Rekomendasi Pengadaan Obat dan Alat Kesehatan dengan Fuzzy Database (Studi Kasus: Instalasi Farmasi Klinik Utama Cideng Medical Center)

Kemudahan dalan melakukan pencarian terhadap persediaan obat dan alat kesehatan untuk pengadaan yang sesuai standar persyaratan mutu pada Instalasi Farmasi merupaka salah satu faktor kunci dalam menunjang pelayanan apa lagi dalam pencarian tersebut dapat direpresentasikan kedalam bahasa sehari-hari semisal: mahal, hampir habis, ataupun banyak oleh karena itu perlu adanya teknik informasi untuk mewujudkannya karena hingga saat ini belum ada suatu penerapan metode untuk permasalahn tersebut terutama di Instalasi Klinik Utama Cideng Medical Center. Metode Fuzzy Database yaitu, suatu sistem basis data yang menggunakan teori himpunan fuzzy ke dalam Databases untuk menghasilkan informasi, dengan demikian pencarian persediaan obat dan alat kesehatan di Database dapat direpresentasikan kedalam bahasa sehari-hari.Maka Fuzzy Database sangat sesuai untuk di terapkan dalam Database pencarian obat dan alkes sebagai rekomendasi pengadaan di Insatalasi Farmasi Klinik Utama Cideng Medical Center, karena pencarian obat dan alat kesehatan itu begitu kompleks, akan sangat mudah apabila bisa dikomunikasikan dalam keseharian kita

Khitin Cangkang Rajungan (Portunus Pelagicus) Sebagai Bikoagulan Untuk Penyisihan Turbidity, TSS, BOD Dan COD Pada Pengolahan Air Limbah Farmasi PT. Phapros Tbk, Semarang

Derived from crab shell waste 40-60% of the total weight of crabs and not have been exploited yet contain 20-30% chitin that can be biocoagulant. The purpose of this study to the effect of the addition of crab shell chitin biocoagulant and to know the dose and the optimal mixing speed quickly on the value of turbidity, TSS, BOD and COD effluent pharmaceutical PT. Phapros Tbk, Semarang and removal efficiency parameters. The independent variable in this study is small crab chitin biocoagulant dose and mixing speed quickly. The dose variation of 0.01%, 0.02%, 0.03%, 0.04% and 0.05% (v / v) while mixing fast speed variation is 100 rpm, 125 rpm and 150 rpm. By using Jar test to compare the preliminary results of the parameter variation biocoagulant dose and mixing speed quickly. In the Jar Test method, to vary the speed of rapid stirring for 1 minute, then continued 45 rpm for 20 minutes, and let stand for 15 minutes. Coagulant used is derived from chitin white colored gray with a degree of deacetylation of 81.2% which is then diluted with 85% phosphate acid.The results showed a decrease concentration in turbidity, TSS, BOD and COD is directly proportional to the dose biocoagulant additions were added and inversely proportional to the speed of mixing quickly used. Biocoagulant optimal dose was 0.05% and the optimum mixing speed of 100 rpm faster and produce the best turbidity removal efficiency is 97%, TSS 70%, BOD 32% and COD 31%. Therefore, biocoagulant crab chitin can be an alternative substitution for PAC Macroflog used in PT. Phapros Tbk, Semarang

Characterization of Carotenoid Pigments From Bacterial Symbionts of Seagrass Thalassia Hemprichii

Carotenoids are pigments that can be used in various applications including cosmetics and precursor ofvitamins A. Carotenoids are mostly found in higher plant leaves, fruit, and bacteria. Marine bacteriaassociated with seagrass Thalassia hemprichii collected from Menjangan Kecil Waters, KarimunjawaIslands were screened to produce the pigment and has allowed the use of these microrganism as anenvironmental friendly alternative source of new natural pigment. The isolation of bacterial symbionts onZobell 2216E medium from seagrass Thalassia hemprichii resulted in 20 isolates of which 8 bacterialsymbionts have produced pigments but only one bacterium positively synthesize carotenoids. Initial analysiswith atomic absorption spectrophotometric method revealed that the wave lengt of bacterial pigment were inthe range of 300-600 nm, which are categorized that within the group of carotenoid pigments. From theresults of molecular identification by 16S rDNA method, it was shown that bacterium TH8 was closelyrelated to Bacillus licheniformis with 98% homology value

