Analisis Kelembagaan Organisasi Di Badan Penanggulangan Bencana Daerah Provinsi Jawa Tengah

The organizational structure is a hierarchical arrangement of organizations ranging from the lower level to the upper level. In each hierarchical division of labor are complex and require specialized expertise in each task execution. BPBDs structure Central Java province has advantages in the job descriptions of the structure of the organization. Human resources have yet to be appropriate competencies for the organization\u27s needs, the emergence of a dispute between the employees and the workload between field uneven. Results of the study aims to describe and analyze the institutional organization and organizational design BPBDs Central Java Province. This type of research used qualitative descriptive data analysis using taxonomic analysis techniques. Selection informant by purposive sampling that later developed through snowball sampling. Data collection techniques used were observation, interviews, documentation and literature. Based on this research, organizational strategy realized in accordance with the target effectively and efficiently manage resources. BPBDs Central Java province has a flat organizational structure, with the advantages of the structure of the job descriptions. Extensive networks reflected on the steering element. Functional organization has not materialized yet being filled with functional groups. As a learning organization, BPBDs Central Java Province continues to improve the quality of employees and freedom emergence of collective aspirations. In terms of organizational design, structural configurations according to the Regional Disaster Management Agency of Central Java province is a simple structure and the structure of professional bureaucracy. Institutional organization BPBDs Central Java Province is still in institutional strengthening. Expected to BPBDs Central Java province to do to optimize the budget to improve the competence of personnel resources and infrastructure, consider filling the functional position, and initiate meetings on the middle line, in order to create a pattern of horizontal communication with the operating core

General Aviation Weather Encounter Case Studies

This study presents a compilation of 24 cases involving general aviation (GA) pilots’ weather encounters over the continental U.S. The project team interviewed pilots who had experienced a weather encounter, and we examined their backgrounds, flight experience, and weather encounter details. Results from meteorological data analysis for each weather encounter were consistent with findings of larger GA weather accident studies in terms of the types of hazards encountered and flight phase during which the encounters occurred. Investigation of pilot weather products and the sources from which they were obtained revealed a lack of uniformity of pre-flight data sources and underutilization of available en route flight information services. The team used these results to develop a set of pilot weather education and training recommendations intended to reduce the number and severity of weather encounters

Aging Puerto Ricans’ Experiences of Depression Treatment: A New Ethnographic Exploration

PurposeTo examine aging Puerto Ricans’ experiences with and perceptions of depression treatment.Methodology/approachIn-depth analysis of eight exemplary cases from ethnographic interviews with a subsample of 16 aging Puerto Ricans in the Boston area who are part of the Boston Puerto Rican Health Study.FindingsThe results show that respondents were resistant to accepting pharmacological treatment for their depression, and they often characterized antidepressants as “dope.” Moreover, they claimed that in addition to their health problems, social stressors such as financial strain, lack of jobs, housing problems, and social isolation are triggering or contributing to their depression. Because of this, they express reluctance in accepting clinical treatment only, and suggest that broader social issues and other health needs ought to be addressed as part of an effective treatment. For many, pharmacological treatment is acceptable only in the more severe forms of depression.Research limitations/implicationsThese results have important implications for improving the quality of depression treatment and reducing health disparities for mainland Puerto Ricans.Originality/value of chapterEven though recent studies continue to show a high frequency of depression among Puerto Ricans, issues of treatment quality are still understudied and ethnographic accounts are especially lacking. Our study offers an exploratory investigation of this unresolved research issue

Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran

<p>Abstract</p> <p>Background</p> <p>People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran.</p> <p>Methods</p> <p>In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach.</p> <p>Results and discussion</p> <p>Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress.</p> <p>Conclusions</p> <p>While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.</p

Psychometric properties of the 12-item WHODAS applied through phone survey: an experience in PERSIAN Traffic Cohort

