Women's empowerment based on self-regulated learning as mother's ability to fulfill nutrition in stunted children.

INTRODUCTION: The role of providing nutrition to children aged 6-24 months who are stunted is related to the mother's ability to provide proper nutrition. Empowerment of mothers based on self-regulated learning is a nursing intervention that can be carried out by using the abilities, belief and individual capacities of mothers in completing tasks, managing and providing nutrition to children aged 6-24 months. Mother's characteristic are motivation, self-esteem, self-efficacy, knowledge, belief and ability to decisionmaking about providing nutrition to children, so it can be a learning process for the mother in using resources which improve the nutrition ability of the mother. This study aims to apply a women's empowerment model based on selfregulated learning in increasing the mother's ability to fulfill nutrition in stunted children aged 6-24 months. MATERIALS AND METHODS: The research design used a quasiexperiment. The sampling technique used cluster sampling with 76 respondents in intervention group and 76 respondents in control group. The research was conducted in the working area in Public Health Center, Malang Regency. Data analysis in this study used the Wilcoxon Signed Rank Test and Mann-Whitney. RESULTS: The results of the study found that there were differences in the ability of mothers to fulfill nutrition in stunted children between the intervention group and the control group (p = 0.000). There were mean differences in the ability of mothers to fulfill nutrition for stunted children before and after the intervention in the intervention group with indicators of breastfeeding, food preparation and processing, complementary- feeding and responsive feeding were increased (p = 0.000). However, in the control group, there were no differences in the ability of mothers to fulfill nutrition with indicator breastfeeding (p = 0.462), food preparation and processing (p = 0.721), complementary feeding (p = 0.721), complementary feeding (p = 0.462). (p = 0.054), responsive feeding (p = 0.465) and adherence to stunting therapy (p = 0.722). CONCLUSION: The women's empowerment model based on self-regulated learning is formed by individual mother factors, family factors, health service system factors, and child factors so that it can increase the mother's ability to fulfill nutrition in children aged 6-24 months who are stunted. The women's empowerment is a learning process about breastfeeding, food hygiene, infant and young children feeding, and responsive feeding by mothers to fulfill nutrition in children with stunting, with a goal and plan to achieve an improvement in mother's ability and nutritional status in children.

Does elective orthopaedic surgery in pandemic era increase risk of developing COVID-19? A combined analysis of retrospective and prospective study at Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

BACKGROUND: To date, no recommendations have been published on when and how to start again carrying out elective, non-urgent surgery on COVID-19-negative patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. This study aims to investigate whether elective orthopaedic surgery will increase the risk of developing COVID-19. MATERIALS AND METHODS: This was a combined retrospective and prospective studies performed at a national tertiary hospital in Jakarta, Indonesia. Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020. Those who were previously infected with COVID-19 from polymerase chain reaction (PCR) reverse transcriptase (RT) examination obtained via nasopharynx and oropharynx swab, as well as those who were reluctant to participate were excluded from the study. RESULTS: A total of 35 subjects (mean age 32.89 ± 17.42) were recruited. Fifteen (42.9%) subjects were male, and 20 subjects (57.1%) were female. Mean duration of surgery was 240 min with the longest and shortest duration of 690 and 40 min, respectively. General anaesthesia was performed in the majority of cases in 18 surgeries (51.4%) with local anaesthesia as the least in 2 surgeries (5.7%). Length of stay of our study was 6 days of average. None of the patients developed symptoms suggestive of COVID-19 infection. CONCLUSION: We found that elective orthopaedic surgery may not be associated with increased cases of COVID-19 cases. However, our study was limited by short duration of follow-up. Further studies are required in order to investigate the affect of undergoing elective surgery and the number of COVID-19 cases.

Wave energy absorption by a submerged air bag connected to a rigid float.

