PERAN BIDAN TERHADAP PELAKSANAAN PROGRAM PERENCANAAN PERSALINAN DAN PENCEGAHAN KOMPLIKASI (P4K) DALAM MENURUNKAN ANGKA KEMATIAN IBU

Maternal Mortality Rate in Indonesia in 2012 that there were 359. In 2007 the Minister of Health planned a delivery planning and complication prevention program (P4K) as an effort to accelerate the decline in MMR in Indonesia. Health workers have a role in carrying out labor preparation and preparation for pregnant women. This program is one of the effective strategies to reduce the number of maternal deaths, besides childbirth assisted by trained midwives also plays a role in reducing maternal morbidity and mortality. Program Implementation Planning Childbirth Complications and Prevention (P4K) on Reducing Maternal Mortality Rate (MMR) Methods phenomenological design, using descriptive data involving informants. The collection of data with verification, data presentation and verification. Results In this study Generally P4K implementation is good enough. Services and cooperation of midwives, as well as the role of all the informant was quite good, facilities are adequate, but there are some activities that still has not been implemented because some of the barriers that exist so that the implementation is not optimal. Conclusions Implementation P4K program is likely to have contributed in helping pregnant women prepare for childbirth, and to reduce maternal mortality (MMR) should be reconsidered from various aspects

Wooden Extra Stories in Concrete Block of Flats in Finland as an Ecologically Sensitive Engineering Solution

This chapter examined the various stages and benefits of wooden extra stories from the perspective of Finnish housing and real estate companies through interviews with professionals involved in these projects. Key findings highlighted are as follows: (1) in the feasibility study, project planning primarily focuses on property condition and potential improvement targets as well as other considerations, for example, compliance with current regulations and parking arrangements; (2) in the project planning, application of extra stories is thoroughly examined, and construction costs, profits, and the sale of building rights are discussed; (3) in implementation planning, issues related to building rights, city plan change, and conditions of the company that manages the property play an important role; and (4) during construction, frequent information updates are made to residents regarding the site arrangements and the construction program. Wooden extra floor construction, which requires commitment, investment, and cooperation among the interested parties, has great potential in construction technology, contracting mechanisms, and ecological engineering solutions. It is believed that this chapter will increase the dissemination of wooden extra stories, thus contributing to the greater use of more sustainable materials in renovation projects and the ecologically sensitive engineering approaches to meet the challenges arising from climate change.

Adapting Caring Contacts for Veterans in a Department of Veterans Affairs Emergency Department: Results From a Type 2 Hybrid Effectiveness-Implementation Pilot Study

Transitions in care, such as discharge from an emergency department (ED), are periods of increased risk for suicide and effective interventions that target these periods are needed. Caring Contacts is an evidence-based suicide prevention intervention that targets transitions, yet it has not been widely implemented. This pilot study adapted Caring Contacts for a Department of Veterans Affairs (VA) ED setting and population, created an implementation toolkit, and piloted implementation and evaluation of effectiveness. To inform adaptation, qualitative interviews were conducted with stakeholders. Data were used by an advisory board comprised of stakeholders, experts, and veterans to make adaptations and develop an implementation planning guide to delineate steps needed to implement. Key decisions about how to adapt Caring Contacts included recipients, author, content, and the schedule for sending. Pilot implementation occurred at one VA ED. Caring Contacts involved sending patients at risk of suicide brief, non-demanding expressions of care. Program evaluation of the pilot used a type 2 hybrid effectiveness-implementation design to both pilot an implementation strategy and evaluate effectiveness of Caring Contacts. Evaluation included qualitative interviews with veteran patients during implementation. VA electronic health records were used to evaluate VA service utilization in the 6-month periods immediately before and after veterans were delivered their first Caring Contact. Hundred and seventy-five veterans were mailed Caring Contacts and the facility continued adoption after the pilot. Participants were positive about the intervention and reported feeling cared about and connected to VA as a result of receiving Caring Contacts. This project developed an implementation planning process that successfully implemented Caring Contacts at one site. This can be used to further implement Caring Contacts at additional VA or community EDs.

