Peranan Pelatihan Learning Organization pada Perubahan Individu dan Institusi: Pengalaman Kabupaten Cianjur

In order to support local government capacity to implement their role and capacity after the implementation of decentralization policy, The Decentralization Unit of Ministry of Health RI has developed several strategic plans which directed to anticipate decentralization transition, such as learning organization. To objective of this study is to understand the effect of training program on individual and institutional changes in a more strict bureocratic environment. This study is a quasi-experimental study with pre and post intervention study design, several times measurements, and unequally distributed control. The first group receive SLLO training (Xa) and assistance (Xb). The second group is a control group. The study result show that: (1) the LO training is efective to increase knowledge and understanding of the trainees on job perspective, problem solving, self improvement need and distribution to group member (2) The individual level changes include the need to job behavioral improvement, the openness and readiness to record behaviour, more problem analysis, more dialogue and not trapped in surface symptoms, want and need to distribute LO in seminar and training (3) the group and institutional changes has not been seen yet (4) only small effect of individual changes to group level changes, communication needs plenty of time, difficult to conduct dialogue among team members. In sub-district level situation has chenged to a better situation, more effect of individual level cahnges to group level changes, faster communication between group members and easier dialogue

Analisis Demand dan Supply Konsumsi Garam Beryodium Tingkat Rumah Tangga

Nasionaly, the consumption of iodized salt is 62,3% and in Province of West Jawa is 58,3%. The coverage consumption of iodezed in household level in Bekasi city only about 62,14%. The monitoring iodezed salt in household level by district health departemen in 2004 showed that the enough iodezed salt is 51%.This research was conducted to determine the factor analysis of demand and supply of iodized salt consumption at household level in the District of West Bekasi. This iodesed salt udy used cross sectional design. The population that was studied was 110 mothers using chi square test. On the demand factor, the result shows that there is a relationship between knowledge and the consumption of iodized salt at household level. However, there is no relationship between the revenue and the consumption of iodized salt at household level. While in the supply factor, shows that there is no relationship between availability and price in the market and the con- sumption of iodized salt at household level. To improve the coverage of iodized salt consumption at household level, it is required cooperation from various partie

Sumber Daya Manusia dan Manajemen Organisasi dalam Pelaksanaan Upaya Kesehatan Masyarakat di Dua Kecamatan di Jakarta Timur

Latar belakang: Prioritas dan fokus kebijakan kesehatan yang berkembang saat ini makin menunjukkan bahwa program public health adalah sama atau bahkan jauh lebih penting daripada tekanan pengobatan dalam meningkatkan status kesehatan penduduk. Meski pemerintah telah meminta puskesmas dan kelurahan fokus pada pengembangan dan pelaksanaan program-program public health, sedikit studi melaporkan kemampuan organisasi pemerintah yang benar-benar mengerjakan fungsi ini. Penelitian ini mengevaluasi hubungan capaian program public health dan apakah capaian itu didukung oleh ketersediaan sumber daya manusia dan kapasitas implementasi program dari organisasi pemerintah. Metode: Data berasal dari “standar pelayanan minimal” kesehatan masyarakat dan “perilaku hidup bersih dan sehat” (PHB), survei dan wawancara mendalam terhadap 46 responden dari 17 puskesmas dan 14 kelurahan di dua kecamatan - Matraman dan Jatinegara - di Jakarta Timur. Hasil: Penelitian ini menemukan bahwa indikator capaian kesehatan di daerah penelitian di kota besar seperti Jakarta adalah lebih rendah dari capaian rata-rata nasional meskipun memiliki ketersediaan sdm yang memadai. Selain itu, kapasitas administrasi dan manajemen proses implementasi di lapangan tidak seperti yang diharapkan. Simpulan: Studi ini menunjukkan paradoks antara ketersediaan sumber daya dan kapasitas yang lemah dalam kolaborasi lintas sektoral dan dalam manajemen implementasi program. Kami mendiskusikan 3 faktor penting yang harus menjadi perhatian dalam pengembangan dan implementasi upaya public health di Jakarta. Pertama, peran lintas sektoral yang jadi kewenangan dari walikota harus mendapat advokasi yang besar dari masyarakat public health. Kedua, administrator kelurahan memiliki kapasitas manajemen implementasi agar program-program dirasakan oleh penduduk setempat. Ketiga, puskesmas memiliki sdm dengan kemampuan manajerial dan bekerja sama dengan sektor lain yang bekerja fokus untuk upaya kesehatan masyarakat

