Download pdf of lets kill isca by sunil sethi

Skip dinner perhaps. But not miss work. It isn't about the story. There are ways and ways of telling a story It isn't about the Truth.

There are ways around that too. It isn't about what Really Happened. It's none of that high falutin' stuff. It's good old Us. We make the decisions about how much we would like to see. And when the mixture's right, it thrills us,. And we purr with approbation. It's a class thing. If the controls are turned up too high, the hordes will get excited and arrive. To watch the centrepiece. They might even whistle. They won't bother to cloak their eagerness in concern like we do.

This way, it's fine, It's just Us and our Imagination. But hey, I have news for you - the hordes have heard and are on their way. They'll even pay to watch. It'll make money, the centrepiece. It's hot stuff.

How does one grade film-rapes on a scale from Exploitative to Non-exploitative? Does it depend on how much skin we see? Or is it a more complex formula that juggles exposed skin, genitalia, and bare breasts? Exploitative I'd say, is when the whole point of the exercise is to stand on high moral ground, and inform us, as if we didn't know , that rape is about abject humiliation. And, as in the case of this film, when it exploits exploitation. Phoolan has said Pioneer, August 15 [] that she thinks they're no better shall the men who raped her.

And they've done it without dirtying their hands. What was that again? The complete domination of the soul? I guess you don't need hands to hold souls down. After the centrepiece, the film rushes through to its conclusion. Phoolan manages to escape from her captors and arrives at a cousin's house, where she recuperates and then eventually teams up with Man Singh who later becomes her lover, though of course the film won't admit it.

On one foray into a village with her new gang, one of the only times we see her indulging in some non-rape-related banditry , we see her wandering through a village in a daze, with flaring nostrils, while the men loot and plunder. She isn't even scared when the police arrive. Before she leaves she smashes a glass case, picks out a pair of silver anklets and gives it to a little girl.

When Phoolan and her gang, arrive in Behmai for the denouement, everybody flees indoors except for a baby that is for some reason, left by the well, The gang fans out and gathers the Thakurs who have been marked for death. Suddenly the colour seeps out of the film and everything becomes bleached and dream sequency. It all turns very conceptual. No brutal close-ups. No bestiality. A girl's gotta do what a girl's gotta do. The twenty-two men are shot The baby wallows around in rivers of blood.

Then colour leaches back into the film. And with that, according to the film, she's more or less through with her business. The film certainly, is more or less through with her. Because there's no more rape. No more retribution. According to the book, it is really only after the Behmai massacre that Phoolan Devi grows to fit her legend. There's a price on her head, people are baying for her blood, the gang splinters. Many of them are shot by the police.

Ministers and Chief-ministers are in a flap. The police are in a panic. Dacoits are being shot down in fake encounters and their bodies are publicly displayed like game. Phoolan is hunted like an animal. But ironically, it is now, for the first time that she is in control of her life.

She becomes a leader of men. Man Singh becomes her lover, but on her terms. She makes decisions. She confounds the police. She evades every trap they set for her. She undermines the credibility of the entire UP police force. And all this time, the police don't even know what she really looks like. Even when the famous Malkhan Singh surrenders, Phoolan doesn't. This goes on for two whole years.

When she finally does decide to surrender, it is after several meetings with a persuasive policeman called Rajendra Chaturvedi, the SP of Bhind, with whom she negotiates the terms of her surrender to the government of Madhya Pradesh. In the film, we see her and Man Singh on the run, tired, starved and out of bullets. Man Singh seems concerned, practical and stoical. Phoolan is crying and asking for her mother!!!

The next thing we know is that we're at surrender. As she gives up her gun, she looks at Man Singh and he gives her an approving nod. Good Girl! Clever girl! God Clever Girl.

Phoolan Devi spent three-and-a-half years in the ravines. She was wanted on 48 counts of major crime, 22 murder, the rest kidnaps-for-ransom and looting. Even simple mathematics tells me that we've been told just half the story. But the cool word for Half-truth is Greater-truth. Other signs of circular logic are beginning to surface. Such as: Life is Art. How about sending it off to an underwater film festival with only one entry?

