bluuebunny/crossref_metadata_2025 huggingface dataset:
Agentes internos de melhoria contínua: uma revisão bibliográfica
Authors: Vivone Marcus Vinicius , Torres Junior Alvair Silveira
Published: December 2016

A implantação de um processo ou programa de melhoria contínua pode ser verificada amplamente no contexto organizacional. Para que produtos, processos e serviços sejam melhorados é necessário a realização de intervenções, usualmente denominadas projetos de melhoria. Os profissionais, membros da organização, devem estar aptos, disponíveis e engajados na identificação, seleção e condução de projetos de melhoria. O presente artigo visa identificar elementos relevantes para a transformação efetiva de profissionais, membros da organização, em agentes internos de melhoria. Foi realizada uma extensa revisão bibliográfica nas bases de dados Web of Sciene e Proquest. Os conceitos identificados como relevantes foram transformados em proposições teóricas. Recomendações a prática gerencial e a teoria acadêmica foram listadas, incluindo as limitações das conclusões.
Economic Analysis of Incentives to Plant Citrus Trees in Florida
Authors: Spreen Thomas H. , Zansler Marisa L.
Published: December 2016

New citrus (Citrus sp.) tree plantings in Florida have been less than 50% of tree mortality/removal rates as indicated by the rate of decline in the Florida commercial citrus tree inventory. The significant decline in tree inventory in recent years, largely due to the citrus disease known as huanglongbing [HLB (Candidatus liberibacter)], remains a critical factor contributing to the sharp decline in citrus production in Florida. Concerns over significantly higher costs of production and the uncertainty associated with the spread of HLB have prompted industry leaders and governmental agencies to develop strategic incentives to promote reinvestment in planting new citrus trees to producers. Several programs have been proposed to encourage new plantings of early- and midseason oranges [Citrus sinensis (primarily ‘Hamlin’)], ‘Valencia’ orange, and grapefruit (Citrus ×paradisi) in Florida. Several existing citrus tree replanting programs are evaluated using net present value (NPV) methods to analyze the outcome of the investment.
Water and Nutrient Uptake Efficiency in Containerized Production of Fern Leaf Lavender Irrigated with Saline Water
Authors: García-Caparrós Pedro , Llanderal Alfonso , Lao María Teresa
Published: December 2016

The scarcity of water in the Mediterranean area has frequently led to the use of saline water for irrigation. Container grown ornamental production has relatively high rates of water and nutrient loss from fertigation. A better understanding of water and nutrient use efficiency with water that has elevated levels of saline could reduce runoff water and its environmental impact. Fern leaf lavender (Lavandula multifida) plants were grown for 8 weeks in plastic containers with a sphagnum peatmoss and perlite substrate (80:20 by volume) to evaluate the effect of saline water [2.0 (T1 or control), 4.5 (T2), or 7.5 (T3) dS·m−1] on water and nutrient uptake efficiency. Leachate was collected to determine runoff volume and composition which included nitrate-nitrogen (NO3−-N), phosphate-phosphorus (PO42−-P), and potassium (K+) concentration. Plant dry weight (DW) and nutrient content were determined in plants at the beginning and at the end of the experiment to establish the nutrient balance. Increasing salinity levels of irrigation water did not significantly reduce either the plant DW or the water use efficiency (WUE). Based on nutrient balance, the increasing salinity (2.0 to 7.5 dS·m−1) affected the plant nutrient uptake efficiency, which decreased 28% for N, increased 26% for P from the lowest to highest sodium chloride levels; whereas K did not show a clear trend. Nutrient runoff increased (28% N, 9% P, and 27% K) to the environment from the lowest to highest sodium chloride levels.
Evaluation of the U.S. Mothbean Collection for Seed Yield Potential in Virginia and Nutritional Composition of Freshly Harvested Seed
Authors: Bhardwaj Harbans L. , Hamama Anwar A.
Published: December 2016

Even though mothbean (Vigna aconitifolia), a drought- and heat-tolerant crop, may have potential in the eastern United States, information about its production in this region is not available. To characterize potential seed yields and preliminary nutritional quality, 54 accessions were grown near Petersburg, VA, during 2011, 2012, and 2013. The seed yields varied from 48 to 413 lb/acre. The mean concentrations of protein, calcium, iron, and zinc in mature mothbean seed were 21.9%, 0.17%, 64.8 ppm, and 37.5 ppm, respectively. These values compared well with those in mungbean (Vigna radiata) and tepary bean (Phaseolus acutifolius). The results demonstrated that mothbean has considerable potential as an alternative, new food legume crop in Virginia and eastern United States.
Cold Hardiness and the Effects of a Low-input Regime on 15 Tall, Warm-season, Native and Ornamental Grasses in the Upper Midwestern United States
Authors: Zuk Alan , Zhang Qi , Helms Ted , Hatterman-Valenti Harlene
Published: December 2016

Fifteen tall, warm-season, native and ornamental grasses were subjected to a 3-year, low-input, and cold hardiness trial conducted from 2010 to 2013 in zone 4a at Fargo and Mandan, ND. Grasses tested were big bluestem [species (Andropogon gerardii)], ‘Pawnee’ big bluestem (A. gerardii), silver banner grass (Miscanthus sacchariflorus), giant miscanthus (Miscanthus ×giganteus), hardy pampas grass, (Saccharum ravennae), and the following maidengrass (Miscanthus sinensis) cultivars: Silver Feather, Narrow Leaf, Blondo, Autumn Light, Condensatus, Grosse Fontaine, Morning Light, Gracillimus, Strictus, and Zebrinus. In addition to survival, the grasses were also rated for spring vigor and fall quality (0–10 scale for both evaluations), fall leaf length, and fall flower height. The grasses received no management during the trial other than irrigation during the first season and weed control. The grasses were exposed to subsurface soil temperatures (at 6-inch depth) that reached as low as −8.6 °C at the Fargo location and −6 °C at the Mandan location. The study revealed that all big bluestem (species), ‘Pawnee’ big bluestem, and silver banner grass survived at both locations; silver banner grass scored the highest spring vigor ratings; silver banner grass and ‘Pawnee’ big bluestem scored the highest fall quality ratings; silver banner grass produced the longest fall leaf length; and ‘Pawnee’ big bluestem, big bluestem (species), and silver banner grass produced the tallest fall flowers.
Conservation Horticulture for Yarey Palm and Buccaneer Palm: Substrate and Sowing Depth Affect Germination and Early Seedling Growth
Authors: Murphy Vickie , Clase Teodoro , Rodríguez-Peña Rosa A. , Jiménez-Rodríguez Francisco , Jestrow Brett , Husby Chad E. , Griffith M. Patrick
Published: December 2016

