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Zusammenfassung Hintergrund Die Diagnostik bei Autismus-Spektrum-Störungen ist aufgrund fehlender biologischer Marker und zahlreicher Komorbiditäten anspruchsvoll. Ziel dieser Arbeit war es, den Stellenwert der neuropädiatrischen Diagnostik zu beurteilen und eine interne Leitlinie zu erstellen. Methodik Eingeschlossen wurden alle Patienten, die sich zwischen 04/2014 und 12/2017 in der neuropädiatrischen Ambulanz am Universitätsklinikum des Saarlandes mit der Diagnose „tiefgreifende Entwicklungsstörungen“ (ICD-Code F84) vorgestellt haben. Ergebnisse Die Studie umfasste 82 Patienten (männlich 78 %, weiblich 22 %; Durchschnittsalter 5,9 ± 2,9 Jahre, Spanne 2 bis 16 Jahre). Häufigste Untersuchung war die Elektroenzephalographie (EEG) (74/82; 90,2 %); diese war bei 33,8 % (25/74) auffällig. Anhand der Anamnese und/oder des EEGs wurde bei 16/82 (19,5 %) Kindern die Diagnose „Epilepsie“ gestellt. Eine kranielle Magnetresonanztomographie (cMRT) erhielten 49/82 (59,8 %) der Patienten; 22/49 (44,9 %) zeigten mindestens einen auffälligen Befund; bei 14/22 (63,6 %) ließen sich eindeutige Pathologien feststellen. Eine Stoffwechseldiagnostik wurde bei 44/82 (53,7 %) Kindern veranlasst; bei 5/44 (11,4 %) resultierte daraus eine Diagnose oder der Verdacht auf eine Stoffwechselerkrankung. Das Ergebnis einer genetischen Diagnostik lag bei 29/82 (35,4 %) Kindern vor mit Auffälligkeiten in 41,4 % (12/29). Eine motorische Entwicklungsverzögerung war häufiger mit Komorbiditäten, EEG-Auffälligkeiten, Epilepsie und Auffälligkeiten in der Stoffwechsel- sowie genetischen Diagnostik assoziiert. Schlussfolgerung Die neuropädiatrische Mitbeurteilung bei Verdacht auf Autismus sollte bei jedem Kind eine detaillierte Anamnese, eine neurologische Untersuchung sowie ein EEG beinhalten. Die Durchführung einer cMRT, einer Stoffwechsel- sowie einer genetischen Diagnostik wird nur bei klinischer Indikation empfohlen.

The drowning emergency is associated with respiratory and cardiovascular problems. Increasing public knowledge to provide first aid needs to be implemented. This study aimed to improve the ability of coastal communities to provide essential life support through participant modeling. The research design used was a quasi-experiment with a one-group pre-post test design approach. The number of samples in this study was 34 respondents. The research was conducted by determining the five models given. Then the model provides education and basic life support training to the respondents. The variables of this study were participant modeling and the ability to provide essential life support. The instrument used was the standard operating procedure for basic life support and observation sheets, and the research analysis used was the paired t-test.This study's results indicate that giving the participant modeling action has an effect and increases the average value of the respondents' knowledge and skills after being given these actions. Participant modeling can improve cognitive, self-confidence, and skills to form new behaviors, such as providing essential life support.

Introduction: Sitting volleyball is a widely practiced paralympic sport. A correct and standardized physical evaluation helps coaches to plan and manage the training. It is also important to evaluate physical fitness accurately and adopt standardized protocols to compare and normalize the data. The aim of the study was to evaluate physical fitness evaluation methods adopted in sitting volleyball and to eventually propose standard operating procedures. Evidence acquisition: English-written and peer-reviewed original articles were included in this review. The population studied was composed only of athletes practicing sitting volleyball. Articles were searched on the electronic databases PubMed, Web of Science, and Scopus using keywords matched with Boolean operators. Two independent investigators collected and screened the studies against the eligibility criteria. Data were analyzed narratively. Evidence synthesis: Only 7 studies were eligible and included in this review, but a wide testing methodology exists. There are some tests commonly adopted in the studies included and these are the handgrip test, the agility t-test, the speed, and endurance test. These tests with the 2-site skinfold thickness evaluation, the modified push-ups, the shoulder-stretch test, the chest throw test and the simple reaction time task were included in the standard operating procedure. Conclusions: The literature on the topic is poor and standardization of the testing procedure to evaluate the physical fitness of people practicing SV has been provided.

В статье рассматривается определение цифрового документа как объекта исследования, установление его аутентичности и пригодности для производства судебных экспертиз. Проанализированы научное и методическое обоснования порядка работы с цифровыми документами. Большое внимание уделено вопросам, связанным с разработкой элементов системы менеджмента качества в рамках аккредитации экспертной лаборатории на соответствие требованиям межгосударственного стандарта ГОСТ ISO/IEC 17025-2019. Автором определены структура и содержание стандартной операционной процедуры системы менеджмента качества. Отмечена необходимость изменения программ подготовки и переподготовки сотрудников экспертных лабораторий., The article considers the definition of a digital document as an object of research, the establishment of its authenticity and suitability for the production of forensic examinations. The scientific and methodological substantiation of the procedure for working with digital documents is analyzed. Much attention is paid to issues related to the development of elements of a quality management system within the framework of the accreditation of an expert laboratory for compliance with the requirements of the interstate standard GOST ISO/IEC 17025-2019. The author defines the structure and content of the standard operating procedure of the quality management system. The necessity of changing the training and retraining programs for the staff of expert laboratories was noted., Судебная экспертиза, Выпуск 1 (73) 2023, Pages 110-116

Fish welfare within aquaculture suffers from the fact that regulations and legal requirements for animal welfare primarily apply to terrestrial animal husbandry. However, fish welfare plays a major role in fish husbandry, and it has been increasingly recognized since the early 2000's that fish can feel pain and need to be protected by law. In order to grant certain standards of welfare in husbandry the ability to measure and monitor welfare is key. For this, fish farmers need assistance and tools that are practicable and can be incorporated into their daily routines. MyFishCheck is such a tool and was developed by the Aquaculture Systems Research Group at the ZHAW in Wädenswil to support fish farmers in monitoring fish welfare. MyFishCheck is a model based on the scoring of different parameters, which are decisive for fish welfare, to assess the current welfare status of fish. The corresponding app facilitates the assessment for fish farms as they can enter the data and analyse the results digitally. The app is built in a modular way to ensure that more fish species, languages, or parameters can be added. This thesis had two goals, first, the implementation of the European perch (Perca fluviatilis) into the model and the app, and second, the development of a Standard Operating Procedure (SOP) on how such a species implementation is to be carried out. A complete implementation of the European perch into MyFishCheck was successfully carried out and its individual steps were documented. The parameters and their weighings within MyFishCheck were adapted to the needs of the European perch and justified based on a comprehensive literature search. A userfriendly SOP was created to facilitate future implementations of additional fish species in a standardised way, allowing for the continuous increase of the use and range of MyFishCheck.

Diese Bachelorarbeit beschäftigt sich mit der Etablierung eines Fed-Batch-Prozesses zur Herstellung eines Masern-Impfstoffes unter Verwendung von auf Microcarriern wachsenden MRC-5-Zellen in einem 50L-Rührkesselreaktor. Ein essenzieller Prozessschritt im Downstream-Processing ist die Aufreinigung des viralen Produkts mittels Ionenaustauschchromatographie. Das Trennungsprinzip beruht auf den in der Probe auftretenden unterschiedlichen Ladungen, wobei sich in der Säule Festionen befinden, an die sich Ionen mit konträrer Ladung reversibel binden, während Ionen mit derselben Ladung wie die Festionen sowie neutrale Moleküle oder Atome eluieren. Um bestmögliche Resultate zu erzielen, muss die Chromatographiesäule ordnungsgemäß gepackt, aufgebaut und betrieben werden. Im Besonderen wird dieser Prozessschritt näher untersucht, um aus neu gewonnenen Erkenntnissen und Zusammenfassen der bisherigen eine Entwicklung zur Prozessverbesserung zu gewährleisten, unter Berücksichtigung des Stands der Technik. Derzeit gibt es verschiedene Harze, wobei für diesen speziellen Anwendungsfall CaptoQTM ausgewählt wurde. Measles is a highly infectious virus-transmitted disease that primarily affects young people. An infection with measles can take a life-threatening course and trigger various symptoms in those affected. The initial symptoms mainly affect the respiratory tract, but as the disease progresses, complications such as encephalitis can occur with a weakened immune system, which has a lethality of 10-20% and causes severe sequelae in another 20-30% of patients. In order to reduce the damage caused by this disease, as many people as possible, especially the young, are vaccinated and vaccines are continuously optimized. This bachelor thesis deals with the establishment of a fed-batch process for the production of a measles vaccine using MRC-5 cells grown on microcarriers in a 50L stirred tank reactor. An essential process step in downstream processing is the purification of the viral product by ion exchange chromatography. The separation principle is based on the different charges occurring in the sample, with fixed ions in the column to which ions with opposite charges bind reversibly, while ions with the same charge as the fixed ions and neutral molecules or atoms elute. To achieve the best possible results, the chromatography column must be properly packed, set up, and operated. Specifically, this process step will be studied in more detail to ensure a development for process improvement from newly gained knowledge and summarizing the previous ones, considering the state of the art. Currently, there are various resins available, and CaptoQTM was selected for this particular application.

Countries in Asia and the Pacific are more prone to natural disasters than those in other parts of the world. Because of this, there is an urgent need to continue developing effective, end-to-end early warning systems that lead to an effective response by emergency managers and people at risk. ESCAP/WMO Typhoon Committee (TC), in cooperation with WMO/ESCAP Panel on Tropical Cyclones (PTC), conducted a regional cooperation project on Synergized Standard Operating Procedures for Coastal Multi-Hazards Early Warning System (SSOP) with fund support from ESCAP Multi-Donor Trust Fund for Tsunami, Disaster and Climate Preparedness in Indian Ocean and South East Asia. SSOP project was conducted successfully and achieved its proposed goals. Its results and achievements greatly benefit the Members not only in the region but also in all other regions of WMO. The paper reviewed its implementation process, strategy and activities; briefed its main achievements including SSOP Manual, capacity building and cooperation mechanism between TC and PTC; summarized the experiences and lessons from project implementation; and highlighted its sustainability. The paper also suggested the approaches to enhance the sustainability of SSOP results and the cooperation between two regional bodies TC and PTC.

Penelitian ini bertujuan untuk menganalisis efektivitas penerapan Standard Operating Procedure (SOP) pada Departemen Community & Academy RUN System (PT Global Sukses Solusi Tbk) berdasarkan tujuh hal pokok dalam SOP yaitu: efisiensi, konsistensi, minimalisasi kesalahan, penyelesaian masalah, perlindungan tenaga kerja, peta kerja, dan batasan pertahanan. Penelitian ini menggunakan pendekatan kualitatif dan menggunakan metode pengumpulan data berupa wawancara, observasi, dan dokumentasi. Metode analisis data yang digunakan adalah reduksi data, penyajian data, dan penarikan kesimpulan. Lima orang anggota RUN System (PT Global Sukses Solusi Tbk) dilibatkan sebagai informan dalam penelitian ini. Dari tujuh indikator efektivitas SOP, empat indikator menunjukkan bahwa penerapan SOP sudah efektif. Maka dari itu, dapat disimpulkan bahwa penerapan Standard Operating Procedure pada Departemen Community & Academy RUN System (PT Global Sukses Solusi Tbk) sudah efektif. Adapun penerapan SOP berdasarkan tujuh hal pokok dalam SOP memiliki beberapa kekurangan antara lain pada indikator efisiensi, konsistensi dan penyelesaian masalah.

The development of high-rise buildings is a current trend in developed cities to answer the challenges of population growth, adding aesthetic value, and optimal use of land. Lagos particularly is one of the fastest growing cities in the world with Gross Domestic Product (GDP) and Internally Generated Revenue (IGR) in Nigeria, which suggests the need for multiple complex buildings, and the need for their maintenance cannot be overemphasised. This maintenance aspect requires tremendous work due to the complexity attached and several strategies springing up. Different studies reveal that both performance measurements and factors are essential aspects in evaluating maintenance management. Thus, this study seeks to explore performance elements that could improve maintenance. Personnel attitude, maintenance policy, maintenance review, and maintenance implementation were measured relative to computerised maintenance management system (CMMS) performance. With a random sampling technique, a sample of 134 Facility Management (FM) practitioners involved in high-rise office buildings was used to assess the effects of CMMS deployment. Results were analysed by Partial Least Squares Structural Equation Modelling (PLS-SEM). Findings from this study highlighted an indirect effect size and a large predictive relevance of personnel attitude as a critical factor for a smooth maintenance execution procedure of 12.59% and a standard operating procedure (SOP) of 15.64% on maintenance implementation to contribute 28.36% to performance. This paper uncovers the place of personnel attitude in determining effective maintenance.