What responsibility does a biographer have to his subject? Particularly to a living subject? None at all? Does it not matter what she thinks or how this is going to affect her life? If the issues involved are culpable criminal offenses such as Murder and Rape - if some of them are still pending in a court of law -- legally, is he allowed to present conjecture, reasonable assumption and hearsay as the unalloyed "Truth?

Shekhar Kapur has made an appeal to the Censor Board to allow the film through without a single cut. He has said that the Film, as a work of Art, is a whole, if it were censored it wouldn't be the same film. What about the Life that he has fashioned his Art from? He has a completelv different set of rules for that. It's been several months since the film premiered at Cannes. Several weeks since the showings in Bombay and Delhi.

Thousands of people have seen the film. It's being invited to festivals all over the world. Phoolan Devi hasn't seen the film. She wasn't invited. It only associate these points with a story.

If you forget the story, you will forget everything. These notes are useless for a person who does not attend the class. These are even useless for the students who does not even revise simultaneously with class.

Dont waste your time and money.. Buy manish valechha for isca. Father of all memory books.. I think my friend Sawita must have taken classes from Memory crafterz long ago. I took class from them recently before May attempt. N this is where memory crafterz helped me, learning the exact language and retaining the same till exams. ISCA is a subject which requires more of mugging the things rather than understanding. As Sawita said, they only help in learning headings , I would say its not absolutely true.

Maximum of course was covered in my batch except few. Next she said we forget the question in which we have to write the points, it may be that in her batch ques answer linkage was not provided as they were new. But now they provide full ques answer linkage and have improved a lot. Atleast it helped me as a ladder in reaching my goal to be a CA.

Sawita Rani ca final 18 September I took the classes for May Attempt in this March The problem which I discussed is the problem of many of my class mates. It might be possible that MC have now changed the format. However, in March , the format was the same which I discussed. I dont know your batch.

I would be really happy if you discuss here the marks of your other 40 or 50 classmates who also appered in May I just want to say dont go on my single decision. Go and attend the trial class. If it suits you, then attend it.

But keep my experience in your mind also. Dear Sawita, i just shared my experience. Can't say about other students and their problems neither bother about any class's results.

I would simply add joining any class never guarantees success. Class is always for a guidance and a little of self effort is always required with any class. During this process, local acidosis occurs due to massive infiltration of neutrophils and macrophages [5] to the site of infection, which subsequently, activates the respiratory burst [6] , [7] in many infection-inflammation related diseases such as trauma-induced infection [8] , acute renal failure [9] , and intra-abdominal infection [10].

These pathological conditions can decrease the pH to as low as 5. Simultaneously, mild hypocalcaemia is closely associated with bacterial infection [12]. The transient changes in the i levels of acute phase proteins, ii local pH and iii calcium concentration, all contribute to a typical infection-inflammation environment generally proposed to result from pathogenic metabolic disorder [16].

However, the concurrence of the infection-inflammation and the changes in pH, calcium and acute phase protein concentrations indicate that these pathophysiological conditions might also be essential for effective host defense. Emerging evidence has demonstrated that a transient drop in pH and calcium level is crucial for triggering many immune processes, for example, TLRs 3, 7, 8 and 9 all require an acidic environment for their activation of the endosomes [17].

However, complement activity, which is the major frontline host defense expected to occur under such typical infection-inflammation condition, is hardly explored even though it elicits a more rapid and direct antimicrobial action against the invading bacteria. CRP and ficolins are known initiators of the complement classical pathway [3] and lectin pathway [21] , respectively, and they are the key molecules that boost the immune response [22].

As an acute phase inflammation marker [23] , CRP is also a multifunctional protein [3] upregulated in many diseases such as acute pneumonia [24] , myocardial infarction [25] and atherothrombosis [26]. Besides binding to a wide range of ligands including phosphorylcholine PC , polycations and polysaccharides displayed on the surface of the invading bacteria [27] , [28] , the CRP was also found to be deposited at the site of injury [2] indicating its crucial role in local inflammation.

Importantly, both CRP and ficolin undergo calcium- and pH- regulated conformational change when binding to their respective ligands [35] , [36] , indicating that their functions might be modulated by inflammation. However, no pathophysiological significance was proposed for CRP and ficolins although Ng et al. As the most common cause of pneumonia in intensive care unit and the second most common cause of nosocomial pneumonia, the Pseudomonas aeruginosa is a ubiquitous opportunistic pathogen which easily overcomes immunocompromised patients.

Its acquisition of multiple antibiobitic-resistance factors [37] , [38] poses a grave challenge to drug manufacturers and patient healthcare management. Here, we found that P. To determine the underlying mechanisms of the antimicrobial action, the interaction between ficolins and CRP was extensively characterized. Importantly, we demonstrated that L-ficolin and CRP collaborate through protein-protein crosstalk resulting in two amplification pathways which reinforce the classical and lectin complement pathways, and ultimately control downstream complement events like C4 deposition and opsonization of the microbe.

Calcium concentrations of 2 and 2. Hence, two typical conditions were defined: i the infection-inflammation induced local acidosis pH 6. Unless otherwise stated, the two buffers used to dilute the serum to mimic the normal and infection-inflammation conditions are: TBS buffer containing 25 mM Tris, mM NaCl, pH 7.

As a proof-of-concept and to demonstrate the prowess of the two typical conditions ascribed above, we compared the bactericidal activity against P. However, the patient serum failed to kill Staphylococcus aureus Video S6 , known to astutely evade the complement system [45] , indicating that the local acidosis-mediated killing effect targets complement-susceptible pathogens.

A Real-time observation of the bacterial killing effect of serum under normal pH 7. The bactericidal effect of patient serum, healthy serum, and heat-inactivated patient serum on P. To show the specificity of the complement-mediated killing, the S.

The bound proteins were eluted with 0. To delineate the mechanisms of complement enhancement by infection-inflammation, we focused on the CRP and ficolins, two pH- and calcium- sensitive components of the complement system. Here, the antibacterial activity resulting from bacteria incubated with heat-inactivated serum was used as a background control to normalize off any potential effect of other heat-resistant serum factors.

To verify this synergistic effect, serum depleted of both CRP and ficolin by PC- or GlcNAc- beads was used for incubation with the bacteria during which increasing concentrations of CRP or L-ficolin or both of the proteins were added. The results confirmed that addition of the two proteins exhibited a significant amplification of bacterial killing compared to adding either of the two proteins, although this process did not restore the antimicrobial effect to the same level as that of the original undepleted serum Figure 1C.

This implies that some other serum factors might have been lost through their association with the GlcNAc or PC beads together with L-ficolin or CRP, and that they for example mannose binding lectin [46] might also contribute to the antimicrobial activity via complement pathways. Our results indicated that without infection-inflammation condition, a high CRP level did not bring about antimicrobial activity Figure 1D.

To ascertain this possibility, P. Furthermore, in patient serum under infection-inflammation condition, CRP enabled the indirect association of L-ficolin to the invading bacteria. This was confirmed by a drop in the level of bound L-ficolin in CRP-depleted serum.

However, the purified H-ficolin on its own used here for comparison with L-ficolin , was bound directly to the bacteria under infection-inflammation condition, independent of CRP Figure 1E. Based on the in vitro bactericidal results we hypothesized that CRP and L-ficolin might interact in the patient's serum under infection-inflammation condition with mild acidosis.

Thus, it was imperative for us to investigate whether CRP has a propensity to complex with L-ficolin in the patient serum. To delineate the effect of different serum factors, we tested the potential interaction between CRP and L-ficolin by varying the pH, calcium and CRP levels.

Consistent with the antibacterial results, co-immunoprecipitation Co-IP of the patient sera under pH 6. However, at pH 7. Furthermore, the protein complex could not be isolated from the healthy serum regardless of pH and calcium status Figure 2B, lanes 2— Lanes 10— proteins in precipitates or supernatants under pH 7.

In B , Lanes 18—21 contained proteins in precipitates or supernatants under pH 7. OD nm was read as the binding signal. To substantiate that CRP and ficolins interact directly, the three ficolin isoforms, which share some common functions such as complement activation [47] — [49] , were purified Figure S4 and ELISA was used to test their interaction status with CRP.

