ABSTRACT
Purpose: to analyze the ability of the National Health Insurance mobile service quality to build BPJS brand image and public trust to increase intention to use online services during the Covid period. The background of this research is based on the phenomenon in the form of complaints on the quality of online services and research gaps on the effect of service quality on the intention to use online services. Brand image and trust are offered as a mediation for gaps in previous research results. Design/ methodology/approach: The type of research is quantitative, using a pre-existing measurement scale related to mobile service quality, brand image, trust and intention. Involving a sample of 140 BPJS users during the Covid pandemic. It is difficult to identify the population size, the sample size is determined by the formulation of a constant value of 5 multiplied by 28 indicators. The technique of selecting respondents was carried out by means of non-probability random sampling. PLS SEM model as an analysis tool. Findings: The results of this study indicate that the direct relationship of mobile service quality on brand image, trust and intention shows significant positive results. Furthermore, the influence of brand image on trust shows significant results. The influence of brand image and trust on intention is also found to be significantly positive. Practical/implications: although management policies encourage customers to use mobile services more, the public still considers the trustworthy image of BPJS to develop their intention to use mobile application services. The government must remain consistent in ensuring that the quality of mobile service is not compromised because the implications for BPJS image and public trust are at stake. Through the person in charge at BPJS, the government must continue to consistently evaluate and improve the system and educate the public regarding this BPJS health mobile service system. Originality/value: This research offers new insights, filling gaps in studies on national health insurance mobile services during the Covid-19 Pandemic
ABSTRACT
Hundreds of surgeries are postponed every day during the global COVID -19 pandemic. The hospital and clinicians are in dilemma scheduling elective procedures during the pandemic. The current study was designed to evaluate postoperative pulmonary complications and mortality in COVID-19 patients in a systematic review and meta-analysis of globally published peer-reviewed literatures. A systematic literature search was conducted using the selection criteria in five databases. A quality assessment was made with a validated Newcastle-Ottawa Scale. The meta-analysis worked as a generic inverse variance meta-analysis. A total of 308 articles were identified from different databases and 5 articles with a total 1408 participants were selected for evaluation after successive screenings. The meta-analysis revealed a high global rate of postoperative mortality among COVID-19 patients, as high as 23% (95% CI: 15 to 26), and high postoperative pulmonary complications including pneumonia and acute respiratory distress syndrome. The 30-days mortality rate and prevalence of pulmonary complications were high. There was one death for every five COVID-19 patients undergoing surgical procedures, indicating the need for mitigating strategies to decrease perioperative mortality, transmission to healthcare workers, and non-COVID-19 patients. Larger samples and/or multicenter trials are needed to explore the perioperative mortality dan morbidity rate of patients with COVID-19 undergoing surgeries, and in particular, factors with the highest impact on perioperative mortality. There should be a clinical guideline to determine when to operate or not to operate on patients with COVID-19 for elective and emergency surgeries. © 2022 National Journal of Clinical Anatomy ;Published by Wolters Kluwer - Medknow.
ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory disease that has become the largest pandemic and also could put the heart at risk of dysfunction. Galectin-3 is involved in the inflammatory process that continues with remodeling and eventually fibrosis. Using galectin-3 examination, we could predict the possible worsening of heart function and evaluate data on influencing factors for increased left ventricular end-diastolic volume (LVEDV) which could later progress to heart failure. METHOD(S): This is an observational prospective analytic study in the COVID-19 ICU of Sanglah Hospital, Bali, Indonesia. The study was conducted from June to October 2021. All research subjects had their blood samples taken for galectin-3 levels examination using enzyme-linked immunosorbent assay (ELISA). Subjects were also evaluated for left ventricular end-diastolic volume (LVEDV) with echocardiography, SOFA scores, and troponin I levels. Subjects were treated with COVID-19 standard protocol established by the Ministry of Health. After 72 h post-admission, subjects were re-examined for galectin-3 levels and LVEDV. Data were analyzed using STATATM. RESULT(S): A total of 45 research subjects were analyzed. Bivariate analysis of the difference of galectin-3 and LVEDV was shown to be insignificant (r = 0.08), no correlation was found between galectin-3 level and LVEDV on ICU admission (r = 0.191), and no correlation found between galectin-3 level and LVEDV after 72 h of hospitalization (r=0.197). Multivariate analysis also showed that none of the variables, namely, difference of galectin-3 level, age, gender, troponin I, SOFA, and Charlson scores had statistically significant correlation with LVEDV (p < 0.05). CONCLUSION(S): No significant correlation was found between galectin-3 level and an increase in LVEDV. Copyright © 2022 Marilaeta Cindryani Lolobali, I. M. G. Widnyana, Ni Made Ayu Wulansari, Ida Bagus Rangga Wibhuti, Made Wiryana, Rudyanto Sedono, Aldy Heriwardito.
