bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGEMBANGAN BERPIKIR KREATIF
Authors: Nurjan Syarifan
Published: September 2019

This study aims to develop students' creative thinking through mind map training by organizing information in learning. Students' thinking skills are needed to understand the subject matter, utilize information and creativity. Thinking is a mental activity in solving problems by distinguishing basic thinking skills and complex thinking skills. Two complex thinking processes namely critical thinking and creative thinking. Critical thinking is an organized process that involves mental activities such as problem-solving, decision making, analyzing assumptions, and scientific inquiry. Creative thinking is a thought process for developing original, aesthetic, constructive ideas or results that relate to views, concepts, and emphasize intuitive, rational, and creative aspects of thinking and synonyms of divergent thinking. The development of students' creative thinking is developing creative thinking, developing a link between mind maps and creative thinking skills, and describing the verses of the Qur'an about creative thinking.
DETERMINANTS SELF SUFFICIENCY OF RICE IN SUPPORTING FOOD INDEPENDENCE
Authors: Kurnia Lendi Ageng , Iskandar Deden Dinar
Published: September 2019

The research objective is to determine the future trends of rice self-sufficiency and to know the factors that influence rice self-sufficiency so as to achieve food independence. Previous research reviews rice self-sufficiency in terms of production factors. In this study, price stability, rice supply and farmers' welfare are taken into account as research variables. The results showed that the trend of analysis with quadratic models to measure rice self-sufficiency tends to increase. Variables that influence rice self-sufficiency are rice productivity, rice supply stability, application of technology and dummy during the New Order government with reform. Whereas the gap between rice price and grain price, the level of rice consumption and the welfare of farmers, does not affect rice self-sufficiency. The conclusion of this research is that to increase rice self-sufficiency, it is necessary to increase rice productivity, ensure that government rice reserves are always available so as to stabilize food supply stability, and always develop appropriate technological innovations to support increased production.
Assessment of Gut Microbiota and Selected Blood Parameters in Weaned Piglets Following Supplementation with a Probiotic and Vitamin C
Authors: Tymczyna Leszek , Trawińska Beata , Kowaleczko Marta , Chmielowiec-Korzeniowska Anna , Lechowski Jerzy
Published: September 2019

The aim of the study was to assess the gut microbiota and selected haematological and biochemical blood parameters of weaned piglets following dietary supplementation with a probiotic and vitamin C. the piglets were divided into a control group (group C) and an experimental group (group E), with 30 piglets in each group. All animals received the same feed ad libitum. The animals in the control group (group C) received feed with no added probiotic and vitamin C. the piglets in the experimental group (group E) were given a supplement containing a probiotic (Bacillus cereus 1×109 CFU/kg) in the amount of 1.5 g/piglet/day and vitamin c in the amount of 300 mg/piglet/day. The supplement was administered for 28 days. The total numbers of bacteria of the family Enterobacteriaceae and of the genus Lactobacillus were determined in faeces. The erythrocyte count, haemoglobin level, haematocrit, leukocyte count, and percentages of neutrophils and lymphocytes were determined in the blood. The biochemical analysis concerned the concentration of triacylglycerols, total cholesterol, and LDL and HDL cholesterol. In group E a significant decrease (P<0.01) in the total number of Enterobacteriaceae bacteria was observed in the faeces of the piglets, accompanied by an increase in the number of lactobacilli relative to group C. E. coli was found to predominate over other microorganisms. Salmonella choleraesuis bacteria were present in the faeces of both groups before administration of the supplement, but were not found after its use. The supplement with probiotic and vitamin C caused a significant increase in the erythrocyte, haemoglobin and haematocrit levels in the blood of the piglets and a significant decrease in the concentration of triacylglycerols, total cholesterol and LDL cholesterol.
A new type of slumping-induced soft-sediment deformation structure: the envelope structure
Authors: Byun Uk Hwan , van Loon A.J. Tom , Kwon Yi Kyun , Ko Kyoungtae
Published: September 2019

The sediments of the Cretaceous Gyeokpori Formation in south-western South Korea accumulated in a lake in which mainly siliciclastic rocks were deposited, with some interbedded volcaniclastics. The nearby volcanic activity resulted in unstable lake margins inducing a dominance of gravity-flow deposits. The high sedimentation rate facilitated soft-sediment deformation on the sloping margin. The deposition of numerous gravity-flow deposits resulted in a vertically heterolithic stratification. The slumps are composed of different lithologies, which is expressed in different types of deformation due to the difference in cohesion between sandy and mussy layers within the slumps. Coarser-grained (cohesionless) slumps tend to show more chaotic deformation of their lamination or layering. The difference in slumping behaviour of the cohesive and non-cohesive examples is explained and modelled.

