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Kinerja tenaga kesehatan yang baik akan berdampak pada kualitas pelayanan pemeriksaan pada ibu hamil, termasuk kinerja bidan sebagai penyedia pelayanan kesehatan maternal dan neonatal.. Apabila proses kehamilan, persalinan dan nifas dapat dilalui oleh seorang perempuan dengan aman, maka Angka Kematian Ibu di Indonesia dapat ditekan.Penelitian ini bertujuan untuk mengetahui faktor – faktor yang memoengaruhi kepatuhan bidan terhadap standar pelayanan Antenatal diKota Palembang. Penelitian menggunakan rancangan data cross sectional dengan populasi bidan di Kota Palembang sebanyak 270 orang sedangkan sampelnya menggunakan proportional stratified random sampling jumlah sampel 126 bidan di kota palembang. Pengumpulan data dengan kuesioner dan ceklis tentang standar pelayanan Antenatal. Data dianalisis dengan uji regresi logistik. Hasil penelitian dengan uji regresi linier berganda variabel yang paling berpengaruh terhadap kepatuhan bidan terhadap standar pelayanan Antenatal adalah usia dan masa kerja. Kekuatan hubungan dapat dilihat dari nilai OR (Exp B). Kekuatan hubungan yang terbesar ke yang terkecil adalah usia (OR = 9,270), masa kerja (OR = 6,387)., persamaan regresi didapatkan bahwa probabilitas terhadap ketidakpatuhan bidan dalam standar pelayanan ANC adalah 70,72%. Kesimpulan dari penelitian ini adalah ada hubungan antara pengetahuan, sikap, motivasi usia dan amasa kerja terhadap standar pelayanan Antenatal dan tidak ada hubungan antara pelatihan dengan standar pelayanan antenatal. Saran dalam penelitian ini adalah agar dapat digunakan untuk melakukan penelitian lanjutan tentang pelaksanaan standar pelayanan Antenatal.

BACKGROUND AND PURPOSE JNJ-26070109 [(R)4-bromo-N-[1-(2,4-difluoro-phenyl)-ethyl]-2-(quinoxaline-5-sulfonylamino)-benzamide] is a novel antagonist at cholecystokinin CCK2 receptors with good pharmacokinetic properties and represents a novel mechanism for the treatment of gastro-oesophageal reflux disease (GORD). The purpose of the present study was to determine whether chronic treatment with JNJ-26070109 could prevent, as well as treat, acid rebound in rats. EXPERIMENTAL APPROACH A chronic fistula was surgically inserted into the stomach of rats to enable the measurement of acid secretion under basal, pentagastrin and histamine-stimulated conditions. JNJ-26070109 and omeprazole were administered separately and in combination. KEY RESULTS Sustained administration of omeprazole alone and in combination with JNJ-26070109 inhibited gastric acid secretion by >90%. However, 3 days after withdrawing treatment, there was a rebound hypersecretion by ∼1.5-fold in omeprazole-treated animals. No such acid rebound was observed with JNJ-26070109 alone or with co-administration of JNJ-26070109 and omeprazole. The anti-trophic effects of JNJ-26070109 in the gastric mucosal paralleled the effects on acid rebound. Administration of JNJ-26070109 for 3 days after cessation of omeprazole prevented the occurrence of acid rebound. Interestingly, chronic, but not acute, treatment with JNJ-26070109 also inhibited histamine-stimulated acid secretion. CONCLUSIONS AND IMPLICATIONS Chronic administration of JNJ-26070109 effectively inhibited gastric acid secretion and suppressed proton pump inhibitor (PPI)-induced acid rebound in the rat. This work advances the field by demonstrating that modest doses of a competitive CCK2 receptor antagonist have significant and functionally important anti-trophic actions in the gastric mucosa. These properties make JNJ-26070109 a suitable candidate for clinical investigation for the treatment of GORD. [ABSTRACT FROM AUTHOR]

Hospital as one of health public services institution on delivering health services supported by multidiscipline professions that have diversity of personality. Personality is one of factor contributed in triggering interpersonal conflict at workplace. There are five interpersonal conflict managements commonly used, namely ; integrating, obliging, dominating, avoiding dan compromising. Research was conducted on March 2015 at Eye Specialist Hospital South Sumatera Province which 75 respondens as samples of the reaserch. The objectives of this reaserch to explore differences among type A and B personality toward interpersonal conflict management in the hospital. Cross Sectional Study as design of the reaserch with Manova and Post Hoc test analyisis. From this reaserch found that type A personality is dominant personality of employee, and dominant interpersonal conflict management is integrating style. Based on the risult of Post Hoc analysis shown that significant difference between type A and B personality towrad management conflict of interpersonal found on obliging style with P value 0,000 < 0,05, for other management conflict style was not found.

