Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Kedokteran nuklir merupakan salah satu bidang ilmu kedokteran yang memanfaatkan sumber radiasi pengion untuk pencitraan diagnostik maupun terapi pada pasien kanker. Jumlah pelayanan kedokteran nuklir yang dimiliki Indonesia sampai saat ini 17 rumah sakit dan hanya 10 yang aktif beroperasi melakukan kegiatan pelayanan kedokteran nuklir. Untuk mendukung program KPKI oleh menteri kesehatan, perlu dilakukan penambahan departemen kedokteran nuklir di Indonesia. Peraturan mengenai standar pelayanan kedokteran nuklir Indonesia diatur oleh Kementrian Kesehatan dan Badan Pengawas Tenaga Nuklir, namun belum melampirkan mengenai syarat konstruksi dan desain bangunan secara spesifik. Untuk itu penulis melakukan penelitian dengan melakukan studi literatur mengenai persyaratan fasilitas kedokteran nuklir Nasional dan Internasional serta melakukan survei observasi di fasilitas kedokteran nuklir di Indonesia. Hasil dari tinjauan persyaratan kedokteran nuklir adalah peraturan kedokteran nuklir di Indonesia sudah sesuai dengan pedoman kedokteran nuklir internasional, namun belum mengatur detail mengenai persyaratan konstruksi yang berkaitan dengan safety dan layout design. Berdasarkan hasil uji statistik dari 5 sampel fasilitas kedokteran nuklir di Indonesia, fasilitas kedokteran nuklir di Indonesia belum memenuhi aspek ruangan yang memenuhi persyaratan dan belum memenuhi aspek konstruksi yang berkaitan dengan safety. Hasil rekomendasi persyaratan dan perancangan fasilitas kedokteran nuklir berupa room layout, mechanical electrical dan equipment dirancang berdasarkan hasil studi literatur dan observasi survei di lima fasilitas kedokteran nuklir. Hasil perancangan room layout fasilitas kedokteran nuklir dinyatakan valid dengan expert judgement kepada lima expert di bidang kedokteran nuklir.

---

ABSTRACT
Nuclear medicine is one of medical fields that uses ionizing radiation sources for therapeutic and diagnostic imaging for cancer. The number of nuclear medicine services in Indonesia is 17 hospitals, which only 10 is active in conducting nuclear medicine services because it doesn't meet the requirements. Regulations about the standards of nuclear medicine services Indonesia are regulated by Ministry of Health and Nuclear Energy Regulatory Agency (BAPETEN) but it have not yet been discussed the requirements for construction building and floor plan layout design. For this reason, the author did literature study about the requirements of National & International nuclear medicine facilities and observation survey in nuclear medicine facilities in Indonesia. This study is done by compare means analysis to review the requirements of nuclear medicine requirements and National & International nuclear medicine facilities and the current state of nuclear medicine facilities di Indonesia. The result of literature study are then carried out into layout design facility and developed by result of observation survey study on 5 nuclear medicine facility in Indoneisa. The results of this study nuclear medicine regulations are in accordance with international nuclear medicine guidelines, but doesn't conduct the details regarding construction requirements and layout design. Based on the results of statistical tests from 5 samples of nuclear medicine facilities in Indonesia, nuclear medicine facilities in Indonesia have not met the aspect of the room that meets the requirements and does not meet the construction aspects relating to safety. Recommendations were made on the requirements and design of nuclear medicine facilities based on the results of literature studies, survey observations at five nuclear medicine facilities and expert judgment on five experts in the field of nuclear medicine. The results are recommendation of nuclear medicine facility's requirement and nuclear medicine facility design (room layout, mechanical electrical and equipment). The room layout is valid with expert judgement method by expert in the field of nuclear medicine.