Palms (Arecaceae) are perhaps the most important tropical plant family for human use, both for utility and ornamental horticulture. The wide diversity of palm species with different seed germination characteristics necessitates tailoring horticultural practices to the needs of each. This is crucial for production and conservation horticulture. In this study, wild-collected seeds of yarey palm (Copernicia berteroana) and buccaneer palm (Pseudophoenix sargentii) were germinated in a variety of organic (standard nursery container mixes) and inorganic substrates. The yarey palm seeds were sown at two different depths, 0.5 inch and at the surface (seed half exposed). Mean maximum germination across all treatments for yarey palm was 79% and for buccaneer palm 60%. The standard nursery mixes generally fostered the best germination and long-term survival. This is likely due to a combination of the lower water availability at the surfaces of the more porous inorganic substrates (sand and perlite) and greater difficulty for coarse palm roots to penetrate the denser inorganic substrates, including fired ceramic, which otherwise had similar water-holding capacity (WHC) and even lower air space than the organic substrates. Difficulty of penetration caused roots of some seedlings to either dry up early in germination as in the surface sown yarey palm, or to “push up” the seed (buccaneer palm) rather than penetrating the substrate and this was often fatal. Thus, inorganic substrates are not recommended for germination and early seedling growth of these palm species and planting the seeds slightly below the surface may be preferable to surface sowing. For conservation horticulture of wild-collected palm seeds, this information can help prevent further genetic bottlenecks while under protective cultivation.
Hydrogen Cyanamide on Citrus: Preliminary Data on Phytotoxicity and Influence on Flush in Potted and Field Trees
Authors: Stover Ed , Lin Youjian , Yang Xiaoe , Vashisth Tripti
Published: December 2016

Bloom in individual citrus (Citrus) trees often continues for more than 1 month in south Florida, with even greater bloom duration within most orchard blocks because of variation in bloom timing between trees. Prolonged bloom contributes to variable fruit maturity as harvest approaches and increases severity of postbloom fruit drop (PFD) disease (caused by Colletotrichum acutatum). Hydrogen cyanamide (cyanamide) has been effective in accelerating bloom in various deciduous fruits, and its potential use in citrus was investigated in this preliminary study. Cyanamide was applied at a range of concentrations, from 0% to 1.0% a.i., to potted trees of six citrus types reflecting fairly broad diversity in commercial citrus that was readily available as seed [alemow (Citrus macrophylla), ‘Duncan’ grapefruit (Citrus paradisi), sour orange (Citrus aurantium), ‘Smooth Flat Seville’ sour orange hybrid (C. aurantium hybrid), ‘Swingle’ citrumelo (C. paradisi × Poncirus trifoliata), and ‘Sun Chu Sha’ mandarin (Citrus reticulata)] in Dec. 1999 while trees were quiescent. Phytotoxicity increased with cyanamide rate, with some damage at 0.125% cyanamide on most tested plants, and large variation among citrus types. All cyanamide rates hastened flushing. Airblast application of cyanamide (0, 0.025%, 0.05%, and 0.10%) was made to mature trees of ‘Valencia’ and ‘Navel’ sweet orange (Citrus sinensis) in Ft. Pierce, FL, on 27 Jan. 2000. On 15 Feb. and 28 Feb. additional trees received cyanamide at 0.05%. There was considerable defoliation, which increased linearly with cyanamide rate. Flushing and flowering were unaffected by cyanamide compared with controls except in February where cyanamide applied at 0.05% increased flowers per tree in ‘Valencia’ sweet orange, and in contrast, 0.1% cyanamide on 27 Jan. reduced ‘Navel’ sweet orange flowering. Cyanamide application to ‘Valencia’ sweet orange on 28 Feb., after initial flowering but 16 days before peak bloom, significantly reduced yield per tree but there were no other effects on cropping. In these trials, cyanamide was not an effective agent for hastening bloom in south Florida citrus with applications late January through February. Further work is needed to determine whether December applications of cyanamide to trees in the field may be more effective in concentrating subsequent flush and bloom.
The Influence of Gardening Activities on Self-reported Health Problems, Allergies, and Body Mass Index
Authors: Etheredge Coleman L. , Waliczek Tina M. , Zajicek Jayne M.
Published: December 2016

In the last quarter century, the epidemic of overweight and obese Americans has increased strikingly. This, in turn, has caused a substantial rise in the risk of cardiovascular diseases, cholesterol, hypertension, osteoarthritis, stroke, type II diabetes, specific forms of cancer, and other diseases. The main purpose of this research was to investigate the influence of gardening activities on activity levels, body mass index (BMI), allergies, and reported overall health of gardeners and nongardeners. The sample population was drawn from two sources: an online survey and an identical paper-pencil formatted survey, which was distributed to church, garden, and community service groups within Texas and parts of the mid-western United States. A total of 1015 people participated in the study. Results from this study indicated nongardeners were less physically active when compared with gardeners. However, frequency of gardening did not have a statistically significant impact on gardeners’ BMI. There was also no difference in BMI between gardeners and nongardeners. Gardeners indicated having more frequently reoccurring symptoms for “ear infection/ear ache,” “high cholesterol,” “kidney stone,” “gallstones,” and “arthritis,” indicating gardening may be being used as a distraction therapy, helping gardeners to cope with pain and remain active when other forms of exercise may not be an option. There was no statistically significant difference in incidence of allergies between gardeners and nongardeners.
Are Floodplain Soils a Potential Phosphorus Source When Inundated That Can Be Effectively Managed?
Authors: Reavis Megan A. , Haggard Brian E.
Published: December 2016

Core Ideas

Dissolved phosphorus is released from floodplain soils when inundated.