Background A recent campaign in the NHS highlighted that sitting in a chair can help to prevent deconditioning such as the loss of muscle strength, as well as helping to maintain a patient’s dignity (NHS improvement). The aim of this audit was to review whether the current seating available in our Emergency Department (ED) meets the needs of the older population who attend. Methods A prospective audit was completed over 6 days. It captured the number of patients who were seated in chairs in the morning and early afternoon, and if not, why. Results Total number of patients reviewed: 62. Total number of patients on a trolley: 50/62. Average CFS: 6. Average age: 83. Sex: 25 male, 37 female. • 54% not appropriate due to ongoing medical issues. Of the remaining 46%; • 17% lacked appropriate seating. • 47.8% who were appropriate to sit out did not for a number of reasons i.e. presentation surges in ED, demand outstripped capacity in terms of 1:1 care. • The remainder either declined to sit out, required specialise seating or no clear reason reported. • Only 10% of those who were in bed had no medic. Conclusion 54% of patients who remained on a trolley were medically unwell and not fit to sit out. However 47.8% of those medically fit to sit were not sitting out as per reasons discussed above. More education is needed for all staff about the importance of sitting patients out. Future plans should include staff education sessions and the development of a standard operating procedure to assist with identifying patients on arrival to the ED who could safely sit out. This could help in preventing patients’ cascade to dependency at the front door.

Publisher Copyright: © 2021 The Authors Objective: Airway management to ensure sufficient gas exchange is of major importance in emergency care. Prehospital endotracheal intubation (ETI) by paramedics is a widely debated method to ensure a patent airway. ETI is performed with procedural sedation in comatose patients because of the regulation. The use of medications increases the rate of successful airway management compared with nonmedication ETI and may also improve outcomes in patients with traumatic brain injury. In the absence of an operative emergency physician and with long distances, paramedic-induced airway management may increase the survival of patients in selected scenarios. A paramedic-staffed helicopter emergency medical system in Northern Finland operates in a rural area without an emergency physician and paralytic medications and treats critically ill patients using basic or advanced life support ground units. The aim of this study was to evaluate the success rates of ETI performed by a small, appropriately trained, and experienced group of 8 nurse paramedics in an out-of-hospital setting. Methods: The inclusion criterion for the study was an attempted intubation in patients with medical or traumatic indication for airway management by nurse paramedic. Results: Fifty-one patients were treated with ETI. The first-pass success rate was 72.5%, the second-pass success rate was 94.1%, and the overall success rate was 100% within 4 attempts. The median on-scene time was 54 minutes, and there were no signs of aspiration during laryngoscopy or after successful ETI. The primary mortality rate was 11.7%. Conclusion: The use of a rigid standard operating procedure for paramedic rapid sequence induction, paralytics, a video laryngoscope, and a gum elastic bougie might positively affect the ETI first-pass success rate. A follow-up study after these future modifications is needed. This small study suggests that intubation might be 1 option for airway management by an experienced nonanesthesiologist in Lapland.

This study aims to see the role of local government in the recovery and development of the tourism sector in the Special Region of Yogyakarta, in overcoming adversity due to the covid-19 pandemic and entering a new era of habits through the Visiting Jogja Apps program. This research is a qualitative descriptive study, collecting data obtained through interviews, observation and document analysis. The research was conducted at the Yogyakarta Special Region Tourism Office and a number of Associations in the Tourism Business Sector and also to the management of tourist sites in a number of regencies in the Special Region of Yogyakarta. The data analysis technique is carried out by means of data reduction, data presentation and verification or conclusions. The results of this study indicate that the Visiting Jogja Apps program has been programmed by the Special Region of Yogyakarta Tourism Office to adapt to pandemic conditions and become an alternative for carrying out tourism activities that adapt to health protocols, which are useful as support for tracing visitors or Covid-19 tracers However, the Visiting Jogja Apps program is still not optimal in carrying out supporting functions in tracing tourists who are confirmed to be positive for Covid, and there is no implementation rule or Standard Operating Procedure related to tracing itself

Internet of things (IoT) application in e-health can play a vital role in countering rapidly spreading diseases that can effectively manage health emergency scenarios like pandemics. Efficient disease control also requires monitoring of Standard operating procedure (SOP) follow-up of the population in the disease-prone area with a cost-effective reporting and responding mechanism to register any violation. However, the IoT devices have limited resources and the application requires delay-sensitive data transmission. Named Data Networking (NDN) can significantly reduce content retrieval delays but inherits cache overflow and network congestion challenges. Therefore, we are motivated to present a novel smart COVID-19 pandemic-controlled eradication over NDN-IoT (SPICE-IT) mechanism. SPICE-IT introduces autonomous monitoring in indoor environments with efficient pull-based reporting mechanism that records violations at local servers and cloud server. Intelligent face mask detection and temperature monitoring mechanism examines every person. Cloud server controls the response action from the centre with an adaptive decision-making mechanism. Long short-term memory (LSTM) based caching mechanism reduces the cache overflow and overall network congestion problem.

Objective To investigate the effect of sensitive quality indicators on quality management of assembly for medical instruments in Central Sterile Supply Department (CSSD). Methods The error rate of assembly was set as an sensitive quality indicator, and root-cause analysis was made to find influencing factors in issues of human resource, instruments, process and methods. The standard operation procedure was established and countermeasures such as personnel training and information technology support were carried out. The error rates of assembly for medical instruments processed in Central Sterile Supply Department after implementation of sensitive quality indicators (between January and September 2020) were collected and compared with those before implementation of sensitive quality indicators (between January and September 2019). Results The error rate of assembly dropped from 0. 020% to 0. 006%. The implementation of sensitive quality indicators had shortened the time cost in assembling instruments and reduced the man-time of changing shift. Conclusion The establishment of sensitive quality indicators makes the work in CSSD more standardized and qualified, and provide scientific evidence for quality assessment and monitoring.

Background Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires specialized clinicians and resources in advanced technology. Moreover, the COVID-19 remains an ongoing global emergency, and there is no evidence-based practice in preparedness. This article proposes an innovative and optimized nursing care protocol, the Standard Operating Procedure (SOP), that regulates safety and efficiency in using personal protective equipment (PPE) during ECMO-relevant procedures while providing ECMO therapy for patients with COVID-19. Methods After performing a narrative literature search, we developed a high-fidelity translational simulation scenario. It included practicing appropriate donning and doffing PPE during work organization, ECMO-related procedures, and routine daily nursing care and management of ECMO over nine hours. In addition, we held supplementary constructive debrief meetings to consult international expert in the field. Results A proposal for nursing standardized operating procedures was created, divided into categories. They included work organization, workload references, competences, infrastructural conditions, cannulation equipment, daily routine nursing care, and procedures during ECMO. Conclusions High-fidelity medical simulation can play an important role in staff training, improvement in previously gained proficiency, and development of optimal SOP for nursing care and management during ECMO in patients with COVID-19. Optimal SOPs may further guide multidisciplinary teams, including intensive care units and interventional departments.