Sugar Habit Hacker: Initial evidence that a planning intervention reduces sugar intake

Background and aimsSugar is a potentially addictive substance that is consumed in such high levels the World Health Organisation has set recommended consumption limits. To date there are no empirically tested brief interventions for reducing sugar consumption in adult populations. The current study aimed to preliminarily assess the feasibility of recruitment, retention, and intervention engagement and impact of a brief intervention.MethodsThis pre-post study recruited 128 adults from New Zealand to complete a 30-day internet-delivered intervention with in-person and email coaching. The intervention components were derived from implementation intention principles whereby the gap between intention and behaviour was targeted. Participants selected sugar consumption goals aligned with WHO recommendations by gender. To meet these goals, participants developed action plans and coping plans and engaged in self-monitoring. Facilitation was provided by a coach to maintain retention and treatment adherence over the 30 days.ResultsIntervention materials were rated as very useful and participants were mostly satisfied with the program. The total median amount of sugar consumed at baseline was 1,662.5 g (396 teaspoons per week) which was reduced to 362.5 g (86 teaspoons) at post-intervention evaluation (d = 0.83). The intervention was associated with large effects on reducing cravings (d = 0.59) and psychological distress (d = 0.68) and increasing situational self-efficacy (d = 0.92) and well-being (d = 0.68) with a reduction in BMI (d = 0.51).ConclusionThis feasibility study indicates that a brief intervention delivering goal setting, implementation planning, and self-monitoring may assist people to reduce sugar intake to within WHO recommendations.

ANALYSIS OF DOMAIN MONITORING AND EVALUATION COBIT MATURITY LEVEL IN GAME DEVELOPMENT COMPANY

There are many opinions that information technology governance is only suitable to be applied by large-scale companies. However this has not been proven to be true. Many small and medium-sized startups fail because they do not have good governance plans. This means that even small and medium-sized companies also need proper IT implementation planning. The purpose of this study was to measure the maturity level of information technology governance, particularly in terms of monitoring and evaluating IT performance, implementing internal controls, and compliance with company external regulations. Based on calculations, this game development company is at maturity level 3 (Defined Process). In addition, it was found that the biggest gap was in the Skill and Expertise attributes and the Goals and Measurement attributes. This study also provides recommendations for companies based on gap analysis in each process.

Rapid Cycle Implementation and Retrospective Evaluation of a SARS-CoV-2 Checklist in Labor and Delivery

Background Preparedness efforts for a COVID-19 outbreak required redesign and implementation of a perioperative workflow for the management of obstetric patients. In this report we describe factors which influenced rapid cycle implementation of a novel comprehensive checklist for the perioperative care of the COVID-19 parturient. Methods Within our labour and delivery unit, implementation of a novel checklist for the COVID-19 parturient requiring perioperative care was accomplished through rapid cycling, debriefing and on-site walkthroughs. Post-implementation, consistent use of the checklist was reported for all obstetric COVID-19 perioperative cases (100% workflow checklist utilization). Retrospective analysis of the factors influencing implementation was performed using a group deliberation approach, mapped against the Consolidated Framework for Implementation Research (CFIR). Results Analysis of factors influencing implementation using CFIR revealed domains of process implementation and innovation characteristics as overwhelming facilitators for success. Constructs within the outer setting, inner setting, and characteristic of individuals (external pressures, baseline culture, and personal attributes) were perceived to act as early barriers. Constructs such as communication culture and learning climate, shifted in influence over time. Conclusion We describe the influential factors of implementing a novel comprehensive obstetric workflow for care of the COVID-19 perioperative parturient during the first surge of the pandemic using the CFIR framework. Early workflow adoption was facilitated primarily by two domains, namely thoughtful innovation design and careful implementation planning in the setting of a long-standing culture of improvement. Factors initially assessed as barriers such as communication, culture and learning climate, transitioned into facilitators once a perceived benefit was experienced by healthcare teams. These results provide important information for the implementation of rapid change during a time of crisis.