A unique soft-sediment deformation structure is recognized. This structure has not been described before, and we call it ‘envelope structure’. It consists of a conglomerate mass that has become entirely embedded in fine-grained sediment because slope failure took place and the fine-grained material slumped down with the conglomerate ‘at its back’. The cohesive laminated mudstone formed locally slump folds that embedded the non-cohesive overlying conglomerate unit, possibly partly due to the bulldozing effect of the latter. This structure presumably can develop when the density contrast with the underlying and overlying deposits is exceptionally high. The envelope structure should be regarded as a special – and rare – type of a slumping-induced deformation structure.
Optimisation of Permanent Magnets of Bioreactor Magnetic Coupling while Preserving their Efficiency
Authors: Konuhova M. , Kamolins E. , Orlova S. , Suleiko A. , Otankis R.
Published: September 2019

The paper discusses issues related to the optimisation of magnetic couplings used in bioreactors (manufactured by JSC “Biotehniskais Centrs”). The purpose of optimisation was to preserve the maximum breakaway torque of the magnetic coupling while reducing the mass of rare earth elements used in its structure. The paper presents the rationale for the selected optimisation option taking into account the economic aspect. To solve the optimisation problem, the factors affecting the maximum torque of the magnetic coupling, such as the shape and height of the internal and external magnets, the angle of the external and internal magnets, as well as the height of the internal and external yoke, were determined. The design of the existing magnetic coupling was optimised and its prototype was made based on the results of optimisation. The results obtained by means of optimisation were compared with the results obtained experimentally by testing the manufactured prototype.
Computer Simulations of the Band Structure and Density of States of the Linear Chains of NaCl Ions
Authors: Myasnikova L.N. , Istlyaup A.S. , Sergeyev D.M. , Zhanturina N.N. , Shunkeyev K.Sh. , Popov A.I.
Published: September 2019

The paper presents the results of first-principles computer simulations of the band structure, the density of states, and the total energy of NaCl (NaCl, Na2Cl2, Na3Cl3, Na4Cl4, Na6Cl6) linear chains of atoms. Modelling of the specified characteristics is realised in the computer code Atomistix ToolKit combined with Virtual NanoLab. The total energy depends on the number of ions in the nanoobject under study, but practically does not depend on the geometric arrangement of ions.
Embedded image processing on Raspberry Pi connected to the industrial control system
Authors: Hrbček Jozef , Bubeníková Emília
Published: September 2019

This paper deals with the image processing from the camera for Raspberry Pi connected with real-time communication network to the control system (PLC). The low time delay for receiving and sending commands, data, etc. is very important in the automating production processes. This can be provided by industrial real-time network based on Ethernet. The Ethernet POWERLINK, which is supported on B&R PLCs, is one of them. It is a simple solution for a variety of applications because the POWERLINK is publicly available as the open source. Connecting the PLC and Raspberry Pi with Ethernet POWERLINK opens up many applications in industrial automation. For example, image data obtained using a camera attached to Raspberry Pi can be used to sense image of manufacturing processes and products and evaluate their quality in industrial automation. This article focuses on an image processing unit and the PLC system with CPU redundancy used in the industrial application. Vision systems are often used to improve products quality control, saving costs and time.
Influences on plasma cutting quality on CNC machine
Authors: Kudrna Lukas , Fries Jiri , Merta Marek
Published: September 2019

This article discusses plasma cutting technology and its influences on the quality of the resulting cut. Plasma or a plasma arch consists of positive and negatively charged particles, excited and neutral atoms and molecules. As it contains free particles, it is electrically conductive and thus subject to the effects of the electrical and magnetic field. The basis of CNC machine design is described in the article, which has at least 3 axes (x, y, z), but there are also more technologically demanding applications, such as pipe cutting, profile and cutting using chamfer to prepare surfaces for welding, where these multi-axis devices are frequently used. The principle of plasma cutting and the plasma cutting phase is described in this article. The materials that can be divided by a plasma arc are described in detail, including graphs displaying the dependence of sheet thickness on the cutting speed. The article describes and lists the gases that are used in plasma-arc cutting, such as oxygen, argon, hydrogen and nitrogen. Important components of plasma cutting technology are the parameters that can be adjusted and set before the cutting so that the cut is of good quality. The most comprehensive chapter deals with the influences that affect plasma cutting quality. Cutting quality can be influenced by a number of factors. Everything starts with the proper choice of a CNC machine and a plasma source. The quality also depends on the expertise and experience of the machine operator and the setting of the plasma cutting parameters. This issue of influences on the plasma cutting quality is based on long-term experience in the field of the thermal cutting process.
Chain of events application in workplaces in safety engineering
Authors: Ignac-Nowicka Jolanta
Published: September 2019

The article presents the hazard identification process as a sequence of events that leads to accident and/or material loss at the workplace. The chain of events can be described as an orderly set of circumstances conducive to the emergence of a threat. The article presents an analysis of the application of elements of the events theory to the identification of hazards in an industrial plant on the example of a gas explosion. The circumstances supporting the emergence of a gas explosion hazard were identified by determining the direct and indirect causes of the event and the main conditions leading to the event (loss). Also indicated is the cause of gas explosion hazard, which is the initiating factor in the chain of events.
Hydrogen fuel in transportation
Authors: Machač Jiří , Majer Milan
Published: September 2019

In the time, when the whole world is increasingly engaged in environmental protection, it is necessary to come up with a fuel alternative for transportation, which means generally abandon the use of non-renewable resources (petrol, oil and fossil fuel in general), as they are one of the many factors influencing the emergence of greenhouse gases and the associated global warming. In today's Europe, the pressure is put mainly on automotive companies, to search for sources other than conventional fuels. At present, there is a big boom in the area of electric cars powered from the power network – the vast majority of electric energy, however, is produced in fossil fuel power plants. The second option of possible development in this area is the use of hydrogen as an alternative fuel. This technology, whether it be direct combustion as in diesel or eventually in petrol engines, or energy production in a hydrogen fuel cell, is certainly the way suitable for further development. With hydrogen as a fuel, it is possible to reduce pollutants almost to zero. The article presents a comparison of electricity generated using renewable and non-renewable sources and focuses on a closer understanding of the myth of the dangers connected with using hydrogen as fuel. Furthermore, compares conventional fuels to re-newable hydrogen technologies and focuses on the hydrogen combustion engines together with hydrogen storage and application in transportation.
Engineer 4.0 in a metallurgical enterprise
Authors: Biały Witold , Gajdzik Bożena , Jimeno Carlos López , Romanyshyn Lyubomyr
Published: September 2019

