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    POLA PENGGUNAAN OBAT, OBAT TRADISIONAL DAN CARA TRADISIONAL DALAM PENGOBATAN SENDIRI DI INDONESIA

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    The National Socio-Economic Survey data 2001 has been analyzed to obtain information on the pattern of the use of medicine, traditional medicine and traditional methods on self-medication. The target population was 225.057 Indonesians who claimed to be ill in 27provinces except Naggroe Aceh Darussalam and Maluku. The sample was people who took medicine, traditional medicine and or traditional methods on self-medication during the last one month before the survey. The data were analyzed using univariat and proportion method. The result of data analysis were: (1) The percentage of Indonesian people who took medicine on self-medication made a normal curve for age, inversity related with the cost of medication and was higher in the urban area, (2) The percentage of Indonesian people who took traditional medicine and traditional methods on self-medication was correlated with age, duration of illness, medication cost and was higher in rural area, (3) The percentage of Indonesian who took self medication was higher among the lower educated, lower economic status and who have less severe illness, and (4) The percentage of Indonesian who took self-medication has been decreased from 62.2% to 57.7% within 4 years period, especially on the use of medicine, but the use of traditional medicine and traditional method have been increase

    Kemandirian dan Ketersediaan Obat Era Jaminan Kesehatan Nasional (JKN): Kebijakan, Harga, dan Produksi Obat

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    National Health Insurance (JKN) is a guarantee program that provides health protection to participants to obtain health care benefits and protection in meeting the basic health needs provided to everyone who pays contributions or whose contributions are paid by the government. Health insurance coverage includes promotive, preventive, curative and rehabilitative including medicines and medical devices. Since the enactment of JKN on 1 January 2014, the demand for generic drugs has greatly increased. JKN drug independence is needed in terms of drug availability, access and affordability of JKN drug.The aimed of this research is to find out the independence and availability of drugs in the JKN era. The study design was cross sectional by conducting interviews, Round Table Discussion, and tracking secondary data documents.The results of this study obtained government policies related to JKN drug price, especially generic drugs, have not fully considered the interest of community and the interest of the pharmaceutical industry, as well as drug price control policies to ensure the availability of drugs both in number and type in the JKN era, especially generic drugs that have not been optimally accessed by the public.The government needs to encourage the independence of JKN drugs, especially generic drugs that have not been fulfilled, with the development of domestic production of medicinal raw materials to support JKN, which is currently mostly imported and the price of imported raw materials continue to rise.The priority of production of medicinal raw materials based on local extractive and fermentative. Abstrak Jaminan Kesehatan Nasional (JKN), merupakan program jaminan yang memberikan perlindungan kesehatan kepada peserta untuk memperoleh manfaat pemeliharaan kesehatan dan perlindungan dalam memenuhi kebutuhan dasar kesehatan yang diberikan kepada setiap orang yang membayar iuran atau yang iurannya dibayar oleh pemerintah. Jaminan pelayanan kesehatan meliputi promotif, preventif, kuratif, dan rehabilitatif, termasuk obat dan alat kesehatan. Sejak diberlakukannya JKN pada 1 Januari 2014, permintaan obat generik sangat meningkat pesat. Kemandirian obat JKN diperlukan dalam hal ketersediaan obat, akses, dan keterjangkauan obat JKN. Tujuan penelitian ini untuk mengetahui kemandirian dan ketersediaan obat era JKN. Desain penelitian adalah cross sectional, dengan melakukan wawancara, round table discussion, dan penelusuran dokumen data sekunder. Hasil penelitian diperoleh kebijakan pemerintah terkait harga obat JKN khususnya obat generik, belum sepenuhnya mempertimbangkan kepentingan masyarakat dan kepentingan industri farmasi,serta kebijakan pengendalian harga obat untuk menjamin ketersediaan obat baik jumlah dan jenisnya di era JKN, khususnya obat generik, belum optimal diakses oleh masyarakat. Pemerintah perlu mendorong kemandirian obat JKN khususnya obat generik yang belum terpenuhi, dengan pengembangan produksi bahan baku obat dalam negeri untuk mendukung JKN, yang saat ini sebagian besar masih impor dan harga bahan baku impor yang terus naik. Prioritas produksi bahan baku obat yaitu berbasis sumber daya lokal, ekstraktif, dan fermentati

