Hubungan Pelayanan Keperawatan Dengan Kepuasan Pasien Bpjs Rawat Inap Di Ruang Hana RSU Pancaran Kasih Gmim Manado

: Nursing service and the satisfaction of the patients are the two things that closely related and can\u27t be separated from each other because the method that being delivered by the nurses would directly impact the patients. The General Hospital Center (RSU) Pancaran Kasih GMIM Manado is a hospital that also giving a service for some people that has the BPJS Card, so that the evaluation about the nursing service and the satisfaction of the inpatients are need to be done. Purpose of the Research To find the correlation between the nursing service and the satisfaction of the BPJS inpatients in Hana room at The General Hospital Center (RSU) Pancaran Kasih GMIM Manado. Research Method that has been used in this research is descriptive analytic, the research design is by using cross sectional study. This research has been made in the Hana inpatients room on December 2016 at the The General Hospital Center (RSU) Pancaran Kasih GMIM Manado with the 84 number of sample Sampling Technique is by using simple random sampling method Research instrument, is by using Questionnaire. Data analysis is by using Chi-square statistic test with the level of significance (α) = 0,05 with the outcome Chi-square Count 47,296 with P-value 0,000. Conclusion there is a correlation between the nursing service and the satisfaction of the BPJS inpatients in Hana room at The General Hospital Center (RSU) Pancaran Kasih GMIM Manado

Influence of Age on Perception of Midwives and Their Performance in Objective Structured Clincial Examination (Osce) in Nigeria

Objective structured clinical examination (OSCE) is a means of assessing clinical competence based on objective testing through direct observation. OSCE, as a method of evaluation, was introduced in 1990 by the Nursing & Midwifery council of Nigeria (N&MCN). The aim of this quantitative study is to ascertain if age has any influence on midwives’ perception of OSCE and their performance in the examination. Ex-post facto design was adopted for this study. That is because the independent variable was studied in retrospect in order to establish possible relationship with the dependent variables. We were concerned with ascertaining and establishing the status quo and facts at the time of the research and used such facts to analyze data, interpret and extrapolate and also draw inferences. Eight institutions of midwifery education in Akwa Ibom and Cross River states of Nigeria were used for this study. 502 out of 532 midwives who graduated from the institutions between 2004 to 2006 participated in the study. Two validated instruments were used for data collection namely: OSCE stake holder’s questionnaire and achievement test on OSCE. The reliability index for perception stood at (r) 0.60 while the index performance stood at (r) 0.66.Data were analyzed using linear regression analysis and one way analysis of variance. Findings show that older midwives had significant higher perception of OSCE than the younger midwives. Conclusion: age has significant influence on midwives’ perception of OSCE but perception has no influence on their performance in OSCE

Assessing regional scale predictions of aerosols, marine stratocumulus, and their interactions during VOCALS-REx using WRF-Chem

This study assesses the ability of the recent chemistry version (v3.3) of the Weather Research and Forecasting (WRF-Chem) model to simulate boundary layer structure, aerosols, stratocumulus clouds, and energy fluxes over the Southeast Pacific Ocean. Measurements from the VAMOS Ocean-Cloud-Atmosphere-Land Study Regional Experiment (VOCALS-REx) and satellite retrievals (i.e., products from the MODerate resolution Imaging Spectroradiometer (MODIS), Clouds and Earth's Radiant Energy System (CERES), and GOES-10) are used for this assessment. The Morrison double-moment microphysics scheme is newly coupled with interactive aerosols in the model. The 31-day (15 October–16 November 2008) WRF-Chem simulation with aerosol-cloud interactions (AERO hereafter) is also compared to a simulation (MET hereafter) with fixed cloud droplet number concentrations in the microphysics scheme and simplified cloud and aerosol treatments in the radiation scheme. The well-simulated aerosol quantities (aerosol number, mass composition and optical properties), and the inclusion of full aerosol-cloud couplings lead to significant improvements in many features of the simulated stratocumulus clouds: cloud optical properties and microphysical properties such as cloud top effective radius, cloud water path, and cloud optical thickness. In addition to accounting for the aerosol direct and semi-direct effects, these improvements feed back to the simulation of boundary-layer characteristics and energy budgets. Particularly, inclusion of interactive aerosols in AERO strengthens the temperature and humidity gradients within the capping inversion layer and lowers the marine boundary layer (MBL) depth by 130 m from that of the MET simulation. These differences are associated with weaker entrainment and stronger mean subsidence at the top of the MBL in AERO. Mean top-of-atmosphere outgoing shortwave fluxes, surface latent heat, and surface downwelling longwave fluxes are in better agreement with observations in AERO, compared to the MET simulation. Nevertheless, biases in some of the simulated meteorological quantities (e.g., MBL temperature and humidity) and aerosol quantities (e.g., underestimations of accumulation mode aerosol number) might affect simulated stratocumulus and energy fluxes over the Southeastern Pacific, and require further investigation. The well-simulated timing and outflow patterns of polluted and clean episodes demonstrate the model's ability to capture daily/synoptic scale variations of aerosol and cloud properties, and suggest that the model is suitable for studying atmospheric processes associated with pollution outflow over the ocean. The overall performance of the regional model in simulating mesoscale clouds and boundary layer properties is encouraging and suggests that reproducing gradients of aerosol and cloud droplet concentrations and coupling cloud-aerosol-radiation processes are important when simulating marine stratocumulus over the Southeast Pacific

