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This research aims to explore the entire consumer purchasing decision process in choosing Barberbos, from problem recognition to post-purchase. The method used is qualitative with a case study approach, the sample was taken by purposive sampling, namely 23 people who were consumers who had tried Barberbos services. Data collection was carried out using interviews, literature studies, documentation studies, and online search methods, then the data was analyzed using thematic analysis. The research results show that in the first stage, the need and desire to shave one's hair was triggered internally by the source himself, there was no encouragement from other people. Information search stages: sources know Barberbos through location, word of mouth, and social media. At the alternative evaluation stage, only some of the material for consideration by the majority of the interviewees was the results of the shaving, followed by the place, then some said there was no particular reason and there were those who were invited by friends. The reason the interviewee chose Barberbos was because it was famous, the shave results, the service and the place was nice. For the final stage, all interviewees felt very satisfied, satisfied, and quite satisfied with the shave they got.

Background: Tuberculosis-diabetes mellitus (TB-DM) is a co-epidemic condition representing a double burden for high TB burden countries like Indonesia. Private primary care (PPC) in Indonesia was newly reintroduced to the TB program. Aims: This study explores the challenges PPC healthcare workers (HCWs) face in implementing TB-DM bi-directional screening and strategies to improve it. Methods: An explorative qualitative method was used by conducting two-round focus group discussions (FGDs) with HCWs (n=15) from five private clinics in Yogyakarta Special Region Province Indonesia and triangulated with 10 DM patients and the TB program manager from the provincial health office. The data were audio recorded, transcribed verbatim, and subjected to thematic analysis. Results: HCWs face complex barriers in TB-DM co-screening implementation from patients, HCWs, and health system aspects. An integrated system to remind, support decision-making, report, reduce documentation duplication, monitor, and evaluate co-screening implementation emerged as a potential strategy, although some challenges to deploy. Conclusion: Albeit HIS is promising in enhancing integrated TB-DM screening and management, a comprehensive approach and multisector roles are still needed to overcome impediments to TB-DM bidirectional screening in PPCs. Keywords: diabetes mellitus, health information system, screening, tuberculosis

The benefits of physical activity and exercise, especially those classified as moderate-to-vigorous activity (MVPA), have been well-established in preventing non-communicable diseases and mental health problems in healthy adults. However, the relationship between physical activity and exercise and the prevention and management of acute respiratory infection (ARI), a global high-burden disease, has been inconclusive. There have been debates and disagreements among scientific publications regarding the relationship between exercise and immune response against the causative agents of ARI. This narrative review aims to explore the theory that sufficiently explains the correlation between exercise, immune response, and ARI. The potential root causes of discrepancies come from research associated with the “open window” hypothesis. The studies have several limitations, and future improvements to address them are urgently needed in the study design, data collection, exercise intervention, subject recruitment, biomarkers for infection and inflammation, nutritional and metabolism status, and in addressing confounding variables. In conclusion, data support the clinical advantages of exercise have a regulatory contribution toward improving the immune response, which in turn potentially protects humans fromARI. However, the hypothesis related to its negative effect must be adopted cautiously.

Introduction: Acetabular fractures make a challenge for orthopedic trauma surgeons. The published data on acetabular fracture in Indonesia are very limited and there is no study to assess the functional outcome of acetabular fracture using the Majeed score. This study aims to report the functional outcome of an acetabular fracture using the Majeed score in one tertiary referral hospital (single center), Dr. Moewardi General Hospital. Methods: This is a retrospective descriptive study with a cross-sectional design from patients who registered on January 1, 2017–December 31, 2021 (5 years) at Dr. Moewardi General Hospital, a referral Hospital in Surakarta, Indonesia. The inclusion criteria included all acetabular fracture patients who registered and had complete data. Results: The most common type of acetabular fracture based on Judet-Letournel classification in this study is both columns (59.1%), most commonly treated by surgery. The most common surgical approach to treating an acetabular fracture is the anterior approach. The Majeed score shows the total of good and excellent outcomes after surgery (57.2%) is higher than fair and poor outcomes (42.9%), and the total of good and excellent outcomes after nonsurgical treatment (66.7%) is higher than fair and poor outcomes (33.3%). Conclusion: Using the Majeed score in a single center, the functional outcomes of acetabular fracture patients treated both surgically and conservatively are good to excellent.

ObjectivesThis study assessed how exposure to slow (SBM) versus fast beat music (FBM) during high-intensity rowing intervals affects performance, heart rate (HR), lactate levels, relative perceived exertion (RPE), and recovery.MethodsThe A/B crossover design involved 21 participants performing 5 × 500 m rowing intervals under two conditions: FBM and SBM. Primary endpoint was the difference in total rowing time. Secondary endpoints included average HR, average RPE as well as rowing interval times, RPE, and HR per interval. For exploratory purpose, HR and lactate drop during the initial 5 min post completion was analyzed.ResultsListening to FBM resulted in significantly shorter total rowing times (p = 0.009, rB = 0.59), especially during the 1st interval. The 1st interval was also significantly faster than intervals 2–5 (p

This research aims to analyze the values ​​of social education in the context of multiculturalism through interreligious dialogue in the Tomohon and Tumatangtang villages in Java. This type of research is qualitative with a case study approach. Data collection by interviews and observations. Data analysis uses triangulation. The research results are the values ​​of social education in the context of multiculturalism through interreligious dialogue in the villages of Tomohon and Tumatangtang Java, illustrating the importance of tolerance, mutual understanding, and interreligious cooperation in building a harmonious and inclusive society. Through this dialogue, people learn to respect religious and cultural diversity and develop a strong sense of brotherhood among themselves. Awareness of universal values ​​such as justice, compassion, and peace is the basis for strengthening relations between religious communities, creating an environment that allows mutual growth and progress within a framework of rich diversity.

Christian religious education in the family is education that aims to teach children the faith and as the first place to spread the Word of God, both through teaching and example in life. Nowadays, almost all groups, especially teenagers, are influenced by gadgets, where this gadget is a communication tool that has many different functions and properties and is considered more complete than other communication tools. Almost every teenager who uses gadgets spends a lot of time a day using gadgets so that this affects their behavior in the family. Therefore, this research aims to find out the role of parents through Christian religious education in the family on the negative influence of gadgets on teenagers. The research is based on changes in adolescent behavior due to excessive use of gadgets. The research uses a qualitative approach with descriptive methods. Data was obtained through observation and in-depth interviews with parents and teenagers who use gadgets at the Theodoron Tateli Congregation, especially teenagers.