Abstrak :
Malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five. Over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life (WHO, 2003). In UNICEF conceptual framework, two immediate causes of malnutrition are inadequate dietary intakes and diseases, and the underlying causes that lead to those two are inadequate access to food in the household, insufficient health services and an unhealthy environment, and inadequate care for children and women (UNICEF, 1998). Inadequate dietary intake is influenced by inappropriate feeding practice. Children who are not breastfed have repeated infections and grow less well than children who at least receive some breast milk (Daelmans and Saadeh, 2003). From six months onward, a child must have complementary food at six-month point, since breast milk alone no longer meets all nutritional needs. Delaying the switch over much beyond six months of age can cause a child's growth to falter. Thus, for optimal growth and development, a child needs to be fed frequently with energy-rich, nutrient-dense foods (UNICEF, 1998). However, the complementary foods do not easily fulfill the nutrient requirement a child needs. Problem nutrients are those for which there is the greatest discrepancy between their content in complementary foods and the estimated amount required by the child (WHO, 1998). Three strategies for obtaining needed amounts of problem nutrients are: optimization of nutrient intake from locally available food, micronutrient supplementation, and fortification of processed complementary foods (Dewey and Brown, 2003). The 541" World Health Assembly in 2001 not only recommended exclusive breastfeeding for six months as a global public health recommendation, but also recommended the widest possible use of indigenous nutrient-rich foodstuffs to improve complementary foods and feeding practice (Daelmans and Saadeh, 2003). In response to that recommendation, this study was aimed to develop a feasible dietary guideline for complementary feeding of infants aged 6-11 months that will used local food available. There have been some researches about developing dietary guideline in other countries for certain age group. This study was planned to develop a dietary guideline in one area of Indonesia where many of its children in the age group of 6-11 month were under nourished.

Abstrak :
ABSTRAK
LATAR BELAKANG: perawatan kandung kemih dan pencegahan retensio urin postpartum sangatlah penting, apabila tidak dikenali secara baik, maka dapat berkembang menjadi kerusakan kandung kemih yang permanen akibat distensi yang berlebihan yang mengakibatkan denervasi. Hal ini akan menyebabkan terjadinya peningkatan resiko infeksi saluran kemih dan kerusakan saluran kencing bagian atas. Tatalaksana retensio urin saat ini adalah dengan melakukan kateterisasi. Penggunaan kateterisasi sangat bervariasi pada beberapa panduan praktek klinik. Selain kateterisasi, saat ini prostaglandin telah terbukti mampu menyebabkan terjadinya kontraksi otot polos kandung kemih sehingga diharapkan dapat menjadi stimulator kontraksi kandung kemih pada pasien retensi urin pasca persalinan pervaginam. TUJUAN: menentukan efektifitas prostaglandin E1 dan kateterisasi atau kateterisasi saja sebagai terapi pilihan dan kelayakan melalui telaah kritis suatu panduan praktek klinik dalam tatalaksana retensio urin postpartum METODE: Evidence Based Case Report ini melakukan pencarian melalui PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library dan Google Scholar. Dengan menggunakan strategi pencarian ini, didapatkan 4 artikel pada PubMed, 101 artikel pada TRIP Database, 991 artikel pada EBM online, 687 artikel pada Clinical Evidence, 1 artikel pada Cochrane Library, dan 12600 artikel pada Google Scholar. Dari 21 artikel didapatkan 11 artikel yang berupa panduan praktek klinik dengan keseluruhan berupa naskah lengkap yang akan dilakukan telaah kritis dengan menggunakan AGREE II. HASIL: dari 11 panduan praktek klinik yang dilakukan telaah kritis, tidak ada satu panduan praktek klinik pun yang memperoleh penilaian pada setiap domain penilaian menurut AGREE II. Penilaian pada domain yang menjabarkan proses pengembangan panduan praktek klinik dengan pencarian evidence based, terapi alternatif, dan kebebasan editorial merupakan domain dengan penilaian terendah pada keseluruhan panduan praktek klinik. SIMPULAN: dari 11 panduan praktek klinik yang dilakukan telaah kritis, disimpulkan bahwa terapi untuk retensio urin postpartum yang digunakan saat ini adalah kateterisasi. Penggunaan terapi alternatif seperti prostaglandin tidak didapatkan pada keseluruhan panduan praktek klinik. Hanya saja keseluruhan panduan praktek klinik tidak didukung oleh evidence based yang sistematis sehingga kurang layak untuk dijadikan acuan untuk terapi. Dibutuhkan pencarian evidenced based secara sistematis terutama yang menggunakan desain randomized controlled trial RCT untuk dijadikan rujukan bagi terapi retensio urin postpartum.

