PENGALAMAN COPING TERHADAP DIAGNOSIS KANKER PADA PENDERITA USIA KERJA DI RUMAH SAKIT MARGONO SOEKARJO PURWOKERTO

Penelitian ini bertujuan untuk mendeskripsikan pengalaman koping terhadap diagnosis pasien penderita kanker yang berada pada usia kerja. Penelitian ini menggunakan pendekatan kualitatif fenomenologis dengan metode analisis IPA (Interpretative Phenomenological Analysis). Subjek dalam penelitian ini berjumlah empat orang yakni pasien penderita kanker yang sedang menjalani Radioterapi di Rumah Sakit Margono Soekarjo Purwokerto dengan rentang umur 35 sampai 50 tahun (usia produktif). Subjek dipilih menggunakan teknik purposive sampling. Hasil penelitian menemukan bahwa pengalaman yang dialami dan pemaknaan yang dibentuk oleh masing-masing subjek akan berbeda dikarenakan beberapa faktor yang mempengaruhi situasi dan kondisi yang dialami subjek, yaitu a) perasaan kaget dan stres menjadi faktor yang muncul ketika subjek didiagnosis penyakit kanker, dan memiliki anggapan bahwa kanker merupakan penyakit yang parah dan sulit menemui kesembuhan dan akan berujung pada kematian; b) pemilihan strategi coping dimunculkan subjek untuk menghadapi kondisi stres tersebut, seperti mengisi kesibukan dan memperbanyak kegiatan spiritual;c) dukungan sosial serta penerimaan diri menjadi titik penting bagi subjek dalam memaknai penyakit kanker yang diderita, dukungan dari keluarga dianggap sebagai bentuk dukungan yang paling berpengaruh bagi subjek; d) subjek yang bekerja sebagai buruh dan guru kursus swasta, kendala biaya pengobatan merupakan masalah yang muncul dibandingkan dengan subjek dengan pekerjaan sebagai PNS, biaya pengobatan yang dikeluarkan dirasa cukup banyak sehingga memerlukan biaya tambahan untuk mencukupi biaya pengobatan tersebut. Keempat subjek menunjukkan pemaknaan dan memiliki pengalaman yang beragam di aspek kehidupannya

The efficacy and safety of a shortened duration of antimicrobial therapy for group A Streptococcus bacteremia

Objectives: To determine if shorter courses of antibiotic therapy for group A Streptococcus (GAS) bacteremia are associated with excess mortality. Methods: In this retrospective study of consecutive cases of GAS bacteremia in tropical Australia, the duration of antibiotic therapy was correlated with 90-day all-cause mortality. Results: There were 286 episodes of GAS bacteremia; the patients’ median (interquartile range) age was 60 (48-71) years and 169/286 (59.1%) patients identified as an Indigenous Australian. There were 227/286 (79.4%) patients with a significant comorbidity. The all-cause 90-day mortality was 16/286 (5.6%); however, 12/16 (81.3%) patients died while still receiving their initial course of antibiotics and only 7/16 (43.8%) deaths were directly attributable to the GAS infection. After excluding patients who died while taking their initial course of antibiotics and those in whom the duration of therapy was uncertain, there was no difference in 90-day mortality between patients receiving ≤5 days of intravenous antibiotics and those receiving longer courses (1/137 [0.7%] vs 3/107 [2.8%], P-value = 0.32) nor in patients receiving ≤10 days of total therapy and those receiving longer courses (1/67 [1.5%] vs 3/178 [1.7%], P-value = 1.0). Conclusion: Even among patients with significant comorbidity, shorter antibiotic courses for GAS bacteremia are not associated with excess mortality

Biodiesel Production From Rubber Seeds (Hevea brasiliensis) with In Situ and Acid Catalyst Method by Using Ultrasonic Assisted