Scanning electron microscopy was used to investigate the surface architecture of the human tympanic membrane. The morphology of the eardrum was compared with the surface structures of preserved tympanic membranes (allografts), fresh air-dried temporalis fascia and preserved calf jugular veins (xenografts). The role of the physical structure and the composition of the extracellular matrix in the regeneration of a tympanic graft is discussed. [ABSTRACT FROM AUTHOR]

Purpose: This article evaluates a possible global nuclear renaissance in the provision of electrical energy. Problem investigated: Several countries, such as South Africa, are experiencing problems in the provision of electricity and the maintenance of the infrastructure to answer growing demand. This article investigates an alternative, which was popular in the 1970s and provides clean energy. Methodology: The study firstly evaluates the main arguments set by anti-nuclear activists critically. It concerns negative public sentiment, human life and environmental endangerment, alternative energy, cost effectiveness and waste disposal concerns. The study focuses on the cost of nuclear power, as the benefits of electricity are assumed homogeneous. The second part of the article reports on an empirical cost-benefit analysis conducted by the authors to estimate the value and likeliness of a nuclear renaissance. Findings and implications: The empirical analysis indicated that nuclear energy is mostly cost-efficient. The research shows that there might be a slight increase in the use of nuclear power-producing technologies in future. Originality and value of the research: This study makes a positive contribution to the electrical power and nuclear energy debate. It assesses the possibility of a nuclear renaissance objectively. The environment, global energy shortage and different cost structures of various modes of energy production were considered. Conclusion: The study concluded that a nuclear renaissance is possible, but that despite the advantages to costs and the environment, this would not yet be statistically significant enough to cause a nuclear renaissance.

No abstract available.

Die artikel het op die belangrikheid en noodsaaklikheid van ‘n hermeneutiek vir die gereformeerde kerkreg gefokus. Die kerkregtelike dokument wat besonderlik ter sake was, is die kerkorde van die Gereformeerde kerke in Suid-Afrika, met sy besondere band met die Dordtse kerkorde van 1618 en 1619. Agtereenvolgens is aandag gegee aan die volgende aspekte soos (1) die eiesoortige aard van ‘n kerkorde as ‘n teologiese dokument en teks, in onderskeiding van regsdokumente; (2) die aard van die hermeneutiek van kerkreg; (3) enkele teorieë oor die interpretasie of uitleg van tekste, veral regstekste en (4) normatiewe vooronderstellings en reëls vir die interpretasie en verstaan van die teks en artikels van die kerkorde asook besluite van kerklike vergaderinge. Die gevolgtrekking was dat weinig indringende navorsing gedoen is oor die saak van hermeneutiek vir kerkreg, hoewel dit noodsaaklik is. Duidelike hermeneutiese reëls is gesuggereer en verduidelik, wat sou kon meehelp dat kerke en kerklike vergaderinge die artikels van die kerkorde asook besluite en reglemente wat daarop berus het, kan interpreteer en toepas. The hermeneutics of reformed church polity. The article focused on the importance and urgency of a design for reformed hermeneutics on church polity. The Church Order referred to in the article is the Church Order of the Reformed Churches in South Africa, which are closely related to the Church Order of Dordt of 1618 and 1619. The following aspects received attention namely (1) the unique character of a Church Order, in comparison to and distinguished from legal documents and statutes; (2) the character and nature of hermeneutics of church polity; (3) theories of interpretation in the common law tradition and their relevance to church polity and (4) normative presuppositions and marks for the interpretation and understanding of the text and articles of the Church Order, as well as the resolutions of church assemblies. It was found that minimum research has been done on the topic of hermeneutics for reformed church polity. This contribution was an effort to suggest and explain a number of hermeneutical principles and guidelines, which may serve and encourage churches and assemblies to interpret, utilise and apply the Church Order in an adequate and responsible way.

The affirmative action bandwagon has finally hit South Africa.