On the premise that both ficolins and CRP can anchor to the invading bacteria directly or indirectly [22] , [29] , we also analyzed the reverse orders of binding by immobilizing the ficolins first to a solid phase followed by addition of CRP. This is consistent with our observation that after anchorage, CRP might recruit ficolin to the bacterial surface Figure 1D.

Our observation that M-ficolin also bound to immobilised CRP Figure 2C , prompted us to perform yeast two-hybrid analysis Figure S5B to confirm their interaction since M-ficolin, the major membrane-associated form of ficolin, has also been implicated in complement activation [47] and phagocytosis of pathogens [50].

As both CRP and ficolins are hitherto well known to separately trigger the classical and lectin complement pathways, we hypothesize that the interaction between CRP and L-ficolin under infection-inflammation condition might connect these two pathways and potentially ramify new conduits to potentiate the bactericidal activity in patients with infection-induced mild local acidosis.

Consistent with the C4 deposition results, only beads with all the components of the amplification pathway added in the infection-inflammation condition underwent significant opsonization and phagocytosis within 15 min Figure 3B and Figure S6.

Taken together, we propose that inflammation drives crosstalk between CRP and L-ficolin from which two new autonomous complement amplification pathways emerge leading to membrane attack complex MAC formation and antimicrobial activity:.

The cleaved C4 deposited on the beads were detected by Western blot. Negative controls were beads incubated with complete amplification components under normal condition, and incomplete amplification pathway components under normal or infection-inflammation conditions. The fluorospheres with PC-BSA red or GlcNAc-BSA green immobilized on the surface were opsonized by incubating with complete or partial components of the amplification pathway as indicated in the C4 cleavage assay under infection-inflammation condition.

These beads red or green were mixed with equal amounts of control beads green or red which have BSA immobilized on their surfaces without PC- or GlcNAc-residues. C Quantification of the phagocytic efficiency observed under the microscope. To determine whether C1q and L-ficolin can bind to CRP simultaneously and which of the two amplification pathways is dominant, competition assay was performed.

Under either infection-inflammation or normal condition, the addition of increasing amounts of L-ficolin to a fixed concentration of C1q did not dissociate C1q from CRP and vice versa Figure 4A and 4B indicating that C1q and L-ficolin might bind to different domains of the CRP molecule. Overall, the two amplification pathways do not compete against the classical and lectin-mediated pathways, rather, they integrate and boost the classical and lectin-mediated complement pathways towards a common goal of overcoming the pathogen more effectively while avoiding complement over-reaction.

The amount of bound C1q black bars or L-ficolin white bars was detected by the corresponding antibodies. The bound C1q black bars or L-ficolin white bars was detected by the corresponding antibodies. Ca annotates calcium. The lower binding affinity between CRP and L-ficolin under normal condition suggests that under physiological condition, the two proteins only co-exist and not interact so as to avoid random complement activation. Data were analyzed using BIAevaluation 3. HSA instead of CRP immobilized on the plates was the negative control and readings were subtracted off the negative controls.

To demonstrate how infection-inflammation condition triggers the interaction between CRP and ficolins, we examined their binding characterisitics over a range of pH 5. Furthermore, it was observed that interaction under 2 mM calcium showed stronger binding compared to that under 2. This is consistent with the previous observations that calcium influences the conformations of CRP and ficolins [51] , [53] and suggests that blood calcium concentration may regulate the recruitment of ficolin to the CRP when the later is anchored on the bacterial surface.

Thus it is possible that CRP anchored to the invading bacteria is recognized by L-ficolin, and their interaction potentially activates the amplification pathways. Since C3-deposition is the pivotal step towards the formation of the MAC, we sought to detect C3 deposition on the bacteria by incubating P.

Figure 6A shows that bacteria incubated with patient serum in infection-inflammation condition had higher C3 deposition compared to normal serum. Adolescent pregnancy of this study, namely parents communication regarding [Internet]. Geneva; [cited Aug 13]. Communication also plays an important role in the process of making 2. Williamson N. Motherhood in Childhood The State decisions in families. Most problems that arise in the of World Population [Internet].