Phosphorus release rates are positively correlated with soil test and water‐extractable P in soil.

Water treatment residuals decrease P release rates, providing a potential mitigation option.

The growing concern over phosphorus (P) and water quality has led to questions as to where the loads originate and how to control landscape inputs from the watershed. We collected soil cores from two locations in the Illinois River watershed to examine the relationship between stored soil P and the amount of soluble reactive P (SRP) released into the water when soils are flooded. After inundation, P flux calculations for durations of ∼24 h ranged from less than 0.1 to 9.3 mg SRP m−2 h−1. Soil test P (STP), measured as water‐extractable P and Mehlich‐III P, correlated with SRP flux, where higher STP resulted in increased P flux to the overlying water. Floodplain soils have the potential to be a P source, potentially releasing more than 1600 mg m−2 yr−1 (>16 kg ha−1 yr−1) depending on length and frequency of inundation and on STP content. Applying water treatment residuals (WTRs) significantly reduced P flux from the cores. Hence, WTR application to critical source areas provides a mitigation strategy to manage floodplain soils and potential SRP release.
Forage and Grasslands as Pollinator Habitat in North Dakota
Authors: Sanderson Matt A.
Published: December 2016

Core Ideas

Forage and grazinglands provide multiple ecosystem services.

Pollinator habitat is an essential service from grasslands.

Mixed cropland use areas support honey bee production.

Perennial grasslands typically support a diversity of vegetation and an abundance of pollinators. The northern Great Plains provide critical habitat for pollinators, both native and those managed for honey production. The objective of this research was to broadly assess the land use adjacent to apiaries across North Dakota. In 2014 and 2015, the land use around 320 apiaries in North Dakota was documented in roadside surveys and site visits. Results showed that apiaries were most often located near perennial grassland, followed by small grain crops, grazingland, and trees. The distribution of apiaries seemed to follow the acreage of crops in North Dakota. There was a greater frequency of apiaries associated with hay and pasture than other crops, except small grains, in relation to crop acreage. The number of crops or land uses surrounding the apiaries ranged from 1 to 5, with hay crops the most common followed by wheat (Triticum aestivum L.) and pasture. Apiaries were also frequently located in abandoned farmsteads and near shelterbelts. The results presented here highlight the value of forage and grazinglands in providing additional ecosystem services that support native pollinators and a large domestic honey bee industry.
Support Vector Machine Untuk Klasifikasi Citra Jenis Daging Berdasarkan Tekstur Menggunakan Ekstraksi Ciri Gray Level Co-Occurrence Matrices (GLCM)
Authors: Neneng Neneng , Adi Kusworo , Isnanto Rizal
Published: December 2016

Texture is one of the most important features for image analysis, which provides informations such as the composition of texture on the surface structure, changes of the intensity, or brightness. Gray level co-occurence matrix (GLCM) is a method that can be used for statistical texture analysis. GLCM has proven to be the most powerful texture descriptors used in image analysis. This study uses the four-way GLCM 0o, 45o, 90o, and 135o. Support vector machine (SVM) is a machine learning that can be used for image classification. SVM has a high generalization capability without any requirement of additional knowledge, even with the high dimension of the input space. The data used in this study are the image of goat meat, buffalo meat, horse meat, and beef with shooting distance 20 cm, 30 cm and 40 cm. The result of this study shows that the best recognition rate of 87.5% was taken at a distance of 20 cm with neighboring pixels distance d = 2 in the direction GLCM 135o.
Metode Jaringan Syaraf Tiruan Untuk Prediksi Performa Mahasiswa Pada Pembelajaran Berbasis Problem Based Learning (PBL)
Authors: Badieah Badieah , Gernowo Rachmat , Surarso Bayu
Published: December 2016

In order to improve academic quality in higher education, students’ performance evaluation is becoming important. To prevent increasing failure rate in the course, we need a system that is capable of predicting student’s performance in the end of the course. The research used several factors that are considered to affect students' performance on Problem Based Learning (PBL), such as students’ demography, students’ prior knowledge and group heterogeneity.  The method used in the study was Artificial Neural Network (ANN) with backpropagation training algorithm. Total 8 neurons were used as inputs for ANN which were obtained from gender variable (2 neurons), age variable (1 neuron), students’ average knowledge variable (1 neuron), students’ average skill variable (1 neuron) and group heterogeneity variable (3 neurons). Several different ANN architecture were tested in the study using 2, 7 and 12 hidden neurons respectively. Each architecture was trained using various different training parameters in order to find the best ANN architecture. Dataset used  in the research were obtained from Academic Information System in Faculty of Dentistry Unissula which contained Adult and Elderly Diseases Course’s participants from year 2009 to 2013. The ANN output were numeric values which represented students’ performance in Adult and Elderly Diseases Course. The output of this study is a system that is able to predict the student performance in block course. The result shows that using 7 hidden neurons in the network combining with 0.5 ,0.1 and  9000 for learning rate, momentum and epoch respectively, were the best ANN architechture and parameters in the study. The MSE obtained from validation test was 0,011926 with correlation coefficient (R) 0,796879. The prediction system are expected to help faculty and academic evaluation team to conduct actions to improve student’s academic performance and prevent them from failure in the course.
Metode Forward Chaining Untuk Penentuan Kelayakan Bisnis Usaha Mikro
Authors: Kurniadi Dedy , Prahasto Toni
Published: December 2016

In this present study has done business feasibility of the micro industrial sector based on the importance of Business Feasibility Study (BFS) on business organization that requires an assessment of the business feasibility process as a benchmark for investors or business owners and also to minimize the business risks that may occur at a later date to be addressed appropriately. This study aims to create a Business Feasibility Information System (BFIS) using a forward chaining. Forward chaining method has a high success rate when applied in various fields. Forward chaining developed for excellent performance in solving various problems. The process of doing a forward chaining requires input variables. The input process covers legal aspects human resources and management environmental aspects marketing aspects aspects of production and financial aspects. Six variables are processed in the database that was later acquired data using inference machine to form a pattern of reasoning that is assembled using forward chaining algorithm. Further reasoning patterns are registered into a database rule to get the address data. Results from this study is a Decision Support System (DSS), which can give a decision on the feasibility assessment and business micro-enterprises in the industrial sector. This device can be developed to help entrepreneurs and investors in the micro industrial sector to assess their business activities
Rancang Bangun Tata Kelola Kinerja Perguruan Tinggi Menggunakan IT Balanced Scorecard
Authors: Solechan Achmad , Prasandy Teguh
Published: December 2016