Background and Aims: DiGeorge syndrome (DGS) is a genetic disorder manifesting in polymorphic symptoms related to developmental abnormalities of various organs including thymus. DGS is caused by microdeletions in the 22q11.2 region between several low copy repeats (LCR) occurring in approximately 1 in 4000 live births. Diagnosis of DGS relies on phenotypic examination, qPCR, ultrasound, FISH, MLPA and NGS which can be relatively inaccurate, time-consuming, and costly., Materials and Methods: A novel multiplex droplet digital PCR (ddPCR) assay was designed, optimized and validated for detection and mapping 22q11.2 microdeletions by simultaneous amplification of three targets - TUPLE1, ZNF74, D22S936 - within the deletion areas and one reference target - RPP30 - as an internal control., Results: The assay reliable identified microdeletions when the template concentration was >32 copies per reaction and successfully detected LCR22A-B, LCR22A-C, LCR22A-D, and LCR22B-C deletions in clinical samples from 153 patients with signs of immunodeficiency. In patients with the microdeletions, flow cytometry detected a significant increase in B-cell and natural killer cell counts and percentages, while T-cell percentages and T-cell receptor excision circle (TREC) numbers decreased., Conclusion: The designed ddPCR assay is suitable for diagnosing DGS using whole blood and blood spots., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: The Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version., Design: A two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers' networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement., Results: Fifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback., Conclusions: The SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The multifaceted nature of neuroinflammation is highlighted by its ability to both aggravate and promote neuronal health. While in mammals retinal ganglion cells (RGCs) are unable to regenerate following injury, acute inflammation can induce axonal regrowth. However, the nature of the cells, cellular states and signalling pathways that drive this inflammation-induced regeneration have remained elusive. Here, we investigated the functional significance of macrophages during RGC de- and regeneration, by characterizing the inflammatory cascade evoked by optic nerve crush (ONC) injury, with or without local inflammatory stimulation in the vitreous. By combining single-cell RNA sequencing and fate mapping approaches, we elucidated the response of retinal microglia and recruited monocyte-derived macrophages (MDMs) to RGC injury. Importantly, inflammatory stimulation recruited large numbers of MDMs to the retina, which exhibited long-term engraftment and promoted axonal regrowth. Ligand-receptor analysis highlighted a subset of recruited macrophages that exhibited expression of pro-regenerative secreted factors, which were able to promote axon regrowth via paracrine signalling. Our work reveals how inflammation may promote CNS regeneration by modulating innate immune responses, providing a rationale for macrophage-centred strategies for driving neuronal repair following injury and disease., (© 2023. The Author(s).)

Neuroinflammation has been put forward as a mechanism triggering axonal regrowth in the mammalian central nervous system (CNS), yet little is known about the underlying cellular and molecular players connecting these two processes. In this study, we provide evidence that MMP2 is an essential factor linking inflammation to axonal regeneration by using an in vivo mouse model of inflammation-induced axonal regeneration in the optic nerve. We show that infiltrating myeloid cells abundantly express MMP2 and that MMP2 deficiency results in reduced long-distance axonal regeneration. However, this phenotype can be rescued by restoring MMP2 expression in myeloid cells via a heterologous bone marrow transplantation. Furthermore, while MMP2 deficiency does not affect the number of infiltrating myeloid cells, it does determine the coordinated expression of pro- and anti-inflammatory molecules. Altogether, in addition to its role in axonal regeneration via resolution of the glial scar, here, we reveal a new mechanism via which MMP2 facilitates axonal regeneration, namely orchestrating the expression of pro- and anti-inflammatory molecules by infiltrating innate immune cells.

Neurodegenerative disorders, characterized by progressive neuronal loss, eventually lead to functional impairment in the adult mammalian central nervous system (CNS). Importantly, these deteriorations are irreversible, due to the very limited regenerative potential of these CNS neurons. Stimulating and redirecting neuroinflammation was recently put forward as an important approach to induce axonal regeneration, but it remains elusive how inflammatory processes and CNS repair are intertwined. To gain more insight into these interactions, we investigated how immunomodulation affects the regenerative outcome after optic nerve crush (ONC) in the spontaneously regenerating zebrafish. First, inducing intraocular inflammation using zymosan resulted in an acute inflammatory response, characterized by an increased infiltration and proliferation of innate blood-borne immune cells, reactivation of Müller glia, and altered retinal cytokine expression. Strikingly, inflammatory stimulation also accelerated axonal regrowth after optic nerve injury. Second, we demonstrated that acute depletion of both microglia and macrophages in the retina, using pharmacological treatments with both the CSF1R inhibitor PLX3397 and clodronate liposomes, compromised optic nerve regeneration. Moreover, we observed that csf1ra/b double mutant fish, lacking microglia in both retina and brain, displayed accelerated RGC axonal regrowth after ONC, which was accompanied with unusual Müller glia proliferative gliosis. Altogether, our results highlight the importance of altered glial cell interactions in the axonal regeneration process after ONC in adult zebrafish. Unraveling the relative contribution of the different cell types, as well as the signaling pathways involved, may pinpoint new targets to stimulate repair in the vertebrate CNS., (© 2021 Wiley Periodicals LLC.)

