Pengaruh Metode Pembelajaran Berbasis Masalah Terhadap Kemampuan Mahasiswa Farmasi Dalam Aspek Informasi Obat

Drug information service is one of competencies that pharmacist should have to increase patient compliance on treatment. It needs a good learning method to improve pharmacy student the ability in applying their theoretical knowledge to clinical practice in community later. The study aims to determine effect of problem based learning method on drug information systems course for the ability of drug information service by pharmacy students. The assessment is on aspects of theoretical knowledge, competence of the learning material and case solving abilities. It is a single-blind, case-control study. The study was carried out in19 months, in January 2014 to July 2015 at the Department of Pharmacy, Udayana University. The case group are pharmacy students who receive problem-based learning method, while control group are students who receive conventional teaching methods. A total 79 students are selected, consisting of 38 students in the control group and 41 students in the case group (PBL), respectively. The score of theoretical competence among students in the control group is signifi cantly higher than the case group (p = 0.047). Whereas, the competency of learning material and problem solving ability in the case group are signifi cantly higher than the case group (p = 0.000). The application of problem based learning method can improve the competencies of learning material and problem solving on drug information service by pharmacy students who take drug information systems course. The application of problem based learning method is good to be used at the pharmacy department in general to improve students soft skills, especially in applied subjects relating to clinical practice competencie among pharmacists in the community

Tingkat Kepuasan Pasien Terhadap Penggunaan Obat Generik Dan Obat Generik Bermerek (Branded Generic) Pada Pasien Rawat Jalan Di Badan Rumah Sakit Umum Tabanan

Perbedaan jumlah penggunaan obat generik dan obat generik bermerek salah satunya dapat disebabkan oleh adanya perbedaan kepuasan pasien. Kaptopril merupakan jenis obat antihipertensi lini pertama yang ada dipasaran dalam bentuk produk generik dan produk generik bermerek. Kaptopril digunakan secara luas dan digunakan dalam jangka waktu panjang oleh pasien hipertensi. Penelitian ini bertujuan untuk mengetahui tingkat kepuasan pasien hipertensi di Badan Rumah Sakit Umum Tabanan terhadap penggunaan obat kaptopril generik dan obat kaptopril generik bermerek. Kepuasan pasien diukur dengan menggunakan skor gap. Skor gap diperoleh dengan membandingkan antara harapan dan persepsi pasien terhadap penggunaan obat kaptopril generik dan kaptopri generik bermerek. Harapan dan persepsi pasien diukur menggunakan skala likert dalam kuisioner yang berisi pernyataan tentang core product, actual product dan augmented product. Data yang diperoleh dianalisis dengan uji statistik parametrik menggunakan uji t berpasangan dengan taraf kepercayaan 95%. Empat puluh sembilan orang responden ikut serta dalam penelitian. Hasil penelitian menunjukkan harapan pasien yang tinggi baik pada penggunaan kaptopril generik maupun kaptopril generik bermerek. Tingkat kepuasan pasien hipertensi di Badan Rumah Sakit Umum Tabanan terhadap penggunaan obat kaptopril generik dan kaptopril generik bermerek termasuk dalam kategori sedang dan tidak terdapat perbedaan yang signifikan antara kepuasan pasien terhadap penggunaan kedua jenis obat tersebut (p > 0,05)

Perilaku Penyalahgunaan Suboxone pada Kalangan Pengguna Napza Suntik di Wilayah Kota Denpasar dan Badung

Penyediaan suboxone adalah salah satu upaya untuk mengobati dan mencegah dampak bahaya dari narkoba suntik di kalangan penasun, dan juga mengurangi ketergantungan mereka pada obat-obatan. Namun, menurut data dasar dan observasi awal, ada indikasi bahwa suboxone juga disalahgunakan. Penelitian ini bertujuan untuk mengeksplorasi penyalahgunaan suboxone kalangan penasun dan mengidentifikasi faktor penentunya. Metode kualitatif digunakan dalam penelitian ini dengan mewawancarai 11 penasun di Denpasar dan Badung. Peserta dipilih dengan menggunakan teknik purposive. Panduan wawancara digunakan selama wawancara. Data kemudian dianalisis dengan menggunakan analisis tematik. Penelitian ini mengungkapkan bahwa peserta memiliki pengetahuan sedang terkait suboxone. Ada beberapa yang bersikap positif terhadap suboxone di mana peserta menganggap bahwa suboxone efektif dalam mengurangi ketergantungan obat, terutama bila digunakan dengan benar. Sikap mereka positif terhadap suboxone, namun bertentangan dengan perilaku mereka. Suboxone disalahgunakan dengan menyuntikkan, dan kadang-kadang digabungkan dengan obat lain. Faktor-faktor penentu penyalahgunaan suboxone, adalah kurangnya kontrol dari penyedia layanan kesehatan dan regulasi yang kurang pada peresepan suboxon, keamanan dan legalitas, pendekatan ekonomi, dorongan individu, kurangnya akses informasi yang akurat, dan juga konteks sosial dan lingkungan. Dukungan dan program pemberdayaan bagi penasun sangat penting untuk mengganti keinginan mereka menyuntikkan suboxone selama terapi. Penguatan pemantauan intensif untuk mengendalikan penyalahgunaan suboxone, dengan mengkombinasikan dukungan dari pihak lain termasuk keluarga juga penting untuk keberhasilan pelaksanaan terapi suboxone

