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Environmental monitoring (EM) is the cornerstone for the assurance of sterility during aseptic manufacturing. In this study, the EM quality aspects in the radiopharmaceutical cleanrooms of the University Medical Center Groningen (UMCG), The Netherlands, were evaluated. Hereto, data obtained from EM over the period 2010–2022 were analyzed. The data were sorted according to the Good Manufacturing Practice (GMP) classification of the respective premises with their corresponding limits, and frequencies of excursions were determined per location. The frequency of conducted measurements gradually increased between the start and end of the assessed period. There was a trend of increased action limit excursions observed between 2010–2022. We found that EM in grade A areas appeared to be significantly less compliant with GMP specifications than the combined data from all sampled premises at the facility (p < 0.00001; two-sided Fisher’s exact test). A trend was found for reduced action limit excursions for passive air sampling and particle counting, suggesting improved GMP compliance over time for this specific type of EM. The contamination recovery rate (CRR) found for cleanroom conditions, around 10%, was considered sufficient. From this comprehensive data analysis, we learn that, in order to be fully compliant with the requirements set in the recent revision of EU (European Union)-GMP Annex 1 ‘Manufacture of sterile medicinal products’ (in force as of 25 August 2023), strategies to further improve product protection are justified. For example, improved cleaning and disinfection procedures, more efficient working methods as well as optimization of the conditions under which aseptic manufacturing is performed are to be considered.

Shani Reich,1 Maria Lopez,2,&ast; Jacqueline Leff,3,&ast; Jordan Herman1 1Clinical Research Center of Florida, Pompano Beach, FL, USA; 2New England Eye Center/Tufts Medical Center, Boston, MA, USA; 3Touro Osteopathic School of Medicine, Touro University, New York, NY, USA&ast;These authors contributed equally to this workCorrespondence: Shani Reich, Tel +1 305 984 7785, Fax + 1 305 570 2642, Email Shani.reich@gmail.comPurpose: To compare clinical outcomes and patient preference for the dexamethasone intracanalicular insert (DEX) versus topical loteprednol (LOT) or olopatadine (OLO) for the treatment of allergic conjunctivitis in a real-world model of allergen exposure.Methods: This was a prospective comparative trial. Adults with testing-confirmed bilateral allergic conjunctivitis received DEX in the more symptomatic eye and either LOT 2 times daily or OLO once daily for 30 days in the fellow eye. The primary outcome was patient preference for treatment. Clinical outcomes included ocular itching and hyperemia, lid swelling, and watering/tearing. Safety outcomes included intraocular pressure (IOP).Results: Thirty patients participated and completed the study. All received DEX in the eye with worse symptoms and 15 received LOT and the other 15 received OLO in the other eye. Patients preferred DEX (10/15; 66.7%) over LOT (4/15; 26.7%), with one patient having no preference (p = 0.0103). Patients had no preference between DEX (8/15; 53.3%) and OLO (6/15; 40%), with one patient having no preference (p = 0.1044). In the DEX/LOT cohort, ocular itching and hyperemia improved more with DEX than LOT (p ≤ 0.009), while in the DEX/OLO cohort, the DEX eyes showed greater improvement in conjunctival hyperemia (p < 0.0001) but not itching (p = 0.074). No between-group differences were seen in eyelid swelling or tearing/watering in either cohort. Mean change in IOP was similar between the DEX and LOT eyes (p = 0.4921), and mean IOP rose more in the DEX eyes than the OLO eyes (by < 1 mmHg; p = 0.0403).Conclusion: Overall, this real-world study demonstrated that the dexamethasone intracanalicular insert was as effective as a topical antihistamine/mast cell stabilizer and more effective than topical steroids in relieving the signs and symptoms of allergic conjunctivitis. This insert should be considered as an alternative to topical therapy for the treatment of allergic conjunctivitis.Keywords: dexamethasone, dextenza, allergic conjunctivitis

Background/Objectives: Products from various parts of Crataegus species are traditionally applied as a cardiotonic. In Europe and the USA, mainly Crataegus monogyna Jacq. (Lindm.) and Crataegus laevigata (Poir.) DC (synonym Crataegus oxyacantha L.) are used, but worldwide, other Crataegus species are also used. Phytotherapeutic preparations with a standardised content of flavonoids and/or oligomeric procyanidins are commercially available. The products are generally considered as safe and are at most associated with minor and atypical adverse reactions. The aim of this study was to critically assess the information about the safety of Crataegus-containing products in humans. Methods: A scoping review of the literature about adverse reactions associated with Crataegus-containing products was performed. Next, individual case safety reports (ICSRs) were assessed, which were included in VigiBase (the World Health Organisation’s global database of adverse event reports for medicines and vaccines) and in the database of the Netherlands Pharmacovigilance Centre Lareb. The findings are discussed in relation to the literature. Results: The scoping review yielded 23 clinical studies with single-herb and 14 with multi-herb preparations, from which only a few minor gastrointestinal and cardiac events had been reported. A total of 1527 reports from VigiBase, from 1970 to 2023, were analysed, as well as 13 reports from Lareb. The most frequently reported adverse reactions belonged to the system organ classes ‘gastrointestinal disorders’, ‘skin and subcutaneous tissue disorders’, ‘general disorders and administration site conditions’, ‘cardiac disorders’ or ‘nervous system disorders’. In 277 reports of VigiBase, a single-herb product was the only suspect for causing the adverse reaction(s). Of these, 12.6% were graded as serious. Conclusions: The results of our study provide deeper insight in the adverse reaction profile of Crataegus-containing products and should contribute to their safe application in the treatment of less severe forms of cardiac failure.

This study investigated whether and how medication reviews (MRs) conducted by pharmacists and general practitioners (GPs) with patient involvement can be performed on the island of Aruba (Dutch Caribbean). In this mixed-methods pilot study (both qualitative and quantitative), constructive and observational methodologies were combined. Healthcare providers’ and patients’ views on MRs and aspects of Aruban healthcare and culture relevant to MRs were examined. These insights were used to develop a protocol for conducting and implementing MRs in Aruba. Surveys were distributed and semi-structured interviews were held among Aruban community pharmacists and GPs, and a pilot program was created in which MRs were carried out with four Aruban patients and their GPs. According to the included healthcare providers, the main purpose of MRs is to optimize the patient experience and achieve concordance. Even though pharmacists and GPs consider their partnership equal, they have different views as to who should bear which responsibility in the MR process in matters regarding patient selection and follow-up. Common Aruban themes that were mentioned by the healthcare providers and deemed relevant for conducting MRs included behaviour/culture, healthcare, lifestyle, and therapy compliance. Anamnesis should be concise during the MR, and questions about medication storage, concerns, beliefs, and practical problems, as well as checks for limited health literacy, were considered important. In the pilot, at least three to, maximally, eight pharmacotherapy-related problems (PRPs) were detected per MR consultation, such as an incorrect dosage of acetylsalicylic acid, an inappropriate combination tablet for blood pressure regulation, and the absence of important laboratory values. All patients considered their consultation to be positive and of added value. In addition, it was observed that an MR can potentially generate cost savings. The information obtained from the healthcare providers and patients, together with the basic principles for MRs, as applied in the Netherlands, led to a definitive and promising MR format with practical recommendations for community pharmacists in Aruba: in comparison with the Dutch MR approach, GPs and pharmacists in Aruba could collaborate more on patient selection for MRs and their follow-up, because of their specific knowledge regarding the medications patients are taking chronically (pharmacists), and possible low levels of health literacy (GPs). Taking into account the Aruban culture, pharmacists could ask extra questions during MRs, referring to lifestyle (high prevalence of obesity), readability of medication labels (limited literacy), and herbal product use (Latin American culture). GPs and medical specialists sometimes experience miscommunication regarding the prescription of medication, which means that pharmacists must carefully take into account possible duplicate medications or interactions.

