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Search Results: 1 - 10 of 52 matches for " Evy Yunihastuti "
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Rates and Factors Associated with Major Modifications to First-Line Combination Antiretroviral Therapy: Results from the Asia-Pacific Region
Stephen Wright, Mark A. Boyd, Evy Yunihastuti, Matthew Law, Thira Sirisanthana, Jennifer Hoy, Sanjay Pujari, Man Po Lee, Kathy Petoumenos, on behalf of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia-Pacific HIV Observational Database (APHOD)
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0064902
Abstract: Background In the Asia-Pacific region many countries have adopted the WHO’s public health approach to HIV care and treatment. We performed exploratory analyses of the factors associated with first major modification to first-line combination antiretroviral therapy (ART) in resource-rich and resource-limited countries in the region. Methods We selected treatment naive HIV-positive adults from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD). We dichotomised each country’s per capita income into high/upper-middle (T-H) and lower-middle/low (T-L). Survival methods stratified by income were used to explore time to first major modification of first-line ART and associated factors. We defined a treatment modification as either initiation of a new class of antiretroviral (ARV) or a substitution of two or more ARV agents from within the same ARV class. Results A total of 4250 patients had 961 major modifications to first-line ART in the first five years of therapy. The cumulative incidence (95% CI) of treatment modification was 0.48 (0.44–0.52), 0.33 (0.30–0.36) and 0.21 (0.18–0.23) for AHOD, T-H and T-L respectively. We found no strong associations between typical patient characteristic factors and rates of treatment modification. In AHOD, relative to sites that monitor twice-yearly (both CD4 and HIV RNA-VL), quarterly monitoring corresponded with a doubling of the rate of treatment modifications. In T-H, relative to sites that monitor once-yearly (both CD4 and HIV RNA-VL), monitoring twice-yearly corresponded to a 1.8 factor increase in treatment modifications. In T-L, no sites on average monitored both CD4 & HIV RNA-VL concurrently once-yearly. We found no differences in rates of modifications for once- or twice-yearly CD4 count monitoring. Conclusions Low-income countries tended to have lower rates of major modifications made to first-line ART compared to higher-income countries. In higher-income countries, an increased rate of RNA-VL monitoring was associated with increased modifications to first-line ART.
Rice Bran Stabilization And G-Oryzanol Content Of Two Local Paddy Varieties Ir 64 And Cisadane Muncul
Evy Damayanthi
Jurnal Teknologi dan Industri Pangan , 2001,
Abstract: An autoclaving procedure was developed to produce stable rice bran from two local paddy varieties IR 64 and Cisadane Muncul. The stable rice bran showed no significant increase in free fatty acid content for 144 hours at 37oC. In the optimum wet heating process, rice bran was heated at 121oC and held for 3 minutes before cooling for both varieties. Stable rice bran contained 3.8 % moisture and the content of total tocopherol was not much changed by heating process, i.e., 209.8 mg/100 g rice bran oil and 279.8 for control (without heating process) of IR 64 variety and 227.4 mg/100 g rice bran oil and 248.8 for control of Cisadane Muncul variety, respectively. The content of g-oryzanol varied and was depended on the degree of milling ranged from 39.1 to 147.7 mg/100 g rice bran oil for both of IR 64 and Cisadane Muncul rice varieties. The content of soluble dietary fiber varied and was depended on the degree of milling which ranged from 3.56 to 8.76 % for both of IR 64 and Cisadane Muncul rice varieties. The content of insoluble dietary fiber varied and was depended on the degree of milling which ranged from 15.00 to 25.38 % for both of IR 64 and Cisadane Muncul rice varieties.
