Mutu Pelayanan Kesehatan Puskesmas Pasir Panjang Pasca Akreditasi

In order to maintain the quality of health services at the health center running maximally, it is necessary to improve performance and sustainable improvement. The Pasir Panjang Health Center has obtained the "Utama" accreditation status in 2018. After the Health Center is accredited, it is hoped that the quality of health services will improve. The purpose of this study was to determine the quality of health services at the Pasir Panjang Health Center after accreditation is implemented. This study used a quantitative method with a cross sectional survey design. The research sample consisted of 34 respondents who were selected by purposive sampling technique. The results of the study found that after accreditation, the quality of health services at Pasir Panjang Health Center obtained the following results: the dimensions of technical competence 83,29%, effectiveness, 82,64%, continuity 82,54%, security 82,64%, information 82,50%, accuracy time 78,23%, and human relations 82,11%. Seeing the results of this study, the Pasir Panjang Health Center must implement a sustainable quality management system to maintain the good quality of its services, including regulating the disciplinary behavior of health care workers, given that the dimension of timeliness received the lowest assessment from the respondents

Persistent currents of noninteracting electrons

We thoroughly study the persistent current of noninteracting electrons in one, two, and three dimensional thin rings. We find that the results for noninteracting electrons are more relevant for individual mesoscopic rings than hitherto appreciated. The current is averaged over all configurations of the disorder, whose amount is varied from zero up to the diffusive limit, keeping the product of the Fermi wave number and the ring's circumference constant. Results are given as functions of disorder and aspect ratios of the ring. The magnitude of the disorder-averaged current may be larger than the root-mean-square fluctuations of the current from sample to sample even when the mean free path is smaller, but not too small, than the circumference of the ring. Then a measurement of the persistent current of a typical sample will be dominated by the magnitude of the disorder averaged current.Comment: 10 pages, 4 figure

Manajemen Logistik Obat Antiretroviral Dalam Program Penanggulangan HIV/AIDS

One of the points of the HIV AIDS prevention strategy is to increase the availability and affordability of antiretroviral treatment in hospitals or health centers. The emptiness in antiretroviral drugs is a phenomenon that commonly occurs in hospitals or health centers at the district or city level, and Manggarai Regency is one of the districts that experienced this condition from 2013 to 2017. The aim of this study is to explain the situation and the causes of the absence of antiretroviral drugs with a logistic management approach. This type of research is qualitative research. The informants of this study amounted to 8 people from RSUD dr. Ben Mboi, NTT Provincial Health Office, KPAP NTT and KPAD Manggarai. Data collection will take place from February to March 2018. The results are: Antiretroviral drug planning using consumption methods; budgeting and procurement of antiretroviral drugs by the Indonesian Ministry of Health; the storage of antiretroviral drugs is carried out according to the current standards for the storage of medicines; distribution of antiretroviral drugs from the provinces with expeditions and from hospitals to PLWHA with individual prescriptions that are represented by one person; the elimination of antiretroviral drugs was never performed; control of antiretroviral drugs that are adapted to the schedule of taking medication; cause of the absence of antiretroviral drugs due to the lack of specialized staff administering antiretroviral drugs in hospital pharmacies. Management of antiretroviral drugs in Manggarai Regency runs accordingly the logistics management cycle, but there are still some issues that accompany this process. Issues in question include insufficient human resources in terms of quantity and quality, non-procedural implementation and a weak coordination system. It is recommended that improvements be made to the logistical management process of antiretroviral drugs in hospitals, as well as strengthening the coordination and evaluation system of all parties involved in the logistics management of antiretroviral drugs

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7±24.0 to 27.4±23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used

In-Service Monitoring of Steam Pipe Systems at High Temperatures

A system and method for monitoring the properties of a fluid, such as water, in a steam pipe without mechanically penetrating the wall of the pipe. The system uses a piezoelectric transducer to launch an ultrasonic probe signal into the pipe. Reflected ultrasonic signals are captured in a transducer, which can be the same transducer that launched the probe signal. The reflected signals are subjected to data processing, which can include filtering, amplification, analog-to-digital conversion and autocorrelation analysis. A result is extracted which is indicative of a property of the fluid, such as a height of the condensed fluid, a cavitation of the condensed fluid, and a surface perturbation of the condensed fluid. The result can be recorded, displayed, and/or transmitted to another location. One embodiment of the system has been constructed and tested based on a general purpose programmable computer using instructions recorded in machine-readable non-volatile memory

Intestine-specific deletion of microsomal triglyceride transfer protein increases mortality in aged mice

BACKGROUND:Mice with conditional, intestine-specific deletion of microsomal triglyceride transfer protein (Mttp-IKO) exhibit a complete block in chylomicron assembly together with lipid malabsorption. Young (8-10 week) Mttp-IKO mice have improved survival when subjected to a murine model of Pseudomonas aeruginosa-induced sepsis. However, 80% of deaths in sepsis occur in patients over age 65. The purpose of this study was to determine whether age impacts outcome in Mttp-IKO mice subjected to sepsis. METHODS:Aged (20-24 months) Mttp-IKO mice and WT mice underwent intratracheal injection with P. aeruginosa. Mice were either sacrificed 24 hours post-operatively for mechanistic studies or followed seven days for survival. RESULTS:In contrast to young septic Mttp-IKO mice, aged septic Mttp-IKO mice had a significantly higher mortality than aged septic WT mice (80% vs. 39%, p = 0.005). Aged septic Mttp-IKO mice exhibited increased gut epithelial apoptosis, increased jejunal Bax/Bcl-2 and Bax/Bcl-XL ratios yet simultaneously demonstrated increased crypt proliferation and villus length. Aged septic Mttp-IKO mice also manifested increased pulmonary myeloperoxidase levels, suggesting increased neutrophil infiltration, as well as decreased systemic TNFα compared to aged septic WT mice. CONCLUSIONS:Blocking intestinal chylomicron secretion alters mortality following sepsis in an age-dependent manner. Increases in gut apoptosis and pulmonary neutrophil infiltration, and decreased systemic TNFα represent potential mechanisms for why intestine-specific Mttp deletion is beneficial in young septic mice but harmful in aged mice as each of these parameters are altered differently in young and aged septic WT and Mttp-IKO mice

Genomic analysis of resistance to fall armyworm (Spodoptera frugiperda) in CIMMYT maize lines

The recent invasion, rapid spread, and widescale destruction of the maize crop by the fall armyworm (FAW; Spodoptera frugiperda (J.E. Smith)) is likely to worsen the food insecurity situation in Africa. In the present study, a set of 424 maize lines were screened for their responses to FAW under artificial infestation to dissect the genetic basis of resistance. All lines were evaluated for two seasons under screen houses and genotyped with the DArTseq platform. Foliar damage was rated on a scale of 1 (highly resistant) to 9 (highly susceptible) and scored at 7, 14, and 21 days after artificial infestation. Analyses of variance revealed significant genotypic and genotype by environment interaction variances for all traits. Heritability estimates for leaf damage scores were moderately high and ranged from 0.38 to 0.58. Grain yield was negatively correlated with a high magnitude to foliar damage scores, ear rot, and ear damage traits. The genome-wide association study (GWAS) revealed 56 significant marker–trait associations and the predicted functions of the putative candidate genes varied from a defense response to several genes of unknown function. Overall, the study revealed that native genetic resistance to FAW is quantitative in nature and is controlled by many loci with minor effects