Along with the growing dynamics of technological changes in production in the perspective of the development of 4.0 industry, there are changes in the structure of employment and professional qualifications of employees. The development of cyber-physical production systems (CPPS) entails an increase in the demand for engineers. Industry 4.0 is a new megatrend in production. In the second decade of this century, the concept of Industry 4.0 gained importance thanks to the policy of the German government and gradually penetrated into other countries. Enterprises, in addition to traditional production organization, started realizing of cyberphysical production lines as well as smart factories. New production solutions based on IT and robotics technologies using IoT the need for new employee competencies. On the market there is still a growing demand for IT specialists, and there is a demand for engineers 4.0, that is employees with new technical competences, able to control and service CPPS.This publication attempts to present the scope of changes in employment and presents the profile of professional qualifications of engineer 4.0 in a metallurgical enterprise. The list of new skills for an engineer 4.0 employed in an metallurgical enterprise is presented in this article by authors.
Inter gases as one of the ways to reduce the risk of endogenous fires in hard coal mines
Authors: Szurgacz Dawid , Sobik Leszek , Brodny Jarosław
Published: September 2019

Endogenous fires are currently one of the most common threats in hard coal mines. They are very dangerous for the staff and can cause very large economical loses. Therefore, the scope of activities aimed at limiting the possibility of these fires and reduction of their consequences constantly broadens. The paper presents the results of research aimed at determining the efficiency of the ventilation system applied to reduce the risk of endogenous fires in the areas where inert gases are used. The calculations included carbon dioxide and nitrogen. Inertisation is one of the ways of combating endogenous fires. This method is included in the developed comprehensive method to reduce the possibility of these fires. The results obtained and the method developed and later applied, should have a significant impact on improving the safety of operations in the scope of occurrence and consequences of endogenous fires.
The analysis of shaft sinking progress as a function of technical and organizational parameters
Authors: Bołoz Łukasz
Published: September 2019

In underground mines, where the deposit is located at considerable depths, mining shafts are key excavations. The project of making the deposit available requires selection of appropriate shaft sinking technology adapted to geological and hydrological conditions and natural hazards. Shafts can be made using the classic drilling and blasting technique or mechanical cutting of the shaft face. Mechanical cutting requires the use of a mining machine, which together with machines for loading and hauling the output and protecting the side walls is a shaft complex. Drilling using mechanized shaft complexes allows for high efficiency and work safety. To improve the efficiency of drilling, it is particularly important to implement many processes in parallel. The article presents an analysis of the progress of shaft sinking with a mechanized complex as a function of technical and organizational parameters. The analysis concerned a new generation cutting shaft complex, developed for the needs of shaft sinking for one of the Polish hard coal mines. The calculations were carried out for a shaft with a maximum diameter of 9.5 m and a total depth of 830 m. The article briefly presents a new solution for the shaft complex. There are presented results of calculations of daily drilling progress and total time of shaft sinking for the developed working technology of this complex. The efficiency of the complex depends on many factors related to technical parameters of individual machines and devices forming the complex and organizational parameters, hence a multi-variant analysis was carried out.
Patterning as a way to identify and assessment of the exploitation policy of selected technical systems
Authors: Loska Andrzej
Published: September 2019

The article presents a method of solving the problem of the assessment of the exploitation policy. It was assumed that the evaluation of the exploitation policy can and should be carried out with reference to defined universal patterns. This allows comparability of such a policy, as well as making decisions regarding necessary changes. Therefore, there was proposed a way of building pattern models of the exploitation policy and there was carried out the assessment of the exploitation policies of the selected technical network systems, based on the selected taxonomic model.
The impact of implemented management systems on the safety culture of work in production
Authors: Nowacki Krzysztof
Published: September 2019

Safety culture is one of the most important elements of the organization's culture. Its role is particularly important in production plants, where employees are more often exposed to threats related to the working environment. The safety culture is strongly associated with the organizational level of the enterprise, which is largely influenced by the implemented management systems. The article presents the results of the evaluation of work safety culture in production plants with different functioning management systems, including the so-called turquoise organization. A relationship between the organizational level of the plant and the culture of occupational safety was stated.
Work ergonomics in a service enterprise – case study
Authors: Kuboszek Artur
Published: September 2019

The article presents the results of research carried out as part of a project aimed at integrated ergonomic diagnosis of the work environment in terms of improvement of technical and psychosocial conditions. The studies carried out so far included small and medium-sized enterprises located in the Śląskie (Silesian) Voivodeship. The research included manual work as well as administrative (mental) work. Ergonomic diagnosis was carried out by direct observation of employees at the workplace using tools such as the Ergonomic Control Test CET II and the Dortmund List. This article presents the results of ergonomic analysis at the hairdresser workplace.
The importance of prediction methods in industry 4.0 on the example of steel industry
Authors: Gajdzik Bożena
Published: September 2019