    Consumers’ Perception in Pharmacy Services in Three Cities in Indonesia

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    Better health services have a strategic role and take part in public health improvement (Blum, 1974). Better quality of pharmacy service and pharmaceutical care may provide public needs and demands, ---which always change and increase, as well as reduce risks, and should be improved continually and be patient (consumer) oriented. To increase the quality of pharmacy service and pharmaceutical care, we need to know what the consumers impression about the pharmacy services they received currently and what the ideal pharmacy is according to consumers opinion. Consumer's impression to pharmacy services in this survey is assessed, based on tangibles dimension (physical facilities, men power etc.), reliability and responsiveness of the services, assurance and empathy. The consumer's impression is categorized as good and bad. Result: overall, 74.5% of consumers had a good impression about the pharmacy although pharmaceutical care they obtained had not yet complied with the community pharmacy standard. In three cities (Jakarta, Yogyakarta, and Makassar), pharmacy services and pharmaceutical care were still based on drug-oriented, and had not yet based on patient/consumer oriented. Pharmaceutical care which fulfilled the community pharmacy standard (such as drug information provided by pharmacist, counseling, medicine use monitoring and treatment evaluation, health promotion and education for patients), had not yet turn out to be a reason for consumers preference of a pharmacy

    Kekambuhan pada Pasien Penyalahguna Narkotika, Psikotropika, Zat Adiktif (Napza) Pasca Rehabilitasi: Kebijakan dan Program Penanggulangan

