5 research outputs found
Flavor enhancement of food as a stimulant for food intake in elderly people
No full textIt is often speculated that the age related decline in taste and smell performance can add to the decreased food intake among elderly by causing a change in liking of food. Flavor enhancement (by adding a taste and/or an odor to enhance or intensify the flavor of the food) has been suggested to counteract for the diminished taste and smell performance in order to increase liking and subsequently intake among elderly people. However, there is no clear relationship between an impaired taste and smell functioning and flavor enhancement. In addition, the results of studies on the effect of flavor enhancement on intake are inconsistent. In this thesis we investigated the effect of flavor enhancement on liking and/or food intake in elderly people and the relationship between an altered taste and/or smell performance and liking of flavor-enhanced foods. When flavor enhancement is used as an approach to stimulate intake, it is important to know how elderly respond to a daily repeated exposure of a food. We first examined the effect of repeated exposure to fruit drinks with different sweet intensities on intake, pleasantness and boredom in young and non-institutionalized elderly adults. Second, the relationship between an impaired taste and smell performance and the liking and intake of tomato soup enhanced with MSG (0.12%) and celery powder (3 g) was studied. Third, the effect of flavor enhancement on liking and intake has been examined in nursing home elderly people that received MSG (0.3%) and/or flavors (700 mg) sprinkled over the protein component of their hot meal during 16 weeks. As last, to study the effect of a determined optimal preferred amount of MSG on food intake, we added 0.5% MSG (optimal amount) to mashed potatoes and 2% MSG to spinach and ground beef and measured the intake of these foods among institutionalized elderly. The results showed that the elderly experienced no increase in boredom and pleasantness after daily repeated exposure to fruit juices. Elderly with an impaired taste and/or smell functioning did not show an increase in liking and intake of the flavor-enhanced soup. Thus, no relationship was established between an impaired chemosensory performance and flavor enhancement. Flavor enhancement also did not increase liking and energy intake of the hot meal after 16 weeks nor did an optimal preferred amount of MSG increase intake of mashed potatoes, spinach and ground beef. A standardized flavor enhancement of foods did not prove an effective approach to increase food intake in frail elderly people. Therefore we reviewed the literature to obtain a recent picture on the causes of taste and smell loss in the elderly and to examine if the available methods to measure these losses are adequate. Results of the review showed that elderly are a heterogeneous group with various degrees of taste and smell loss and that the applied methods can distinguish the variations. This result implies a more individual, tailored taste and/or flavor enhancement of foods when it is part of a treatment or used in the prevention of undernutrition. We proposed a future strategy for flavor enhancement of foods in which we embedded the results of this review. </p
PENERAPAN PENDEKATAN REALISTIC MATHEMATICS EDUCATION UNTUK MENINGKATKAN KEMAMPUAN BERPIKIR KREATIF MATEMATIKA SISWA KELAS VIII SMP NEGERI 1 PALOPO
Full text linkJenis penelitian ini adalah penelitian eksperimen semu yang bertujuan untuk mengetahui apakah penerapan pendekatan pembelajaran realistic mathematics education dapat meningkatkan kemampuan berpikir kreatif matematika siswa kelas VIII SMP Negeri 1 Palopo. Satuan eksperimen pada penelitian ini adalah seluruh siswa kelas VIII SMP Negeri 1 Palopo yang terdiri dari sepuluh kelas dan dengan teknik purposive sampling terpilih dua kelas sebagai kelas sampel yaitu kelas VIIIJ sebagai kelas eksperimen dan kelas VIIIF sebagai kelas kontrol. Instrumen penelitian ini adalah tes kemampuan berpikir kreatif matematika, lembar keterlaksanaan pembelajaran, aktivitas siswa dan respon siswa. Teknik analisis data yang digunakan adalah analisis deskriptif dan analisis inferensial. Hasil penelitian ini menunjukkan bahwa peningkatan rata-rata kemampuan berpikir kreatif matematika siswa yang diajar dengan pendekatan RME lebih baik dari pembelajaran konvensional.
