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"Latar Belakang: Petani sawit seringkali terpajan dengan berbagai macam polusi berupa debu dari pupuk dan pajanan pestisida.Pestisida yang paling sering digunakan adalah organofosfat (OP) dan insektisida karbamat (34%). Tingkat kejadian penyakit pernapasan yang berhubungan dengan pestisida di tempat kerja sebesar 1,17 per 100.000 penuh waktu pekerja setara (FTEs).Tujuan: Menilai faalparu dan kadar kolinesterse serum padapetani sawit di Kuantan Singingi, Propinsi Riau.Metode: Penelitian cross sectional pada petani sawit di Kuantan Singingi, Propinsi Riau  bulan Agustus 2018. Sampel diambil dengan teknik cluster sampling. Variabel yang dinilai adalah karakteristik sosiodemografik, klinis, spirometri dan serum kolinesterase. Analisis data menggunakan program SPSS 20.0 dengan hasil dinyatakan berbeda bermakna bila p<0,05.Hasil: Didapatkan 116 subjek penelitian dengan rerata usia 34,5±8 tahun, berjenis kelamin perempuan (87,1%), tingkat pendidikan terakhir SD (59,5%), tidak merokok (89,7%), dan masa kerja >2 tahun (84,5%). Indeks Massa Tubuh median 24,5 Kg/m² (16,85 – 44,44 Kg/m²) dan rerata kolinesterase serum 8,1±1,5 kU/L. Hasil spirometri menunjukkan kelainan restrikif pada 21,6% dan obstruktif pada 0,9% subjek penelitian. Hasil analisis menunjukkan terdapat  hubungan antara lama pajanan (p=0,035) dengan kelainan faal paru. Analisis korelatif antara lama masa kerja dengan KVP (r_s=-0,205; p=0,027), VEP₁ (r_s=-0,235; p=0,011) dan VEP₁/KVP (r_s=-0,234; p=0,011).Kesimpulan: Rerata kolinesterase serum petani sawit di Kabupaten Singingi, Propinsi Riau sebesar 8,1±1,5 kU/L dan terdapat hubungan antara lama pajanan pestisida dengan kelainan faal paru.

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Background: Palm oil farmers are in risk to be exposed to various kinds of pollution, pesticide and fertilizer. Organophosphate (OP) and carbamate 34% insecticidesare the common pesticides used in palm oil farms. The incidence rate of pesticide-related respiratory diseases at work is 1.17 per 100.000 full-time equivalent workers (FTEs).This studyaims to characterize lung function and serum cholinesterase levels of palm oil farmers in Kuantan Singingi Regency, Riau, Indonesia.Methods: This cross-sectional study involved oil palm farmers in the study location on August 2018 by cluster sampling design. Sociodemographic, clinical, spirometry and serum cholinesterase level characteristics were observed and statistically analyzed.Results: The study involved 116 subjects with mean age of 34.5±8 y.owhich predominated by females (87.1%), elementary school degrees (59.5%), non-smokers (89.7%) and workers with working period >2 years (84.5%). Mean body mass index was 24.5kg/m² (16.85–44.44 Kg/m²) and mean serum cholinesterase was 8.1±1.5kU/L. Spirometric examination showed restrictive (21.6%) and obstructive (0.9%) lung function. There was a significant correlation between length of working period and FVC (r=-0.205; p=0.027), VEP₁ (r=-0.235; p=0.011) and VEP₁/FVC (r=-0.234; p=0.011). There was no significant difference of serum cholinesterase level between abnormal lung function groups (p> 0.05).Conclusions: The mean serum cholinesterase of palm oil farmers was 8.1±1.5kU/L. The study showed there wascorrelation between the duration of exposure to pesticides and lung function abnormalities."

"Penelitian dengan desain potong lintang ini membahas cakupan pengguna kacamata (CPK) pasca operasi katarak terkait status sosioekonomi. Hasil penelitian menunjukkan usia, informasi dokter dan tingkat ekonomi rumah tangga (ruta) berhubungan kuat terhadap proporsi pengguna kacamata (p<0,05). Kelompok usia produktif memiliki CPK lebih rendah namun penelitian ini hanya melibatkan usia 50 tahun keatas sehingga tidak mempresentasikan usia produktif seluruhnya. Kelompok yang menerima informasi dokter memiliki CPK lebih tinggi dari yang tidak menerima informasi dan CPK pada kelompok tingkat ekonomi ruta kaya lebih tinggi dibanding ruta lainnya. Kesimpulannya adalah semakin tinggi informasi dokter dan tingkat ekonomi ruta maka semakin tinggi nilai CPK.

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This study discussed the correlation between socioeconomy and spectacle coverage rate (SCR) after cataract sugery. The multivariate analysis showed that physician information, age and the economic level of household had a strong relation with SCR (p<0.05). Productive age had a lower SCR. This study included age of 50 and above, therefore it did not represent the real proportion of productive age. Participants who received physician information to use spectacle after cataract surgery had a higher SCR. Physician information is important in influencing SCR. The richest household had the highest SCR. The richest the household was, the highest value of SCR."