This paper presents the importance of the prediction of steel production in industry 4.0 along with forecasts for steel production in the world until 2022. In the last two decades, the virtual world has been increasingly entering production. Today’s manufacturing systems are becoming faster and more flexible – easily adaptable to new products. Steel is the basic structural material (base material) for many industrial sectors. Industries such as automotive, mechanical engineering, construction and transport use steel in their production processes. Prediction methods in cyber-physical production systems are gaining in importance. The task of prediction is to reduce risk in the decision-making process. In autonomous manufacturing systems in industry 4.0 the role of prediction is more active than passive. Forecasts have the following functions: warning, reaction, prevention, normative, etc. The growing number of customized solutions in industry 4.0 translates into new challenges in the production process. Manufacturers must respond to individual customer needs more quickly, be able to personalize products while reducing energy and resource costs (saving energy and resources can increase the product competitiveness). The modern market becomes increasingly unpredictable. Production prediction under such conditions should be carried out continuously, which is possible because there is more empirical data and access to data. Information from the ongoing monitoring of the company’s production is directly transferred to the prospective evaluation. In view of the contemporary reciprocal use of automation, data processing, data exchange and manufacturing techniques, there is greater access to external data, e.g. on production in different target markets and with global, international, national, regional coverage. Companies can forecast in real time, and the forecasts obtained give the possibility to quickly change their production. Industry 4.0 (from the business objective point of view) aims to provide companies with concrete economic benefits – primarily by reducing manufacturing costs, standardizing and stabilizing quality, increasing productivity. Industry 4.0 aims to create a given autonomous smart factory system in which machines, factory components and services communicate and cooperate with each other, producing a personalized product. The aim of this paper is to present new challenges in the production processes in relation to steel production, as well as to prepare and present forecasts of (quantitative) steel production of territorial, global and temporary range until 2022, taking into account the applied production technologies (BOF and EAF). For forecasting purposes, classic trend models and adaptive trend models were used. This methodology was used to build separate forecasts for: total steel production, BOF steel and EAF steel. Empirical data is world steel production in 2000-2017 (annual production volume in Mt).
Prospects for development movement in the industry concept 4.0
Authors: Palka Dorota , Ciukaj Jolanta
Published: September 2019

The aim of the article is to present the perspective of maintenance development in the context of the 4.0 industry concept. One of the factors that determine the safe and effective use of machines and devices is the properly maintained maintenance process. Correct performance of activities as part of this process requires the use of appropriate knowledge and experience from people implementing this process. Very important in this process is, above all, good organization of work and technical knowledge. The very rapid development of technology causes that teams dealing with the maintenance of traffic in enterprises must systematically acquire knowledge and optimize their activities. Effective exploitation of all types of devices is a set of rules, rules, procedures and actions, the main aspect of which is a human being. Knowledge resources should have appropriate substantive content adapted to the recipient. The article presents a modern solution supporting the maintenance process, taking into account the tools supporting the activities of human teams. The basic principles of maintenance in the enterprise covering machine monitoring systems, production management and management of information on the state of the machine park are discussed. There are also examples of the use of selected tools in the mining industry. Reference was also made to the prospects and directions of the development of maintenance in relation to the fourth industrial revolution.
Hazard analysis and risk assessment in metal cutting process
Authors: Kotus Martin , Drlička Róbert , Mikuš Rastislav , Žarnovský Jozef
Published: September 2019

The paper deals with the issue of occupational health and safety in a metalworking manufacturing organization. Hazard and threat have been defined when cutting metal materials with a band saw. We assessed the risk by an extended point method, where we determined the risk rate values. In most cases of sawmill work, we found a “moderate” or “negligible” risk. The highest, ‘serious’ risk we found in a possible electric shock. In this case, we have also taken the necessary actions. As a precaution, we have also proposed safety measures for other threats.
Product analysis using value stream mapping
Authors: Michalski Krzysztof
Published: September 2019

The sales market requires both the highest quality of offered goods and satisfactory prices for the buyer. In addition to the reliability of the important aspects are also the time of order fulfillment, reliability, readiness to act around the clock, and service of sold goods after their sale. In the production and confection of conveyor belts, the priority is a customer who, having strictly defined product requirements, also has individually focused goals. To meet these aspects, you need to look after the product both during its production and after. The products of this industry are specific, so that they can be used, after sales service is often required to be installed at the customer and possible actions to maintain their good condition during operation. The article analyzes selected production processes of transmission belts to identify disturbances. The analysis uses the value stream mapping method. Then, improvement methods were proposed.
Hierarchical EPC models – review of model linking concepts
Authors: Szczęśniak Bartosz
Published: September 2019

EPC models are currently among the leading standard business process modelling solutions. As long as the rules for creating flat EPC models are explicit and raise no significant doubts, when it comes to linking models of different types, the literature of the subject delivers diversified solutions. Four such alternative concepts that can be applied in this respect have been identified and described in this article. They have been used to link EPC models for four cases proposed. These cases differ as to the degree of complexity, and they represent different kinds of potential links between processes being modelled. Using the concepts in question with reference to the cases defined has made it possible to identify situations in which it is impossible to link models, or when it raises certain doubts. What has also been proposed is that one of the concepts identified in the paper can be modified in such a manner that using it to link EPC models does not pose any problem in any of the cases discussed.
Barriers of implementation of pro-environmental activities in supply chains
Authors: Maryniak Anna
Published: September 2019

