Faktor-faktor yang Mempengaruhi Semangat Kerja Pegawai

Morale plays an important role in the achievement of organizational goals and is strongly influenced by the leadership style and motivation of employees.. The purpose of this study was to determine the effect of participatory leadership style and work motivation partially and simultaneously on morale. The research location is at the Medium Village Office in Badung. The sample used was 34 respondents. The data analysis technique used is the validity test, reliability, classical assumptions, multiple linear regression, coefficient of determination, t test and F test. Based on the results of the study, the results obtained: (1) participatory leadership style has a significant positive effect on morale, (2) work motivation has a significant positive effect on morale, and (3) simultaneously participatory leadership style and work motivation have a significant effect on morale. The amount of influence of the independent variables on morale is 60.4%

The role of REST and HDAC2 in epigenetic dysregulation of Nav1.5 and nNav1.5 expression in breast cancer

Background: Increased expression of voltage-gated sodium channels (VGSCs) have been implicated with strong metastatic potential of human breast cancer in vitro and in vivo where the main culprits are cardiac isoform Nav1.5 and its ‘neonatal’ splice variant, nNav1.5. Several factors have been associated with Nav1.5 and nNav1.5 gain of expression in breast cancer mainly hormones, and growth factors. Aim: This study aimed to investigate the role of epigenetics via transcription repressor, repressor element silencing transcription factor (REST) and histone deacetylases (HDACs) in enhancing Nav1.5 and nNav1.5 expression in human breast cancer by assessing the effect of HDAC inhibitor, trichostatin A (TSA). Methods: The less aggressive human breast cancer cell line, MCF-7 cells which lack Nav1.5 and nNav1.5 expression was treated with TSA at a concentration range 10–10,000 ng/ml for 24 h whilst the aggressive MDA-MB-231 cells was used as control. The effect of TSA on Nav1.5, nNav1.5, REST, HDAC1, HDAC2, HDAC3, MMP2 and N-cadherin gene expression level was analysed by real-time PCR. Cell growth (MTT assay) and metastatic behaviors (lateral motility and migration assays) were also measured. Results: mRNA expression level of Nav1.5 and nNav1.5 were initially very low in MCF-7 compared to MDA-MB-231 cells. Inversely, mRNA expression level of REST, HDAC1, HDAC2, and HDAC3 were all greater in MCF-7 compared to MDA-MB-231 cells. Treatment with TSA significantly increased the mRNA expression level of Nav1.5 and nNav1.5 in MCF-7 cells. On the contrary, TSA significantly reduced the mRNA expression level of REST and HDAC2 in this cell line. Remarkably, despite cell growth inhibition by TSA, motility and migration of MCF-7 cells were enhanced after TSA treatment, confirmed with the up-regulation of metastatic markers, MMP2 and N-cadherin. Conclusions: This study identified epigenetics as another factor that regulate the expression level of Nav1.5 and nNav1.5 in breast cancer where REST and HDAC2 play important role as epigenetic regulators that when lacking enhances the expression of Nav1.5 and nNav1.5 thus promotes motility and migration of breast cancer. Elucidation of the regulatory mechanisms for gain of Nav1.5 and nNav1.5 expression may be helpful for seeking effective strategies for the management of metastatic diseases

Salford postgraduate annual research conference (SPARC) 2012 proceedings

These proceedings bring together a selection of papers from the 2012 Salford Postgraduate Annual Research Conference (SPARC). They reflect the breadth and diversity of research interests showcased at the conference, at which over 130 researchers from Salford, the North West and other UK universities presented their work. 21 papers are collated here from the humanities, arts, social sciences, health, engineering, environment and life sciences, built environment and business

Juara Sihat™: study design of a school-based childhood obesity nutrition education programme in Kuala Lumpur, Malaysia

The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, including in Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions

The Relationship between Salivary IgA and White Oral Lesion in Bedridden Patients