Budgeting most colleges are not based on good governance and conceptual, but based on short-term needs in each college. Other problems are related to the use of information technology in both hardware, software and brain ware (user) in the management of information technology is still not well-thought in its development. This research aims to design a wake-up governance by using the Information Technology IT Balanced Scorecard framework is a system of management, measurement and control quickly, accurately and comprehensively can provide insight to the Leadership of the portrait and the development of information technology in institution. Information system development using SDLC (system development life cycle). College performance measurement method using IT balanced scorecard framework. The results showed that the use of information systems governance college performance using IT Balanced Scorecard help the efficiency and effectiveness in making an evaluation report IT governance, helping the presentation of information and error reduction calculations, the transaction data maintained intact his security, was able to complete the reporting process with fast, speed up the calculation process and the conclusion of the assessment of the performance of the college.
Vesicovaginal fistula diagnosis and repair, Benghazi-Libya (Nine years of experience)
Authors: Etabbal A , El Kawafi R , Greiw A
Published: December 2016

Introduction: Although most of vesicovaginal fistulas (VVF) are iatrogenic, they can also occur as a result of congenital anomalies, neoplastic changes, and complications of radiotherapy. In rural areas, the obstructed labor may lead to the development of VVF. However, the most common cause of VVF in developed areas is iatrogenic damage of the bladder tissue.

Aim: To confirm that the immediate repair of iatrogenic urinary bladder injures during obstetric or gynecological surgeries prevents VVF formation, and to identify optimal time and outcome of surgical techniques of VVF repair.

Patients & Methods: Prospective study was carried over 9 years and included 95 patients. These patients were divided into two groups; one group underwent immediate intra-operative repair of urinary bladder injuries (n=76), while other group presented with VVF and underwent either reconstructive or urinary diversion surgeries on elective bases (n=19).

Results: The mean age of 19 cases having VVF was 29.4 ± 8.4 years. One case was missed and other 18 cases underwent abdominal repair (n=8), vaginal repair (n=5) and permanent urinary diversion (n=5). The time of repair ranged from 2 day to 7 months after detection of VVF. The success rate of post-surgical VVF repair was 92.3%.

Conclusion: Immediate repair of urinary bladder injuries during obstetric or gynecological surgeries prevents development of VVF. Post-surgical VVF repair can be done in first post-operative days before inflammatory changes takes place. The result of VVF repair depends on the experience of the surgeon rather than the used surgical techniques.
The role of communication in the deployment of water loss and energy management strategies: the experience of collaborative research with water utilities
Authors: Ribeiro R. , Alegre H. , Loureiro D. , Mamade A.
Published: December 2016

Water utilities (WU) have to deal with different challenges including ageing infrastructures, demand variability, climate change and increased societal expectations. This paper aims at outlining potential synergies between communication promotion and the implementation of a structured approach to enhance water loss and energy management in WU. The use of a structured approach in the decision-making process leverages knowledge production from various stakeholders, enabling them to propose solutions for the challenges faced by the WU. Collaboration is essential to achieve improvements in the long-term by breaking down information silos and boundaries resulting from functional specialism. In the scope of the iPerdas 2014 project, 17 Portuguese WU followed a joint training and capacity-building approach to work strategically with water loss and energy efficiency issues. The benefits of implementing a comprehensive communication framework are presented, highlighting the interconnected nature of barriers to energy and water efficiency and the need to address these barriers in a holistic manner. The paper concludes with the presentation of some lessons learned regarding the promotion of communication in collaborative projects.
A new reactor for denitrification and micro-particle removal in recirculated aquaculture systems
Authors: Boley A. , Korshun G. , Boley S. , Jung-Schroers V. , Adamek M. , Steinhagen D. , Richter S.
Published: December 2016

A ‘membrane-denitrification’ reactor (MDR) was developed and tested in a semi-technical recirculation aquaculture system in comparison to a double – without MDR – as reference system. The MDR consisted of a reactor with an ultrafiltration membrane unit for removal of micro-particles (e.g. sludge flocs, bacteria and parasites). Specific carrier material provided surfaces for biofilm growth in a fluidized bed reactor with ethanol as carbon source for denitrification. The continuous motion of these carriers cleaned the membrane surface. With online and laboratory measurements of water parameters and operational data the feasibility of the concept was verified. An advantage is that no chemicals are needed to clean the membranes. Examinations of the fish and water analyses proved an MDR can positively influence cortisol, as a stress marker, and the microflora of the aquatic system.
Solar photodegradation of a textile azo dye using synthesized ZnO/Bentonite
Authors: Boutra B. , Trari M.
Published: December 2016

The present work is devoted to the synthesis of a new photocatalyst ZnO (7.5%)/Bentonite prepared by impregnation method and its successful application for the degradation of Solophenyl Red 3BL (SR 3BL) under solar light (∼660 W/m2). The X-ray diffraction (XRD) indicates mixed phases of the nanocomposite catalyst (ZnO/Bentonite), characterized by scanning electron microscopy, X-ray fluorescence and attenuated total reflection. The optical properties confirm the presence of the Wurtzite ZnO phase with an optical gap of 3.27 eV. The catalyst dose (0.25–1 gL−1), pH solution (2.5–11) and initial dye concentration (5–75 mg/L) are optimized. The optimal pH (∼6.7) is close to the natural environment. The photodegradation yield increases with decreasing the SR 3BL concentration. The equilibrium is reached within 160 min and the data are well fitted by the Langmuir-Hinshelwood model; the SR 3BL disappearance obeys to a first-order kinetic with an apparent rate constant of 10−2 mn−1. The best yield of SR 3BL photodegradation (92%) is achieved for a concentration of 5 mg/L and a catalyst dose of 0.75 gL−1 at free pH.
Faktor-faktor Penyebab Ketidaklengkapan Pengisian Rekam Medis Dokter di Ruang Rawat Inap RSI Unisma Malang
Authors: Lihawa Cicilia , Mansur Muhammad , S Tri Wahyu
Published: December 2016