A constant growth of interest in GSCM on the part of business practitioners creates a need to develop research within this field. One of the basic questions is why, despite numerous evidence of benefits resulting from the use of pro-environmental practices in supply chains, the level of GSCM implementations is low. Therefore, the aim of the paper is determining which barriers constitute the greatest obstacles on the way of GSCM implementation. The studies were conducted among Polish market entities. Therefore, they were prepared in the part of Europe in which there are not many studies regarding this topic. As a result of the conducted studies, it was determined that the greatest barriers for pro-environmental practices are included in the field which concerns knowledge and cost. What is more, the importance of particular barriers was specified in the paper.
Factors Associated with the Occurrence of Death Outcome in Children with Neonatal Respiratory Distress Syndrome
Authors: Kočović Aleksandar G. , Kostić Gordana D. , Savić Dragana M. , Stanojević Milica M. , Milosavljević Miloš N. , Janković Slobodan M. , Milosavljević Milica N , Stefanović Srdjan M.
Published: September 2019

Neonatal respiratory distress syndrome (NRDS) is a consequence of immaturity at birth and it is still associated with relatively high mortality rate. The aim of this study was to identify the factors associated with the occurrence of fatal outcome in newborns with neonatal respiratory distress syndrome.The research was designed as a case-control study nested in a retrospective cohort, and it enrolled newborns treated during 2015 at Pediatric Clinic of Clinical Center in Kragujevac. Diagnosis of NRDS and decision about the treatment were left at the discretion of attending pediatricians. The cases were patients with fatal outcome, while controls were randomly selected from the pool of survivors and matched with each case by gender in a ratio of 4:1. The study included 371 newborns, of whom 201 (54.2%) were male and 170 (45.8%) female. Lethal outcome occurred in 36 newborns (9,7%). Significant association was found between death and APGAR score (ORadjusted: 0.516, 95% CI: 0.322-0.827), weight on delivery (ORadjusted: 0.996, 95% CI: 0.993-0.999), duration of hospitalization (ORadjusted: 0.901, 95% CI: 0.835-0.972) and mechanical ventilation (ORadjusted: 165.256, 95% CI: 7.616-3585.714). Higher gestational age, higher birth weight, higher APGAR score and longer duration of hospitalization were singled out as protective factors, while use of mechanical ventilation increased the risk of death. Major limitations of the study were retrospective nature and relatively small number of identified cases. Postponing delivery and delivery in institution with neonatal intensive care unit are crucial for survival of newborns with NRDS.
Risk Factors and Characteristics of Falls Among Hospitalized Stroke Patients
Authors: Djurovic Olivera , Radovanovic Snezana , Djonovic Nela , Vukomanovic Ivana Simic , Gajovic Gordana , Radevic Svetlana
Published: September 2019

Falls and fall-related injuries during hospitalization may cause serious problems and consequences for patients, their quality of life as well as increased healthcare expenses. The aim of the paper were to assess fall risks and identify risk factors, related to falls among stroke patients. This was a retrospective cohort study that included 217 neurological patients with acute stroke who have experienced fall during hospitalization. Morse Fall Scale was used to estimate a likelihood of falling for hospitalized patients. In total, 1.4% patients with acute stroke experienced a fall during hospitalization. According to the fall risk assessment, 77% of the patients presented a high risk for falls. Women, older respondents and those who were hospitalized for period longer than 22 days and who had higher levels of care, had higher values of Morse score. The most common risk factors for falls are: the presence of other medical diagnosis, the use of disability aids while walking, the use of intravenous therapy, disorientation in time and space, and the largest contribution to Morse score comes from using disability aids while walking and transferring patients. Greater risk of falling was observed in older neurological patients with ischemic type of stroke and weakness on the left side of the body, patients with longer hospitalization period and those with higher level of care.
Pola Kuman dan Uji Kepekaan pada Pasien Community Acquired Pneumonia di RSUP Dr. M. Djamil Padang Tahun 2016
Authors: Narlis Narlis , Nasrul Ellyza , Efrida Efrida
Published: September 2019

Community acquired pneumonia (CAP) merupakan infeksi yang paling sering menyebabkan sepsis dan dapat menimbulkan kematian. Pertimbangan pemilihan antimikroba yang tepat dan menghindari penggunaan yang berlebihan perlu dilakukan untuk mencegah terjadinya resistensi. Tujuan penelitian ini adalah mengetahui pola kuman dan uji kepekaan pasien CAP di RSUP Dr. M. Djamil Padang. Penelitian ini merupakan penelitian deskriptif retrospektif terhadap 201 sampel sputum pasien CAP yang diperiksa kultur kemudian dilanjutkan dengan pewarnaan Gram dan uji biokimia untuk mengidentifikasi bakteri. Uji kepekaan antimikroba menggunakan metode difusi cakram. Penelitian dilakukan di Laboratorium Sentral RSUP Dr. M. Djamil Padang periode Januari 2016 hingga Desember 2016. Data ditampilkan dalam bentuk tabel distribusi frekuensi. Mikroorganisme yang ditemukan adalah Klebsiella pneumonia (55,23%), Staphylococcus aureus (25,87%), Streptococcus pneumonia (7,96%), Pseudomonas aeruginosa (5,97%), Staphylococcus epidermidis (2,9%), Acinetobacter baumani (1,99%), Proteus vulgaris (0,49%). Antimikroba yang paling sensitif adalah Meropenem (78,7%), sedangkan antimikroba resisten dengan persentase tertinggi adalah Ampisilin (90%), Amoksisilin (89,4%), Eritromisin (73,5%), Amoksisilin + Klavulanat (64,6%), dan Kloramfenikol (61,7%). Mikroorganisme yang paling banyak ditemukan adalah Klebsiella pneumonia (55,23%). Meropenem merupakan antimikroba sensitif dengan persentase paling tinggi (78,7%) sedangkan antimikroba resisten dengan persentase paling tinggi adalah ampisilin (90%).
Analisis Sistem Rujukan Kelainan Refraksi dari Puskesmas ke Rumah Sakit di Kota Pariaman Tahun 2018
Authors: Marwis Marwis , Firdawati Firdawati , Erkadius Erkadius
Published: September 2019

