SAREDIMENSI MUTU PELAYANAN PADA UNIT RAWAT INAP RUMAH SAKIT UMUM DAERAH KAREL SADSUITUBUN LANGGUR KABUPATEN MALUKU TENGGARA TAHUN 2013

Masih banyak keluhan pasien yang disampaikan yaitu, pasien mengeluhkan tentang ketepatan waktu dalam pemeriksaan rutin, perawat sering mengacuhkan pasien yang datang, juga keluhan yang disampaikan adalah faktor fasilitas. Penelitian ini bertujuan untuk mengetahui gambaran mutu pelayanan kesehatan. Metode penelitian ini adalah observasional deskriptif yaitu untuk mengetahui gambaran mutu pelayanan di Rumah Sakit Umum Daerah Karel Sadsuitubun Langgur. Populasi dalam penelitian ini adalah pasien yang menggunakan rawat inap Rumah Sakit Umum Daerah Karel Sadsuitubun Langgur. Dan penelitian dilaksanakan pada bulan Januari ??? Februari Tahun 2013, dengan jumlah sampel 80 responden. Metode yang digunakan dalam penelitian ini adalah survey dengan menggunakan kuesioner, untuk mengetahui gambaran mutu pelayanan kesehatan. Hasil penelitian menunjukkan bahwa sebagian besar responden Rumah Sakit Umum Daerah Karel Sadsuitubun Langgur menyatakan cukup baik terhadap ketepatan waktu (98.7%), informasi (85.0%), dan hubungan antar manusia (95.0%). Berbeda halnya dengan kenyamanan (65.0%), dimana sebagian besar responden menyatakan kurang nyaman. Secara keseluruhan persepsi responden terhadap mutu pelayanan pada RSUD Karel Sadsuitubun Langgur Kabupaten Maluku Tenggara 51.3% menyatakan cukup baik, dan 48.7% menyatakan kurang baik. Saran yang diberikan adalah hendaknya beberapa petugas yang kurang tanggap terhadap segala macam kebutuhan pasien, sekiranya lebih bersedia untuk meluangkan waktunya mendengarkan keluhan maupun keinginan pasien. Hendaknya pihak Rumah Sakit Karel Sadsuitubun Langgur lebih memperhatikan ketersediaan Air yang kurang pada hampir setiap ruang perawatan. Hendaknya petugas dapat memperbaiki dan menjaga kebersihan sarana dan prasarana rumah sakit, karena semua ini sangat berdampak terhadap mutu pelayanan kesehatan

Phase formation processes and synthesis of solid solutions in Ca-R-Nb-M-O systems

During the study of the phase formation process in Ca-R-Nb-M-O systems (R=La, Bi, M=Mo, W), an attempt was made to obtain single-phase compounds of CaRNbMO8 composition by the standard ceramic technique. In addition, samples based on LaNbO4, CaWO4, BiNbO4 were also synthesized by the standard ceramic technique. The phase composition of the samples was studied by XRD analysis. The electrical conductivity of the obtained solid solutions and potential composite materials was investigated by impedance spectroscopy

Biodigital publics: personal genomes as digital media artifacts

The recent proliferation of personal genomics and direct-to-consumer (DTC) genomics has attracted much attention and publicity. Concern around these developments has mainly focused on issues of biomedical regulation and hinged on questions of how people understand genomic information as biomedical and what meaning they make of it. However, this publicity amplifies genome sequences which are also made as internet texts and, as such, they generate new reading publics. The practices around the generation, circulation and reading of genome scans do not just raise questions about biomedical regulation, they also provide the focus for an exploration of how contemporary public participation in genomics works. These issues around the public features of DTC genomic testing can be pursued through a close examination of the modes of one of the best known providers—23andMe. In fact, genome sequences circulate as digital artefacts and, hence, people are addressed by them. They are read as texts, annotated and written about in browsers, blogs and wikis. This activity also yields content for media coverage which addresses an indefinite public in line with Michael Warner’s conceptualisation of publics. Digital genomic texts promise empowerment, personalisation and community, but this promise may obscure the compliance and proscription associated with these forms. The kinds of interaction here can be compared to those analysed by Andrew Barry. Direct-to-consumer genetics companies are part of a network providing an infrastructure for genomic reading publics and this network can be mapped and examined to demonstrate the ways in which this formation both exacerbates inequalities and offers possibilities for participation in biodigital culture