A new wave energy device features a submerged ballasted air bag connected at the top to a rigid float. Under wave action, the bag expands and contracts, creating a reciprocating air flow through a turbine between the bag and another volume housed within the float. Laboratory measurements are generally in good agreement with numerical predictions. Both show that the trajectory of possible combinations of pressure and elevation at which the device is in static equilibrium takes the shape of an S. This means that statically the device can have three different draughts, and correspondingly three different bag shapes, for the same pressure. The behaviour in waves depends on where the mean pressure-elevation condition is on the static trajectory. The captured power is highest for a mean condition on the middle section.

Immune responses to filarial parasites.

Filarial nematode parasites are long-lived organisms which are responsible for one of the major tropical diseases. Their ability to survive may be related to the antigen-specific anergic state observed in carriers of the parasite. Severe disease symptoms are associated with the breakdown of anergy. Different stages of the parasite life cycle are anti-genetically distinct, and a state of concomitant immunity is therefore possible which prevents superinfection. The evidence for these conclusions is discussed, in the context of the need for an effective vaccine against filarial parasites which will avoid any risk of increasing disease severity.

HLA and elephantiasis in lymphatic filariasis.

Lymphatic filariasis presents a spectrum of manifestations with infection-free asymptomatics at one end and elephantiasis at the other. In order to determine if any HLA antigens are associated with the development of elephantiasis, we compared the HLA frequencies in 55 elephantiasis patients with those in 40 controls consisting of individuals older than 45 years of age without any signs of elephantiasis. The only significant difference in class I antigen frequencies was observed for B27, which was present in 11% of the patients and absent in the controls. More differences were observed in HLA class II antigen frequencies. Both DR3 and the 2B3 epitope (on DQ6, DQ8, and DQ9 molecules) were significantly decreased in patients with elephantiasis whereas the DQ5 frequency was significantly higher in patients than in controls. Analysis of specific antibody isotype profiles revealed that DQ5-positive individuals had increased levels of antifilarial IgG3, an isotype known to be involved in tissue damage. These data suggest that HLA class II genes may control the course of Brugian filariasis by influencing the T-cell-dependent antibody repertoire.

A model for quantitative follow-up studies of cervical lesions.

A model for follow-up studies of cervical lesions is described in which the specimen were taken in a noninvasive way using Cytobrushes and in which automatic measurement of the abnormal nuclei in the sampled epithelial fragments was possible because 2-microns thin Feulgen-stained plastic sections were prepared. The planimetric parameters AREA, PERIMETER, FORM PE, and FORM ELL, and the densitometric parameters optical density (OD) and integrated optical density (IOD) were assessed. The mean total volume and the mean total DNA were calculated using stereological methods. The moderate dysplasias differed from the carcinoma in situs for all the densitometric parameters except for OD, and from the invasive carcinomas for IOD and 5cER. In the moderate-dysplasia group, there were three types of DNA histograms: a highly abnormal type resembling the histograms of the carcinoma group, a normal type, and an intermediate type. Changes in DNA histograms can be established during follow-up studies of dysplasias without having disturbed the lesion due to the efficient and elegant noninvasive sampling method that was not used in earlier quantitative studies.

Nasopharyngeal carcinoma: correlation of histopathology with radiation response.

Forty-nine cases of NPC were evaluated histopathologically and the radiation responses of the tumor types were assessed. The overall radiation response were as follows: CR 40.8%, PR 14.3%, NC 42.9%, PD 2.0%. The distribution of tumor types were: Squamous cell carcinoma (WHO type I) 4.08%; Non-keratinizing carcinoma (WHO type II) 4.08%; Undifferentiated carcinoma (WHO type III) 91.84% var. Lympho-epitheliomatous (LE), Anaplastic (A), Spindle cell (SC), Clear cell (CC). 94.38% of the cases were classified as clinical stage II, III and IV (tumor found beyond the nasopharyngeal space). The radiation response rate of the tumor in the lymphnode was reversed to the clinical stage and extent of node involvement, namely the higher stage and node involvement, the less rate of radiation response. Twelve cases received radiation dose of less than 4000 cGy, which comprised 11 NC cases and 1 PD case. Of the 37 cases who got 4000 cGy and over, the response rate was 72.97%. Of these WHO type I was not evaluated because of insufficient radiation dose; WHO type II showed 50% response rate; WHO type III showed 74.29% response rate. Radiation response (as assessed from the cervical lymphnode involvement) of NPC was influenced by tumor burden and histologic type of the tumor, namely the less differentiated tumor responded better than the more differentiated one. No definite conclusion can be drawn yet of the different behaviour (if any) of the variants of undifferentiated carcinoma (WHO type III) toward irradiation.