Salah satu upaya pelayanan kesehatan mata adalah pelayanan kelainan refraksi. Berdasarkan Peraturan Menteri Kesehatan Nomor 5 Tahun 2014, kelainan refraksi masuk dalam 144 diagnosis yang harus diselesaikan di Fasilitas Kesehatan Tingkat Pertama (FKTP). Data Dinas Kesehatan Kota Pariaman Tahun 2015–2017 menunjukkan bahwa semua kelainan refraksi dirujuk ke rumah sakit yang jumlahnya setiap tahun menunjukan peningkatan yang berakibat pada tingginya angka rujukan dari puskesmas ke rumah sakit. Tujuan penelitian ini adalah untuk menentukan bagaimana penanganan kelainan refraksi dan faktor penyebab dirujuknya kelainan refraksi ke rumah sakit. Penelitian ini merupakan penelitian kualitatif. Data karakteristik responden didapatkan melalui wawancara mendalam, telaah dokumen dan observasi tentang pelayanan kelainan refraksi pada Puskesmas-Puskesmas di Kota Pariaman. Hasil penelitian menunjukan bahwa SDM untuk pelayanan refraksi di puskesmas Kota Pariaman sudah memadai dari segi kompetensi. Sarana prasarana untuk pemeriksaan refraksi sudah lengkap pada semua puskesmas. SOP untuk pemeriksaan refraksi hanya dimiliki oleh puskesmas yang memiliki tenaga refraksionis. Pelayanan sudah dimulai dari anamnesa, pemeriksaan mata dasar dan pemeriksaan refraksi. Semua kelainan refraksi dirujuk ke rumah sakit karena adanya panduan pelayanan alat kesehatan dari BPJS Kesehatan bahwa untuk mendapatkan kacamata bagi peserta JKN harus dengan rekomendasi dokter spesialis mata. Hasil penelitian dapat disimpulkan merujuk semua kelainan refraksi ke rumah sakit adalah karena panduan pelayanan alat kesehatan dari BPJS Kesehatan yang berakibat pada tingginya angka rujukan dari puskesmas ke rumah sakit serta terjadinya in-efisiensi anggaran.
Evaluasi Implementasi Kebijakan Standar Pelayanan Minimal Unit Radiologi Rumah Sakit Umum Daerah (RSUD) Dr. Rasidin Padang
Authors: Rahmaddian Tosi , Semiarty Rima , Lita Ratni Prima
Published: September 2019

Pentingnya pelayanan radiologi di rumah sakit sebagai bagian yang terintegrasi dari pelayanan kesehatan secara menyeluruh. Tujuan penelitian ini adalah mengevaluasi implementasi Kebijakan Standar Pelayanan Minimal (SPM) unit radiologi di RSUD X Padang. Penelitian ini menggunakan metode kualitatif melalui wawancara mendalam, Focus Group Discussion, telaah dokumen, dan observasi. Pengumpulan data dilakukan dengan cara wawancara mendalam kepada delapan orang informan, dan Focus Group Discussion kepada enam orang informan. Komponen yang diteliti mengenai input (kebijakan, sumber daya), process (komunikasi, disposisi/ sikap, struktur birokrasi), output (pencapaian indikator SPM). Hasil penelitian menunjukan bahwa kebijakan tersedia, namun sumber daya belum lengkap. Komunikasi tidak berjalan dengan baik. Disposisi/ sikap dalam hal ini terkendala oleh dokter yang tidak standby. Struktur birokrasi berjalan sesuai dengan prosedur. Belum tercapainya tiga target indikator SPM unit radiologi, diantaranya waktu tunggu hasil pelayanan thorax foto, kejadian kegagalan foto rontgen, dan kepuasan pelanggan. Kesimpulannya, implementasi kebijakan standar pelayanan minimal unit radiologi RSUD X Padang tidak berjalan maksimal dan hasil belum mencapai target.
Faktor yang Berhubungan dengan Kunjungan Voluntary Counsaling and Testing Pada Lelaki Seks Lelaki di Kota Padang
Authors: Nurlindawati Nurlindawati , Hardisman Hardisman , Yanis Amel
Published: September 2019

