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"ABSTRACTThis paper studies about managing the effectiveness of public health performance in Surabaya City, Indonesia. The research method uses a qualitative approach through focus group discussion elaborated with secondary data of the health sector performance. This paper proves that vertical and horizontal balanced performance measurements in the health sector are essential. Vertical stable performance is in the context of a hierarchical performance of top-level performance and lower-level performance in the public institution. In contrast, a horizontal balanced performance is the arrangement of qualitative and quantitative performance indicators and targets"

"Standar Pelayanan Minimal (SPM) pelayanan kesehatan pada usia produktif merupakan hak dasar penduduk usia 15-59 tahun untuk mendapatkan pelayanan kesehatan sesuai standar yang harus dipenuhi oleh pemerintah daerah kab/kota. Dengan status akreditasi puskesmas yang sudah diraih dan manajemen puskesmas yang sudah diterapkan, capaian SPM pelayanan kesehatan pada usia produktif di Kota Cirebon masih rendah. Tujuan penelitian untuk mengetahui efek status akreditasi dan manajemen puskesmas terhadap capaian SPM pelayanan kesehatan pada usia produktif puskesmas di Kota Cirebon. Jenis penelitian adalah penelitian kuantitatif dengan desain penelitian crossectional. Populasi penelitian adalah seluruh puskesmas di Kota Cirebon. Sampel penelitian adalah 22 puskesmas (total sampling). Analisis statistik menggunakan uji annova one way, uji korelasi dan uji regresi linier sederhana. Hasil penelitian menunjukkan status akreditasi puskesmas tidak berefek terhadap capaian SPM pelayanan kesehatan pada usia produktif, sedangkan semua aspek manajemen puskesmas berkorelasi cukup kuat dan kuat kecuali fokus pelanggan yang berkorelasi lemah/tidak berkorelasi. Diperlukan penerapan manajemen puskesmas yang berkualitas dan dukungan dinas kesehatan agar SPM pelayanan kesehatan pada usia produktif dapat tercapai.  

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Minimum Service Standards (SPM) for health services at productive age are the basic rights of the population aged 15-59 years to obtain health services according to the standards that must be met by the district/city regional government. With the accreditation status of the public health center that has been achieved and the management of the public health center that has been implemented, the achievement of SPM for health services at productive age in Cirebon City is still low. The aim of the study was to determine the effect of the accreditation status and management of the public health center on the achievement of the MSS for health services at the productive age of the public health center in Cirebon City. This type of research is quantitative research with a cross-sectional research design. The research population was all health centers in Cirebon City. The research sample was 22 health centers (total sampling). Statistical analysis using one-way annova test, correlation test and simple linear regression test. The results showed that the accreditation status of the public health center had no effect on the achievement of SPM for health services at productive age, while all aspects of public health center management had a fairly strong and strong correlation except for customer focus which had a weak correlation/no correlation. It is necessary to implement quality health center management and the support of the health office so that the SPM for health services at productive age can be achieved."

"Tesis ini membahas kapasitas manajemen program pencegahan dan pemberantasan penyakit Demam Berdarah dengue di Puskesmas Kecamatan Pasar Minggu Jakarta Selatan pada tahun 2009. Penelitian kapasitas manajemen ini mempergunakan metode penilaian kinerja Puskesmas (Depkes RI, 20060. hal-hal yang diteliti kegiatan-kegiatan yang terdapat pada tahapan manajemen program pencegahan dan pemberantasan penyakit DBD di Puskesmas. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif analitik. Tujuan Penelitian ini adalah agar instansi yang berkepentingan mempunyai perhatian terhadap peningkatan kapasitas manajemen program pencegahan dan pemberantasan DBD di Puskesmas. Hasil penelitian ini ditemukan kapasitas manajemen program Pencegahan dan Pemberantasan DBD Puskesmas Kecamatan Pasar Minggu belum mencukupi. Sehingga penelitian ini menyarankan agar Departemen Kesehatan RI mengembangkan suatu pedoman manejemen program pencegahan dan pemberantasan penyakit DBD untuk Puskesmas, Dinas Kesehatan Provinsi perlu meningkatkan sosialisasi pedoman P2DBD dan pelatihan manajemen program, dan Puskesmas perlu meningkatkan kapasitas manajemen Program pencegahan dan pemberantasan DBD dengan melakukan perbaikan pada kegiatan-kegiatan pada tiap langkah manajemen program serta meningkatkan koordinasi dan fasilitasi kepada setiap stakeholder terkait di tingkat Kecamatan.

