Examining Clinical Practice and Short-Term Results in Ventral Hernia Repair

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Background and Objectives: This prospective observational study conducted at Parul Sevashram Hospital, Vadodara aimed to examine the diversity in surgical techniques used for primary and incisional ventral hernia repair (VHR).

Methods: Twenty-five elective VHR patients treated from January 1, 2023, to March 31, 2023, were enrolled. Patients were monitored for 90 days post-surgery. Exclusion criteria included patients under 18 years old and those undergoing emergency surgeries. The primary objective was to compare surgical approaches between primary and incisional hernia repairs. Secondary objectives focused on intraoperative procedures such as mesh selection, fixation techniques, and drain placement, as well as evaluating postoperative outcomes at 3 months, including infection rates, surgical site issues, mortality, and readmission rates within 90 days.

Results: Data from 25 patients were analysed: 14 (58%) had primary hernias (PH) and 11 (42%) had incisional hernias (IH), including 1 (9.09%) recurrent case.

– PH Group: Procedures included 6 (42.85%) open Onlay, 4 (28.57%) open Sublay, 1 (7.14%) intraperitoneal Onlay meshplasty (IPOM), and 3 (21.42%) suture repairs. Complications: 7% seroma, 0% surgical site infection (SSI), 0% recurrence.

– IH Group: Procedures included 7 (63.63%) open Onlay, 3 (27.3%) open Sublay, and 1 (9.09%) suture repair. Complications: 9% seroma, 9% hematoma, 0% SSI, 9% wound sinus, 0% recurrence.

Conclusion: Onlay meshplasty emerged as the predominant procedure for both primary and incisional hernias. However, open Sublay repair showed promising results with fewer seroma-related complications. Standardizing guidelines could optimize outcomes in VHR.

An Analysis of the Role of Work Motivation and Work Discipline in Improving Employee Performance: Job Satisfaction as a Mediating Factor (Case study on PT Prima Sejati Sejahtera I)

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This study analyzes how worker motivation and discipline affect performance through job satisfaction. Using primary data, this study is quantitative. This study took a sample of all workers totaling 48 people because the population was below 100. Path analysis and multiple linear regression are used. The hypothesis of this study produces the following conclusions: work motivation, discipline, and job satisfaction improve employee performance at PT Prima Sejati Sejahtera I. Work motivation and discipline increase job satisfaction in employees. PT Prima Sejati Sejahtera I workers will be more productive when job satisfaction is high, because they can moderate the relationship between work motivation and work discipline.

Business Solution for Profit Optimization at PBS Clinic

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Health service profitability is an important factor for the sustainability and growth of clinics such as PBS Clinic. PBS Clinic, like many other healthcare providers, faces challenges in balancing quality of service with financial viability. These issues collectively contribute to suboptimal profitability, requiring thorough investigation and strategic intervention. This research aims to determine the root cause of declining profits at the PBS clinic and propose a business solution to increase revenue and reduce costs in the PBS clinic. This research will use a mixed methods approach, combining quantitative and qualitative data collection and analysis. Quantitative data will be collected through financial performance data, patient volume statistics, and satisfaction surveys. Qualitative data will be obtained from interviews and focus groups with staff. The results of the review found that The root causes of declining profits at the PBS clinic include: inappropriate practice hours that reduce patient visits, an inefficient IT system that hinders operational efficiency and service delivery, insufficient staff training affecting the quality of care, ongoing construction limiting space and services, issues with insurance payments constraining financial flexibility, and weak marketing efforts diminishing the clinic’s visibility and attractiveness in a competitive healthcare market. The proposed solutions include expanding clinic services, improving staff training and facilities, simplifying insurance payment processes, and leveraging digitalization. This research is critical because it addresses the urgent need for clinics to adapt to changing healthcare demands and economic pressures.

Evaluating Factors Affecting the Effectiveness of Customer Service Training Programs: A Study of IOH Outlets in Jakarta

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In the dynamic telecommunications market of Indonesia, quality customer service is pivotal for sustaining competitive advantage. IOH faces persistent challenges in meeting customer service expectations, evidenced by consistent customer complaints regarding the customer service representative performance despite extensive training programs for their representatives. This study aims to evaluate the effectiveness of IOH’s customer service training programs in Jakarta, identifying key factors influencing training effectiveness and proposing improvements. Utilizing a quantitative approach, a survey was conducted among 49 customer service representatives, and the data were analyzed using spearman rank correlation. The results revealed that training content, method, schedule, and facilities significantly impact training effectiveness, with training content identified as the most influential. Improved training content to be more relevant with the needs of representatives, implement the diverse and interactive methods, well-structured schedules, and utilize the high-quality facilities can enhance the effectiveness of training programs. These strategies will enhance the competency and confidence of customer service representatives, ultimately improving customer satisfaction. Future research should explore personalized training approaches tailored to individual needs and assess the long-term impacts of training programs and expanding the study beyond Jakarta will provide a more comprehensive understanding of training effectiveness across different regions. By addressing these recommendations, IOH can significantly improve their customer service training programs, leading to higher service quality and customer satisfaction.

Combustion Properties of Biochar Briquettes Blend of Goat Manure Charcoal, Saboak Shell and Other Biomass

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This study aims to determine the quality of combustion properties of biochar briquettes mixed with goat manure charcoal, lontar shell and other biomass. The completely randomized design was applied with 4 different combinations tested, as follows: T1= 50% goat manure charcoal + 40% lontar shell + 10% lontar male fruit; T2= 50% goat manure charcoal + 40% lontar shell + 10% lamtoro twigs; T3= 50% goat manure charcoal + 40% lontar shell + 10% rice husk and T4= 50% goat manure charcoal + 40% lontar shell + 10% corn cob. The variables studied were combustion temperature, combustion rate, combustion resistance, flame color and combustion smoke. The average values obtained consecutively from T1-T4 are as follows: combustion temperature 272.9; 231.5; 228.8 and 280.8˚C; combustion rate 2.03; 1.61; 1.67 and 2.03 g/min; combustion resistance 210.0; 205.0; 195.0 and 225.0 min; flame color and combustion smoke 3.70; 3.65; 3.60 and 3.75. The results of variance analysis showed that the treatment had a very significant effect (P<0.01) on combustion temperature, but no significant effect (P>0.05) on combustion rate, combustion resistance, flame color and combustion smoke. It was concluded that the biochar briquettes produced had good combustion properties with indications of high combustion temperature (253.5°C), slow combustion rate (1.83 g/min), long combustion resistance (208.75 min), bluish red flame colour and no smoke emitted (score 3.68). The best treatment was shown in the mixture of 50% goat dung charcoal + 40% palm shell charcoal +10% corn cob charcoal (T4).