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    Abstract Narcotics, Psychotropic, and Addictive Substance Abuse (NAPZA) is a problem in Indonesia, one of the consequences is relapse. Relapse is a process where someone has been declared abstinence (recovered) and returns to using drugs. Relapse rates also still high in some countries. Drug users experience a relapse between one month to one year after leaving the treatment program. The aim of this research was to find out the policies and programs related to handling of NAPZA relapse in rehabilitation centers. The study design was cross sectional with qualitative study by conducting round table discussion (RTD) with stakeholders from the National Narcotics Agency (BNN), Drug and Food Control Agency (BPOM), Directorate for Prevention and Control of Mental Health and Drug Problems Ministry of Health, Drug Addiction Hospital, psychiatric practioners, volunteers, and confirmation to the rehabilitation center. The results of study showed that there was no national minimum standard for handling NAPZA relapse. The various relapse definition caused differences in relapse rates. Relapse rate according to Directorate Mental Health and NAPZA of the Ministry of Health in 2018 was 24.3% as rough figures (claim data). NAPZA relapse rates in the National Narcotics Agency, prior to the post rehabilitation program, was 90%, and decreasing to 30% after conducting post-rehabilitation program. While relapse rate in Rehabilitation and Therapy House, Lido Bogor was around 7%. There is no national standard for how many times a drug user is considered a victim or categorized as criminal action. In conclusion, there is Ministries/institutions of egocentrism in handling NAPZA relapse. Ministry of Health emphasizes medical rehabilitation, Ministry of Social emphasizes social rehabilitation, while BNN more comprehensively covering medical rehabilitation, social rehabilitation, and post rehabilitation. Narcotics, psychotropic, and comprehensive precursor control is carried out by the BPOM comprehensively, from imports, production, distribution, delivery and the use. The existence of E-NAPZA, administrative sanctions and criminal sanctions will reduce illicit trafficking and drug abuse. Indonesian Presidential Instruction No. 6 of 2018 concerning the National Action Plan for the Prevention of Eradication of drug abuse and Circulation (P4GN), in ministries/institutions is expected to decrease the number of NAPZA relapse. Abstrak Penyalahgunaan Narkotika, Psikotropika, dan Zat Adiktif (NAPZA) merupakan masalah di Indonesia yang salah satu akibatnya yaitu kekambuhan (relapse). Relapse merupakan suatu proses dimana seseorang telah dinyatakan abstinence (pulih) dan kembali menggunakan NAPZA. Angka relapse masih tinggi di beberapa negara. Pengguna NAPZA mengalami kekambuhan antara satu bulan sampai dengan satu tahun setelah keluar dari program pengobatan. Tujuan penelitian adalah untuk mengetahui kebijakan dan program yang terkait dengan penanggulangan relapse NAPZA di panti rehabilitasi. Desain penelitian berupa cross sectional dan studi kualitatif melalui round table discussion (RTD) dengan para pemangku kepentingan yaitu Badan Narkotika Nasional (BNN), Badan Pengawasan Obat dan Makanan (BPOM), Direktorat Pencegahan dan Pengendalian Masalah Kesehatan Jiwa dan NAPZA Kementerian Kesehatan, Rumah Sakit Ketergantungan Obat (RSKO), praktisi kejiwaan, dan relawan, serta konfirmasi ke panti rehabilitasi. Hasil penelitian yang diperoleh menunjukkan belum ada standar minimal nasional untuk penanganan relapse NAPZA. Definisi relapse yang beragam menyebabkan perbedaan angka relapse. Angka relapse di Direktorat Jiwa dan NAPZA Kementerian Kesehatan tahun 2018 yaitu 24,3% sebagai angka kasar (data klaim). Angka relapse NAPZA di BNN sebelum adanya program pasca rehabilitasi yaitu 90% dan setelah ada program pasca rehabilitasi menjadi 30%. Angka relapse di UPT Rumah Rehabilitasi dan Terapi NAPZA, Lido Bogor sekitar 7%. Belum ada standar secara nasional sampai berapa kali seorang penyalahguna NAPZA dianggap sebagai korban atau masuk kategori tindakan pidana. Kesimpulan penelitian menunjukkan adanya egosentrisme di masing-masing kementerian/lembaga dalam melakukan kebijakan penanganan penyalahgunaan NAPZA. Kebijakan Kementerian Kesehatan lebih menekankan pada rehabilitasi medis, Kementerian Sosial menekankan pada rehabilitasi sosial, sedangkan kebijakan BNN lebih komprehensif meliputi rehabilitasi medis, rehabilitasi sosial, dan pasca rehabilitasi. Pengawasan narkotika, psikotropika, dan prekusor komprehensif dilakukan oleh BPOM, mulai dari hulu sampai hilir yaitu dari impor, produksi, penyaluran, penyerahan, dan penggunaan. Aadanya aplikasi E-NAPZA serta sanksi administratif dan pidana dapat mengurangi peredaran gelap dan penyalahgunaan NAPZA. Melalui Instruksi Presiden Republik Indonesia No. 6 Tahun 2018 tentang Rencana Aksi Nasional Pencegahan Pemberantasan Penyalahgunaan dan Peredaran NAPZA dan Prekusor (P4GN) di kementerian/lembaga diharapkan membantu menurunkan angka relapse NAPZA

    Situasi Pencatatan dan Pelaporan Efek Samping Alat Kesehatan Beresiko di Rumah Sakit

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    The incidences of adverse effects of medical device used in hospitals either as an allergic reaction, user error or as a device malfimction have been much revealed in mass media up to this moment. In an attempt to develop an assessment and monitoring system of risky medical device in hospitals, a study to explore the medical device adverse eflects in type A, B and C hospitals in four provinces (North Sumatera, DKI Jakarta, West and East Java),including psychiatric, Haji and district hospitals which were selected purposively, was carried out in 2006. Data were collected by interview using questionnaire and focus group discussion as well as direct observation. Study results show that in general the number and kind of medical devices depend on the hospital type and status. Hospital of the A type had more medical devices than type B and C hospitals. Psychiatric hospitals had just several risky medical devices, whereas educational hospitals had many more medical devices. Several adverse effects that were found and ever happened concerning the use of risky medical devices are among others the skin inflammation caused by overdoses in thermodermal therapy, renal inflammation and hematoma following the ultrasonic destruction of renal stone, depigmentation of CT scan operator facial skin and symptoms of anemia in radioisotope and X -ray operator

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods
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