A clinico-pathologic study of cases with Schistosoma japonicum infection in Indonesia.

Combined clinico-pathological and laboratory examinations were carried out on 52 S. japonicum infected patients from an endemic area in Central Sulawesi, Indonesia. All of these patients exhibited signs and symptoms of chronic hepato-splenic schistosomiasis. None of the patients showed evidence of liver cirrhosis on histopathological examination. However, varying degrees of portal fibrosis were exhibited. The correlation between the degree of fibrosis and the clinical and laboratory findings were presented and discussed. Based on the results, liver biopsy proved to be a vaulable method of diagnosis in this particular type of infection. This study provides new information on S. japonicum infection in the area and may support a more solid basis for treatment.

Ivermectin and diethylcarbamazine trials in leaf monkeys (Presbytis cristatus) infected with Wuchereria kalimantani.

Clinical trials of Ivermectin in single oral doses of 200, 400, and 1,000 mg/kg body weight or in multiple doses of 200 mg/kg body weight for 5 consecutive days were performed in leaf monkeys (Presbytis cristatus) infected with Wuchereria kalimantani. Optimal microfilaricidal effect occurred at 200 mg/kg body weight. The drug was less effective than diethylcarbamazine in this animal model for human filariasis but had no adverse effects.

Epstein-Barr virus DNA load in nasopharyngeal brushings and whole blood in nasopharyngeal carcinoma patients before and after treatment.

PURPOSE: Nasopharyngeal carcinoma (NPC) is consistently associated with Epstein-Barr virus (EBV) and highly prevalent in Indonesia. EBV-DNA load can be used for early diagnosis and may have prognostic value. In this study, EBV-DNA load was evaluated in minimal invasive nasopharyngeal (NP) brushings and whole blood for initial diagnosis and therapy assessment against the standard-of-care diagnosis by biopsy with EBV-RISH and standard EBV-IgA serology. EXPERIMENTAL DESIGN: NP brushings and blood samples were collected from 289 consecutive ENT patients suspected of NPCs and 53 local healthy controls. EBV-DNA load was quantified by real-time PCR and serology by peptide-based EBV-IgA ELISA. Tissue biopsies were examined by routine histochemistry and by EBER RNA in situ hybridization. RESULTS: Repeated NP brushing was well tolerated by patients and revealed high viral load in the 228 NPC cases at diagnosis than 61 non-NPC cancer cases and healthy controls (P < 0.001). The diagnostic value of EBV-DNA load in blood and EBV-IgA serology was inferior to the NP brush results. The level of EBV-DNA load in brushes of patients with NPC was not related to T, N, or M stage, whereas elevated EBV-DNA load in blood correlated with N and M stage. EBV-DNA levels in brushings and whole blood showed a significant reduction at 2 months after treatment (P = 0.001 and P = 0.005, respectively), which was not reflected in EBV-IgA serology. CONCLUSIONS: NP brush sampling combined with EBV-DNA load analysis is a minimal invasive and well-tolerated diagnostic procedure, suited for initial diagnosis and follow-up monitoring of NPCs.

Intestinal parasitic infections in HIV/AIDS patients presenting with diarrhoea in Jakarta, Indonesia.