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This thesis discuss about the Public Health Center management capacity to prevent and eliminate the Dengue Hemorrhagic Fever in Pasar minggu District of South Jakarta on 2009. This management capacity research is using job appraisal methods for Public Health Center (Ministry Of Health Republic Of Indonesia, 2006). The research concerning is activities that on stage of DHF?s preventing and eliminating program management on Public Health Center. The research method is the qualitative research with analytic descriptive design.

The research purpose is in order to the significant institution will have attention about preventing and eliminating program management capacity of Dengue Haemorrhagic fever. The research result is the program management capacity is not effective yet.

The research result suggests that Ministry of Health on Republic of Indonesia needs to develop a guideline on Program Management to prevent and eliminate the Dengue Haemorraghic Fever to Public Health Center, Province Health Office needs to increase the guideline socialization of and Program Management Training. The Public Health Center needs to improve the preventing and eliminating program management capacity by repairing of the activities on the stage of program management and increasing the coordination and facilitation to every stakeholders on District level."

"Sejak tahun 2008, Pemerintah Kabupaten Tabalong memberikan subsidi pelayanan kesehatan gratis tingkat Puskesmas melalui program Jaminan Tabalong Sehat (JTS). Sasarannya seluruh penduduk Tabalong yang tidak tercakup oleh asuransi atau jaminan kesehatan. Namun pemanfaatan pelayanan kesehatan Puskesmas dan serapan dana yang telah dianggarkan masih rendah. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan rendahnya pemanfaatan subsidi pelayanan kesehatan gratis tingkat Puskesmas di Kabupaten Tabalong. Penelitian ini merupakan studi analitik dengan disain cross sectional. Sampel sebanyak 405 rumah tangga, diambil secara acak sistematik dari klaster 15 desa/kelurahan yang berada di tiga wilayah Puskesmas terpilih. Analisis dilakukan menggunakan statistik regresi logistik ganda. Hasil penelitian menunjukkan bahwa pemanfaatan subsidi pelayanan kesehatan gratis belum optimal. Sebanyak 58% responden pernah memanfaatkan pelayanan kesehatan Puskesmas, dalam setahun terakhir. Faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan di Puskesmas adalah pengetahuan, kemauan untuk membayar (WTP), adanya penyakit dan biaya transportasi. Rendahnya pemanfaatan pelayanan Puskemas yang sudah digratiskan terkait dengan kurang optimalnya kegiatan Puskesmas, kurangnya sosialisasi ke masyarakat dan sasaran masyarakat yang diberikan subsidi kurang tepat. Disarankan kepada jajaran kesehatan untuk lebih meningkatkan sosialisasi dan mendekatkan kegiatan program JTS pada masyarakat. Kepada Pemda Tabalong sebaiknya target sasaran subsidi pelayanan kesehatan gratis diprioritaskan pada masyarakat kurang mampu, dan dilakukan upaya peningkatan kualitas pelayanan kesehatan yang lebih komprehensif.

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Since 2008, Government of Tabalong District have been giving free health care subsidies at public health centre (PHC) through Tabalong Health Security (Jaminan Tabalong Sehat /JTS) program. Targetting of JTS program are all of Tabalong citizen that have not covered by health insurance or health security programs. But, rates of PHC utilization and budget reserved have been low.

This research aim to know the factors that related with low utilization of free health care subsidies at PHC in Tabalong District. This research was analitycal study with cross sectional design. Sampels are 405 household that selected by systematic random from 15 villages cluster at three selected PHC areas. To provide relationship of variables used multiple logistic regression statistical analysis.

Result of the study show that utilization of free health care subsidies were not optimize yet. Just 58% of respondent utilized health care at PHC in the last year. The factors that related with health care utilization at PHC are knowledge, willingness to pay (WTP), diseases avalaibility, and cost of transportation. The low rates utilization of free PHC were also caused by un-optimize of PHC?s activities, lack of promotion the JTS program, not matching of subsidies targetting.

For health providers were recommended to increase promotion and enclose the implementation program to the community. For Government of Tabalong District were suggested to provide focussed targetting of JTS program due the poor and near poor citizen, and increasing the health care quality more comprehensive."

