Zenuwchirurgie en “If not now, when?”

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Ungkapan tradisional yg berkaitan dengan sila-sila pancasila daerah Maluku

Buku ini berisi tentang ungkapan tradisional yg berkaitan dengan sila-sila pancasila daerah maluku yang meliputi bahasa daerah Seram dialek Ambon dan bahasa daerah Ternat

PENGARUH DUKUNGAN KELUARGA TERHADAP PEMANFAATAN PELAYANAN KESEHATAN DI PUSKESMAS KORBAFO KECAMATAN PANTAI BARU KABUPATEN ROTE NDAO.

Kesehatan adalah keadaan sempurna baik fisik, mental dan sosial, tidak hanya bebas dari penyakit dan cacat, juga dapat diukur dari produktivitas dalam arti mempunyai pekerjaan atau penghasilan secara ekonomi. Pembangunan kesehatan merupakan penyelenggaraan upaya kesehatan oleh bangsa Indonesia untuk mencapai kemampuan hidup sehat bagi setiap penduduk agar dapat mewujudkan derajad kesehatan masyarakat yang optimal sebagai salah satu unsur kesejahteraan umum dari tujuan nasional. Untuk mencapai kderajad kesehatan yang optimal, keluarga mempunyai peran yang penting untuk kesehatan anggota keluarga lainnya, yaitu dengan dukungan keluarga (dukungan instrumental, dukungan informasional, dukungan penilaian dan dukungan emosional). Penelitian ini adalah penelitian kuantitatif dengan pendekatan cross sectional pada 137 responden dengan teknik Accidental Sampling di satu puskesmas di Kecamatan Pantai Baru Kabupaten Rote Ndao pada bulan Agustus 2019. Pengumpulan data menggunakan kosiuner dukungan keluarga dan pemanfaatan pelayanan kesehatan. Analisis data menggunakan statistik non parametrik dan uji Regresi Logistik. Dari hasil penelitian menjukan ada pengaruh antara dukungan instrument dengan pemanfaatan pelayanan kesehatan dengan nilai siqnifikannya adalah 0,044, tidak ada pengaruh dukungan informasional dengan pemanfaatan pelayanan kesehatan dengan nilai siqnifikannya 0,128, tidak ada pengaruh antara dukungan penilaian denga pemanfaatan pelayanan kesehatan dengan nilai siqnifikannya adalah 0,99, tidak ada pengaruh dukungan emosional dengan pemanfaatan pelayanan kesehatan dengan nilai siqnifikannya 1,000. Hitungan statistik bermakna atau ada pengaruh antara variable dukungan instrument terhadap pemanfaatan pelayanan kesehatan. Sehingga disarankan untuk keluarga tetap memberi dukungan instrumental,informasional,penilaian,emosional agar anggota keluarga merasa selalu di perhatikan dan di cintai oleh keluarga

Perajin tradisional di daerah Propinsi Maluku

Tujuan penulisan ini adalah mendeskripsikan keberadaan berbagai perajin tradisional dan hasil kerajinannya pada berbagai kelompok masyarakat di Indonesia, khususnya di daerah Propinsi Maluku. Tujuan berikutnya adalah merigungkap ciri-ciri perajin dan kerajinan tradisional untuk menemukan kaitannya dengan pembangunan sosial, ekonomi dan budaya di Indonesia dewasa ini. Ruang lingkup perekaman tertulis ini adalah kerajinan tradisional lokal yang tersebar di daerah Propinsi Maluku dengan menggunakan bahan baku dan menghasilkan berbagai bahan yang berfungsi dalam kehid upan sehari-hari, baik bagi para perajin itu sendiri maupun untuk masyarakat umumnya. Fungsi itu dapat bersifat, baik ekonomi, sosial maupun budaya. Mengingat begitu banyaknya jenis-jenis kerajinan tradisional yang tersebar di daerah Propinsi Maluku tidak memiliki potensi pengembangan yang merata untuk memasuki khasanah perekonomian Indonesia dewasa ini, maka untuk mempertajam penulisan, maka untuk setiap jenis bahan baku tersebut hanya akan dipilih salah satu bahan saja. Pemilihan tersebut dimaksudkan agar tidak terjadi kerancuan arti dan penelaah dalam proses perekaman data dan informasi di lapangan sehingga aspek pada masing-masing jenis kerajinan tradisional dapat diungkap sesuai sasaran. Untuk setiap jenis kerajinan akan diungkap tentang pengadaan bahan dan pengolahannya sehingga menjadi barang yang berfungsi dalam kehid upan sosial, ekonomi atau budaya perajin dan keluarganya serta masyarakat pada umumnya. Aspek lain yang akan dikaji adalah organisasi kerja dan teknologi yang digunakan

Evidence that nerve surgery improves functional outcome for obstetric brachial plexus injury

The majority of children with obstetric brachial plexus injury show some degree of spontaneous recovery. This review explores the available evidence for the use surgical brachial plexus repair to improve outcome. So far, no randomized trial has been performed to evaluate the usefulness of nerve repair. The evidence level of studies comparing surgical treatment with non-surgical treatment is Level IV at best. The studies on natural history that are used for comparison with surgical series are also, unfortunately, of too low quality. Among experts, however, the general agreement is that nerve reconstruction is indicated when spontaneous recovery is absent or severely delayed at specific time points. A major obstacle in comparing or pooling obstetric brachial plexus injury patient series, either surgical or non-surgical, is the use of many different outcome measures. A requirement for multicentre studies is consensus on how to assess and report outcome, both concerning motor performance and functional evaluation.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Gripforce reduction in children with an upper neonatal brachial plexus palsy