Background Due to limited capability to function in post-injury daily life injury, survivors need to be reliably assessed without need to commute more than necessary. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate into Persian and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury. Methods First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel evaluation, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, through a psychometric study within a national cohort platform, the validity, reliability and applicability of the 12-item WHODAS was assessed through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test-retest data of 50 patients with an average 7-day time span. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on data from 255 patients. Regarding the multiple criteria including an eigenvalue > 0.9, Cattell's scree test, cumulative variance, and the theoretical basis, the minimum number of factors were retained. Data were analyzed using STATA statistical software package. Results The respondents were mostly male (81%), employed (71%), educated (87%), and with a mean age of 37.7(14.9). The Persian version had high internal consistency reliability (Cronbach's alpha = 0.93) and excellent stability reliability (ICC = 0.97, 95% CI: 0.92-0.98). An exploratory factor analysis retained four factors defining 86% of all the variance. Factors of Self-care, Mobility, and Cognition were completely retained. Conclusions The brief Pesrian WHODAS 2.0 was highly reliable and valid to be applied through phone interviews post injury

The association between melasma and iron profile: A case-control study

Background ' Melasma is a chronic acquired localized hypermelanosis, causing aesthetic problem for women and impairing their quality of life. Evidence has suggested that hyperpigmentation can occur as a result of iron deficiency anemia and vitamin B12 deficiency. Aim ' We aimed to evaluate the serum parameters of iron profile in melasma patients. Material and Methods ' This case-control study investigated 51 adult non pregnant women with melasma, compared with 51 controls, from patients referred to the Hospital, Tehran, Iran, 2017-2018. Melasma was diagnosed clinically according to the melasma area and severity index (MASI) score was calculated and recorded by the physician. The groups were compared in terms of vitamin B12, folate, serum iron, hemoglobin (Hb), mean corpuscular volume (MCV), total iron binding capacity (TIBC), and ferritin. Results ' The mean and standard deviation of the women's age was 36.89±8.88 years, significantly higher in the group of patients with melasma. Comparing the serum parameters between the groups indicated no statistically significant difference in terms of mean levels of ferritin, Hb, MCV, iron, vitamin B12, TIBC, and folate. The women in melasma group had a higher frequency in below normal range of ferritin and serum iron compared to the control group. None of the serum parameters were correlated with MASI. Conclusion ' The higher frequency of below normal range of ferritin and serum iron levels in women with melasma compared to the control group showed a possible association between these serum parameters and melasma. © 2020, LLC Science and Innovations, Saratov, Russi

Mammography screening: views from women and primary care physicians in Crete

Background: Breast cancer is the most commonly diagnosed cancer among women and a leading cause of death from cancer in women in Europe. Although breast cancer incidence is on the rise worldwide, breast cancer mortality over the past 25 years has been stable or decreasing in some countries and a fall in breast cancer mortality rates in most European countries in the 1990s was reported by several studies, in contrast, in Greece have not reported these favourable trends. In Greece, the age-standardised incidence and mortality rate for breast cancer per 100.000 in 2006 was 81,8 and 21,7 and although it is lower than most other countries in Europe, the fall in breast cancer mortality that observed has not been as great as in other European countries. There is no national strategy for screening in this country. This study reports on the use of mammography among middleaged women in rural Crete and investigates barriers to mammography screening encountered by women and their primary care physicians. Methods: Design: Semi-structured individual interviews. Setting and participants: Thirty women between 45–65 years of age, with a mean age of 54,6 years, and standard deviation 6,8 from rural areas of Crete and 28 qualified primary care physicians, with a mean age of 44,7 years and standard deviation 7,0 serving this rural population. Main outcome measure: Qualitative thematic analysis. Results: Most women identified several reasons for not using mammography. These included poor knowledge of the benefits and indications for mammography screening, fear of pain during the procedure, fear of a serious diagnosis, embarrassment, stress while anticipating the results, cost and lack of physician recommendation. Physicians identified difficulties in scheduling an appointment as one reason women did not use mammography and both women and physicians identified distance from the screening site, transportation problems and the absence of symptoms as reasons for non-use. Conclusion: Women are inhibited from participating in mammography screening in rural Crete. The provision of more accessible screening services may improve this. However physician recommendation is important in overcoming women's inhibitions. Primary care physicians serving rural areas need to be aware of barriers preventing women from attending mammography screening and provide women with information and advice in a sensitive way so women can make informed decisions regarding breast caner screening