"ABSTRAKKeputusan Presiden nomor 38 tahun 1991 tentang unitswadana dan tatacara pengelolaan keuangannya, yang merupakankebijaksanaan nasional dan berlaku umum untuk semua satuan kerjaPemerintah, oleh Departemen Kesehatan ditindak lanjuti dalambentuk kebijaksanaan rumah sakit unit swadana. Pada tahun angga-ran 1992/1993 Departemen Kesehatan mengusulkan empat rumah sakitumum miliknya dan sebelas rumah sakit umum Daerah, dikonversimenjadi unit swadana Pusat dan unit swadana Daerah. Satu diantararumah sakit umum Daerah yang diusulkan adalah RSUD Pasar ReboJakarta.Untuk rumah sakit yang diubah menjadi unit swadanaPusat, sudah ada kebijaksanaan keuangan dari Menteri Keuanganyang diatur melalui Keputusan Menteri Keuangan nomor 47 tahun1992 tentang Penatausahaan dan pertanggungjawaban keuangan unitswadana Pusat. Kebijaksanaan keuangan ini diharapkan bisa menjadipedoman dan menyelesaikan masalah keuangan rumah sakit sebagai unit swadana pusat.Sampai dengan tesis ini diserahkan, belum ada kebijak-sanaan keuanuan untuk unit swadana Daerah dari Departemen DalamNegeri, walaupun Departemen Keuangan sudah menyerahkan kewenangan untuk membuat kebijaksanaan keuangan unit swadana Daerah,kepada Departemen Dalam Negeri.Kebijaksanaan keuangan untuk RSUD sebagai unit swadanaDaerah, diharapkan dapat menyelesaikan masalah keuangan RSUD yangdihadapi saat ini dan dapat mengantisipasi masalah keuanganpotensial yang akan datang. Dari analisis masalah keuangan RSUD saat ini dihasilkan: pertama, identifikasi duabelas masalah keuangan dan dua masalahkeuangan potensial ; kedua, sebagian besar penyebab dari masalahkeuangan RSUD bersumber dari kebijaksannan PemerintahPusat/Daerah ; ketiga, sebagian besar masalah keuangan menjadiselesai dengan berubahnya RSUD menjadi unit swadana Daerah,sebagian lagi memerlukan dukungan kebijaksanaan lain baik dariPusat maupun Daerah dan keempat, masalah keuangan RSUD terkaiterat dengan aspek lain manajemen RSUD.Berdasarkan analisis ini, disarankan dibuat beberapamacam kebijaksanaan dari tingkat Pusat maupun Daerah , yang dapatmenyelesaikan masalah keuangan yang ada, melengkapi KeputusanPresiden dan Menteri Keuangan yang sudah ada. Khusus untuk RSUDPasar Rebo disarankan, sambil menunggu kebijaksanaan keuanganunit swadana Daerah dari Departemen Dalam Negeri, melaksanakanujicoba RSUD Pasar Rebo sebagai unit swadana Daerah dengan meng-gunakan kewenangan Kepala Daerah. Kepala Daerah berdasarkan Undang undang nomor 5 tahun 1974 tentang pokok pokok Pemerintahandi Daerah, dapat mengatur segala sesuatu kebijaksanaan Pusat yangbelum jelas. Disamping itu berdasarkan Undang undang nomor 11tahun 1990 tentang susunan Pemerintahan Daerah Khusus IbukotaNegara Republik Indonesia Jakarta, dimungkinkan melakukan pengat-uran tersendiri."

"Promosi Kesehatan Rumah Sakit (PKRS) adalah upaya meningkatkan kemampuan pasien kelompok masyarakat agar dapat mandiri dalam mempercepat kesembuhan dan rehabilitasinya, meningkatkan kesehatan, mencegah masalah-masalah kesehatan dan mengembangkan upaya kesehatan bersumberdaya masyarakat sesuai sosial budaya mereka serta didukung kebijakan publik yang berwawasan kesehatan. Kesiapan adalah keseluruhan kondisi perawat/bidan yang membuat siap untuk memberi respon atau jawaban di dalam cara tertentu terhadap suatu situasi. Tujuan penelitian ini untuk menggambarkan kesiapan respoden dan sarana pendukung terkait dengan faktor-faktor yang dapat mempengaruhi kesiapan tersebut. Penelitian ini menggunakan dua pendekatan yakni kuantitatif dan kualitatif dengan tujuan selain mendapatkan gambaran juga mendapatkan informasi yang mendalam tentang kesiapan perawat/bidan dan sarana pendukung pelaksanaan PKRS. Dari hasil analisis didapatkan bahwa individu lebih siap dibandingkan dengan sarana (manajemen) meskipun secara kuantitatif tidak ada hubungan yang bermakna antara variable independen dengan kesiapan, secara keseluruhan responden bersikap positif meskipun masih lebih dari 20% responden yang berpengetahuan kurang tentang pengetahuan dasar PKRS, sehingga masih banyak responden yang tidak berperilaku baik terkait PKRS dirawat inap. Kesimpulan serta saran dari penelitian ini diutamakan pada peningkatan pengetahuan perawat/bidan dengan diberikan pelatihan tentang PKRS seta dilakukan pengawasan oleh Tim PKRS,dan penelitian ini diharapkan menjadi masukan bagi rumah sakit dalam upaya pengembangan PKRS di RSUD Kabupaten Bekasi.