Влияние функциональной взаимосвязи понятия, образа и действия на процесс решения междисциплинарных технологически ориентированных задач

This article studies the influence of the methods used by students to solve tasks on the effectiveness of the learning process based on their analysis. The study has revealed that mastering the combined method based on the functional relationship between concept, image and action in the process of solving interdisciplinary technological tasks is one of the mechanisms of effective preparation of students for professional activity in the labour market of related professions.En este artículo, basado en un análisis de los métodos utilizados por los estudiantes para resolver problemas, se investiga su influencia en la efectividad del proceso de aprendizaje. En el curso del estudio, se reveló que el dominio del método combinado, basado en la relación funcional del concepto, la imagen y la acción, en el proceso de resolución de problemas tecnológicos interdisciplinarios es uno de los mecanismos para la preparación efectiva de los estudiantes para actividades profesionales en el contexto de la aparición de profesiones relacionadas en el mercado laboral.В данной статье на основе анализа используемых обучающимися способов решения задач исследуется их влияние на результативность процесса обучения. В процессе исследования выявлено, что владение комбинированным способом, основанном на функциональной взаимосвязи понятия, образа и действия, в процессе решения междисциплинарных технологических задач выступает одним из механизмов эффективной подготовки обучающихся к профессиональной деятельности в условиях появления на рынке труда смежных профессий

The Prevalence of Reflux Esophagitis in the Elderly and Its Associated Risk Factors

Background: Reflux esophagitis is a common problem in the elderly. Compare to the Western Countries, esophageal cancer where reflux esophagitis is the most predominant risk factor is considered rare in Asia. Many other risk factors have not been well studied especially in most Asian countries. The objective of this study is to evaluate the presence of reflux esophagitis in elderly patients and its associated risk factors.Method: This was a cross-sectional study in elderly patients who underwent upper gastrointestinal endoscopy. Patients who received long-term proton pump inhibitor (PPI) therapy, suffered from gastrointestinal malignancies, recently receiving chemotherapy agents, diagnosed with cerebrovascular disease or Helicobacter pylori infection were excluded. Statistical analyses were performed using the SPSS software version 17.00 (SPSS Inc., Chicago, Illinois, USA).Results: A total of 238 elderly patients were enrolled. Patients’ mean age was 69.8 ± 6.8 years old. Reflux esophagitis was found in 22 (9.2%) patients. Several comorbidities were found in these patients, such as diabetes, hypertension, coronary artery disease, chronic kidney disease, and liver cirrhosis. The only factor that associated with reflux esophagitis was the presence of hiatus hernia esophagus (p = 0.038). However, reflux esophagitis seemed to be more found in the elderly patients who have history of reflux inducing drugs consumption without any proton pump inhibitor (PPI) protection.Conclusion: Reflux esophagitis is still a major problem in the elderly. The presence of hiatus hernia might give an important consideration of upper gastrointestinal endoscopy screening. However, it would be a debate matter with regards to the cost burden and the low risk of esophageal cancer in Asian countries.

Avalanches in self-organized critical neural networks: A minimal model for the neural SOC universality class

The brain keeps its overall dynamics in a corridor of intermediate activity and it has been a long standing question what possible mechanism could achieve this task. Mechanisms from the field of statistical physics have long been suggesting that this homeostasis of brain activity could occur even without a central regulator, via self-organization on the level of neurons and their interactions, alone. Such physical mechanisms from the class of self-organized criticality exhibit characteristic dynamical signatures, similar to seismic activity related to earthquakes. Measurements of cortex rest activity showed first signs of dynamical signatures potentially pointing to self-organized critical dynamics in the brain. Indeed, recent more accurate measurements allowed for a detailed comparison with scaling theory of non-equilibrium critical phenomena, proving the existence of criticality in cortex dynamics. We here compare this new evaluation of cortex activity data to the predictions of the earliest physics spin model of self-organized critical neural networks. We find that the model matches with the recent experimental data and its interpretation in terms of dynamical signatures for criticality in the brain. The combination of signatures for criticality, power law distributions of avalanche sizes and durations, as well as a specific scaling relationship between anomalous exponents, defines a universality class characteristic of the particular critical phenomenon observed in the neural experiments. The spin model is a candidate for a minimal model of a self-organized critical adaptive network for the universality class of neural criticality. As a prototype model, it provides the background for models that include more biological details, yet share the same universality class characteristic of the homeostasis of activity in the brain.Comment: 17 pages, 5 figure