When communication with a partner Aug 13]. Available from: www. Early In children with adolescence, communication age at first intercourse and subsequent gaps in between parents and adolescents will lead adolescents to contraceptive use.

J Womens Health Larchmt improve social and health behavior, in this case sexual [Internet]. Young women are usually more 9. Asante K, Adam A. International note: Analysis of risk and protective factors for risky sexual Regarding the barrier in communication, parents behaviours among school-aged adolescents.

Arch Sex were still small first. Premarital sexual The study of qualitative systematic review concludes relationships: Explanation of the actions and that parent-adolescent communication about sexual and functions of family. J, Lutalo T, Nalugoda F, et al. Family structure effects on early sexual debut among adolescent Conflict of Interest: None. Vulnerable Child Youth Stud [Internet]. Source of Funding: Self-funded.

Influences of family structure A qualitative analysis initiation during adolescence in Cameroon. Goldberg RE. Family instability and early health. Vaccine [Internet]. Aug 13];29 47 —5. Sneed CD. Available National Teen Pregnancy Prevention J and Health Care. Talking to J Fam Issues [Internet]. J Adolesc Heal [Internet]. Mother-daugther J Pediatr Nurs [Internet]. Available from: ncbi. Mother— J Adolesc [Internet]. J Pediatr Adolesc Gynecol [Internet].

Available from: Apr 1 [cited Aug 13];31 2 — Expert knowledge and perceived Reprod Health [Internet]. Soc Sci Med [Internet]. Buku knowledge, attitudes, and behaviors for Ajar Keperawatan Keluarga: Riset, teori, dan adolescents and young adults in three Asian cities.

Hamid et al. AYS, editor. Jakarta, J Adolesc Health [Internet]. Aug 13];50 3 Suppl :S Hypertension, one of the main characteristics of preeclampsia, is the second main causes of maternal mortality at During pregnancy, they will face physical and psychological stressors. This study aims to identify the relationship between the five types of personality and the locus of internal control in relation to preeclampsia in pregnancy.

This study used a cross-sectional design. The population of this study consisted of pregnant women with preeclampsia who came to the independent midwifery practices in Jombang; women total. The sample was selected using the total sampling method.

The data was analysed by regression analysis. It is expected that midwifery professionals can provide counselling services effectively and efficiently in relation to performing antenatal care services. In Jombang City in , Preeclampsia is one of the highest mortality factors there were 28 maternal deaths following live births.

Hypertension, one of the main The number increased from , with 17 deaths. The characteristics of preeclampsia, is the second main 28 deaths in were caused by preeclampsia 5 cause of maternal mortality at These cases must be considered to devise in Indonesia was still high, by as many as and more effective initial assessments and interventions in per, live births respectively.

This number is order to decrease the maternal mortality rate caused by still far from the target of the Millennium Development preeclampsia and eclampsia. Goals MDGs , which aims for per, live births3. Pregnant women are one of the most vulnerable members of a community.

Good stress Java Province in and , the mortality rate was management determines the success of the pregnancy.

The purpose of 1. Most of the women had locus of internal control with preeclampsia pregnancy. The most common locus of control had was negative, and the most common personality was This study used a cross-sectional design.

Age is a determinant factor Table 1: Demographic characteristics of the influencing the health status of pregnant women. The many occurrences of Pregnancy preeclampsia at a healthy age are due to most Multigravida 91 Locus Internal Positive 53 39 2.

Pregnancy: The characteristics of the respondents Control Negative 82 61 based on their pregnancy showed that most of Openness to the respondents had multigravida pregnancy. This is non-primigravida. Occupation: The characteristics of the respondents based on their work indicated that most of the The negative attributes of neuroticism as mentioned pregnant women work as factory workers.

The risk above show that the pregnant women were not ready factors for preeclampsia include their socioeconomic to adapt to the physical and psychological alterations condition, in which one of the supporting factors of pregnancy. It influences their mental and emotional is employment7. Work as a factory worker is an health, and can affect their cardiovascular condition, activity that involves physical activity.

In a factory, increasing their blood pressure and thus, leading to the conditions are always pressured, which is a preeclampsia11who were matched for age and date of factor that causes psychological disorders that delivery. The incidences of diabetes, dyslipidemia, affect maternal pregnancy.

