Factors Influencing Patient Delay in Pulmonary Tuberculosis in a Community Setting: A Cross-Sectional Study

/in /by

Delays in the treatment of Tuberculosis (TB) result in the failure to achieve the TB program’s goals. The delay in TB treatment can be measured by patient delay and healthcare service delay.This study aims to analyze the factors influencing the occurrence of patient delay in pulmonary tuberculosis. The type of this research is quantitative with a cross-sectional approach. The research population consists of all suspected Pulmonary TB patients, totaling 182 patients, with a sample of 158 respondents using the proportional random sampling technique. This research was conducted in the Working Area of Maja Public Health Center, Marga Punduh District, Pesawaran Regency, Lampung, Indonesia, in September-October 2024. Data collection was conducted using a questionnaire. Data analysis was conducted univariately (frequency distribution), bivariately (chi-square), and multivariately (logistic regression). The research results indicate that there are factors associated with the occurrence of patient delay in this study, namely age factor (p-value <0.001), gender (p-value = 0.017), employment status (p-value <0.001), economic status (p-value <0.001), education level (p-value = 0.003), knowledge level (p-value = 0.023), smoking history (p-value = 0.022), distance from residence (p-value = 0.040), and cadre support (p-value <0.001). The dominant factor influencing the occurrence of patient delay in tuberculosis treatment is the employment factor (p-value = 0.019; OR (95% CI) = 21.5 (1.67-279.24). Advice for healthcare workers includes providing education about TB, particularly the cough symptoms suspected to be TB, especially in the smoking community, and efforts to change patients’ perceptions about TB are essential to reduce the level of delay in seeking early healthcare.

Role of The Forest-Savanna Transition Zones in Mitigating Climate Change at Lamto Scientific Reserve, Côte d’Ivoire

/in /by

In the context of global climate change, forests play a crucial role as carbon sinks, contributing to regulating greenhouse gases and stabilising the climate. This study evaluates the role of forest-savanna transition zones in mitigating climate change at Lamto Scientific Reserve, Côte d’Ivoire, by assessing their carbon sequestration capacity and economic value. The study employed a combination of field surveys, remote sensing and statistical analysis to gather and analyse the data. The floristic inventory recorded 4,018 individuals, distributed among 142 species, 92 genus, and 37 families.  The stem density ranges from 510 stems/ha (shrub savanna) to 758 stems/ha (moist semi-deciduous forest), with a basal area varying from 5.65 m²/ha (open forest) to 11.79 m²/ha (gallery forest). The vegetation structure, characterised by a “bell-shaped” vertical stratification and an “inverted J” horizontal distribution, reflects active regeneration. In terms of biomass and carbon sequestration, the gallery forest dominates with 287.37 ± 201.68 t/ha of biomass, 143.69 ± 100.84 tC/ha of carbon, and an exceptional capacity to sequester 526.856 tCO₂/ha, accounting for 57.6% of the total carbon sequestered. Its economic value, supported by mechanisms such as REDD+ High, reaches 13,171 EUR/ha (8,639,880 FCFA). In contrast, the shrub savanna, with a biomass of 9.38 ± 8.41 t/ha and limited sequestration of 17.203 tCO₂/ha, offers a maximum value of 430 EUR/ha (282,111 FCFA). The results highlight the key role of the gallery forest as the primary carbon sink and the economic potential of Lamto’s ecosystems. They underscore sustainable management’s importance in maximising climate regulation, preserving biodiversity, and enhancing ecological resilience.

A Study on Dietary Services in Public Hospitals of Sri Lanka: Reducing Food Waste and Enhancing Patient Outcomes

/in /by

 Dietary services in public hospitals are integral to patient recovery and overall care. The existing dietary circular governing these services requires revision to enhance efficiency, effectiveness, and patient satisfaction while addressing cost concerns. A cross-sectional observational study was conducted using a mixed-method approach to identify gaps and inefficiencies in the current dietary practices, including focus group discussions, key informant interviews, and desk reviews. The findings indicated significant food waste in hospitals and considerable patient dissatisfaction with current dietary options. These challenges underscore serious gaps in aligning dietary practices with patient needs and resource allocation. This study emphasizes the importance of revising the dietary circular to establish more efficient and patient-centered dietary services. Proposed revisions focus on reducing food waste, improving the nutritional adequacy of meals, and addressing patient preferences, ultimately contributing to better clinical outcomes. The recommendations focus on developing a cost-effective strategy for hospital dietary services to achieve sustainable improvements that align with healthcare objectives. Updating and implementing these guidelines can greatly benefit the healthcare system by optimizing resource allocation and enhancing patient care in Sri Lankan public hospitals.