We investigated the occurrence of intestinal parasites in Indonesian HIV/AIDS patients with chronic diarrhoea prior to administering antiretroviral therapy. The influence of age, CD4(+) cell count and season on parasite occurrence was also studied. In total, 318 unconcentrated stool samples were analysed using Lugol's iodine and modified acid fast staining to detect intestinal coccidia. Most samples (94.5%) were from males aged 21-40 years with CD4(+) counts < or = 50 cells/mm(3). Parasites were found in 84.3% of samples (single species infections, 71.4%; polyparasitism, 12.9%), with protozoan pathogens occurring most commonly. Cryptosporidium (4.9%), Cyclospora cayetanensis (4.5%) and Giardia duodenalis (1.9%) were the most frequent single infections, but Blastocystis hominis (72.4%) was the most commonly occurring protist. Cryptosporidium and C. cayetanensis occurred in 11.9% and 7.8% of all (single and mixed) infections. The most common co-infection was with B. hominis and Cryptosporidium (6.3%). Intestinal protozoan pathogens were detected more frequently in cases with CD4(+) counts < or = 200/mm(3). No seasonal influence was determined for Cryptosporidium, C. cayetanensis or B. hominis, but gross seasonal disturbances may have influenced our findings. Intestinal parasites should be looked for routinely in this group of individuals and should be treated to reduce complications and the likelihood of transmission.

Monitoring the soot emissions of passing cars.

We report on the first application of a novel fast on-road sensing method for measurement of particulate emissions of individual passing passenger cars. The studywas motivated by the shift of interest from gases to particles in connection with strong adverse health effects. The results correspond very much to findings by Beaton et al. (Science, May 19,1995) for gaseous hydrocarbon and CO emissions: A small percentage of "superpolluters" (here 5%) account for a high percentage (here 43%) of the pollution (here elemental carbon). We estimate that up to 50% of the particulate emissions of vehicles could be avoided on the basis of the present legislation, if on-road monitoring would be applied to enforce maintenance. Our fast sensing method for particles is based on photoelectron emission from the emitted airborne soot particles in combination with a CO2 sensor delivering a reference.

Product stewardship of Paraquat in Indonesia.

In Indonesia, paraquat products play an important role in controlling weed in plantation estates, small-holders farming land and potentially in tidal swamp areas to be converted to tidal rice farming. Laboratory and field data which showed that paraquat did not cause a health hazard to users/farmers if used normally or as recommended, and the virtual absence of environmental impact, were important information conveyed to the customers in the product stewardship activities. Education and training have been implemented in 11 provinces, covering 4934 farmers group, 206 Zeneca field staffs and 100 local government staffs since January 1993. Using interactive method and field practicals, significant improvements in the knowledge and skill of safe and effective use of pesticide have been achieved. The success of this stewardship initiative lies upon good relationship with government authorities and informal local leaders, besides careful planning.

Some experience with in vivo staining of early laryngeal cancer in Jakarta, Indonesia.

Laryngeal cancer, clinically as well as pathologically, usually does not pose a difficult problem in diagnosis. The problem lies in the clinical diagnosis of early laryngeal cancer. We began to study and develop the in vivo staining technique for laryngeal lesions in our clinic, using toluidine blue, an acidophilic metachromatic dye. This preliminary study comprised eight cases of laryngeal lesions, five of which were carcinoma. Among these latter cases, besides carcinoma, we were able to detect dysplasia in two cases, carcinoma in situ in one case, and a false-positive area in one case. Noncarcinoma cases consisted of dysplasia, dysplasia in postradiation for carcinoma, and carcinoma in situ. In two cases of carcinoma, the tumor margin was accurately defined by positive staining area. This experience suggests that in vivo staining may be a useful method for early detection of laryngeal cancer used as an adjunct to microlaryngoscopy.

T-cell activation and the balance of antibody isotypes in human lymphatic filariasis.

Human filarial infection presents a spectrum of clinical states with two major poles: asymptomatic microfilaraemia and amicrofilaraemic chronic disease. Microfilaremia is associated with a Th1-type tolerance, and maximal IgG4 antibodies, while elephantiasis patients react across a broad range of immune parameters. In this review, Rick Maizels and his colleagues discuss recent advances in the immunology of human filariasis and present a summary of their latest studies in an endemic area of Indonesia.