The Influence of Exclusive Breastfeeding to Emotional Development of Children Aged 48-60 Months

Impaired emotional development is a problem faced by children and this can negatively impact on function, development and readiness of their school. Exclusive breastfeeding is able to meet brain development needs that affect child development. This study aimed to determine correlation between exclusive breastfeeding and emotional development of children aged 48-60 months. This study used historical cohort.The subjects of this study were 7-12-month old infants living in area of Borobudur Primary Health Care Primary Health Care, Central Java Province, Indonesia in 2011-2012. Independent variable of exclusive breastfeeding was when infants received only breast milk without any supplementary food or drink including water since birth until the age of 6 months. Data were obtained from medical records of children. The emotional development was assessed directly by using questionnaires on emotional and mentalproblems. Data analysis used cox regression. This study found that provision of exclusive breast milk was evidently correlated with child's emotional development. Infants who did not receive exclusive breastfeeding had 2.96 higher risk of having abnormal emotional development than infants who received exclusive breastfeeding. Exclusive breastfeeding greatly influences emotional development of the child

Diversity of Actinomycetes From Eka Karya Botanical Garden, Bali

A total of 229 strains of actinomycetes were isolated and identified by full sequence of 16S rRNA gene analysis. Samples consisted of 18 soil and 20 leaf-litter were collected from Eka Karya Botanical Garden, Bali Island, Indonesia. Two isolation methods, i.e. SDS-Yeast Extract (SY) and Rehydration-Centrifugation (RC) were used in this study. Based on 16S rRNA gene analysis, isolated actinomycetes may be grouped into 28 genera. Based on molecular analysis of 16S rRNA gene similarities showed that isolated actinomycetes of Eka Karya Botanical Garden origin is diverse. Analysis on 144 isolates from soil samples, resulted in 24 genera and more than 87 species. Streptomyces is the most dominant genus where 65 isolates or 45% from isolated actinomycetes belong to this genus. It was followed by Actinoplanes (25 isolates =17%). From leaf-littersamples, the total number of 85 isolates may be grouped into 9 genera and more than 41 species. The most dominated genus is Actinoplanes (42 isolates =49%) followed by Catenuloplanes (16 isolates=19%)

One million dog vaccinations recorded on mHealth innovation used to direct teams in numerous rabies control campaigns

<div><p>Background</p><p>Canine transmitted rabies kills an estimated 59,000 people annually, despite proven methods for elimination through mass dog vaccination. Challenges in directing and monitoring numerous remote vaccination teams across large geographic areas remain a significant barrier to the up-scaling of focal vaccination programmes to sub-national and national level. Smartphone technology (mHealth) is increasingly being used to enhance the coordination and efficiency of public health initiatives in developing countries, however examples of successful scaling beyond pilot implementation are rare. This study describes a smartphone app and website platform, “Mission Rabies App”, used to co-ordinate rabies control activities at project sites in four continents to vaccinate over one million dogs.</p><p>Methods</p><p>Mission Rabies App made it possible to not only gather relevant campaign data from the field, but also to direct vaccination teams systematically in near real-time. The display of user-allocated boundaries on Google maps within data collection forms enabled a project manager to define each team’s region of work, assess their output and assign subsequent areas to progressively vaccinate across a geographic area. This ability to monitor work and react to a rapidly changing situation has the potential to improve efficiency and coverage achieved, compared to regular project management structures, as well as enhancing capacity for data review and analysis from remote areas. The ability to plot the location of every vaccine administered facilitated engagement with stakeholders through transparent reporting, and has the potential to motivate politicians to support such activities.</p><p>Results</p><p>Since the system launched in September 2014, over 1.5 million data entries have been made to record dog vaccinations, rabies education classes and field surveys in 16 countries. Use of the system has increased year-on-year with adoption for mass dog vaccination campaigns at the India state level in Goa and national level in Haiti.</p><p>Conclusions</p><p>Innovative approaches to rapidly scale mass dog vaccination programmes in a sustained and systematic fashion are urgently needed to achieve the WHO, OIE and FAO goal to eliminate canine-transmitted human deaths by 2030. The Mission Rabies App is an mHealth innovation which greatly reduces the logistical and managerial barriers to implementing large scale rabies control activities. Free access to the platform aims to support pilot campaigns to better structure and report on proof-of-concept initiatives, clearly presenting outcomes and opportunities for expansion. The functionalities of the Mission Rabies App may also be beneficial to other infectious disease interventions.</p></div