Biological invasions are a major global challenge for the conservation of biodiversity, maintenance of ecosystem health and sustainable livelihoods. As the number of novel introductions of invasive species is predicted to increase due to rising trade volumes in the emerging economies, regulatory policies to prevent the introduction and spread of invasive species are of paramount importance. However, poor response capacities, lack of coordination between stakeholders, heavy dependence on biological resources and little public awareness are some of the formidable barriers in framing and implementing such policies in developing countries. This study was conceptualized to establish common ground by considering the diverse interests of different actors and design a policy framework to control invasive alien plant species (IAPS) in the lower-middle income economies considering India as a case study. To achieve this objective, we evaluated the introduction pathways and current economic uses of IAPS in India and critically reviewed the infrastructure and current response capacity of the country for regulating pre- and post-border trading of these problematic species. We found that the majority of IAPS were introduced for ornamental purposes and some of them are still actively traded and used for several economic purposes. Despite having a rich legacy of environmental policies, a legal framework exclusively to deal with invasive species is non-existent in India. Here, we propose a set of policy interventions, for international and domestic trading, by integrating trade regulations based on a risk assessment framework with interests of both consumers and traders to ensure effective compliance from all stakeholders. Further, we identify potential hurdles for policy implementation in India and therefore, based on the existing biosecurity infrastructure, we outline an operable and dynamic decentralized system having a standard operating procedure to ensure coordination between different stakeholders, increase public awareness and guide further research direction.

The purpose of this article is to analyze the impact of the COVID-19 pandemic on hotel operation at The Atrium Hotel and Resort Yogyakarta. This study is using a descriptive qualitative approach. The results of the study indicate operational constraints faced by The Atrium Hotel and Resort during the COVID-19 pandemic, which include a longer check-in process, increased operational cost, food and beverage services are not optimal, difficulties in determining the selling price of rooms, difficulty finding guests, and difficulty arranging the employee work schedules. The effort to adjust The Atrium Hotel and Resort Yogyakarta’s operation amid the COVID-19 pandemic are modifying of standard operating procedure (SOP), selling room only, adding facilities to prevent the spread of COVID-19, strict monitoring of health protocols, and MICE activities requiring permission from the COVID-19 force

Skin crackers are well known and popular as a superior regional product that can be developed. Skin crackers, better known as "Karupuak Jangek" in West Sumatra, is a typical snack that is liked and easy to find in every restaurant because it has become a favorite menu. This service aims to improve the sanitation and hygiene aspects and improve the layout of the production room by the requirements of SSOP (Sanitation Standard Operating Procedure) and GMP (Good Manufacturing Practice). The approach method offered to support the realization of the science program is training and consultation methods through lecture and discussion methods. The focus of the activity is the renovation of the production room layout and the introduction of sanitation and hygiene improvements during the production of sanitary equipment and tools. Based on the dedication to introducing appropriate technology, Mitra is very enthusiastic about improving the sanitary and hygienic aspects of production through the use of cleaning tools to clean wet production rooms and clean skin quickly and hygienically. Improvement of the cracker storage room equipped with a box container to extend the skin's shelf life after drying is a solution to one of the SSOP and GMP applications for IKM Rizky. Improvement of storage area for hygienic skin crackers and meet the sanitation aspects expected to maintain the quality of skin crackers.

For the past two decades, the guidelines put forth by the American College of Medical Genetics and Genomics (ACMG) detailing providers' clinical responsibility to recontact patients have remained mostly unchanged, despite evolving variant interpretation practices which have yielded substantial rates of reclassification and amended reports. In fact, there is little information regarding genetic counselors' roles in informing patients of reclassified variants, or the process by which these amended reports are currently being handled. In this study, we developed a survey to measure current experiences with amended variant reports and preferences for ideal management, which was completed by 96 genetic counselors from the United States and Canada. All respondents indicated they were the individuals responsible for disclosing initial positive genetic testing results and any clinically actionable reclassified variant reports, and over half (56%) received at least a few amended variant reports each year. Nearly a quarter (20/87) of respondents reported having a standard operating procedure (SOP) for managing amended reports and all were very satisfied (12/20) or satisfied (8/20) with the SOP. Of those without a protocol, 76% (51/67) would prefer to have an SOP implemented. Respondents reported a preference for (1) laboratories to send amended variant reports directly to the genetic counselor or ordering physician through email or an online portal, and (2) notification to patients ideally occurring through a phone call. In the event that the original genetic counselor is inaccessible, respondents reported a preference for reports to be sent directly to another genetic counselor (36%) on the team or the clinic in general (27%). Information from this study provides insight into the current practices of genetic counselors as applied to amended reports and what improvements may increase the efficiency of the reporting process. Moreover, these results suggest a need for an updated statement addressing duty to recontact, specifically as it applies to amended variant reports.

The problem of low absorption of vocational graduates is allegedly due to a gap between the competencies possessed by students and the needs in the world of work. The participation of the industrial world and the world of work in the learning process in SMK is still low. The general objective of this study is to identify and analyze the implementation of the teaching factory in improving the competence of vocational students. The specific objectives of this study are to determine: (1) planning of the teaching factory; (2) teaching factory organization; (3) implementation of teaching factory; (4) evaluation of teaching factory implementation; (5) partnership in teaching factory implementation; (6) problems and solutions in the implementation of the teaching factory; (7) the results obtained from the implementation of the teaching factory. The theoretical basis uses the management theory of G.R. Terry, and the policy foundation is Presidential Instruction No. 6 of 2016 concerning Vocational Revitalization, where the teaching factory is one of the strategies for implementing Vocational Revitalization. The study used a qualitative approach with descriptive data collection techniques through interviews, observations, and documentation studies. Testing the validity of the data is done through triangulation of sources and triangulation of methods. The results of the study stated that: 1) the planning of the teaching factory in the fields of curriculum, infrastructure and financing had been carried out well, but in the field of human resources it was necessary to plan for teacher competency improvement; 2) the organization of the teaching factory has been carried out well, but it is necessary to make a SOP (Standard Operating Procedure) for activities; 3) The implementation of the teaching factory has been running well, supported by Jobsheet devices, but verification and validation activities are needed for the Jobsheets used; 4) The teaching factory evaluation activities have been going very well; 5) Partnerships in teaching factories have been going well for Lemon Juice, Herbs way and Yoghurt products, but it is necessary to increase the number of industrial partners for other types of products; 6) Solutions to the problem of improving teacher competence are handled through internal internships in teaching factory activities and becoming supervisors for Industrial Work Practices; 7) The results obtained from the teaching factory implementation activities can increase the competence of hard skills and 78.26% of students' soft skills.

