ASPEK PERTAHANAN BIOLOGI (BIODEFENSE) PADA PENUGASAN OPERASI PRAJURIT TNI DI LUAR NEGERI

Background. Biodefense in military operation assignments is an efforts to defend against biological agents that used as weapons by the sides involved in a conflict, as well as against endemic infectious diseases. The Garuda XXIII Contingent has been on assignment in Lebanon since 2005, and the Garuda XX Contingent in the Democratic Republic of Congo (DRC) since 2003. Hepatitis B in Lebanon and Malaria in DRC are endemic infectious diseases that are highly prevalent in each respective area. Objective. To assess how exposure towards endemic infectious diseases and other biological agents affect personnel health status, as well as the effectiveness of preparation and precautionary measures. Method. Cohort study was performed on 275 Lebanon Team members and 175 DRC team members. Pre-deployment data was obtained from health selection examination results, on-deployment data from medical records taken throughout the deployment period, post-deployment data from the post-deployment health examination. Statistical analysis was carried out using the Chi-square and multivariat technique, molecular analysis was carried out on hepatitis B virus and malarial Plasmodium DNA. Result. There was a significant decline (p=0.000) in the post deployment health status of personnel from both deployment areas, as well as significant health status decline (p=0.032) among members infected by endemic diseases during their deployment. 8 members (2.9%) of the Lebanon team were found as hepatitis B positive based on rapid test examination, confirmed through serology and molecular (PCR and genotyping) methods. These methods show all specimens are consistent with the hepatitis B genotype B (HBV/B) cluster, thus it is highly likely that infection occurred not in Lebanon, but in Indonesia prior to deployment. Microscope and PCR analysis were carried out for 4 members of the DRC team who were diagnosed with P. vivax infection during deployment, results show no Plasmodium DNA. Physical examination on infectious disease cases during and after deployments did not yield any clinical symptoms of biological agent infections that might have been used as weapons. Conclusion. Exposure of endemic diseases results in a decline in post-deployment health conditions. Physical examinations do not show any evidence of exposure from biological agents that may be used as weapons. Keywords: Biodefense, infectious endemic diseases and other biological agents, health status

HUBUNGAN STRES DENGAN KEJADIAN DISPEPSIA (UNINVESTIGATED DYSPEPSIA) DI KABUPATEN TEGAL PROVINSI JAWA TENGAH

Background Dyspepsia is the one of non communicable disease that can interfere of the daily activit

PENGARUH PELATIHAN PENGENDALIAN KELELAHAN KERJA (FATIGUE) PADA DOSEN SEKOLAH TINGGI ILMU KESEHATAN DI WILAYAH KOPERTIS IV

Background. In a healthy person fatigue is a normal phenomenon, experienced by everyone and usually easily relieved by rest or sleep. Increased sleepiness at work is increasingly being focused on a safety health issue. However, research on lecturer�s fatigue is very limited and has not been fully addressed. Objectives: This study was aimed to analyze the efficacy of fatigue-controlled training program to reduce objective and subjective fatigue and increase knowledge of fatigue among university teachers. Methods: A quasi experimental design was used to examine the efficacy of fatigue-controlled training among university teachers in intervention and control groups. As many as 37 teachers from intervention group and 40 teachers from control group completed T1 (baseline) and T2 (follow-up) data on knowledge, subjective fatigue using an item subscale of Self-Diagnosis Checklist for Assessment of Workers� Accumulative Fatigue and reaction timer for objective fatigue using reaction timer Lakassidaya L77. Results: The results of repeated measured analysis of variances showed that fatigue-controlled training program was associated with higher knowledge and lowered subjective fatigue and reaction time compared with control group. Significant main effects of fatigue-controlled training on knowledge, subjective and reaction time were revealed. After controlling for all covariates, the repeated measured analysis of variances showed significant main effects of fatigue controlled training program on knowledge and subjective fatigue. Conclusions: Fatigue-controlled training program reported in this study was efficacious to enhance university teachers� knowledge about fatigue and occupational health and safety at a work place. After traininguniversity teachers experienced lower subjective fatigue and reaction time. This program may be considered as an initial strategy for occupational safety and health program in education setting to reduce subjective fatigue particularly among university teachers. The training should be conducted frequently to enable university teachers controlled their fatigue

HUBUNGAN ANTARA KEJADIAN REAKSI DENGAN KECACATANPADA PENDERITA KUSTA (Studi Kohort Retrospektif di Kabupaten Blora, Jawa Tengah )

