Decision Making Towards Maternal Health Services in Central Java, Indonesia

Background: Indonesia has always been struggling with maternal health issue even after the Millennium Development Goals (MDGs) programs were done. Prior research findings identified many factors which influenced maternal health status in developing countries such Indonesia and even though various efforts had been made, the impact of the transformation of maternal health behavior was minimal.Purpose: This study aimed to seek an understanding of the factors influencing decisions towards maternal health services.Methods: A case study with a single case embedded design was employed. Interviews and Focus Group Discussions (FGDs) were held to collect data from 3 health workers and 40 maternal women in a sub-district in Central Java, Indonesia.Results: Interviews with the village midwives as the main health providers in the Getasan sub-district concluded that there were several factors influencing the women\u27s decisions towards maternal services. The factors were options to have services with other health workers outside the area, and shaman services as alternative care and family influencing maternal health behaviors. The analysis of the FGDs also supported the village midwives\u27 statements that in spite of their awareness towards the available maternal health services, the existence of shamans and traditional beliefs strongly affected their decision.Conclusion: The findings in this study showed that cultural issues prevented the maximum maternal health status in Getasan sub-district. This study recommends Puskesmas (Primary Health Care) as the first level of health institutions in Indonesia to support the village midwives\u27 roles within their target area

Digital Records Management: The History of Your City

As technology rapidly advances, city governments face the challenge of preserving the past and preparing for the future. This article explores digital records management, outlining the background of historical records and their significance in understanding a city’s history. Crucial digitization steps include gathering the right team, following records retention policies, identifying documents, and efficiently managing data. The challenges of preservation efforts, technical and training concerns, workflow management, and compliance with open records laws are addressed. The City of Kilgore’s digitization process reveals how managing records is key to forming a city’s identity and linking the community to its history. This includes discussing the methods used to digitize the records, the benefits of making them available to the public, and how these digital records help preserve the city’s heritage for future generations

POST-TRAUMATIC SLEEP FOLLOWING DIFFUSE TRAUMATIC BRAIN INJURY

Traumatic brain injury (TBI) is a major cause of death and disability throughout the world with few pharmacological treatments available for individuals who suffer from neurological morbidities associated with TBI. Cellular and molecular pathological processes initiated at the time of injury develop into neurological impairments, with chronic sleep disorders (insomnia, hypersomnolence) being among the somatic, cognitive and emotional neurological impairments. Immediately post-injury, TBI patients report excessive daytime sleepiness, however, discordant opinions suggest that individuals should not be allowed to sleep or should be frequently awoken following brain injury. To provide adequate medical care, it is imperative to understand the role of acute post-traumatic sleep on the recovery of neurological function after TBI. The aim of this thesis was to examine post-traumatic sleep after experimental TBI, defined as an increase in sleep during the first hours post-injury. In these studies, we non-invasively measured sleep activity following diffuse brain injury induced by midline fluid percussion injury to examine the architecture of post-traumatic sleep in mice. We detected significant injury-induced increases in acute sleep for six hours regardless of injury severity or time of day injury occurred. We found concurrent increases in cortical levels of the sleep promoting inflammatory cytokine interleukin 1-beta. We extended the timeline of post-injury sleep recording and found increases in post-traumatic sleep are distinctly acute with no changes in chronic sleep following diffuse TBI. Further, we investigated if post-traumatic sleep was beneficial to neurological outcome after brain-injury by disrupting post-traumatic sleep. Disruption of post-traumatic sleep did not worsen functional outcome (neuromotor, sensorimotor, cognition) at one week after diffuse TBI. With sufferers of TBI not always seeking medical attention, our final studies investigated over-the-counter analgesics and their effect on post-traumatic sleep and functional outcome. Acute administration of analgesics with varying anti-inflammatory properties had little effect on post-traumatic sleep and functional outcome. Overall, these studies demonstrated translational potential and suggest sleep after a concussion is part of the natural recovery from injury. While disrupting sleep does not worsen outcome, it is in no way beneficial to recovery. Additionally, a single analgesic dose for pain management following concussion plays little role in short term outcome

The Third Gravitational Lensing Accuracy Testing (GREAT3) Challenge Handbook

The GRavitational lEnsing Accuracy Testing 3 (GREAT3) challenge is the third in a series of image analysis challenges, with a goal of testing and facilitating the development of methods for analyzing astronomical images that will be used to measure weak gravitational lensing. This measurement requires extremely precise estimation of very small galaxy shape distortions, in the presence of far larger intrinsic galaxy shapes and distortions due to the blurring kernel caused by the atmosphere, telescope optics, and instrumental effects. The GREAT3 challenge is posed to the astronomy, machine learning, and statistics communities, and includes tests of three specific effects that are of immediate relevance to upcoming weak lensing surveys, two of which have never been tested in a community challenge before. These effects include realistically complex galaxy models based on high-resolution imaging from space; spatially varying, physically-motivated blurring kernel; and combination of multiple different exposures. To facilitate entry by people new to the field, and for use as a diagnostic tool, the simulation software for the challenge is publicly available, though the exact parameters used for the challenge are blinded. Sample scripts to analyze the challenge data using existing methods will also be provided. See http://great3challenge.info and http://great3.projects.phys.ucl.ac.uk/leaderboard/ for more information.Comment: 30 pages, 13 figures, submitted for publication, with minor edits (v2) to address comments from the anonymous referee. Simulated data are available for download and participants can find more information at http://great3.projects.phys.ucl.ac.uk/leaderboard

Interprofessional, student-led intervention to improve insulin prescribing to patients in an Acute Surgical Receiving Unit

Our aim was to test the feasibility of interprofessional, workplace-based learning about improvement through a 4-week placement for one medical and two pharmacy final year students in an Acute Surgical Receiving Unit (ASRU). The target was insulin because this is a common, high-risk medicine in this ASRU and the intervention was medicines reconciliation. Baseline data were collected from 10 patients and used to construct a cause and effect diagram and a process map through feedback and discussions with staff. Hypoglycaemia occurred in four patients but hyperglycaemia occurred in eight patients, of whom six were placed on intravenous insulin infusion (IVII). We estimated that £2454 could be saved by preventing one patient from going on IVII. The students designed and tested a sticker to improve medicines reconciliation for insulin patients. An online form was created to capture clinician feedback on the layout and usability of the sticker. The intervention was associated with improvements in the reliability of medicines reconciliation. The students’ work contributed to a larger project to reduce the risk of hypoglycaemia in the ASRU. This proved beneficial in enabling the students to engage with the clinical team. Nonetheless, it was challenging for students from two Universities to get a shared understanding of improvement methods and work effectively with the clinical team. The students said that they learnt more about quality improvement in a working healthcare environment than they would ever learn in a classroom and they valued the opportunity to work with students from other healthcare backgrounds in practice. Despite the additional staff time required to support students from two Universities, both have supported continuation of this work

Five Hundred Families Rehabilitate Themselves

Contents: The Problems --- Food --- Farm Management --- Land --- Tenure --- Livestock --- Marketing --- Nonfarm Employment --- Housing and Sanitation --- Health --- Social and Educational Activities --- Emotional Difficulties --- Administrative Problems --- Appraisals --- Appendix (Table 2. – Loans and Grants Made to Noncommercial Families – Table 3. – Extent of Survey and Classification of Classes – Table 4. – Extent of Services and Improvements–1940 – Program of Work for Beltrami County Non-Commercial Project for 1940