Factors associated with zidovudine substitution in HIV/AIDS patients attending Badung Hospital, Bali, Indonesia between 2006-2014

Background: Zidovudine (AZT) is the most commonly used drug in first line antiretroviral therapy (ART) in Indonesia; however, substitution due to its side effect is common. The majority of HIV positive patients in Badung Hospital Bali are treated with AZT yet no longitudinal studies in Bali have investigated the number of substitutions or the factors associated with it.Methods: A retrospective cohort study of HIV positive persons aged >15 years, receiving AZT between 1st January 2006 – 31st August 2014 was conducted. Persons were included from their date of starting AZT. Cox proportional hazard models were applied to estimate the risk and time to substitution. Substitution was defined as single drug change due to side effects and initiating another drug of the same class.Results: During our study 260 patients started AZT, of which 77 (29.6%) experienced substitution. The risk of substitution was 19 per 100 person years. Of those 77, the median time to AZT substitution was 69 days (IQR 25-178). Factors significantly associated with an increased risk of AZT substitution included women (HR 1.79; 95% CI 1.09-2.94), having low hemoglobin levels <10g% (HR 2.72; 95% CI 1.02-7.21), clinical stage III and IV (HR 3.53; 95% CI 1.26-6.19) at the time of starting AZT, and starting ART after 2012 (HR 3.83; 95% CI 2.19-6.70).Conclusions: Present study identified individuals that may be at a high risk of AZT substitution who should be monitored more closely or consideration given to initiating them on another treatment regimen

Design and Performance of the XENON10 Dark Matter Experiment

XENON10 is the first two-phase xenon time projection chamber (TPC) developed within the XENON dark matter search program. The TPC, with an active liquid xenon (LXe) mass of about 14 kg, was installed at the Gran Sasso underground laboratory (LNGS) in Italy, and operated for more than one year, with excellent stability and performance. Results from a dark matter search with XENON10 have been published elsewhere. In this paper, we summarize the design and performance of the detector and its subsystems, based on calibration data using sources of gamma-rays and neutrons as well as background and Monte Carlo simulations data. The results on the detector's energy threshold, energy and position resolution, and overall efficiency show a performance that exceeds design specifications, in view of the very low energy threshold achieved (<10 keVr) and the excellent energy resolution achieved by combining the ionization and scintillation signals, detected simultaneously

Search for Dark Matter with CRESST

The search for direct interactions of dark matter particles remains one of the most pressing challenges of contemporary experimental physics. A variety of different approaches is required to probe the available parameter space and to meet the technological challenges. Here, we review the experimental efforts towards the detection of direct dark matter interactions using scintillating crystals at cryogenic temperatures. We outline the ideas behind these detectors and describe the principles of their operation. Recent developments are summarized and various results from the search for rare processes are presented. In the search for direct dark matter interactions, the CRESST-II experiment delivers competitive limits, with a sensitivity below 5x10^(-7) pb on the coherent WIMP-nucleon cross section.Comment: Accepted for publication in New Journal of Physics. 25 pages, 18 figure

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

A matrix approach to tropical marine ecosystem service assessments in South east Asia

Ecosystem service assessments are increasingly used to support natural resource management, but there is a bias in their application towards terrestrial systems and higher income countries. Tropical marine applications are particularly scarce, especially in SE Asia. Given the growing coastal population and expansion in blue economy sectors in SE Asia, evidence to support effective marine planning, such as ecosystem service assessments, is urgently needed. Data deficiencies for marine systems, especially (but not only) in lower income countries is a significant obstacle for ecosystem service assessments. To overcome this, we develop an ecosystem service potential matrix which combines evidence taken from an extensive literature review together with expert opinion. The matrix includes both natural and modified habitats as the service providing units. The ecosystem service potential for habitats are scored at the macro level (e.g. mangrove) due to insufficient evidence to score micro-habitats (e.g. fringe, basin or riverine mangroves). The majority of evidence is available for biogenic habitats (mangroves, coral reefs and seagrass meadows) with comparatively little for sedimentary habitats. While provisioning, regulating and cultural services are scored, published evidence is more readily available for provisioning and regulating services. Confidence scores, indicating the uncertainty in the ecosystem service potential scores are included in the matrix. To our knowledge this is the first attempt to systematically capture the provision of ecosystem services from tropical marine habitats. Although initially developed for four marine biosphere reserves and protected areas in SE Asia, the generic nature of the evidence included suggests that the matrix constitutes a valuable baseline for marine ecosystem service assessments within SE Asia and provides a robust foundation for development in future work

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

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