Hubungan Berat Badan Lahir dengan Status Nutrisi Pada Balita di Wilayah Kerja Puskesmas Undaan Kabupaten Kudus

This research is motivated by the high prevalence of problems with the nutritional status of children under five in Indonesia, such as stunting, wasting and overweight, which have a significant impact on the quality of human resources in the future. One of the main factors contributing to this problem is low birth weight (LBW), which reflects a lack of nutritional intake during pregnancy. LBW conditions can trigger various long-term health risks in toddlers, including growth disorders, stunting and malnutrition. The nutritional status of toddlers is assessed through various anthropometric indicators, such as body weight, height and body mass index (BMI), thus providing a comprehensive picture of the balance of nutritional intake and body needs. This research was carried out in the work area of the Undaan Community Health Center, Kudus Regency, involving a population of 83 toddlers. From this population, 68 toddlers were selected as samples based on predetermined inclusion criteria. Data collection was carried out through direct measurements of the toddler's weight and height and using a questionnaire that included information related to birth weight and nutritional patterns. Data analysis was carried out in stages, starting from univariate analysis to map data distribution, followed by bivariate analysis using the Spearman test to identify the relationship between birth weight and nutritional status of toddlers. The results of the study showed that there was a statistically insignificant relationship between birth weight and nutritional status of toddlers with a value of p = 0.442 (p > 0.05). However, birth weight remains one of the factors that can influence a child's nutritional development during the growth period. Therefore, it is necessary to educate mothers regarding the importance of fulfilling nutrition during pregnancy and monitoring the growth of toddlers regularly. It is hoped that the Community Health Center can improve its nutrition education program to optimize the growth and development of toddlers and prevent malnutrition problems

Fundación del TEU de Murcia (1939) y etapa de dirección de Alberto González Vergel (1949-1954)

Este artículo expone en qué circunstancias y cómo se produjo la fundación del TEU de Murcia en 1939. Este se destaca por su carácter de pionero en el contexto nacional, por la precocidad de su fecha de creación solo unos meses después del fin de la Guerra Civil. Más adelante, en 1949, llega González Vergel a la dirección del TEU, quien instituye en el colectivo un nuevo esquema de producción, basado en las aspiraciones de rigor e innovación escénicos, en consonancia con el espíritu dominante tanto en el teatro de cámara y ensayo como en el teatro universitario español del momento. Este TEU se perfila como espacio de experimentación y de formación autodidacta a través de la propia práctica teatral, la cual pretendía sustentarse en el rigor escénico y actoral, convirtiéndose en bastantes casos en el paso previo al acceso a la profesión teatral.The article deals with the foundation of the University Theatre (TEU) of Murcia in 1939. It was a pioneer in the national context, since it was created just a few months after the end of the Spanish Civil War. Later, in 1949, González Vergel took over the direction of this theatre group, and instituted a new way of producing. The goals were rigour and innovation in the staging, according to the dominant spirit in both national chamber theatre and university theatre at the period. The TEU of Murcia became a space of experimentation and self-learning through the theatre practice itself, which tried to be rigurous in the staging and acting. In many cases, it was the previous step before entering the theatre profession

Una mirada al testimonio en Colombia: Piedad Bonnett y Héctor Abad Faciolince

Resumen: El texto lee dos modos de elaboración del duelo, dos modos de escritura testimonial de dos escritores colombianos que luego de la pérdida de un ser querido -hijo y padre- le dan un giro a su forma de narrar y hacen visible la tendencia autobiográfica (testimonio) en las letras de este país. Seguir las huellas del giro autobiográfico de la literatura actual (Giordano), empezar a pensar las variantes del giro en un país con condiciones sociales derivadas del conflicto armado como Colombia; ubicar este tipo de relatos entre la avalancha de testimonios del secuestro y autobiografías de todos los bandos son objetivos de este artículo2.Palabras Clave: Testimonio, literatura colombiana, giro autobiográfico, duelo

COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss

Background: Cisplatin is one of the most ototoxic chemotherapy drugs, resulting in a permanent and irreversible hearing loss in up to 50% of patients. Cisplatin and gentamicin are thought to damage hearing through a common mechanism, involving reactive oxygen species in the inner ear. Aspirin has been shown to minimise gentamicin-induced ototoxicity. We, therefore, tested the hypothesis that aspirin could also reduce ototoxicity from cisplatin-based chemotherapy. Methods: A total of 94 patients receiving cisplatin-based chemotherapy for multiple cancer types were recruited into a phase II, double-blind, placebo-controlled trial and randomised in a ratio of 1:1 to receive aspirin 975 mg tid and omeprazole 20 mg od, or matched placebos from the day before, to 2 days after, their cisplatin dose(s), for each treatment cycle. Patients underwent pure tone audiometry before and at 7 and 90 days after their final cisplatin dose. The primary end-point was combined hearing loss (cHL), the summed hearing loss at 6 kHz and 8 kHz, in both ears. Results: Although aspirin was well tolerated, it did not protect hearing in patients receiving cisplatin (p-value = 0.233, 20% one-sided level of significance). In the aspirin arm, patients demonstrated mean cHL of 49 dB (standard deviation [SD] 61.41) following cisplatin compared with placebo patients who demonstrated mean cHL of 36 dB (SD 50.85). Women had greater average hearing loss than men, and patients treated for head and neck malignancy experienced the greatest cHL. Conclusions: Aspirin did not protect from cisplatin-related ototoxicity. Cisplatin and gentamicin may therefore have distinct ototoxic mechanisms, or cisplatin-induced ototoxicity may be refractory to the aspirin regimen used here

