Analisis Biaya Jaminan Kesehatan Masyarakat Dan Asuransi Kesehatan Pada Pasien Stroke Non-hemoragik Di Rumah Sakit Umum Daerah Kabupaten Sleman

Background: Non-hemorrhagic stroke causes many deaths.Its treatment requires long-term care, resulting in very highcost. Controlinging costs and quality are very important in maintainingsustainability, however, in reality there are cost sharingby patients and hospitals outside the insurance coverage.Aim: This study aims to identify the difference in cost thatmust be shared to the patient and the hospital for inpatientnon-hemorrhagic stroke of the Jamkesmas and Askes patientsin Sleman Hospital.Method: This study used a cross ssectional design. Datawere retrieved retrospectively with a primary diagnosis ofnon-hemorrhagic stroke hospitalizations for patients admittedto the hospital during the period of January 2011 to May 2012.Data were analyzed using univariate, bivariate correlation,and multivariate.Result: The average cost of inpatient care non-hemorrhagicstroke Jamkesmas patients was Rp3.541.021,00 +Rp2.609.488,00 and for Askes patients Rp4.678.509,00 +3.257.816,00. The average cost sharing in Askes patients isRp.1.851.536,00 + 1.968.757,00 and Jamkesmas isRp405.976,00 +Rp2.303.903,00. Percentage the greatest costcomponent in Askes patients is drugs (47%) and accomodation(44%), while in Jamkesmas is drug (52%) and accommodation(36%). Components of the cost sharing in Askes patients wasdrug (87%). The difference in the cost of hospital rates wasgreater than INA-CBGs respectively Rp3.541.021,00 +Rp2.609.488,00 and Rp3.135.045,00 + Rp727.710,00.Conclusion: The proportion of costs covered by the insuranceand shared by patient/hospital is 87:13 for Jamkesmaspatient, 55:45 for Askes patients (January 2011-May 2011),and 59:41 for the Askes patients (June 2011-May 2012). Theproportion of cost sharing of inpatient care non-hemorrhagicstroke by Askes patients outside the program is greater thanthe proportion of costs sharing by the hospital on Jamkesmasprogram

Pengaruh Istirahat terhadap Aktivitas Kolinesterase Petani Penyemprot Pestisida Organofosfat di Kecamatan Pacet, Jawa Barat

PENGARUH ISTIRAHAT TERHADAP AKTIVITAS KOLINESTERASE PETANI PENYEMPROT PESTISIDA ORGANOFOSFAT DI KECAMATAN PACET, JAWA BARA

Leadership and Communication Effectiveness on Patient Safety Teamwork Ibnu Sina Islamic Hospital Pekanbaru Riau

Patient safety is a priority in hospitals services. Implementation of patient safety are expected to minimize the risk of adverse event. Committee of Patient Safety in Hospitals invite all stakeholders to be more attention on patient safety issues. However, in the process, teamwork seems not effective. Leadership is one of the characteristics that an teamwork should have. Various patient safety studies have been done and the result is communication also affects the efficiency of teamwork. This study was aimed to evaluate leadership and communication effectiveness  of patient safety teamwork in Ibnu Sina Islamic Hospital, Pekanbaru, Riau. This study  used a mixed method exploratory sequential design. In-depth interview and observation were used to explore  perception and behavior that describe leadership and communication effectiveness on patient safety teamwork. A Survey using questionnaires were used to categorize  perception of both aspects into YAKKUM competency level. Data were analyzed qualitatively using open code 3.6 and quantitatively through frequency distribution. All member of patient safety team participated in the study. The results of study, Of the 42 cases reported incidents, there were 45.22% medication error cases, in which 2.38% result in death and 50% were not analyzed. There were no reports of internal and external work done by  team. The effectiveness of leadership and communication still at level 2nd and 3rd. The Conclusion of the research was leadership and communication effectiveness on this team is not optimal and predominantly used passive leadership. Round of Patient Safety (RPS), The SBAR Tools, reward and punishment are recommended in this study.&nbsp

