FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN POLA PENCARIAN PENGOBATAN KE PELAYANAN KESEHATAN ALTERNATIF PASIEN SUSPEK TUBERCULOSIS DI KOMUNITAS

ABSTRAKLatar Belakang : Angka penemuan kasus Tuberculosis (TB) di Propinsi DIY pada tahun 2009 baru mencapai 52,90% (target 70%). Penemuan pasien TB di unit pelayanan kesehatan masih secara pasif, sehingga pola perilaku pencarian pengobatan pasien TB ataupun suspek TB sangatlah penting dipahami. Penelitian yang dilakukan sebelumnya menunjukkan bahwa 43% suspek TB mencari pengobatan di pelayanan kesehatan alternatif. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pola pencarian pengobatan ke pelayanan kesehatan alternatif suspek TB di komunitas.Metode : Penelitian ini menggunakan pendekatan cross sectional. Sampel penelitian menggunakan total  sampel cluster sebesar 750 responden. Responden diambil secara acak dengan menggunakan prosedur survei cepat. Analisis data yang dipergunakan adalah analisis univariat dan analisis bivariat.Hasil : Secara statistik, tidak ada hubungan antara jenis kelamin, pendidikan, umur dan status ekonomi dengan pola pencarian pengobatan alternatif. Hal ini dapat dilihat dari nilai P value yang semuanya menunjukkan angka lebih besar dibandingkan 0.05. Secara biologis, jenis kelamin laki-laki  merupakan faktor protekif  pengampilan keputusan suspek TB untuk tidak melakukan pengobatan. Jenis kelamin laki-laki mempunyai resiko 0,708 kali dibanding perempuan untuk berobat ke apotik/toko obat. Hal ini ditunjukkan dari nilai Ratio Prevalen (RP) = 0,708 (dengan CI 95% : 0,471 – 1,066). Variabel pendidikan, umur dan status ekonomi mempunyai nilai nilai Ratio Prevalen (RP) >1 artinya bahwa umur lansia belum tentu merupakan faktor resiko pengambilan keputusan suspek TB untuk melakukan pengobatan alternatif.Kesimpulan : Tidak ada hubungan antara pendidikan, status ekonomi, jenis kelamin, dan umur dengan pola pencarian pengobatan ke pelayanan kesehatan alternatif. Kata Kunci : Tuberculosis, pencarian pengobatan, pelayanan kesehatan alternatif  ABSTRACTBackground : Daerah Istimewa Yogykarta (DIY) in TB case detection rate in 2009 reached 52.90 % (target 70 % ). The discovery of TB patients in the health care unit is still passive, so the pattern of health seeking behavior of TB or suspected TB patients is very important to understand. Past research indicates that 43 % of TB suspects to seek treatment in alternative health care. This study aimed to determine the factors associated with treatment seeking patterns of alternative health services to suspected tuberculosis in the community.Methods : This study used a survey method with cross-sectional design. Total study sample using cluster sample of 750 respondents. Respondents were drawn at random by using a quick survey procedures. Analysis of the data used were univariate and bivariate analysis.Results : There were not relationship between gender, education, age and economic status of the search patterns of alternative medicine. It can be seen from the value P value indicates the number of which are smaller than 0.05. Biologically, male gender was a factor suspected tuberculosis protekif pengampilan decision not to take medication. Male sex had 0.708 times the risk than women to go to a pharmacy / drug store. It is shown from the values prevalent Ratio ( RP ) = 0.708 ( with 95 % CI : 0.471 to 1.066 ). Variables of education, age and economic status have values prevalent Ratio ( RP ) > 1 means that the age of the elderly is not necessarily a risk factor for tuberculosis suspects decision to perform alternative medicine.Conclusion : There were not relationship between education, economic status, the sex, and age at treatment seeking patterns to alternative health care. Keyword : Tuberculosis, treatment seeking, alternative health car

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings.EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Paroxysmal Cerebral Disorder