BACKGROUND: In Indonesia, the maternal mortality rate is still high and far from the Sustainable Development Goals target of 305 compared to 70 per 100,000 live births. AIM: This study aims to design the mHealth concept to improve the quality of antenatal care (ANC) with features that support service workers during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: The method used was literature study and conceptual design of the mHealth model with Rapid Application Development approach. RESULTS: The result showed that several factors influence the quality of ANC and the potential for improvement with mHealth. There are nine features of pregnancy services designed to improve the quality of ANC, such as standard operating procedure compliance, maternal health records, clinical decision aids, referral links, teleconsultation, health promotion improvement, alerts, and reminders, real-time reports, and distribution maps for pregnant women. The depicted context diagram consists of four external entities such as pregnant women, midwives, maternal and child health coordinators at Health centers and Health offices in Indonesia as well as the flow of data or information to and from mHealth, and the interface design understands users’ role and is executed accordingly. CONCLUSION: The problems of pregnant women during the COVID-19 pandemic or the new normal were partially resolved with mHealth innovations, teleconsultation features, and improving health promotion. Therefore, all the mHealth features this helps in improving the quality of ANC.

Redundant deliberation is a cognitively demanding form of inertia in which a decision-maker fails to gain any additional advantage by thinking about a problem compared to the risk of failing to act and deal with the problem. It most commonly occurs where there is no standard operating procedure (to help provide guidance) or where experience is lacking. This article argues that training interventions, including ‘grim storytelling’, must focus on supporting decision-makers’ ability to imagine rare, high-impact events, and construct ‘least–worst’ scenarios to help them anticipate, prevent, mitigate, adapt to and recover from such threats.

The College of Science and Health Professions offers a university preprofessional program. Like most medical schools in Saudi Arabia, the teaching delivery strategy in the university preprofessional program is on campus and face-to-face. During the month of March 2020, teaching activities of the spring semester were proceeding as normal; however, the sudden emergence of COVID-19 disturbed routine activities and compelled authorities to switch all teaching activities from face-to-face to online. Training sessions and workshops for all stakeholders on online delivery methods were arranged. Blackboard and other online facilities were utilized. All teaching materials, including newly made video clips for anatomy and physiology practicals, were uploaded on Blackboard and discussed online with students. Students’ anxiety related to the exam was reassured by giving them the option of open book quizzes during summative continuous assessment. All scheduled teaching sessions, lectures, and practicals were conducted proficiently. Revision sessions and assessment quizzes were conducted with students’ satisfaction. At the end of the semester, a final exam was conducted online as an open book exam. Students with technical issues while attempting the exam were given an opportunity to make up for it. After a successful final exam, the cumulative block grades showed students secured higher grades in the open book exam. Following that, the King Saud bin Abdulaziz University for Health Sciences has managed to conduct on-campus close book exams that abide by self-distancing and standard operating procedure policies.

This is a report of the OHEJP project: PARADISE, concenring the development of Standard Operating Procedures (SOPs) for the C. parvum and G. duodenalis Multi Locus Typing Schemes (MLST)

This is a report of the OHEJP project: PARADISE, concenring thedevelopment ofStandard Operating Procedures (SOPs)for theC. parvum and G. duodenalis Multi Locus Typing Schemes (MLST)&nbsp

This paper aims to identify indicators of community preparedness for disasters and apply these indicators to a critical case study context, namely the local communities in two districts of Lombok Island of Indonesia, which were stricken by earthquakes in 2018 and 2019. Community preparedness indicators are identified through a systematic literature review (SLR) and in-depth interviews with governmental and non-governmental stakeholders. These indicators are grouped into capability, coordination and networking, legal and institutional support, facilities and infrastructure, disaster management plan, and early warning system. Preparedness is then assessed using these indicators as a framework for conducting interviews and observations in the two districts. Results from the case study indicate that most villages are relatively prepared for disasters because they conduct regular meetings concerning disaster preparedness, participate in disaster simulations, and receive socialization/education from the government and humanitarian organizations, including the Indonesian Red Cross. Most villages also have disaster preparedness infrastructure in place, such as disaster risk maps, evacuation routes, and a standard operating procedure to follow in the event of a disaster. This preparedness was reflected in the involvement of communities in the early response to the 2019 earthquake. However, further enhancement is still needed to ensure that all disaster-prone villages have the required disaster preparedness infrastructure, and the communities are actively involved in disaster preparedness activities. This research contributes to better understanding disaster preparedness at the community level in a critical case study context. The results are valuable for governmental and non-governmental agencies to optimize the pre- and post-disaster planning.

The management of educational institutions requires accountability for managing education costs related to the management of school financing. Accountability is a concept of openness in education management. This study aimed to determine the effect of planning, reporting, and standard operating procedures on the accountability of the management of education costs. This research used quantitative research. Participants were employees of the University of Indonesia. Data in the form of a questionnaire was taken using a survey method. Data analysis used regression analysis. The results of the study concluded that 1) there is a direct positive effect of planning on the accountability of the management of education costs (t-count 2.406 t-table 2.08), 2) there is a direct positive effect of reporting on the accountability of the management of education costs (t-count 2.981 t-table 2.08), and 3). there is a direct positive effect of standard operating procedures on the accountability of the management of education costs (t-count 2.547 t-table 2.08). This also impacts the efficiency level of accountability in education cost management at the University of Indonesia.

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.

Government policies that apply social distancing, work from home, and learn from home to prevent the spread of the Covid-19 corona virus have an impact on learning methods. Clinical learning methods in pre-pandemic health education are carried out in campus laboratories and direct clinical services to patients. Thus, in this condition, the provision cannot be implemented. For this reason, it is necessary to modify the learning method from offline to online to meet the continuity of the student learning process. In the first stage, the clinical skills online learning method using online videos is supported by lecturers’ explanations in a 120-minute meeting. In the second stage, students are given the task of making videos of procedural skills that have been taught in 170 minutes, with a video duration of 10-15 minutes. At the next meeting, a review or response is carried out with students on the standard operating procedure and the theory that underlies it. The design in this study is a descriptive analysis with 511 respondents from the medical education study program and the nursing diploma 3 study program at the Faculty of Medicine, Mulawarman University. The research used was 44 items of statement questionnaire that had been tested for validity and reliability, and questionnaire items were sent to respondents via Google Forms. From the results of this study, there is a significant relationship between the perceptions of students who apply clinical skills online learning seen from the effectiveness of learning in the Covid-19 pandemic era with p-value = 0.000, with a very strong relationship with the Spearman value rho of 0.791 in a positive direction. Thus, it can be concluded that the application of online clinical skills learning during the Covid-19 pandemic was effective. As a suggestion, clinical learning methods with various blended learning or hybrid learning methods should be modified.

