Paramater on Maternal Delivery Referral Process

Introduction: The rate of maternal mortality in Indonesia according to 2002–2003 Indonesian Demographic and Health Survey (IDHS) was 307 per 100,000 live births. The direct causes of maternal deaths, among others, are prolonged labor, hemorrhage, infection, and preeclampsia. Referral system includes referring responsibility to better facilitated healthcare sites to obtain more adequate services. However, maternal referral process in Banjar District still faces some problems such as referral health providers with inadequate skills of handling emergency cases, insufficient means of transportation, and no referral letter or partograph. Usually, when referred, the pregnant woman is only accompanied by her family so that she is brought to the referral site without being equipped with infusion. The objective of the study was to evaluate the parameter of maternal delivery referral in Ratu Zalekha Martapura District Hospital. Method: This study used observational study with a cross-sectional study design using quantitative and qualitative approaches. Samples were 107 delivering women referred to hospitals selected with non probability sampling. Data were analyzed with Chi-square (χ) and logistic regression test. Result: Quality maternal referral process resulted in healthy women 78.8%. Post delivery women's health was greater in quality maternal referral process (RP = 2.1; 95% CI = 1.28–3.52). Normal delivery had an opportunity towards post delivery women's health (RP = 1.6; 95% CI = 1.13–2.20). In addition, time needed to reach the referral sites and referral birth attendants were significantly associated with maternal referral process (p = 0.002 and p = 0.002). Meanwhile, women's condition when referred was insignificant statistically. Discussion: Quality maternal referral process could likely improve post delivery women's health.Normal delivery affected the women's health condition

Evolution of microstructural and mechanical properties of nanocrystalline Co2FeAl Heusler alloy prepared by mechanical alloying

Mechanical alloying (MA) has been used to fabricate the Co2FeAl Heusler alloy with a nanocrystalline structure. The formation mechanism of the alloy has been investigated. Rietveld analysis showed that all samples that were milled for more than 15 hours had an L21 structure with a space group of Fm3m. The crystallite size and internal strain of the samples were calculated using the Williamson-Hall equation. With mechanical alloying of up to 20 hours the crystallite size of Co2FeAl increased, after which the crystallite size started to decrease. In contrast, internal strain first decreased during the process and then increased with the increase of milling time. The powder obtained after 20 hours of MA was split into three parts and separately annealed at 300, 500 and 700 oC for 5 hours. A considerable increase was observed in the hardness value of powder particles with the increase of annealing temperature up to 500 oC. However, the hardness value of the sample annealed at 700 oC decreased. It seems that this feature is related to parameters such as increase of crystallite size, enhancement of lattice ordering, change in density of defects and impurities and nonstoichiometric effects

A Flow Based Horizontal Scan Detection Using Genetic Algorithm Approach

Abstract: An attacker has to "scan" susceptible points of a network before attacking. There are several methods of detection of such behavior which are mostly based on thresholding. As the performance of these methods is highly dependent on the value of threshold, it is crucial to adjust this value appropriately. This adjustment is not always trivial. In this study we proposed a new method to optimize the parameters of the system using genetic algorithms (GA) based on network flows. Subsequently we compared our method with Snort. The results showed a superior performance as measured by the sensitivity index of d"

The effect of mirabegron on patient-related outcomes in patients with overactive bladder: the results of post hoc correlation and responder analyses using pooled data from three randomized Phase III trials

Purpose To understand how improvements in the symptoms of overactive bladder (OAB) seen with the b3-adrenoceptor agonist mirabegron 50 mg, correlate with patient experience as measured by validated and standard patient-reported outcomes (PROs), and to identify whether there is overall directional consistency in the responsiveness of PROs to treatment effect. Methods In a post hoc analysis of pooled data from three randomized, double-blind, placebo-controlled, 12-week Phase III trials of mirabegron 50 mg once daily, responder rates for incontinence frequency (C50 % reduction in incontinence episodes/24 h from baseline to final visit), micturition frequency (B8 micturitions/24 h at final visit), and PROs [minimally important differences in patient perception of bladder condition (PPBC) and subsets of the overactive bladder questionnaire (OAB-q) measuring total health-related quality of life (HRQoL), and symptom bother] were evaluated individually and in combination. Results Mirabegron 50 mg demonstrated greater improvement from baseline to final visit than placebo for each of the responder analyses, whether for individual objective and subjective outcomes or combinations thereof. These improvements versus placebo were statistically significant for all double and triple responder analyses and for all single responder analyses except PPBC. PRO measurements showed directional consistency and significant correlations, and there were also significant correlations between objective and subjective measures of efficacy. Conclusions The improvements in objective measures seen with mirabegron 50 mg translate into a meaningful clinical benefit as evident by the directional consistency seen in HRQoL measures of benefit

Survey of Authors’ Collaboration Rate in Scientometrics Journal Articles during 2004 to 2008

There are evidences of the relationship between collaboration rate and quality of articles. The more the number of authors, the more qualified the article. Study of the collaboration rate among researchers is essential for strategic planning and research policy in major.The main objective of this research is to determine the authors' collaboration rate in the articles of Scientometrics journal. Other aims are determination of the number of articles of the journal during the mentioned year, the most prolific authors, the most prolific organizations and research centers, etc. The type of research is descriptive survey. Data was gathered via check list and analyzed through Excel.The most articles have been published in 2006 and the least in 2004. The mean number for each article is 2.33 authors. The collaboration coefficient is 0.60. Wolfgang Glänzel, Ronald Rousseau, and Leo Egghe are 3 writers who had the most articles and also the more collaboration during the mentioned years.Katholieke Universiteit Leuven (Belgium) with 71 articles, University of Granada (Spain (with 49 articles and Hungarian Academy of Sciences (Hungary) with 33 articles are the centers which had the most collaborations

Adherence and persistence to oral medication in patients with overactive bladder (OAB) in a real-world setting – a systematic literature review.

Purpose To evaluate persistence and adherence of oral pharmacotherapy used in the treatment of overactive bladder (OAB) in a real-world setting. Materials and methods Systematic literature searches of six electronic publication databases were performed to identify observational studies of patients with OAB treated with antimuscarinics and/or mirabegron. Studies obtaining persistence and adherence data from sources other than electronic prescription claims were excluded. Reference lists of identified studies and relevant systematic reviews were assessed to identify additional relevant studies. Results The search identified 3897 studies, of which 30 were included. Overall, persistence ranged from 5% to 47%. In studies reporting data for antimuscarinics and mirabegron (n=3), 1-year persistence was 12%–25% and 32%–38%, respectively. Median time to discontinuation was <5 months for antimuscarinics (except one study (6.5 months)) and 5.6–7.4 months for mirabegron. The proportion of patients adherent at 1 year varied between 15% and 44%. In studies reporting adherence for antimuscarinics and mirabegron, adherence was higher with mirabegron (mean medication possession ratio (MPR): 0.59 vs 0.41–0.53; mean proportion of days covered: 0.66 vs 0.55; and median MPR: 0.65 vs 0.19–0.49). Reported determinants of persistence and adherence included female (sex), older age group, use of extended-release formulation and treatment experience. Conclusion Most patients with OAB discontinued oral OAB pharmacotherapy and were non-adherent 1 year after treatment initiation. In general, mirabegron was associated with greater persistence and adherence compared with antimuscarinics. Combined with existing clinical trial evidence, this real-world review merits consideration of mirabegron for first-line pharmacological treatment among patients with OAB. PROSPERO registration number CRD4201705989