A study mentioned hypertension and cardiovascular events after pregnancy that mothers who work in the formal sector have were identified from medical records after the date of better access to information about their health, delivery to the date of an event or the end of the study. Education: The characteristics of the respondents The study showed that there was a relationship based on education level was that the majority of between negative locus of control and the incidence rate respondents had a high school level of education.

When a pregnant woman is unable to adapt to a they experience. The risk factors for preeclampsia are health services. A study mentioned that mothers nullipara, the environment, socioeconomic conditions, with a higher education level have better access to seasonal influences, obesity, gemelli pregnancy, information about health.

It makes them have a better maternal age, impaired metabolism and a family history decision-making process related to determining care of preeclampsia or a history of previous preeclampsia, as planning for the duration of their pregnancy8. It means that pregnant women and having a negative internal locus of control were with a neurotic personality are The negative ILC has preeclampsia.

It is expected that a midwifery professional a relationship with preeclampsia with Exp B can provide counselling services effectively and efficiently This means that pregnant women with a in relation to performing antenatal care services. Neuroticism is a personality in which a person Ethical Clearance: The study passed ethical clearance can evaluate their ability to handle pressure or stress9.

Individuals with emotional stability tend to be calm in facing problems, have self-confidence and Source of Funding: This study is self-funded by the firm principles. However, the negative characteristics researchers.

Science; Biomarkers in pre-eclampsia: A novel approach to google. J Obstet Gynaecol Lahore [Internet]. Padila P. Buku ajar keperawatan maternitas. Yogyakarta: Nuha Medika; John OP, Srivastava S. Paradigm Shift to the. Soedarmono YSM. The Indonesian approach to Measurement, and Conceptual Issues.

In: reduce maternal mortality. Handbook of personality: Theory and research Feb 1 [cited Aug 2];12 1 — Available from: voxs. Survei Demografi dan Kesehatan The predictive Aug 24]. Epidemiol Glob Health [Internet]. Fleeson W, Wilt J. The relevance of big five trait Taiwan J Obstet undermine or enable authenticity achievement? Gynecol [Internet]. Faktor Risiko N, Haque A. The study aimed to examine the effect of diabetes self-management education, based on the Health Belief Model HBM , on the psychosocial outcome self-efficacy, self-care behaviour, distress, and quality of life , and glycemic control measured by their blood glucose level.

A randomised control trial was employed, using a pre-test-post-test design. The data was analysed using an independent t test with a significance level of 0.

After the intervention, the intervention group and control group showed significantly different scores in self-efficacy, self-care behaviour, diabetes distress, quality of life, and blood glucose level.

Diabetes self-management education based on the HBM had a significant effect on the phycosocial outcome of patients with type 2 diabetes. Keywords: health education, health belief model, type 2 diabetes, psycosocial outcome, glycemic control. Diabetic patients can show negative Diabetes Mellitus DM is a major chronic disease psychological responses, including feeling guilty and in the world which can cause heart disease, blindness, hopeless, losing confidence, having a low self-image, renal failure and lower extremity amputations.

Appropriate treatment is required to prevent population, approximately Perceived severity relates to beliefs Doctoral Program of Public Health, on the severity level of the disease and the consequences Faculty of Public Health, Universitas Airlangga relevant to the illness.

Perceived susceptibility represents Faculty of Nursing, Universitas Jember to what extent the person perceives their risk of having Email: rondhianto fkm. The pre-test was conducted advantages and accessibility of the actions that they before the intervention started, while the post-test was are to take. Perceived barriers includes the negative conducted three months after the intervention. The study population consisted of 20 items with a Likert scale of The was made up of patients with type 2 DM attending results of the validity test showed an r-value of 0.

The inclusion criteria of 17 items was adopted from the instrument developed was that the patients had been diagnosed with type 2 DM by Polonsky, et al. The SDSCA Their age should have been between 40 and 65 years questionnaire consisted of 12 items with a scoring old, they lived within the Patrang CHC service area, system of 0 — 7, using the Wu modified version and expressed a willingness to participate in the study.