Abstract Background The relationship between Tuberculosis (TB) and Diabetes Mellitus (DM) is intricate and intertwined, posing significant global health challenges. In addition, the increasing prevalence of DM worldwide raises concerns regarding the potential resurgence of tuberculosis. The implementation of tuberculosis prevention strategies is of the utmost importance, especially in countries like Indonesia that encounter a dual burden of TB and DM. The significance of TB screening in private primary care settings for patients with diabetes cannot be overstated. Implementing TB screening protocols in private primary care settings can assist in identifying diabetic patients with tuberculosis. Therefore, this study aims to explore the acceptability and feasibility of tuberculosis-diabetes mellitus screening implementation in private primary care clinics. Methods We conducted implementation research with an exploratory qualitative design. Fifteen healthcare professionals from five private primary health care clinics in Yogyakarta, Indonesia, participated in five focus groups. The discussions were audio recorded, transcribed verbatim, and thematically analyzed. As part of the feasibility assessment, surveys were conducted in each clinic. We conducted a thematic analysis in accordance with the theoretical framework of acceptability and the feasibility assessment. Results We identified that most private primary care clinics deemed the implementation of TB screening in DM patients acceptable and practicable. We revealed that the majority of diabetes patients enthusiastically accepted TB-DM screening services. In addition, we found that the healthcare professionals at the clinic are aware of the nature of the intervention and demonstrates a positive attitude despite a subtle burden. The stigma associated with COVID-19 has emerged as a new implementation barrier, joining TB stigma, lack of resources, and regulatory issues. We identify concealed and tiered screening as a potential method for enhancing the implementation of TB-DM screening. Conclusions The implementation of TB screening in DM patients in private primary care clinics had the potential to be acceptable and feasible. To achieve a successful implementation, consideration should be given to supporting factors, hindering factors, and strategies to improve TB screening in DM patients.

Humans need fresh water for many functions, including cleaning, irrigating plants, drinking, cooking, industrial uses, and more. It cannot be denied that the excessive exploitation of the environment by humans is the cause of the current decline in water quality. This study aims to test water quality such as pH, conductivity, total dissolved solids, salinity, and turbidity. The research method uses quantitative methods. The research area was taken from 10 subdistricts around the Arau River Basin. The sample is measured using a predetermined measuring instrument. Based on the test results from all research areas, several parameters for testing water quality meet the standards of the 2010 Ministry of Health Regulations, such as the pH test except for the Indarung and Lubuk Begalung sub-districts. and East Padang. The Total Dissolved Solids test in all areas is in good water standard except for Koto Tangah. The salinity test for all areas met the requirements for water quality standards except for the West Padang sub-district and the Turbidity test showed that all areas had turbidity values > 5 NTUs..

Introducción. El objetivo de la siguiente revisión fue caracterizar la adherencia al tratamiento antirretroviral en pacientes adultos con VIH-SIDA en las dimensiones de grado de adherencia y factores de riesgo. Metodología. La presente revisión de la evidencia se llevó a cabo utilizando varios estudios que se hubieran publicado en los últimos 10 años en cualquier país a nivel mundial; la búsqueda de información se hizo en las bases de datos SciELO, PubMed, LILACS y Dialnet. Resultados. Se identificaron un total de 227 artículos; de los cuales, se excluyeron 211 publicaciones por no cumplir con los criterios de elegibilidad y finalmente los estudios que se incluyeron en esta investigación, fueron 14. Discusión. La falta de adherencia al tratamiento antirretroviral es un problema latente que se puso de manifiesto en la evidencia científica analizada y a partir de los diferentes estudios que fueron recabados, se encontró que más de la mitad de los pacientes si fueron adherentes; mientras que en otros, ocurrió totalmente lo contrario y en relación a los factores de riesgo asociados a la falta de adherencia, se identificaron los siguientes: factores relacionados con el régimen terapéutico (aparición de reacciones adversas; presencia de comorbilidades; mayor tiempo bajo tratamiento), relacionados con el individuo (estrés, depresión, estigma, olvido, consumo de sustancias psicoactivas y alcohol, grado académico, sexo masculino y menor edad) y relacionados con la situación social (falta de apoyo social familiar). ABSTRACT Introduction. The objective of the following review was to characterize adherence to antiretroviral treatment in adult patients with HIV-AIDS, in the dimensions of degree of adherence and risk factors. Methodology. This evidence review was carried out using several studies that have been published in the last 10 years in any country worldwide; the information search was carried out in the SciELO, PubMed, LILACS and Dialnet databases. Results. A total of 227 articles were identified; of which, 211 publications were excluded for not meeting the eligibility criteria and finally the studies that were included in this research were 14. Discussion. Lack of adherence to antiretroviral treatment is a latent problem that was highlighted in the scientific evidence analysed and from the different studies that were collected, it was found that more than half of the patients were adherent; while in others, the complete opposite occurred and in relation to the risk factors associated with non-adherence, the following were identified: factors related to the therapeutic regimen (occurrence of adverse reactions; presence of comorbidities; longer time under treatment), factors related to the individual (stress, depression, stigma, forgetfulness, consumption of psychoactive substances and alcohol, academic grade, male sex and younger age) and factors related to the social situation (lack of family social support).

The purpose of this research is to reveal the direct meaning or conceptual meaning and figurative meaning or associative meaning. The method used in this research is analytical descriptive method with data collection techniques by literature review, namely looking for the data needed and then recording it so that there are six data used which are sourced from several libraries namely “Kamus Bahasa Sunda R.A. Danadibrata”, “Kamus Idiom Sunda-Indonesia”, and “Peperenian Urang Sunda”. The data used were Ngadaun seureuh, Bitis Jaksi Sajantung, Mucuk Eurih, Lambey Jeruk Sapasi, Pipi Kadu Sapasi and Héjo Carulang. The analysis technique starts from collecting data, reducing the initial data and analyzing the data used in this study. The result of this study is to reveal that the conceptual meaning does not show the standard of beauty in Sundanese language but refers to the plant used as a simile, but the standard of beauty can be found when looking by means of associative meaning or figurative meaning that is continuous with the referred flora. The beauty is borrowed from the form or nature of the flora used in the idiom. Abstrak Tujuan dari penelitian ini adalah untuk mengungkap makna langsung atau makna konseptual dan makna kiasan atau makna asosiatif. Metode yang digunakan dalam penelitian ini adalah metode deksriptif analitis dengan teknik pengumpulan data dengan tinjauan pustaka yakni mencari data yang dibutuhkan lalu mencatatnya sehingga terdapat enam data yang digunakan yang bersumber dari beberapa pustaka yakni “Kamus Bahasa Sunda R.A. Danadibrata”, “Kamus Idiom Sunda-Indonesia”, dan “Peperenian Urang Sunda”. Data yang digunakan adalah Ngadaun seureuh, Bitis Jaksi Sajantung, Mucuk Eurih, Lambey Jeruk Sapasi, Pipi Kadu Sapasi dan Héjo Carulang. Teknik analisis dimulai dari pengumpulan data, mereduksi data awal dan menganalisis data yang digunakan dalam penelitian ini. Hasil dari penelitian ini adalah mengungkap bahwa makna konseptual tidak menunjukan standar kecantikan dalam bahasa Sunda melainkan merujuk pada tanaman yang digunakan sebagai perumpamaan, namun standar kecantikan tersebut dapat ditemukan apabila melihat dengan cara makna asosiatif atau makna kiasan yang berkesinambungan dengan flora yang dirujuk. Kecantikan tersebut dipinjam dari bentuk atau sifat flora yang digunakan dalam idiom tersebut.