Wooden Additional Floors in Old Apartment Buildings: Perspectives of Housing and Real Estate Companies from Finland

This paper examined various stages and advantages of wooden additional floors from the perspective of Finnish housing and real estate companies through interviews with professionals involved in these projects. Main findings highlighted: (1) commercial conditions should be carefully analyzed for return on investment; (2) city plan change and the presence of a potential contractor and an expert were generally considered important issues; (3) considerations regarding city planning, parking spaces, load-carrying capacity, and new building codes were highlighted as critical factors for feasibility study; (4) existing building regulations and building rights regarding the subscription fee and tax issues should be considered during project planning; (5) city plan change and building rights with different tendering conditions were reported as important parameters in implementation planning; (6) an efficient flow of information between the parties involved was vital to the successful progress of the construction phase. Wooden additional floor construction, which requires commitment, investment, and cooperation between interested parties, has great potential regarding construction technology and contracting mechanisms. Additionally, this sustainable approach has many advantages concerning the environment, economy, energy efficiency, and aesthetics. In this sense, it is believed that this study will contribute to the diffusion of wooden additional floor construction in other countries besides Finland.

Validating an individual innovation competence assessment tool for university–industry collaboration

University–industry collaboration produces networks that may be capable of innovations, such as novel products and services. The collaboration projects also need to benefit student learning, yet teachers have little clarity with regard to innovation competence development. Individual innovation competence is a set of personal characteristics, knowledge, skills and attitudes that are connected to create concretised and implemented novelties via collaboration in complex innovation processes. The paper reports on the findings from the development and validation of an individual innovation competence assessment tool. The aim is to determine which individual innovation competences are significant in university–industry collaboration and which of these competences are sensitive to educational interventions. The study used a three-phase method involving development of the questionnaire items, validation in teacher and student panels, and a pilot pre- and post-survey study. All seven domains of individual innovation competences were significant and sensitive to educational intervention (a multidisciplinary innovation project conducted with industry). The most responsive competence domains regarding change were concretisation and implementation planning skills, and project management skills. The paper concludes with application opportunities for the tool and recommendations for further research.

Analisis Maturity Level Perencanaan Strategis Sistem Informasi Pemerintahan Daerah Di Indonesia: Systematic Literature Review

Meningkatnya kesadaran akan perlunya penyusunan rencana strategis dalam pengembangan sebuah sistem informasi terintegrasi dapat kita lihat pada penelitian yang dilakukan di beberapa pemerintah daerah di Indonesia, namun tidak semua perencanaan strategis sistem informasi (PSSI) yang disusun sudah memenuhi aspek kelengkapan sesuai tahapan PSSI sehingga kurang memberikan manfaat yang maksimal. Pada penelitan ini dilakukan analisis untuk mengetahui tren metode apa saja yang digunakan dari tahun ke tahun, mengukur aspek kelengkapan tahapan serta maturity level dari masing-masing tahapan PSSI menggunakan Systematic Literature Review. Dari 33 studi yang memenuhi inklusi dan eksklusi, terdapat 8 jenis metode yang digunakan dan metode yang paling banyak digunakan adalah metode Ward and Peppard yaitu 17 Studi (52%), metode Ward and Peppard menjadi paling populer karena memiliki alat analisis sangat lengkap seperti SWOT, PEST, Five Force Competitive, Value Chain, Critical Success Factors, Balance Scorecard, dan McFarlan’s Strategic Grid. Hasil pengukuran maturity level dari masing-masing tahapan PSSI menunjukkan tahapan yang sudah memenuhi mature level sebagai berikut 57,6% studi pada tahapan kesadaran strategis (strategic awareness), 42,4% studi pada tahapan analisis situasi (situation analysis), 39,4% studi pada tahapan konsepsi strategi (strategy conception), 54,6% studi pada tahapan perumusan strategi (strategy formulation), 36,3% studi pada tahapan perencanaan implementasi strategi (strategy implementation planning). Secara garis besar maturity level pada setiap tahapan PSSI menunjukkan hasil kurang baik dengan rata-rata keseluruhan di angka 46,1%.

Pharmacogenomics education, research and clinical implementation in the state of Minnesota

Several healthcare organizations across Minnesota have developed formal pharmacogenomic (PGx) clinical programs to increase drug safety and effectiveness. Healthcare professional and student education is strong and there are multiple opportunities in the state for learners to gain workforce skills and develop advanced competency in PGx. Implementation planning is occurring at several organizations and others have incorporated structured utilization of PGx into routine workflows. Laboratory-based and translational PGx research in Minnesota has driven important discoveries in several therapeutic areas. This article reviews the state of PGx activities in Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these advances.