Early Delirium Assessment for Hospitalized Older People in Indonesia: a Systematic Review

Background: Due to the increasing risk of getting co-morbidity and frailty, older people tend to be prone to hospitalization. Hospitalization in older people brings many adverse effects. Moreover, when these elderly get delirium, the mortality and morbidity will increase. The risk of getting deterioration and worsening condition because of delirium would also increase. In fact, delirium assessment is not a high priority in taking care older people during hospitalization because the focus of care is treating the disease.Delirium screening as an early recognition of delirium in the hospitalized elderly inIndonesia remains unreported and even do not well evaluated. Therefore, delirium as a preventable problem or causing problems remains unrecognized.Purpose: This paper aims to review the current evidence of early assessment of delirium in hospitalized older people.Methods: A systematic review was conducted from four databases yielding to 4 articles which met the inclusion and exclusion criteria.Results: There are four focuses on the result, namely delirium screening tools, patient characteristics, identified early delirium assessment, and outcomes affected by early delirium assessment. Confusion Assessment Method (CAM) was used as the delirium screening tool in the hospital. Establishing the care team involving many disciplines will give a better way to improve the integrated care and collaborative care.Conclusion: Performing CAM integrated into comprehensive geriatric assessment can be the most important thing to be undertaken when looking after the hospitalized elderly

Is Contract Farming More Profitable and Efficient Than Non-Contract Farming-A Survey Study of Rice Farms In Taiwan

Trade liberalization and globalization has modernized the food retail sector in Taiwan, affecting consumers, producers and trade patterns. These changes have placed significant pressures on farmers and processors including more stringent quality control and product varieties. The government has launched a rice production-marketing contract program in 2005 to assist rice farmers and the agro-business sector to work together as partners. The minimum scale for each contract is 50 hectares of adjacent rice paddies with 50 participants including rice farmers, seedling providers, millers and marketing agents. In order to evaluate the outcome of this program, a survey is conducted in the summer of 2005 after the first (spring) crop is harvested. Information of price and value of output and major variable and fixed inputs are collected along with characteristics of the farmers and farms. The survey results show that the average revenue of a contract farm is about 11 percent higher than an average non-contract farm. The per hectare cost of production in a contract farm is about 13 percent lower and as a result the average profit margin under contract is more than 50 percent above those without contract. A swtiching regression profit frontier model is adopted to further investigate their efficiency performance. The result indicates that an average contract farms is 20 percent more efficient than an average non-contract farm in a comparable operating environment. The result also suggests that although contract farming has potential to improve the profit of smallholders, it is not a sufficient condition for such improvement.Land Economics/Use,

Proposing a Return Migration Policy: Insights from Indonesia Japan Economic Partnership Agreement (IJEPA) Nurses Study

There are few data on return migration of Indonesian nurses from Japan to Indonesia, especially in the context of bilateral agreement. Yet our study results point out that managing return migration needs a holistic approach. We discuss the motivation of ex-IJEPA nurses for coming home, their lived after return, intention to go back to Japan, and any other insights related to return migration. The analysis showed that the decision for return was due to the expiration of the contract; therefore, they were fully aware that they must return to Indonesia. In the origin country, Indonesian nurses face challenges and difficulty for finding a new job and struggle with their current status. We propose that return migration should be managed in comprehensive approach. The role of sending and receiving country is an imperative to maximize the benefit of return and minimize the negative effects. Bilateral agreement or Indonesia Japan Economic Partnership Agreement (IJEPA) may become a good starting point in developing cooperative approach to manage the return migration

Monitoring the implementation of the WHO Global Code of Practice on the international recruitment of health personnel: the case of Indonesia

Background Indonesia has become one of the international nurse migration players that has supported the Code that was endorsed by the World Health Assembly, year 2010. In reference to the Code, the Minister of Health (MoH) as designated by the national authority, issued the regulation on the management of Indonesian nurses’ migration. This study aimed to monitor the implementation of the Code on state policy changing in facilitating nurse migration. Go to: Materials and methods Qualitative and quantitative data were collected in order to understand the impact of the Code on Indonesian nurse migration. A triangulation approach was achieved through semi-structured interviews with key stakeholders, and records review of nurses’ migration in the last two years. Go to: Results The Global Code of Practice contributed to shape the migration policy at the national level. This regulation provided a shift change of migration policy, which can be conducted by a country that had an agreement with Indonesia or a country that had a law on migrant protection. Acknowledging the importance of the Code, the MoH translated the Code into Indonesian, and disseminated the material to multiple stakeholders. By the spirit of this Code, Indonesia received financial and technical cooperation and agreement with Japan on the improvement of nursing capacity. The challenge faced by the MoH was a need for strong regulation which could accommodate the relevant players to coordinate on the national level, notably for the MoH, National Board for The Placement and Protection of Indonesia Manpower, Ministry of Foreign Affairs and private recruiters. Quantitative data showed that there was a significant flow of nurse migration, especially on nurses’ movement before and after the code was adopted. Nurse migration was increased four-fold between 2010 (567 nurses) to 2012 (2512 nurses) compared to three years before the Code was adopted. Indonesia’s government should carefully assess the flow of migration as the country has suffered a shortage of nurses. Lack of HRH information system and no integrated national HRH observatory hinder the policy maker to promote a strategic approach in nurse migration. Go to: Conclusions The Code has been utilized by the Ministry of Health to manage migration. This guideline at the least provides direction that may be used where appropriate in the formulation and implementation of nurse migration. A stronger regulation which not only ties the MoH, but also other stakeholders in health migrant placement needs to be established. Further, strengthening HRH information system and research on the impact of migration on Indonesia’s health system must be conducted soon

ON THE EQUIVALENCE OF IMPORT TARIFF AND QUOTA: THE CASE OF RICE IMPORT IN TAIWAN

This paper extends the existing theory on the equivalence of import tariff and quota. If the equivalence is defined on the domestic price level (weak equivalence), then either the zero conjectural variation for domestic country or a perfectly competitive market will be sufficient to support this equivalence. If the equivalence is defined both on the same domestic price level as well as tariff rate (strong equivalence), then the conditions are that either domestic country acts as a Cournot competitor and foreign country is a price taker, or both domestic and foreign country are price takers. An empirical spatial-equilibrium trade model is constructed to simulate the impacts of import tariff and quota. Using Taiwan¡¦s rice import as an example, the empirical results show that if Taiwan switches from the quota system to tariff system, the domestic rice price as well as total social welfare can be increased given the same import volume.International Relations/Trade,

INTELLIGENT ENVIRONMENTAL SENSING WITH AN UNMANNED AERIAL SYSTEM IN A WIRELESS SENSOR NETWORK

This paper proposes a novel environmental monitoring mechanism to integrate recentlyestablished development of an Unmanned Aerial System (UAS) with WSNs for remote monitoring. The high mobility of UASs can solve the limitations associated with using WSNs in hazardous areas. In this paper, the WSN node, the Wireless Environmental Monitoring Station (WEMS), is based on ZigBee protocol for long-duration monitoring. Furthermore, to ensure the integrity of collected environmental data, an algorithm is designed in WEMS for verification. Finally, a detailed analysis of packet transmission efficiency based on ranges of flight distance is proposed to examine the effect of environmental monitoring