Even though, nowadays, most medicines are manufactured industrially, patients may have medical needs that can only be met by a tailor-made approach. This requires the availability of pharmacy preparations made under Good Manufacturing Practice (GMP) conditions. An efficient hand hygiene practice is essential herewith, especially if sterile products that are prepared in a cleanroom are concerned. The effectiveness of hand washing and hand disinfection procedures greatly relies on adequate training. We carried out an observational cross-sectional pilot study aimed at optimizing hand hygiene training with objective and measurable quality assessments using an ultraviolet (UV) dye. Practical acceptance criteria for qualifying personnel through this method were set and evaluated. In total, 25 GMP-qualified cleanroom operators washed and disinfected their hands with UV dye hand wash lotion and UV dye hand alcohol, respectively. To obtain a proof-of-concept, the results were judged based on adherence to the WHO six-step protocol and associated acceptance criteria. Commonly missed areas were brought to light, and the influence of procedure duration was investigated. UV-dye-based assessments appeared to be more valuable in hand disinfection than in hand washing. In both procedures, the back of the hands and the thumbs were frequently missed. This underpins the need for enhanced and repeated education on hand washing and disinfection. Additionally, a dry skin gave rise to extra cleaning challenges. From this pharmacy practice pilot study with a focus on pharmaceutical product care, it may be concluded that the application of UV-dye-based assessments offers valuable insights for pharmacists to optimize hand hygiene, thereby increasing the safety of tailor-made medicines and on-site preparations.

Conventional therapy is commonly used for the treatment of inflammatory skin conditions, but undesirable effects, such as erythema, dryness, skin thinning, and resistance to treatment, may cause poor patient compliance. Therefore, patients may seek complementary treatment with herbal plant products including essential oils (EOs). This scoping review aims to generate a broad overview of the EOs used to treat inflammatory skin conditions, namely, acne vulgaris, dermatitis and eczema, psoriasis, and rosacea, in a clinical setting. The quality, efficacy, and safety of various EOs, as well as the way in which they are prepared, are reviewed, and the potential, as well as the limitations, of EOs for the treatment of inflammatory skin conditions are discussed. Twenty-nine eligible studies (case studies, uncontrolled clinical studies, and randomized clinical studies) on the applications of EOs for inflammatory skin conditions were retrieved from scientific electronic databases (PubMed, Embase, Scopus, and the Cochrane Library). As an initial result, tea tree (Melaleuca alternifolia) oil emerged as the most studied EO. The clinical studies with tea tree oil gel for acne treatment showed an efficacy with fewer adverse reactions compared to conventional treatments. The uncontrolled studies indicated the potential efficacy of ajwain (Trachyspermum ammi) oil, eucalyptus (Eucalyptus globulus) oil, and cedarwood (Cedrus libani) oil in the treatment of acne, but further research is required to reach conclusive evidence. The placebo-controlled studies revealed the positive effects of kānuka (Kunzea ericoides) oil and frankincense (Boswellia spp.) oil in the treatment of psoriasis and eczema. The quality verification of the EO products was inconsistent, with some studies lacking analyses and transparency. The quality limitations of some studies included a small sample size, a short duration, and the absence of a control group. This present review underscores the need for extended, well-designed clinical studies to further assess the efficacy and safety of EOs for treating inflammatory skin conditions with products of assured quality and to further elucidate the mechanisms of action involved.

In this study, a variety of ZnO-based heterojunctions with disparate wt.% doping of WO3 and BiOI have been prepared for the photodestruction of methyl orange (MO) dye in aqueous solution. The composites were analysed by scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, optical studies, and nitrogen adsorption-desorption isotherms. The SEM images revealed non-uniform surfaces of the ZnO–BiOI based composites while mostly nodular morphology was observed for all three samples of ZnO-WO3. As the WO3 loading increased, more clustering was detected. The analysed samples exhibited characteristic peaks representative of the triclinic phase of WO3 and the hexagonal wurtzite structure of ZnO, while the diffractogram observed from the materials displayed distinct peaks corresponding to the crystalline phases of both BiOI and ZnO in their pure forms. Further evidence of the samples' characteristics includes the presence of distinct crystalline patterns without any impurity peaks, a red shift in the absorption spectra of the heterostructure, the detection of only the reference elements, and mostly Type IV isotherm adsorption. This study identified the ZnO-[10%]BiOI and ZnO-[10%]WO3 heterojunctions as the best performing photocatalysts, as MO was completely destroyed in 120 and 90 min, respectively. Thus, confirming 10% wt. as the optimal doping concentration for the best photo-activity in this study. The impact of varying process parameters demonstrates that at an elevated photocatalyst mass of 40 mg, both heterojunctions effectively degraded MO. The photodegradation efficiency of MO was more pronounced in strong acidic conditions (pH 2) when compared to high alkaline conditions (pH 11) for the ZnO-[10%]BiOI heterostructure. However, a decrease in performance was observed for both strong acidic and high alkaline pH values when the ZnO-[10%]WO3 heterostructure was applied. The kinetic analysis of the photodegradation study reveals that all the photodegradation experiments can be represented by the pseudo-first-order kinetic model. The findings from this investigation propose that the ZnO-[10%]BiOI heterojunction photocatalyst holds significant potential for the effective treatment of dye-contaminated wastewater.

Indigenous fire stewardship enhances ecosystem diversity, assists with the management of complex resources, and reduces wildfire risk by lessening fuel loads. Although Indigenous Peoples have maintained fire stewardship practices for millennia and continue to be keepers of fire knowledge, significant barriers exist for re-engaging in cultural burning. Indigenous communities in Canada have unique vulnerabilities to large and high-intensity wildfires as they are predominately located in remote, forested regions and lack financial support at federal and provincial levels to mitigate wildfire risk. Therefore, it is critical to uphold Indigenous expertise in leading effective and socially just fire stewardship. In this perspective, we demonstrate the benefits of cultural burning and identify five key barriers to advancing Indigenous fire stewardship in Canada. We also provide calls to action to assist with reducing preconceptions and misinformation and focus on creating space and respect for different knowledges and experiences. Despite growing concerns over wildfire risk and agency-stated intentions to establish Indigenous Peoples as partners in wildfire management, power imbalances still exist. The future and coexistence with fire in Canada needs to be a shared responsibility and led by Indigenous Peoples within their territories.