The Prevalence of Reflux Esophagitis in the Elderly and Its Associated Risk Factors

Background: Reflux esophagitis is a common problem in the elderly. Compare to the Western Countries, esophageal cancer where reflux esophagitis is the most predominant risk factor is considered rare in Asia. Many other risk factors have not been well studied especially in most Asian countries. The objective of this study is to evaluate the presence of reflux esophagitis in elderly patients and its associated risk factors.Method: This was a cross-sectional study in elderly patients who underwent upper gastrointestinal endoscopy. Patients who received long-term proton pump inhibitor (PPI) therapy, suffered from gastrointestinal Malignancies, recently receiving chemotherapy agents, diagnosed with cerebrovascular disease or Helicobacter pylori infection were excluded. Statistical analyses were performed using the SPSS software version 17.00 (SPSS Inc., Chicago, Illinois, USA).Results: A total of 238 elderly patients were enrolled. Patients\u27 mean age was 69.8 ± 6.8 years old. Reflux esophagitis was found in 22 (9.2%) patients. Several comorbidities were found in these patients, such as diabetes, hypertension, coronary artery disease, chronic kidney disease, and liver cirrhosis. The only factor that associated with reflux esophagitis was the presence of hiatus hernia esophagus (p = 0.038). However, reflux esophagitis seemed to be more found in the elderly patients who have history of reflux inducing drugs consumption without any proton pump inhibitor (PPI) protection.Conclusion: Reflux esophagitis is still a major problem in the elderly. The presence of hiatus hernia might give an important consideration of upper gastrointestinal endoscopy screening. However, it would be a debate matter with regards to the cost burden and the low risk of esophageal cancer in Asian countries

HIV-care access among people with incarceration experience in St. Petersburg, Russia

Background: Little is known about the clinical care experiences of HIV-infected persons in St. Petersburg who have experience with incarceration. To address this question, we conducted a capture-recapture study to identify individuals who had been diagnosed with HIV infection while incarcerated and who subsequently presented for medical care in St. Petersburg, Russia following release from prison. Methods: We matched 292 HIV-positive prisoners tested by the prison system in 2010 to the medical records at the St. Petersburg AIDS Center in the following 4 years. Results: The data analysis shows that as many as half of HIV+ prisoners fail to seek treatment in the community upon release. Of those who had sought care post-release, only 36% were receiving HAART. Of the 109 individuals for whom tuberculosis testing was indicated post-release, 36.7% were found to be reactive. Conclusion: Despite the limitations of the data, this study is the first of its kind to review records documenting HIV care among prisoners in Russia post-incarceration. In addition to providing important descriptive information about this marginalized population, the findings from this study highlight areas where HIV control efforts could be improved in order to address the HIV epidemic in the Russian Federation

Fine Structure of Avalanches in the Abelian Sandpile Model

We study the two-dimensional Abelian Sandpile Model on a square lattice of linear size L. We introduce the notion of avalanche's fine structure and compare the behavior of avalanches and waves of toppling. We show that according to the degree of complexity in the fine structure of avalanches, which is a direct consequence of the intricate superposition of the boundaries of successive waves, avalanches fall into two different categories. We propose scaling ans\"{a}tz for these avalanche types and verify them numerically. We find that while the first type of avalanches has a simple scaling behavior, the second (complex) type is characterized by an avalanche-size dependent scaling exponent. This provides a framework within which one can understand the failure of a consistent scaling behavior in this model.Comment: 10 page

Diagnostics and therapy of peripheral neuropathy (literature review)

The review is devoted to diagnostics and treatment of neuropathic pain in patients with peripheral nervous system diseases. Main assessment tools are shown including Visual analog Scale (VAS), Neuropathic Pain Scale (NPS), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS), Neuropathic Pain Questionnaire (NPQ), Questionnaire Douleur Neuropathique 4 (DN-4), pain DETECT Questionnaire, Standardized Evaluation of Pain (StEP), identification pain questionnaire (ID-pain), clinical investigation (quantitative sensorial test are included), neurophysiological studies (electroneuromyography, evoked potentials) and MRI. Novel therapy in neuropathic pain disorders is described including both medicamentous and additional therapeutics methods