Kata Kunci: Pendekatan RME, Berpikir Kreatif Matematik
Analysis of the Economic Life of Pan Mixer Machines and Spinning Machines at PT. Wijaya Karya Beton North Sumatra
No full text58 HalamanPT. WIJAYA KARYA adalah salah satu perusahaan badan usaha milik
negara ( BUMN ) yang bergerak dalam bidang usaha industri , realty, perdagangan
dan konstruksi. Dalam operasionalnya PT. WIJA YA KARY A membagi unit-unit
usaha kedalam divisi-divisi dan anak perusahaan. Salah satu anak perusahaan dari
PT. WIJAYA KARYA adalah PT. WIJAYA KARYA BETON yang bergerak dalam
industri produk beton. Produk-produk yang dihasilkan berupa tiang pancang, tiang
listrik, bantalan jalan rel (BJR) dan komponen beton pracetak lainnya.
PT. WIJAYA KARYA BETON mempunyai beberapa• lokasi pabrik yang
tersebar dibeberapa propinsi di Indonesia. Salah satu pabrik tersebut berada di jalan
medan-binjai km 15,5 Sumatera Utara. Dipilihnya lokasi pabrik tersebut karena
tempatnya yang strategis berada dijalur jalan lintas Sumatera dan dekat dengan
sumber material dan kantor pemasaran. Produk-produk yang sudah dihasilkan oleh
Pabrik Produk Beton Sumatera Utara adalah tiang pancang, tiang listrik, bantalan
jalan rel , bantalan jalan rolly dan beam jembatan untuk pemasaran didaerah medan,
Aceh, Riau bahkan sudah ada yang diekspor ke Malaysia.
Dalam beroperasinya pabrik tersebut mempergunakan beberapa jenis alat
yang terdiri dari peralatan utama dan peralatan pendukung. Peralatan utama adalah
peralatan yang dominan untuk proses produksi dan kalau tidak ada a.lat tersebut maka
proses produksi tidak dapat dilaksanakan. Dalam skripsi ini penulis akan membahas
umur ekonomis dari 2 jenis peralan utama yaitu, mesin pan mixer sebagai alat untuk membuat adukan beton dan mesm spmnmg sebagai alat untuk memutar cetakan
untuk produksi tiang pancang dan tiang listrik.
Dalam operasinya kedua mesin tersebut membutuhkan biaya yang dibagi
menjadi biaya operasional dan biaya penyusutan. Kedua factor biaya tersebut akan
mempengaruhi apakah peralatan tersebut cukup ekonomis untuk dioperasikan atau
tidak. Umur dimana peralatan tersebut masih ekonomis untuk dipergunakan disebut
dengan umur ekonomis. Dalam tugas akhir ini umur ekonomis dihitung berdasarkan
total biaya tahunan terkecil.
Dari hasil perhitungan tersebut diketahui bahwa Mesin Pan Mixer mempunyai
umur ekonomis 5 ( lima ) tahun dengan total biaya tahunan terkecil sebesar Rp.
74.994.525,56 dan Mesin Spinning Mempunyai umur ekonomis 5 ( lima ) tahun
dengan total biaya tahunan terkecil Rp. 56.305.158,89.
Umur ekonomis ini penting diketahui oleh mana1emen perusahaan agar
mana1emen perusahaan dapat mengambil keputusan apakah peralatan akan terus
dioperasikan atau mengganti peralatan tersebut dengan peralatan yang baru ataupun
mencari alternatif-alternatif yang lain. PT. WIJAYA KARYA is one of the company owned business entities
state (BUMN) which operates in the business sectors of industry, realty, trade
and construction. In its operations PT. WIJA YA KARY A divides the units
business into divisions and subsidiaries. One of the subsidiaries of
PT. WIJAYA KARYA is PT. WIJAYA KARYA CONCRETE which moves deep
concrete products industry. The products produced are piles and poles
electricity, railway sleepers (BJR) and other precast concrete components.
