Multi Drug Resistant Tuberculosis at Dr Zainoel Abidin Hospital (A Case Study After 13 Years of Tsunami Disaster in Aceh)

Background: Spontaneous mutations into multi-drug resistant Tuberculosis (MDR-TB) in the Mycobacterium tuberculosis (TB) genome occur in very rare frequencies. Most of MDR-TB sare man-made phenomenon associated with the regularity of taking medicine and comorbid factors. This is also influenced by social factors, economic recession, industry, conflict and natural disasters. Increased cases of TB and MDR-TB post conflict and natural disasters were reported by Raviv (2010), Kanamori et al (2011), and WHO (2013). Thus, the province of Aceh that has experienced conflicts since 1998-2004 and tsunami in 2004 is the area with the increased risk of MDR cases in Indonesia. Method: This research was conducted at dr. Zainoel Abidin Hospital in Banda Aceh as the MDR-TB referral center in Aceh Province. The purpose of this study was to determine what contributed to the occurrence of MDR-TB. An analytical observational study with cross sectional design was performed from September to November 2017 on 49 MDR-TB patients undergoing treatment. Primary data were obtained through interviews using questionnaires, while the secondary data were gathered from medical records. Results: The availability of drugs and regularity of taking anti-tuberculosis medication (OAT) are the main factors contributing to MDR-TB (multivariate analysis using logistic regression: p=0.035). Other influencing factors are: economic status (p=0.041) and comorbid Diabetes Mellitus (p=0.040). Conclusion: MDR-TB cases in dr. Zainoe lAbidin Hospital is primarily associated with the availability of regimens and regularity of taking OAT. As an area in the post-conflict and tsunami recovery period, Aceh is the area with the potential for increasing TB and MDR - TB cases. Stronger efforts are required in case findings, identification and comprehensive treatments to reduce TB morbidity and mortality and to prevent MDR-TB in Aceh Province. Keywords: disaster affected areas, tuberculosis, multi-drug resistant Tuberculosi

Pemecahan Masalah Matematika Tipe Pisa pada Siswa Sekolah Menengah dengan Konten Hubungan dan Perubahan

Penelitian ini bertujuan untuk mendeskripsikan pemecahan masalah matematika siswa sekolah menengah tipe PISA dengan konten Perubahan dan hubungan. Penelitian ini merupakan penelitan deskriptif dengan pendekatan kualitatif, dimana subjek dalam penelitian ini adalah seorang siswi kelas VII SMP Negeri 1 Banda Aceh. Penelitian ini dimulai dengan memberikan Masalah Literasi Matematika (MLM) tahap pertama yang kemudian diikuti dengan wawancara, kemudian selang beberapa hari siswa diberikan lagi Masalah Literasi Matematika (MLM) dengan masalah yang setera dan juga diikuti dengan wawancara. Hal ini dilakukan sebagai langkah pengecekan data dengan cara triangulasi waktu.Hasil penelitian ini menunjukkan bahwa dalam menyelesaikan masalah PISA dengan konten Perubahan dan hubungan, siswa sekolah menengah mampu mengidentifikasikan masalah dengan cara mengungkapkan informasi yang diketahui dari masalah PISA yang terkait dengan konten Perubahan dan hubungan, pada tahap berikutnya yaitu menyusun rencana peneyelesaian masalah, siswa bisa menyebutkan langkah atau rencana yang akan digunakan untuk menyelesaikan masalah ini, dan pada tahap pelaksanaan rencana tersebut, siswa sangat dipengaruhi oleh rencana yang telah dibuat dan dia berhasil menyelesaikan masalah tersebut dengan benar. Setelah itu, diakhir langkahnya responden juga mengecek hasil kerja dengan alasan untuk membuat dia lebih yakin

Profile of Secondary School Students with High Mathematics Ability in Solving Shape and Space Problem