On dogs, people, and a rabies epidemic:results from a sociocultural study in Bali, Indonesia

Background Previously free of rabies, Bali experienced an outbreak in 2008, which has since caused a large number of human fatalities. In response, both mass dog culling and vaccination have been implemented. In order to assess potential community-driven interventions for optimizing rabies control, we conducted a study exploring the relationship between dogs, rabies, and the Balinese community. The objectives of this study were to: i) understand the human-dog relationship in Bali; ii) explore local knowledge, attitudes, and practices (KAPs) relating to rabies; and iii) assess potential community-driven activities to optimize rabies control and surveillance. Methods Conducted between February and June 2011, the study combined a questionnaire (n = 300; CI = 95 %; error margin = 5 %) and focus group discussions (FGDs) in 10 villages in the Denpasar, Gianyar, and Karangasem regencies. The questionnaire included a Likert scale to assess community knowledge and attitudes. For the knowledge assessment, three points were given for a correct answer, while wrong answers and uncertain answers were given zero points. For the attitudes assessment, three points were given for a positive answer, two points for a neutral answer, and one point for a negative answer. Respondent knowledge was categorized as good (score >40), fair (score 20–40), or poor (score 26), neutral (score 13–26), or negative (score <13), based on a maximum total score of 39. Mixed-gender FGDs in each sub-village (banjar) were conducted, each involving 7–15 participants to complement the questionnaire results. On a follow-up research trip in mid-2013, the data analysis was triangulated and validated using semi-structured interviews. Questionnaire data were analyzed descriptively using SPSS 17.0, while qualitative data from interviews and FGDs were analyzed manually according to accepted methods of coding and memo writing. The chi-square test was then used to analyze the statistical relationships between knowledge and attitudes of the respondents. Results Out of the total 300 respondents, most were predominantly male (82 %), Hindu (99 %), married (96 %), older than 30 years of age (92 %), and owned dogs (72 %). Dog ownership was motivated by culture, personal taste, and function, with dogs was being used as guards (85 %) and companion animals (27 %), and was sometimes related to religious or traditional obligations (2 %). Relating to their culture and local beliefs, and eventually becoming their way of life, 79 % of respondents kept free-roaming dogs. With the rabies outbreak in Bali and Western breeds becoming more popular, more responsible dog ownership (leashing, confining, regular feeding) became more acceptable and changed community perceptions on keeping dogs, even though the sustainability of this practice cannot be gauged. In addition, the economic situation posed major problems in rural areas. The level of community knowledge about rabies and its associated control programs were generally fair and community attitudes were positive. However, community KAPs still need to be improved. A total of 74 % respondents reported to have vaccinated their dogs in 2011, but only few were found to report rabid animals to livestock officers (12 %) and a significant number believed that washing a bite wound was not important (62 %). Moreover, free-roaming dog practices and discarding of unwanted female puppies still continue and possibly create difficulties for rabies elimination as these practices potentially increase the stray dog population. We identified three major sociocultural aspects with potential for community-driven interventions to optimize current rabies elimination efforts: integrating local notions of ahimsa (non-violence) into education campaigns, engaging communities through the local banjar sociopolitical system, and working with traditional legal structures to increase local compliance with rabies control. Conclusion The human-dog relationship in Bali is multifaceted. Due to the uniqueness of the culture and the local beliefs, and encouraged by a socioeconomic aspect, a number of local practices were found to be constituting risk factors for continued rabies spread. Community knowledge and attitudes, which can consequently result in behavioral changes, needs to be improved across different genders, ages, educational backgrounds, and roles in the community, regardless of the individual village’s experiences with rabies. Furthermore, community-driven activities based on sociocultural conditioning and community capacity at the banjar and village levels, such as public awareness activities, vaccination, dog registration, dog population management, and rapid response to dog bites, were identified as being able to complement the rabies control program in Bali. The program also needs recognition or acknowledgement from governments, especially local government as well as regular mentoring to improve and sustain community participation

