417 research outputs found
Muslim Suardi Rekomendasi GB Prof Edy Meiyanto UGM
Muslim Suardi Rekomendasi GB Prof Edy Meiyanto UG
Patients’ Expectation Of Pharmaceutical Care In Puskesmas: A Qualitative Study
For the last decade in Indonesia, pharmacist roles and responsibilities has been
more expanding from medication dispensing to patient-focused care services
(Pharmaceutical Care). This alteration consequently will affect pharmacist-patient
professional relationship, including interpersonal communication. To determine the
relationship, pharmacist and patient rely on role perceptions of one another, which
also form expectations of one another and influence the produced interaction.
The aim of study is to describe the patients’ expectation of pharmacist associated
with Pharmaceutical Care practice in Puskesmas.
We developed a semi-structure interview guide using a focus group of clinical
pharmacists. The interview guide was used to direct face-to-face patient interviews
at 5 different Puskesmas in East Java. The interviews were conducted in April and
May 2011, recorded and transcribed verbatim. The interview transcripts were
analysed to determine related themes.
Total 10 interviews were conducted. Several themes emerged from interview
transcripts were medicines services, medicines information, self-surrender, and
speedy health recovery.
The lack of patients’ understanding of pharmaceutical care services could be one
reason for the minimal patients’ expectation from pharmacist
Pharmaceutical Care In Puskesmas: What We Have Done So Far (A Preliminary Survey)
Puskesmas, a Technical Implementation Unit of District Level Health Office, is
responsible to establish healthy community in specific working area, at least in a sub
district level (kecamatan sehat). Hence, pharmaceutical care in Puskesmas should be
well practiced. However, there is no published report regarding pharmaceutical care
implementation in Puskesmas.
This study aimed to describe the pharmaceutical care activities in several
Puskesmas in East Java and the related barriers.
Pharmaceutical Care in Puskesmas questionnaire (PCPQ) was developed using
Pharmaceutical Care in Puskesmas Guideline (2006) and The Government Regulation
No. 51 of 2009 on Pharmaceutical Activities. The questionnaire consisted of three
sections, i.e. Pharmaceutical Care, Monitoring and Evaluation, and Documentation.
Pharmaceutical Care section consisted of two subsections i.e. prescription service
and medicines information service. An expert panel had reviewed the content of
questionnaire.
Thirty six pharmacists from different Puskesmas in East Java completed the
survey in April, May and September 2011 and in June 2012. All activities stated in the
questionnaire had been implemented by pharmacist in Puskesmas, although in vary
level of frequency. In providing prescription service, 97.2% (35/36) pharmacists had
checked patient’s name, appropriateness and suitability of medicines dose and
administration; and had consulted prescriber if medicines prescribed were not
available. Medicines information had been given by pharmacists were time to use
medication [91.7% (33/36)], the way to use medication [88.9% (32/36), medication’
name and indication [86.1% (31/36)], and the way to store medication [86.1%
(31/36)]. Meanwhile, the activities implemented by only 44.4% (16/36) and 47.2%
(17/36) pharmacists were in Monitoring section, i.e. measuring patient’s satisfaction
toward Puskesmas services and monitoring specific disease (tuberculosis, diarrhea,
and malaria) respectively. The reported barriers for pharmaceutical care
activitiesw ere lack of administrative completeness and limited supporting
infrastructure and resources.
There is variation in implementation level of Pharmaceutical Care activities by
pharmacists in several Puskesmas in East Java. Observation of actual implementation
and barriers in daily practice need to be explored further
Extracts Ethanol of Centella Asiatica Enhance Interferon-gamma and Tumor Necrosis Factor-alpha in Macrophage Culture Infected by Mycobacterium Tuberculosis
Micobacterium tuberculosis has capacity to manipulate host defense pathway, particularly the ability to inhibit cellular immune response. Centella Asiatica is a medicinal plant which able to treaat inflammatory condition and infection. The aims of this research is to determine the effect of the extracts of Centella asiatica in enhancing interferon-gamma and tumor necrosis factor alpha in macrophages culture infected by Mycobacterium tuberculosis.
