PENGARUH DIMENSI SERVICE QUALITY (TANGIBLE, RELIABILITY, ASSURANCE, RESPONSIVENESS DAN EMPHATY) PADA CUSTOMER SERVICE BANK BCA KCU DARMO SURABAYA TERHADAP PERSEPSI

Penelitian ini membahas tentang Pengaruh Dimensi Service Quality (Tangible, Reliability, Assurance, Responsiveness dan Emphaty) Pada Customer Service Bank BCA KCU Darmo Surabaya Terhadap Persepsi Nasabah Tahun 2019. Adakah pengaruh dimensi SERVQUAL pada Customer Service bank BCA KCU Darmo Surabaya terhadap persepsi nasabah. Data yang digunakan dalam penelitian ini diperoleh dari hasil kuesioner yang telah dibagikan kepada nasabah bank BCA KCU Darmo Surabaya. Metode yang digunakan dalam penelitian ini adalah metode kuantitatif. Probability sampling adalah teknik pengambilan sampel yang memberikan peluang yang sama bagi setiap unsur (anggota) populasi untuk dipilih menjadi sampel dalam penelitian ini. Jenis probability sampling yang digunakan dalam pengambilan sampel pada penelitian ini adalah simple random sampling. Karena didalam penelitian ini tidak membedakan gender, ras, status sosial, pekerjaan dan lain sebagainya. Variabel yang digunakan dalam penelitian ini adalah persepsi nasabah sebagai variabel dependen (Y) dan Service Quality sebagai variabel independen (X). Kemudian, dimensi SERVQUAL yang terdiri dari (tangibles) (X1), (reliability) (X2), (assurance) (X3), (responsiveness) (X4), dan (emphaty) (X5). Hasil dari penelitian ini diperoleh bahwa dimensi SERVQUAL yang terdiri dari Tangible, Reliability, Assurance, Responsiveness dan Emphaty pada Customer Service bank BCA KCU Darmo Surabaya mempunyai pengaruh yang signifikan terhadap persepsi nasabah. Dan faktor yang paling dominan adalah variabel emphaty.

HUBUNGAN INDEKS MASSA TUBUH (IMT) DENGAN TINGKAT KEBUGARAN JASMANI PEGAWAI KEMENTERIAN KESEHATAN

<p class="16bIsiAbstrak">Kebugaran jasmani merupakan kemampuan tubuh untuk melakukan kegiatan sehari-hari secara efektif, efisien dalam jangka waktu relatif lama, dipengaruhi faktor umur, genetik, ras, jenis kelamin, merokok, status kesehatan, aktivitas fisik, dan status gizi. Pegawai pemerintahan termasuk kelompok dengan proporsi tertinggi kegemukan 20% dan obesitas 33,7%. Program pengukuran kebugaran jasmani merupakan salah satu kebijakan kesehatan. Instansi pemerintah diharapkan melaksanakan pengukuran kebugaran jasmani minimal 1 kali/tahun termasuk di Kementerian Kesehatan sebagai inisiatornya. Penelitian ini merupakan penelitian kuantitatif <em>cross sectional</em>. Menggunakan data sekunder dari aplikasi SIPGAR periode April – Mei 2021 kemudian dilakukan penelusuran untuk mengontrol faktor lain yang dapat menjadi pengganggu. Tujuan penelitian ini, untuk mengetahui hubungan IMT dengan tingkat kebugaran jasmani pegawai Kementerian Kesehatan. Hasil menunjukan sebagian besar responden berada pada kelompok bugar 54,2% dengan proporsi kategori bugar terbanyak (73%) pada umur 40-49 tahun; responden dengan status IMT gemuk mencapai 46,7%, atau lebih rendah dibandingkan IMT pada kelompok pegawai pemerintahan berdasarkan hasil Riskesdas. Setelah dilakukan pengontrolan terhadap faktor ras, status merokok, status kesehatan, aktivitas fisik, umur dan jenis kelamin; hasil uji <em>Chi Square</em> diperoleh nilai p=0.159, sehingga tidak ada hubungan yang signifikan antara status IMT dengan kebugaran jasmani pada pegawai Kementerian Kesehatan tahun 2021.</p>

Examination of Micro Vascular Density on Metastatic Colorectal Cancer of RAS Mutant-Type as Anti Vegf Therapy Predictor

According to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) on Colon Cancer Version 2.2019, mCRC patients with mutant type RAS were treated with anti-VEGF. However, the use of the targeting therapy still had inconsistent results. Neoangiogenesis studies had been used as a basis to assess the prognosis of mCRC. Microvascular density (MVD) had become the morphological gold standard to assess neovascularization in human tumors. This study proved the existence of low microvascular density (MVD) in mCRC patients with mutant type RAS status as a predictor of failure of anti-VEGF therapy. There were 29 patients at Dr. Soetomo Academic Hospital from 2015-2018 who had their RAS status checked and tested for microvascular density (MVD). The results of this study were analyzed using SPSS 23.0. In the Mutant-type of RAS group, this study examined microvascular density (MVD). 11 (73%) research subjects with high MVD scores and 4 (27%) research subjects had low MVD scores. Besides, 27% microvascular density (MVD) was low, in the mutant-type of RAS mCRC patient which could be a predictor factor for the failure of anti-VEGF therapy.

