Impelementasi Kebijakan Pemerintah dalam Mengoptimalkan Kinerja Pegawai Negeri Sipil untuk Meningkatkan Kualitas Pelayanan Jaminan Kesehatan Nasional-Badan Penyelenggara Jaminan Sosial Kesehatan

The program of government is ruled by an organization which is pointed out to perform as the first target. But there are not programs of government has not been maximumly ruled by the organization which is pointed. The program of guarantee of national health of the board of social guarantee at The Common Hospital of South Bangka Hospital, Regional Hospital of Pangkalpinang, Bhakti Timah Hospital Pangkalpinang hasn't succeeded maximum. It is caused by the medical workers haven't been suitable, the sum of doctors are not enough, the facilities haven't been enough, a few of socialisations about the programs. It is needed the policy of the government to manage the programs so the service of heath can be touched for all people of South Bangka, Pangkalpinang according to the law of Republic of Indonesia number 24 in the year 2011, the regulation of minister of the heath of Republic of Indonesia number 28 in the year 2014. The policy of government is influenced by four of communication factors, human resource, disposition, and bureaucratic structure, whereas the work of civil government officers to give a service of guarantee of national health, the board of social guarantee at The Common Hospital of South Bangka, The Regional Hospital of Pangkalping, and The Bhakti Timah Hospital hasn't been ability, motivation, and maximum chance. The utility of the writing to see the work of civil government officers in giving a service of national guarantee, the board of social guarantee

A Theoretical Study of the Hidden Wounds of War: Disenfranchised Grief and the Impact on Nursing Practice

Combat veterans face enormous challenges upon the return to civilian life, one of which is the ability to integrate incidences of death and killing into a healthy postdeployment life. This paper presents the lived experience of grief and loss resulting from the trauma of war. Social constructionist theory, due to its emphasis on meaning-making, serves as the theoretical framework. The effects of inhibited mourning due to the inability to mourn in combat and lack of nurturing upon returning home are described. Personal excerpts derived from interviews of warfare from veterans that experienced death and killing are presented. It is suggested that combat veterans experience a unique form of grief and therefore require a style of grieving that differs from those that have not served on the battlefield. Regardless of the point of care, nurses are positioned to help with the challenges of readjustment. A better understanding of combat veterans as a disenfranchised group would enable nurses to intervene in ways that contribute to the readjustment process

Menyikapi Rahasia di Balik Rasio dan Rasa pada Manusia

The sciense of human will not able to solve all of things, according to the words of Allah: “And we are not given a science except a little”, (Q.S 17/ Al-Isra': 85). Instinct of human must get a direction of Allah who is explained at his book. Unless the instinct will be wrong in its channel. The position of instinct and intelligence at Islam ethics, both are necessary to be used and dropped well by counselling and directing which are settled in Al-Qur'an and the guide of propnet Muhammad SAW. Philosophy of Islam also bases on or follows the healthy intelligence to interpret all of problems of divinity, human and nature, because of necessity of thing is intelligence. It is either a subject or object of thinking. From it exits an active intelligence, because it is the first which is created by Allah. By intelligence we analyze and prove about truthm, to expose the scientific realities, about filling, idealism, ethics, law, aesthetics, extra sensory perception, and purity of heart. Intelligence is a door of science. There are not all of sciences are revealed but there are obliged to be deductive by intelligence through experiment. Allah also gives Islam Religion which is an association of power of God which is given to human (command and prohibition). Islam Religion is a mercy to manage intelligence, feeling, heart and emotion of human. We are obliged to believe, to study so that we know which is comman ded and prohibited, to do and to broadcast the Islam Religion well and truly according  to his instruction (Muslim Law)

Inverse Raman Scattering in Femtosecond Broadband Transient Absorption Experiments