This study aims to explain the conflict phenomenon and types, also its resolution efforts made by the main character in the novel Panganten by Deden Abdul Aziz. The descriptive-qualitative research uses Karen Horney's literary psychology approach (psychoanalysis theory), which emphasizes that literature is a reflection of society, to analyze the data. The data analysis technique of this research is interpretative descriptive analysis. The results show that there are interpersonal conflicts between characters in this novel and intrapsychic conflicts consisting of despised real self, real self, ideal self, and actual self. In addition, conflict resolution efforts that occur in this novel are approaching others, fighting others, and staying away from others. Abstrak Penelitian ini bertujuan untuk menjelaskan fenomena, jenis, dan upaya penyelesaian konflik yang dilakukan oleh karakter utama dalam novel Panganten karya Deden Abdul Aziz. Penelitian ini menggunakan pendekatan psikologi sastra Karen Horney yang menekankan bahwa sastra merupakan cerminan masyarakat. Penelitian deskriptif kualitatif dengan teori psikoanalisis sosial Karen Horney ini menggunakan pendekatan psikologi sastra untuk menganalisis datanya. Teknik analisis data penelitian ini adalah teknik analisis deskriptif interpretatif. Hasil penelitian menunjukkan bahwa terdapat konflik interpersonal antartokoh dalam novel dan konflik intrapsikis yang terdiri atas diri rendah (despised real self), diri nyata (real self), diri ideal (ideal self), dan diri aktual (actual self). Di samping itu, upaya penyelesaian konflik yang terjadi dalam novel ini adalah mendekati orang lain, melawan orang lain, dan menjauhi orang lain.

Adventure tourism has received significant attention recently because it offers unique sensations. Managers of adventure tourism objects need to understand the determinants of satisfaction in adventure tourism. This study aims to examine the effect of intrinsic motivation and flow theory on extreme and non-extreme adventure tourists’ satisfaction in Indonesia. This study uses a quantitative approach. The sample includes 405 tourists engaged in adventure tourism activities (extreme adventure tourism activities – 200 respondents, and non-extreme adventure tourism activities – 205 respondents). Structural Equation Modeling-Partial Least Square (SEM-PLS) was used to analyze the data. The results show that autonomy and competence influence flow experience (p-value < 0.05). This applies to extreme adventure and non-extreme adventure tourism. Furthermore, flow experience has a positive effect on adventure tourist satisfaction. In the context of extreme adventure tourism, autonomy does not affect the satisfaction of extreme adventure tourists (path coefficients = 0.025 and p-value = 0.761). In the context of non-extreme adventure tourism, competence does not affect the satisfaction of non-extreme adventure tourists (path coefficients = –0.036 and p-value = 0.682). This study recommends that managers of non-extreme tourism spots add challenging aspects to tour packages because they are believed to increase tourist satisfaction.

This study investigates the characteristics of TiO2/ZnO nanoparticles and the application of TiO2/ZnO in matt-type water-based paint as a pigment. This study aims to determine the quality of TiO2-ZnO pigments in water-based paints in terms of whiteness, hiding power, dispersibility, and gloss. Matt-type water-based paint has been made by mixing water and additives substances in a high-speed mixer to result in a mill base paste, which is mixed with the pigment of TiO2/ZnO (25:75), CaCO3 filler, water, and additives, then filtered and mixed again with the C-817 binder. The characterization results showed that TiO2/ZnO nanoparticles contained TiO2 of 18.62% and ZnO of 77.49%, with an average particle diameter of 151.54 nm. TiO2/ZnO has a crystal size of 28.4 nm and a crystallinity degree of 72.3%. The application of TiO2/ZnO nanoparticles as a pigment in matt-type water-based paint resulted in good dispersion and hiding power and achieved whiteness of 82.2 and gloss at 60° of 2.00 better than TiO2 of 81.8 and gloss at 60° of 1.77.

BackgroundGlobal burden of hypertension among young people continues to increase. There have been many studies examining the effect of aerobic and muscle-strengthening physical activity on blood pressure, many of them didn't consider interdependence between them. Conflicting results of health-related fitness, particularly handgrip strength, as intermediate outcomes of muscle-strengthening physical activity on blood pressure also emerged. This research will carry out a mediation-moderation analysis to find out the relationship between muscle strengthening physical activity and blood pressure among young adults by considering health-related fitness and 24-hour movement behavior.MethodsA cross-sectional study among 221 Indonesian young adults attending a physical activity intervention collected participant's muscle-strengthening physical activity, and 24 h movement behavior, including aerobic physical activity, sedentary and sleep behavior, and mental well-being using validated questionnaires. Mediation and moderation analyses were conducted using Process Macro model 10 on SPSS 25 to investigate the association of muscle-strengthening physical activity on blood pressure, with gender and blood pressure as moderator, mediators consist of handgrip strength, muscle mass percentage and cardiorespiratory fitness. A subgroup analysis was conducted based on participant's cardiorespiratory fitness level.ResultsVolume of muscle-strengthening physical activities in a week have a direct association with systolic blood pressure among prehypertensive male with an effect of 0,00989359 (95% CI 0,0046488 to 0,00336478). Considering its volume as mediator, the frequency of muscle-strengthening physical activity contributed to a significant direct effect on diastolic blood pressure in both genders, but the duration of MSPA has a significant direct effect on systolic blood pressure in male subjects. There is no component of physical fitness that provides a significant mediating effect. After a subgroup analysis, the relationship between MSPA Volume and blood pressure is not significant for individuals with a high level of cardiorespiratory fitness.ConclusionsThis study shows that increased participation in muscle strengthening physical activity, especially in subject with low cardiorespiratory fitness, could increase blood pressure in prehypertensive young adult male population without mediation by physical fitness. Further research is needed to investigate other mechanisms that influence this relationship.

The purpose of this study was to improve the mechanical and physical properties, degradation performance, and water absorption of a thermoplastic mixture of sago starch with the addition of Linear Low-Density Polyethylene (LLDPE). The method used is the grafting method where polyethylene is grafted onto Maleic Anhydride (LLDPE-g-MA). In this research, Thermoplastics Sago Starch (TPSS) was made with a mixture of Sago Starch (65%) and Glycerol (35%), added with water as a solution. Compatibilizer (PE-g-MA) was made by reacting LLDPE (88%) and Maleate Anhydride (9%) with an additional initiator of Benzoyl Peroxide (3%). The concentration of LLDPE varied from 10,15, 20, 25, and 30%. Substances were mixed into an internal mixer Thermo Haake Polydrive with a speed of 100 mm/minute, for 15 minutes. The concentration of 30% LLDPE produced the highest tensile strength and elongation at a break of 4.30 N/mm2 and 2.15%, respectively. Simultaneously, as LLDPE concentration increased, Young's Modulus decreased. This was powered by the morphology of the sampling surface, with the occurred reaction of adhesion interface or dispersion of LLDPE toward the whole surface with the assistance of compatibilizer as connecting substance between hydrophilic polymer and a hydrophobic polymer, which could improve the properties of mechanical. The formation of ester groups from the reaction of inter groups of hydroxyls derived from the starch with the groups of anhydride derived from the mixture of compatibilizer was visibly seen at the peak of 1693 cm-1. The degradation performance of the TPSS: LLDPE mixture with a ratio of 70:30 showed good performance where the degradation continued to increase up to 42% on the 30th day of degradation in freshwater, 18% in seawater, and 17% in soil burial. While the water absorption test showed that the higher concentration of LLDPE, the lower speed of water absorption.