Ketidaklengkapan pengisian rekam medis di RSI Unisma Malang menggambarkan Â pelayanan kesehatan yang diberikan dan Â mutu pelayanan rekam medis. Salah satu indikator mutu pelayanan di unit rekam medis adalah kelengkapan pengisian rekam medis setelah pelayanan. Adanya ketidaklengkapan pengisian rekam medis setelah selesai pelayanan di ruang rawat inap RSI Unisma Malang perlu dicari penyebab dan solusinya. Pendekatan deskriptif dilakukan dengan metode studi dokumen, observasi unit pelayanan, dan kuesioner yang telah dilakukan uji validitas dan reliabilitas dengan tambahan pertanyaan terbuka untuk saran. Sampel dalam penelitian ini adalah dokter sejumlah 27 orang. Penentuan akar masalah menggunakan diagram fishbone, yang kemudian di tentukan salah satu menjadi prioritas masalah menggunakan metode USG (Urgency, Seriousness, and Growth) dan penetapan solusi dengan tapisan McNamara. Hasil menunjukkan peran faktor susunan form RM yang kurang sistematis dalam ketidaklengkapan pengisian rekam medis. Sebagai solusi untuk meningkatkan kelengkapan pengisian rekam medis Â adalah dengan membuat rancangan form rekam medis terintegrasi.Â Kata Kunci: Dokter, ketidaklengkapan rekam medik, rawat inap
Faktor Sumber Daya Manusia dan Komitmen Manajemen yang Mempengaruhi Surveillance Infeksi Nosokomial di Rumah Sakit Paru Batu
Authors: S Yuni Kartika , Hariyanti Tita , Pujiastuti Lucia
Published: December 2016

Surveilans infeksi nosokomial merupakan salah satu kegiatan dalam program Pencegahan dan Pengendalian Infeksi (PPI) di rumah sakit. Studi Pendahuluan menunjukkan angka kejadian plebitis di RS Paru Batu pada tahun 2013 tercatat sebesar 8,23% dan pada bulan Juni 2014 tercatat sebesar 6,3%. Kejadian ini cukup tinggi mengingat standar kejadian plebitis yang direkomendasikan oleh standar pelayanan medis minimal tahun 2008 adalah sebesar â‰¤1,5%.. Tujuan dari penelitian ini adalah untuk mengidentifikasi akar permasalahan kurang optimalnya pelaksanaan program pelaporan surveillance infeksi nosocomial di RS Paru Batu. Penelitian dilakukan dengan pendekatan deskriptif kualitatif dengan studi dokumen, wawancara terstruktur dan observasi. Pencarian akar masalah dilakukan dengan melakukan Focus Group Discussion dengan peserta 1 perawat IPCN (Infection Prevention Control Nurse), 8 kepala ruangan rawat inap di RS Paru Batu, koordinator keperawatan dan koordinator pelayanan medis. Hasil penelitian menunjukkan sebagian besar komponen surveilans belum dijalankan dengan benar sesuai Petunjuk Teknis Surveilans dari Kemenkes tahun 2010. Hal tersebut disebabkan kurangnya dukungan manajemen untuk program dan sarana penunjang PPI, belum adanya sosialisasi program kepada seluruh pelaksana surveilans, serta belum adanya fungsi pengawasan terhadap pelaksanaan program surveilans infeksi nosokomial. Hasil tapisan pilihan solusi terbaik dengan skala matriks adalah pengesahan SK pengangkatan Komite dan Tim PPI, menyusun panduan surveilans infeksi nosokomial dan sosialisasi surveilans infeksi nosokomial.Kata Kunci: Â Angka kejadian plebitis, IPCN, sumberdaya manusia, surveilans infeksi nosokomial
Faktor Penyebab Kurangnya Kinerja Surveilans Infeksi Nosokomial di RSUD Dr. Iskak Tulungagung
Authors: Lelonowati Dewi , Koeswo Mulyatim , Rochmad Kasil
Published: December 2016

Surveilans infeksi nosokomial merupakan salah satu kegiatan dalam program Pencegahan dan Pengendalian Infeksi (PPI) di rumah sakit. Â Pada studi pendahuluan menunjukkan kegiatan pencatatan dan pelaporan infeksi nosokomial di RSUD Dr. Iskak Tulungagung (minimal 1 parameter) jauh lebih rendah dari Standar Pelayanan Minimal (SPM), meskipun sudah tersedia Tim PPI yang terlatih. Â Hal ini mengindikasikan kinerja surveilans infeksi nosokomial belum berjalan dengan baik. Â Tujuan dari penelitian ini adalah untuk mengidentifikasi, menganalisis dan menentukan solusi dari faktor penyebab kurangnya kinerja surveilans infeksi nosokomial di RSUD Dr. Iskak Tulungagung. Penelitian ini dilakukan dengan pendekatan deskriptif kualitatif dengan mempelajari dokumen-dokumen, wawancara terstruktur dan observasi dengan checklist. Â Pencarian akar masalah dilakukan dengan melakukan Focus Group Discussion dengan peserta 19 perawat Infection Prevention Control Nurse (IPCN) dan Infection Prevention Control Link Nurse (IPCLN). Â Hasil penelitian menunjukkan sebagian besar komponen surveilans infeksi nosokomial belum dijalankan dengan benar sesuai Petunjuk Teknis Surveilans dari Kemenkes tahun 2010. Hal tersebut disebabkan belum adanya kebijakan untuk sosialisasi program kepada Tim PPI, kurangnya dukungan manajemen terhadap program dan sarana penunjang, serta belum adanya fungsi pengawasan terhadap pelaksanaan program surveilans infeksi nosokomial. Kesimpulan hasil tapisan pilihan solusi terbaik dengan metode Nominal Group Technique (NGT) dan metode CARL adalah pengadaan program pendidikan dan pelatihan yang berkesinambungan kepada Tim PPI untuk meningkatkan pengetahuan, ketrampilan dan sikap demi menunjang keberhasilan program surveilans infeksi nosokomial di rumah sakit.Kata Kunci: Â Pendidikan dan pelatihan, surveilans infeksi nosokomial, Tim PPI
Faktor-faktor yang Mempengaruhi Tingginya Angka Kematian di IGD Rumah Sakit
Authors: Limantara Rudy , Herjunianto Herjunianto , Roosalina Arma
Published: December 2016