The feruloyl esterase B gene (faeB) is specifically induced by hydroxycinnamic acids (e.g. ferulic acid, caffeic acid and coumaric acid) but the transcriptional regulation network involved in faeB induction and ferulic acid metabolism has only been partially addressed. To identify transcription factors involved in ferulic acid metabolism we constructed and screened a transcription factor knockout library of 239 Aspergillus niger strains for mutants unable to utilize ferulic acid as a carbon source. The ΔfarA transcription factor mutant, already known to be involved in fatty acid metabolism, could not utilize ferulic acid and other hydroxycinnamic acids. In addition to screening the transcription factor mutant collection, a forward genetic screen was performed to isolate mutants unable to express faeB. For this screen a PfaeB-amdS and PfaeB-lux613 dual reporter strain was engineered. The rationale of the screen is that in this reporter strain ferulic acid induces amdS (acetamidase) expression via the faeB promoter resulting in lethality on fluoro-acetamide. Conidia of this reporter strain were UV-mutagenized and plated on fluoro-acetamide medium in the presence of ferulic acid. Mutants unable to induce faeB are expected to be fluoro-acetamide resistant and can be positively selected for. Using this screen, six fluoro-acetamide resistant mutants were obtained and phenotypically characterized. Three mutants had a phenotype identical to the farA mutant and sequencing the farA gene in these mutants indeed showed mutations in FarA which resulted in inability to growth on ferulic acid as well as on short and long chain fatty acids. The growth phenotype of the other three mutants was similar to the farA mutants in terms of the inability to grow on ferulic acid, but these mutants grew normally on short and long chain fatty acids. The genomes of these three mutants were sequenced and allelic mutations in one particular gene (NRRL3_09145) were found. The protein encoded by NRRL3_09145 shows similarity to the FarA and FarB transcription factors. However, whereas FarA and FarB contain both the Zn(II)2Cys6 domain and a fungal-specific transcription factor domain, the protein encoded by NRRL3_09145 (FarD) lacks the canonical Zn(II)2Cys6 domain and possesses only the fungal specific transcription factor domain.

Phytoestrogens (PEs) are plant-based compounds that can interact with estrogen receptors and are mainly used to treat menopausal complaints. However, the safety of products with assumed phytoestrogenic activity is not fully understood. This study aimed to identify plant species with assumed phytoestrogenic activity, review existing literature on their use and safety, and critically evaluate adverse reaction (AR) reports of single-herb, multi-herb, and mixed-multiple products, as submitted to the Netherlands Pharmacovigilance Centre Lareb and to VigiBase of the World Health Organization (WHO). In the Lareb database, the most commonly reported plant species to cause ARs (total of 67 reports) were Actaea racemosa L. (black cohosh) (47.8%), Humulus lupulus L. (hops) (32.8%), and Glycine max (L.) Merr. (soybean) (22.4%). In the VigiBase database (total of 21,944 reports), the top three consisted of Glycine max (L.) Merr. (71.4%), Actaea racemosa L. (11.6%), and Vitex agnus-castus L. (chaste tree) (6.4%). In the scoping review (total of 73 articles), Actaea racemosa L. (30.1%), Glycine max (L.) Merr. (28.8%), and Trifolium pratense L. (13.7%) were the most frequently mentioned plant species. ARs were most frequently reported in the system organ classes “gastrointestinal disorders”, “skin and subcutaneous tissue disorders”, “reproductive system and breast disorders”, and “general disorders and administration site conditions”. Furthermore, from the scoping review, it appeared that the use of products with assumed phytoestrogenic activity was associated with postmenopausal bleeding. It was concluded that, while the potential benefits of products with assumed phytoestrogenic activity have been extensively pursued, the potential occurrence of ARs after using these products is less well understood. This study highlights the need for further investigation and careful monitoring of these products to better understand their effects and ensure the safety and well-being of individuals using them.

Quasi-periodic eruptions (QPEs) are luminous bursts of soft X-rays from the nuclei of galaxies, repeating on timescales of hours to weeks1-5. The mechanism behind these rare systems is uncertain, but most theories involve accretion disks around supermassive black holes (SMBHs) undergoing instabilities6-8 or interacting with a stellar object in a close orbit9-11. It has been suggested that this disk could be created when the SMBH disrupts a passing star8,11, implying that many QPEs should be preceded by observable tidal disruption events (TDEs). Two known QPE sources show long-term decays in quiescent luminosity consistent with TDEs4,12 and two observed TDEs have exhibited X-ray flares consistent with individual eruptions13,14. TDEs and QPEs also occur preferentially in similar galaxies15. However, no confirmed repeating QPEs have been associated with a spectroscopically confirmed TDE or an optical TDE observed at peak brightness. Here we report the detection of nine X-ray QPEs with a mean recurrence time of approximately 48 h from AT2019qiz, a nearby and extensively studied optically selected TDE16. We detect and model the X-ray, ultraviolet (UV) and optical emission from the accretion disk and show that an orbiting body colliding with this disk provides a plausible explanation for the QPEs.

Abstract: The purpose of this study is to describe the values of character education for Drama course. It is a qualitative descriptive study. The data were obtained from the play entitled Opera Kecoa¸ written by N.Riantiarno. by looking at the settings, the characters, the plots and some relevant documents. The technique used to collect the data was by document analysis technique. As one form of literary work, Opera Kecoa drama script contains character education values. The values of character education in this drama script are shown through characterizations and events in each chapter. Based on the results of the analysis found ten character education values contained in the drama Opera Kecoa, these values include: social care, tolerance, hard work, discipline, peace,patriotism, friendly, independent, creative, and responsibility. By reason of the values of these characters, the Opera Kecoa drama script can be used as a medium of learning in the college literature. Abstrak: Penelitian ini bertujuan mendeskripsikan nilai-nilai pendidikan karakter yang terdapat pada sebuah naskah drama. Penelitian ini menggunakan metode deskriptif kualitatif dengan subjek penelitiannya adalah naskah drama Opera Kecoa karya N.Riantiarno. Sumber data diperoleh dari tempat dan peristiwa, informan, naskah drama, dan dokumen. Pengumpulan data menggunakan teknik analisis dokumen. Sebagai salah satu bentuk karya sastra, naskah drama Opera Kecoa memuat nilai-nilai pendidikan karakter. Nilai-nilai pendidikan karakter dalam naskah drama ini ditampilkan melalui penokohan dan alur peristiwa pada setiap babaknya. Berdasarkan hasil analisis maka ditemukan sepuluh nilai pendidikan karakter yang terdapat dalam naskah drama Opera Kecoa, nilai-nilai tersebut antara lain: peduli sosial, toleransi, kerja keras, disiplin, cinta damai, cinta tanah air, bersahabat, mandiri, kreatif, dan tanggung jawab. Dengan alasan adanya nilai-nilai karakter tersebut maka naskah drama Opera Kecoa dapat digunakan sebagai salah satu media pembelajaran sastra di perguruan tinggi.

Objective: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is standard of care in the Netherlands in patients with stage III epithelial ovarian cancer following interval cytoreductive surgery (CRS). Differences in patient selection, technical aspects, and perioperative management exist between centers performing HIPEC. Standardization aims to reduce unwanted variation in clinical practice. As part of an implementation process, we aimed to standardize perioperative care for patients treated with CRS and HIPEC using a Delphi-based consensus approach. Methods: We performed a two-phase modified Delphi method involving a multidisciplinary panel of 40 experts who completed a survey on CRS and HIPEC. During a consensus meeting, survey outcomes and available scientific evidence was discussed. Items without consensus (

Cine-MRI for adhesion detection is a promising novel modality that can help the large group of patients developing pain after abdominal surgery. Few studies into its diagnostic accuracy are available, and none address observer variability. This retrospective study explores the inter- and intra-observer variability, diagnostic accuracy, and the effect of experience. A total of 15 observers with a variety of experience reviewed 61 sagittal cine-MRI slices, placing box annotations with a confidence score at locations suspect for adhesions. Five observers reviewed the slices again one year later. Inter- and intra-observer variability are quantified using Fleiss’ (inter) and Cohen’s (intra) κ and percentage agreement. Diagnostic accuracy is quantified with receiver operating characteristic (ROC) analysis based on a consensus standard. Inter-observer Fleiss’ κ values range from 0.04 to 0.34, showing poor to fair agreement. High general and cine-MRI experience led to significantly (p < 0.001) better agreement among observers. The intra-observer results show Cohen’s κ values between 0.37 and 0.53 for all observers, except one with a low κ of −0.11. Group AUC scores lie between 0.66 and 0.72, with individual observers reaching 0.78. This study confirms that cine-MRI can diagnose adhesions, with respect to a radiologist consensus panel and shows that experience improves reading cine-MRI. Observers without specific experience adapt to this modality quickly after a short online tutorial. Observer agreement is fair at best and area under the receiver operating characteristic curve (AUC) scores leave room for improvement. Consistently interpreting this novel modality needs further research, for instance, by developing reporting guidelines or artificial intelligence-based methods.