This standard operating procedure (SOP) defines the ethical rules of official conduct, the appearance of nurses and nurses at the Samara Regional Clinical Oncological Dispensary.

Este artigo o tem por objetivo refletir sobre a importância da normatização do procedimento operacional padrão (POP), na atividade operacional da Polícia Militar do Estado do Rio Grande do Norte/RN, baseado nas experiências e atividades realizadas pelos aplicadores da lei na atividade operacional. A pesquisa é de cunho exploratório, de campo com uso de questionário e com abordagem quantitativa. É de fundamental importância a normatização no âmbito institucional, a qual proporcionará inúmeras vantagens, para a minimização de possíveis erros profissionais, tanto para respaldar legalmente as ações durante suas atividades operacionais, afastando a insegurança jurídica que permeia a nossa atividade fim, como para criar, através de treinamentos constantes uma conduta com padrões aceitáveis de eficiência, eficácia e efetividade, baseada nas experiências realizadas pelos aplicadores da lei.

Uveal melanoma is a rare intraocular tumour, for which there is currently no national evidence-based guideline in Germany. The aim of this project was to provide a common standard operating procedure (SOP) for the diagnosis, treatment and follow-up care of uveal melanoma, within the network of German leading oncology centres funded by German Cancer Aid. The SOP was created as part of a moderated consensus process.In a multistage process, a common SOP was developed for the diagnosis, therapy and follow-up of uveal melanoma, as based on current knowledge of the subject.Für das uveale Melanom fehlt als seltene onkologische Erkrankung derzeit in Deutschland eine nationale evidenzbasierte Leitlinie. Bis diese erstellt wird, bietet sich eine zentrumsübergreifende Standard Operating Procedure (SOP) an. Ziel des Projektes war die Erarbeitung einer konsentierten SOP zur Diagnostik, Therapie und Nachsorge des uvealen Melanoms im Rahmen des Netzwerkes Onkologischer Spitzenzentren, die von der Deutschen Krebshilfe gefördert werden.In einem auf dem aktuellen Wissensstand basierenden mehrstufigen Prozess eines moderierten Konsensusverfahrens konnte eine konsentierte SOP für die Diagnostik, Therapie und Nachsorge des uvealen Melanoms erarbeitet werden.

T The Movement Control Order (MCO) was declared by the Malaysian Government on 18 March 2020 to avoid the transmission of the Covid -19 infection. The MCO was continued until phase four and then commenced to the Conditional Movement Control Order (CMCO) which was less restrictive starting 4 May 2020. For the first two months of the implementation of the MCO, all business premises, places of worship and educational institutions were closed totally to the public. schools were reopened in stages during the CMCO following the advice of the Ministry of Health (MOH). The objective of this research is to do an analysis of the maslahah element which was applied in the management of the reopening of schools according to the Sunnah Nabawiyyah perspective. This research was conducted using the qualitative method which involved literature and field research. By analyzing the primary documents released by the Ministry of Education (MOE) and the feedback posted by the mass media, the research found that the maslahah element such as maslahah daruriyyah, dunyawiyah and khassah are already implemented by the MOE in the preparation of School Reopening Management Guidelines. This element was aimed specifically in order to safeguard the health and the well-being of the students and the teachers. Even though education is important and mandatory for all, yet the constraints faced by the people concerned are equally important. Thus, the Standard Operating Procedure (SOP) is for the sake of making sure the well-being of school community is assured from the disease. Therefore, the guidelines of school reopening are in line with the Islamic approach based on the discussion of maqasid al-syari'ah which is to realize maslahah for human beings and avoiding any bad circumstances.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has severely affected the provision of health-care services in hospitals around the world, including bringing challenges to those who perform surgical procedures. Multidepartment data analysis will reflect the pandemic’s impact and challenges in managing surgical cases in various surgery departments. AIM: This study aims to assess the impact of COVID-19 lockdowns on surgical cases carried out in eight tertiary care center surgery departments. METHODS: Retrospective data from all patients in the eight surgery departments of Dr. Moewardi General Hospital, Surakarta, during the lockdown period due to COVID-19 were collected and compared to the period before the lockdown. Then, the data were analyzed regarding the effects of following the standard operating procedure for surgical services in the hospital during the lockdown period. RESULTS: All the surgery departments involved in the study showed a significant reduction in the number of patients treated during the lockdown period than before the lockdown, with a total number of cases across all departments of 2432, a decrease from 4503 before the lockdown. In surgical patient care, several special measures during the COVID-19 pandemic were carried out in outpatient, intraoperative, and inpatient services to reduce the virus spread to patients and health workers. CONCLUSION: The COVID-19 pandemic has severely affected the provision of health services in hospitals with a reduction in the number and types of patients in each surgery department, and the obligation to follow hospital protocols against COVID-19 has resulted in various treatments and services being delayed in all surgery departments.

Background: Population of people with diabetes mellitus (DM) are increasing every year. As a chronic illness, patients with DM needs to practice self-management for life. Adopted the nursing system in other countries that are more advanced in DM care, however the study is still under investigation. Objectives: Primary objective was to analyze the diabetic Self-management among the Indonesian and Taiwan population in Hospital. Secondary was to develop theory-guided and/or evidence-based nursing model in the self-management among diabetic patient with practical issues. Methods: We used a case study design by discussion across the multi-discipline of health care provider point of view, observation and brief interview session with patient, observe the health care model, learning process of health education between nurse and patient and whole application of the health education, at Veteran Hospital in Taiwan and Manambai Abdulkadir Hospitals in Indonesia. Results: Education system related to self-management of DM patients have been running and prepared by the Veteran hospital in Taiwan. The health system for diabetes management was called by diabetes shared care. Nurse, nutritionist and doctor have similar opinions about self-management in DM patients in Taiwan but different perspective among health professionals in Indonesia. The process of applying of evidence-based nursing practice and guidelines for providing health education to patients in Veteran Hospital Taiwan was using guidelines from the diabetes federation of China (Taiwan), on the other hand, standard operating procedure in Hospital in Manambai Abdulkadir Hospital, Indonesia, it is due to different policy in each country. Conclusion: The model of self-management might can be successfully be applied in clinical setting with several strategies by resolve the challenges. Hopefully, this study can be providing valuable information to the health professionals in order to provide the best service for patients with DM. Keywords: Diabetes, self-management, model, health education.

The research objectives were to analyze the legal protection of participants of the old age guarantee program as well as the threat of sanctions for companies that delinquent payment of Social Security Agency for Employe (BPJS Employment) dues. The research used a juridical-sociological approach with a type of sociolegal research. Data sources in the form of primary, secondary, and tertiary data were analyzed qualitatively. Legal protection of participants of the old age guarantee program consisted of preventive legal protection, namely through Government Regulation Number 60 of 2015, and repressive legal protection based on internal Standard Operating Procedure (SOP) from BPJS Employment provided if the company in question delinquent dues payment. The threat of sanctions for companies that delinquent payment of BPJS Employment dues was in the form of administrative sanctions, although in practice the sanctions were considered ineffective to be applied.