Cultured macrophages derived from monocytes were isolated from human
peripheral blood vessels. Macrophages that pretreated with extracts ethanol Centella asiatica
for 2 days were infected by Mycobacterium tuberculosis H37 Rv. After 2 hours, the cultured
macrophages were washed with 2o/o FBS-HBSS to remove unphagocSosed bacteria. The
resultant macrophages were further cultured in fresh medium (0.2 ml) at 37 C in a CO2
incubator for up to 2 days. Interferon- gamma and tumor necrosis factor- alpha levels were measured
using ELISA method.
The result have shown that the extracts ethanol of Centella asiatica at 200 ppm and
400 ppm were able to enhance significantly interferon-gamma and tumor necrosis factor-alpha. In
conclusion, the extracts ethanol of Centella asiatica can enhance interferon-gamma and tumor
necrosis factor-alpha in macrophages culture infected by Mycobacterium tuberculosis
POCKET BOOK AS AN EDUCATIONAL METHOD TO IMPROVE PATIENT’S KNOWLEDGE AND ADHERENCE TO RATIONAL ANTIBIOTIC USE: A RANDOMIZED CONTROLLED TRIAL IN SURABAYA
Background: Irrational use of antibiotics has caused bacterial resistances. The lack of
understanding of antibiotic use contributes to this phenomenon. Based on survey results in
Surabaya, the level of bacterial resistance to antibiotics was high due to lack of
understanding of education from health care providers in a time constrained context. We
tested the effectiveness of pocket book to provide a new way of education that is more
informative and easily understood by patients.
Methods: We conducted a Randomized Controlled Trials in 200 patients who got antibiotics
prescription in a community pharmacy. The intervention group received a pocket book
summarizing the information of rational antibiotic use plus a standard education about
antibiotic use given by pharmacist, while the control group received only the standard
education. A validated questionnaire was used to test patient's knowledge and adherence.
Intention to treat analysis was used to measure the outcome.
Results: The baseline characteristics and the pre-test showed that the groups are
comparable. There is no significant difference between the intervention and the control in
level of knowledge pre-test (10.78 ± 2.647, p = 0.345), but there are significant difference in
the level of knowledge post-test (11.72 ± 2.362, p = 0.02) and the level of adherence (2.36 ±
1.021, p = 0,011). The difference of level of knowledge between intervention and control
group is clearly seen at their percentage of right answers from each question.
Conclusion: This education method with pocket book has significant influence on the
knowledge and adherence of patients to rational antibiotic use
EFFECT OF ERDOSTEINE ON HEALTH STATUS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic obstructive pulmonary disease (COPD) is a respiratory system disease that causes high morbidity and mortality in the world. Exposure to oxidant substances from smoking and air pollution on the lungs will lead to lung inflammation and worsening of COPD conditions. Therefore we need an antioxidant agent that can inhibit oxidative stress in order to obtain improved health status in COPD patients.Objectives. To analyze the comparison between the health status of COPD patients who get regular pharmacotherapy and COPD patients who received additional erdosteine in their treatment. Methods. Randomized-double blind study. The study subjects were divided into two randomized groups, regular pharmacotherapy group (control) and groups of regular pharmacotherapy plus erdosteine (test). Observations made during the 10 days, the parameter used is the score of Clinical COPD Questionnaire. Outcomes. In the control group, after 10 days, the values obtained between pre-test and post-test differ significantly in symptom score (p = 0.000; CI 95%), functional score (p = 0.001; CI 95%), mental score (p = 0.001; CI 95%), and total score (p = 0.000; CI 95%). Likewise, the value in the test group, symptom score (p = 0.000; CI 95%), functional score (p = 0.002; CI 95%), mental score (p = 0.000; CI 95%), and total score (p = 0.000; CI 95%). However, the improvements that analyzed with delta scores between pre-test and post test showed a better improvement in the test group symptom score (p = 0.040; CI 95%), mental score (p = 0.023; CI 95%), and total score (p = 0.022; CI 95%). Meanwhile, the delta functional score between the two groups was not significant (p = 0.835; CI 95%). Conclusion. Overall, regular pharmacotherapy or with additional erdosteine can provide significant improvements in COPD patients, but the value of improvements is greater in patients who get an additional erdosteine
A 3-YEAR ECOLOGICAL STUDY OF ANTIBIOTIC USE AND ANBIOTIC RESISTANCE AT A PRIVATE HOSPITAL IN INDONESIA,2008-2010
BACKGROUND:
Antibiotic use is one of the main risk factors for the development of antibiotic
resistance. Several studies have investigated the relationship between antibiotic use
and antibiotic resistance, but the results of these studies have been inconsistent.