PT. WIJAYA KARYA BETON has several factory locations
spread across several provinces in Indonesia. One such factory is on the road
Medan-Binjai km 15.5 North Sumatra. The factory location was chosen because
The strategic location is on the Sumatra route and close to
material sources and marketing offices. Products that have been produced by
North Sumatra Concrete Products Factory is piles, electric poles, bearings
railways, roll bearings and bridge beams for marketing in terrain areas,
Aceh, Riau have even been exported to Malaysia.
In operating the factory, several types of equipment are used
which consists of main equipment and supporting equipment. The main equipment is
dominant equipment for the production process and if there is no such equipment then
the production process cannot be implemented. In this thesis the author will discuss
The economic life of the 2 main types of equipment, namely, a pan mixer machine as a tool for making concrete mix and a spmnmg machine as a tool for rotating molds.
for the production of piles and electricity poles.
In operation, the two machines require shared costs
into operational costs and depreciation costs. These two cost factors will
affects whether the equipment is economical to operate or not
No. The age at which the equipment is still economical to use is called
with economic life. In this final project the economic life is calculated based on
smallest total annual costs.
From the results of these calculations it is known that the Pan Mixer Machine has
economic life of 5 (five) years with the smallest total annual cost of Rp.
74,994,525.56 and Spinning Machines have an economic life of 5 (five) years
with the lowest total annual costs of Rp. 56,305,158.89.
This economic age is important for company management to know
Company management can take the decision whether the equipment will continue
operated or replaced the equipment with new equipment or
look for other alternative
Guidance on the use of logic models in health technology assessments of complex interventions
No full textChallenges in assessments of health technologiesIn recent years there have been major advances in the development of health technology assessment (HTA). However, HTA still has certain limitations when assessing technologies, which? are complex, i.e. consist of several interacting components, target different groups or organisational levels, have multiple and variable outcomes, and/or permit a certain degree of flexibility or tailoring;? are context-dependent, with HTA usually focusing on the technology rather than on the system within which it is used;? perform differently depending on the way they are implemented; and/or? have distinct effects on different individuals.Logic models are one important means of conceptualising and handling complexity in HTAs or systematic reviews (SRs) of complex technologies, as well as integrating the findings of multi-component HTAs. A logic model is described as “… a graphic description of a system … designed to identify important elements and relationships within that systemâ€. When evaluating complex health technologies, logic models can serve an instrumental purpose at every stage of the HTA/SR process, from scoping the topic of the HTA/SR, including formulating the question and defining the intervention; conducting the HTA/SR; interpreting results and making the HTA/SR relevant for decision makers to implement in policy and practice.Purpose and scope of the guidanceThis guidance is targeted at commissioners, producers and users of guidelines, HTAs and SRs with an interest in using logic models as an overarching framework for their work. It aims to make the use of logic models as straightforward as possible by facilitating the systematic identification or development as well as utilisation of different types and sub-types of logic models. In principle, logic models are a useful tool in any kind of SR or HTA, as they aid with the conceptualisation of the intervention and the review question. This is particularly useful for complex technologies, where conceptualising the intervention and its implementation within a system is critical. In addition, logic models can enhance communication within the HTA/SR team and with relevant stakeholders. Three types of logic model are described: With a priori logic models the logic model is specified upfront and remains unchanged during the HTA/SR process. With iterative logic models the logic model is subject to continual modification throughout the course of an HTA/SR. The staged logic model harnesses the strengths of both a priori and iterative approaches by pre-specifying revision points at which major data inputs are anticipated. In | 6 addition, two subtypes are identified, namely logic models that seek to represent structure (system-based) and those that focus on processes or activities (process-orientated).This guidance offers direction on how to choose between distinct types and sub-types of logic models, describes each logic model type and its application in detail, and provides templates for getting started with the development of an HTA/SR-specific logic model.Development of the guidanceThis guidance was informed by a combination of (i) systematic searches for published examples of logic models supplemented by purposive sampling of