Optimizing Logistics Operations: Identifying and Mitigating Risks through FMEA and Poka Yoke

/in /by

The logistics industry plays a crucial role in facilitating the smooth distribution of goods both nationally and internationally. With the growth of the transportation and warehousing sector contributing significantly to Indonesia’s GDP, logistics companies are increasingly vital in supporting trade activities. However, logistics companies face significant challenges, especially when shipping high-risk goods such as hazardous chemicals, which require careful handling due to their potential hazards to human health, safety, and the environment. In addition, maintaining service quality is essential to ensure consumer satisfaction, as delays, errors in documentation, and other issues can lead to dissatisfaction. PT XYZ, a logistics company in Indonesia, has encountered operational issues leading to delays in shipments, caused by factors such as bad weather, inconsistent schedules, and incomplete or inaccurate shipping documents. This study applies risk management techniques, specifically Failure Mode and Effect Analysis (FMEA) and Poka Yoke, to identify, assess, and mitigate risks in PT XYZ’s shipping operations. 15 risks are obtained with the most critical risk is inaccurate information about the goods being shipped, resulting in delays and financial losses. The Risk Priority Number (RPN) for this risk was calculated as 252, indicating a high severity and frequency of occurrence. To mitigate this risk, the study recommends implementing a Smart Logistic Checker system, which integrates automatic technologies such as barcode scanning, digital weighing, dimension measurement, and label printing, with automatic validation to ensure that the information matches the physical condition of the goods. This approach aims to reduce errors, enhance operational efficiency, and prevent failure.

Reflection Survey on Krupskaya’s Pedagogical Contributions to TVET or The Politically-driven Deliberate Marginalization in Education: An Attempt of Rehabilitation

/in /by

This paper presents a comprehensive analysis of the significant yet frequently studiously overlooked contributions of Nadezhda Krupskaya to vocational education and training (VET), emphasizing the troubling trend of her deliberate marginalization and underestimation within contemporary educational discourse. Despite her groundbreaking principles that advocate for the seamless integration of practical experience with theoretical knowledge, Krupskaya’s innovative ideas have often been rebranded and repackaged in modern meretricious educational frameworks, stripped of their original context and significance. Her pioneering emphasis on polytechnic education, which engenders a holistic approach to learning that connects academic study with real-world labour activities, has been co-opted by various educational incondite reforms, presented as novel concepts while neglecting their roots in her foundational work. Her advocacy for experiential learning and the cultivation of technical creativity has laid the groundwork for many current pedagogical practices, yet these contributions are frequently unrecognized, leading to a historical amnesia regarding her influence. This study seeks to reclaim Krupskaya’s legacy, firmly asserting that her innovative methodologies and educational philosophies are not only essential to understanding the evolution of VET but also critical in addressing contemporary educational challenges in general. By illuminating the profound impact of her prolific ideas, this paper calls for a re-evaluation of Krupskaya’s role in the history of educational thought, advocating for the recognition and celebration of her contributions as vital to the ongoing discourse on inclusive and equitable education. In doing so, it highlights exhortatively the necessity of acknowledging the origins of educational innovations that have been unjustly appropriated, ensuring that Krupskaya’s rightful place in the annals of pedagogical history is restored and honoured.

The Importance of Hospital Governance in Indonesia: Enhancing Healthcare Quality and Accountability

/in /by

The Indonesian healthcare system is undergoing significant transformation to meet the needs for improved service delivery, patient safety, and equity in accessing quality care. According to the World Health Organization (WHO), Indonesia faces substantial challenges within its healthcare system, including a high burden of disease, limited access to healthcare services, and disparities in health outcomes across different regions. Despite ongoing reforms, the country continues to grapple with issues such as inconsistent healthcare quality, inefficient resource management, and a lack of accountability among healthcare providers. This paper explores the critical role of hospital governance in addressing these challenges, emphasizing the need for clear governance structures, effective leadership, and stakeholder engagement to enhance healthcare quality and ensure equitable access to services. By examining the implications of governance frameworks on hospital performance, this study aims to contribute valuable insights for policymakers and healthcare administrators in Indonesia, ultimately fostering a more effective and equitable healthcare system.

Assessment on HIV Testing Among Newly Diagnosed Tuberculosis Patients at the National Hospital for Respiratory Diseases (NHRD) in Welisara, Sri Lanka during the first quarter of 2024

/in /by

This study was aimed to assess and review the current practice of screening of HIV in TB patients within NHRD Welisara hospital against the recommended standard practice by the National Guideline and the cross-sectional study was conducted on newly diagnosed tuberculosis patients. Simple random sampling was used to collect data from a sample size of 163, with retrospective data gathered from patient ward records. Data quality was enhanced by reviewing clinic and laboratory records, and a secure Excel spreadsheet was maintained for data management.

Results: Data indicated that 12.3% (n=20) lacked documentation for HIV testing. Of the 143 patients tested, only 43.4% (n=62) were tested while in the ward; others were tested at follow-up clinics. The average time from TB confirmation to HIV testing was 4.8 days (range: 0 to 36 days). Though average post-TB diagnosis hospital stay was 20.9 days (range: 0 to 129 days) for HIV tested patients, those without HIV testing had an average stay of 12 days (range: 0 to 40 days).

The primary reason for not undergoing HIV testing was patient transfer, but with an average ward stay of 14.6 days post-TB diagnosis. Other factors included patient death, disappearance, or leaving against medical advice. Notably, four patients were discharged without HIV testing, having stayed 3 to 11 days post-TB diagnosis. Most patients (51.7%, n=74) were tested at the NHRD laboratory, while 39.9% (n=57) were tested at an STD clinic, and only 5.6% underwent RDTs in the ward.

Conclusion: Those without HIV testing had prolonged hospital stays, suggesting missed opportunities. Underutilization of RDTs by ward staff needs attention. Incorporating HIV test results into the discharge checklist may prevent these oversights. Therefore, findings will be presented to the director-NHRD aiming to initiate a discussion and create an audit cycle.

Exploring the Impact of Social Media on Entrepreneurial Branding: Small and Medium Enterprises in Lembang, Indonesia

/in /by

This study aims to analyze the impact of social media on entrepreneurial branding in the Lembang area, West Bandung, focusing on 10 (ten) business units that use social media platforms to build their brand image. In today’s digital era, social media plays an increasingly important role in marketing strategies, allowing entrepreneurs to increase consumer engagement and expand market reach. Through a quantitative approach, this study uses simple linear regression analysis to identify the relationship between the intensity of social media use and the strength of branding perceived by consumers. Data were collected through surveys filled out by business owners and consumers who engage with the brand on social media. The results show that the use of social media has a significant influence on entrepreneurial branding and contributes to strengthening entrepreneurial branding. Several recommendations are given to small and medium business actors in utilizing social media to strengthen their brand image.

Work Motivation as a Mediator in the Influence of Work Environment and Burnout on Nurse Turnover at Husada Hospital

/in /by

Nurse turnover is one of the main challenges in various hospitals, including Husada Hospital. High turnover rates can disrupt the quality of health services, increase recruitment costs, and hinder continuity of services. This study aims to analyze how the work environment and burnout affect nurse turnover at Husada Hospital, and how work motivation can mediate the relationship. Data were collected through questionnaires filled out by 167 nurses at Husada Hospital, then analyzed using Structural Equation Modeling (SEM) to test the relationship between variables. The results showed that the work environment had a significant effect on work motivation, while burnout had a significant negative effect on work motivation. Work motivation was also shown to mediate the influence of the work environment and burnout on nurse turnover. These findings emphasize the importance of improving the quality of the work environment and reducing burnout as an effort to increase nurse work motivation, which can ultimately reduce turnover. This study provides important implications for hospital management in designing policies that support nurse welfare in order to maintain workforce stability.

Prevalence and Comorbidity of Generalized Anxiety and Depression among Medical Students at Selected Universities in Lusaka, Zambia

/in /by

Research shows that medical students suffer from anxiety and depression, which are the 2 biggest mental health disorders, and their health only deteriorates upon entering the medical field. Although studies have been conducted to investigate their existence, very few to none have explored their prevalence and association amongst medical students in Zambia. This study will therefore investigate on the prevalence and comorbidity of both anxiety and depression amongst medical students in Zambia. A cross-sectional study was conducted on 376 medical students from 2 medical universities which were selected using a combination of convenience and voluntary sampling techniques. The Patient health questionnaire was used to assess depression whilst the Generalised Anxiety Disorder Scale was used to assess anxiety amongst medical students. The data was analyzed using both Descriptive statistics, specifically measures of central tendencies and cross-tabulation were used to explain the study participant in relation to study variables. The study employed inferential statistics, specifically, the Pearson’s Product Moment correlation coefficient (r) was used to measure the correlation between anxiety and depression. The study revealed that the prevalence of depression amongst the participants was 68% and the comorbidity of anxiety and depression was found to be 60.4% (p < 0.001). The study revealed high prevalence and comorbidity of anxiety and depression. Universities should collaborate with non-governmental organizations to treat, educate and improve on the management of anxiety and depression among medical students.