This chapter reports on one of the nonlinear spectral features, the inverse Raman scattering (IRS), observed upon the interaction of ultrafast‐pulsed lasers in a Raman‐active medium. Hereby, a comprehensive theoretical description of the IRS is exposed. Furthermore, the investigation carried out on synthetic eumelanin dispersions is addressed to show how the transient absorption measurements can be influenced by the IRS, if probing at energies close to Stokes and anti‐Stokes vibrational modes of the medium. A thorough analysis demonstrates that the IRS affects the sign of dynamics but not relaxation times. A specific kind of spectroscopy based on the IRS effect (ultrafast Raman loss spectroscopy) is eventually illustrated as valuable tool to characterize the structure of molecules and to investigate their dynamics during chemical reactions, even occurring at ultrafast timescales

Benefits of using digital thoracic drainage systems for post-operative treatment in pediatric populations: personal experience and review of literature

introduction: the digital chest drainage monitoring system (Medela Thopaz+), unlike analogical systems, reliably regulates the pressure applied to the patient's chest and digitally and silently monitors critical therapeutic indicators (volume of fluid and/or drained air). Its use in adulthood has been widely described, but there is still little experience in the pediatric field. the aim of this study is to test this new device in the pediatric population. materials and methods: we conducted a retrospective study of 160 patients undergoing chest surgery at our hospital. these patients were divided into 82 treated with the Thopaz system in the period from January 2021 to April 2023 and 78 in whom pleurevac, had been used in the time period from January 2020 to april 2023. results: the average age of patients was 10.45 years (range: 3.1–17.2) for the thopaz Group and 10.71 years for Pleurevac Group. The groups were homogeneus also by weight and type of intervention. the device was held in place for 10.64 days (mean) for thopaz group, compared to 16.87 days (mean) for pleurevac group (p < 0.05). The median number of postoperative x-rays before the closure of the chest tube was 4.29 in the digital drainage group compared to 8.41 in the traditional draining group (p < 0.05). conclusions: the digital chest monitoring device provides objective measurement, allows for rapid patient mobilization (with good pain control and increased compliance). in addition, the use of Thopaz in the paediatric population seems to be safe (there is no statistically significant difference in terms of complications such as prolonged air leaks and pneumothorax after the chest tube closure) and potentially beneficial

Efficacy of adalimumab as second-line therapy in a pediatric cohort of crohn’s disease patients who failed infliximab therapy: The Italian society of pediatric gastroenterology, hepatology, and nutrition experience

Background: Adalimumab (Ada) treatment is an available option for pediatric Crohn’s disease (CD) and the published experience as rescue therapy is limited. Objectives: We investigated Ada efficacy in a retrospective, pediatric CD cohort who had failed previous infliximab treatment, with a minimum follow-up of 6 months. Methods: In this multicenter study, data on demographics, clinical activity, growth, laboratory values (CRP) and adverse events were collected from CD patients during follow-up. Clinical remission (CR) and response were defined with Pediatric CD Activity Index (PCDAI) score ≤10 and a decrease in PCDAI score of ≥12.5 from baseline, respectively. Results: A total of 44 patients were consecutively recruited (mean age 14.8 years): 34 of 44 (77%) had active disease (mean PCDAI score 24.5) at the time of Ada administration, with a mean disease duration of 3.4 (range 0.3–11.2) years. At 6, 12, and 18 months, out of the total of the enrolled population, CR rates were 55%, 78%, and 52%, respectively, with a significant decrease in PCDAI scores (P<0.01) and mean CRP values (mean CRP 5.7 and 2.4 mL/dL, respectively; P<0.01) at the end of follow-up. Steroid-free remission rates, considered as the total number of patients in CR who were not using steroids at the end of this study, were 93%, 95%, and 96% in 44 patients at 6, 12, and 18 months, respectively. No significant differences in growth parameters were detected. In univariate analysis of variables related to Ada efficacy, we found that only a disease duration >2 years was negatively correlated with final PCDAI score (P<0.01). Two serious adverse events were recorded: 1 meningitis and 1 medulloblastoma. Conclusion: Our data confirm Ada efficacy in pediatric patients as second-line biological therapy after infliximab failure. Longer-term prospective data are warranted to define general effectiveness and safety in pediatric CD patients