Evaluation of Benzene Exposure and S-PMA as a Biomarker of Exposure to Workers in the Informal Footwear Industry

Benzene (C6H6) is one of the most widely used chemical compounds in the world. Although its use has been limited, humans may be exposed to benzene in the natural and  industrial  environments.  Small-scale  footwear  industry  still  uses  adhesives containing  benzene.  The  benzene  profile  has  been  well-documented,  and  it  has been  classified  as  a  carcinogen  compound.  The  purpose  of  this  study  is  to  assess the  risk  of  benzene  exposure  in  the  work  environment  and  individual  exposure  in footwear factory in Ciomas, Bogor, West Java, during August–September 2017. Urine test  with  S-Phenylmercapturic  Acid  biomarker  was  performed  on  40  workers  and measurements  performed  simultaneously  at  9  air  sample  points  from  3  workshop locations  in  accordance  with  NIOSH  1501  method,  risk-level  assessment  through calculation Risk Quotient (RQ) and Excess Cancer Risk (ECR). The S-PMA subject has not exceeded the exposure limit (>25 μg/g) as Biological Exposure Indices (BEIs) with a  median  value  of  0.190  mg/g  (min  0.019–max  17.61).  The  results  of  the  air  sample analysis showed 8 sampling points below the TLV (Threshold limit values) of 0.5 ppm (1.6 μg/m3) and 1 point of air sampling has exceeded 0.5 ppm (1.6 μg/m3) of 2, 1074 ppm. the result of calculation of minimum cancer risk, it has been obtained that 13 workers  (32.5%)  have  cancer  risk  that  has  exceeded  the  reference  value  (ECR>1  ⋅10−4)  and  27  (67.5%) have ECR  <  1•10−4.  In  the  calculation of real-time  non-cancer risk, it has been obtained that 8 (20%) workers have had non-cancer risk (RQ>1) and 32 (80%) have RQ<1. The concentration of air and S-PMA of workers is still below the TLV, but considering the risk of cancer and non-cancer workers who have exceeded the reference value, it is necessary to improve the working conditions. Keywords: benzene, S-PMA, risk assessmen

Intervention Model Using a Game to Improve Knowledge and Attitudes of Mothers in Reproductive Age of Reproductive Health in Pernantin Village of Juhar, Karo District, Indonesia

The high rate of maternal mortality is one indicator of national welfare in Indonesia. One contributing factor toward this problem is mothers’ lack of knowledge of reproductive health resulting from their lack of education. The use of a snakes and ladders game could be one way of improving mothers’ knowledge. This game waspreviously implemented along with the distribution of an informational leaflet in the fishing community of Bagan Deli Village. The aim of this study was to examine the effect of this game intervention on the knowledge and attitudes of respondents in Pernantin village. This quasi-experimental study included a pre-test, an intervention, and a post-test. Respondents, consisting of 48 mothers of reproductive age (20–45 years old), were divided into two groups: the control group and the intervention group. According to a t-test, the intervention group, consisting of 24 respondents, showed an improvement in their knowledge (p<0.05), while no difference was found in their attitudes (p>0.05). This result proved that the snakes and ladders game and leaflets were effective as an intervention to improve the health knowledge of mothers in reproductive age. Based on these results, it is important to provide information on reproductive health to mothers of reproductive age in such villages or elsewhere. It is also important to develop other ways of creatively imparting knowledge that are easily understood by mothers. Keywords: knowledge and attitude, mothers of reproductive age, interventio

