Penilaian Kinerja di Divisi Pelayanan Terminal untuk Mengukur Keberhasilan Organisasi di PT. Pelabuhan Indonesia I Belawan

PT Pelabuhan Indonesia I merupakan Perusahaan yang bergerak dibidang penyelenggaraan dan pengusahaan jasa kepelabuhanan bertujuan mengoptimalisasi pemanfaatan sumber daya yang dimiliki Perusahaan untuk menghasilkan barang atau jasa yang bermutu tinggi dan berdaya saing kuat maka kebutuhan akan tingkat kinerja yang tinggi dari setiap karyawan merupakan hal yang mutlak bagi PT. Pelabuhan Indonesia I. Berdasarkan hasil penilaian persentase kompetensi dan produktivitas yang telah ada, persentase realisasi yang dicapai lebih kecil dari angka target yang ditetapkan oleh Perusahaan. kesenjangan ini mengindikasikan bahwa kinerja karyawan belum maksimal dan perlu adanya penilaian kinerja lebih lanjut. Penilaian kinerja merupakan suatu evaluasi hasil kerja dari seorang karyawan secara sistematis yang berhubungan dengan jabatannya dan potensi yang dimilikinya untuk dikembangkan. Penilaian kinerja ini diharapkan dapat menjadi umpan Balik bagi karyawan tersebut tentang prestasi kerjanya selama ini dan mengembangkan kemampuannya lebih lanjut. Penilaian kinerja bertujuan untuk akan meningkatkan prestasi organisasi. Penelitian ini menggunakan kuesioner, software SPSS 17.0 dan Matlab sebagai instrumen penelitian. Hasil perhitungan menunjukkan bahwa pada level top manajemen, Manajer pelayanan terminal memiliki penilaian kinerja tertinggi dengan nilai eigen 2.1903. Pada level middle manajemen, Supervisor Pelayanan Operasi Senior memiliki penilaian kinerja tertinggi dengan nilai eigen 2.7424. Pada level lower manajemen, penilaian kinerja tertinggi adalah Pelaksana Perencanaan & Pengendalian Operasi Senior dengan nilai eigen 2.6141. Jabatan Asisten Manajer Pelayanan Operasi dan Jabatan Pelaksana Pelayanan Operasi Senior merupakan jabatan yang memiliki penilaian kinerja yang sangat rendah sehingga memerlukan evaluasi lebih lanjut. Hal ini dapat dilihat dari nilai eigen kedua jabatan yang bernilai negatif, masing-masing yaitu -0.0005 dan -0.000

Monogenic Primary Immunodeficiency Disorder Associated with Common Variable Immunodeficiency and Autoimmunity

Background: Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency disorder mainly characterized by recurrent bacterial infections besides other immunological defects including loss of or dysfunction of B cells and decreased immunoglobulin levels. In this study, our aim is to evaluate clinical, immunological, and molecular data of patients with a primary clinical diagnosis of CVID and autoimmune phenotype with a confirmed genetic diagnosis. Methods: Among 297 patients with CVID, who were registered in the Iranian Primary Immunodeficiency Registry at Children's Medical Center Hospital in Iran, 83 patients have been genetically examined and 27 patients with autoimmunity and confirmed genetic mutations were selected for analysis. Whole-exome sequencing and confirmatory Sanger sequencing methods were used for the study population. A questionnaire was retrospectively filled for all patients to evaluate demographic, laboratory, clinical, and genetic data. Results: In the 27 studied patients, 11 different genetic defects were identified, and the most common mutated gene was LRBA, reported in 17 (63.0) patients. Two patients (7.7) showed autoimmune complications as the first presentation of immunodeficiency. Eleven patients (40.7) developed one type of autoimmunity, and 16 patients (59.3) progressed to poly-autoimmunity. Most of the patients with mono-autoimmunity (n = 9, 90.0) primarily developed infectious complications, while in patients with poly-autoimmunity, the most common first presentation was enteropathy (n = 6, 37.6). In 13 patients (61.9), the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency. The most frequent autoimmune manifestations were hematologic (40.7), gastrointestinal (48.1), rheumatologic (25.9), and dermatologic (22.2) disorders. Patients with poly-autoimmunity had lower regulatory T cells than patients with mono-autoimmunity. Conclusion: In our cohort, the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency in most patients. This association highlights the fact that patients referring with autoimmune manifestations should be evaluated for humoral immunity. © 2020 Georg Thieme Verlag. All rights reserved

Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in 14 countries: study protocol

Introduction: Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8–17 years old in 14 LMICs and HICs representing all continents; and generate the ‘first available data’ on active play in most participating countries. Methods and analysis: Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC-PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC-PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot-test of the app-based GAC-PAQ; and, (8) main study with a stratified, sex-balanced and urban/rural-balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC-PAQ twice to assess 1-week test–retest reliability and wear an ActiGraph wGT3X-BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys. Ethics and dissemination: Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC-PAQ will facilitate global surveillance of PA in children/adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Consideration of Intestinal Parasite in Day-Care Center Children in Karaj City in 2012

History and Aim: Parasitical Diseases are the most important economic- health problems of most developing countries. Children who belong to very important constituents of society are at risk of such diseases. The parasitic transmission in some places with children come together has a very special importance because they interact closely to each others. Constant and regular study in developing countries for planning to control these diseases is essential. Thus, the present study aims to explore the prevalence of parasites and enterobius and effective factors in their spread among children of Karaj kindergartens in 1391. Materials and Methods: This is a descriptive study and sampling was random clustering from34 kindergartens out of 154 active kindergartens of 9 districts of Karaj city under supervision of state welfare organization of Karaj using a random number table. In this project the prevalence of enterobius and other intestinal parasites in 904 children from one to six years old in Karaj in 2o13 was studied. The number of samples was calculated using 95% confidence interval and relative accuracy of 35% and hypothetical prevalence of 5% of intestinal parasites to be 596. Considering 50% efficacy for clustering method, increased the sample size to 894. The questionnaires collecting the required data like age and gender of the child, and were used for gender, age, occupation and education of the parents and effective factors on infection with intestinal parasites like hand washing and using personal drinking glass and clinical symptoms in children and symptoms reported by the child to his/her parents or caregiver and the demographic data. The results of the scotch test, either positive or negative, were recorded. Formalin ether and direct smear test were performed on three samples of every case which collected for find determination inconsecutively. For the eneterobius diagnosis, the scotch test which is more specific was used. Results: A totally of 904 samples were collected which 460 of them (50.9%) were male and 444 (49.1%) were female. The prevalence of intestinal parasite infection with formalin ether test was 16.7% and in Scotch tape test for Enterobius vermicularis was 2.3%. The most common protozoan was Blastocystis hominis in 84 children (9.3%) and Giardia in 66 children (7.3%). Additionally, infection with Endolimax nana was reported in 3 children (0.3%) and Entamoeba histolitica was reported in 4 children (0.4%). In this study there was a significant correlation between intestinal parasite and children’s age and also the way that vegetables were washed. Conclusion: According our results, the prevalence of intestinal parasites especially Giardia and Blastocystis in kindergartens of Karaj is high. This can be due to the lack of awareness of parents and children about the modes of transmission and Untreated infected persons and carriers that serve as carriers know. Health education to children, teachers and parents and six-month trial for child care staff and cure of infected people is effective in reducing the transmission of infection. Overall, poor personal hygiene, transmission of infection from mother to children and from child to other children are effective in persistence of the disease. Therefore high education of children, caregivers and parents and effective treatment of infected people are keys to reduce the rate of infection and transmission

Effect of Clupeonella grimmi (anchovy/kilka) fish oil on dysmenorrhoea

ABSTRACT To examine whether dietary supplementation with omega-3 fatty acids from Clupeonella grimmi can relieve symptoms of dysmenorrhoea, we carried out a cross-over clinical trial on 36 girls aged 18-22 years. They were randomly allocated into 2 groups of 18. Group A received 15 mL fish oil daily (550 mg eicosapentaenoic acid; 205 mg decosahexaenoic acid) while Group B received placebo. After 3 months, the treatment regimens were swapped. The treatment groups reported a significant difference after 3 months of supplementation with fish oil (visual analogue scale score 20.9 compared with 61.8 for the placebo (P = 0.001). There was also a marked reduction in low back pain and abdominal pain (P < 0.05), and participants needed significantly fewer rescue doses of ibuprofen while using fish oil

