Implementation of Village Government Public Services During the Covid-2019 Pandemic

Public services will continue to run and are needed even though the world and society are faced with various situations and conditions. The current Covid-19 pandemic requires governments at all levels of government to make arrangements and adjustments. Through the use of a qualitative design this research was conducted to explain the form and pattern of services carried out by the village government in the Sonder District Government, Minahasa Regency, North Sulawesi Province in the Covid-19 pandemic situation. work for local governments during the Covid 19 pandemic and work systems in the new normal order set by the central government as well as the implementation of health protocols. The form and pattern of public services is limited in terms of time and physical involvement in the village office, dividing work in the form of pickets and conducting house-to-house services and utilizing communication media for the publication of service information. Work competence and supporting facilities as a step in implementing online services as needed and required during the pandemic have not been carried out

Toilet Sanitation Management in Supporting the Implementation of Public Services

Good toilet sanitation management will not only provide added value in service satisfaction but is also a reflection of personal and environmental hygiene. However, toilet sanitation is one of the problems that people often complain about when they are in government offices. The availability of good toilet sanitation facilities has not been a concern of the government until now. This research was conducted using a qualitative design, collecting data directly or using google form and making direct observations of the condition of the toilet and its management. Data collection was also carried out using researchgate, google scholars and google scholars. By using systematic literature review technique data analysis and the use of primary data, it was found that the management of toilet sanitation in government offices was not good as seen from the quality of cleanliness and availability of facilities. There is no work unit available and responsible for toilet sanitation hygiene. The government can fix this by collaborating with third parties with a cleaning service workforce outsourcing system

Management of Natural Tourism Objects in Minahasa Regency North Sulawesi Province

Minahasa Regency has the potential of natural resources to become a tourist attraction. This potential has been managed by the government but the management pattern is the same as that carried out by other regions that rely more on natural conditions. This research was conducted to find the form and pattern of managing natural tourism objects in Minahasa Regency. The research method used is descriptive qualitative. The findings of this study are that the form and pattern of managing natural tourism objects in Minahasa Regency can be done by combining the principles of local wisdom and special local sense.    reflecting the uniqueness of the cultural heritage and the uniqueness of the environment. Natural tourism objects in Bukit Kasih, Lake Tondano and at Kombi Beach in Minahasa Regency have the value of local wisdom and special local sense which can be used as main aspects in managing tourism objects such as the Toar Lumiluut story, the symbol of inter-religious harmony, the legend of Watu Pinabetengan, the legend of the tondano lake, the history of Fort Moraya, the Japanese Heritage Airport Site as well as performances for maengket dance, katrilli and fish farming tours, planting rice around Lake Tondano and the community of grabah craftsmen

Pemanfaatan Alokasi Dana Desa (Add) dalam Pembangunan Desa Didesa Tanjung Sidupa Kecamatan Pinogaluman Kabupaten Bolaang Mongondow Utara

Abastrack: In accordance with the village development goals mandated in Law No. 6 of2014, thus, the Utilization of Village Allocation Fund (ADD) is expected by the GovernmentBolaang North Mongondow can increase community participation in rural development in mutualcooperation. Rural development is directed to make optimum use of natural resources and humanresources development by improving the quality of life, skills and initiative with guidance andassistance from the government.To find out how the Village Fund Allocation Utilization in promoting rural development inthe village of Tanjung Sidupa District of North Mongondow Pinogaluman Bolaang.As for the benefits of this research are: (1) Purpose Theoretical results of this study areexpected to be useful in the development of science related to the science of government. Especiallyin the analysis of the Village Fund Allocation Utilization (ADD). (2) Practical Uses results of thisstudy are expected to contribute ideas on the implementation of the policy to the perpetrators ofthe policy and decision makers related to the development of regional development.In this regard the government to increase the capacity of the village, development andempowerment of rural communities need to gain greater attention, including through the patternof allocation of funds pengelolahan village or the Village Fund Allocation (ADD). ADD isdistributed to all villages in North Mongondow Bolaang fair and equitable manner and its use inaccordance with the needs of the village.Based on the results of these studies in deduced that the utilization of the Village FundAllocation (ADD) as a replacement for the use of development funds / District Village can increasecommunity participation in village development in Tanjung Sidupa.Based on the conclusions of the research results it is suggested several things: (1) Tointensify community participation in rural development. (2) Create a bulletin board in every villageto announce the implementation report the use of ADD to be known by the whole community