Fundamentos teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal

Introduction: the aim to graduate a general dentist with a high standard in knowledge to solve the most general and prevalent periodontal oral health issues is a social demand that is revealed in the current study program of dentistry major. Objective: to elaborate some theoretical references concerning dentistry student preparation in terms of education for periodontal oral health. Method: from January to July 2020, at the Facultad de Estomatología in the Universidad de Ciencias Médicas Guantanamo, a narrative review on the subject was carried out through a search in electronic databases (Virtual Health Library, LILACS, PubMed, SciELO, REDALYC, Scopus). It was systematized all the theoretical references that support the preparation of the dentistry students in terms of education for periodontal oral health.Conclusions: it is evident the necessity of this type of training due to its implication in the way to the best professional performance for an integral oral care. The foundations for achieving this goal emerge from the harmonious conjugation of philosophical, sociological, legal, psychological, pedagogical and didactic referents, in accordance to the practice of the profession.Introducción: la aspiración de egresar un estomatólogo general suficientemente preparado para resolver los problemas de salud bucal periodontal más generales y prevalentes es una exigencia social que se revela en el actual plan de estudio de la carrera de Estomatología. Objetivo: elaborar unos referentes teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Método: de enero a julio de 2020, en la Facultad de Estomatología de la Universidad de Ciencias Médicas Guantánamo se realizó una revisión narrativa sobre el tema a través de una búsqueda en bases de datos electrónicas (Biblioteca Virtual en Salud, LILACS, PubMed, SciELO, REDALYC, Scopus). Se sistematizaron referentes teóricos que sustentan la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Conclusiones: se evidencia la necesidad de esta preparación dada su implicación en el modo de actuación profesional para una Atención Bucal Periodontal Integral. Las bases para esta finalidad emergen de la conjugación armoniosa de referentes filosóficos, sociológicos, legales, psicológicos, pedagógicos y didácticos en función de la práctica de la profesión

La integración de Sistemas de Gestión Empresariales, conceptos, enfoques y tendencias

La presente investigación tiene como objetivo describir e interpretar los antecedentes sobre los Sistemas de Gestión Empresarial, fundamentalmente en su integración. En la metodología se consideró la revisión y análisis de publicaciones para identificar aquellos aspectos de interés a tener en cuenta para emprender la conformación de un único sistema de gestión. Los principales hallazgos indican que la conceptualización de lo entendido por Sistema Integrado de Gestión es heterogénea, además se han propuestos varios niveles de integración en función del grado de avance alcanzado por las empresas y se identifica que el número mayor de las investigaciones al respecto están centradas en Europa. Se añade un análisis del estado de la certificación de sistemas empresariales en Cuba y se enfatiza en la necesidad de fortalecer la integración en todos los sectores empresariales

MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol.

BACKGROUND: Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer. METHODS: This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed. DISCUSSION: There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively help women with hot flushes and whether and how it can be translated into routine clinical practice. TRIAL REGISTRATION: ISRCTN 12824632 . Registered 25-01-2017

Digital transformation of business-to-government reporting:An institutional work perspective

Traditional business-to-government reporting is a core remit of the accounting function but is associated with a significant administrative burden on business. This burden is a major obstacle hindering business efforts to achieve core efficiency and innovation objectives. We use the conceptual lens of institutional work to examine how traditional business-to-government reporting is abolished and how digital reporting is established to replace it in attempts to reduce administrative burden but without compromising regulation effectiveness. We adopt a comparative approach to analyse qualitative evidence from three jurisdictions, namely, Netherlands, United Kingdom, and Australia. Regulators across these jurisdictions have been both pioneers and leaders internationally to transform business-to-government reporting in multi-agency settings. Our analyses illustrate how institutional work to develop digital business-to-government reporting across the jurisdictions was shaped by international influences and local factors. We also illuminate how actor engagement issues and the intertwined and mutually reinforcing nature of a mosaic of forms of institutional work shaped the path of these transformations. The study contributes to existing research by explaining how supportive conditions and structures are brought about and made to coalesce in the regulatory business reporting space for digital reporting to become established and widely adopted by business

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society