HUBUNGAN ANTARA PERSEPSI PASIEN TERHADAP MUTU JASA PELAYANAN KESEHATAN DENGAN KEPUASAN PASIEN RAWAT JALAN DI PUSKESMAS RATAHAN KABUPATEN MINAHASA TENGGARA

Persepsi dari setiap pasien terhadap kepuasan mutu jasa pelayanan kesehatan yang di dapat sangat menentukan berkembangnya suatu instansi pelayanan kesehatan. Penurunan kunjungan pasien setiap tahunnya di Puskesmas Ratahahan menggambarkan adanya suatu hal dalam kualitas mutu pelayanan.  Oleh karena itu  pengukuran mutu jasa pelayanan kesehatan sangat penting untuk mendapatkan perhatian lebih dalam upaya peningkatan kesehatan masyarakat. Tujuan penelitian ini adalah untuk mengetahui hubungan antara persepsi pasien terhadap mutu jasa pelayanan kesehatan dengan kepuasan pasien rawat jalan di Puskesmas Ratahan. Metode penelitian yang digunakan yaitu survei analitik dengan menggunakan pendekatan cross sectional study bertempat di Puskesmas Ratahan pada bulan September - November 2018. Sebanyak 90 pasien rawat jalan sebagai sampel penelitian di Puskesmas Ratahan. Instrumen penelitian menggunakan kuesioner dan analisis data yaitu analisis univariat dan bivariat, serta uji statistik menggunakan uji Chi- square. Hasil penelitian menunjukkan mutu jasa pelayanan kesehatan terdiri dari Reabilitas baik (91,1%), cukup baik (6,7%), kurang baik (2,2%). Daya Tanggap baik (85,6%), cukup baik (14,4%). Jaminan baik (86,7%), cukup baik (11,1%), kurang baik (2,2%). Empati baik (82,2%), cukup baik (15,6%), kurang baik (2,2%). Bukti langsung baik (86,7%), cukup baik (10,0%), kurang baik (3,3%). Hasil dari seluruh dimensi mutu jasa pelayanan kesehatan diperoleh (93,3%) dalam kategori baik kepuasan pasien (16,7%) dan dalam kategori cukup puas sebesar (72,2%) dalam kategori puas. Pada uji statistik persepsi pasien terhadap mutu jasa pelayaan dan kepuasan pasien diperoleh hasil p value= 0,000. Kesimpulan dari penelitian ini terdapat hubungan antara persepsi pasien terhadap mutu jasa pelayanan kesehatan dengan kepuasan pasien rawat jalan di Puskesmas Ratahan. Kata Kunci : Persepsi, Mutu Jasa Pelayanan, Kepuasan Pasien ABSTRACTPerception from each patient to health services that can be permitted to improve health services. Decreasing patient visits at Ratahahan Health Center for several things in service quality. Therefore it is very important for users of health services. The purpose of this study was to determine the relationship between health services and patient satisfaction at Ratahan Health Center. The research method used was an analytical survey using a cross sectional study approach that took place at the Ratahan Health Center in September - November 2018. As many as 90 outpatients as research samples at the Ratahan Health Center. The research instrument used questionnaires and data analysis, namely univariate and bivariate analysis, and statistical tests using Chi-square test. The results showed that various services from Reability were good (91.1%), quite good (6.7%), not good (2.2%). Good response (85.6%), quite good (14.4%). Guaranteed good (86.7%), quite good (11.1%), not good (2.2%). Good empathy (82.2%), good enough (15.6%), not good (2.2%). Good direct evidence (86.7%), good enough (10.0%), not good (3.3%). Results from all health care measures (93.3%) in the category of both patient satisfaction (16.7%) and in the category were quite satisfied at (72.2%) in the satisfied category. In the statistical test, the ratio of patient satisfaction to patient satisfaction and satisfaction results in p value = 0,000. The level of this service includes the relationship between patients and health services with patient satisfaction at the Ratahan Health Center. Keywords: Perception, Quality of Service, Patient Satisfactio

Histology and symplasmic tracer distribution during development of barley androgenic embryos

The present study concerns three aspects of barley androgenesis: (1) the morphology and histology of the embryos during their development, (2) the time course of fluorescent symplasmic tracers’ distribution, and (3) the correlation between symplasmic communication and cell differentiation. The results indicate that barley embryos, which are developing via an androgenic pathway, resemble their zygotic counterparts with respect to their developmental stages, morphology and histology. Analysis of the distribution of the symplasmic tracers, HPTS, and uncaged fluorescein indicates the symplasmic isolation of (1) the protodermis from the underlying cells of the late globular stage onwards, and (2) the embryonic organs at the mature stage of development

Developmental Localization and Methylesterification of Pectin Epitopes during Somatic Embryogenesis of Banana (Musa spp. AAA)