Angka kematian pada Instalasi Gawat Darurat merupakan indikator penting kinerja rumah sakit. Data angka kematian pada tahun 2013 sangat tinggi, baik GDR, NDR maupun kematian di IGD â‰¤ 24jam. Kajian dilakukan untuk mengevaluasi penyebab masalah tingginya angka kematian â‰¤ 24jam di IGD. Untuk mencari akar penyebab masalah digunakan analisis tulang ikan (fishbone) dengan data dari observasi, wawancara yang dibahas melalui FGD. Dalam memilih alternatif solusi digunakan teori tapisan Mc Namara. Gambaran pola kematian menunjukkan kematian terbesar pada 6-12 jam pertama yang juga dipengaruhi jenis morbiditas dan usia pasien. Analisis akar masalah mengidentifikasi faktor pre-hospital, sumberdaya manusia, dan kinerja monitoring komite mutu sebagai determinan keterlambatan penanganan yang dapat meningkatkan risiko kematian. Faktor kontributor utama adalah belum optimalnya standar prosedur operasional pengelolaan emergency meskipun response time sudah cukup optimal sehingga perlu dilakukan emergency drill secara berkala.Kata Kunci: Angka kematian, emergency drill, Instansi Gawat Darurat (IGD), Standar Prosedur Operasional (SPO)
Analisis Rendahnya Laporan Insiden Keselamatan Pasien di Rumah Sakit
Authors: Gunawan Gunawan , Harijanto Harijanto , Harijanto Tatong
Published: December 2016

Data laporan IKP yang akurat sangat bermanfaat untuk pemetaan risiko keselamatan pasien dan dasar perbaikan sistem pelayanan yang berorientasi pada keselamatan pasien. Penelitian ini bertujuan untuk menganalisa rendahnya laporan IKP dan Â faktor Â yang berpengaruh pada sistem pelaporan IKP di salah satu Rumah Sakit (RS) Malang. Metode yang digunakan adalah diskripsi analitik. Penggalian data dilakukan dengan telusur data laporan IKP, observasi lapangan, wawancara terstruktur dan survei dengan menggunakan kuesioner. Responden pada penelitian ini adalah 20 petugas kesehatan dan keluarga pasien sebanyak 6 orang. Analisis data dilakukan secara deskriptif untuk melihat distribusi frekuensi menggunakan microsoft excel. Hasil menunjukkan angka IKP lebih tinggi dari angka laporan IKP. Faktor penyebabnya adalah rendahnya laporan IKP yang disebabkan oleh rasa takut pada kepala unit kerja.Kesimpulan dari penelitian ini adalah data laporan IKP belum menggambarkan kondisi sebenarnya dari kejadian insiden keselamatan pasienyang terjadi di RS X. Faktor penyebab utama kondisi tersebut adalah kurangnya pemahaman tentang konsep pelaporan IKP.Â Kata Kunci: Budaya keselamatan pasien, insiden keselamatan pasien
Redesain Sistem Identitas Pasien sebagai Implementasi Patient Safety di Rumah Sakit
Authors: Tulus Hesty , Maksum Halimi
Published: December 2016

Identifikasi pasien merupakan bagian terpenting dari sebuah keamanan dalam memberikan sebuah pelayanan. Penandaan identitas pasien RS X di Jawa Timur baru dilaksanakan dalam beberapa bulan. Evaluasi dilakukan oleh bagian pendaftaran adalah 90% identitas pasien yang berupa gelang identitas tidak terpasang pada ibu hamil yang akan melahirkan di kamar bersalin. Data menunjukkan kurangnya sosialisasi di bagian rawat jalan dan yang memasang gelang identitas adalah petugas admisi. Dokumentasi yang berhubungan dengan identitas pasien di rumah sakit ini hanya Standar Prosedur Operasional (SPO) gelang identitas pasien menurut akreditasi 2007. Tujuan dari penelitian ini adalah mendesign ulang dokumen yang berkaitan dengan identifikasi pasien, melalui pembuatan dan penyempurnaan panduan dan SPO Identifikasi Pasien, yang sesuai dengan akreditasi 2012. Penelitian kualitatif dilakukandengan menggunakan braistroming secara bertahap melibatkan instalasi terkait , komite KPRS dan kelompok kerja akreditasi RS di Pokja SKP (Sasaran Keselamatan Pasien). Selanjutnya dilakukan sosialisasi dan simulasi pada perawat pelaksana di instalasi terkait. Â Hasil menunjukkan SPO yang diberlakukan tidak sesuai lagi dengan akreditasi 2012. Dilakukan pembuatan SPO tentang pemberian gelang identitas, pemasangan gelang identitas, pemasangan tanda risiko dan pelepasan gelang identitas dan tanda risiko pada pasien dewasa, menyusun panduan identitas pasien. Rumah Sakit perlu segera menetapkan Surat Keputusan Kebijakan pemberlakuan panduan atau pedoman dan SPO Identifikasi Pasien yang sesuai akreditasi 2012. Â Telah diikuti dengan sosialisasi dan simulasi pada para perawat pelaksana di instalasi terkait. Perlu Monitoring dan evaluasi oleh tim KPRS (Keselamatan Pasien Rumah Sakit) secara periodik untuk Â meningkatkan kepatuhan pelaksanaan SPO Identifikasi Pasien.Kata Kunci: Identifikasi pasien, keselamatan pasien, panduan identitas pasien, standar akreditasi, Standar Prosedur Operasional (SPO)
Pengembangan Alur Pasien dan Berkas Rekam Medis sebagai Optimalisasi Sistem Informasi Rekam Medis
Authors: P Agni Hadi , Hariyanti Tita , Susilo Sugeng
Published: December 2016