ABSTRACT
Due to its expression by macrophages, galectin-3 is among the most recently studied biomarkers. It is likely involved in the inflammatory process that leads to remodeling and eventually fibrosis of organs such as the heart, brain, and kidneys. Coronavirus disease 19 (COVID-19) infection causes excessive inflammatory reactions in the whole body, playing a role in the development of fibrosis due to the activation of the galectin-3-macrophage-fibroblast axis. Heart failure or cardiac dysfunction occurred not only due to pro-inflammatory activation but also due to the overactivation of sympathetic nerves and failure of the respiratory system. The latter increases. the possibility of direct infection or necrosis of the heart due to the heart-lung interaction observed in our pilot study. Forty-five intensive care unit (ICU) patients were recruited consecu-tively in this study to be observed their galectin-3 and troponin I levels. This pilot study demonstrates the correlation between galectin-3 as a proinflammatory biomark-er and troponin I as a definitive biomarker for direct heart injury and highlights its potential use in COVID-19 patients. With the assessment of appropriate biomarkers such as cardiac fibro-sis markers, possible worsening of cardiac conditions in COVID-19 patients treated in the ICU can be detected in its early stages.
ABSTRACT
Era revolusi industri 4.0 dan situasi pandemi COVID-19 menuntut entitas usaha untuk memaksimalkan penggunaan teknologi informasi berbasis digital secara tepat guna yakni melakukan pemasaran produk usaha. Namun saat ini tidak banyak BUMDes yang menggunakan teknologi informasi dalam pemasarannya. Hal ini juga terjadi di Desa Kesiut yang berlokasi di Kecamatan Kerambitan Kabupaten Tabanan Bali. BUMDes di Desa Kesiut masih menerapkan sistem pemasaran konvensional dalam memasarkan produk usahanya. Tentu hal ini jika tidak segera ditindaklanjuti akan menimbulkan tidak kompetitifnya usaha yang berdampak pada risiko kerugian dimasa depan terlebih saat ini sedang dilanda COVID-19 yang memerlukan model cashlees dan social distance dalam aktifitas transasksi. Kendala utama yang dihadapi adalah kurangya sumber daya manusia yang handal dan profesional. Solusi pemecahan masalah dilaksanakan dengan melakukan sosialisasi edukasi pelatihan dan pendampingan implementasi sistem pemasaran secara digital. Dari solusi yang dicanangkan tersebut maka diharapkan mampu memberi pengetahuan sekaligus meningkatkan keterampilan masyarakat khususnya manajemen BUMDes untuk menggunakan teknologi informasi didalam menerapkan sistem pemasaran produk berbasis teknologi digital. Metode pelaksanaan dilakukan dalam beberapa tahap yakni diawali dengan memberikan pemahaman akan pentingya penggunaan teknologi informasi selanjutnya dilakukan juga pelatihan pembuatan portal website. Tahap akhir dilakukan pendampingan untuk membantu pemecahan masalah yang dihadapi terkait dengan penerapkan sistem digital marketing. Harapan yang diinginkan melalui program kemitraan masyarakat yang dikejewantahkan melalui tahapan sosialisasi edukasi pelatihan maupun pendampingan ini adalah BUMDes dalam menjalankan kegiatan usahanya mampu menerapkan teknologi informasi berbasis digitalisi Marketing dalam menjalankan usahanya. Dengan melaksanakan kegiatan ini diharapkan dalam jangka panjang BUMDes di Desa Kesiut akan semakin berkembang dan mampu menggeliatkan perekonomian Desa sehingga akan terjadi akselerasi kesejahteraan masyarakat Desa.