IMPROVING TUBERCULOSIS RESPONSE STRATEGIES BY INVOLVING THE PRIVATE SECTOR IN THE PUBLIC-PRIVATE MIX SCHEME: A SYSTEMATIC REVIEW

Private sector involvement in national tuberculosis (TB) programs positively impacts prevention and service, but challenges remain. The World Health Organization (WHO) provides a framework to enhance public-private engagement. Our aims were to explore evidence and measure success in TB control programs. We conduct systematic literature reviews using PubMed, Embase, and ProQuest databases to find reports published in English with no time limit. PRISMA was used to filter titles and abstracts for inclusion. A search of 176 studies found that 14 fit the inclusion criteria, with 92.8% collaborating on multiple interventions for TB outcomes. Private sector support, health worker assistance, and innovative projects, such as medical associations and religious organizations, improved TB program achievement. In conclusion, the government has implemented four intervention strategies from the WHO framework to increase private sector engagement in each region. These strategies must be implemented in the local context, with a focus on medium and long-term implementation to ensure sustainable results.   

Role of the Srs2-Rad51 Interaction Domain in Crossover Control in Saccharomyces cerevisiae.

Saccharomyces cerevisiae Srs2, in addition to its well-documented antirecombination activity, has been proposed to play a role in promoting synthesis-dependent strand annealing (SDSA). Here we report the identification and characterization of an SRS2 mutant with a single amino acid substitution (srs2-F891A) that specifically affects the Srs2 pro-SDSA function. This residue is located within the Srs2-Rad51 interaction domain and embedded within a protein sequence resembling a BRC repeat motif. The srs2-F891A mutation leads to a complete loss of interaction with Rad51 as measured through yeast two-hybrid analysis and a partial loss of interaction as determined through protein pull-down assays with purified Srs2, Srs2-F891A, and Rad51 proteins. Even though previous work has shown that internal deletions of the Srs2-Rad51 interaction domain block Srs2 antirecombination activity in vitro, the Srs2-F891A mutant protein, despite its weakened interaction with Rad51, exhibits no measurable defect in antirecombination activity in vitro or in vivo Surprisingly, srs2-F891A shows a robust shift from noncrossover to crossover repair products in a plasmid-based gap repair assay, but not in an ectopic physical recombination assay. Our findings suggest that the Srs2 C-terminal Rad51 interaction domain is more complex than previously thought, containing multiple interaction sites with unique effects on Srs2 activity

Srs2 promotes synthesis-dependent strand annealing by disrupting DNA polymerase δ-extending D-loops.

Synthesis-dependent strand annealing (SDSA) is the preferred mode of homologous recombination in somatic cells leading to an obligatory non-crossover outcome, thus avoiding the potential for chromosomal rearrangements and loss of heterozygosity. Genetic analysis identified the Srs2 helicase as a prime candidate to promote SDSA. Here, we demonstrate that Srs2 disrupts D-loops in an ATP-dependent fashion and with a distinct polarity. Specifically, we partly reconstitute the SDSA pathway using Rad51, Rad54, RPA, RFC, DNA Polymerase δ with different forms of PCNA. Consistent with genetic data showing the requirement for SUMO and PCNA binding for the SDSA role of Srs2, Srs2 displays a slight but significant preference to disrupt extending D-loops over unextended D-loops when SUMOylated PCNA is present, compared to unmodified PCNA or monoubiquitinated PCNA. Our data establish a biochemical mechanism for the role of Srs2 in crossover suppression by promoting SDSA through disruption of extended D-loops