---

ABSTRACT
Bladder management and prevention of postpartum urinary retetntion are very important, and a failure in recognizing these conditions may lead to permanent bladder injury caused by overdistention which in turn lead to denervation. This may increase the risk of urinary tract infections and upper urinary tract damage. Current management of urinary retention is catherization. Besides catherization, prostaglandin have been proven to be effective in stimulating smooth muscle contraction of the bladder and is a promising alternative management in stimulating bladder contraction in vaginal postpartum urinary retention patients. GOALS to review several guidelines on postpartum urinary retention management METHOD The literature search for this Evidence Based Case Report conducted article from PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library and Google Scholar were used for article searching. Using this strategy, we obtained 4 articles from PubMed, 101 articles from TRIP Database, 991 articles from EBM online, 687 articles from Clinical Evidence,1 article from Cochrane Library, and 12600 articles from Google Scholar. From 21 articles we found 11 with attached guidelines on its full text, and these articles will be critically reviewedusing AGREE II. RESULTS From 11 guidelines that have been critically reviewed, not one guideline had an appropriate score in each assessment domain according to AGREE II. Guideline development using evidence based materials, alternative management and editorial freedom were the lowest scored domains in general. CONCLUSION From the 11 guidelines that have been critically reviewed, we concluded that the current management of postpartum urinary retention is catherization. Alternative managements such as prostaglandin usage are not present in current guidelines. In general, current guidelines are not supported by systematic evidence based materials, rendering them less reliable to be used as the basis for management. A systematic evidence based search, especially randomized controlled trial RCT , is needed for references of postpartum urinary retention management.

Abstrak :
Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation.

Abstrak :
Tujuan : Di Indonesia, kanker payudara (KPD) menempati urutan pertama kanker pada wanita dengan jumlah kasus baru 58.256 (19,8 %) dari semua kasus kanker, dengan jumlah kematian sebanyak 22.692 jiwa. Hal ini menunjukkan perlunya suatu terapi terstandar dalam tatalaksana KPD. KPKN pada tahun 2016 telah mengeluarkan Pedoman Nasional Pelayanan Kedokteran KPD sebagai panduan dalam terapi, yang diterapkan di RSCM sebagai Pedoman Praktis Klinis (PPK) KPD. Penelitian ini bertujuan menilai kepatuhan dalam tatalaksana KPD dan hubungannya dengan kesintasan pasien. Metode : Studi kohort retrospektif ini menilai pasien KPD yang menjalani radioterapi di RSCM periode Januari 2017-Juni 2018, dengan kriteria inklusi pasien non metastasis, menjalani operasi sebagai terapi primer, dan menggunakan BPJS. Kepatuhan terapi dinilai dengan menggunakan PPK KPD 2016 sebagai acuan. Hasil : Terdapat 165 pasien yang masuk kriteria inklusi, dengan usia median 48 (28-82) tahun. Sebanyak 61% pasien terdiagnosa stadium III. Median follow-up 30 bulan. Kesintasan hidup 1 dan 2 tahun adalah 100% dan 97% pada kelompok yang mendapatkan terapi standar, lebih tinggi dibandingkan pada kelompok yang tidak mendapatkan terapi standar, yaitu 100% dan 92%. Kelompok yang tidak mendapatkan terapi tidak standar berisiko 5,38 kali lebih tinggi untuk mengalami metastasis jauh (HR 5,38; 95% IK 1,3-22,5). ......Objective : In Indonesia, breast cancer ranks first among women with new cases of 58,256 (19.8%) of all cancer cases, with 22,692 deaths. This shows the need for a standardized therapy in the management of breast cancer. Our national guidelines, derived from The National Comprehensive Cancer Network (NCCN) are becoming a national standard of care for breast cancer, but there is still no research to asses the compliance of national guideline in Indonesia for our current clinical practice of breast cancer. This study aims to assess compliance in the management of breast cancer and its relationship with patient survival. Methods : This retrospective cohort study assessed breast cancer patients who underwent radiotherapy at the RSCM in the period January 2017-June 2018. Therapy compliances was assessed using the breast cancer national guideline as a reference. Results : There were 165 patients who were included in the inclusion criteria, with a median age of 48 (27-82) years. As many as 61% of patients are diagnosed with stage III. Median follow-up is 30 months. The survival rate of 1 and 2 years is 100% and 97% in the group that received standard therapy, higher than in the group that did not get standard therapy, which is 100% and 92%. The group that did not get non-standard therapy was 5,28 times more likely to have distant metastases (HR 5,28; 95% CI 1.3-22,5).