Introduction: The number of institutions engaging in research with potentially biohazardous materials has increased, indicating a need for newly formed Institutional Biosafety Committees (IBCs) in the United States and for similar biorisk management committees located outside the United States. Our institution identified the need for an IBC due to the growth of pertinent activities on campus. Objectives: This article shares our experiences creating a new IBC at our institution from September 2017 to April 2019. Our lessons learned and approaches to the challenges faced may be helpful to others finding themselves with similar needs. Methods: In this case study, we outline IBC membership, documents, relationships with federal agencies and within the institution, creation of registration forms, and the review process. Along with our account, we have included links to helpful resources from federal agencies. Results: At the time of the submission of this article, we have established our IBC and reviewed two registrations. Conclusion: This case report demonstrates the successful creation of an IBC that works for our current institutional needs.

In recent years, various ecotoxicological test guidelines and (technical) guidance documents have been evaluated and updated with regard to their applicability to nanomaterials (NMs). Several of these have currently reached official regulatory status. Ensuring their harmonized implementation with previously recognized methods for ecotoxicity testing of chemicals is a crucial next step towards effective and efficient regulation of NMs. In the present study, we evaluated the feasibility of assessing multigenerational effects in the first generation of offspring derived from exposed Daphnia magna whilst maintaining test conditions in accordance with regulatory test guidelines and guidance documents for NMs. To do so, we integrated the recommendations for ecotoxicological testing of NMs as defined in OECD Guidance Document 317 into an extended long-term D. magna reproduction test method (OECD Test Guideline 211) and assessed effects of two poorly soluble NMs (nTiO2 and nCeO2). Our results show adverse effects on life-history parameters of D. magna exposed to the selected nanomaterials within the range of reported environmental concentrations. We argue that conforming to OECD test guidelines and accompanying guidance for nanomaterials is feasible when performing D. magna reproduction tests and can minimize unnecessary duplication of similar experiments, even when extensions to the standardized test setup are added.

In the operation of electrical components in the ship engineering laboratory of the Maritime University of AMNI Semarang, various kinds of protection are needed. Errors in installing and operating electrical equipment can reduce protection. This protection aims to improve the safety of electrical work in ship engineering laboratories. And in the application of electrical work safety, it is necessary to evaluate based on the 2000 Electrical Installation General Requirements standard (PUILL 2000). The purpose of this study was to evaluate the use of the laboratory of the Maritime University of AMNI Semarang in the aspect of work safety. Based on the results of the evaluation, the criteria for electrical work safety are determined, namely: protection for safety, protection from overvoltages and currents, protection from thermal effects, and protection from fault currents. After the evaluation was carried out, alternatives were found to improve electrical safety: standard operating procedure (SOP), an inspection of cable installations, checking MCB panels and switches. The criteria and alternatives obtained then processed using the software super decision ver.2.10.0 with the Analytical Network Process (ANP) method so that the priority results of electrical safety improvements in the ship engineering laboratory of AMNI Maritime University Semarang are: repair of SOP 63.7%, cable installation 25.8%, MCB panel, and 10.5% switch.

The delivery system for Base Transceiver System (BTS) to strengthen the telecommunication network throughout Indonesia maritime country is needed to speed up the process due to uneven distribution of sufficient telecommunications infrastructure. PT. Gunadhya Rajawali Logistik (GRL) is a third-party logistics company that focuses on transportation and warehouse management and delivery for telecommunication equipment tools. Unfortunately, in delivering BTS installation part throughout Indonesia, PT. GRL received several warning letters and had to pay a penalty from one of customers, for being late in reporting the delivery proof. This study aims to analyze the root causes of late submission of Soft Copy of Proof of Delivery (SCPOD) to avoid penalty given by the customer and determine suitable solutions to improve the process. The approach used in this study is lean six sigma with the help of Define, Measure, Analyze, Improve, and Control (DMAIC) roadmap. According to the interview with the employees related, the root causes of late submission of SCPOD are irresponsible drivers, indiscipline drivers in carrying out deliveries, and lack of data management in the transportation system. To be able to solve this problem, several proposed solutions can be applied. The proposed solutions to overcome the root causes that should be applied by the company are to hire a document control, retraining the Standard Operating Procedure (SOP) for drivers, utilize transportation management system application, and apply incentive systems for drivers. In the future, it is recommended for PT. GRL to have a minimum standard in recruiting the drivers for example only recruit who possess a minimum of high school education to ease the completion of administrative tasks.

The goal of this research is to see how successful the Women's Empowerment Program is at improving the economy in Poso Regency. With the aim of answering research questions, such as how to motivate women in improving the economy in Poso district, the research approach used qualitative research and data processing with descriptive analysis methods. Data was gathered through library analysis and recording, observation, and in-depth interviews with a variety of informants, including Poso, Observers of Women, Women's Organizations, and three Home Industry Entrepreneurs from the Office of Women's Empowerment and Child Protection (DP3A) district. According to the findings of this report, the Women's Empowerment Program at DP3A Poso Regency is not succeeding. Since the program being introduced is not on track, implementation times are often late, there is a lack of executive engagement, there is no bureaucratic structure or standard operating procedure, and there are insufficient human resources. There is also a lack of communication both internally (inter-coordination) and externally (external coordination).

Background: Public health emergency is vulnerable time where maintaining ethical principles is obligatory while doing research, on the other hand, it is the same time when breach in ethics is much likely whenever a researcher is unaware, unprepared or hastens to do research. The aim of this study was to assess ethical issues of the coronavirus disease 2019 (COVID-19) related research proposals submitted during the early stages of pandemic in Nepal.Methods: Retrospective analysis of COVID-19 related research proposals and their informed consent document submitted to the ethical review board at Nepal Health Research Council was done for the study. The analysis was done as per the National Ethical Guidelines, Standard Operating Procedure for Health Research in Nepal and World Health Organization guidelines for infectious disease outbreak, 2016 under ethically relevant headings. Descriptive data were analyzed in SPSS v24.Results: The major issues were observed in the informed consent documents where 55% were lacking principal investigator’s contact information, 68% not having participant selection criteria, 70% without clear informed consent taking process, 57% without explanation of possible risks. Similarly, 68% of the interventional studies’ consent form didn’t mention possible adverse events and mitigation mechanisms.Conclusions: Most of the research proposals related to COVID-19 were devoid of major ethical elements which took longer time for receiving approval and eventually delayed the opportunity for evidence generation in critical time. More attention is needed to increase awareness and to develop capacity of researchers, reviewers, ethics committees and relevant stakeholders at the time of health emergencies.Keywords: COVID-19; ethics pandemic; research proposals