Kepuasan Pasien Pengguna Kartu Jakarta Sehat di Unit Rawat Jalan Rumah Sakit

Peluncuran Kartu Jakarta Sehat (KJS) pada bulan November 2012 mengakibatkan jumlah kunjungan pasien yang melonjak drastis di fasilitas kesehatan, khususnya rumah sakit, baik itu rumah sakit pemerintah pusat, rumah sakit pemerintahdaerah maupun rumah sakit swasta yang berkomitmen dengan Pemerintah Daerah Jakarta. KJS memberikan kemudahan akses layanan kesehatan agar pasien dapat berobat secara gratis. Namun persoalan yang muncul kemudian adalah pasien harus mengantre lama di loket pendaftaran, ruang pemeriksaan, maupun ruang pengambilan obat. Penelitian ini bertujuan untuk mengetahui hubungan faktor sosial budaya, pribadi, dan psikologis dengan kepuasan pasien pengguna KJS pada 110 responden di Unit Rawat Jalan RSU UKI, dan telah dilaksanakan pada bulan Maret 2013. Rancangan penelitian yang digunakan adalah deskriptif kuantitatif dengan pendekatan potong lintang. Hasil penelitian menunjukkan kepuasan pasien KJS sebesar 40,9%. Akses ke rumah sakit, motivasi, informasi baik dan informasi tidak baik berhubungan signifikan dengan kepuasan pasien KJS, tetapi motivasi adalah hal yang paling dominan berhubungan. Selain itu, kepuasan pasien KJS juga berhubungan bermakna dengan pemanfaatan kembali layanan dan minat merekomendasikan layanan pada orang lain.Jakarta Health Card (JHC) was launched on November 2012, followed by sudden increase number of patient in any hospital accordingly. Jakarta Health Card ease the patient to afford health care without payment. We conducted study on the relation among socio-culture, demographic characteristics, and psychology factors toward patient satisfaction in using JHC. The study subjects were 110 outpatient of UKI Hospital, with study design descriptive quantitative with cross sectional approach. The result showed 40,9% of the patients were satisfied with the hospital service. Factors such as hospital access, motivation, good information and bad information were associated with patient satisfaction significantly, and motivation was the dominant factor. Besides, patient satisfaction also has significant correlation with revisiting/ reusing and recommendation of the hospital to other patients

Effect of Lean Hospital on Waiting Time at Outpatient Unit in Indonesia

Background: Prolonged waiting time in hospitals especially in outpatient unit resulted in dissatisfaction among patients. In order to improve the efficiency, quality of healthcare, and patients‘ satisfaction, lean has been introduced widely as a quality improvement method at hospitals. It may improve patient flow to reduce the waiting time at the outpatient unit. This study aimed to review systematically the effect of lean hospital on waiting time at outpatient unit in Indonesia. Subjects and Method: This was systematic review conducted by searching published articles from EBSCO, Science Direct, Google Scholar, and Willey Online Library. The key words were “waiting time”, “waiting time improvement”, “outpatient unit”, and “lean hospital”. The articles collected were using qualitative data. Initially 17,514 articles obtained. During screening 200 were excluded. After review process 4 articles were finally retained in this review. Results: In outpatient unit, non-value added activity was higher (>70%) than value added activities (<50%). Analysis of Cycle Time and Takt Time at outpatient unit showed that there were more work requests than it can process (Bottleneck). It causes interruption to the flow of work and delays the services. Waiting time was varying in all sectors including: (1) Registration (30.9 minutes); (2) Waiting for doctor (25.2 minutes); and (3) Submission of medical records (8.8 minutes). Implementation of lean hospital with eliminate non-value added and continuous improvement with Plan– Do–Check–Action (PDCA) cycle were efforts to reduce waiting time at outpatient unit in hospital Conclusion: Lean hospital and continuous improvement at all levels are efforts to reduce waiting time at outpatient unit in hospital. Keywords: waiting time, outpatient unit, Lean hospital

Intervention Model Using A Game to Improve Knowledge and Attitudes of Mothers in Reproductive Age of Reproductive Health in Pernantin Village of Juhar, Karo District, Indonesia

The high rate of maternal mortality is one indicator of national welfare in Indonesia. One contributing factor toward this problem is mothers' lack of knowledge of reproductive health resulting from their lack of education. The use of a snakes and ladders game could be one way of improving mothers' knowledge. This game waspreviously implemented along with the distribution of an informational leaflet in the fishing community of Bagan Deli Village. The aim of this study was to examine the effect of this game intervention on the knowledge and attitudes of respondents in Pernantin village. This quasi-experimental study included a pre-test, an intervention, and a post-test. Respondents, consisting of 48 mothers of reproductive age (20–45 years old), were divided into two groups: the control group and the intervention group. According to a t-test, the intervention group, consisting of 24 respondents, showed an improvement in their knowledge (p&lt;0.05), while no difference was found in their attitudes (p&gt;0.05). This result proved that the snakes and ladders game and leaflets were effective as an intervention to improve the health knowledge of mothers in reproductive age. Based on these results, it is important to provide information on reproductive health to mothers of reproductive age in such villages or elsewhere. It is also important to develop other ways of creatively imparting knowledge that are easily understood by mothers. Keywords: knowledge and attitude, mothers of reproductive age, interventio