OBJECTIVE:
We investigated the relationship between antibiotic use and antibiotic resistance at a
private hospital in Surabaya, Indonesia, from 2008-2010.
METHOD:
This was an ecological study based on inpatient retrospective data froma private
hospital in Surabaya 2008-2010.We examined the percentage of resistantbacterial
isolates (using WHONET software)as the dependent variable and the amount of
antibiotic use (expressed as defined daily doses (DDDs) per 100 patient days) as the
independent variable. Correlation and linear regression analyseswere used to
analyse antibiotic use and antibiotic resistance among six most commonly isolated
bacteria: Escherichia coli, Klebsiella pneumoniae ss. pneumoniae, Pseudomonas
aeruginosa, Acinetobacter baumannii, Staphylococcus epidermidis and Streptococcus
non-haemolytic (gamma).
RESULT:
Total antibiotic use was 80.9 DDD per 100 patient days.The most commonly used
antibiotics were ceftriaxone (10.7 DDD per 100 patient days), levofloxacin (8.6 DDD
per 100 patient days) and amoxicillin (8.3 DDD per 100 patient days). Correlation
between antibiotic use and antibiotic resistance was weak and not statistically
significant for the six bacteria (R = -0.04–0.2; p = 0.4–0.9). The small R2 (0.002–0.04)
indicated much stronger factor(s)other than the use of antibiotics that affected
antibiotic resistance.
CONCLUSION:
This ecological study found no significant relationship between antibiotic use and
antibiotic resistance.There needs to be further research to analyse antibiotic use,
antibiotic resistance and other factors affecting antibiotic resistance
The FORA Framework - A Fuzzy Grassroots Ontology for Online Reputation Management
Online reputation management deals with monitoring and influencing the online record of a person, an organization or a product. The Social Web offers increasingly simple ways to publish and disseminate personal or opinionated information, which can rapidly have a disastrous influence on the online reputation of some of the entities. The author focuses on the Social Web and possibilities of its integration with the Semantic Web as resource for a semi-automated tracking of online reputations using imprecise natural language terms. The inherent structure of natural language supports humans not only in communication but also in the perception of the world. Thereby fuzziness is a promising tool for transforming those human perceptions into computer artifacts. Through fuzzy grassroots ontologies, the Social Semantic Web becomes more naturally and thus can streamline online reputation management. For readers interested in the cross-over field of computer science, information systems, and social sciences, this book is an ideal source for becoming acquainted with the evolving field of fuzzy online reputation management in the Social Semantic Web area.
Edy Rahmayadi Governor of North Sumatra's Leadership Style in Infrastructure Development in North Sumatra for the 2018-2023 Period
Edy Rahmayadi's victory as Governor of North Sumatra 2018-2023 was the
beginning of a number of major tasks such as overcoming the Covid-19 Pandemic
and especially the development and revitalization of North Sumatra's
infrastructure. Edy Rahmayadi, who has a military background, has his own unique
leadership style when leading North Sumatra 2018-2023. The theory that the author
uses is the theory of good governance and political leadership style. This research
aims to describe the factors that influence infrastructure development in North
Sumatra and the relationship between Edy Rahamayadi's leadership style for the
2018-2023 North Sumatra Governor Period on North Sumatra's infrastructure
development. The research method used to answer this research is descriptive
qualitative research method, through literature study, observation and interviews.
The results of this research include: (1) At the beginning of his leadership, Edy
Rahmayadi's leadership style was tough and firm where he did not care about other
people's opinions about him, this disharmonization even occurred with his
subordinates and even his deputy, namely Musa Rajekshah, so it can be said that
Edy's leadership style was authoritarian. ; (2) Edy's character is dynamic, able to
accept opinions from multi-segment communities, and has good thoughts and ideas,
so it can be said that Edy is a transformational leader; (3) Edy Rahmayadi is
considered capable of stabilizing the conditions affected by Covid-19, apart from
that, Edy is a leader who prioritizes dialogue and collaboration, therefore it can be
said that Edy is a leader with a participative leadership style.95 PagesSkripsi Sarjan
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