Monitoring adverse drug reactions is a vital issue to ensure drug safety and to protect the general public from medication-related harmful effects. In order to properly monitor drug safety, a regulatory system needs to be in place as well as an infrastructure that allows for analyzing national and international safety data. In Mongolia, adverse drug reaction (ADR) reporting activities have been implemented in the past decade. During this period, the basic structure and legal basis of an adverse drug reaction monitoring system was established. Because of the fragmented but growing healthcare system and the complexity of pharmaceutical issues in Mongolia, a sustainable process for the development of the adverse drug reaction reporting system is a key issue. The aim of this article is to disclose the Mongolian situation for the rest of the world and to share experiences on how an ADR reporting system can be developed towards a higher and more advanced level to contribute to both national and international drug safety issues. In this article, we review the features of the Mongolian health care and pharmaceutical systems, as well as the current development of the adverse drug reaction reporting system.

The effects of stress may be alleviated when its impact or a decreased stress-resilience are detected early. This study explores whether wearable-measured sleep and resting HRV in police officers can be predicted by stress-related Ecological Momentary Assessment (EMA) measures in preceding days and predict stress-related EMA outcomes in subsequent days. Eight police officers used an Oura ring to collect daily Total Sleep Time (TST) and resting Heart Rate Variability (HRV) and an EMA app for measuring demands, stress, mental exhaustion, and vigor during 15–55 weeks. Vector Autoregression (VAR) models were created and complemented by Granger causation tests and Impulse Response Function visualizations. Demands negatively predicted TST and HRV in one participant. TST negatively predicted demands, stress, and mental exhaustion in two, three, and five participants, respectively, and positively predicted vigor in five participants. HRV negatively predicted demands in two participants, and stress and mental exhaustion in one participant. Changes in HRV lasted longer than those in TST. Bidirectional associations of TST and resting HRV with stress-related outcomes were observed at a weak-to-moderate strength, but not consistently across participants. TST and resting HRV are more consistent predictors of stress-resilience in upcoming days than indicators of stress-related measures in prior days.

Abstract: This research is meant to: (1) describe the planning of Drama learning using Dongkrek-based Teams Games Tournament (TGT) strategy, (2) describe the implementation of Drama learning using Dongkrek-Based TGT strategy, and (3) describe the obstacles faced by the lecturers and students in drama learning using Dongkrek-Based TGT strategy. This descriptive qualitative research took place in IKIP PGRI Madiun, East Java. The result shows that (1) The lecturer who responsible for the planning of Drama learning using Dongkrek-Based TGT strategy has implemented the designed syllabus while the objectives has been in accordance with the Standard Competency and Basic Competence. Furthermore, the syllabus has includes the complete implementation procedures starting from initial activity of apperception, elaboration, confirmation and motivation. Main activities includes exploration, elaboration and confirmation followed by closing. (2) The implementation of Drama learning using Dongkrek-based TGT strategy included ‘Practice/performance test” in the syllabus but performed written test in the implementation while giving assignment to the student. In addition, there are some points of indicators which have not been achieved by students and didn’t received any special attention from the lecturer. The learning objectives have been in accordance with the Standard Competency and Basic Competency of the syllabus. (3) Obstacles faced by lecturer and students in the implementation of drama learning using Dongkrek-Based TGT strategy proved to be joyful learning as it comes from local culture called Dongkrek as students gained immediate competency on literacy instead of the theory. Abstrak: Penelitian ini bertujuan untuk: (1) mendeskripsikan perencanaan pembelajaran drama dengan strategi Teams Games Tournament (TGT) berbasis dongkrek, (2) mendeskripsikan penerapan pembelajaran drama dengan strategi TGT berbasis dongkrek, dan (3) mendeskripsikan kendala-kendala apa sajakah yang dihadapi dosen dan mahasiswa dalam pembelajaran drama dengan strategi TGT berbasis dongkrek. Bentuk penelitian ini adalah deskriptif kualitatif yang mengambil lokasi di IKIP PGRI Madiun Jawa Timur. Hasil penelitian ini menunjukkan bahwa (1) Dosen pengampu dalam perencanaan pembelajaran drama dengan strategi TGT berbasis dongkrek, sudah mengikuti silabus yang dibuat, tujuan sudah sesuai dengan SK dan KD yang digunakan. Kemudian silabus langkah-langkah pembelajaran sudah lengkap dimulai dari kegiatan awal yang melingkupi apersepsi, elaborasi, konfirmasi dan motivasi. Kegiatan inti melingkupi eksplorasi, elaborasi, dan konfirmasi, kemudian penutup. (2) Penerapan pembelajaran drama dengan TGT berbasis dongkrek pada teknik penilaian pada silabus dicantumkan “tes praktik/ kinerja” namun dosen lebih kepada tes tulis ketika memberikan tugas mahasiswa, ada pula beberapa poin indikator yang belum mampu dicapai oleh mahasiswa dan tidak mendapat perhatian khusus dari dosen. Tujuan pembelajaran juga sudah sesuai dengan SK dan KD pada silabus. (3) Kendala-kendala dosen dan mahasiswa dalam pembelajaran drama dengan strategi TGT berbasis dongkrek, karena sebuah pembelajaran yang berangkat dari sebuah kesenian lokal yaitu kesenian dongkrek maka pembelajaran drama untuk mahasiswa menyenangkan (joyful learning) karena mahasiswa mendapatkan pengalaman langsung tentang kompetensi kesastraan dan bersastra dan tidak hanya berteori. Permalink/DOI: http://doi.org/10.15408/dialektika.v6i1.9679

This research aimed to find out the discrimination against women in Indonesia, especially reflected in novels Entrok, Maryam, and Pasung Jiwa written by Okky Madasari. Over centuries, women in Indonesia had faced various forms of discrimination that happened because of the strong influence of patriarchal culture, norms, customs, and even religion. That viewpoint then caused men and women to have different roles, both biologically and socially. Women had roles to keep house, family, and children, meanwhile, men had roles to provide for living and protection to the family. The discrimination problem, especially for women, was still the most discussed topic due to the lack of public awareness about women’s roles in community life. This research was a descriptive qualitative research using feminism approach. The data in this research were in the forms of sentences, paragraphs, dialogues, and discourses that reflect discrimination against women. The data analysis technique used in this research was content analysis. The research result shows that there is discrimination towards women in the sectors of economic and social based on the utterances from these three novels by Okky Madasari.