A pandemia da COVID-19 gerou mudanças normativas, gerenciais e assistenciais na área da psicologia hospitalar. Os procedimentos assistenciais foram modificados nas instituições hospitalares em decorrência da pandemia. O Procedimento Operacional Padrão (POP) orienta a execução de tarefas. O distanciamento social, criado pela pandemia, trouxe limitações para o trabalho do psicólogo. O atual relato de experiência pretende descrever e analisar o processo de readequação do POP da equipe de Psicologia Hospitalar de um Hospital Universitário do semiárido pernambucano. Essa modalidade de pesquisa de caráter qualitativa é caracterizada pela relação dos autores com o objeto de estudo. Os dados foram coletados do e-mail institucional, das atas das reuniões e do POP. A análise dos dados foi realizada considerando estudos na área da saúde mental e atenção psicossocial (SMAPS) e da pandemia da COVID-19. O POP foi elaborado considerando as restrições impostas pela pandemia, as normativas criadas pelo CFP no contexto da pandemia e a literatura especializada em SMAPS. A elaboração do documento foi realizada através de E-mail, nos quais eram realizadas a distribuição de tarefas e os profissionais compartilhavam suas análises e produções. A organização e execução do trabalho respeitaram o distanciamento social, porém desacelerou a construção do documento. O procedimento foi atravessado pela Tecnologia da Informação e Comunicação (TIC). A falta de experiência com a TIC exigiu pesquisas e aprendizagem a partir da assistência. Os profissionais discutiram o uso de novos recursos e as dificuldades associadas a esse processo, o que fomenta a pesquisa na área de atendimento psicológico on-line.

The Ministry of PUPR is the Ministry in charge of public works and public housing through the Housing and Settlements program, which is an obligation that must be held by the Central, Provincial and Regency / City Governments, related to basic services. Furthermore, the Self-Help Housing Stimulant Assistance Program (BSPS) in Padang Laweh District is a program of the Ministry of Public Works and Public Housing. The research objectives, to determine the implementation of the Self-Help Housing Stimulant Assistance program, to find out what obstacles are faced in the implementation of the Self-Help Housing Stimulant Assistance program, to find out the efforts made in overcoming the obstacles in implementing the Self-Help Housing Stimulant Assistance program. This research uses descriptive qualitative method, qualitative research methodology is a research procedure that produces descriptive data in the form of written or spoken words. Based on the results of the research conducted, the implementation of the Self-Help Housing Stimulant Assistance program can be seen from several variables, namely communication, resources, disposition, and bureaucratic structure. The results of this study indicate that in Padang Laweh Subdistrict there are still many community houses that are unfit for habitation, obstacles encountered in the field are still many people who are uninformed about the BSPS program. The BSPS program coordinates with each village under the Padang Laweh District government. The conclusion of the implementation of the Self-Help Housing Stimulant Assistance (BSPS) program in Padang Laweh District in 2019, first, information is very important for the community, secondly there must be human resources, third there must be knowledge in policy making and fourth there must be a Standard Operating Procedure (SOP) in implementation.

The mission of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is to innovate, educate, and collaborate to improve patient care. A critical element in meeting this mission is the publishing of trustworthy and current guidelines for the practicing surgeon. In this manuscript, we outline the steps of developing high quality practice guidelines using a completely volunteer-based professional organization. SAGES has developed a standardized approach to train volunteer surgeons and trainees alike to develop clinically pertinent guidelines in a timely manner, without sacrificing quality. This methodology can be used more widely by volunteer organizations to efficiently develop effective tools for practicing physicians.

Treatment of pemphigus poses a significant challenge in dermatology practice. Rituximab has recently been accepted as a first-line drug for pemphigus. This article tries to propose a standard operating procedure for the administration of rituximab.

This Standard Operating Protocol (SOP) describes the key steps of experimental setup for an inhibition assay of enzymatic activity. The protocol begins with the design of an experiment, including the choice of a catalytic reaction, optimal conditions, fraction and concentration of the active enzyme, substrate and inhibitor concentrations and the positive and negative controls. The protocol ends with the data analysis followed by a typical example of an experiment. Despite an apparently standard procedure, the assay has a number of possible pitfalls such as low fraction of the active enzyme or errors in the analysis such as application of an improper model or incorrect determination of the inhibition constant while not recognizing the dependence on enzyme concentration. The protocol provides examples of necessary steps and controls to avoid these problems and obtain highly reliable results.

The coronavirus pandemic has brought about an economic and healthcare crisis. This has resulted in delays in virtually all areas of patient care and has forced clinicians to review and adapt their processes, in order to ensure patients continue to have access to timely and effective services. In the author's local Trust, this manifested in altered protocols, developed in order to maintain patient and staff safety while conducting invasive and potentially virus-spreading investigations. A new (temporary) standard operating procedure was developed in conjunction with Cancer Alliance South West to introduce the quantitative faecal immunochemical test (qFIT) as an indicator for diagnostic testing after the majority of diagnostic services were suspended or drastically reduced. Patients would then have their investigation(s) deferred on the basis of a negative result (

The Government Performance Accountability System (SAKIP) is a systematic series of activities as well as tools and procedures designed to determine, measure, collect data, classify, summarize, and report the accountability and the improvement of government agency performance to the government. The level of performance accountability of the Directorate General of Human Settlements (Cipta Karya), the Ministry of Public Works and Housing from 2015-2019 experienced fluctuation indicating that the organizational performance management is considered not optimal. Therefore, this study elucidates the implementation of performance management (SAKIP), analyzes the root cause, and formulates a strategy to improve the implementation of SAKIP at the Directorate General of Human Settlements (Cipta Karya), the Ministry of Public Works and Housing. This qualitative research employed a case study. The result of this study revealed that the implementation of SAKIP has not run optimally with eight repeated problems as seen from the evaluation conducted by the Inspectorate General. The root causes of SAKIP implementation are the programs based on presidential directive (budgeted), no regulations/Standard Operating Procedure (SOP) related to SAKIP, no performance cascading, non-integrated information systems, leadership awareness, and evaluator capacity. The strategy for improving the implementation of SAKIP includes solving performance measurement, drafting rules/SOP related to SAKIP, constructing the performance tree, integrating information systems, and SAKIP training for leaders and evaluators. The performance management issues for each organization are different. Thus, future researchers are expected to conduct further research related to performance management in various central and local government organizations. Keywords: Performance Management, Accountability, Government, SAKIP, Strategy.