iterative logic modelling approaches; (ii) searches for existing guidance on the use of logic models in primary research, SRs and HTAs; (iii) development of two draft templates for system-based and process-orientated logic models in an iterative process within the research team and in consultation with external methodological experts; and (iv) application of these draft templates in multiple SRs and one HTA of different complex health technologies covering technical, educational and policy interventions in environmental health, e-learning for health professionals and models of palliative care.Application of this guidanceFor a comprehensive integrated assessment of a complex technology we have developed a five step process, the INTEGRATE-HTA model. In Step 1 the HTA objective and the technology are defined with the support from a panel of stakeholders. A system-based logic model is developed in Step 2. It provides a structured overview of technology, the context, implementation issues, and relevant patient groups. It then frames the assessment of the effectiveness, as well as economic, ethical, legal, and socio-cultural aspects in Step 3. In Step 4 a graphical overview of the assessment results, structured by the logic model, is provided. Step 5 is a structured decision-making process informed by the HTA (and is thus not formally part of the HTA but follows it). Logic models therefore form an integral element of the INTEGRATE-HTA model but may also be useful in individual steps.This guidance starts off by offering support in identifying and, as needed, adapting existing logic models from the literature or developing an HTA-/SR-specific logic model de novo. In either case, the user will need to decide upfront whether to pursue an a priori, staged or iterative approach to logic modelling, and the guidance offers criteria on how to decide between these distinct types of logic modelling. The system-based and process-orientated logic model templates provide a starting point for the de novo development of either type of logic model. The guidance also discusses the advantages and drawbacks of adopting the system-based or process-orientated sub-type, and offers some general considerations in applying logic models, such as the variety of data sources used, transparency in reporting and necessary trade-offs between comprehensiveness and complexity of the logic model in communicating with stakeholders. For a priori logic modelling, a six-step process comprises: (1) defining the PICO elements of the HTA/SR as well as relevant aspect of context and implementation; (2) deciding on a system- vs. process-orientated logic model subtype with the former focusing on a conceptualization of the question and the latter more concerned with an explanation of the pathways from the intervention to the outcomes; (3) populating the logic model template with information obtained through literature searches, discussions within the author team and consultations with content experts; (4) asking stakeholders for input and refining the logic model accordingly; (5) repeating steps 3 and 4 until all members of the author team agree that the logic model accurately represents the framework for the specific HTA/SR; and (6) publishing the final logic model with the protocol of the HTA or SR. This logic model remains unchanged during the HTA/SR process. For iterative logic modelling, a five-step process includes: (1) creating an initial logic model as a starting point for subsequent exploration, where a logic model template is used to create an initial logic model de novo; (2) identifying data on the whole system or entire process, or on individual components of the model, where data may come from stakeholders, the review team, ongoing primary research or the published literature; (3) making 7 |changes to the initial logic model repeatedly and at any point of the review and documenting these changes carefully; (4) creating a new numbered version of the logic model, where changes are considered substantive or stepwise; and (5) recording a definitive version of the logic model for the purpose of publication within the final HTA/SR report. It is recognised that this version of the logic model is only definitive with regard to the specific project timeframe and may well be subject to subsequent modification by the HTA/SR team, or indeed by other teams.For staged logic modelling, a four-step process consists of: (1) developing an initial logic model, using one of the templates and various mechanisms to populate them, in particular input from stakeholders and literature searches; (2) pre-specifying points within the HTA/SR process at which significant inputs, defined in terms of quantity or importance, are likely to have an impact on the structure and content of the HTA/SR and thus the logic model; (3) revisiting the logic model at the pre-specified review and revision points, and creating new and clearly labelled versions, documenting how and based on which data sources changes were made; and (4) presenting selected versions of the logic model, as a minimum the initial and the final logic models, in the HTA/ SR report.ConclusionsLogic models are an important tool when conducting HTAs or SRs of complex health technologies, as they enhance transparency on underlying assumptions and