The plant cell walls play an important role in somatic embryogenesis and plant development. Pectins are major chemical components of primary cell walls while homogalacturonan (HG) is the most abundant pectin polysaccharide. Developmental regulation of HG methyl-esterification degree is important for cell adhesion, division and expansion, and in general for proper organ and plant development.Developmental localization of pectic homogalacturonan (HG) epitopes and the (1→4)-β-D-galactan epitope of rhamnogalacturonan I (RG-I) and degree of pectin methyl-esterification (DM) were studied during somatic embryogenesis of banana (Musa spp. AAA). Histological analysis documented all major developmental stages including embryogenic cells (ECs), pre-globular, globular, pear-shaped and cotyledonary somatic embryos. Histochemical staining of extracellularly secreted pectins with ruthenium red showed the most intense staining at the surface of pre-globular, globular and pear-shaped somatic embryos. Biochemical analysis revealed developmental regulation of galacturonic acid content and DM in diverse embryogenic stages. Immunodots and immunolabeling on tissue sections revealed developmental regulation of highly methyl-esterified HG epitopes recognized by JIM7 and LM20 antibodies during somatic embryogenesis. Cell walls of pre-globular/globular and late-stage embryos contained both low methyl-esterified HG epitopes as well as partially and highly methyl-esterified ones. Extracellular matrix which covered surface of early developing embryos contained pectin epitopes recognized by 2F4, LM18, JIM5, JIM7 and LM5 antibodies. De-esterification of cell wall pectins by NaOH caused a decrease or an elimination of immunolabeling in the case of highly methyl-esterified HG epitopes. However, immunolabeling of some low methyl-esterified epitopes appeared stronger after this base treatment.These data suggest that both low- and highly-methyl-esterified HG epitopes are developmentally regulated in diverse embryogenic stages during somatic embryogenesis. This study provides new information about pectin composition, HG methyl-esterification and developmental localization of pectin epitopes during somatic embryogenesis of banana

Light Plays an Essential Role in Intracellular Distribution of Auxin Efflux Carrier PIN2 in Arabidopsis thaliana

BACKGROUND: Light plays a key role in multiple plant developmental processes. It has been shown that root development is modulated by shoot-localized light signaling and requires shoot-derived transport of the plant hormone, auxin. However, the mechanism by which light regulates root development is not largely understood. In plants, the endogenous auxin, indole-3-acetic acid, is directionally transported by plasma-membrane (PM)-localized auxin influx and efflux carriers in transporting cells. Remarkably, the auxin efflux carrier PIN proteins exhibit asymmetric PM localization, determining the polarity of auxin transport. Similar to PM-resident receptors and transporters in animal and yeast cells, PIN proteins undergo constitutive cycling between the PM and endosomal compartments. Auxin plays multiple roles in PIN protein intracellular trafficking, inhibiting PIN2 endocytosis at some concentrations and promoting PIN2 degradation at others. However, how PIN proteins are turned over in plant cells is yet to be addressed. METHODOLOGY AND PRINCIPLE FINDINGS: Using laser confocal scanning microscopy, and physiological and molecular genetic approaches, here, we show that in dark-grown seedlings, the PM localization of auxin efflux carrier PIN2 was largely reduced, and, in addition, PIN2 signal was detected in vacuolar compartments. This is in contrast to light-grown seedlings where PIN2 was predominantly PM-localized. In light-grown plants after shift to dark or to continuous red or far-red light, PIN2 also accumulated in vacuolar compartments. We show that PIN2 vacuolar targeting was derived from the PM via endocytic trafficking and inhibited by HY5-dependent light signaling. In addition, the ubiquitin 26S proteasome is involved in the process, since its inhibition by mutations in COP9 and a proteasome inhibitor MG132 impaired the process. CONCLUSIONS AND SIGNIFICANCE: Collectively, our data indicate that light plays an essential role in PIN2 intracellular trafficking, promoting PM-localization in the presence of light and, on the other hand, vacuolar targeting for protein degradation in the absence of light. Based on these results, we postulate that light regulation of root development is mediated at least in part by changes in the intracellular distribution of auxin efflux carriers, PIN proteins, in response to the light environment

Lanthanide(III) complexes of bis(phosphonate) monoamide analogues of DOTA: Bone-seeking agents for imaging and therapy

Lanthanide complexes of DOTA derivatives 2a (BPAMD) and 2b (BPAPD), having a monoamide pendant arm with a bis(phosphonate) moiety, were comparatively tested for application in MRI, radiotherapy, and bone pain palliation. H-1, P-31, and O-17 NMR spectroscopy show that they are nine-coordinated, with one water molecule in the first coordination sphere of the Ln(III) ion. The bis(phosphonate) moieties are not coordinated to the lanthanide and predominantly mono- and diprotonated at physiological pH. The parameters governing the longitudinal relaxivities of the Gd complexes are similar to those of other monoamides of DOTA reported in the literature. Upon adsorption on hydroxyapatite, the relaxivities at 20 MHz and 25 degrees C of Gd-2a and Gd-2b were 22.1 and 11 s(-1) mM(-1), respectively. An in vivo gamma-ray imaging study showed that the Lu-177 complexes of 2a and 2b have a high affinity for bones, particularly for growth plates and teeth with a prolonged retention