In this paper, we report that the compatibility of polymer blends between linear low-density polyethylene (LLDPE) and cyclic natural rubber (CNR) can be increased by the addition of oleic acid-grafted linear low-density polyethylene. The research aims to investigate the effect of LLDPE-g-OA compatibilizer in LLDPE/CNR blends on improving the mechanical properties and characteristics of the blends. The LLDPE/CNR/LLDPE-g-OA blends (compatible blends) were prepared by blending methods in the molten phase using an internal mixer set at a temperature of 160oC with a rotation speed of 100 rpm. The LLDPE pellets were inserted into it until melts and followed with an addition of CNR and LLDPE-g-OA. The tensile strength test results have shown an increase in mechanical properties after the addition of the compatibilizer with a maximum content of 4 wt%. The difference in FTIR spectra of compatible blends is indicated by the presence of C=C bonds from CNR, which appear at 1654.9 cm-1, indicating the occurrence of physical bonds in the blends. The existence of the LLDPE-g-OA compatibilizer has increased the thermal stability of the polymer blends and changes in the melting point temperature of 1240C. Compatible blends showed that the surface morphology was smoother, and there were significant microstructural changes compared to incompatible blends.

Background: During the COVID-19 pandemic, there were reductions in university students' physical activity, which further increased their mental distress, calling for technology-based physical activity interventions to address the challenges in delivering in-person interventions. This study aimed to develop a technology-based physical activity intervention and pilot test it. Methods: We developed a virtually-delivered team-based physical activity challenge using the Behavior Change Wheel and Co-creation Framework based on Self-determination Theory. A pilot study was conducted in the evaluation phase to measure the recruitment rate, dropout rate, change in physical activity, and mental distress while identifying problems and collecting participants' opinions regarding the challenge. Wilcoxon signed-rank tests were conducted to assess the change in physical activity and mental distress. Qualitative data were analyzed using thematic analysis. Results: A three-week physical activity challenge comprising five identified intervention functions was held with 480 participants. The recruitment rate was 84.8% resulting from 407 virtual challenge participants who were conveniently joined as research participants. The dropout rate for the pilot study was 10.96% resulting from the incompatibility problems with the application. Among sample participants who lacked physical activity, participation in this challenge improved their physical activity by 52.5 min of moderate-intensity physical activity per week and reduced their mental distress by three points of self-reporting questionnaire-20 score. Issues regarding the virtual application and the influence of participation in the challenge on basic psychological needs emerged. Participants' opinions identified lack of time as the main barrier to physical activity. Conclusion: A co-created physical activity intervention developed using the Behavioral Change Wheel Framework inspired high interest from university students and may increase their physical activity and improve their mental health. Several suggestions were discussed to address the identified problems and improve the internal and external validity of the evaluation phase. Trial registration: TCTR20220720004 (retrospectively registered on July 19, 2022).

This study aims to determine Indonesia's Islamic Bank Adoption drivers, especially in some customer groups. PLS-SEM is an analytical method used to test hypotheses. The analysis results show that the mediation type is partial mediation, but the mediation type for East Java customers and Generation Z is complete mediation. Based on the results, Islamic Banks must maintain their excellence to attract more customers. The sense of security in using Islamic Bank products and services is the primary indicator for East Java, generation Z, and non-generation Z customers. The reliability of Islamic Bank products and services is the primary indicator for non-East Java customers. Islamic Banks must also be able to build customer intentions to use Islamic Bank products and services, especially for Generation Z East Java customers. This study finds that intention needs to be built to increase the Adoption of Islamic banking products and services.

The background of this research is the curiosity about the practice of giving personal names in the Kasepuhan Ciptagelar indigenous people. In the name string generally implies faith and wisdom (wisdom) and can reflect prayer, ideals (expectation). This means that the name given (bears) will be in accordance with the demands (expectations) of the community at the time it was made. The purpose of this study is to photograph the practice of giving personal names in the Kasepuhan Ciptagelar indigenous people and to examine the factors and values underlying this practice. This study uses a qualitative methodological approach, namely descriptive analytical method. The data source in this study is the Kasepuhan Ciptagelar indigenous people in three generations. Data collection techniques in this study were participant observation and observation and note-taking techniques. Data analysis techniques begin with collecting data, reducing data, conducting analysis based on classification. The results of this study show that the pattern of giving and changing names is caused by several reasons. First, driven for psychological reasons, in the form of hopes such as for the sake of glory, fame, profit and avoidance of disaster as well as inner satisfaction. Second, related to socio-cultural values that have roots in the past. From the diachronic study, the pattern of naming the Kasepuhan Ciptagelar indigenous people has experienced a shift, although the shift or change is relatively not that massive. This is because the Kasepuhan Ciptagelar indigenous people still adhere to traditions and customs that have been passed down from generation to generation. Abstrak Penelitian ini dilatarbelakangi oleh keingintahuan praktik pemberian nama diri di masyarakat adat Kasepuhan Ciptagelar. Dalam untaian nama itu umumnya menyiratkan keyakinan dan kebijaksanaan (wisdom) serta dapat merefleksikan doa, cita-cita (expectation). Artinya bahwa nama yang diberikan (disandangnya) tersebut akan sesuai dengan tuntutan (harapan) masyarakat pada masa dibuatnya. Tujuan penelitian ini adalah untuk memotret praktik pemberian nama diri dalam masyarakat adat Kasepuhan Ciptagelar dan akan mengkaji faktor-faktor dan nilai-nilai apa saja yang melatarbelakangi praktik tersebut. Penelitian ini menggunakan pendekatan metodologi kualitatif yakni metode deskriptif analitis. Sumber data dalam penelitian ini adalah masyarakat adat Kasepuhan Ciptagelar dalam tiga generasi. Teknik pengumpulan data dalam penelitian ini adalah observasi partisipan serta teknik simak dan catat. Teknik analisis data dimulai dengan mengumpulkan data, mereduksi data, melakukan analisis berdasarkan klasifikasi. Hasil dari penelitian ini bahwa pola pemberian maupun pergantian nama disebabkan oleh beberapa alasan. Pertama, didorong karena alasan psikologis, berupa harapan seperti demi kejayaan, ketenaran, keuntungan dan terhindar dari malapetaka serta kepuasan batiniah. Kedua, yaitu berkaitan dengan nilai sosio-kultural yang mempunyai akar ke masa silam. Dari kajian secara diakronis pola pemberian nama masyarakat adat Kasepuhan Ciptagelar telah mengalami pergeseran, walaupun pergeseran atau perubahan itu relatif tidak begitu masif. Hal ini dikarenakan masyarakat adat Kasepuhan Ciptagelar masih pengkuh (kuat) memegang tradisi dan adat istiadat yang sudah diwariskan secara turun-temurun.

IntroductionStair climbing intervention could be suggested to address low occupational physical activity amongst university students and employees. Strong evidence showed the effectiveness of signage intervention in increasing stair use in public areas. However, evidence in worksite settings, including university settings, was inconclusive. This study aimed to evaluate the process and impact of a signage intervention to increase stair use at a university building using the RE-AIM framework.MethodWe conducted a non-randomised controlled pretest-posttest study to examine the effect of signage intervention placed in university buildings in Yogyakarta (Indonesia) between September 2019 and March 2020. The process of designing the signage involved the employees in the intervention building. The main outcome was the change in the proportion of stair use to elevator use measured by manual observations of video recordings from closed-circuit television. A linear mixed model examined the intervention effect by controlling the total visitor count as a confounder. RE-AIM framework was used in the process and impact evaluation.ResultsThe change in the proportion of stair climbing from baseline to the 6th-month phase at the intervention building (+0.067 (95% CI = 0.014–0.120)) was significantly higher than that of the control building. However, the signs did not change the proportion of the stair descending at the intervention building. The signs were potentially viewed 15,077–18,868 times/week by visitors.ConclusionSignage intervention using portable posters could easily be adopted, implemented, and maintained in similar settings. A co-produced low-cost signage intervention was found to have a good reach, effectiveness, adoption, implementation, and maintenance dimension.