The state of health in Indonesia's provinces, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Analysing trends and levels of the burden of disease at the national level can mask inequalities in health-related progress in lower administrative units such as provinces and districts. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to analyse health patterns in Indonesia at the provincial level between 1990 and 2019. Long-term analyses of disease burden provide insights on Indonesia's advance to universal health coverage and its ability to meet the United Nations Sustainable Development Goals by 2030. Methods We analysed GBD 2019 estimated cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 286 causes of death, 369 causes of non-fatal health loss, and 87 risk factors by year, age, and sex for Indonesia and its 34 provinces from 1990 to 2019. To generate estimates for Indonesia at the national level, we used 138 location-years of data to estimate Indonesia-specific demographic indicators, 317 location-years of data for Indonesia-specific causes of death, 689 location-years of data for Indonesia-specific non-fatal outcomes, 250 location-years of data for Indonesia-specific risk factors, and 1641 location-years of data for Indonesia-specific covariates. For subnational estimates, we used the following source counts: 138 location-years of data to estimate Indonesia-specific demographic indicators; 5848 location-years of data for Indonesia-specific causes of death; 1534 location-years of data for Indonesia-specific non-fatal outcomes; 650 location-years of data for Indonesia-specific risk factors; and 16 016 location-years of data for Indonesia-specific covariates. We generated our GBD 2019 estimates for Indonesia by including 1 915 207 total source metadata rows, and we used 821 total citations. Findings Life expectancy for males across Indonesia increased from 62·5 years (95% uncertainty interval 61·3–63·7) to 69·4 years (67·2–71·6) between 1990 and 2019, a positive change of 6·9 years. For females during the same period, life expectancy increased from 65·7 years (64·5–66·8) to 73·5 years (71·6–75·6), an increase of 7·8 years. There were large disparities in health outcomes among provinces. In 2019, Bali had the highest life expectancy at birth for males (74·4 years, 70·90–77·9) and North Kalimantan had the highest life expectancy at birth for females (77·7 years, 74·7–81·2), whereas Papua had the lowest life expectancy at birth for males (64·5 years, 60·9–68·2) and North Maluku had the lowest life expectancy at birth for females (64·0 years, 60·7–67·3). The difference in life expectancy for males between the highest-ranked and lowest-ranked provinces was 9·9 years and the difference in life expectacy for females between the highest-ranked and lowest-ranked provinces was 13·7 years. Age-standardised death, YLL, and YLD rates also varied widely among the provinces in 2019. High systolic blood pressure, tobacco, dietary risks, high fasting plasma glucose, and high BMI were the five leading risks contributing to health loss measured as DALYs in 2019. Interpretation Our findings highlight that Indonesia faces a double burden of communicable and non-communicable diseases that varies across provinces. From 1990 to 2019, Indonesia witnessed a decline in the infectious disease burden, although communicable diseases such as tuberculosis, diarrhoeal diseases, and lower respiratory infections have remained a main source of DALYs in Indonesia. During that same period, however, all-ages death and disability rates from non-communicable diseases and exposure to their risk factors accounted for larger shares of health loss. The differences in health outcomes between the highest-performing and lowest-performing provinces have also widened since 1990. Our findings support a comprehensive process to revisit current health policies, examine the root causes of variation in the burden of disease among provinces, and strengthen programmes and policies aimed at reducing disparities across the country. Funding The Bill & Melinda Gates Foundation and the Government of Indonesia. Translation For the Bahasa Indonesia translation of the abstract see Supplementary Materials section