Abstract Background Standard strategies to identify genomic regions involved in a specific trait variation are often limited by time and resource consuming genotyping methods. Other limiting pre-requisites are the phenotyping of large segregating populations or of diversity panels and the availability and quality of a closely related reference genome. To overcome these limitations, we designed efficient Comparative Subsequence Sets Analysis (CoSSA) workflows to identify haplotype specific SNPs linked to a trait of interest from Whole Genome Sequencing data. Results As a model, we used the resistance to Synchytrium endobioticum pathotypes 2, 6 and 18 that co-segregated in a tetraploid full sib population. Genomic DNA from both parents, pedigree genotypes, unrelated potato varieties lacking the wart resistance traits and pools of resistant and susceptible siblings were sequenced. Set algebra and depth filtering of subsequences (k-mers) were used to delete unlinked and common SNPs and to enrich for SNPs from the haplotype(s) harboring the resistance gene(s). Using CoSSA, we identified a major and a minor effect locus. Upon comparison to the reference genome, it was inferred that the major resistance locus, referred to as Sen3, was located on the north arm of chromosome 11 between 1,259,552 and 1,519,485 bp. Furthermore, we could anchor the unanchored superscaffold DMB734 from the potato reference genome to a synthenous interval. CoSSA was also successful in identifying Sen3 in a reference genome independent way thanks to the de novo assembly of paired end reads matching haplotype specific k-mers. The de novo assembly provided more R haplotype specific polymorphisms than the reference genome corresponding region. CoSSA also offers possibilities for pedigree analysis. The origin of Sen3 was traced back until Ora. Finally, the diagnostic power of the haplotype specific markers was shown using a panel of 56 tetraploid varieties. Conclusions CoSSA is an efficient, robust and versatile set of workflows for the genetic analysis of a trait of interest using WGS data. Because the WGS data are used without intermediate reads mapping, CoSSA does not require the use of a reference genome. This approach allowed the identification of Sen3 and the design of haplotype specific, diagnostic markers.

Novel is one of literature which full of character education value. The aims of this research describe the character education value of hard work in the novel. The mental hard work of participants in educators have faded and much the mentality to get instant results. This research uses the descriptive qualitative method with source data from novel Raden Mandasia Si Pencuri Daging Sapi by Yusi Avianto Pareanom Banan publisher 2016. Close reading was used to collect the data, then the data was recorded in the form of hard work education data, processing data and analyzing data The results of this research that novel contains a lot of hard-working education values shown by the characters. Figures from this novel are (1) Sungu Lembu, (2) Raden Mandasia, (3) Prabu Watugunung, (4) Loki Tua, (5) Nyai Manggis, (6) Many Wetan, (7) Barja, (8) Wulu Many, (9) Jongkeng, (10) Resi Tama, and (11) Melur. The value of character education of hard work on this novel can be instilled to learners along with related learning. Thus it can assist the educator in determining the proper literary works for the material to grow the character of the hard work of the learners.

In the compounding facilities of hospital pharmacies, extemporaneous preparations for parenteral administration are produced using aseptic handling. The designated environment for this practice is a clean area, such as a laminar airflow (LAF) cabinet placed in a classified cleanroom complying with good manufacturing practices (GMP) and International Organization for Standardization (ISO) 14644-1 guidelines. The European GMP Annex 1 (Revision 2020) and United States Pharmacopeia (USP) monograph state that airflow visualization studies (“smoke” studies) should be performed to substantiate the cleanroom and LAF cabinet performance and their qualification status. Even though smoke studies are required by these guidelines, current literature does not describe detailed practical protocols and acceptance criteria. The objective of this study was to develop and implement a practical smoke study protocol to ensure compliance with aseptic handling guidelines in hospital pharmacies. First, a literature search was performed to collect information about smoke study protocols and acceptance criteria. Subsequently, a smoke study protocol was developed for a downflow and crossflow LAF cabinet as well as for grade C/B cleanroom areas. As a proof of concept, the smoke study protocol for the downflow LAF cabinet was executed in the at-rest and in-operation states. Video recordings of the smoke studies were analyzed to assess the performance of the cabinet. Finally, the video recordings obtained from the smoke studies were used in a training program for hospital pharmacy operators, which showed that smoke studies might aid in operators’ aseptic handling awareness. To the best of our knowledge, the present study provides for the first time a practical approach for the development of smoke study protocols in a hospital pharmacy setting and shows potential for training operators, process optimization, and continuous quality improvement.

To evaluate and compare the risk of emerging vector-borne diseases (VBDs), a Model for INTegrated RISK assessment, MINTRISK, was developed to assess the introduction risk of VBDs for new regions in an objective, transparent and repeatable manner. MINTRISK is a web-based calculation tool, that provides semi-quantitative risk scores that can be used for prioritization purposes. Input into MINTRISK is entered by answering questions regarding entry, transmission, establishment, spread, persistence and impact of a selected VBD. Answers can be chosen from qualitative answer categories with accompanying quantitative explanation to ensure consistent answering. The quantitative information is subsequently used as input for the model calculations to estimate the risk for each individual step in the model and for the summarizing output values (rate of introduction; epidemic size; overall risk). The risk assessor can indicate his uncertainty on each answer, and this is accounted for by Monte Carlo simulation. MINTRISK was used to assess the risk of four VBDs (African horse sickness, epizootic haemorrhagic disease, Rift Valley fever, and West Nile fever) for the Netherlands with the aim to prioritise these diseases for preparedness. Results indicated that the overall risk estimate was very high for all evaluated diseases but epizootic haemorrhagic disease. Uncertainty intervals were, however, wide limiting the options for ranking of the diseases. Risk profiles of the VBDs differed. Whereas all diseases were estimated to have a very high economic impact once introduced, the estimated introduction rates differed from low for Rift Valley fever and epizootic haemorrhagic disease to moderate for African horse sickness and very high for West Nile fever. Entry of infected mosquitoes on board of aircraft was deemed the most likely route of introduction for West Nile fever into the Netherlands, followed by entry of infected migratory birds.

Antibiotic resistance has become a global health issue, negatively affecting the quality and safety of patient care, and increasing medical expenses, notably in Indonesia. Antibiotic stewardship programs (ASPs) aim to reduce resistance rates and their implementation in hospitals, has a high priority worldwide.We aimed to monitor the progress in the organizational implementation of ASPs in Indonesian hospitals by an Antimicrobial Resistance Control Program (ARCP) team and to identify possible hurdles. We conducted a cross-sectional study with structured interviews based on a checklist designed to assess the achievement of structural indicators at the organizational level in four private and three public hospitals in four regions (Surabaya, Sidoarjo, Mojokerto, Bangil) in East Java, Indonesia.The organizational structure of public hospitals scored better than that of private hospitals. Only three of the seven hospitals had an ARCP team. The most important deficiency of support appeared to be insufficient funding allocation for information technology development and lacking availability and/or adherence to antibiotic use guidelines. The studied hospitals are, in principle, prepared to adequately implement ASPs, but with various degrees of eagerness. The hospital managements have to construct a strategic plan and to set clear priorities to overcome the shortcomings.