Evaluasi Penggunaan Antibiotika Profilaksis Dari Aspek Ketepatan Jenis, Waktu Dan Durasi Pemberian Pada Pasien Instalasi Bedah Sentral Sebuah Rumah Sakit Swasta Di YOGYAKARTA

Surgical site infection is one of surgical infection that frequently happened in hospital sothat the use of antibiotic prophylaxis must be safe. The research was conducted to know incidenceof adverse event at USAge of antibiotic prophylaxis in surgery installation. We use concordancesheet of antibiotic prophylaxis either from accuracy aspect of the drug type, administration time,duration of USAge. Result analysis in the form of calculation relative risk of USAge of antibioticdissected pre prophylaxis to risk the happening of surgical site infections cases. Result thisresearch show that relative risk value of USAge of antibiotic to case of infection of operation hurtevaluated from inaccurate of type antibiotic 1,12 ( CI 95 %: 0,138-9,1), inaccurate aspect of gift time5,8 ( CI 95 % : 1,024 - 32,86) and from inaccurate aspect of duration of gift 3,21 ( CI 95 % : 1,043 -9,9)

Spectroscopic analysis and cytotoxic activity of quas-sinoid isolated from the seeds of Brucea javanica on Hela cell = Spektroskopik dan aktivitas sitotoksik kuasinoid hasil isolasi dari biji buah Brucea javanica ...

The quassinoids from Brucea javanica exhibit biological activities as antimalarial, antitumor, antiviral and antiamoebic activities. These quassinoids having a promising antitumor activity.This research was aimed to isolated quassinoid (bruceine A, MW 522 g/mol) compound from B. javanica and to investigate the cytotoxicity of brucetne A under invitro conditions in Hela cells. The cytotoxicity assays using MTT assay. The bruceine showed a good cytotoxic activity in Hela cells at 24 hours with doxorubicine as a positive control. Structural elucidation of bruceine is done by using UV and Ff-IR spectra, NMR spectra recorded on Tesla av600, (400 MHz) lHNMR in pyridine (Os), some in Gyro (300 MHz) lHNMR in acetone-(d6), OMSO-(d6) and CdCI3 ,13CNMR,75 MHz, mass spectra on biospectrometry LC-MS. Analytical HPLC retention time,tR was 4.617 minutes (Met/H20) 60:40. Its Molecular formula was determined to be ( C26H34011) by the [M+H]+ ion peak at m/z 523 and m/z 1045 confirmed by High Resolution mass spectra Orbitrap (HRESIMS). From the results demonstrated that could be bruceine A compound refers to our spectral data. Its has activity in ICso value 191,5 ~M on Hela Cells under invitro conditions

Hubungan Faktor Komorbiditas, Intensifikasi Terapi, dan Pengendalian Tekanan Darah

Background: Therapy intensification (TI) is the most important factor in blood pressure control among the adherent patients. The TI is the physician prescription behavior to add the item(s) and/or the dosage of hypertensive medicine when the patients\u27 BP was ≥10mmHg above the target. Comorbid patients have 10mmHg lower BP target. Aims: to evaluate the effect of comorbidity on TI score and blood pressure control; and to correlate the variables of TI and BP control. Method: retrospective cohort study done in 4 hospitals in Yogyakarta for 5 months. The subjects of age >18 years, hypertensive out-patient covered with Askes insurance, and ≥1 visit with uncontrolled BP were included. Hemodialysis subjects were excluded. Subjects were grouped into with/without comorbid. The BP profile was analyzed with T-test, repeatedmeasurement Anova, and odds ratio. Results: subjects consisted of without (WO) (n=268) vs. with comorbid (W) (n=401) patients. Comorbid subjects had older age, more male proportion and more visits (p<0.05). The profiles of final SBP/DBP in WO vs. W subjects were as follow: 148.9/89.1 (WO) vs. 143.8/86.1mmHg (W) (p<0.05); TI score (-) 0.36±0.26 (WO) vs. (-)0.38±0.24 (W) (p>0.05); the final SBP: worse BP control 20.9 (WO) vs.16.2% (W), not controlled in all visits 38.1 vs. 45.9%, improved 17.5 vs. 23.9%, and good controlled in all visit 23.5 vs.13.2%; proportion of subjects reached BP target 40.7% (WO) vs. 37.4% (W) (p>0.05); the different of final minus target SBP: (-)9.0±18.5 vs. (-)13.9±17.4mmHg (p<0.05); correlation between TI and variables of SBP (p<0.05) with the coefficient (r) at 0.4-0.6 (medium). Conclusion: comorbidity had no effect on TI score; but subjects with comorbid had worse BP control (p<0.05); TI score correlated in medium level with SBP