Alur sistem dan dokumen merupakan komponen penting dalam sistem informasi rekam medis baik berbasis komputer maupun konvensional. Tujuan dari penelitian ini adalah mengidentifikasi alur pasien dan berkas rekam medis yang sesungguhnya untuk merancang rekomendasi alur pasien dan alur berkas rekam medis. Data diperoleh dari wawancara dengan perawat Instalasi Gawat Darurat (IGD), rawat inap, koordinator keperawatan, penanggung jawab bidang layanan medis dan keperawatan, serta petugas rekam medis sebagai dasar dalam pengembangan alur pasien dan alur berkas rekam medis. Data menunjukkan alur yang diterapkan di rumah sakit terlalu panjang dan pada pasien rawat inap yang datang kembali tidak mendapatkan berkas rekam medis. Alur pasien IGD dan berkas rekam medis rawat inap belum sesuai dengan alur yang ditetapkan oleh Depkes RI. Alur pasien rawat jalan, rawat inap dan alur berkas rekam medis pasien rawat jalan sudah sesuai dengan alur yang ditetapkan oleh Depkes RI walaupun pada pengelolaan berkas rekam medis masih terdapat kekurangan. Untuk meningkatkan efisiensi alur perlu adanya tenaga distribusi, pemotongan alur Instalasi Gawat Darurat, dan pasien lama mendapatkan berkas rekam medis sebelumnya, serta koordinasi antara petugas rekam medis dan petugas pendaftaran rawat inap Â saat ada pasien lama kembali ke rumah sakit.Kata Kunci: Alur pasien, alur rekam medis, dokumen
Faktor Penghambat Implementasi Sistem Informasi Manajemen Rumah Sakit di RSUD Blambangan Banyuwangi
Authors: Suyanto Suyanto , Taufiq Hidayat , Indiati Indiati
Published: December 2016

Penerapan Sistem Informasi Rumah Sakit (SIM RS) berbasis komputer semakin menjadi tuntutan, namun implementasinya memerlukan upaya lebih dari sekedar pengembangan SIM RS. Penelitian ini bertujuan untuk mengetahui faktor penghambat pelaksanaan SIM RS di Rumah Sakit Umum Daerah Blambangan Kabupaten Banyuwangi yang telah mengembangkan SIM RS. Penelitian ini merupakan penelitian deskriptif kualitatif dengan wawancara dan observasi sebagai petode pengambilan data pada periode September hingga Oktober 2014. Analisis akar masalah menggunakan fishbone melalui brainstorming, kemudian disepakati akar masalah yang paling penting dan dipilih alternatif solusi yang paling efektif, relatif murah, mudah dan bisa dikerjakan dalam waktu. Hasil penelitian mengidentifikasi tiga akar masalah utama kelengkapan standar prosedur operasional (SPO), kejelasan tugas pokok dan fungsi, serta supervise yang belum efektif sebagai penyebab belum optimalnya SIMRS secara maksimal. Sebagai langkah awal RS telah mengembangkan 12 SPO melalui proses pengkajian dan uji coba yang akan ditindaklanjuti dengan evaluasi implementasi berkelanjutan.Â Kata Kunci: Faktor penghambat, implementasi, SIM RS, standar prosedur operasional
Peningkatan Mutu Pelayanan RSI Unisma Malang Melalui Reformasi Manajemen Laundry dan Linen
Authors: A Jamilatus Syamsiah , S Tri Wahyu , Mansur Muhammad
Published: December 2016

Pelayanan linen yang tidak memenuhi standar seperti jumlah linen kurang, kebersihan linen kurang, ketidaktepatan waktu dalam pelayanan linen akan mempengaruhi mutu pelayanan rumah sakit. Disamping itu berdampak juga kepada pembiayaan kebutuhan linen yang tidak efisien dan menurunnya kepuasan pasien terhadap pelayanan linen. Penelitian ini merupakan studi deskriptif yang bertujuan untuk mencari akar masalah dan alternatif solusi tentang ketidaktepatan waktu penyediaan linen rawat inap di RSI Unisma Malang. Penelitian ini menggunakan responden sejumlah 10 orang yang terdiri dari kepala ruang dan petugas linen rawat inap. Penentuan akar masalah menggunakan diagram fishbone, identifikasi alternatif solusi masalah menggunakan media Focus Group Discussion (FGD) dengan pemilihan solusi melalui teori tapisan Mc Namara. Dari hasil penelitian yang terkait dengan ketidaktepatan waktu penyediaan linen adalah belum adanya struktur organisasi, Standar Prosedur Operasional (SPO) waktu pelayanan linen, kualifikasi Sumber Daya Manusia (SDM), pelatihan manajemen linen, dan kebijakan yang mengatur standar waktu pelayanan linen. Alternatif solusi yang dipilih berdasarkan teori tapisan Mc Namara adalah memperbaiki manajemen linen.Â Kata Kunci: Ketidaktepatan waktu, linen, ruang rawat inap
Faktor Penyebab Waktu Tunggu Lama di Pelayanan Instalasi Farmasi Rawat Jalan RSUD Blambangan
Authors: Purwanto Heri , Indiati Indiati , Hidayat Taufiq
Published: December 2016