Background : Incidence of disability is the main problem by leprosy. Disability maked patients will be shunned, ostracized and difficult to get a job that will be dependent on others both physically and financially. Blora District a high endemic area of leprosy with a high defect rate that far exceeds the national target (13%). Incidence of reactions was also occured by both types of lepros

ANALISIS SPASIAL DAN FAKTOR RISIKO TB PARU DI PUSKESMAS KABUPATEN BANYUMAS TAHUN 2013

Background: Pulmonary TB is still a problem in Banyumas. Cases in Puskesmas, in 2012, 716 cases, the most cases in District of Kembaran. Contact with previous TB patient, dwelling density, poverty, smoking status, and diabetes mellitus as risk of pulmonary TB. Spatial analysis such as buffers, clusters, and diffusion describe patterns of TB transmission. Objectives: to know relationships contacts with previous TB patient, dwelling density, poverty, smoking status, and diabetes mellitus against pulmonary TB, and the pattern of spatially TB distribution. Methods: study design is, spatial and case-control study, subject 10 -> 64 years. Cases are smear-positive pulmonary TB, the fourth quarter of 2012 to the third quarter of 2013. Controls were patients who are not sick pulmonary TB. Samples were taken by purposive sampling, and do matching based age and gender, a sample size of 124 people. Data collection by questionnaires, and location coordinates by GPS (Global Positioning System). Analysis by logistic regression, using Stata version 10 while buffer and kernel density analysis by arcgis arview. Results: subjects aged 11-80 years old. Pulmonary TB associated with previous TB patients contacts (coworkers) (p = 0.04

SISTEM PENDUKUNG KEPUTUSAN KLINIS DALAM PELAKSANAAN INA-CBG DI RSUP DR. SARDJITO YOGYAKARTA (MODEL PENERIMAAN TEKNOLOGI OLEH KLINISI)

Introduction. Some problems occurred, after the implementation of the DRG in the Sardjito Hospital Yogyakarta. One is them is a discrepancy between the real health care cost and INA-CBGs tariff. This establishes the gap. Gap was caused by incompatibility use drug formularies, incompatibility laboratory use, incompatibility using other medical support services with standard INA-CBGs, errors diagnosis coding classification INA-CBGs, LOS lengthy, incomplete medical records and more. Studies to investigate the cause of the gap will help hospitals to control expenditure financing. Modeling gap with several factors is used to help efficiency planning of clinical care of patients JAMKESMAS. The gap modeling will be used to construct clinical decision support systems. Clinical decision support systems are used by clinician in medical care planning that did not cause financial loss to the hospital and the patient. Objective. 1) This study was analyze the factors that influence the gap of Acute Lymphoblastic Leukemia (ALL) diagnosis. ALL is the diagnosis with the highest rates of visits and gap. 2) Constructing Clinical Decision Support System (DSS) applications that can help clinician provide health services with efficient cost. 3) Evaluate the level of clinician acceptance of clinical decision support systems applications. Methods. This research is quantitative and qualitative in-depth interviews and focus group discussions. The sample was medical records of ALL patients in 2009-2010 in Sardjito Hospital. To analyze the factors that influence the gap using ridge regression analysis, in order to eliminate the effects of multicollinearity among the independent variables. To analyze the level of acceptance of DSS application using path analysis. The analysis is based on data about the clinician's perception of the application. Clinician sample size was 31 residents. Results. The diagnosis of ALL have outlier values of gap as much as 8.1%. ALL patients were included in the group of chemotherapy without complication comorbidity (without CC)and Length of Stay (LOS) high (> 5 days) about 20.8%. It causes chemotherapy without CC have extreme values (outliers) of gap. The main factors that affect the gap is the cost of medicine / medical equipment and medical support costs. This occurred in the group of patients chemotherapy with CC and chemotherapy with major CC. While the chemotherapy without CC, the main factors affecting the gap is the cost of accommodation. Clinician acceptance of the DSS application is affected by the ease of application used. Benefits of the application of INA-CBGs and useful applications to have only small influence, whereas clinician knowledge about the INA-CBGs do not affect the interest of clinicians using the application Conclusion. Heterogeneity gap values found in patients without CC with the highest factor affecting gap was cost of acomodation. Cost of acomodation is related to the length of patients treated in the chemotherapy group without CC. Based on the results of FGD with clinicians, the cause of the high days of treatment in patients with chemotherapy without CC is indiscipline clinicians fill medical records so that the classification grouping CBG should be shifted from CBG chemotherapy with CC / MCC, but classified in the chemotherapy group without CC. Highest gap in the chemotherapy group with CC and MCC, with the highest factors that affect the gap is cost of medicine/medical equipment. DSS applications have acceptance rate of 61.3% and was highest influence on the ease of application used

