FACTORS ASSOCIATED WITH THE UTILIZATION OF PUBLIC HEALTH CENTER IN CENTRAL JAVA

Background: The Public Health Center (PHC) is a gatekeeper to formal healthcare in Indonesia. PHCs in Central Java have met the basic health facility readiness standard, but there are still numerous challenges to increasing the utilization of PHCs. Aims: This study aimed to analyze the factors related to the utilization of PHC in Central Java. Methods: This cross-sectional study used secondary data from the 2018 Indonesia Basic Health Research, with 63,118 total samples. The independent variables were residence, age, gender, marital status, education, insurance, and socioeconomic, while the dependent variable was the utilization of PHC. The data were analyzed using a binary logistic regression. Results: The average rate of utilization of PHC in Central Java in 2018 was 5.7%. Those aged 46-65 and >65 years old, women, married and widowers, and those with health insurance had a higher possibility of utilizing PHC. Meanwhile, those who graduated from secondary and tertiary school, the employed, and the wealthiest group had a lower possibility of utilizing PHC. Conclusion: The factors related to the utilization of PHC in Central Java are age group, gender, marital status, education level, working status, health insurance ownership, and socioeconomic status. Keywords: basic health service, health service access, public health, public health cente

Pemanfaatan Internet dalam Meningkatkan Kinerja Penyuluh Pertanian di Kabupaten Cianjur

As the science and technology have developed rapidly, as well as current globalization, farmer\u27s needs are increasingly diverse nowadays. Therefore, extension workers are required to develop their abilities according to current conditions and challenges. But in reality the competencies of extension workers was still low. The low competence of extension workers resulted in low performance as well. It was influenced by the lack of training that has been held for extension workers. Based on this point, it is necessary to improve the performance of extension workers, utilizing the internet media can be an answer which is very rapidly growing at this time. This study analyzed: 1) the level of internet media utilization, 2) factors influencing internet utilization, and 3) the effect of internet utilization on extension worker performance. Field research conducted in January-March 2017 in Cianjur Regency. The sample of research were 26 government extension workers and 74 contract-based extension workers. Descriptive statistics and inferential statistics (Multiple Linear Regression) was used for analytical method. The results showed that the use of internet by extension workers was moderate, especially for the preparation of reports, the design of extension methods, preparation of “programma” and design extension method. The result of the analysis showed that factors influencing internet USAge were age, formal education, internet perception, duration, and diversity of accessed internet media. Performance of extension-workers to increase internet utilization effectively is needed for increase information and insight to be applied to farmers. As the science and technology have developed rapidly, as well as current globalization, farmer\u27s needs are increasingly diverse nowadays. Therefore, extension workers are required to develop their abilities according to current conditions and challenges. But in reality the competencies of extension workers was still low. The low competence of extension workers resulted in low performance as well. It was influenced by the lack of training that has been held for extension workers. Based on this point, it is necessary to improve the performance of extension workers, utilizing the internet media can be an answer which is very rapidly growing at this time. This study analyzed: 1) the level of internet media utilization, 2) factors influencing internet utilization, and 3) the effect of internet utilization on extension worker performance. Field research conducted in January-March 2017 in Cianjur Regency. The sample of research were 26 government extension workers and 74 contract-based extension workers. Descriptive statistics and inferential statistics (Multiple Linear Regression) was used for analytical method. The results showed that the use of internet by extension workers was moderate, especially for the preparation of reports, the design of extension methods, preparation of “programma” and design extension method. The result of the analysis showed that factors influencing internet USAge were age, formal education, internet perception, duration, and diversity of accessed internet media. Performance of extension-workers to increase internet utilization effectively is needed for increase information and insight to be applied to farmers