Loss to Followup in HIV-Infected Patients from Asia-Pacific Region: Results from TAHOD
Jialun Zhou,Junko Tanuma,Romanee Chaiwarith,Christopher K. C. Lee,Matthew G. Law,Nagalingeswaran Kumarasamy,Praphan Phanuphak,Yi-Ming A. Chen,Sasisopin Kiertiburanakul,Fujie Zhang,Saphonn Vonthanak,Rossana Ditangco,Sanjay Pujari,Jun Yong Choi,Tuti Parwati Merati,Evy Yunihastuti,Patrick C. K. Li,Adeeba Kamarulzaman,Van Kinh Nguyen,Thi Thanh Thuy Pham,Poh Lian Lim
AIDS Research and Treatment , 2012, DOI: 10.1155/2012/375217
Abstract: This study examined characteristics of HIV-infected patients in the TREAT Asia HIV Observational Database who were lost to follow-up (LTFU) from treatment and care. Time from last clinic visit to 31 March 2009 was analysed to determine the interval that best classified LTFU. Patients defined as LTFU were then categorised into permanently LTFU (never returned) and temporary LTFU (re-entered later), and these groups compared. A total of 3626 patients were included (71% male). No clinic visits for 180 days was the best-performing LTFU definition (sensitivity 90.6%, specificity 92.3%). During 7697 person-years of follow-up, 1648 episodes of LFTU were recorded (21.4 per 100-person-years). Patients LFTU were younger ( ), had HIV viral load ≥500?copies/mL or missing ( ), had shorter history of HIV infection ( ), and received no, single- or double-antiretroviral therapy, or a triple-drug regimen containing a protease inhibitor ( ). 48% of patients LTFU never returned. These patients were more likely to have low or missing haemoglobin ( ), missing recent HIV viral load ( ), negative hepatitis C test ( ), and previous temporary LTFU episodes ( ). Our analyses suggest that patients not seen at a clinic for 180 days are at high risk of permanent LTFU, and should be aggressively traced. 1. Introduction Loss to followup (LTFU) in patients receiving antiretroviral therapy can cause serious consequences such as discontinuation of treatment and increased risk of death [1–3]. At a program level, LTFU can make it difficult to evaluate outcomes of treatment and care [4, 5]. In resource-limited settings, where treatment has become rapidly available following the rollout of antiretroviral therapy, LTFU presents even more challenging obstacles that require special consideration and approaches [6, 7]. One of the key questions in patient followup is how to define a patient as LTFU. This has varied in studies conducted in different settings [8–10]. Defining LTFU using a very early threshold, for example, a patient with no clinic visit in the last three months, may result in many patients being considered as LTFU who would return to clinic naturally at a later date. Defining LTFU with a long threshold, for example, one year, may mean delaying too long before any effort is made to track patients potentially at risk of LTFU. The majority of research into LTFU in HIV-infected patients receiving antiretroviral treatment in resource-limited settings has been conducted in the sub-Saharan Africa region [3, 10–13]. A few studies have been conducted among Asian, mostly female, patients
Trends in CD4 counts in HIV-infected patients with HIV viral load monitoring while on combination antiretroviral treatment: results from The TREAT Asia HIV Observational Database
Jialun Zhou, Thira Sirisanthana, Sasisopin Kiertiburanakul, Yi-Ming A Chen, Ning Han, Poh_Lian Lim, Nagalingeswaran Kumarasamy, Jun Choi, Tuti Merati, Evy Yunihastuti, Shinichi Oka, Adeeba Kamarulzaman, Praphan Phanuphak, Christopher KC Lee, Patrick CK Li, Sanjay Pujari, Vanthanak Saphonn, Matthew G Law
BMC Infectious Diseases , 2010, DOI: 10.1186/1471-2334-10-361
Abstract: Treatment-naive HIV-infected patients who started cART with three or more and had three or more CD4 count and HIV VL tests were included. CD4 count slopes were expressed as changes of cells per microliter per year. Predictors of CD4 count slopes from 6 months after initiation were assessed by random-effects linear regression models.A total of 1676 patients (74% male) were included. The median time on cART was 4.2 years (IQR 2.5-5.8 years). In the final model, CD4 count slope was associated with age, concurrent HIV VL and CD4 count, disease stage, hepatitis B or C co-infection, and time since cART initiation. CD4 count continues to increase with HIV VL up to 20 000 copies/mL during 6-12 months after cART initiation. However, the HIV VL has to be controlled below 5 000, 4 000 and 500 copies/mL for the CD4 count slope to remain above 20 cells/microliter per year during 12-18, 18-24, and beyond 24 months after cART initiation.After cART initiation, CD4 counts continued to increase even when the concurrent HIV VL was detectable. However, HIV VL needed to be controlled at a lower level to maintain a positive CD4 count slope when cART continues. The effect on long-term outcomes through the possible development of HIV drug resistance remains uncertain.Studies show that latent infection of CD4 cells provides a mechanism for lifelong persistence of HIV-1, even in patients on effective anti-retroviral therapy [1]. To suppress viral replication so that the VL is below the level of detection with standard assays is thus one of the aims at the start of antiretroviral treatment. Maximal and durable suppression of HIV VL prevents or delays development of drug resistant mutations, preserves CD4 cells, and eventually results in better clinical outcomes. According to the US guidelines, if HIV VL suppression is not achieved, it is necessary to change to a new regimen, a second or third line regimen, with at least two active drugs [2].HIV-infected patients in most developing countries h
Superstructure Strategy: Do Indonesian EFL Learners Use It?