Biodiesel production from the non-edible raw materials become very important because will not collide with human needs. Furthermore, this research studies to biodiesel production with ultrasonic assisted by in situ method. The raw material uses rubber seed and ultrasonic process use ultrasonic cleaner. The objective of this research was to study the influence of catalyst concentration and ratio of raw materials to methanol. The process was done at 60oC for 30 minutes reaction time. The results showed that maximum yield of Fatty Acid Methyl Ester (FAME) was 34.74% by using sulphuric acid 0.1% as catalyst and rubber seed ratio to methanol 1:1.75 (w/v)

Optimal estimation of time-dependent gravitational fields with quantum optomechanical systems

We study the fundamental sensitivity that can be achieved with an ideal optomechanical system in the nonlinear regime for measurements of time-dependent gravitational fields. Using recently developed methods to solve the dynamics of a nonlinear optomechanical system with a time-dependent Hamiltonian, we compute the quantum Fisher information for linear displacements of the mechanical element due to gravity. We demonstrate that the sensitivity can not only be further enhanced by injecting squeezed states of the cavity field, but also by modulating the light--matter coupling of the optomechanical system. We specifically apply our results to the measurement of gravitational fields from small oscillating masses, where we show that, in principle, the gravitational field of an oscillating nano-gram mass can be detected based on experimental parameters that will likely be accessible in the near-term future. Finally, we identify the experimental parameter regime necessary for gravitational wave detection with a quantum optomechanical sensor

Classical and nonclassical time dilation for quantum clocks

Proper time, ideal clocks, and boosts are well understood classically, but subtleties arise in quantum physics. We show that quantum clocks set in motion via momentum boosts do not witness classical time dilation. However, using velocity boosts we find the ideal behavior in both cases, where the quantum clock and classical observer are set in motion. Without internal state-dependent forces additional effects arise. As such, we derive observed frequency shifts in ion trap atomic clocks, indicating a small additional shift, and also show the emergence of nonideal behavior in a theoretical clock model

Exciton Condensation and Perfect Coulomb Drag

Coulomb drag is a process whereby the repulsive interactions between electrons in spatially separated conductors enable a current flowing in one of the conductors to induce a voltage drop in the other. If the second conductor is part of a closed circuit, a net current will flow in that circuit. The drag current is typically much smaller than the drive current owing to the heavy screening of the Coulomb interaction. There are, however, rare situations in which strong electronic correlations exist between the two conductors. For example, bilayer two-dimensional electron systems can support an exciton condensate consisting of electrons in one layer tightly bound to holes in the other. One thus expects "perfect" drag; a transport current of electrons driven through one layer is accompanied by an equal one of holes in the other. (The electrical currents are therefore opposite in sign.) Here we demonstrate just this effect, taking care to ensure that the electron-hole pairs dominate the transport and that tunneling of charge between the layers is negligible.Comment: 12 pages, 4 figure

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Clinical aspects of sentinel node biopsy

Sentinel lymph node (SLN) biopsy requires validation by a backup axillary dissection in a defined series of cases before becoming standard practice, to establish individual and institutional success rates and the frequency of false negative results. At least 90% success in finding the SLN with no more than 5-10% false negative results is a reasonable goal for surgeons and institutions learning the technique. A combination of isotope and dye to map the SLN is probably superior to either method used alone, yet a wide variety of technical variations in the procedure have produced a striking similarity of results. Most breast cancer patients are suitable for SLN biopsy, and the large majority reported to date has had clinical stage T1-2N0 invasive breast cancers. SLN biopsy will play a growing role in patients having prophylactic mastectomy, and in those with 'high-risk' duct carcinoma in situ, microinvasive cancers, T3 disease, and neoadjuvant chemotherapy. SLN biopsy for the first time makes enhanced pathologic analysis of lymph nodes logistically feasible, at once allowing greater staging accuracy and less morbidity than standard methods. Retrospective data suggest that micrometastases identified in this way are prognostically significant, and prospective clinical trials now accruing promise a definitive answer to this issue