Socioeconomic inequalities in maternal health care utilization in Ghana

BACKGROUND: Improving maternal and child health remains a public health priority in Ghana. Despite efforts made towards universal coverage, there are still challenges with access to and utilization of maternal health care. This study examined socioeconomic inequalities in maternal health care utilization related to pregnancy and identified factors that account for these inequalities. METHODS: We used data from three rounds of the Ghana Demographic and Health Surveys (2003, 2008 and 2014). Two health care utilization measures were used; (i) four or more antenatal care (ANC) visits and (ii) delivery by trained attendants (DTA). We first constructed the concentration curve (CC) and estimated concentration indices (CI) to examine the trend in inequality. Secondly, the CI was decomposed to estimate the contribution of various factors to inequality in these outcomes. RESULTS: The CCs show that utilization of at least four ANC visits and DTA were concentrated among women from wealthier households. However, the trends show the levels of inequality decreased in 2014. The CI of at least four ANC visits was 0.30 in 2003 and 0.18 in 2014. Similarly, the CIs for DTA was 0.60 in 2003 and 0.42 in 2014. The decomposition results show that access to National Health Insurance Scheme (NHIS) and women's education levels were the most important contributors to the reduction in inequality in maternal health care utilization. CONCLUSIONS: The findings highlight the importance of the NHIS and formal education in bridging the socioeconomic gap in maternal health care utilization

Development of a Case-Mix Funding System for Adults with Combined Vision and Hearing Loss

Background: Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity. Methods: A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, multidimensional assessment, the interRAI Community Health Assessment and the Deafblind Supplement. The main outcome was a summary of formal and informal service costs which included intervenor and interpreter support, in-home nursing, personal support and rehabilitation services. Informal costs were estimated based on a wage rate of half that for a professional service provider ($10/hour). Decision-tree analysis was used to create groups with homogeneous resource utilization. Results: The resulting CM model had 9 terminal nodes. The CM index (CMI) showed a 35-fold range for total costs. In both the derivation and replication sample, 4 groups (out of a total of 18 or 22.2%) had a coefficient of variation value that exceeded the overall level of variation. Explained variance in the derivation sample was 67.7% for total costs versus 28.2% in the replication sample. A strong correlation was observed between the CMI values in the two samples (r = 0.82; p = 0.006). Conclusions: The derived CM funding model for adults with DSL differentiates resource intensity across 9 main groups and in both datasets there is evidence that these CM groups appropriately identify clients based on need for formal and informal support

A Spatial Analysis of Child Labour Utilization in the Tourism Industry of the Eastern Tourism Region of Sri Lanka: Issues and Challenges

Tourism is the world’s leading and fastest growing industry which generates many positive impacts on the destinations. It is also considered as a root cause of generating different socio-cultural problems. Employing of child labor in different tourism related activities is a prominent issue and it has now become a common jeopardy and a public debate, especially among social scientists. Therefore, an incessant attention has been given to study the different facets of this issue. This background is common in the Sri Lankan tourism industry too. The main objective of this research was to study the issues and challenges of utilizing child labor in the tourism industry of the Eastern Tourism Region of Sri Lanka. After a preliminary survey, Ampara, Trincomalee and Batticaloa districts were selected as the study area. The judgment and purposive sampling methods were used to select the sample and the total sample of this research was 190, which comprised of 140 child workers and 50 tourism related establishments. Both quantitative and qualitative methods were employed to collect data. The data was analyzed applying qualitative and quantitative analytical methods. The overall findings of the study are discussed under several sub headings including the overall nature of the child labour utilization with main facets such as the existing nature and types of work, the place of work, salaries and wages, different problems faced by child workers and the existing issues and challenges. As per the general findings of the research the child workers of the study area have been employed in both formal and informal sectors of the tourism industry. The issues related to child labour utilization are in two main forms viz. the different issues and challenges faced by child labourers and the business community of the study area

Pipelines to Leadership: Aspirations of Faculty in the Community College Kentucky Community and Technical College System

Community colleges are challenged to find their next set of leaders who can respond to the diverse challenges of leading the institution. This study examined the impact of institutional and personal factors on faculty aspirations to leadership roles within the community college through the utilization of the Social Cognitive Career Theory framework. A case study research design utilizing mixed-methods investigated the perceived and preferred organizational culture(s) and the manner in which institutional and personal factors influence faculty aspirations to assume leadership roles at Southcentral Kentucky Community and Technical College. The findings of the research indicate that affecting change and being asked to lead are personal factors of influence that motivate faculty to aspire to formal leadership positions within the community college. On the other hand, the challenge of formal leadership roles, family and work-life balance might dissuade faculty aspirations of faculty to formal leadership roles. The study reveals that organizational culture was a positive factor of institutional influence. This study advances the field of educational leadership in that a number of personal and institutional factors influence the aspirations of faculty as they consider movement into formal leadership position within the community college. The findings identify the need for research across multiple institutions and the need to expand Social Cognitive Career Theory to include personal-cognitive barriers of race and gender

Fostering Rural Development through Improved Financial Inclusion in Thoothukudi District: The Involvement of Commercial Banks.

