Methods</p> <p>A questionnaire was developed and sent to a random sample of 600 hospital departments in Sweden. The adjusted response rate was 75%. The data were analysed with confirmatory factor analysis and structural equation modeling in LISREL. This is to our knowledge the first large quantitative study that applies Donabedian's model to quality systems.</p> <p>Results</p> <p>The model with relationships between structure, process, and outcome was found to be a reasonable representation of quality systems at hospital departments (p = 0.095, indicating no significant differences between the model and the data set). Structure correlated strongly with process (0.72) and outcome (0.60). Given structure, process also correlated with outcome (0.20).</p> <p>Conclusion</p> <p>The model could be used to describe and evaluate single quality systems or to compare different quality systems. It could also be an aid to implement a systematic and evidence-based system for working with quality improvements in hospital departments.</p

Pain in the lumbar, thoracic or cervical regions: do age and gender matter? A population-based study of 34,902 Danish twins 20–71 years of age

Background. It is unclear to what extent spinal pain varies between genders and in relation to age. It was the purpose of this study to describe the self-reported prevalence of 1) pain ever and pain in the past year in each of the three spinal regions, 2) the duration of such pain over the past year, 3) pain radiating from these areas, and 4) pain in one, two or three areas. In addition, 5) to investigate if spinal pain reporting is affected by gender and 6) to see if it increases gradually with increasing age. Method. A cross-sectional survey was conducted in 2002 on 34,902 twin individuals, aged 20 to 71 years, representative of the general Danish population. Identical questions on pain were asked for the lumbar, thoracic and cervical regions. Results. Low back pain was most common, followed by neck pain with thoracic pain being least common. Pain for at least 30 days in the past year was reported by 12%, 10%, and 4%, respectively. The one-yr prevalence estimates of radiating pain were 22% (leg), 16% (arm), and 5% (chest). Pain in one area only last year was reported by 20%, followed by two (13%) and three areas (8%). Women were always more likely to report pain and they were also more likely to have had pain for longer periods. Lumbar and cervical pain peaked somewhat around the middle years but the curves were flatter for thoracic pain. Similar patterns were noted for radiating pain. Older people did not have pain in a larger number of areas but their pain lasted longer. Conclusion. Pain reported for and from the lumbar and cervical spines was found to be relatively common whereas pain in the thoracic spine and pain radiating into the chest was much less common. Women were, generally, more likely to report pain than men. The prevalence estimates changed surprisingly little over age and were certainly not more common in the oldest groups, although the pain was reported as more long-lasting in the older group

Housing Arrangement and Location Determine the Likelihood of Housing Loss Due to Wildfire

Surging wildfires across the globe are contributing to escalating residential losses and have major social, economic, and ecological consequences. The highest losses in the U.S. occur in southern California, where nearly 1000 homes per year have been destroyed by wildfires since 2000. Wildfire risk reduction efforts focus primarily on fuel reduction and, to a lesser degree, on house characteristics and homeowner responsibility. However, the extent to which land use planning could alleviate wildfire risk has been largely missing from the debate despite large numbers of homes being placed in the most hazardous parts of the landscape. Our goal was to examine how housing location and arrangement affects the likelihood that a home will be lost when a wildfire occurs. We developed an extensive geographic dataset of structure locations, including more than 5500 structures that were destroyed or damaged by wildfire since 2001, and identified the main contributors to property loss in two extensive, fire-prone regions in southern California. The arrangement and location of structures strongly affected their susceptibility to wildfire, with property loss most likely at low to intermediate structure densities and in areas with a history of frequent fire. Rates of structure loss were higher when structures were surrounded by wildland vegetation, but were generally higher in herbaceous fuel types than in higher fuel-volume woody types. Empirically based maps developed using housing pattern and location performed better in distinguishing hazardous from non-hazardous areas than maps based on fuel distribution. The strong importance of housing arrangement and location indicate that land use planning may be a critical tool for reducing fire risk, but it will require reliable delineations of the most hazardous locations

Avoidable mortality across Canada from 1975 to 1999

BACKGROUND: The concept of 'avoidable' mortality (AM) has been proposed as a performance measure of health care systems. In this study we examined mortality in five geographic regions of Canada from 1975 to 1999 for previously defined avoidable disease groups that are amenable to medical care and public health. These trends were compared to mortality from other causes. METHODS: National and regional age-standardized mortality rates for ages less than 65 years were estimated for avoidable and other causes of death for consecutive periods (1975–1979, 1980–1985, 1985–1989, 1990–1994, and 1995–1999). The proportion of all-cause mortality attributable to avoidable causes was also determined. RESULTS: From 1975–1979 to 1995–1999, the AM decrease (46.9%) was more pronounced compared to mortality from other causes (24.9%). There were persistent regional AM differences, with consistently lower AM in Ontario and British Columbia compared to the Atlantic, Quebec, and Prairies regions. This trend was not apparent when mortality from other causes was examined. Injuries, ischaemic heart disease, and lung cancer strongly influenced the overall AM trends. CONCLUSION: The regional differences in mortality for ages less than 65 years was attributable to causes of death amenable to medical care and public health, especially from causes responsive to public health

Cause-specific mortality time series analysis: a general method to detect and correct for abrupt data production changes

<p>Abstract</p> <p>Background</p> <p>Monitoring the time course of mortality by cause is a key public health issue. However, several mortality data production changes may affect cause-specific time trends, thus altering the interpretation. This paper proposes a statistical method that detects abrupt changes ("jumps") and estimates correction factors that may be used for further analysis.</p> <p>Methods</p> <p>The method was applied to a subset of the AMIEHS (Avoidable Mortality in the European Union, toward better Indicators for the Effectiveness of Health Systems) project mortality database and considered for six European countries and 13 selected causes of deaths. For each country and cause of death, an automated jump detection method called Polydect was applied to the log mortality rate time series. The plausibility of a data production change associated with each detected jump was evaluated through literature search or feedback obtained from the national data producers.</p> <p>For each plausible jump position, the statistical significance of the between-age and between-gender jump amplitude heterogeneity was evaluated by means of a generalized additive regression model, and correction factors were deduced from the results.</p> <p>Results</p> <p>Forty-nine jumps were detected by the Polydect method from 1970 to 2005. Most of the detected jumps were found to be plausible. The age- and gender-specific amplitudes of the jumps were estimated when they were statistically heterogeneous, and they showed greater by-age heterogeneity than by-gender heterogeneity.</p> <p>Conclusion</p> <p>The method presented in this paper was successfully applied to a large set of causes of death and countries. The method appears to be an alternative to bridge coding methods when the latter are not systematically implemented because they are time- and resource-consuming.</p