This study reports that Precipitated Calcium Carbonate (PCC) nanoparticles from limestone can be modified with oleic acid (OA), which was applied to LLDPE/CNR blends in the presence of the LLDPE-g-OA coupling agent. This study investigates PCC characteristics from limestone that has been modified with OA and its implications of increasing impact strength, thermal properties, and morphology changes in LLDPE/LLDPE-g-OA/CNR/O-PCC composites. Organo-PCC (O-PCC) was prepared by mixing the PCC with OA in n-hexane solvent. The polymer composites were made by mixing LLDPE, LLDPE-g-OA, and CNR simultaneously in an internal mixer at 160 °C with speed rotation of 100 rpm, followed by O-PCC. The characterization results of O-PCC obtained CaO compounds of 97.9%, crystallinity degree of 61.6%, crystals size of 48.6 nm, and scalenohedral-shaped crystals. The results of the impact strength test on LLDPE/LLDPE-g-OA/CNR/O-PCC composites with an O-PCC concentration of 5 wt% showed an increase of 21.5% compared to no fillers. The presence of O-PCC resulted in the thermal properties of polymer composites with a melting point of 125.5 °C and a decomposition temperature of 468.7 °C. The morphology did not result in significant differences in the surface structure after adding O-PCC nanoparticles.

Abstract: One of the consequences of the Covid-19 pandemic is the adaptation process and changes in the education process. During the Covid-19 crisis, the Indonesian Ministry of Education and Culture implemented a policy to aid in preventing Covid-19 spread through regulations governing the implementation of "Learning from Home" education. The implementation of this program which has been going on for quite a long time can create additional life burdens that produce a psychological impact on parents such as stress, anxiety, and depression. The purpose of this study is to determine the prevalence of stress, depression, and anxiety in parents of children who are "Learning from Home" as a response of the Covid-19 epidemic. An online survey was conducted from August 2020 until September 2020 among parents who have a minimum of one child with the age of children or adolescents. The Google Form was used to create a structured self-reported e-questionnaire, and the link was shared through WhatsApp. Respondents completed a survey measuring socio-demographic variables and the DASS-42 (Depression, Anxiety, Stress Scale) to measure stress, depression, and anxiety, after giving informed consent. Researchers received 225 online responses. Microsoft Excel and SPSS 21 were used to perform a univariate analysis on the data collection. Stress, depression, and anxiety were found to be prevalent among parents of “Learning from Home” children in 43.56%, 13.78%, and 18.22%, respectively. This research showed that during the Covid-19 pandemic, a significant number of parents of "Learning from Home" children encountered stress, anxiety, and depression symptoms Keywords: Stress-depression-anxiety; Learning from home; Parents; Covid-19

The addition of LLDPE-g-MA into the compound of sago starch/LLDPE was studied to improve its mechanical, morphology, degradation performance, and water absorption properties. Thermoplastic Sago Starch was composed of a mixture of sago starch and glycerol. LLDPE-g-MA was prepared in varied concentrations based on the weight of TPSS (0, 6, 8, 10, and 14 wt.%) by reacting LLDPE, maleic anhydride, and benzoyl peroxide using an internal mixer. The results showed an increase in values obtained from mechanical tests, i.e., tensile strength was improved from 0.6902 to 3.6187 N/mm2 with the addition of LLDPE-g-MA at 10 wt.%. The addition also resulted in a 1.44% increment in elongation at break and 251 N/mm2 for Young's Modulus. The surface morphology of the sample demonstrated an excellent interfacial adhesion reaction or LLDPE dispersion over the entire surface of the matrix (starch). The water absorption test continued to decrease with the increase in the LLDPE-g-MA concentration from 53 wt.% (without LLDPE-g-MA) to 14 wt.% at 10 wt.% LLDPE-g-MA concentration. The degradation performance showed that the sample could be degraded under all three conditions for up to 30 days.

This study investigates the improvement of the mechanical, thermal, and morphological properties of linear low-density polyethylene (LLDPE)/cyclic natural rubber (CNR) after the addition of organo-precipitated calcium carbonate (O-PCC). The impact on the properties of the LLDPE/CNR/LLDPE-g-OA/O-PCC composites was investigated by a series of empirical experiments. First, the polymer composite was blended in the molten state using an internal mixer with a heating temperature of 160 °C and a rotation speed of 100 rpm. The LLDPE was placed in a chamber of internal mixer until melted, followed by CNR, LLDPE-g-OA, and O-PCC. The polymer composites with an O-PCC concentration of 5% obtained the optimal mechanical properties compared to other variations, with a tensile strength of 17.17 MPa and Young's modulus of 252.68 MPa. The presence of O-PCC resulted in better thermal stability and a change in the melting point temperature of 124 °C. The FTIR spectra of the polymer composite showed the specific characteristics of O-PCC at 872.1 cm–1. The morphology of the polymer composite indicates that the O-PCC is evenly dispersed in the polymer composite.

The purpose of this study is to explain the government's role in overcoming the Covid-19 problem through the socialization of PrayfromHome as an effort to improve ways to improve themselves in increasing the immunity of religious communities. This was done because a vaccine for the Covid-19 virus has not yet been found. To find out the role of the government, the researchers conducted data collection based on the propositions contained in the virtual joint editorial prayer offered by policy makers and representatives of interfaith prayer. The method used in this research is a qualitative research based on cyber pragmatics based on each thematic content contained in the editorial propositions of the prayers offered. The results of the study show that Pray from home activities have thematic content which is divided into (1) from the policy makers, the Covid-19 outbreak requires every religious adherent to provide physical and mental enthusiasm as an initial provision of intangible vaccines for the Indonesian people, (2) from the representative side of inter-religious prayer that raises several inner conditions, including (a) there are several acknowledgments of mistakes for all actions carried out in the world to the Creator before asking for the world to return to normal, (b) the existence of a form of superiority of God's natural power, as the greatest power, a place to surrender, (c) hope for all parties involved or at the forefront in handling the Covid-19 pandemic so as not to provide strength and safety during the handling process. Abstrak Tujuan dari penelitian ini adalah untuk menjelaskan peran pemerintah dalam mengatasi permasalahan Covid-19 melalui sosialisasi doa bersama PrayfromHome sebagai upaya meningkatkan keimanan yang berujung pada peningkatan imun umat beragama. Hal itu dilakukan karena vaksin dari virus Covid-19 belum ditemukan. Untuk mengetahui peran pemerintah tersebut, peneliti melakukan pengambilan data berdasarkan proposisi-proposisi yang terdapat dalam redaksional doa bersama secara virtual yang dipanjatkan oleh pemangku kebijakan dan perwakilan pendoa antaragama. Metode yang digunakan dalam penelitian ini adalah penelitian kualitatif berbasis analisis pragmatik siber berdasarkan setiap muatan tematik yang terdapat dalam proposisi-proposisi redaksional doa yang dipanjatkan. Hasil penelitian menunjukkan kegiatan Pray from Home memiliki muatan tematik yang terbagi atas (1) dari sisi pemangku kebijakan, adanya wabah pandemi Covid-19 ini mengharuskan setiap pemeluk agama untuk memberikan penguatan diri secara fisik maupun mental sebagai bekal awal vaksin tak benda bagi masyarakat Indonesia, (2) dari sisi perwakilan pendoa antaragama yang memunculkan beberapa kondisi batiniah, di antaranya (a) terdapat beberapa pengakuan kekhilafan atas segala perbuatan yang dilakukan didunia kepada Sang Pencipta sebelum meminta agar dunia kembali seperti sediakala, (b) adanya bentuk superioritas kekuatan alami Tuhan, sebagai kekuatan terbesar, tempat memasrahkan diri, (c) terselipkan harapan kepada semua pihak yang terlibat atau garda terdepan dalam penanganan pandemi Covid-19 agar diberikan kekuatan serta keselamatan selama proses penanangan wabah berlangsung.