Instalasi Farmasi RSUD Blambangan merupakan revenue center bagi Rumah Sakit. Waktu tunggu pelayanan Apotek Rawat Jalan RSUD Blambangan belum sesuai Standar Pelayanan Minimal Departemen Kesehatan Republik Indonesia. Penelitian ini bertujuan mengidentifikasi, menentukan akar permasalahan dan menentukan alternatif solusi atas permasalahan waktu tunggu pelayanan Instalasi Farmasi. Metode untuk mengidentifikasi akar masalah digunakan analisis tulang ikan (fish bone ishikawa) dan dilakukan Focus Group Discussion. Untuk memprioritaskan akar masalah ini digunakan metode USG (Urgency, Serious, and Growth). Metode untuk alternatif solusi adalah Mc. Namara. Hasil penelitian menunjukan 3 akar masalah yaitu proses screening lama dan satu loket, jauhnya Poli Penyakit Dalam sebagai resep terbanyak, tempat penerimaan resep BPJS dan umum jadi satu loket. Solusi terpilih adalah menambah tenaga screening dan loket antrian. Sebelum menambah tenaga screening dan loket antrian, waktu tunggu rata-rata obat jadi 70,81 menit, racikan 139,85 menit. Setelah solusi waktu tunggu rata-rata obat jadi 63,88 menit, racikan 108 menit. Hasil solusi waktu tunggu mengalami penurunan, obat jadi 7 menit, racikan 31 menit.Kata Kunci: Antrian, instalasi farmasi, loket antrian, screening, waktu tunggu
Nanosecond Pulsed Electric Fields (nsPEFs) Induce Socs1 and Socs3 but not Socs2 Gene Expressions in Hela S3 Cells
Authors: Rohmah Martina Kurnia , Lyrawati Diana , Yano Kenichi
Published: December 2016

Nanosecond Pulsed Electric Fields (nsPEFs) is one of bioelectric technologies applied widely in a number of sciences. nsPEFs cause some biological responses and known to play a role as a novel cancer therapy. However, the nsPEFs molecular mechanisms have not been fully elucidated. This study determines the effects of nsPEFs in socs (Suppressor of Cytokine Signaling) genes which are target genes of JAK/STAT signaling pathway. Through a negative feedback mechanism, SOCS proteins can suppress both cytokine signal transduction and overgrowth factor, so the cell growth is controlled. In cervix cancer, the presence of E6 and E7 HPV's oncoprotein is associated with methylation and inactivation of socs1 and socs3 genes. This mechanism is related to the increase of STAT expression and cancer prognostic. In this research, nsPEFs as much as 20 kV/cm for 80 ns was exposed over HeLa S3 cells in 4 mm cuvette. Socs1, socs2 and socs3 gene expressions were analyzed using real time PCR SYBR green and reverse transcription PCR (RT-PCR). This study shows that at 20 and 30 shots, nsPEFs significantly increase socs1 and socs3 but not socs2 gene expression. Effect of nsPEFs on socs1 and socs3 gene expression pattern is influenced by duration of post exposure incubation and each cell activity on internal cell condition. This research provides a new cancer therapy target for nsPEFs.Keywords: Bioelectric, gene expression, nsPEFs, shot, socs gene
Infeksi Cacing Tidak Berpengaruh terhadap Kadar Transforming Growth Factor (TGF)-Î² dan Kejadian Dermatitis Atopik pada Anak
Authors: Mukhasin Nadiah Soleman , Wahyuni Sitti , Ilyas Faridha S , Amin Safruddin , Satriono R , Tabri Farida
Published: December 2016

Infeksi cacing melalui kemampuannya memacu proliferasi sel T regulator dilaporkan dapat mempengaruhi manifestasi klinik dari alergi. Selain Interleukin (IL)-10, Transforming Growth Factor (TGF)-Î² merupakan sitokin yang di lepaskan oleh sel T regulator. Penelitian ini bertujuan untuk melihat pengaruh infeksi cacing terhadap kejadian dermatitis atopik (DA) melalui TGF-Î². Penelitian ini dilakukan di beberapa rumah sakit pendidikan Fakultas Kedokteran Universitas Hasanuddin. Dermatitis atopik (DA) didiagnosis dengan menggunakan kriteria William, ada dan beratnya infeksi cacing diperiksa dengan metode Kato Katz dan kadar TGF-Î² serum diukur menggunakan metode ELISA. Â Sebanyak 80 anak usia 2-7 tahun berpartisipasi pada penelitian ini. Partisipan dibagi menjadi kelompok DA (30 anak) dan non-DA (50 anak). Persentasi infeksi cacing adalah 21,2% (17/80) dengan intensitas infeksi yang ringan. Infeksi cacing tidak mempengaruhi kadar TGF-Î², demikian juga infeksi cacing serta kadar TGF-Î² tidak mempengaruhi kejadian DA. Penelitian ini menyimpulkan bahwa infeksi cacing dengan intensitas ringan tidak mempengaruhi kadar TGF-Î² maupun kejadian DA pada anak di Makassar.Kata Kunci: Dermatitis atopik, infeksicacing, TGF-Î²
Pengaruh Pemberian Susu Sapi Bubuk terhadap Kadar MDA Hepar pada Tikus Putih (Rattus Novergicus Strain Wistar) Jantan Model Diabetes Melitus Tipe 2
Authors: Kurniawan Adi Lukas , Nugroho Fajar Ari , Adi Prasetyo
Published: December 2016

Susu sapi bubuk mengandung kalsium, dan vitamin D yang dapat mencegah peningkatan kadar Malondialdehyde (MDA) pada diabetes melltus tipe 2 melalui mekanisme perbaikan sekresi dan sensitivitas insulin. Susu sapi bubuk mampu menurunkan kondisi stress oksidatif pemicu peningkatan kadar MDA. Tujuan penelitian ini untuk mengetahui pengaruh pemberian susu sapi bubuk terhadap kadar MDA hepar pada tikus wistar model diabetes melitus tipe 2. Penelitian ini adalah penelitian eksperimental post test only control group design menggunakan 30 tikus wistar model diabetes melitus tipe 2. Selama 90 hari, kelompok perlakuan diberikan susu sapi bubuk 0,9g (P1); 1,8g (P2); dan 2,7g (P3) per hari. selanjutnya pada hari ke-91 dilakukan pengukuran kadar MDA dari jaringan hepar dengan spektrofotometer. Hasil menunjukkan terdapat pengaruh pemberian susu sapi bubuk dengan berbagai dosis terhadap kadar MDA jaringan hepar tikus (p=0,003), dengan dosis efektif adalah 1,8g/hari karena dapat mencegah peningkatan kadar MDA mendekati kelompok negatif.Kata Kunci: Diabetes melitus tipe 2, Malondialdehyde (MDA), susu sapi bubuk