Evaluation of reactivity indexes and durability properties of slag-based eopolymer concrete incorporating corn cob ash

The method of determining the quantities of geopolymer concrete (GPC) ingredients to attain the required and specifiable characteristics is complex owing to the involvement of more variables compared with Portland cement concrete (PCC) systems. Therefore, this study evaluated the hydraulic responses and chemical resistance of GPC produced with supplementary cementitious materials (SCMs), ground granulated blast furnace slag (GGBFS) and corn cob ash (CCA) at ambient curing conditions. Corn cob was dehydroxylated at 600 �C and used as a partial replacement for GGBFS at 0, 20, 40, 60, 80, and 100%. The activators used were 12, 14 and 16 M concentration (M) of both sodium silicate (SS) and sodium hydroxide (SH). The chemical compositions of individual and mixed binders were analyzed, while the chemical moduli of each and blended binder were examined and evaluated based on the significant reactive oxides, hence resulting in the evaluation of reactivity indexes (RIs). Moreover, the compressive strength was predicted based on the RIs and mix design proportions (MDPs) of the blended concrete, while the durability properties of each concrete sample were investigated. The results indicated that the oxide compositions of GGBFS and CCA influenced the compressive strength of GPC produced. Compared with the experimental results, the predictive compressive strengths based on the RIs and the MDPs yielded a high precision with 95% ‘‘R2”. Furthermore, the incorporation of both GGBFS and CCA increased the durability of GPC produced against sulfate attacks. Ultimately, the model equations developed by this study can be beneficial in the refinement of mix designs of both GPC and conventional concrete incorporating SCMs provided the oxide compositions of the elements are obtained

HPV-related oropharyngeal cancer: a review on burden of the disease and opportunities for prevention and early detection

The incidence of oropharyngeal cancer (OPC) related to infection with human papillomavirus (HPV) is rising, making it now the most common HPV-related malignancy in the United States. These tumors present differently than traditional mucosal head and neck cancers, and those affected often lack classic risk factors such as tobacco and alcohol use. Currently, there are no approved approaches for prevention and early detection of disease, thus leading many patients to present with advanced cancers requiring intense surgical or nonsurgical therapies resulting in significant side effects and cost to the health-care system. In this review, we outline the evolving epidemiology of HPV-related OPC. We also summarize the available evidence corresponding to HPV-related OPC prevention, including efficacy and safety of the HPV vaccine in preventing oral HPV infections. Finally, we describe emerging techniques for identifying and screening those who may be at high risk for developing these tumors

Adherence in Pulmonary Tuberculosis Patients Based on King's Interacting Systems Theory

Introduction: Indonesia is one of largest contributor countries to pulmonary TB cases in the world. One of the factors that cause it is no adherence in the treatment. It is necessary to develop a model in order to improving compliance in patient. For an initial step, it is necessary to explore patient's adherence that based on King's interacting systems theory. The objective of this study was to explore the patients experience that cause them obedient the treatment based on King's interacting systems theory. Method: This research was a qualitative research with descriptive explorative approach. The samples were selected through purposive sampling method. Participants in this study were 8 patients who met the inclusion criteria. In this study, participants were pulmonary TB patients who have undergone treatment for 5-6 months. Results: There were 12 themes in patients compliance based on King's interacting systems theory; (1) true perception of pulmonary tuberculosis, (2) self-awareness, (3) optimal growth and development, (4) positive self-image, (5) a healthy environment, (6) discipline to take medication, (7) effective coping, (8) open communication with the patient's health workers and family, (9) to perform its role optimally, (10) balancing stress during illness, (11) knowing the health care bureaucracy and (12) able to take decisions. Discussion: The 12 themes describe that adherent patients have interaction systems that were personal systems, interpersonal systems and social systems