This paper aims to explore the relationship of structure and meaning in the short stories “Kucing” by Toni Lesmana and “Kucing Hitam” by Edgar Allan Poe. This paper is a comparative literary study with the Levi-Strauss mythological structuralism study model. The method used in this study is descriptive qualitative. The result shows that through the mythicization of the black cat, the two short stories try to reveal the dominance of gender in the opposite domestic area. The difference in dominance is represented through the relational structure of the short story which is oppositional. Abstrak Tulisan ini bertujuan untuk menggali relasi struktur dan makna dalam cerita pendek “Kucing” karya Toni Lesmana dan “Kucing Hitam” karya Edgar Allan Poe. Tulisan ini merupakan kajian sastra bandingan dengan model kajian strukturalisme mitos Levi-Strauss. Metode yang digunakan dalam kajian ini adalah deskriptif kualitatif. Hasil kajian menunjukkan bahwa melalui pemistisan kucing hitam, kedua cerpen berusaha mengungkap dominasi gender dalam wilayah domestik yang berlawanan. Perbedaan dominasi tersebut direpresentasikan melalui relasi struktur cerpen yang oposisional.

A recent systematic review found a significant drop in physical activity (PA) among university students during the coronavirus disease 2019 (COVID-19) pandemic. Identifying students’ attitudes and feelings about PA and coronavirus, which could facilitate or hinder PA, is essential to guide intervention planning. Therefore, this study aimed to examine attitudes and feelings about PA and coronavirus as predictors of PA levels. We conducted a cross-sectional study among undergraduate university students in Indonesia to collect their PA levels using the global PA questionnaire version 2 and their attitudes and feelings about PA in pandemic situations. A binomial logistic regression has been conducted to predict whether students will sufficiently engage in PA based on their attitudes and feelings related to PA, coronavirus, and demographic characteristics. Results from 588 undergraduate students (75% female) showed that students perceived the health benefits of PA, perceived feeling guilty about wanting to do PA during the pandemic, body mass index (BMI), and field of study were statistically significant predictors of PA levels. An increase of one unit of perceived health benefits of PA increases the odds of meeting the PA guidelines by 2.313 (95% confidence interval 1.708–3.132, p < 0.001). On the other hand, raising one point of feeling guilty about conducting PA was associated with 1.285 times lower odds (95% confidence interval 1.062–1.558, p = 0.01) of meeting the PA guidelines. Thus, intervention should increase students’ awareness of the physical health benefits of PA during the pandemic and reduce their feeling of guilty about conducting the PA.

Several studies have highlighted the link between sleep, learning, and memory. Strong evidence shows that sleep deprivation can affect a student’s ability to learn and academic performance. While delayed sleep-wake phase disorder was prevalent among young adults, available evidence showed an inconclusive association between sleep times and academic performance in university students. Therefore, we conducted a cross-sectional study among university students in Indonesia to collect their sleep duration, bedtime, wake-up time, and academic performance. An analysis of 588 university students in Indonesia found that only 38.6% of students sufficiently slept, and their median bedtime and wake-up time was 11:30 pm and 5:30 am, respectively. Gender and wake-up time accounted for a 5.8% variation in academic performance (adjusted R2 = 4.5%) after controlling for sleep duration, bedtime, body mass index, the field of study, batch year, and physical activity. Male had 0.116 [95% Confidence Interval (CI) −0.167 to −0.064] lower grade point average (p < 0.001) than female and students who wake up later had 0.077 (95% Confidence Interval 0.025 to 0.129) greater grade point average (p = 0.004) than students who wake-up earlier. The prevalence of sleep deprivation related to the delayed sleep-wake phase among university students in Indonesia was high. Since wake-up time was related to the increased grade point average, the university should consider developing sleep-friendly policies and interventions to improve their academic performance.

ABSTRACT Hospital fires have the potential to cause fatalities and huge material losses, there were 22 hospital fires covered by newspapers in India in 2011-2012 with 102 dead. Buildings are considered safe if all occupants building threatened by fire must be able to exit and assembly point before available safe egress time. This study aimed to analyze the effect of preconditions and unsafe acts (violations of evacuation procedures) on evacuation duration in fire disaster conditions in the inpatient building of general hospital R. Koesma Tuban. This study was an observational study, a quantitative method and cross sectional design, which were carried out in April-July 2019. Analysis of Covariance test results stated preconditions (age, sex, exercise habits, location of inpatient ward, distance traveled) affect the duration of evacuation (p 0.05). Violation of evacuation procedures has the potential to influence the duration of evacuation (p = 0.054). The conclusions this study are age, gender, exercise habits, location of the inpatient ward, and distance traveled affect the duration of the evacuation. Keywords: Duration of evacuation, preconditions, violations of evacuation procedures, hospital

Menabung air hujan adalah salah satu upaya untuk mengendalikan kekurangan air dimusim kemarau. Sistem penjernih air hujan menjadi air bersih ini adalah rangkaian kegiatan gerakan menabung air hujan dan menggunakannya kembali untuk konservasi air tanah serta kebutuhan sehari-hari. Desa Arjosari mengalami kekurangan air bersih pada saat musim kemarau, maka dari itu peneliti membuat sistem penjernih air ini dengan memanfaatkan air hujan. Metode yang digunakan adalah tandon air kemudian pipa penjernih yang terdiri dari Zeolit, kerikil, Arang, ijuk dan spoons. Hasil analisa yang telah dilakukan dilaboratorium menggunakan parameter logam metode AAS (atomic absorbance spectrofotometri), parameter anion (spectrofotometer uv vis), dan parameter fisik (water quality checker dan tss meter). Didapatkan rata-rata nilai untuk pH 6.71, TSS 0, TDS 40,3, CaCO3 0, kandungan besi 0,032, Mangan 0,113. Pengujian yang telah dilakukan, mendapatkan hasil yang sesuai dengan persyaratan menurut Peraturan Menteri Kesehatan Republik Indonesia No. 492/MENKES/PER/IV/2010. Sehingga Air yang dipakai memenuhi syarat penggunaan air bersih.