An AeroCom initial assessment – optical properties in aerosol component modules of global models

The AeroCom exercise diagnoses multi-component aerosol modules in global modeling. In an initial assessment simulated global distributions for mass and mid-visible aerosol optical thickness (aot) were compared among 20 different modules. Model diversity was also explored in the context of previous comparisons. For the component combined aot general agreement has improved for the annual global mean. At 0.11 to 0.14, simulated aot values are at the lower end of global averages suggested by remote sensing from ground (AERONET ca. 0.135) and space (satellite composite ca. 0.15). More detailed comparisons, however, reveal that larger differences in regional distribution and significant differences in compositional mixture remain. Of particular concern are large model diversities for contributions by dust and carbonaceous aerosol, because they lead to significant uncertainty in aerosol absorption (aab). Since aot and aab, both, influence the aerosol impact on the radiative energy-balance, the aerosol (direct) forcing uncertainty in modeling is larger than differences in aot might suggest. New diagnostic approaches are proposed to trace model differences in terms of aerosol processing and transport: These include the prescription of common input (e.g. amount, size and injection of aerosol component emissions) and the use of observational capabilities from ground (e.g. measurements networks) or space (e.g. correlations between aerosol and clouds)

Analysis and quantification of the diversities of aerosol life cycles within AeroCom

Simulation results of global aerosol models have been assembled in the framework of the AeroCom intercomparison exercise. In this paper, we analyze the life cycles of dust, sea salt, sulfate, black carbon and particulate organic matter as simulated by sixteen global aerosol models. The diversities among the models for the sources and sinks, burdens, particle sizes, water uptakes, and spatial dispersals have been established. These diversities have large consequences for the calculated radiative forcing and the aerosol concentrations at the surface. The AeroCom all-models-average emissions are dominated by the mass of sea salt (SS), followed by dust (DU), sulfate (SO_4), particulate organic matter (POM), and finally black carbon (BC). Interactive parameterizations of the emissions and contrasting particles sizes of SS and DU lead generally to higher diversities of these species, and for total aerosol. The lower diversity of the emissions of the fine aerosols, BC, POM, and SO_4, is due to the use of similar emission inventories, and does therefore not necessarily indicate a better understanding of their sources. The diversity of SO_4-sources is mainly caused by the disagreement on depositional loss of precursor gases and on chemical production. The diversities of the emissions are passed on to the burdens, but the latter are also strongly affected by the model-specific treatments of transport and aerosol processes. The burdens of dry masses decrease from largest to smallest: DU, SS, SO_4, POM, and BC. The all-models-average residence time is shortest for SS with about half a day, followed by S_O4 and DU with four days, and POM and BC with six and seven days, respectively. The wet deposition rate is controlled by the solubility and increases from DU, BC, POM to SO_4 and SS. It is the dominant sink for SO_4, BC, and POM, and contributes about one third to the total removal rate coefficients of SS and DU species. For SS and DU we find high diversities for the removal rate coefficients and deposition pathways. Models do neither agree on the split between wet and dry deposition, nor on that between sedimentation and turbulent dry Deposition. We diagnose an extremely high diversity for the uptake of ambient water vapor that influences the particle size and thus the sink rate coefficients. Furthermore, we find little agreement among the model results for the partitioning of wet removal into scavenging by convective and stratiform rain. Large differences exist for aerosol dispersal both in the vertical and in the horizontal direction. In some models, a minimum of total aerosol concentration is simulated at the surface. Aerosol dispersal is most pronounced for SO4 and BC and lowest for SS. Diversities are higher for meridional than for vertical dispersal, they are similar for a given species and highest for SS and DU. For these two components we do not find a correlation between vertical and meridional aerosol dispersal. In addition the degree of dispersals of SS and DU is not related to their residence times. SO_4, BC, and POM, however, show increased meridional dispersal in models with larger vertical dispersal, and dispersal is larger for longer simulated residence times

Non-work-related services at the workplace : an exploratory study

In an era of diminishing public funds, the profession of social work is looking more and more toward the private sector as an arena for social work practice. Social work has had a long-standing interest in the impact of work and the workplace on the individual. This study was developed in response to the lack of documentation of non-work-related services in Oregon\u27s businesses and industries. The research team set out to discover what non-work-related services are available to employees at or through the workplace in the TriCounty area (Multnomah, Clackamas, and Washington Counties) of Oregon. This study was exploratory, similar to one done by Hans Spiegel and colleagues in 1974, through Hunter College in New York City

Addressing inequities in maternal health among women living in communities of social disadvantage and ethnic diversity.

The response to the coronavirus outbreak and how the disease and its societal consequences pose risks to already vulnerable groups such those who are socioeconomically disadvantaged and ethnic minority groups. Researchers and community groups analysed how the COVID-19 crisis has exacerbated persisting vulnerabilities, socio-economic and structural disadvantage and discrimination faced by many communities of social disadvantage and ethnic diversity, and discussed future strategies on how best to engage and involve local groups in research to improve outcomes for childbearing women experiencing mental illness and those living in areas of social disadvantage and ethnic diversity. Discussions centred around: access, engagement and quality of care; racism, discrimination and trust; the need for engagement with community stakeholders; and the impact of wider social and economic inequalities. Addressing biomedical factors alone is not sufficient, and integrative and holistic long-term public health strategies that address societal and structural racism and overall disadvantage in society are urgently needed to improve health disparities and can only be implemented in partnership with local communities