The DQOL questionnaire had 30 items inclusion and exclusion criteria. Simple random sampling was applied in order to select the study participants. Table 1 shows the mean of patient age was The average duration of illness sessions.

The control group received their usual daily among the patients was The patient care. Every educational session lasted for approximately characteristics showed no significant difference between minutes. The intervention group received knowledge the intervention group and the control group. Table 1 about diabetes and self-management activities based displays the baseline score of self-efficacy, self-care on the four main sources of self-efficacy including behaviour, diabetes distress, quality of life and blood performance accomplishment, vicarious experience, glucose level.

The mean scores for self-efficacy, self- verbal persuasion, and physiological and emotional care behaviour, diabetes distress, and quality of life arousal. The six intervention sessions were divided were The educational and the control group. Likewise, the average blood program was prepared based on the national standard glucose level was Table 2 shows that both groups had increased scores for self-efficacy, self-care, and quality of life from the baseline.

The diabetes distress score and blood glucose level were reduced in both groups after the intervention. The post-test results show a statistically significant difference in each score of the psychosocial outcome between the intervention group and the control group.

A more significant improvement in psychosocial outcome was experienced by the intervention group than the control group, indicating the positive effect of diabetes self-management education using the HBM approach. Table 2: Comparison of the pre- and post-intervention variables of each group and the results of the independent t-test after the intervention. Having proper patients with type 2 diabetes in this study were female, health education can help them to gain self-control so again confirming the results of previous studies.

Perceived self-efficacy the disease and to reduce the risk of disability. This educational intervention, along with The results showed that there were significant differences the HBM approach, has significantly improved self- related to self-care behaviour between the intervention efficacy, self-care behaviour and quality of life, as well group and the control group.

The acquisition of as reducing the level of diabetes distress and their blood knowledge about the disease and care management glucose level. The diabetes self-management education of the disease is crucial in helping diabetic patients based on the Health Belief Model is recommended to be perform the proper self-care behaviour.

Ethical Clearance: Ethical approval was granted by Journal of Source of Funding: Self funding. Diabetes care. Standards of Medical Care in Diabetes— Diabetes Wu SF. Effectiveness of self-management for Care. Diabetes, metabolic syndrome 3. Situasi dan analisis diabetes. Jakarta: and obesity: targets and therapy. Kementerian Kesehatan RI; Zimmet P, Alberti G.

Philadelpia: Lippincott Sons; Waspadji S. Diabetes Melitus, Penyulit Kronik, 5. Dalam: Penatalaksanaan Savoy S. The Fakultas Kedokteran Universitas Indonesia. Diabetes Educator. Notoatmodjo S. Promosi kesehatan dan ilmu 6. Menkes: Mari Kita Cegah Diabetes dengan perilaku. Jakarta: Rineka Cipta. A survey among Malaysians depkes. Asian mari-kita-cegah-diabetes-dengan-cerdik. Role of self-care in management of diabetes Importance of illness beliefs mellitus.

Journal of Advanced Nursing. The effect of ;60 2 Diabetes Self- diabetes. Australian journal of advanced nursing. Evaluating the American Diabetes Association, the American effectiveness of health belief model interventions Association of Diabetes Educators, and the in improving adherence: a systematic review.

Academy of Nutrition and Dietetics. Diabetes Health Psychology Review. Bandura A. Perceived self-efficacy in cognitive adults with type 2 diabetes. BMC family practice. Educational ;14 1 Wade C, Travis C. Upper Saddle Edberg M. Teori Sosial dan Perilaku. Alih bahasa: Anwar, Konsensus pengelolaan dan dkk, Jakarta: EGC. Jakarta: PB. Heisler M. The influence of diabetes psychosocial Group based diabetes self- change in diabetes status. Patient education and management education compared to routine counseling.

Effects of self-care, self- Health Services Research. The elimination of Malaria has been among the strategies used to improve the health status of the community. However, most traditional tribes in Indonesia who live in remote areas may opt to use traditional medicine instead of the biomedical services available in health facilities.

This study aimed to shed a light on the use of traditional medicine for treating malaria within the Dayak Ngaju community.