help understand complexity by depicting the entire system, its parts and the interactions between intervention and outcomes; they also play a key role in integrating across different parts of a multi-component HTA. Nonetheless, logic models are not a panacea in addressing or resolving complexity and each type shows its specific strengths and limitations. This guidance provides a stateof-the-art overview of current practices in the use of logic models within HTAs and SRs. By providing templates for generating a logic model de novo, it aims to make the process of logic model development and application as straightforward as possible. Certain types and sub-types of logic models are more or less suitable depending on the technology concerned and the HTA/SR question addressed and approach pursued. This guidance offers a series of considerations on how to choose between a priori, iterative and staged logic models, illustrated with example applications of each type.</p
Guidance on the use of logic models in health technology assessments of complex interventions
No full textChallenges in assessments of health technologiesIn recent years there have been major advances in the development of health technology assessment (HTA). However, HTA still has certain limitations when assessing technologies, which? are complex, i.e. consist of several interacting components, target different groups or organisational levels, have multiple and variable outcomes, and/or permit a certain degree of flexibility or tailoring;? are context-dependent, with HTA usually focusing on the technology rather than on the system within which it is used;? perform differently depending on the way they are implemented; and/or? have distinct effects on different individuals.Logic models are one important means of conceptualising and handling complexity in HTAs or systematic reviews (SRs) of complex technologies, as well as integrating the findings of multi-component HTAs. A logic model is described as “… a graphic description of a system … designed to identify important elements and relationships within that systemâ€. When evaluating complex health technologies, logic models can serve an instrumental purpose at every stage of the HTA/SR process, from scoping the topic of the HTA/SR, including formulating the question and defining the intervention; conducting the HTA/SR; interpreting results and making the HTA/SR relevant for decision makers to implement in policy and practice.Purpose and scope of the guidanceThis guidance is targeted at commissioners, producers and users of guidelines, HTAs and SRs with an interest in using logic models as an overarching framework for their work. It aims to make the use of logic models as straightforward as possible by facilitating the systematic identification or development as well as utilisation of different types and sub-types of logic models. In principle, logic models are a useful tool in any kind of SR or HTA, as they aid with the conceptualisation of the intervention and the review question. This is particularly useful for complex technologies, where conceptualising the intervention and its implementation within a system is critical. In addition, logic models can enhance communication within the HTA/SR team and with relevant stakeholders. Three types of logic model are described: With a priori logic models the logic model is specified upfront and remains unchanged during the HTA/SR process. With iterative logic models the logic model is subject to continual modification throughout the course of an HTA/SR. The staged logic model harnesses the strengths of both a priori and iterative approaches by pre-specifying revision points at which major data inputs are anticipated. In | 6 addition, two subtypes are identified, namely logic models that seek to represent structure (system-based) and those that focus on processes or activities (process-orientated).This guidance offers direction on how to choose between distinct types and sub-types of logic models, describes each logic model type and its application in detail, and provides templates for getting started with the development of an HTA/SR-specific logic model.Development of the guidanceThis guidance was informed by a combination of (i) systematic searches for published examples of logic models supplemented by purposive sampling of iterative logic modelling approaches; (ii) searches for existing guidance on the use of logic models in primary research, SRs and HTAs; (iii) development of two draft templates for system-based and process-orientated logic models in an iterative process within the research team and in consultation with external methodological experts; and (iv) application of these draft templates in multiple SRs and one HTA of different complex health technologies covering technical, educational and policy interventions in environmental health, e-learning for health professionals and models of palliative care.Application of this guidanceFor a comprehensive integrated assessment of a complex technology we have developed a five step process, the INTEGRATE-HTA model. In Step 1 the HTA objective and the technology are defined with the support from a panel of stakeholders. A system-based logic model is developed in Step 2. It provides a structured overview of technology, the