This study aimed to describe the profile of secondary school students with high mathematics ability in solving shape and space problem in PISA (Program for International Student Assessment). It is a descriptive research with a qualitative approach, in which the subjects in this study were students of class VIII SMP N 1 Banda Aceh. The results show that in solving the problem PISA on shape and space, high mathematics ability students were able to identify the problem by making the information known from PISA issues related to the shape and space content

Pelaksanaan Strategi Differensiasi sebagai suatu Strategi Bersaing Guna Mempertahankan Pelanggan ( Kasus Industri Jasa Pengiriman PT Indah Logistik Cabang Pekanbaru )

In the higher levels of competition, companies must be able to deal withcompetitors that offer similar products. Implementation required the rightcompetitive strategy to win the competition. The implementation of the differentiationstrategy is the implementation of the policy by the company by providing a series ofimportant and valuable differences, in order to differentiate the products offered bythe company with competitors products. This strategy is implemented by thecompany because consumers now have more choices in selecting a product. For thatthe company should be able to create a different product or service., Superior, andattractive than other companies in order to attract the attention of consumers.This study aims to identify and analyze the implementation of thedifferentiation strategy as an alternative strategy to retain customers and what arethe factors inhibiting PT Indah Logistic faced in implementing the differentiationstrategy. This is a descriptive study. The sampling technique used is AcidentalSampling data collected with interviews and observations.The results of this study indicate that the implementation of the differentiationstrategy undertaken by PT. Indah branch Logistic Pekanbaru pretty good. The besteffects are the product differentiation and image. Implementation Strategy andPersonnel Service differentiation is still pretty good company or not fullyimplemented by the company.Keywords: Implementation of Differentiation Strategy, Products, Services, Personnel, andImag

Antiretroviral (ARV) untuk Anak dengan HIV di Indonesia : Sudah Siapkah?

Anak dengan HIV bukanlah orang dengan HIV dalam bentuk yang kecil. Meski layanan dan obat ARV telah tersedia di berbagai daerah dan tingkat layanan kesehatan, tetapi pemberian terapi ARV secara khusus pada anak masih sangat terbatas. Keterbatasan ini bisa dilihat dari jumlah layanan yang bisa memberikan terapi ARV sesuai dengan pedoman maupun keterbatasan dalam ketersediaan obat ARV untuk anak. Akibatnya jumlah anak yang masuk ke dalam perawatan HIV masih belum optimal meski mereka telah memenuhi syarat untuk memperoleh terapi. Jika mereka telah memperoleh ARV, banyak dari mereka memperoleh obat ARV bagi orang dewasa. Demikian pula permasalahan kepatuhan minum obat dari anak yang mengikuti terapi masih jadi pertanyaan karena hingga saat ini belum ada laporan tentang itu. Melihat permasalahan tersebut maka bukan usulan kebijakan yang menjadi rekomendasi dari policy brief ini tetapi mendesak pemerintah sesegera mungkin melaksanakan kebijakan yang telah dibuat secara bertanggungjawab dan meluas ke berbagai wilayah dimana banyak anak dengan HIV yang membutuhkan ARV sesuai dengan kebutuhannya. Ketidakmampuan pemerintah untuk melaksanakan kebijakan ARV untuk anak ini akan mengancam hidup anak-anak dengan HIV di Indonesia

Community acceptance and implementation of HIV prevention interventions for injection drug users

In 1997, the National Institutes of Health (NIH) reviewed evidence of the effectiveness of HIV prevention programs for injection drug users (IDUs) and recommended that three types ofinterventions be implemented to prevent transmission of HIV among IDUs: 1) community-based outreach, 2) expanded syringe access (including needle exchange programs [NEP] and pharmacy sales), and 3) drug treatment. Progress on increasing the acceptance and feasibility of implementing these programs has been made at the national level, but their implementation has been varied at the local level.Understanding the conditions under which communities accept and implement interventions can help guide effective strategies to foster the implementation of these interventions in areas where programs do not currently exist