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Abstract Background In moderate-to-high malaria transmission regions, the World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) alongside insecticide-treated bed nets to reduce the adverse consequences of pregnancy-associated malaria. Due to high-grade Plasmodium falciparum resistance to SP, novel treatment regimens need to be evaluated for IPTp, but these increase pill burden and treatment days. The present qualitative study assessed the acceptability of IPTp-SP plus dihydroartemisinin-piperaquine (DP) in Papua New Guinea, where IPTp-SP was implemented in 2009. Methods Individual in-depth interviews (IDIs) and focus group discussions were conducted at health facilities where a clinical trial evaluated IPTp-SP plus DP (three-day regimen) versus IPTp-SP plus DP-placebo. IDIs were conducted with: (1) trial participants at different stages of engagement with ANC and IPTp, e.g. first antenatal clinic visit, subsequent antenatal clinic visits and postpartum; (2) local health workers (nurses, community health workers, midwives, health extension officers, doctors); and (3) representatives of district, provincial and national health authorities involved in programming ANC and IPTp. Focus group discussions comprised pregnant women only, including those engaged in the clinical trial and those receiving routine ANC outside of the trial. All interviews were audio recorded and transcribed. Transcripts were analysed using inductive and deductive thematic analysis applying a framework assessing: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. Results Women expressed positive feelings and attitudes towards SP plus DP/DP-placebo; reported limited side effects; and found the size, number, colour, and taste of study medicines acceptable. Health workers and policymakers were concerned that, compared to SP alone, additional tablets, frequency (three-day regimen), and tablet size might be barriers to acceptability for users outside a non-trial setting. There was a high perceived effectiveness of SP plus DP; most women reported that they did not get malaria or felt sick during pregnancy. Broader healthcare benefits received through trial participation and the involvement of health workers, relatives and community members in the clinical trial enabled antenatal clinic attendance and perceived acceptability of this IPTp regimen. Conclusions In the trial context, IPTp-SP plus DP was acceptable to both users and providers. Healthcare providers were concerned about the realities of acceptability and adherence to SP plus DP outside a clinical trial setting.

Background/Objectives: Schizophrenia is a severe mental disorder requiring prolonged treatment, and adherence to the treatment is an important factor. The reasons for nonadherence vary according to disease severity, treatment, local perceived problems, environment, and sociocultural factors. It is necessary to understand the pattern and factors related to adherence. This study aims at understanding adherence to treatment in the patients of schizophrenia and associated psycho-social and disease-related factors. It also analyzes the change in adherence over a period of the last 35 years. Methods: A review of past psychiatry records and nonadherence to the treatment of patients of schizophrenia that followed up in outpatient department was done over the last 35 years. For the evaluation of psychotic symptoms, positive and negative syndrome scale (PANSS) and for attitude toward medicine, drug attitude inventory-10 (DAI-10), and clinician rating scale (CRS) were used. Statistical analysis was done using SPSS-20 software. Results: Sixty-five percent of the patients were adherent to the treatment. Sociodemographic factors such as age, gender, family type, marital status, education as well as factors related to accessibility to medicines were not significantly associated with adherence. Adherence had significant positive correlation with CRS scores and negative correlation with PANSS positive and general score. Adherence of =80% for current year was found to be associated with the cross-sectional positive DAI score. Patient perceived causes such as social, financial, unwillingness, and lack of insight, side-effect profile had a significant association. Conclusions: Attitude and willingness toward treatment, insight into illness, and side-effect profile play a pivotal role in adherence. [ABSTRACT FROM AUTHOR]

Di era teknologi yang semakin canggih ini, rata-rata masyarakat sudah mulai beralih dari tanda tangan statik yang menggunakan media kertas ke tanda tangan digital dengan menggunakan media pentablet. Maka dari itu kebutuhan akan proses identifikasi tanda tangan digital secara otomatis dengan menggunakan kecerdasan buatan pun semakin banyak diminati. Metode yang peneliti gunakan dalam pengembangan sistem adalah waterfall model yang terdiri dari 6 tahapan. Metode yang digunakan dalam proses identifikasi ini adalah Jaringan syaraf tiruan dengan algoritma Backpropagation. Proses identifikasi ini melewati beberapa tahapan yaitu dari pre-processing data hingga pengolahan citra, citra RGB diubah menjadi grayscale sampai menjadi citra biner yang kemudian digunakan sebagai data input pada proses pelatihan dan pengujian menggunakan Backpropagation. Citra tanda tangan yang telah melewati pre-processing data ini berjumlah 200 sampel yang berasal dari 10 subjek penelitian. Dari 200 citra tersebut, 180 citra digunakan untuk pelatihan dan 20 citra digunakan untuk pengujian. Hasil pengujian pada saat proses pelatihan adalah 75% training = 88.1%, 15% validation = 60.3%, 15% test adalah 59.5% dan 100% all adalah 79.7% sedangkan pada proses pengujian adalah 65%.

E-learning in higher education is a technique to improve learning and teaching experience, and as a tool to educate students through digital media, with or without the guidance of their instructors. STMIK BI Balikpapan has been using it since 2015, but its implementation has not been as optimal as expected. The research aims to identify the factors that influence the success of the application of e-learning in STMIK BI Balikpapan by referring to the model adopted from TAM (Technology Acceptance Model) and TOE (technological, organizational and environment). The research respondents were 94 people. Data were collected through questionnaires and analyzed using the Structural Equation Model (SEM) through the Smart PLS program. The results showed that of the four hypotheses tested, one hypotheses had significant influence (habits) and the other three hypotheses were not significant (connections, motivation and facility).

Abstract Background Plasmodium falciparum in pregnancy results in substantial poor health outcomes for both mother and child, particularly in young, primigravid mothers who are at greatest risk of placental malaria (PM) infection. Complications of PM include maternal anaemia, low birth weight and preterm delivery, which contribute to maternal and infant morbidity and mortality in coastal Papua New Guinea (PNG). Methods Placental biopsies were examined from 1451 pregnant women who were enrolled in a malaria prevention study at 14–26 weeks gestation. Clinical and demographic information were collected at first antenatal clinic visits and women were followed until delivery. Placental biopsies were collected and examined for PM using histology. The presence of infected erythrocytes and/or the malaria pigment in monocytes or fibrin was used to determine the type of placental infection. Results Of 1451 placentas examined, PM infection was detected in 269 (18.5%), of which 54 (3.7%) were acute, 55 (3.8%) chronic, and 160 (11.0%) were past infections. Risk factors for PM included residing in rural areas (adjusted odds ratio (AOR) 3.65, 95% CI 1.76–7.51; p ≤ 0.001), being primigravid (AOR 2.45, 95% CI 1.26–4.77; p = 0.008) and having symptomatic malaria during pregnancy (AOR 2.05, 95% CI 1.16–3.62; p = 0.013). After adjustment for covariates, compared to uninfected women, acute infections (AOR 1.97, 95% CI 0.98–3.95; p = 0.056) were associated with low birth weight babies, whereas chronic infections were associated with preterm delivery (AOR 3.92, 95% CI 1.64–9.38; p = 0.002) and anaemia (AOR 2.22, 95% CI 1.02–4.84; p = 0.045). Conclusions Among pregnant PNG women receiving at least one dose of intermittent preventive treatment in pregnancy and using insecticide-treated bed nets, active PM infections were associated with adverse outcomes. Improved malaria prevention is required to optimize pregnancy outcomes.