context, implementation issues, and relevant patient groups. It then frames the assessment of the effectiveness, as well as economic, ethical, legal, and socio-cultural aspects in Step 3. In Step 4 a graphical overview of the assessment results, structured by the logic model, is provided. Step 5 is a structured decision-making process informed by the HTA (and is thus not formally part of the HTA but follows it). Logic models therefore form an integral element of the INTEGRATE-HTA model but may also be useful in individual steps.This guidance starts off by offering support in identifying and, as needed, adapting existing logic models from the literature or developing an HTA-/SR-specific logic model de novo. In either case, the user will need to decide upfront whether to pursue an a priori, staged or iterative approach to logic modelling, and the guidance offers criteria on how to decide between these distinct types of logic modelling. The system-based and process-orientated logic model templates provide a starting point for the de novo development of either type of logic model. The guidance also discusses the advantages and drawbacks of adopting the system-based or process-orientated sub-type, and offers some general considerations in applying logic models, such as the variety of data sources used, transparency in reporting and necessary trade-offs between comprehensiveness and complexity of the logic model in communicating with stakeholders. For a priori logic modelling, a six-step process comprises: (1) defining the PICO elements of the HTA/SR as well as relevant aspect of context and implementation; (2) deciding on a system- vs. process-orientated logic model subtype with the former focusing on a conceptualization of the question and the latter more concerned with an explanation of the pathways from the intervention to the outcomes; (3) populating the logic model template with information obtained through literature searches, discussions within the author team and consultations with content experts; (4) asking stakeholders for input and refining the logic model accordingly; (5) repeating steps 3 and 4 until all members of the author team agree that the logic model accurately represents the framework for the specific HTA/SR; and (6) publishing the final logic model with the protocol of the HTA or SR. This logic model remains unchanged during the HTA/SR process. For iterative logic modelling, a five-step process includes: (1) creating an initial logic model as a starting point for subsequent exploration, where a logic model template is used to create an initial logic model de novo; (2) identifying data on the whole system or entire process, or on individual components of the model, where data may come from stakeholders, the review team, ongoing primary research or the published literature; (3) making 7 |changes to the initial logic model repeatedly and at any point of the review and documenting these changes carefully; (4) creating a new numbered version of the logic model, where changes are considered substantive or stepwise; and (5) recording a definitive version of the logic model for the purpose of publication within the final HTA/SR report. It is recognised that this version of the logic model is only definitive with regard to the specific project timeframe and may well be subject to subsequent modification by the HTA/SR team, or indeed by other teams.For staged logic modelling, a four-step process consists of: (1) developing an initial logic model, using one of the templates and various mechanisms to populate them, in particular input from stakeholders and literature searches; (2) pre-specifying points within the HTA/SR process at which significant inputs, defined in terms of quantity or importance, are likely to have an impact on the structure and content of the HTA/SR and thus the logic model; (3) revisiting the logic model at the pre-specified review and revision points, and creating new and clearly labelled versions, documenting how and based on which data sources changes were made; and (4) presenting selected versions of the logic model, as a minimum the initial and the final logic models, in the HTA/ SR report.ConclusionsLogic models are an important tool when conducting HTAs or SRs of complex health technologies, as they enhance transparency on underlying assumptions and help understand complexity by depicting the entire system, its parts and the interactions between intervention and outcomes; they also play a key role in integrating across different parts of a multi-component HTA. Nonetheless, logic models are not a panacea in addressing or resolving complexity and each type shows its specific strengths and limitations. This guidance provides a stateof-the-art overview of current practices in the use of logic models within HTAs and SRs. By providing templates for generating a logic model de novo, it aims to make the process of logic model development and application as straightforward as possible. Certain types and sub-types of logic models are more or less suitable depending on the technology concerned and the HTA/SR question addressed and approach pursued. This guidance offers a series of considerations on how to choose between a priori, iterative and staged logic models, illustrated with example applications of each type.</p