Layanan VCT (Voluntary Counsaling and Testing), atau dikenal dengan pelayanan konseling dan testing HIV adalah upaya menegakkan diagnosis HIV/AIDS untuk mencegah sedini mungkin terjadinya penularan atau peningkatan HIV/AIDS. Lelaki Seks dengan Lelaki (LSL) menjadi penyumbang terbesar dalam penularan HIV/AIDS. Tujuan penelitian ini adalah menentukan faktor-faktor yang berhubungan dengan kunjungan VCT pada LSL di Kota Padang. Penelitian ini merupakan cross sectional study. Sampel adalah bagian dari populasi yang dinilai atau karakteristiknya diukur dan nantinya akan dipakai untuk menduga karakteristik dari populasi. Besar sampel enam puluh satu (61) responden yang diambil secara accidental sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner. Data dianalisis secara univariat, bivariat menggunakan Chi Square, dan multivariat menggunakan uji regresi logistik. Hasil penelitian menunjukkan bahwa waktu lama menjadi seorang LSL diatas 10 tahun (45,9%), waktu terakhir melakukan kunjungan VCT > Tahun 2019 (59,0%), tempat terakhir melakukan kunjungan VCT di Puskesmas (52,5%), responden melakukan kunjungan VCT minimal tiga bulan terakhir sejak penelitian ini dilakukan (59,0%), uji Chi Square menunjukkan bahwa variabel yang berhubungan secara signifikan dengan kunjungan VCT adalah keyakinan mengenai VCT (p=0,005), dorongan orang lain (p=0,001). praktik organisasi (p=0,001), nilai mengenai manfaat VCT tidak mempunyai hubungan signifikan. Hasil analisis multivariat menunjukkan bahwa dorongan dari orang lain tentang VCT merupakan variabel yang mempunyai pengaruh paling signifikan dibanding variabel lainnya.
Analisis Pelaksanaan Program Pencegahan dan Pengendalian Infeksi Nosokomial di RSUD Pasaman Barat (Standar Akreditasi Versi 2012)
Authors: Ramayanti Ramayanti , Semiarty Rima , Lestari Yuniar
Published: September 2019

Program pencegahan dan pengendalian infeksi {PPI} sangat penting untuk rumah sakitkarena menjadi syarat untuk akreditasi. Resiko terjadinya infeksi nosokomial dapat diminimalkan dengan melaksanakan PPI. Kejadian infeksi di RSUD Pasaman Barat besar dari 1,5%, pelaksanaan program sudah berjalan tapi belum optimal. Tujuan penelitian ini adalah menganalisis pelaksanaan program PPI melalui studi kebijakan bersifat deskriptif dengan pendekatan kualitatif. Pengumpulan data dilakukan melalui wawancara, FGD, telaah dokumen dan observasi. Komponen input yang diteliti adalah (kebijakan, pedoman, metode, tenaga, dana, sarana dan monitoring evaluasi), proses pelaksanaan program PPI dan output adalah penerapan program sesuai standar akreditasi versi 2012. Hasil penelitian menunjukkan beberapa komponen input tidak sesuai standar, pelaksanaan PPI belum optimal dan konsisten dan hasilnya penerapan program PPI belum tercapai sesuai standar. Kesimpulan dari penelitian ini adalah masih ada kendala pelaksanaan PPI di RSUD Pasaman Barat setelah dianalisa dengan pendekatan sistem. Kendala pada input adalah SDM, dana dan sarana sedangkan pada proses adalah pelaksanaan yang tidak optimal karena masih ada petugas belum menjalankan sesuai SOP. Capain program PPI sudah sesuai standarakreditasi versi 2012 hanya perlu penguatan komitmen oleh seluruh staf RS.
Upaya Peningkatan Cakupan Pemeriksaan Inspeksi Visual Dengan Asam Asetat (Iva) Di Dinas Kesehatan Kota Solok
Authors: Sari Ridholla Permata , Abdiana Abdiana
Published: September 2019

Kanker serviks merupakan penyebab kematian tertinggi kedua pada wanita di negara yang sedang berkembang setelah kanker payudara, diperkirakan sebesar 273.000 kematian setiap tahunnya. Tujuan penelitian ini adalah untuk mengetahui gambaran upaya peningkatan cakupan pemeriksaan inspeksi visual dengan asam asetat di Dinas Kesahatan Kota Solok dan merumuskan alternatif penyelesaian masalahnya. Identifikasi masalah penelitian ini dilakukan dengan dua pendekatan yaitu pendekatan logis dan pendekatan politis. Identifikasi masalah kesehatan melalui pendekatan logis dilakukan dengan cara melihat dan menganalisis data-data yang ada. Masalah yang ditemukan dengan menggunakan metode USG adalah rendahnya cakupan pemeriksaan IVA di Kota Solok (19%). Hal ini disebabkan oleh beberapa faktor yaitu kurangnya motivasi wanita usia subur (WUS) untuk pemeriksaan iva, tidak adanya kader khusus iva, kurangnya sosialisasi / penyuluhan pada wanita usia subur (WUS) tentang pemeriksaan iva, kurangnya tersedia poster, brosur dan pamflet tentang IVA, serta kurangnya dukungan dari keluarga (suami). Program intervensi prioritas upaya peningkatan cakupan IVA yaitu: melakukan penyuluhan tentang kesehatan reproduksi dan tentang pemeriksaan IVA serta langsung melakukan pemeriksaan IVA gratis dan membentuk kader-kader khusus IVA untuk melakukan promosi IVA kepada masyarakat. Dalam pelaksanaan kegiatan penyuluhan IVA dan pelaksanaan pemeriksaan IVA ini digunakan Plan, Do. Check, dan Action (PDCA). Dari data yang didapatkan sekitar 88 % WUS tidak pernah memeriksakan diri ke Puskesmas, hal ini karena pengetahuan masyarakat yang cukup (58%).
Penyakit Ginjal Kronis pada Kehamilan
Authors: Aprillia Dinda
Published: September 2019