Quantitative understanding of transmission with and without control measures is important for the control of infectious diseases because it helps to determine which of these measures (or combinations thereof) will be effective to reduce transmission. In this paper, the statistical methods used to estimate transmission parameters are explained. To show how these methods can be used we reviewed literature for papers describing foot-and-mouth disease virus (FMDV) transmission in pigs and we used the data to estimate transmission parameters. The analysis showed that FMDV transmits very well when pigs have direct contact. Transmission, however, is reduced when a physical barrier separates infected and susceptible non-vaccinated pigs. Vaccination of pigs can prevent infection when virus is administered by a single intradermal virus injection in the bulb of the heel, but it cannot prevent infection when pigs are directly exposed to either non-vaccinated or vaccinated FMDV infected pigs. Physical separation combined with vaccination is observed to block transmission. Vaccination and separation can make a significant difference in the estimated number of new infections per day. Experimental transmission studies show that the combined effect of vaccination and physical separation can significantly reduce transmission (R < 1), which is a very relevant result for the control of between-farm transmission.

Escherichia coli strains carrying Shiga toxins 1 and 2 (stx1 and stx2), intimin (eae), and hemolysin (ehxA) production genes were found in grass shoot, rhizosphere soil, and stable manure samples from a small-scale cattle farm located at the center of Netherlands, using cultivation-dependent and -independent microbiological detection techniques. Pasture land with grazing heifers in the first year of sampling in 2014 and without grazing cattle in 2015 was physically separated from the stable that housed rose calves during both years. Manure from the stable was applied to pasture via injection into soil once per year in early spring. Among a variety of 35 phylogenetic distinctly related E. coli strains, one large group consisting of 21 closely resembling E. coli O150:H2 (18), O98:H21 (2), and O84:H2 (1) strains, all belonging to phylogenetic group B1 and carrying all screened virulence traits, was found present on grass shoots (10), rhizosphere soil (3), and stable manure (8) in 2014, but not anymore in 2015 when grazing heifers were absent. Presence and absence of these strains, obtained via enrichments, were confirmed via molecular detection using PCR-NALFIA in all ecosystems in both years. We propose that this group of Shiga toxin-producing E. coli phylogenetic group B1 strains was originally introduced via stable manure injection into the pasture. Upon grazing, these potential pathogens proliferated in the intestinal track systems of the heifers resulting in defecation with higher loads of the STEC strain onto the grass cover. The STEC strain was further smeared over the field via the hooves of the heifers resulting in augmentation of the potential pathogen in the pasture in 2014, whereas in 2015, in the absence of heifers, no augmentation occurred and only a more diverse group of potentially mild virulent E. coli phylogenetic group A and B1 strains, indigenous to pasture plants, remained present. Via this model, it was postulated that human pathogens can circulate between plants and farm animals, using the plant as an alternative ecosystem. These data indicate that grazed pasture must be considered as a potential carrier of human pathogenic E. coli strains and possibly also of other pathogens.

The benefits of studying history, in addition to remembering the past, are also valuable lessons for future generations. Through history, the younger generation knows the cultural treasures of the nation so that they can preserve them. One of the original arts belonging to West Kalimantan is the traditional theater mendu. This theater was successful at the beginning of its emergence (1876 AD) until the Japanese colonial era. After that it was dim because society was forbidden by Japan to gather and associate. Mendu was bloated again and became the belle of the 80's which was driven by the maestro Sataruddin Ramli (1948 - 2015). However, this particular art of West Kalimantan is now only a memory. This research aims to describe the golden age of West Kalimantan's traditional theater. The method used is descriptive qualitative form with a literature study approach. The results of the study describe (1) the glory period from the beginning of the emergence of the mendu to the Japanese occupation (1876 - 1942), (2) the traditional theater of the mendu became the belle of the community (1980s - 2000s). Factors that cause the mendu golden period include because in the past the world of entertainment was not yet sophisticated and modern, the characteristics of the traditional and simple community, the story that was served favored by the community at that time, the participation of the Regional Government of West Kalimantan, as well as coaching was held for the younger generation.

Swallowing problems and the required dose adaptations needed to obtain optimal pharmacotherapy may be a hurdle in the use of tablets in daily clinical practice. Tablet splitting, crushing, or grinding is often applied to personalise medication, especially for the elderly and children. In this study, the performance of different types of (commercially available) devices was studied. Included were splitters, screwcap crushers, manual grinders, and electric grinders. Unscored tablets without active ingredient were prepared, with a diameter of 9 and 13 mm and a hardness of 100–220 N. Tablets were split into two parts and the difference in weight was measured. The time needed to pulverise the tablets (crush time) was recorded. The residue remaining in the device (loss) was measured. The powder was sieved to obtain a particle fraction >600 µm and

This study aims to describe the intertextuality relationship between the novel Pasung Jiwa by Okky Madasari and Calabai by Pepi Al-Bayqunie. The type of research is descriptive qualitative approach using content analysis. Data are collected by inventorying events that are similarities and differences, specifications on the characters, settings, plots, and themes of both text. The research results indicate that there are similar themes on the two novels, the theme of self actualization in addition with the theme of family and friendship. The same characterization are also used by both author, masculine figures with feminine soul characters. The difference between the two novels lies on the plot and setting. Pasung Jiwa uses progressive plot and Calabai uses a flash-back plot.. Okky Madasari takes Java Island as the background in the novel Pasung Jiwa, while the novel Calabai, Pepi Al-Bayqunie using the setting of Sulawesi Island. The basis of the similarity of theme and characterization supported by the similirity of events in the story shows the existence of intertextual relationship between the two novels. As a previously published work, the novel Pasung Jiwa by Okky Madasari is a hipogram and novel Calabai by Pepi A-Bayqunie as a transformational text. On the theme and characterization, the transformation of Calabai forward the hypogram, while in the plot and setting deviates his hypogram, Pasung Jiwa.Penelitian ini bertujuan untuk mendeskripsikan hubungan intertekstualitas antara novel Pasung Jiwa karya Okky Madasari dan novel Calabai karya Pepi Al-Bayqunie. Jenis penelitian ini adalah deskriptif kualitatif dengan pendekatan konten analisis. Data dikumpulkan dengan menginventariskan peristiwa yang merupakan persamaan dan perbedaan, spesifikasi pada tokoh, latar, alur, dan tema dari kedua teks. Hasil penelitian ini menunjukkan bahwa terdapat kesamaan tema pada kedua novel, yaitu tema aktualisasi diri, ditambah dengan tema keluarga dan persahabatan. Penokohan yang sama juga digunakan oleh kedua penulis, yaitu tokoh maskulin dengan karakter jiwa feminin. Perbedaan kedua novel terletak pada alur dan latar. Pasung Jiwa menggunakan alur maju dan Calabai menggunakan alur campuran. Latar dalam novel Pasung Jiwa, Okky Madasari mengambil latar Pulau Jawa, sedangkan novel Calabai, Pepi Al-Bayqunie menggunakan latar Pulau Sulawesi. Dasar kesamaan tema dan penokohan didukung kesamaan peristiwa-peristiwa dalam cerita menunjukkan adanya hubungan intertekstual antara kedua novel. Sebagai karya yang terbit terlebih dahulu menjadikan novel Pasung Jiwa karya Okky Madasari adalah hipogram dan novel Calabai karya Pepi Al-Bayqunie sebagai teks transformasi. Pada tema dan penokohan, transformasi Calabai meneruskan hipogram, sedangkan pada alur dan latar menyimpangi hipogramnya, Pasung Jiwa.