Currently the need for domestic packaging paper continues to increase, driven by the level of consumer awareness about sustainable packaging. PT XYZ is a local company engaged in the Corrugated Cardboard Box (KKG) industry. So far, the problems in fulfilling incoming orders every month are not optimal with an average of about 30% inaccuracy. This is because the orders that enter cannot be predicted. As an effort to win market competition in packaging paper, PT. XYZ must improve the fulfillment of incoming orders by predicting incoming orders using the Long Short-Term Memory (LSTM) method. The aim of this research is to provide a predictive model for incoming orders in accordance with the needs of order fulfillment to be applied to production planning. So that order fulfillment can be on time. The method used in predicting incoming orders is the Long Short-Term Memory (LSTM) method using weighting evaluations with the lowest Root Mean Squared Error (RMSE) and Augmented Dickey-Fuller test (ADF). The test results of the LSTM method with parameter sizes of Batch: 1 Epochs: 5000 Neurons: 1 show that the RMSE for MDM products is 8.767582 and 0.287924, LNR products are 10.623984 and 0.466621, WTP products are 1.636849 and 0.361515 lower than the size of the fit parameters for other LSTM models, and the ADF Statistic value for MDM products -6.137597, LNR -6.753697, WTP -4.872927

Abstract Muscovy ducks are included in the genus Cairina (Cairina moschata) originating from Mexico, Central America and South America. In Indonesia, this type of duck is known as a duck (entok) or Muscovy duck (muscovy duck). The Muscovy duck belongs to poultry that has relatively shorter legs than its body; the fingers have swimming membranes; the beak is covered by a delicate, sensitive membrane; concave-shaped fur, thick and greasy. The Muscovy duck is a waterfowl that leads to meat as potential commodity that has to be cultivated. This study aims to determine the phenotypic diversity of the Muscovy duck based on morphometrics. The method used in this study was purposive random sampling with the provision that Muscovy ducks aged over 6 months with a total of 100 male and 100 female Muscovy ducks. The parameter measured in this study were beak length, neck length, body length, wing bone length, body weight, femur length, shank length and third finger bone length. The results indicate that the head includes the beak length of males 5.65 ± 0.35 cm and females 4.81 ± 0.31 cm. Male neck length 17.68±0.98 cm, and female 9.01±0.62 cm. Body parts include male body length of 25.86±0.86 cm, and female body length of 23.22±1.02 cm. The length of the wing bones of males is 27.50±1.24 cm, and that of females is 21.76±1.05 cm. Male body weight 3.45±0.20 kg, and female 1.99±0.28 kg. The legs include the length of the male thigh 8.72±0.44 cm, and the female 8.59±0.35 cm. male tarsometatarsus shank length 4.56±0.43 cm, and female 3.83±0.32 cm. The length of the third finger is 7.8±0.26 cm, and the female is 6.40±0.65 cm. The results showed that the morphometric size of the male Muscovy duck was longer than that of the female Muscovy duck due to its phylogenetic characteristics. Keywords: Muscovy Duck, Morphometric Abstrak Itik Muscovy termasuk dalam keluarga (genus) Cairina (Cairina moschata) berasal dari Meksiko, Amerika Tengah dan Amerika Selatan. Di Indonesia bebek ini dikenal dengan mentok (entok) atau itik Muscovy (muscovy duck) dan cukup berpotensi untuk dibudidayakan. Penelitian ini bertujuan untuk mengetahui keragaman fenotipik itik Muscovy berdasarkan morfometrik. Metode yang digunakan dalam penelitian ini adalah purposive random sampling dengan ketentuan itik Muscovy berusia diatas 6 bulan dengan jumlah data 100 ekor jantan dan 100 ekor betina itik Muscovy. Data yang diukur adalah panjang paruh, panjang leher, panjang badan, panjang tulang sayap, bobot badan, panjang tulang paha, panjang shank dan panjang tulang jari ketiga. Panjang paruh jantan 5,65±0,35 cm dan betina 4,81±0,31 cm. Panjang leher jantan 17,68±0,98 cm, dan betina 9,01±0,62 cm. Panjang badan jantan 25,86±0,86 cm, dan betina 23,22±1,02 cm. Panjang tulang sayap jantan 27,50±1,24 cm, dan betina 21,76±1,05 cm. Bobot badan jantan 3,45±0,20 kg, dan betina 1,99±0,28 kg. Panjang paha jantan 8,72±0,44 cm, dan betina 8,59±0,35 cm. Panjang shank tarsometatarsus jantan 4,56±0,43 cm, dan betina 3,83±0,32 cm. Panjang jari ketiga 7,8±0,26 cm, dan betina 6,40±0,65 cm. Kesimpulan: Ukuran morfometrik itik Muscovy jantan lebih panjang dari pada itik Muscovy betina karena sifat phylogenetik. Kata Kunci : Itik Muscovy, Morfometrik

Salah satu gangguan musculoskeletal yang dapat terjadi pada pergelangan tangan adalah Carpal Tunnel Syndrome (CTS). Pekerja wanita berisiko lebih tinggi terhadap kejadian CTS dibandingkan pria. Gerakan pekerjaan yang dilakukan secara repetitif dan berkepanjangan dapat memperbesar risiko terjadinya keluhan CTS. Pekerja wanita bata pres di Dusun Kaligoro masih melakukan aktivitas pencetakan bata pres secara manual dan berulang sehingga pekerja memiliki risiko mengalami keluhan CTS. Penelitian ini bertujuan untuk menggambarkan kuat dan arah hubungan antara masa kerja dan gerakan repetitif dengan keluhan CTS pada pekerja wanita bagian produksi bata pres di Dsn. Kaligoro, Ds. Kaligoro, Kec. Kutorejo, Kab. Mojokerto, Jawa Timur. Jenis penelitian ini merupakan penelitian observasional dengan rancang bangun crossectional. Jumlah sampel dalam penelitian ini diambil dengan teknik simpel random sampling berjumlah 42 pekerja dari total populasi 47 pekerja. Hasil analisis menunjukkan terdapat hubungan cukup kuat dengan arah positif antara masa kerja (r=0,367) dan gerakan repetitif (r=0,493) dengan keluhan CTS. Semakin lama bekerja dan semakin banyak frekuensi gerakan repetitif yang dilakukan maka risiko pekerja mengalami keluhan CTS semakin besar.

Myrlene Sanon Aigbogun,1 Dorothee Oberdhan,1 Michael J Doane,2 Jillian Rooney,2 Brian C Inyart,2 Christina S Pao,1 Alexis H Denny3 1Health Outcomes, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA; 2Health Outcomes Research, New York, NY, USA; 3Government Affairs, Polycystic Kidney Disease (PKD) Foundation, Kansas City, MO, USACorrespondence: Dorothee OberdhanHealth Outcomes, Otsuka Pharmaceutical Development & Commercialization, Inc., 2440 Research Boulevard, Rockville, MD, 20850, USATel +1 240-683-3517Fax +1 301-721-7517Email dorothee.oberdhan@otsuka-us.comBackground: Autosomal dominant polycystic kidney disease (ADPKD) is a rare inherited kidney disorder with considerable symptom burden and negative effects even in early-stage disease. Patients’ reporting of ADPKD symptom burden may differ from physicians’ impressions. In this quantitative, cross-section survey study, we evaluated patient and physician assessments of symptom burden at early- and late-stage ADPKD.Methods: In the United States, 300 patients with ADPKD and 155 physicians treating patients with ADPKD completed online surveys administered by Kantar. Disease stage was categorized as early (chronic kidney disease [CKD] stages 1– 3) or late (stages 4– 5). Patients completed the Work Productivity and Activity Impairment Questionnaire and reported current disease symptoms. Patients and physicians assessed impacts of ADPKD on daily life and burden of specific symptoms. Statistical analyses compared patient versus physician responses stratified by early- versus late-stage ADPKD.Results: We found that impairment in work productivity was statistically greater in late- versus early-stage CKD. Compared with physicians’ impressions, patients were more likely at early stages and less likely at later stages to report a moderate/strong impact of ADPKD on daily life. Among patients, 74% with early- and 88% with late-stage disease reported that ADPKD caused them to modify their daily lives. In early-stage disease, patients reported a statistically greater burden from feeling exhausted and less burden from dull kidney pain, cardiovascular problems, high blood pressure, and liver cysts than physicians assumed. At later stages, patients reported feeling exhausted and skeletal/joint pain as more burdensome, and frequent urination, high blood pressure, liver cysts, and hematuria as less burdensome, compared with physicians’ impressions.Conclusion: The results of this survey study demonstrate a disconnect between patients’ experiences and physicians’ awareness of the burden of ADPKD and highlight the need for more patient/physician discussion of symptoms and disease management.Keywords: autosomal dominant polycystic kidney disease, ADPKD, symptom burden, patient reports, physician views, survey