Penyakit ginjal kronis dini secara klinis sering tidak dapat terdeteksi sampai gangguan ginjal lanjut terjadi. Kehamilan sebenarnya jarang terjadi pada seseorang dengan penyakit ginjal kronis, kelainan utama pada wanita dengan PGK adalah tidak terjadinya ovulasi, sehingga wanita menjadi infertil. Gangguan menstruasi yang terjadi bahkan biasanya berakhir dengan amenorrhea pada saat pasien jatuh ke kondisi gagal ginjal tahap akhir. Selain kehamilan yang jarang terjadi, tingkat abortus spontan meningkat tajam pada wanita dengan PGK. Berkembangnya pusat-pusat dialisis dan transplantasi ginjal meningkatkan keberhasilan kehamilan pada pasien dengan PGK. Namun, perjalanan kehamilan pada penyakit ginjal kronik masih erat kaitannya dengan kematian janin, kelahiran prematur, keterlambatan pertumbuhan janin intrauterin, dan hipertensi yang sulit terkontrol, sehingga kehamilan yang terjadi pada PGK menurunkan fungsi ginjal dan peningkatan morbiditas serta mortalitas janin. Pemahaman lebih lanjut dibutuhkan untuk penatalaksanaan PGK pada kehamilan yang lebih baik untuk meminimalkan efek pada ibu dan janin.
Otitis Media Supuratif Kronis Tipe Kolesteatom dengan Komplikasi Sekuele Stroke Akibat Meningoensefalitis
Authors: Grecwin Debby Apri , Edward Yan
Published: September 2019

Otitis media supuratif kronis tipe kolesteatom bisa menyebabkan komplikasi ekstrakranial dan intrakranial. Meningitis merupakan komplikasi intrakranial dari otitis media supuratif kronis yang paling sering terjadi. Meningitis bakteri dapat menyebabkan terjadinya stroke. Terapi medikamentosa dengan antibiotik intravena spektrum luas dan tindakan operasi akan memberikan outcome yang baik. Dilaporkan seorang pasien anak laki-laki usia 13 tahun dengan diagnosis otitis media supuratif kronis auris dekstra tipe kolesteatom dengan komplikasi sekuele stroke akibat meningoensefalitis yang ditatalaksana dengan terapi medikamentosa dan timpanomastoidektomi dinding runtuh. Penatalaksanaan otitis media supuratif kronis tipe kolesteatom dengan komplikasi sekuele stroke akibat meningoensefalitis terdiri dari terapi medikamentosa yang adekuat dan timpanomastoidektomi dinding runtuh untuk menghilangkan sumber infeksi di telinga tengah.
Rhabdomyosarcoma Orbita
Authors: Puteri Elfi Risalma , Rahman Ardizal
Published: September 2019

Rhabdomyosarcoma (RMS) merupakan tumor ganas pada jaringan lunak yang sering mengenai anak-anak. Lokasi primernya 25-30% pada orbita. Tumor ini merupakan tumor yang agresif, dengan kecenderung terjadi invasif lokal dan dapat terjadi rekurensi lokal, dengan metastasis secara hematogen dan limfatik. Dilaporkan kasus Rhabdomyosarcoma orbita pada anak laki-laki umur 12 tahun dengan progresivitas yang cepat , dengan hasil pemeriksaan patologi anatomi menunjukkan suatu embryonal rhabdomyosarcoma retroorbita serta penatalaksanaannya. Saat ini penatalaksanaan RMS orbita tidak hanya dengan penatalaksanaan bedah saja, dengan perkembangan radioterapi dan khemoterapi dapat meningkatkan survival rate penderita RMS. Selain itu dibutuhkan kolaborasi antara Konsultan Onkologi Mata dengan Bedah Saraf serta Konsultan Pediatrik Onkologi.
A CASE OF LENS SUBLUXATION IN EXFOLIATIVE GLAUCOMA
Authors: Sari Suci Permata , Ariesti Andrini
Published: September 2019

Glaukoma eksfoliasi dengan luksasi lensa ke posterior pada satu mata dan subluksasi lensa ke anterior pada mata yang lain dengan tanda dan gejala glaukoma akut. Dilaporkan seorang pria berusia 54 tahun datang ke Rumah Sakit dr. M. Djamil Padang dengan keluhan utama penglihatan mata kiri kabur dan merah sejak 15 hari yang lalu dan penglihatan mata kanan kabur sejak 6 bulan yang lalu. Tidak ada riwayat trauma dan operasi pada kedua mata. Tajam penglihatan mata kanan 1/60 dan mata kiri 1/300. Pemeriksaan status oftalmologi mata kanan, kedalaman COA didapatkan VH4 dan lensa luksasi ke posterior. Pemeriksaan status oftalmologi mata kiri ditemukan tanda dan gejala glaucoma akut. Tekanan intra ocular mata kanan 32 mmHg dan mata kiri 50 mmHg. Pemeriksaan funduskopi pada mata kanan terlihat lensa di retina inferior. Pasien direncanakan untuk ekstraksi lensa dan implantasi IOL. Intra operatif ketika pupil dalam keadaan dilatasi terlihat white dandruff like flakes di permukaan lensa anterior dan lensa subluksasi ke anterior, sehingga pada pasien ini diputuskan untuk dilakukan intra capsular cataract extraction. Sebagian besar glaukoma eksfoliasi onsetnya lambat, namun pada kasus ini tanda dan gejala glaukoma akut disebabkan oleh subluksasi lensa ke anterior.