Method: This research was designed using a qualitative approach. Five respondents, consisting of a community leader and traditional healers, agreed to participate in the study. Descriptive analysis was employed to explain the phenomena of the use of traditional medicine within the study community.

Results: Three themes emerged as the result of the study, including 1 the community perception of malaria, 2 familial influence on the use of traditional medicine, and 3 access to public health facilities for malaria treatment. People consider malaria to be a mild disease that the traditional healer has adequate knowledge of and capacity to cure.

The family has the role of encouraging and deciding on the use of traditional medicine. Despite the use of traditional medicine, Dayak Ngaju community use the biomedical health services when they are accessible.

Conclusion: Traditional medicine is considered to be the first option for seeking care among the Dayak Ngaju community. Providing access to health facilities will promote the use of said facilities and biomedical services for malaria treatment. The physical environment such , people worldwide. Central Kalimantan is an endemic area of malaria Corresponding Author: in Indonesia. The researcher TL was population from other provinces or islands of Indonesia. Dayak in the study.

The five respondents consisted of the Ngaju are one of the Dayak ethnicities that still practice community leader and four traditional healers Bahtra. The researcher was a native to speaking the language, therefore no language barrier was experienced during With the rapid development of medical science the interview. Some community members options are used by the Dayak Ngaju community? The data analysis process included of traditional medicine has received attention for its listening carefully to the records and reading the interview potential success, acceptability and accessibility.

Key statements were extracted and highlighted healer, locally known as the tabib or lasang or bahtra, at to grasp the meanings. The meanings were consolidated the residence of the sick man. Traditional medicine has been seen by the Dayak Ngaju community as the primary treatment before RESULTS utilising modern medicine in district hospitals or other modern health facilities. For this community, illness is From the data analysis, three themes emerged on the not only viewed as a symptom of individual biology, but belief and practice of traditional medicine for treating is holistically related to the nature, humanity and God.

It may also affect an alternative to malaria treatment. The patient would be laid down in the living room near to the house entrance. The first Knowledge of disease is a crucial competency of cousin of the patient would be requested to burn leaves the traditional healer bahtra in order to determine the from any green plants found in the yard, and blow the illness and the medication required for the ill person.

This practice should be The competency is obtained usually from knowledge conducted three times a day, in the morning, afternoon passed down from generation to generation within the and evening. The patient would also be given a drink bahtra family.

In the Dayak Ngaju language, malaria of medicated water. Finally, mild and not dangerous with some common symptoms the traditional healer also applied oil rubbed over the including fever, bone pain and a prolonged headache.

It is Sahangen, not dangerous. Everyone Access to public health facilities for malaria treatment: can get it including my own children. Especially for Although the Dayak Ngaju community would go first to elderly, sometimes having fever is just normal. Malaria is also considered to be a disease now also use the modern medicine available in the that is necessary for a person to grow in maturity, as community health centre and village health posts.

It means that he is experiencing Sahangen. A process go to community health centre if their fever gets worse. The Dayak Ngaju community trust the bahtra and their knowledge of malaria. Often, they consider visiting The traditional healer expects that community would a traditional healer first in order to have an opinion on the preserve the traditional practices as they are inherited severity of the disease and to utilise traditional medicine, from their ancestors.

In addition, some of the community as well as the ritual required for healing. They may use still live separately in remote locations which are far this to see whether or not the patient requires going to a from the modern health facility. Encouraging them to modern health facility. Therefore, the traditional healer solely use modern medicine without considering the has a central role in treating malaria.

This is also part of the local wisdom that continues to use a certain plant to treat malaria. A similar concept of health and disease was family. The ritual done while providing the traditional also described in a previous qualitative study about medicine also involves the family member with guidance the use of traditional medicine and practices among from the bahtra.

One of the bahtra respondents recalled postpartum women in China. Family also plays a crucial role in preserving Source of Funding: Self funding. Support from the family is a beneficial factor related to seeking care. Diversity in breeding sites and distribution satisfy supernatural powers and help in the recovery of Anopheles mosquitoes in selected urban from illness, as seen in a previous study.

Traditional medicine has been the first choice for the Dayak Ngaju community when seeking treatment. World malaria report The Dayak Ngaju community believe that selecting the