El análisis de las propiedades físicas, mecánicas e hidráulicas del suelo, existente en el relleno sanitario de la ciudad de Jipijapa, permitió obtener como resultado conocer las características y el comportamiento del suelo existente en la zona, además de comprobar si el suelo cumple con lo necesario para alojar esta clase de relleno sanitario. Para el análisis de estos resultados se realizó la exploración del subsuelo, mediante el ensayo de penetración estándar (SPT), basado en la norma técnica del Instituto Ecuatoriano de Normalización - INEN 689, el cual consistió en realizar 3 sondeos a 6 metros de profundidad en diferentes puntos, tomándose 18 muestras de suelo para su posterior análisis de laboratorio .Se analizaron las muestras realizando ensayos de granulometría, límites de consistencia para su posterior clasificación. Una vez realizado el análisis, se pudo conocer que el sitio estudiado cuenta con un suelo adecuado para alojar este relleno sanitario, con características de suelos de plasticidad media a elevada, con presencia de humedad natural, generando así una baja permeabilidad, reduciendo considerablemente la contaminación del subsuelo

Despite established efficacy for oral pre-exposure prophylaxis (PrEP) in reducing HIV incidence, multi-level barriers within the health system, clinics, and the processes that shape practice have hindered service delivery and subsequent population-level effects. We applied the Consolidated Framework for Implementation Research (CFIR) to assess the context of PrEP delivery for adolescent girls and young women (AGYW) in rural South Africa and identify the factors supporting and impeding PrEP implementation to develop strategies to improve PrEP delivery. Between 2021 and 2022, we conducted in-depth interviews with five young women with PrEP use experience and 11 healthcare providers as well as four key informant stakeholder interviews. Tailored interviews organized around the CFIR domains provided multiple perspectives on the inter-connected processes, gaps, and opportunities between health systems, clinics, communities, and PrEP services. Shifts in PrEP policies, funding pressures, and inconsistent communications from the National Department of Health spurred fragmented planning, engagement, execution, and monitoring of PrEP delivery processes within clinics already struggling to address multiple population health needs. Resulting challenges included: conflicting priorities within clinics and across NGO partners, unclear goals and targets, staffing and space constraints, and insufficient community engagement. Individual clinics' implementation climate and readiness to deliver PrEP varied in terms of operational plans and delivery models. Interviewees reported complexity of initiation procedures and support for PrEP maintenance, with opportunities to improve systems communications and processes to facilitate integrated services and more user-friendly experiences. Applying CFIR identified opportunities to strengthen PrEP delivery across levels within this complex service delivery setting.

Disentangling the effects of cyclical variability in environmental forcing and long-term climate change on natural communities is a major challenge for ecologists, managers, and policy makers across ecosystems. Here we examined whether the vertical distribution of rocky intertidal taxa has shifted with sea-level variability occurring at multiple temporal scales and/or long-term anthropogenic sea-level rise (SLR). Because of the distinct zonation characteristic of intertidal communities, any shift in tidal dynamics or average sea level is expected to have large impacts on community structure and function. We found that across the Northeast Pacific Coast (NPC), sea level exhibits cyclical seasonal variability, tidal amplitude exhibits ecologically significant variability coherent with the 18.6-year periodicity of lunar declination, and long-term sea-level rise is occurring. Intertidal taxa largely do not exhibit significant vertical distribution shifts coherent with short-term (monthly to annual) sea-level variability but do exhibit taxa-specific vertical distribution shifts coherent with cyclical changes in lunar declination and long-term SLR at decadal timescales. Finally, our results show that responses to cyclical celestial mechanics and SLR vary among taxa, primarily according to their vertical distribution. Long-term SLR is occurring on ecologically relevant scales, but the confounding effects of cyclical celestial mechanics make interpreting shifts in zonation or community structure challenging. Such cyclical dynamics alternatingly amplify and dampen long-term SLR impacts and may modify the impacts of other global change related stressors, such as extreme heat waves and swell events, on intertidal organisms living at the edge of their physiological tolerances. As a result, intertidal communities will likely experience cyclical periods of environmental stress and concomitant nonlinear shifts in structure and function as long-term climate change continues. Our results demonstrate that consistent, large-scale monitoring of marine ecosystems is critical for understanding natural variability in communities and documenting long-term change.

BACKGROUND: Co-administration of inactivated influenza vaccine (IIV) and SARS-CoV-2 vaccine may impact SARS-CoV-2 vaccine induced humoral immune responses. We aimed to compare IIV and SARS-CoV-2 vaccine induced cellular and humoral immune responses in those receiving concomitant vaccination to those receiving these vaccines separately. METHODS: We conducted a cohort study between 29th September 2021 and 5th August 2022 in healthcare workers who worked at the local NHS trust and in the surrounding area that were vaccinated with a mRNA SARS-CoV-2 booster and cell-based IIV. We measured haemagglutination inhibition assay (HAI) titres, SARS-CoV-2 anti-spike antibody and SARS-CoV-2 ELISpot count pre-vaccination, 1-month and 6-months post-vaccination and evaluated differences by vaccine strategy. FINDINGS: We recruited 420 participants, 234/420 (56%) were vaccinated concomitantly and 186/420 (44%) separately. The 1-month post-vaccination mean fold rise (MFR) in SARS-CoV-2 anti-spike antibodies was lower in those vaccinated concomitantly compared to separately (MFR [95% confidence interval (CI)] 9.7 [8.3, 11.4] vs 12.8 [10.3, 15.9], p = 0.04). After adjustment for age and sex, the adjusted geometric mean ratio (aGMR) remained lower for those vaccinated concomitantly compared to separately (aGMR [95% CI] 0.80 [0.70, 0.92], p = 0.001). At 6-months post-vaccination, we found no statistically significant difference in SARS-CoV-2 anti-spike antibody titres (aGMR [95% CI] 1.09 [0.87, 1.35], p = 0.45). We found no statistically significant correlation between vaccine strategy with SARS-CoV-2 ELISpot count and influenza HAI titres at 1-month and 6-months post-vaccination. INTERPRETATION: Our study found that concomitant vaccination with SARS-CoV-2 and IIV has no statistically significant impacts on long-term immunogenicity. Further research is required to understand the underlying mechanisms and assess the clinical significance of reduced anti-spike antibodies in those vaccinated concomitantly. FUNDING: Research and Innovation (UKRI) through the COVID-19 National Core Studies Immunity (NCSi) programme (MC_PC_20060).