ABSTRACT
The COVID-19 pandemic that is happening now is affecting the economy. This study aims to examine changes in the supply of consumer goods to Bali from outside Bali in the Indonesian territory and changes in the per capita consumption of the Balinese population due to the COVID-19 pandemic. Two events were observed, namely the first event was the announcement of the first positive case of COVID-19 in Indonesia and the 2nd event was the determination of the status of a national disaster by the Indonesian government. Data analysis was performed using a different test with the SPSS v.23 program. The results of the analysis found that there was a difference in the supply of consumer goods to Bali from outside Bali and the per capita consumption of the Balinese population in the first and 2nd events. The supply of consumer goods and per capita consumption decreased significantly after the announcement of the first positive case of COVID-19 and then further decreased after the Indonesian government declared a national disaster status. The determination of the status of a national disaster has a greater impact on reducing the per capita consumption of the Balinese population than the announcement of the first COVID-19 patient. As a result of COVID-19 it is hoped that the Bali Provincial Government needs to make policy breakthroughs to encourage the fulfillment of consumer goods needs in Bali independently so that they do not always depend on supplies from outside Bali. The COVID-19 pandemic has reduced peoples income and reduced buying power thus demanding people to be smarter in managing finances including adjusting consumption patterns according to the priority scale of needs.
ABSTRACT
The determination of a public policy is of course always faced with the problem of budget constraints which often puts the government in a trade-off situation which is defined as a dilemma condition that makes it difficult to make choices in determining priorities. This is what makes many policies that are not effectively implemented. The neglect of community expectations has resulted in negative reactions ranging from acts of violation even to anarchy that leads to crime. For this reason, it is deemed very important for the government to have a strategy in setting a priority scale so that a policy is more beneficial to people's lives not just focusing on legal certainty. For this reason, the main problem is related to the efforts of the Regional Government in determining the priority scale so that an implementation of public policy is truly on target. Keywords: Budget Constraint, Trade off, priority scale Penetapan suatu kebijakan publik tentunya selalu dihadapkan dengan permasalahan keterbatasan anggaran (Budget Constraint) yang kerap kali menempatkan pemerintah dalam situasi Trade-Off yang diartikan sebagai kondisi dilematis yang membuat adanya pilihan sulit dalam menentukan prioritas. Hal ini lah yang membuat banyaknya kebijakan yang tidak efektif diterapkan. Terabaikannya ekspektasi komunitas membuat reaksi negatif mulai dari aksi pelanggaran bahkan hingga anarkis yang berujung kriminal. Untuk itu dirasa sangat penting strategi bagi pemerintah dalam menetapkan suatu skala prioritas agar suatu kebijakan lebih bermanfaat bagi kehidupan masyarakat bukan hanya fokus pada kepastian hukum semata. Untuk itu pokok permasalahan terkait Upaya Pemerintah Daerah dalam menentukan skala prioritas agar suatu implementasi kebijakan publik benar-benar tepat sasaran.Kata Kunci: Budget Constraint, Trade off, Skala Prioritas.
ABSTRACT
Coronaviruses have caused several global challenges for health-care providers all over the world. The notorious SARS-CoV-2 could attack the lower respiratory tract and trigger the immune systems to release massive number of immune cells and pro-inflammatory cytokines and cause immunopathology consequences called cytokine release syndrome. These pro-inflammatory cytokines and other immune cells caused lung injury and severe acute respiratory distress syndrome in COVID-19 (CARDS) and multiple organ failure. There are still many intertwined immune responses that not yet been discovered in SARS-CoV-2 infections. Targeted and specific cell therapy would be reasonable and considered safer to be employed in patients who present with comorbidities and at risk of complications. © 2020 Bali Journal of Anesthesiology ;Published by Wolters Kluwer-Medknow.