Efficacy of an anti-EGFR after ctDNA conversion from mutated RAS status of metastatic colorectal cancer: Results of a pilot study.

e15574 Background: This pilot study aimed at the evaluation of the efficacy of anti-EGFR therapy in patients with initially RAS-mutated metastatic colorectal cancer, whose liquid biopsy found no RAS mutation after prior chemotherapy failure. Methods: Sixteen patients with RAS-mutated metastatic colorectal cancer in the solid tumor were included, after they had received 1 to 3 prior chemotherapy lines without anti-EGFR. Before inclusion, RAS genotyping was performed in circulating tumor DNA (ctDNA) from liquid biopsy, after a median duration of ̃24 months after the initial RAS status determination. No RAS mutation was detected in the circulating tumor DNA from 9 patients (56%), who then received cetuximab-FOLFIRI. The 7 patients who had persistent RAS mutation in the liquid biopsy (44%) were treated according to standard recommendations without anti-EGFR. Results: The median progression free survival was 8.2 months [95%CL, 4.5 – 11.8] in patients without detectable ctDNA RAS mutation, as compared to 3.5 months [2.1 – 4.9] in the ctDNA mutated patients (p < 0.001). The median overall survival was 22.3 months [17.3 - 27.3] in the patients with undetectable ctDNA RAS mutation, whereas it was 4.7 months [2.6 - 6.7] in those with ctDNA RAS mutation (p = 0.013). These results suggested the efficacy of cetuximab-based chemotherapy in patients with initially RAS mutated metastatic colorectal cancer, who later displayed no detectable ctDNA RAS mutation. Conclusions: The introduction of an anti-EGFR could provide an additional treatment option for patients with metastatic colorectal cancer with apparent conversion of initial RAS mutation, based on ctDNA assessment after prior failure on anti-EGFR-free chemotherapy.

Impact of RAS status and prior targeted therapy on the activity of aflibercept plus FOLFIRI in patients with metastatic colorectal cancer (mCRC) in daily practice. Final results of the QoLiTrap prospective non-interventional study.

e15570 Background: The anti-angiogenic fusion protein aflibercept targets VEGF-A, VEGF-B and PIGF. It is approved in combination with FOLFIRI for treatment of mCRC previously treated with an oxaliplatin-containing regimen. We evaluated the influence of RAS status and prior targeted therapy on the efficacy and safety of aflibercept plus FOLFIRI in daily practice. Methods: QoLiTrap is a large international (Germany, Austria, Switzerland), non-interventional study evaluating the quality of life (QoL), efficacy and safety of aflibercept plus FOLFIRI in daily clinical practice. The primary endpoint was QoL assessed by EORTC QLQ-C30 questionnaire. Secondary endpoints included overall survival (OS), progression-free survival (PFS), tumor response and safety. Patients were evaluable for primary and secondary endpoint analysis if they had a QoL questionnaire at baseline and at least 2 post baseline. Safety was analyzed in all patients exposed to at least one dose of study drug. We report here the results by RAS status and prior targeted therapy received. Results: 1277 patients with mCRC were treated (median age 66 years, males 64.8%, right colon tumor 27.6%, liver metastases 53.2% , ECOG 0-1 84.7%) mainly in second-line (50.3%) but also in third-line (23.1%) and fourth-line (11.9%) setting. Median duration of treatment was 12 weeks. Overall, 872 patients were evaluable for the efficacy analysis. At baseline, the global health (mean) score was 58.7 and the mean change from baseline over 12 weeks was -4.6%. A clinically meaningful decline of -10 points was not reached, regardless of RAS status and prior targeted therapy. Secondary endpoints are provided in the Table below. Most common all grade adverse events were diarrhea (34.2%), nausea (17.9%), fatigue (17.2%), stomatitis (17.2%) and hypertension (11.6%). Conclusions: Aflibercept plus FOLFIRI administered in daily practice shows no deleterious effect on QoL and retains its activity irrespective of RAS status and prior targeted therapy. The safety profile was manageable. Clinical trial information: AIO-LQ-0113. [Table: see text]