Hubungan Faktor Komorbiditas, Intensifikasi Terapi, dan Pengendalian Tekanan Darah

Background: Therapy intensification (TI) is the most important factor in blood pressure control among the adherent patients. The TI is the physician prescription behavior to add the item(s) and/or the dosage of hypertensive medicine when the patients\u27 BP was ≥10mmHg above the target. Comorbid patients have 10mmHg lower BP target. Aims: to evaluate the effect of comorbidity on TI score and blood pressure control; and to correlate the variables of TI and BP control. Method: retrospective cohort study done in 4 hospitals in Yogyakarta for 5 months. The subjects of age >18 years, hypertensive out-patient covered with Askes insurance, and ≥1 visit with uncontrolled BP were included. Hemodialysis subjects were excluded. Subjects were grouped into with/without comorbid. The BP profile was analyzed with T-test, repeatedmeasurement Anova, and odds ratio. Results: subjects consisted of without (WO) (n=268) vs. with comorbid (W) (n=401) patients. Comorbid subjects had older age, more male proportion and more visits (p<0.05). The profiles of final SBP/DBP in WO vs. W subjects were as follow: 148.9/89.1 (WO) vs. 143.8/86.1mmHg (W) (p<0.05); TI score (-) 0.36±0.26 (WO) vs. (-)0.38±0.24 (W) (p>0.05); the final SBP: worse BP control 20.9 (WO) vs.16.2% (W), not controlled in all visits 38.1 vs. 45.9%, improved 17.5 vs. 23.9%, and good controlled in all visit 23.5 vs.13.2%; proportion of subjects reached BP target 40.7% (WO) vs. 37.4% (W) (p>0.05); the different of final minus target SBP: (-)9.0±18.5 vs. (-)13.9±17.4mmHg (p<0.05); correlation between TI and variables of SBP (p<0.05) with the coefficient (r) at 0.4-0.6 (medium). Conclusion: comorbidity had no effect on TI score; but subjects with comorbid had worse BP control (p<0.05); TI score correlated in medium level with SBP

Antibiotic Resistomes and Microbiomes in the Surface Water along the Code River in Indonesia Reflect Drainage Basin Anthropogenic Activities

Water and sanitation are important factors in the emergence of antimicrobial resistance in low-and middle-income countries. Drug residues, metals, and various wastes foster the spread of antibiotic resistance genes (ARGs) with the help of mobile genetic elements (MGEs), and therefore, rivers receiving contaminants and enfluents from multiple sources are of special interest. We followed both the microbiome and resistome of the Code River in Indonesia from its pristine origin at the Merapi volcano through rural and then city areas to the coast of the Indian Ocean. We used a SmartChip quantitative PCR with 382 primer pairs for profiling the resistome and MGEs and 16S rRNA gene amplicon sequencing to analyze the bacterial communities. The community structure explained the resistome composition in rural areas, while the city sampling sites had lower bacterial diversity and more ARGs, which correlated with MGEs, suggesting increased mobility potential in response to pressures from human activities. Importantly, the vast majority of ARGs and MGEs were no longer detectable in marine waters at the ocean entrance. Our work provides information on the impact of different influents on river health as well as sheds light on how land use contributes to the river resistome and microbiome.Peer reviewe