This research delves into the dynamics of economic growth and development in Thoothukudi District, Tamil Nadu, India, with a specific focus on the role of commercial banks in fostering financial inclusion and rural development. The study explores the challenges faced by rural communities in accessing formal banking services and examines the effectiveness of current financial inclusion initiatives. Utilizing a mixed-methods research design, including surveys and factor analysis, the research identifies three dimensions of financial inclusion: Utilization, Approach, and Quality of Services. The findings indicate positive perceptions regarding the convenience and accessibility of banking services, with room for improvement in documentation processes, communication, and the adoption of digital banking. Confirmatory Factor Analysis validates the dimensions, revealing good to very good fits. The study concludes with actionable recommendations for banks to enhance their role in promoting sustainable rural development, emphasizing technological innovation, improved communication, and a customer-centric approach

Charge Makes a Difference: Molecular Ionic Bismuth Compounds

Key challenges in modern synthetic chemistry include the design of reliable, selective, and more sustainable synthetic methods, as well as the development of promising candidates for new materials. Molecular bismuth compounds offer valuable opportunities as they show an intriguing spectrum of properties that is yet to be fully exploited: a soft character, a rich coordination chemistry, the availability of a broad variety of oxidation states (at least +V to −I) and formal charges (at least +3 to −3) at the Bi atoms, and reversible switching between multiple oxidation states. All this is paired with the status of a non-precious (semi−)metal of good availability and a tendency towards low toxicity. Recent findings show that some of these properties only come into reach, or can be substantially optimized, when charged compounds are specifically addressed. In this review, essential contributions to the synthesis, analyses, and utilization of ionic bismuth compounds are highlighted

Curr Trop Med Rep

Diagnosis of histoplasmosis remains challenging in resource-limited regions where HIV/AIDS is epidemic and histoplasmosis is endemic. Early and rapid detection of histoplasmosis is essential to preventing morbidity and mortality, yet few diagnostic options are available in low-resource areas of the world. The aim of this review is to provide an overview of the current status of the diagnosis of histoplasmosis, including an update on recent developments and utilization of new technologies. We discuss the specific diagnostic challenges faced in endemic regions, emphasizing the need for greater availability and standardization of rapid diagnostics for this endemic and neglected disease. While significant progress has been made in the development of new methods, clinical utility must be established by means of formal and extensive clinical studies.CC999999/Intramural CDC HHS/United States2019-06-10T00:00:00Z31187020PMC65568966385vault:3240

Towards a Framework for Managing Inconsistencies in Systems of Systems

The growth in the complexity of software systems has led to a proliferation of systems that have been created independently to provide specific functions, such as activity tracking, household energy management or personal nutrition assistance. The runtime composition of these individual systems into Systems of Systems (SoSs) enables support for more sophisticated functionality that cannot be provided by individual constituent systems on their own. However, in order to realize the benefits of these functionalities it is necessary to address a number of challenges associated with SoSs, including, but not limited to, operational and managerial independence, geographic distribution of participating systems, evolutionary development, and emergent conflicting behavior that can occur due interactions between the requirements of the participating systems. In this paper, we present a framework for conflict management in SoSs. The management of conflicting requirements involves four steps, namely (a) overlap detection, (b) conflict identification, (c) conflict diagnosis, and (d) conflict resolution based on the use of a utility function. The framework uses a Monitor-Analyze-Plan- Execute- Knowledge (MAPE-K) architectural pattern. In order to illustrate the work, we use an example SoS ecosystem designed to support food security at different levels of granularity