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Health Promotion Hospital (HPH) is an effort to improve the patient's ability to be selfsufficient communities in accelerating the healing and rehabilitation, improving health, preventing health problems and develop appropriate health efforts Community Based sociocultural and supported them sound public health policy. Readiness is the overall condition of the nurse / midwife who makes ready to respond or answer in a certain way to a situation. The purpose of this study to describe the readiness of respondents and supporting facilities associated with the factors that can affect the readiness.

This study uses two approaches to the quantitative and qualitative objectives other than getting an idea also get in-depth information about the readiness of nurses / midwives and support facilities HPH implementation.

From the analysis it was found that individuals are more ready than the means (management) although quantitatively there is no significant relationship between the independent variable with readiness, overall respondents are positive though still more than 20% of respondents who are less knowledgeable about basic knowledge HPH, so it is still many respondents who do not behave properly related hospitalization HPH.

Conclusions and suggestions of this study preferred on increased knowledge nurses / midwives to be trained on HPH supervision by HPH team, and the study is expected to be the input for hospitals in developing HPH in Bekasi Regency Hospital."

"This book includes a collection of state-of-the-art contributions addressing both theoretical developments in, and successful applications of, seismic structural health monitoring (S2HM). Over the past few decades, Seismic SHM has expanded considerably, due to the growing demand among various stakeholders (owners, managers and engineering professionals) and researchers. The discipline has matured in the process, as can be seen by the number of S2HM systems currently installed worldwide. Furthermore, the responses recorded by S2HM systems hold great potential, both with regard to the management of emergency situations and to ordinary maintenance needs.The books 17 chapters, prepared by leading international experts, are divided into four major sections. The first comprises six chapters describing the specific requirements of S2HM systems for different types of civil structures and infrastructures (buildings, bridges, cultural heritage, dams, structures with base isolation devices) and for monitoring different phenomena (e.g. soil-structure interaction and excessive drift). The second section describes available methods and computational tools for data processing, while the third is dedicated to hardware and software tools for S2HM. In the books closing section, five chapters report on state-of-the-art applications of S2HM around the world."

"Ketidakefektifan manajemen kesehatan merupakan masalah pada klien dengan gangguan jiwa yang apabila tidak ditangani akan menimbulkan kerugian pada klien, keluarga, masyarakat, bahkan pemerintah. Tujuan dari penanganan kasus ini untuk mengetahui pengaruh terapi Acceptance and Commitment Therapy (ACT) pada ketidakefektifan manajemen kesehatan serta mengidentifikasi kepatuhan, penerimaan, serta komitmen dalam regimen demi mencapai self care yang mandiri. Tindakan keperawatan dilakukan terhadap 5 klien dengan ketidakefektifan manajemen kesehatan. Penulisan karya ilmiah ini berdasarkan pendekatan Case Study. Pengukuran kepatuhan menggunakan kuesioner MARS (Medication Adherence Rating Scale). Hasil yang didapatkan setelah pemberian tindakan keperawatan ners dan ACT terjadi peningkatan kepatuhan sebesar 71% (14 poin), kemampuan penerimaan dan komitmen meningkat sebesar 70% pada kelima klien dengan ketidakefektifan manajemen kesehatan. Tingkat kepatuhan, penerimaan, serta komitmen lebih rendah pada klien yang memiliki usia lebih muda, mendapat stigma dari orang terdekat, dan dukungan  keluarga yang kurang. Studi ini merekomendasikan terapi ACT untuk meningkatkan manajemen kesehatan pada klien gangguan jiwa dan teori Orem sebagai pendekatan dalam meningkatkan kemandirian dalam perawatan.