Monogenic Primary Immunodeficiency Disorder Associated with Common Variable Immunodeficiency and Autoimmunity

BACKGROUND: Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency disorder mainly characterized by recurrent bacterial infections besides other immunological defects including loss of or dysfunction of B cells and decreased immunoglobulin levels. In this study, our aim is to evaluate clinical, immunological, and molecular data of patients with a primary clinical diagnosis of CVID and autoimmune phenotype with a confirmed genetic diagnosis. METHODS: Among 297 patients with CVID, who were registered in the Iranian Primary Immunodeficiency Registry at Children's Medical Center Hospital in Iran, 83 patients have been genetically examined and 27 patients with autoimmunity and confirmed genetic mutations were selected for analysis. Whole-exome sequencing and confirmatory Sanger sequencing methods were used for the study population. A questionnaire was retrospectively filled for all patients to evaluate demographic, laboratory, clinical, and genetic data. RESULTS: In the 27 studied patients, 11 different genetic defects were identified, and the most common mutated gene was LRBA, reported in 17 (63.0) patients. Two patients (7.7) showed autoimmune complications as the first presentation of immunodeficiency. Eleven patients (40.7) developed one type of autoimmunity, and 16 patients (59.3) progressed to poly-autoimmunity. Most of the patients with mono-autoimmunity (n = 9, 90.0) primarily developed infectious complications, while in patients with poly-autoimmunity, the most common first presentation was enteropathy (n = 6, 37.6). In 13 patients (61.9), the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency. The most frequent autoimmune manifestations were hematologic (40.7), gastrointestinal (48.1), rheumatologic (25.9), and dermatologic (22.2) disorders. Patients with poly-autoimmunity had lower regulatory T cells than patients with mono-autoimmunity. CONCLUSION: In our cohort, the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency in most patients. This association highlights the fact that patients referring with autoimmune manifestations should be evaluated for humoral immunity

Monogenic Primary Immunodeficiency Disorder Associated with Common Variable Immunodeficiency and Autoimmunity

Background: Common variable immunodeficiency (CVID) is the most frequent primary immunodeficiency disorder mainly characterized by recurrent bacterial infections besides other immunological defects including loss of or dysfunction of B cells and decreased immunoglobulin levels. In this study, our aim is to evaluate clinical, immunological, and molecular data of patients with a primary clinical diagnosis of CVID and autoimmune phenotype with a confirmed genetic diagnosis. Methods: Among 297 patients with CVID, who were registered in the Iranian Primary Immunodeficiency Registry at Children's Medical Center Hospital in Iran, 83 patients have been genetically examined and 27 patients with autoimmunity and confirmed genetic mutations were selected for analysis. Whole-exome sequencing and confirmatory Sanger sequencing methods were used for the study population. A questionnaire was retrospectively filled for all patients to evaluate demographic, laboratory, clinical, and genetic data. Results: In the 27 studied patients, 11 different genetic defects were identified, and the most common mutated gene was LRBA, reported in 17 (63.0) patients. Two patients (7.7) showed autoimmune complications as the first presentation of immunodeficiency. Eleven patients (40.7) developed one type of autoimmunity, and 16 patients (59.3) progressed to poly-autoimmunity. Most of the patients with mono-autoimmunity (n = 9, 90.0) primarily developed infectious complications, while in patients with poly-autoimmunity, the most common first presentation was enteropathy (n = 6, 37.6). In 13 patients (61.9), the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency. The most frequent autoimmune manifestations were hematologic (40.7), gastrointestinal (48.1), rheumatologic (25.9), and dermatologic (22.2) disorders. Patients with poly-autoimmunity had lower regulatory T cells than patients with mono-autoimmunity. Conclusion: In our cohort, the diagnosis of autoimmune disorders preceded the diagnosis of primary immunodeficiency in most patients. This association highlights the fact that patients referring with autoimmune manifestations should be evaluated for humoral immunity. © 2020 S. Karger AG, Basel. All rights reserved