This paper reports on research that was undertaken to determine the problems experienced by deputy principals in secondary schools, and the extent to which these problems were experienced. Although some research was conducted on the deputy principalship, no research treats the problems that deputy principals experience upon appointment comprehensively. An understanding of the problems experienced by secondary school deputy principals is a necessary precursor of an induction program to address the problems. A quantitative approach which was underpinned by the post-positivist paradigm was adopted. In order to determine the extent to which the problems were experienced, a survey was conducted among one hundred and fifty seven secondary school deputy principals in the North West Province. The participants came from a diverse context of rural, township and urban schools. The deputy principals who participated in the study included those who were newly appointed (one to three years of service) and those who were experienced (more than three years of service). Data were analyzed by means of descriptive statistics such as frequencies, means and percentages. There were no significant differences in the responses of both newly-appointed and experienced deputy principals. The results revealed that deputy principals experienced administrative, financial management, work pressure, personal and physical resources problems. In an attempt to address the problems identified, a context-specific induction program is recommended. The induction program should be an on-going program of professional development and should preferably include specific aims, action steps to be taken to achieve the aims that are set and measures to evaluate progress.

Tujuan penelitian ini adalah mendeskripsikan: (a) cara guru memilih cerita pendek yang diajarkan dalam pembelajaran sastra di SMA Surakarta, (b) alasan guru memilih cerita pendek dengan cara tersebut, dan (c) pertimbangan-pertimbangan guru dalam memilih cerpen. Tujuan ini dicapai dengan penelitian kualitatif deskriptif. Data berupa pernyataan guru tentang cara memilih cerpen dan alasannya. Sumber datanya adalah guru-guru bahasa Indonesia yang tergabung dalam Musyawarah Guru Mata Pelajaran Bahasa Indonesia SMA di Surakarta. Teknik sampling yang diterapkan adalah purposive sampling, yaitu dipilih berdasarkan variasi kondisi sekolah: negeri, swasta, umum, dan keagamaan. Teknik pengambilan data dengan angket. Teknik analisis data dengan teknik analisis interaktif. Hasil penelitian ini sebagai berikut. (1) Guru memilih cerita pendek dengan 3 cara yaitu: 78% guru memilih cerpen yang tercantum di dalam buku pelajaran, 11% guru memilih cerpen dari buku pelajaran dan menambah cerpen dari sumber lain, dan 11% memilih cerpen dari berbagai sumber dan sering mengesampingkan cerpen yang ada di buku pelajaran. (2) Alasan guru memilih cerita pendek dengan cara tersebut sebagai berikut; (a) Guru yang memilih cerpen dari buku pelajaran memiliki alasan: mudah didapatkan, semua siswa memiliki, lebih terprogram, biasanya sudah dibaca rumah sehingga KBM lebih mudah, lebih praktis, semua siswa sudah siap dengan cerpen yang diajarkan, dan merata untuk semua siswa, (b) Guru yang memilih cerpen dari buku pelajaran dan dari sumber lain memiliki alasan semua siswa telah mempunyai cerpen yang mempermudah proses pembelajaran dan dalam rangka memberi latihan untuk memperdalam pengetahuan siswa, guru memilih cerpen dari Koran, (c) Guru yang memilih cerpen dari berbagai sumber dan mengesampingkan cerpen yang dimuat di buku pelajaran memiliki alasan sebagai berikut: cerpen itu sangat banyak sehingga guru tidak bisa mengandalkan cerpen yang ada di buku pelajaran; bahan cerpen dalam buku pelajaran terbatas, padahal di luar kelas siswa berhadapan dengan dunia sastra yang begitu luas; perlu memberikan bacaan yang beragam; merupakan usaha membentengi siswa dari bacaan yang tidak mendidik, (3) Pertimbangan guru dalam memilih cerpen adalah: kepraktisan, isi cerita menarik, isi cerpen sesuai usia siswa, bebas dari pornograf dan SARA, mengandung nilai pendidikan, dan penanaman budi pekerti.

This study aims to describe the content of the novel Simple Miracles by Ayu Utami in terms of literary sociology studies. In addition, this study also sees its relevance to the learning of literature in high school grade XII. Novel Simple Miracles tells the spiritual story of the main character and his family in everyday life. In addition, in it also told about the relation of society related to religious, social, culture, and residence. This research uses qualitative descriptive method to describe the result of research of literary sociology on Simple Miracles novel. The results of this study indicate a social relationship between the character both in one family member and outside family members. It is that which indicates a relationship or social value in the novel. This novel also has a Javanese cultural value related to its birth and its inner death. The value of sociology literature study on social, religious, and cultural activities can be used as reference material in the study of literature in high school class XII in KD 4.1.

This article is aimed to describe post-colonial forms which represented by the figures in the Pramoedya Ananta Toer’s novel Perburuan. This novel portrays about a character named Hardo who fought Japanese colonialism together with his two friends, Dipo and Karmin. However, their plan was failed to be implemented. It was making Hardo a Japanese fugitive. This novel is about the history of Japanese colonialism in Indonesia. Therefore, this novel can be studied with post-colonial theory. Type of this research is descriptive qualitative research using post-colonial approach. Researchers gathered the data by searching data in the novel that has relevance to the three formulations of the post-colonial theory that have been found. These three formulations include resistance, betrayal, and character’s self-doubt (ambivalence). The technique used in this article is content analysis. The research steps were determined the data source, collection the data, classification the data, and data analysis. Data analysis technique used was Miles and Huberman model that consists of data reduction, data presentation, and drawing conclusions. Through the representation of characters in the novel found the forms of resistance, betrayal, and characteristic’s self-doubts as forms of post-colonial representation.

This study aims to describe the content of Ayu Utami's Simple Miracles novel in terms of literary sociology and character education. Besides this research also see its relevance to the learning of literature in high school grade 12. This research uses qualitative descriptive method with the subject of Simple Miracles novel. Ayu Utami's novel tells about the life of one family and about the deaths of several family members. The results of this study indicate a social relationship between the characters both in one family member and outside family members. In addition, the results of this study can be deduced from 18 things that are characterized by the characters in this novel, religious, honest, tolerant, independent, democratic, curiosity, friendly, reading, social, and responsibility. This novel also has local cultural features known, religious, and social so that it can be a teaching material in high school grade 12 in accordance with KD 4.1.

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

All school populations are diverse in many ways. The diversity in South African schools has been compounded since 1994 with the migration of Black learners to former ‘white’ schools. Some schools and their principals have succeeded in coping efficiently with the new social and cultural makeup of their schools, while others have been struggling and even resigned under the pressures of all the conflicting demands from stakeholders. The theoretical and empirical investigation reported in this paper shows that principals and schools could benefit enormously from learning from the experiences of the more successful schools and their principals

Accurate Calcium Oxalate Monohydrate (COM) solubility measurements are essential for elucidating the physiochemical mechanism behind the formation of kidney stones, nephrolithiasis. Yet the reported solubility values of COM in ultrapure water, arguably the simplest solvent relevant for nephrolithiasis, vary significantly depending on implemented method. To address this variation, we present an experimental study of the solubility of COM validated by a model based on the Debye–Hückel theory describing the solution chemistry and the complex formation. We also carefully monitor potential pseudopolymorphic/hydrate transitions during the solubility measurements with in-situ and ex-situ methods. Our results indicate that the solubility of COM in ultrapure water is a weak function of temperature. However, the measured solubility varies significantly in buffer solutions across physiologically relevant pH values at body temperature. The proposed model explains observed trends as a combined effect of ionic strength, protonation reactions, and soluble complex formation. Moreover, it predicts solubility of COM in buffer solutions remarkably well using our measurements in ultrapure water as input, demonstrating the consistency of presented approach. The presented study parleying experiments and modelling provides a solid stepping stone to extend the physiochemical understanding of nephrolithiasis to more realistic solutions laden with biological complexity.