 

 

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Ineffective health management is a problem in mentally ill patient if not handled will harm to clients, families, communities, and even the government.The aim of this study was to identify the effect of Acceptance Commitment Therapy (ACT) on Inefective health management and  identfy adherance, acceptance, and commitment in the regimen to achieve independent self care. The research approach used in this  study was case study conducted on 5 respondents consist of  mentally ill patient with Ineffective health management. Measurement used the MARS (Medication Adherence Rating Scale). The analysis result showed, after the client were given ACT and nursing intervention, the adherence increased 71% (14 points), the acceptance ability and commitment increased into 70% on five clients with Ineffective health management. Medication adherence, acceptance and commitment level were lower on the younger clients, client who gets stigma from family and client with lack of family support. Nursing care and ACT were recommended as the basic management of mentally ill patient with Ineffective health management and Orem's theory as an approach in increasing self care."

"[ABSTRAKPemeriksaan kesehatan secara umum merupakan bagian yang umum dari perawatan kesehatan di beberapa negara. Jumlah permintaan layanan kesehatan di Taiwan mengalami peningkatan selama sepuluh tahun terakhir. Kenaikan permintaan tersebut didorong oleh beberapa faktor, termasuk populasi yang semakin menua, dan peningkatan jumlah kasus penyakit kronis. Fluktuasi jumlah kedatangan peserta tes kesehatan yang tidak menentu, membuat rumah sakit sulit untuk memberikan pelayanan yang memuaskan. Rumah sakit perlu membuat strategi perencanaan, seperti manajemen kesehatan untuk menangani masalah tersebut dengan cara memprediksi kedatangan peserta uji kesehatan. Aplikasi data mining dalam perawatan kesehatan adalah pembuktian bahwa data mining dapat memberikan informasi yang sangat berguna untuk semua pihak yang terlibat dalam industri kesehatan, seperti meningkatkan kualitas pelayanan rumah sakit. Penelitian ini menggunakan pengelompokan dan aturan asosiasi untuk mengetahui pola dari data pemeriksaan penyakit cerebrovascular, dengan tujuan memprediksi kedatangan kembali peserta tes kesetahan. Algoritma Apriori pembobotan dapat mengetahui hubungan antar item menggunakan nilai support, confidence, dan bobot masing-masing item sebagai tingkat prioritas dari aturan asosiasi, karakteristik aturan asosiasi dapat diketahui, yang mana hasil tersebut dapat membantu rumah sakit dalam meningkatkan kualitas pelayanan. Pada dasarnya, data memiliki partisi yang berbeda satu sama lain, atas dasar tersebut maka dalam penelitian ini dilakukan pengelompokan sebelum dilakukan penggalian informasi menggunakan aturan asosiasi, dimana proses tersebut merupakan salah satu proses yang penting. Setiap kelompok diharapkan mengandung asosiasi tanpa kontaminasi dari bagian kelompok lain yang memiliki pola hubungan yang berbeda. Penelitian ini menggunakan metode pengelompokan hirarki yang dikenal dengan Ward?s Agglomerative yang relatif sederhana untuk dipahami. Diimplementasikan, dan tidak perlu menentukan banyaknya jumlah kelompok pada awal proses.

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ABSTRACTGeneral health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.;General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.;General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees? re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward?s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance., General health examinations are common elements of health care in some country. Taiwan demand for healthcare services has increased over the past decade. The increase has been driven by several factors, including an ageing population, and the increasing prevalence of chronic disease. The fluctuation number of examinees with unpredictable coming behavior makes hospital difficult to provide the satisfying service. Hospital needs to make strategic planning such as healthcare management to solve this problem by predicting examinee coming. Data mining applications in healthcare is the realization that data mining can generate information that very useful to all parties involved in the healthcare industry, such as improving the treatment quality of hospitals. This research used clustering and association rule task to know the pattern of cerebrovascular medical examination databases to predict examinees’ re-coming. The Weighted-Apriori algorithm finds out the relationships among item sets using support, confidence, and weight of each feature as the priority rank of the association rule, the characteristic of the rule can be generated, which help the hospital to improve the service quality. The data is performed on partitions that are essentially distinct from each other is the reason why clustering performs before association rule mining is one of essential process. Each cluster would be expected to contain associations without interference or contamination from other sub groupings that have different patterns of relationships. This research used hierarchical clustering method called Ward’s agglomerative which relatively simple to understand, implement, and does not need to specify number of clusters in advance.]"