Evy C Ridwan
TEFLIN Journal , 1997,
Abstract: : This paper reports on a study conducted among Indonesian undergraduate students majoring in English as a Foreign Language (EFL). One strategy that learners generally use to understand the main ideas of an expository text is the superstructure strategy (i.e., utilizing the text structure to understand the main ideas). While research in English as First Language reading has demonstrated the benefit of using this strategy, little do we know whether Indonesian EFL learners use this strategy in reading and whether this strategy is beneficial to them or not. Two versions of an expository text were developed: One version had an explicit text structure, with the inclusion of discourse markers, to elicit learners to use the superstructure strategy; the other was without discourse markers. It was hypothesized that learners who read the version with an explicit text structure would utilize the superstructure strategy thereby comprehending main ideas better than those who read the other version. Additionally, to confirm the hypothesis learners were also asked to answer a questionnaire developed from O'Malley and Chamot (1993) followed by an interview to find out if EFL learners used other strategies to comprehend main ideas.
The Ritual Year of the Icon of the Annunciation on the Island of Tinos, Greece
Evy Johanne H?land
Folklore : Electronic Journal of Folklore , 2011,
Abstract: After several mystical visions of the nun, Pelagia, the holy icon of the Annunciation of the Blessed Virgin (Panagia) was found in 1823. According to tradition, Pelagia repeatedly witnessed the Panagia in her visions where she received orders from her to find the Virgin’s icon and also to build her church. The icon was unearthed in the field where it had remained since the church, built on the ruins of a pagan temple, was destroyed in the 10th century. Two years before the icon was found, the Greek War of Independence broke out. The finding of the icon, the construction of the Church of the Panagia, Euangelistria, the enormous crowds of pilgrims and all the miracles worked by the icon, contributed to the outcome that the island was declared a sacred island, and Pelagiabecame sanctified.The ritual year of the miraculous icon on Tinos starts on 30 January with the festival dedicated to the Finding of the Icon. The next festival is dedicated to the Day of the Annunciation of the Virgin Mary. This day has both a religious and a national ideological significance, since 25 March is celebrated as Independence Day. July 23 is dedicated to the “Vision” of Saint Pelagia. The most importantfestival, the Dormition of the Panagia, is celebrated on 15 August.During the festivals official processions, carrying the icon in its midst, are important, but also popular customs related to the importance of fetching holy water and earth as well as the other symbols which have a long tradition within Greek religions.Accordingly, the article aims to present the ritual year of the miraculous icon on Tinos, thus exploring the relation between official and popular religion. Since several of the rituals and symbols recur across many religious groupings in the Middle East and Mediterranean, they might be studied from a comparative perspective, thus transcending European heritages: liberating the ethnologicalimagination.
15th August on the Aegean island of Tinos
Haland Johanne Evy
Glasnik Etnografskog Instituta SANU , 2009, DOI: 10.2298/gei0902095h
Abstract: The most important festival on the island of Tinos, the 'Dormition' of the Panagia (the Virgin Mary), is celebrated on 15th August. During the festival an official procession, carrying her icon (image) in its midst, is important but also popular customs as the importance of fetching holy water and earth having a long tradition within Greek religions. The article presents the festival on Tinos, thus exploring the relation between the official and popular religion, also related to gendered values.