Abstract The worldwide increase in the aging population poses tough challenges to the health care community. Indeed, older age has been associated with increased burden of chronic diseases. A decline in the protective functions of the oral mucosa could expose the aging individual to a variety of pathogens and chemicals that enter the oral cavity. The role of mucosal immunity in the defence against pathogens is well established. However, there does not seem to be much research on the relationship between salivary secretory immunoglobulin A (sIgA) and white lesion particularly among geriatric residents of long-term health care. Immunoglobulin A (IgA) is the dominant immunoglobulin isotype on oral mucosal surface where it acts as a first line of defence against microbial invasion. Recent investigations suggest that secretory IgA concentrations vary over the day due to a range of variables including dietary factors, daily mood, and exercise. The aim of this study is to investigate the relationship of sIgA level, and salivary pH with white lesion in bedridden patients. In this study, salivary IgA was determined by ELISA in samples of 34 elderly ( 60-80 years old ) subjects grouped as male and female . Unstimulated saliva was collected, saliva flow, PH, and sIgA concentrations were measured. The results showed that the sIgA concentration was significantly higher in patients with white lesion (536.97±88.63) comparing to those with healthy mucosa (323.79±64.01) , and there is no significant difference of sIgA concentration between male (476.46±145.58) and female (396.83±108.09). We concluded that early detection of oral health problems especially white lesion can be determined by the assessment of the sIgA level. This would reflect the salivary IgA protective mechanism in patients with white lesion problems

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The effects of different disinfectants and application conditions on microbial contaminants at dairy processing line

Disinfectants are very crucial in reducing microbial contaminants at dairy processing lines. However, there are limitations of their efficacy due to broad spectrum of microorganisms. Therefore, the aim of the present work was to investigate varying implementation conditions of disinfectants, Oxonia Active, Whisper V®, and carvacrol, that could give the highest reduction of foodborne pathogens. The killing efficacy of disinfectants were determined through suspension test at different concentrations (0.3‐1.0%), temperatures (25‐70°C), and contact times (5‐15 min) against six foodborne pathogens. 1.0% Oxonia Active at 25°C for > 10 min in suspension test achieved > 5 log CFU/mL microbial reduction for all foodborne pathogens with a complete elimination of Escherichia coli, Staphylococcus aureus, and Bacillus subtilis. The application of Oxonia Active on the surface and biofilm tests (representing dairy processing equipment) showed significant microbial (pathogen) reduction (> 3 log CFU/mL) of 4 pathogens cocktail

BARRIERS IN INTERVENTION CHARACTERISTICS OF CLUSTER HOSPITAL (CH) IMPLEMENTATION IN MALAYSIA: AN EXPLORATORY STUDY

To address an imbalance between congested specialist hospitals and underutilised district non-specialist hospitals, Ministry of Health Malaysia introduced Cluster Hospital (CH) in 2014. Following successful implementations from countries with similar healthcare system such as Hong Kong, and Australia, CH merges hospitals to establish an integrated network of specialist and non-specialist hospitals through shared resources, streamlined services and care coordination. A qualitative study was conducted to explore perceived barriers and boosters towards CH implementation and its sustainability among healthcare providers via semi-structured focus group discussions and in-depth interviews with purposefully selected respondents from the first six CHs. An Interview protocol was developed based on Consolidated Framework for Implementation Research (CFIR) covering five domains; intervention characteristics, outer setting, inner setting, characteristics of individuals, and process. This paper will only highlight the perceived barriers in the intervention characteristics domain. A total of 274 participants from varying professions were interviewed. Interviews were audio-recorded, transcribed and thematic analysis was performed. In this domain, barriers to implementation were found within three constructs; complexity, design quality &amp; packaging, and cost. Issues highlighted include intervention was designed with vague guidelines &amp; policies, distance and travel costs within a CH, medical record safety, huge capital and operating cost involved. It was found that adaptation of evidence-based interventions needs to take into account the local context of an organisation for the implementation to be successful and produce desired outcomes. Thus, these perceived barriers raised by ground-level implementers should be considered and acted upon when strategising towards CH sustainability