Pengaruh Penerapan Sanksi Administrasi terhadap Tingkat Kesadaran Masyarakat dalam Membayar Pajak Bumi dan Bangunan di Kecamatan Melonguane Kabupaten Kepulauan Talaud

Property tax is a tax leived for the person or entityy that actually has the rights to theland and property, or to benefit over the earth and the building, which aims to provide benefitsfor the survival. Implementation of the tax, it still has not reached level as expected. Generallybecause people still laqck confidence in the existence of the tax because they feel burdensome,and the payment often have difficulty, misunderstanding of what society and how taxes andthe difficualty of calculating and reporting.This study di kecamatan Melonguane island. Population and sample taken amounted to 33people. Data obtained from 10 employees district offices, 20 communities in the districtMelonguane, and three employees of the local revenue office with interview terstukture, theanalyzed with statistical information that simple linear regression analysis and the simplecorrelatio analysis of penelitian can be concluded that the effect of the application ofadministrastive sanctions running properly where this is caussed their public awareness andthe role of government in addressing the problem

Neoadjuvant letrozole in postmenopausal estrogen and/or progesterone receptor positive breast cancer: A phase IIb/III trial to investigate optimal duration of preoperative endocrine therapy

<p>Abstract</p> <p>Background</p> <p>In recent years, preoperative volume reduction of locally advanced breast cancers, resulting in higher rates of breast-conserving surgery (BCS), has become increasingly important also in postmenopausal women. Clinical interest has come to center on the third-generation nonsteroidal aromatase inhibitors (AIs), including letrozole, for such neoadjuvant endocrine treatment. This usually lasts 3–4 months and has been extended to up to 12 months, but optimal treatment duration has not been fully established.</p> <p>Methods</p> <p>This study was designed as a multicenter, open-label, single-arm, exploratory phase IIb/III clinical trial of letrozole 2.5 mg, one tablet daily, for 4–8 months. The primary objective was to investigate the effect of neoadjuvant treatment duration on tumor regression and BCS eligibility to identify optimal treatment duration. Tumor regression (by clinical examination, mammography, and ultrasound), shift towards BCS eligibility, and safety assessments were the main outcome measures. Standard parametric and nonparametric descriptive statistics were performed.</p> <p>Results</p> <p>Letrozole treatment was received by 32 of the enrolled 33 postmenopausal women (median (range): 67.0 (56–85) years) with unilateral, initially BCS-ineligible primary breast cancer (clinical stage ≥ T2, N0, M0). Letrozole treatment duration in the modified intent-to-treat (ITT; required 4 months' letrozole treatment) analysis population (29 patients) was 4 months in 14 patients and > 4 months in 15 patients. The respective per-protocol (PP) subgroup sizes were 14 and 11. The majority of partial or complete responses were observed at 4 months, though some beneficial responses occurred during prolonged letrozole treatment. Compared with baseline, median tumor size in the ITT population was reduced by 62.5% at Month 4 and by 70.0% at final study visit (Individual End). Similarly, in the PP population, respective reductions were 64.0% and 67.0%. Whereas initially all patients were mastectomy candidates, letrozole treatment enabled BCS (lumpectomy) in 22 ITT (75.9%) and 18 PP (72.0%) patients.</p> <p>Conclusion</p> <p>Over half of patients become BCS-eligible within 4 months of preoperative letrozole treatment. While prolonged treatment for up to 8 months can result in further tumor volume reduction in some patients, there is no clear optimum for treatment duration. Letrozole has a favorable overall safety and tolerability profile.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier NCT00535418.</p

Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial

Background Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS. Methods In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358. Results Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6–8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64–1·23]). The non-inferiority of anastrozole was established (upper 95% CI <1·25), but its superiority to tamoxifen was not (p=0·49). A total of 69 deaths were recorded (33 for anastrozole vs 36 for tamoxifen; HR 0·93 [95% CI 0·58–1·50], p=0·78), and no specific cause was more common in one group than the other. The number of women reporting any adverse event was similar between anastrozole (1323 women, 91%) and tamoxifen (1379 women, 93%); the side-effect profiles of the two drugs differed, with more fractures, musculoskeletal events, hypercholesterolaemia, and strokes with anastrozole and more muscle spasm, gynaecological cancers and symptoms, vasomotor symptoms, and deep vein thromboses with tamoxifen. Conclusions No clear efficacy differences were seen between the two treatments. Anastrozole offers another treatment option for postmenopausal women with hormone-receptor-positive DCIS, which may be be more appropriate for some women with contraindications for tamoxifen. Longer follow-up will be necessary to fully evaluate treatment differences