Abstrak :
Pembangunan Ibu Kota Baru Nusantara bertujuan untuk mewujudkan kota cerdas, dengan penekanan pada integrasi bangunan cerdas sebagai komponen inti. Saat ini, belum ada standar yang bisa dijadikan pedoman dalam pembangunan gedung cerdas di Nusantara. Oleh karena itu, laporan ini mengusulkan pedoman komprehensif pengembangan gedung cerdas yang dirancang untuk mengatasi masalah ini, sehingga memfasilitasi realisasi konsep kota cerdas. Pedoman ini mengidentifikasi fitur-fitur penting yang diperlukan dalam bangunan cerdas, yang didasari oleh prinsip-prinsip pembangunan kota yang ramah lingkungan, berkelanjutan, berketahanan, inklusif, dan cerdas. Selain itu, pedoman ini memberikan rekomendasi sistem banguna cerdas untuk diterapkan pada berbagai klasifikasi bangunan gedung yang termasuk dalam kategori Bangunan Gedung Negara (BGN) dan Bangunan Gedung Non-BGN (non-BGN). Sistem-sistem tersebut terdiri dari Sistem Kontrol Akses, Sistem Komunikasi, Sistem Energi, Sistem Keselamatan, Sistem Pemanasan, Ventilasi, dan Pendingin Udara (HVAC), Sistem Pencahayaan, Sistem Mobilitas, Sistem Keamanan, dan Sistem Sumber Daya. Pedoman ini bertujuan untuk memposisikan Ibu Kota Nusantara sebagai teladan kota cerdas, yang menetapkan standar yang dapat digunakan pada pembangunan perkotaan berkelanjutan dalam skala global. ......The development of Indonesia's Nusantara New Capital City is a megaproject aimed at establishing a smart city, with an emphasis on the integration of smart buildings as a core component. At present, there are no standards can serve as a guide for the construction of smart buildings in the Nusantara. Therefore, this report proposes a comprehensive guide for smart building development tailored to bridge this gap, thereby facilitating the realization of the smart city concept. The guide outlines essential features necessary for smart buildings, underpinning the city's developmental principles of green, sustainable, resilient, inclusive, and smart aspects. In addition, this guide provides recommendations for smart building systems recommended for implementation across various building classifications included in the State Buildings (BGN) and Non-State Buildings (non-BGN) categories. These smart systems encompass Access Control Systems, Communication Systems, Energy Systems, Safety System, Heating, Ventilation, and Air Conditioning (HVAC) System, Lighting System, Mobility System, Security System, and Resource Management System. The articulation of these guidelines is is poised to position the Nusantara Capital as a role model of smart city, setting a replicable standard for sustainable urban development on a global scale.

Abstrak :
Penelitian ini bertujuan untuk mengevaluasi implementasi pedoman komite audit sektor publik di Kementerian Keuangan. Penelitian ini menggunakan pendekatan studi kasus kualitatif, termasuk analisis dokumen primer dan wawancara terstruktur dan semi terstruktur pada Komite Audit dan Inspektorat Jenderal Kementerian Keuangan. Dengan menggunakan pedoman best practice Audit and Risk Assurance Committee Handbook dari H.M. Treasury dan Independent Audit Committee in Public Sector Organizations dari IIA sebagai tolok ukur, penelitian ini menemukan bahwa Kementerian Keuangan telah membentuk komite audit sesuai dengan pedoman yang mengatur tentang elemen dan prinsip komite audit sektor publik. Hasil penelitian ini mengindikasikan bahwa masih terdapat ruang perbaikan untuk menyempurnakan implementasi, terkait dengan mandat, komposisi, persyaratan kapabilitas, peran dan tanggung jawab, kinerja, serta komunikasi dan pelaporan komite audit di sektor publik berdasarkan pedoman best practice. Penelitian ini juga memberikan gambaran atas ruang perbaikan yang dapat dilaksanakan dalam perwujudan mandat Komite Audit Kementerian Keuangan. Penelitian ini dapat menjadi salah satu referensi dalam membuat peraturan dan pedoman pembentukan komite audit pada organisasi sektor publik (pemerintah) sesuai dengan tata kelola sektor publik. ......While prior studies on audit committees have focused on the private sector, this is the first research on audit committees focusing on the public sector in Indonesia. This paper aims to evaluate the implementation public sector audit committee guidelines in Ministry of Finance Audit Committee as government. This paper utilizes a case study approach, including analysis of primary documents, also structured and semi-structured interviews the Ministry of Finance Audit Committee and parties directly involved. Using best practice guidelines for public sector audit committees, namely H.M. Treasury's Audit and Risk Assurance Committee Handbook and the IIA's Independent Audit Committees in Public Sector Organizations as benchmarks, this paper finds that Ministry of Finance established an audit committee in accordance with the guidelines governing the principles and elements of public sector audit committees. Nonetheless, there is still room for improvement to refine the implementation of the audit committee. This research is expected to provide recommendations for the improvement of regulations related to the mandate, composition, capability requirements, role and responsibility, performance, also communicate and reporting of the Audit Committee in the public sector based on the best practice guidelines. This research also provides an overview of the room for improvement that can be implemented in realizing the mandate of the Ministry of Finance Audit Committee. This research can also be a reference in making regulations and guidelines for the formation of audit committees in public sector organizations (government) in accordance with public sector governance.