Glaucoma is a disease associated with the loss of retinal ganglion cells (RGCs), and remains one of the primary causes of blindness worldwide. Major research efforts are presently directed towards the understanding of disease pathogenesis and the development of new therapies, with the help of rodent models as an important preclinical research tool. The ultimate goal is reaching neuroprotection of the RGCs, which requires a tool to reliably quantify RGC survival. Hence, we demonstrate a novel deep learning pipeline that enables fully automated RGC quantification in the entire murine retina. This software, called RGCode (Retinal Ganglion Cell quantification based On DEep learning), provides a user-friendly interface that requires the input of RBPMS-immunostained flatmounts and returns the total RGC count, retinal area and density, together with output images showing the computed counts and isodensity maps. The counting model was trained on RBPMS-stained healthy and glaucomatous retinas, obtained from mice subjected to microbead-induced ocular hypertension and optic nerve crush injury paradigms. RGCode demonstrates excellent performance in RGC quantification as compared to manual counts. Furthermore, we convincingly show that RGCode has potential for wider application, by retraining the model with a minimal set of training data to count FluoroGold-traced RGCs.

Increasing evidence suggests that functional impairments at the level of the neurovascular unit (NVU) underlie many neurodegenerative and neuroinflammatory diseases. While being part of the NVU, astrocytes have been largely overlooked in this context and only recently, tightening of the glia limitans has been put forward as an important neuroprotective response to limit these injurious processes. In this study, using the retina as a central nervous system (CNS) model organ, we investigated the structure and function of the glia limitans, and reveal that the blood-retina barrier and glia limitans function as a coordinated double barrier to limit infiltration of leukocytes and immune molecules. We provide in vitro and in vivo evidence for a protective response at the NVU upon CNS injury, which evokes inflammation-induced glia limitans tightening. Matrix metalloproteinase-3 (MMP-3) was found to be a crucial regulator of this process, thereby revealing its beneficial and immunomodulatory role in the CNS. in vivo experiments in which MMP-3 activity was deleted via genetic and pharmacological approaches, combined with a comprehensive study of tight junction molecules, glial end feet markers, myeloid cell infiltration, cytokine expression and neurodegeneration, show that MMP-3 attenuates neuroinflammation and neurodegeneration by tightening the glia limitans, thereby pointing to a prominent role of MMP-3 in preserving the integrity of the NVU upon injury. Finally, we gathered promising evidence to suggest that IL1b, which is also regulated by MMP-3, is at least one of the molecular messengers that induces glia limitans tightening in the injured CNS., (© 2020 Wiley Periodicals LLC.)

Neurodegenerative diseases and central nervous system (CNS) trauma are highly irreversible, in part because adult mammals lack a robust regenerative capacity. A multifactorial problem underlies the limited axonal regeneration potential. Strikingly, neuroinflammation seems able to induce axonal regrowth in the adult mammalian CNS. It is increasingly clear that both blood-borne and resident inflammatory cells as well as reactivated glial cells affect axonal regeneration. The scope of this review is to give a comprehensive overview of the knowledge that links inflammation (with a focus on the innate immune system) to axonal regeneration and to critically reflect on the controversy that still prevails about the cells, molecules and pathways that are dominating the scene. Also, a brief overview is given of what is already known about the crosstalk between and the heterogeneity of cell types that might play a role in axonal regeneration. Recent research indicates that inflammation-induced axonal regrowth is not solely driven by a single-cell population but probably relies on the crosstalk between multiple cell types and the strong regulation of these cell populations in time and space. Moreover, there is growing evidence that the different cell populations are highly heterogeneous and as such can react differently upon injury. This could explain the controversial results that have been obtained over the past years. The primary focus of this manuscript is the retinofugal system of adult mammals, however, when relevant, insights or examples of the spontaneous regenerating zebrafish model and spinal cord research are added.