In this article the design of three master programs (MSc in Pharmacy) and two postgraduate specialization programs for community or hospital pharmacist is described. After a preceding BSc in Pharmacy, these programs cover the full pharmacy education capacity for pharmacists in primary and secondary health care in the Netherlands. All programs use the CanMEDS framework, adapted to pharmacy education and specialization, which facilitates the horizontal integration of pharmacists’ professional development with other health care professions in the country. Moreover, it is illustrated that crossing the boundary from formal (university) education to experiential (workplace) education is eased by a gradual change in time spent in these two educational environments and by the use of comparable monitoring, feedback, and authentic assessment instruments. A reflection on the curricula, based on the principles of the Integrative Pedagogy Model and the Self-determination Theory, suggests that the alignment of these educational programs facilitates the development of professional expertise and professional identity of Dutch pharmacists.

Most influenza vaccines are administered via injection, which is considered as user-unfriendly. Vaccination via oral cavity using an orodispersible film (ODF) might be a promising alternative. To maintain the antigenicity of the vaccine during preparation and subsequent storage of these ODFs, sugars such as trehalose and pullulan can be employed as stabilizing excipients for the antigens. In this study, first, β-galactosidase was used as a model antigen. Solutions containing β-galactosidase and sugar (trehalose or trehalose/pullulan blends) were pipetted onto plain ODFs and then either air- or vacuum-dried. Subsequently, sugar ratios yielding the highest β-galactosidase stability were used to prepare ODFs containing H5N1 whole inactivated influenza virus vaccine (WIV). The stability of the H5N1 hemagglutinin was assessed by measuring its hemagglutination activity. Overall, various compositions of trehalose and pullulan successfully stabilized β-galactosidase and WIV in ODFs. WIV incorporated in ODFs showed excellent stability even at challenging storage conditions (60 °C/0% relative humidity or 30 °C/56% relative humidity) for 4 weeks. Except for sugars, the polymeric component of ODFs, i.e., hypromellose, possibly improved stability of WIV as well. In conclusion, ODFs may be suitable for delivering of WIV to the oral cavity and can possibly serve as an alternative for injections.

Background: The use of medication in pediatrics, children aged 0−5 years, was explored so as to identify active pharmaceutical ingredients (APIs) suitable for inkjet printing on a plain orodispersible film (ODF) formulation in a pharmacy. Methods: The database IADB.nl, containing pharmacy dispensing data from community pharmacies in the Netherlands, was used to explore medication use in the age group of 0−5 years old, based on the Anatomical Therapeutic Chemical classification code (ATC code). Subsequently, a stepwise approach with four exclusion steps was used to identify the drug candidates for ODF formulation development. Results: there were 612 Active Pharmaceutical Ingredients (APIs) that were dispensed to the target group, mostly antibiotics. Of the APIs, 221 were not registered for pediatrics, but were used off-label. After the exclusion steps, 34 APIs were examined regarding their suitability for inkjet printing. Almost all of the APIs were sparingly water soluble to practically insoluble. Conclusion: Pharmaceutical inkjet printing is a suitable new technique for ODF manufacturing for pediatric application, however the maximal printed dose as found in the literature remained low. From the selected candidates, only montelukast shows a sufficiently high water-solubility to prepare a water-based solution. To achieve higher drug loads per ODF is ambitious, but is theoretically possible by printing multiple layers, using highly water-soluble APIs or highly loaded suspensions.

After conducting research with an in-depth study of the moral aspects with the perspective of Islamic Archipelago in the children’s story on Bobo Magazine and Kompas Daily, two substantial findings were found. First, the dominant moral values in children’s stories are the value of hard work, honesty, obedience, responsibility, friendship, courage, discipline, compassion, sharing, and creativity, all of which are related to children’s moral formation. Second, values moral stories of children in the context of the Islamic archipelago related to the relationship of children’s moral values in children’s stories in the context of Islam based on the Al-Qur’an and Al-Hadits and the context of children’s moral values in children in the context of Indonesian humanity and Archipelago culture.

This study aims to investigate and describe the values of archipelagic Islam in A. Mustofa Bisri’s poetry. Archipelagic Islam contains three narratives at once, namely: politics, nationality, and culture. The main principle is National brotherhood (ukhuwah wathaniyah), Human brotherhood (ukhuwah basyariyah ), and Islamic brotherhood (ukhuwah Islamiyah ). A. Mustofa Bisri is chosen as the subject of this research because besides being a charismatic kiai , he is also a famous poet. A. Mustofa Bisri often voiced the values of humanity, love, compassion, peace and human equality. The results of this study are some principles, namely the principle to establish God as God, treat humans as human beings, and manage nature properly and correctly. The principles constitute the contextualization of the values of archipelagic Islam that was received by A. Mustofa Bisri in his poetry, as well as the prophetic manifestations.

Novel sebagai karya fiksi prosa sarat dengan nilai-nilai moral yang dapat diteladankan. Nilai-nilai moral dalam novel dapat dijadikan sebagai media bahan ajar di lingkup pendidikan formal untuk membangun karakter peserta didik melalui karya sastra. Novel Calabai karya Pepi Al-Bayqunie menghadirkan tokoh utama bernama Saidi yang merepresentasikan kecerdasan moral. Keunikan novel tersebut terletak pada karakter Saidi yang merupakan calabai (transgender), namun mampu memberikan teladan yang baik bagi masyarakat dan generasi muda khususnya. Bukan teladan atas tabiatnya namun teladan atas sikap dan tindakan moralnya sebagai makhluk sosial. Artikel ini bertujuan untuk mendeskripsikan kecerdasan moral tokoh transgender dalam novel Calabai karya Pepi Al-Bayqunie. Pendekatan analisis konten digunakan untuk menganalisis dan memaknai data yang terkumpul dari novel Calabai terkait kecerdasan moral. Hasil analisis menunjukkan bahwa novel Calabai karya Pepi Al-Bayqunie mengandung kecerdasan moral yang direpresentasikan oleh tokoh utama bernama Saidi. Komponen kecerdasan moral yang ditemukan dalam bentuk empati, hati nurani, kontrol diri, rasa hormat, kebaikan hati, toleransi, dan keadilan. Kata kunci: kecerdasan moral, novel calabai, transgender

Artikel ini berusaha mendeskripsikan bentuk mimikri sebagai upaya untuk melwan dengan menggunakan kajian poskolonial. Novel Gadis Pantai karya Pramoedya Ananta Toer digunakan sebagai objek penelitian lalu dianalisis dengan pendekata poskolonial untuk mencari bentuk mimikri yang ada dalam novel tersebut. Penelitian ini menggunakan kajian deskriptif analitis dengan menggunakan sumber data novel Gadis Pantai. Penelitian ini menggambarkan bagaimana perbedaan status sosial yang menyebabkan inferioritas dari stastus sosial tertentu yang kemudian melakukan penituan atau mimikri untuk melakukan perlawanan. Gadis Pantai merupakan tokoh utama yang melakukan mimikri kemudian melawan sistem kebangsawanan Bendoro untuk mempertahankan harga diri dan keluarganya Kata kunci: gadis pantai, mimikri, poskolonial