Abstrak :
ABSTRAK Dalam Renstra Badan Pusat Statistik (BPS) RI 2015-2019 disebutkan bahwa salah satu tahapan dalam menyusun IT Design and Strategy adalah menyusun tata kelola dan tata laksana teknologi informasi (IT governance and management). Namun, tata kelola teknologi informasi (TI) di BPS belum mencakup semua bidang keputusan terkait TI. Salah satu bidang keputusan TI yaitu Infrastruktur TI. Infrastruktur TI yang memiliki peranan penting di BPS adalah Data Center atau Pusat Data. Tidak adanya tata kelola yang mengatur pengelolaan Pusat Data dapat berdampak pada terganggunya layanan Pusat Data yang menghambat proses bisnis. Penelitian ini bertujuan untuk membuat rancangan kebijakan dan pedoman pengelolaan Pusat Data yang sesuai untuk BPS. Penelitian ini adalah penelitian kualitatif dengan metodologi penelitian case study dan action research. Perancangan kebijakan dan pedoman diawali dengan penyusunan aspek-aspek pengelolaan Pusat Data yang diperoleh dari standar ANSI/TIA-942 dan standar ANSI/BICSI-002. Dari aspek-aspek pengelolaan Pusat Data tersebut kemudian diamati kondisi pengelolaan Pusat Data saat ini dan kendala yang dihadapi dalam pengelolaan Pusat Data, Kemudian dari kondisi yang ada dan kendala yang dihadapi diberikan rekomendasi. Selanjutnya dilakukan perancangan kebijakan dan pedoman pengelolaan Pusat Data dengan masukan berupa hasil dari tahapan sebelumnya. Dari penelitian ini dihasilkan usulan kebijakan dan pedoman pengelolaan Pusat Data yang sesuai untuk BPS sehingga pengelolaan Pusat Data dapat lebih baik dalam memberikan layanan kepada pengguna.

---

ABSTRACT On the strategic plan of BPS-Statistics Indonesia 2015-2019, one phase to develop IT design and strategy is to develop IT governance and management. However, IT governance in BPS does not include all area of IT decisions. One of these areas is IT infrastructure. IT infrastructure which has an important function in BPS is data center. The absence of governance that regulates the data center management can have an impact on service disruption of data center that later impedes the business process. The purpose of this research is to make a design of policy and guideline of data center management that is suitable for BPS. This research is qualitative research using two methodologies: case study and action research. Design of policy and guideline begins with drafting aspects from data center standards: ANSI/TIA-942 and ANSI/BICSI-002. Then, the current condition and constraints encountered on data center management are observed based on aspects derived from standards. If the management does not meet the standards then recommendations given. Next, design of policy and guideline for data center management, using aspects from standards, current conditions, constraints and recommendations. The result of this research is a proposed policy and guideline for data center management that fit to BPS in providing better services to users.

Abstrak :
PURPOSES: The purpose of this study was to evaluate the influence of comorbidities on the surgical outcomes of early cholecystectomy for acute cholecystitis.

METHODS: Data were retrospectively collected for patients with acute cholecystitis who underwent early cholecystectomy. Patients were separated into three groups based on the cholecystitis severity grade, and the surgical outcomes of early cholecystectomy were analyzed. Patients with mild and moderate cholecystitis were subdivided into a comorbidity group (n = 10) and a non-comorbidity group (n = 83).

RESULTS: There were 57 (55.3%) patients with mild cholecystitis, 36 (35.0%) with moderate cholecystitis, and 10 (9.7%) with severe cholecystitis. The surgical outcomes were significantly worse for patients with severe cholecystitis than for patients with mild or moderate cholecystitis. There were no postoperative deaths after cholecystectomy. There were no significant differences in the complication rate (P = 0.629), conversion rate (P = 0.114), or intraoperative blood loss (P = 0.147) between the comorbidity and non-comorbidity groups.

CONCLUSION: Our findings suggest that early cholecystectomy can be performed safely for patients with mild and moderate cholecystitis even if comorbidities are present. Early cholecystectomy may be an alternative treatment strategy for patients with severe cholecystitis who are candidates for anesthesia and surgery.