"Industri perkapalan adalah sebuah industri padat modal dan padat karya yang ikut menopang perkembangan Industri di Indonesia. Industri perkapalan melakukan kegiatannya yaitu pembuatan kapal dan reparasi kapal dan memiliki resiko yang beragam, salah satu resiko yang penting adalah resiko penurunan kualitas lingkungan galangan kapal akibat banyaknya kapal yang direparasi di atas Dok. Manajemen resiko di Industri galangan Kapal adalah manajemen pengalihan resiko yang mampu mengelola bahaya potensi resiko lingkungan dalam bentuk Asuransi Lingkungan Analisa pengalihan resiko lingkungan ditentukan dari faktor-faktor analisa resiko (nilai resiko) estimasi resiko (karakteristik resiko) dan permodelan asuransi lingkungan (preventive cost & risk based margin) dengan menggunakan metode SAST (Strategic Assumption Surfacing and Testing) dan metode PPA (Participatory Perspectives Analysis) dan hasilnya faktor resiko terbesar adalah faktor penggerak yaitu risiko pencemaran galangan akibat sandblasting dalam proses reparasi kapal yang diikuti faktor pengungkit yaitu limbah cat, karat, tritip dan lain-lain. Model asuransi lingkungan progresif adalah yang terbaik untuk pengalihan resiko lingkungan di dalam reparasi kapal dengan membangun instalasi Dok yang ramah lingkungan yaitu Instalasi Graving Dok. Waterblasting dan cat antifouling yang ramah lingkungan dan pembebanan preventive cost terhadap stakeholder atau dapat menggunakan rumus atau formula biaya premi Asuransi Lingkungan yang dibebankan kepada kapal-kapal yang melakukan kegiatan reparasi di atas Dok.

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The shipyard industry is a capital- and labour-intensive industry, which also supports Indonesia?s industrial development. In carrying out its activities, which include shipbuilding and ship repair works, the shipyard industry is challenged by a number of risks, one of the crucial ones being the risk of deterioration of the shipyard environmental quality due to the great number of ships repaired in the docks.

Risk management practice in the Shipyard Industry involves transferring risks to manage potential environmental risk threats through the use of Environmental Insurance. Environmental risk transfer analysis is determined by risk analysis factors (risk values), risk estimates (risk characteristics), and environmental insurance modeling (preventive cost & risk-based margin) using SAST (Strategic Assumption Surfacing and Testing) and PPA (Participatory Perspectives Analysis) methods. The results demonstrate that the biggest risk factor - also a driving factor - is the risk of shipyard contamination due to the sandblasting process in a series of activities in ship repair, followed by leverage factors, which are paint wastes, rust, barnacles, and others.

The most suitable progressive environmental insurance model for environmental risk transfer within the scope of ship repair suggests the installation of environmentally friendly docks, namely Graving Docks. Water blasting, the use of environmentally friendly antifouling paints, or charging preventive costs to stakeholders may be calculated based on the Environmental Insurance premium calculation formula and are charged to ships repaired on such docks."

"Latar Belakang: Kanker paru menjadi penyebab kematian utama akibat keganasan pada laki-laki sebesar 31% dan perempuan sebesar 27%. Pada pasien adenokarsinoma paru dengan mutasi pada exon 20 T790M memberikan respons yang buruk terhadap terapi EGFR-TKI generasi pertama maupun generasi kedua. Tujuan: Mengetahui profil serta angka tahan hidup 1 tahun pasien kanker paru jenis Adenokarsinoma dengan mutasi exon 20 T790M primer. Metode: Penelitian menggunakan desain kohort terhadap pasien-pasien adenokarsinoma paru stadium IV dengan mutasi exon 20 T790M primer dari bulan September 2015 sampai Desember 2017 di RSUP Persahabatan. Variabel yang diteliti adalah karakteristik klinis dan angka kesintasanberdasarkan kurva Kaplan Meier. Hasil analisis dinyatakan berbeda bermakna apabila nilai p<0,05. Hasil: Didapatkan 27 subjek penelitian dengan rerata usia 58,5 tahun dan berjenis kelamin laki-laki (70,6%). Keluhan utama berupa sesak napas (73,5%) dan nyeri dada (55,9%). Mutasi genetik tunggal pada Exon 20 T790M (64,7%), sedangkan mutasi Exon 20 T790M dengan Exon 21 L858R (11,8%) dan mutasi Exon 20 T790M dengan 21 L861Q (8,8%). Organ target metastasis adalah efusi pleura (73,5%), tulang (26,5%) dan otak (20,6%). Angka kesintasan 360 dan 990 hari sebesar 35% dan 20% dengan median kesintasan sebesar 213 hari. Kesimpulan: Mutasi exon 20 T790M pada adenokarsinoma paru memegang peranan penting terhadap kesintasan dan prediktor responsterhadap terapi yang diberikan.

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Background: Lung cancer causes mortality in men (31%) and in women (27%). Lung adenocarcinoma patients with exon 20 T790Mepidermal growth factor receptor(EGFR) mutation showed poor response to the first generation and second generation of EGFR tyrosine kinase inhibitor (TKI) therapy.

Purpose: This study aims to reveal the characteristics and one year survival rate of lung adenocarcinoma patients with primary exon 20 T790M EGFR mutations treated at Persahabatan Hospital Jakarta, Indonesia.

Methods: The cohort study involved patients with primary exon 20 T790M EGFR mutation between September 2015 to December 2017 in Persahabatan Hospital Jakarta, Indonesia. The survival rate was observed from Kaplan Meier estimator curve and was statistically analyzed.

Results: There were 27 subjects with mean age of 58.5 years and were predominated male (70.6%). The most common chief complaints were shortness of breath (73.5%) and chest pain (55.9%). The EGFR mutations detected were exon 20 T790M (64.7%), exon 20 T790M with exon 21 L858R (11.8%) and exon 20 T790M with exon 21 L861Q (8.8%). Metastatic target organs were pleural effusions (73.5%), bone (26.5%) and brain (20.6%). Survival rate of 360 and 990 days was 35% and 20% respectively with median survival rate was 213 days.

Conclusion: Exon 20 T790M EGFR mutation in lung adenocarcinoma was revealed to be an important factor in survival and in predicting response to EGFR TKI chemotherapy."