PENGEMBANGAN MODEL SISTEM INFORMASI MANAJEMEN DOKUMEN ELEKTRONIK PELAYANAN FARMASI DALAM RANGKA AKREDITASI RS PKU MUHAMMADIYAH CEPU KABUPATEN BLORA

PKU Muhammadiyah Hospital of Cepu is a private hospital for medical referral in Cepu regions. Just as other hospitals, PKU Muhammadiyah Hospital of Cepu is obliged to participate in accreditation based on Health Minister�s Decree of number 436/ Menkes/ SK/ VI/ 1993. Fulfil the accreditation, a good and well-planned preparation is needed to improve quality and readiness of all parts of the hospital in order to support accreditation smoothness. Pharmaceutical services are one of services that are found in second phase of the accreditation process, an information system needed to support pharmaceutical installation needs on help the successful accreditation process. Purpose of the research was to develop a model of Management Information System of electronic document of pharmaceutical service accreditation in order to support accreditation of PKU Muhammadiyah Hospital of Cepu, Blora Regency. The research is a descriptive-qualitative study research with an action research design. Development of a management information system of electronic document for accreditation of PKU Muhammadiyah Hospital of Cepu by using Webbased prototyping with CodeIgnitier Framework. Subjects of the research are director, leader of accreditation team, secretary, working groups, chief of pharmaceutical installation and secretary division of PKU Muhammadiyah Hospital of Cepu. Analysis of demand for the information system and evaluation of the information system are based on a HOT-Fit method. Data were collected by observation of the existing system, reviewing documents and in depth interview. Development of a model Management Information System of electronic document for hospital accreditation in pharmaceutical installation of PKU Muhammadiyah Hospital of Cepu was found appropriate to use. The document database that can be managed effectively and efficiently. The Information System can be used in simulation of accreditation scoring of a Hospital in second stage

KAJIAN DETERMINAN SOSIAL KEJADIAN TUBERKULOSIS PARU BERBASIS GEOSPASIAL DAN MODEL PREDIKSINYA DI BANDAR LAMPUNG

TB Background: TB control program has been successful in increasing the cure rate and saved many lives, but less successful in reducing the incidence, especially in thirteen countries with high TB incidence, including Indonesia. Therefore, TB control will move \"out of the box TB\" with emphasis on the social determinants. In Bandar Lampung, the incidence of TB has been increasing, although its cure rate has been reaching above 85%. Bandar Lampung also has low social determinants and low TB�s risk factors indicators. Objectives of this research are to provide a prediction model of social determinants and TB incidence as well as to study spatial analysis of social determinants and TB incidence. as case group Methods: The research was conducted at 27 primary health centers and one hospital that have implemented DOTS strategy in Bandar Lampung. Population of the research consisted of all patients with smear-positive TB that was recorded in the health services during January to July 2012 with total of 628 people. In the first subtopic, sample consisted of 238 cases of smear-positive TB patients and 238 TB suspects who have been diagnosed without TB as control group. Variables of the first subtopic of this research are social determinants, housing conditions, household food security, access to health service and incidence of TB. In the second sub-topic, sample consisted of 628 patients with smear-positive TB. Variable in this sub-topic consisted of the geographical coordinates of patients with TB, population density and proportion of poor households. Analysis of this research consisted of Structural Equation Modeling with Partial Least Square method, SaTScan and Geoda 0.95-i (Beta). : Results: The result shows that the social determinants affect TB incidence through housing conditions and household food security with equation TB incidence = 0,266* housing condition + 0,094* social determinants + 0,328* household food security + 0,067* health access and R 2 = 34.15%. Spatial analysis proved that although there is no spatial relationship between population density and the proportion of poor household of TB incidence, but the distribution and clustering of TB has been occurred in areas with high number of both population density and proportion of poor household. Conclusions: Social determinants indirectly influence the TB incidence through housing conditions and food safety. Therefore, it is required a DOTS program that supported by improvement efforts of the social determinants that will be able to improve housing conditions and food safety. The program should be supported by other health related sectors and other sectors