Vildagliptin: a new oral treatment for type 2 diabetes mellitus
Chantal Mathieu,Evy Degrande
Vascular Health and Risk Management , 2008,
Abstract: Chantal Mathieu, Evy DegrandeDepartment of Endocrinology, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Vildagliptin is a new oral antidiabetic agent that enhances pancreatic islet cell responsiveness to glucose. An extensive clinical program involving approximately 22,000 patients and 7000 patient-years of exposure to vildagliptin has shown that the agent is well tolerated and efficacious in improving glycemic control in patients with type 2 diabetes mellitus (T2DM). Monotherapy trials have shown that significant HbA1c lowering is accompanied by body weight-neutral and lipid-neutral effects, low risk of edema, and low risk of hypoglycemia. These characteristics make vildagliptin a favorable partner for combination therapy. Studies of vildagliptin as an add-on to metformin have shown significant improvements in glycemic control (comparable to that of thiazolidinedione add-on), with the combination being well tolerated and associated with low risks for hypoglycemia and adverse effects on weight or lipid levels. Good tolerability and clinically relevant improvements in glycemic control have also been observed with vildagliptin as an add-on treatment to sulfonylurea, thiazolidinedione, or insulin treatment or in initial combination treatment with pioglitazone. Improved β-cell function and glycemic control have been shown with vildagliptin in subjects with impaired glucose tolerance and in T2DM patients with mild hyperglycemia, with some evidence in the latter suggesting the potential for modifying disease course.Keywords: diabetes, vildagliptin, incretin, metformin, add-on treatment, hypoglycemia
Acceleration of UHE Cosmic Rays in Gamma-Ray Bursts
Guy Pelletier,Evy Kersale
Physics , 2000,
Abstract: Gamma-Ray Bursts are good candidates of the ``bottom up'' scenario for the generation of the UHE Cosmic Rays. In the most discussed model of GRBs, namely the ``fireball'' model, a highly relativistic shock forms and seems capable of accelerating the cosmic rays up to the EeV range. However, only the first Fermi cycle produces a large energy gain to particles coming from the external medium. Thus, a complementary acceleration is proposed, downstream of the external shock, in the relativistic plasma of the GRBs, where crossings of relativistic fronts are likely to occur. Both forward and backward fronts are necessary for the internal Fermi acceleration to work and the physical process that generates them is presented. We found that there exists a relevant physical process similar to Brillouin backscattering that redistributes the incoming energy in the plasma shell. This redistribution occurs through the generation of sound waves that heat the plasma shell and also through the generation of both forward and backward relativistic Alfven fronts that accelerate cosmic rays by the Fermi process. We show that this ensemble of processes is able to account for the generation of UHE cosmic rays. There are two opportunities for these combined processes, first during the ``primary'' Gamma-Ray Burst where baryons are entrained by the relativistic pair wind, second during the predeceleration and deceleration stages when the fireball interacts with the interstellar medium. However, because of the synchrotron losses, only the second stage can produce the UHE cosmic rays.
Burnout amongst urban secondary school teachers in Namibia
Dap Louw,Evy George,Karel Esterhuyse
South African Journal of Industrial Psychology , 2011, DOI: 10.4102/sajip.v37i1.1008
Abstract: Orientation: Burnout seems to be particularly common amongst professionals who help and enable people to cope with the demands of their daily lives. Motivation for the study: The study focused on the magnitude and nature of burnout amongst Namibian teachers as well as the influence of biographical factors on their levels of burnout. Another aim was to determine the extent to which the results of this study correlate with research findings in other countries. Research design, approach and method: The researchers used a non-experimental research method. The study involved more than 300 secondary school teachers from the Windhoek region of Namibia. They administered the Maslach Burnout Inventory (MBI) and a biographical questionnaire to achieve the goals of the study. Main findings: The main findings of the study were that the participants experienced similar levels of burnout compared to teachers in other countries. This was especially true for emotional exhaustion. Teaching experience was the biographical variable that yielded the most significant positive correlation with burnout. Practical/managerial implications: The education authorities should address the emotional needs of secondary school teachers in Namibia urgently. They should introduce effective burnout intervention and prevention programmes. These programmes could result in higher levels of job satisfaction and educational effectiveness. They could also lead to increased general fulfilment and better teacher retention. How to cite this article: Louw, D.A., George, E., & Esterhuyse, K. (2011).Burnout amongst urban secondary school teachers in Namibia. SA Journal of Industrial Psychology/SA Tydskrif vir Bedryfsielkunde,37(1), Art. #1008, 7 pages. doi:10.4102/sajip.v37i1.1008
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