Objective: To assess gripforce in children with a C5 and C6 neonatal brachial plexus palsy, as it may affect hand use. Applying classic innervation patterns, gripforce should not be affected, as hand function is not innervated by C5 or C6. This study compares gripforce in children with a neonatal brachial plexus palsy with that in a healthy control group, and assesses correlations with hand sensibility, bimanual use and external rotation.Methods: A total of 50 children with neonatal brachial plexus palsy (mean age 9.8 years) and 25 controls (mean age 9.6 years) were investigated. Nerve surgery had been performed in 30 children, and 20 children had been treated conservatively. Gripforce of both hands was assessed using a Jamar dynamometer. Sensibility of the hands was assessed with 2-point discrimination and Semmes-Weinstein monofilaments. External rotation was assessed using the Mallet score. Bimanual use was measured by using 1 of 3 dexterity items of the Movement Assessment Battery for Children-2. The affected side of the neonatal brachial plexus palsy group was compared with the non-dominant hand of the control group using 1-way analysis of variance (ANOVA), x(2) and Mann-Whitney tests.Results: The mean gripforce of the affected non-dominant hand of children with neonatal brachial plexus palsy was reduced compared with healthy controls (95 N and 123 N, respectively, with p = 0.001). The mean gripforce of the non-dominant hand in the control group was 92% of that of the dominant hand, while it was only 76% in the neonatal brachial plexus palsy group (p =0.04). There was no relationship between gripforce reduction and sensibility, bimanual use or shoulder external rotation.Discussion: The gripforce in neonatal brachial plexus palsy infants with a C5 and C6 lesion is lower than that of healthy controls, although classic interpretation of upper limb innervation excludes this finding. The reduction in gripforce in upper neonatal brachial plexus palsy lesions is not widely appreciated as a factor inherently compromising hand use. The reduction in gripforce should be taken into consideration in planning the type of rehabilitation and future activities.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Emoto - visualising the online response to London 2012.

In recent years we have moved from data scarcity to data abundance. As a response, a variety of methods have been adopted in art, design, business, science and government to understand and communicate meaning in data through visual form. emoto (emoto2012.org) is one such project, it visualised the online audience response to a major global event, the London 2012 Olympic and Paralympic Games. emoto set out to both give expression to and augment online social phenomena, that are emergent and only recently made possible by access to huge real-time data streams. This report charts the development and release of the project, and positions it in relation to current debates on data and visualisation, for example, around the bias and accessibility of the data, and how knowledge practices are changing in an era of so-called 'big data.

Reestablishment of the smile after hypoglossal-facial nerve transfer: what can we learn

Objective The aim of this study was to assess the ability to smile following a hypoglossal-facial nerve transfer (N12-N7).Design This is a retrospective chart review.Setting National tertiary referral center for skull base pathology.Participants Seventeen patients.Main Outcome Measures The ability to smile following an N12-N7 transfer was assessed by five medical doctors on photographs of the whole face and frontal, orbital, and oral segments. The (segmented) photographs were scored for the symmetry, asymmetry, and correct or incorrect assessment of the affected side.Results Seventeen patients were analyzed by 5 assessors providing 85 assessments. The whole face at rest was judged symmetrical in 26% of the cases and mildly asymmetrical in 56%. Frontal, orbital, and oral segments were symmetrical in 63, 20, and 35%, respectively. The affected side was correctly identified in 76%. When smiling, the whole face was symmetrical in 6% and mildly asymmetric in 59%. The affected side was correctly identified in 94%. The frontal, orbital, and oral segments during smiling were symmetrical in 67, 15, and 6%, respectively. The affected side of the frontal, orbital, and buccal facial segments during smiling was correctly identified in 89, 89, and 96%, respectively. Interobserver variability with Fleiss' kappa analysis showed that the strength of the agreement during smile of the total face was good (0.771)Conclusions Following an N12-N7 transfer, a good facial symmetry at rest can be achieved. During smiling, almost all patients showed asymmetry of the face, which was predominantly determined by the orbital and oral segments. To improve the ability to smile after an N12-N7 transfer, additional procedures are needed.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie

Brain plasticity in neonatal brachial plexus palsies: quantification and comparison with adults' brachial plexus injuries

PurposeTo compare two populations of brachial plexus palsies, one neonatal (NBPP) and the other traumatic (NNBPP) who underwent different nerve transfers, using the plasticity grading scale (PGS) for detecting differences in brain plasticity between both groups.MethodsTo be included, all patients had to have undergone a nerve transfer as the unique procedure to recover one lost function. The primary outcome was the PGS score. We also assessed patient compliance to rehabilitation using the rehabilitation quality scale (RQS). Statistical analysis of all variables was performed. A p & LE; 0.050 set as criterion for statistical significance.ResultsA total of 153 NNBPP patients and 35 NBPP babies (with 38 nerve transfers) met the inclusion criteria. The mean age at surgery of the NBPP group was 9 months (SD 5.42, range 4 to 23 months). The mean age of NNBPP patients was 22 years (SD 12 years, range 3 to 69). They were operated around sixth months after the trauma. All transfers performed in NBPP patients had a maximum PGS score of 4. This was not the case for the NNBPP population that reached a PGS score of 4 in approximately 20% of the cases. This difference was statistically significant (p < 0.001). The RQS was not significantly different between groups.ConclusionWe found that babies with NBPP have a significantly greater capacity for plastic rewiring than adults with NNBPP. The brain in the very young patient can process the changes induced by the peripheral nerve transfer better than in adults.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie