Practice License Research Articles

CRIMINAL LAW ENFORCEMENT ANALYSIS AGAINST INDEPENDENT PRACTICE MIDWIVES IN COMMITTING UNLAWFUL ACTS

The phenomenon of maternal and infant mortality in Banten Province is still high. Based on data released by the United States Agency for International Development (USAID) Jalin, in Banten Province every week there are an average of 5 mothers and 27 newborns who die the highest deaths are in Pandeglang Regency with 59 cases. and when the public's need for health services increases, especially midwife services, it is not balanced by the expertise and skills of midwives to form a good service work mechanism. So often we also find midwife services not in accordance with their authority. The problems that the author will discuss are related tothe criminal law enforcement of the actions of midwives who are against the law and the authority of independent practice services in Pandeglang Regency and theimplementation of legal policies regarding criminal acts in cases of malpractice in Pandeglang Regency. The method used in this study is a normative juridical descriptive method using a problem approach with the Law by prioritizing primary data and secondary data. The results of this study that midwives who carry out obstetric services are not in accordance with applicable regulations, will be sanctioned in accordance with the Minister of Health of the Republic of Indonesia Number. 1464/Menkes/PER/X/2010 on the licensing and administration of midwife practices. Sanctions given to midwives can be in the form of revocation of the midwife's practice license, revocation of Surat Izin Praktek Bidan temporary, or it can also be a fine. In addition, midwives can also be sentenced to prison if they violate the laws and regulations. If a midwife violates the code of ethics, the settlement of this matter is carried out by the midwife professional forum, namely the Midwife Professional Council or the Indonesian Midwife association.Keywords: Law Enforcement, Midwives, and Unlawful Acts

PEMODELAN DAN SIMULASI ANTRIAN UNTUK MEMPERBAIKI WAKTU TUNGGU POLIKLINIK VITREORETINA RS MATA “DR.YAP” YOGYAKARTA

Background: Queuing problems often occur in the health care industry, such as hospitals. The problem has arisen because many requests access the services, but it is in imbalance with the adequacy of providers. Increased outpatient visits at the vitreoretinal polyclinic at the “Dr. YAP” causes long queues and long waiting times. Meanwhile, waiting time is an essential indicator of service quality in hospitals and affects patient satisfaction. Queueing model and simulation can be one method to identify queuing process problems and find the most optimal queuing scenario.
 Objectives: Identify the queuing system model at the vitreoretinal polyclinic service at the “Dr. YAP”, analyze the vitreoretinal polyclinic queuing system’s performance measures, and identify the optimal queuing scenario through simulation to improve the total waiting time.
 Methods: This research was conducted in two stages. The first stage is a quantitative descriptive analysis where the queue performance parameters are calculated. Data collection techniques used in this
 research are observation to obtain primary data (patient arrival time, service time, and waiting time on each server) and interviews to get supporting data. The second stage is the study of model construction. At this stage, the simulation model is designed to predict changes in patient waiting time for several scenarios using Ms. Excel and JaamSim software.
 Results: The queuing system model in the vitreoretinal polyclinic is Multi-Channel Multi-Phase, consisting of 3 queue phases with more than 1 server. A total of 338 patients were served, and the patients’ largest distribution for total waiting time was patients who waited for > 2 hours (41.12%) and between 1-2 hours (37.57%). The longest waiting time is for a doctor’s check-up length of 1 hour and 47 minutes. Several queuing scenarios were made from several identified problems. The first scenario, simulating the doctor’s arrival on time, reduces 25% of the total waiting time to 1 hour and 20 minutes. In the second scenario, separating the laser procedure schedule reduces 4% of the waiting time to 1 hour and 43 minutes. By combining scenarios 1 and 2, the third scenario reduced the total waiting time by 29% to 1 hour and 16 minutes. The fourth scenario is carried out
 through modeling on the JaamSim software by adding one doctor and one nurse, and the result is that there is a decrease in waiting time and the number of patients waiting in queues.
 Conclusions: Hospitals can take several ways to improve the waiting time. The first is to improve the punctuality of doctor’s practice time. This effort can be made by evaluating the starting hours of a doctor’s
 practice following the doctor’s feasibility and using an information system that can send automatic messages to the patients regarding the doctor’s practice start time and the patient’s arrival time. The second is the separation of the queue for laser procedures from the polyclinic queue. Laser procedures for reserved patients can be scheduled before the start of practice, after the practice, or on another day. Third, the addition of a Retinal Subspecialist Doctor and nurses at certain hours when there is no retinal schedule. The doctor is a preferably permanent doctor who has first practice license at the “Dr. YAP” Eye Hospital.

Developing and sustaining advanced practice provider services: A decade of lessons learned.

Developing and sustaining advanced practice provider services: A decade of lessons learned.

Integrating training, practice, and reflection within a new model for Canadian medical licensure: a concept paper prepared for the Medical Council of Canada.

In 2020 the Medical Council of Canada created a task force to make recommendations on the modernization of its practices for granting licensure to medical trainees. This task force solicited papers on this topic from subject matter experts. As outlined within this Concept Paper, our proposal would shift licensure away from the traditional focus on high-stakes summative exams in a way that integrates training, clinical practice, and reflection. Specifically, we propose a model of graduated licensure that would have three stages including: a trainee license for trainees that have demonstrated adequate medical knowledge to begin training as a closely supervised resident, a transition to practice license for trainees that have compiled a reflective educational portfolio demonstrating the clinical competence required to begin independent practice with limitations and support, and a fully independent license for unsupervised practice for attendings that have demonstrated competence through a reflective portfolio of clinical analytics. This proposal was reviewed by a diverse group of 30 trainees, practitioners, and administrators in medical education. Their feedback was analyzed and summarized to provide an overview of the likely reception that this proposal would receive from the medical education community.

IZIN PRAKTIK TENAGA KESEHATAN TRADISIONAL KOMPLEMENTER YANG BERKEPASTIAN HUKUM

A license to practice complementary traditional medicine is the granting of a license to an individual or entity that establishes a health service facility. Everyone who provides complementary traditional medicine services is required to have a practice license. This legal research aims to determine the regulation regarding the license to practice complementary health workers in providing health services in the field of complementary traditional health. The type of research used is normative legal research. The approach used is using the legal approach (statute approach) and the conceptual approach (conceptual approach). Based on this research, shows that the regulation of the practice of complementary traditional health workers refers to the Minister of Health Regulation Number 15 of 2018 concerning the Implementation of Complementary Traditional Medicine. Independent practice must have a practice permit marked by having STRTKT and SIPTKT. As for the agency that establishes (Griya Sehat), it must have an operating permit, where the permit is granted by the district/city health office. On the other hand, with a legal practice permit, traditional complementary health services can be accounted for their benefits and safety so that a health worker can be held accountable for the services provided. In this case, the Government must also regulate and supervise the safety, interests, and protection of clients

Legal Responsibility of Substitute Doctors Who Do Not Yet Have a License to Practice

The purpose of the need for a Practice License for a doctor is, Protection for the public and health workers, if the practice of medicine causes adverse effects on the physical, mental health or life of the patient. Then it becomes a guide for health workers in providing services to the community must have qualifications, competence, and licenses or legality, as well as community empowerment, professional organizations & existing institutions. This study aims to find out how the authority and legal consequences of substitute doctors who do not have a license to practice against the patient's losses. In this writing, the method used by the author is a type of normative legal research. Using laws and regulations and other relevant reference materials, then analyzed with applicable laws relating to the practice of doctors without a license to practice. The result of this study is the service for obtaining licenses for medical practice should be disseminated to the wider community so that the public knows how to take care of licensing, especially doctor's licenses and the service for obtaining licenses for medical practice should be disseminated to the wider community so that the public knows how to take care of licensing, especially doctor's licenses.

POLITIK HUKUM PEMBATASAN TEMPAT PRAKTIK DOKTER

This article aims to discuss about the legal arrangements against of based on legal policy in Indonesia. With restrictions on the place of practice creates legal uncertainly. Forms of constitutional loss experienced by doctors are reduced or limited space for the medical profession. Meanwhile, on the other hand, the restrictions on the place of practice make public access to obtain and choose adequate and quality health services no longer possible to actualize properly, considering that safe, quality and affordable health services are also the right of all Indonesian people. Type of this research is normative juridical research, with the approach of related laws and regulations, the collection of legal materials is carried out by literature study, namely collecting legal materials with a systematic method. The obtained data were then collected and analized in depth, then submitted descriptive qualitatively. The results showed that the restrictions of doctor’s practice license in three places as regulated in Article 37 paragraph (2) of the Medical Practice Law is based on various considerations and wich is not contradicting with the 1945 Constitution of the Republic of Indonesia. In addition, it can provide legal protection for doctors as health provider as well and the patients as health receiver.
 
 Keywords: Legal Policy, Restrictions, Doctor’s practice

Juridical Aspects Of Complementary Traditional Medicine In Indonesia

Alternative, complementary medicine is non-conventional medicine aimed at improving public health status, including promotive, curative, preventive, and rehabilitative efforts obtained through structured education with high quality, safety, and effectiveness based on biomedical science, which has not been accepted in conventional medicine. In several hospitals in Indonesia, this complementary medicine has begun to be applied as supportive therapy or replacement therapy for patients who refuse traditional treatment methods. This complementary therapy can also be carried out at the patient's request or with the referral of other doctors. The approach method used in this study, namely normative juridical, is a method of legal research conducted on library materials or secondary data using deductive thinking methods based on truth criteria. Coherent. There is also a complementary therapy called holistic medicine, which is because the form of therapy can affect individuals. The limitations of conventional medicine are one of the reasons why complementary and alternative therapies are an option in treating/healthy Indonesian people. The development of complementary and alternative therapies must be the responsibility of health workers, especially nurses. Legality for complementary and integrated health services must have a Traditional Health Worker Registration Certificate (STRTKT) and a Traditional Health Worker Practice License (SIPTKT).

POSTPARTUM ACUYOGA SEBAGAI PELUANG USAHA MANDIRI BIDAN DI ERA MILLENIAL PRODI KEBIDANAN CURUP TAHUN 2020

The paradigm of midwifery services at this time has experienced a shift where the high public interest in quality midwifery services demands midwifery service innovation and creativity from midwives. Many forms of entrepreneurship from the Midwife's Independent Practice are an option for midwives to increase the types of complementary midwifery services holistically (Body, mind and Spirit) to reduce medical interventions during pregnancy and postpartum, one of which is postpartum acuyoga, a combination of acupressure and yoga. The purpose of this community service is to provide information on knowledge and skills about postpartum Acuyoga to alumni of the Curup Midwifery Study Program who already have a Midwife Practice License. The method used in this community service is a workshop which is carried out for 3 days including the activities on the first day, namely the delivery of material about the independent business opportunities of midwives and Postpartum Acuyoga followed by the second day, namely the practice of Postpartum Acuyoga. This activity went smoothly and was attended by 30 midwives, where all participants were able to participate in the activity for 3 days without any obstacles. Participants understand the importance of innovating in developing midwifery services so that they can increase their income and experience in entrepreneurship.

Analysis of Medical Legal Order as A Basis For Settlement of Medical Malpractice Disputes

This study aims to determine whether the medical legal order can provide a solution for resolving medical disputes carried out by doctors against health service recipients in hospitals. The absence of a malpractice law creates confusion in decision making when doctors become involved in medical disputes. As primary legal material, is has a strong legal basis in making decisions on sanctions that can be imposed on doctors who commit malpractice by violating the professional code of ethics or working not according to standard operating procedures. The methods used are normative legar research methods and library legal research by conducting critical analysis on primary and secondy legal materials. The results of the study have shown that malpractice acts committed by doctors have a clear legal accountability mechanism ,as regulated in Health law number 36 of 2009, law number 29 of 2004 concerning medical practice.Administratively all forms of malpractice committed by docors can be threatened with criminal,civil,administrative sanctions an fines. At a more final level, administrative sanctions from malpractice acts committed by doctors can lead to on revocation of practice license.

Methodological Considerations in the Professional Accreditation Research

This essay paper provides methodological considerations for research on turnaround management (business rescue) practitioner (BRP) accreditation. The article responds to recent BRP licensing debates and the need to enhance BRP capabilities through continuing professional development (CPD). We assess existing data collection procedures using the practice theory and demonstrate sequenced integrated data collection procedures (IDCPs) to study BRPs’ professional accreditation frameworks. We illustrate IDCPs using a research design for “how BRPs should be accredited by their professional bodies (PBs) before obtaining a practice license”. The proposed IDCPs call for the purposeful interpretation of legislative instruments governing BRP work and other multiple-party data collection techniques. The paper lays out the problems associated with using questionnaire surveys and semi-structured interviews to document BRP practices and the required professional capabilities. We propose a research design to illustrate the application of the IDCPs in a multiple PB occupation.

Implementasi Standar Pelayanan Kefarmasian di Apotek Kupang

According to applicable standards, pharmaceutical services strongly support the role of pharmacists in realizing quality pharmaceutical services to protect patients and the community and provide legal certainty for pharmaceutical personnel. This study aims to evaluate the implementation of pharmaceutical service standards in pharmacies by pharmacists in Kupang City. This study uses a quantitative descriptive approach. Data were collected using a questionnaire adapted from Regulation of the Minister of Health Number 73 of 2016 concerning Pharmaceutical Service Standards in Pharmacies. The population in this study were all pharmacies in Kupang City, totaling 90 pharmacies based on data from the Health Service, with valid pharmacy permits. Respondents are pharmacists who have a valid practice license in pharmacies and are willing to participate in the survey. A total of 66 respondents returned the questionnaire, and 64 were declared complete and qualified for analysis. Data were analyzed using univariate analysis with SSPS 25. The results showed that 53.75% of pharmacies in Kupang City had implemented pharmaceutical service standards in pharmacies by Regulation of the Minister of Health Number 73 of 2016, while 46.25% have not implemented service standards properly. Pharmacies that manage pharmaceutical preparations, medical equipment, and disposable medical equipment (BMHP) according to standards are 66.1%, and clinical pharmacy services are 41.4%. The conclusion shows that pharmaceutical service standards in pharmacies have not been carried out optimally by pharmacists in Kupang City.

Komputerisasi Sistem Informasi Keanggotaan DPC PORMIKI Solo (SIKPOSO) Berbasis Android

The Solo branch of the Indonesian Association of Medical Recorders and Health Information Professionals (PORMIKI) serves various kinds of correspondence requests from members. Services that are done manually cause the service to be slow. With a well-developed information system, it is hoped that the membership service process will be faster and easier. PORMIKI Solo Membership Information System (SIKPOSO), is an information system in the form of a mobile application with the Android operating system. The form of the mobile application was chosen considering the ease of access for members of PORMIKI (Indonesian Association of Medical Recorders and Health Information Professionals). The design of SIKPOSO includes the preparation of Flowcharts, Use Case Diagrams, Entity Relationship Diagrams, Data Flow Diagrams, Activity Diagrams, Wireframes, and User Interfaces as a reference for developing membership systems that currently do not exist. The method used in the development of this system is the Prototyping method.
 SIKPOSO is designed to provide 6 service menus, as Request for recommendation of Practice License (SIK), Request for Membership Mutation Letter, Virtual Member Card (KTA), Membership Information, Annual Fee Information and Event Information. Evaluation of the SIKPOSO design was carried out using the SUS (System Usability Scale) questionnaire, getting the final score of 77 indicating that SIKPOSO is on a B grade, have a good rating and can be accepted by user for further development.

NCLEX-RN© preparation resources available online in French: An integrative review.

This review describes the availability of online French NCLEX-RN© preparation resources for candidates BACKGROUND: One entry to practice requirement for Canadian nurses is to successfully pass a licensing exam upon graduation from their educational program. In 2015, the American NCLEX-RN© replaced the Canadian entry to practice licensing examination which was offered in Canada's two official languages: English and French. The NCLEX-RN© was developed in English and later translated to French. Since its implementation, Francophone candidates and educators in Canada have reported a lack of preparatory resources available in their language and have had substantial lower NCLEX-RN© pass rates, consistently below 50% METHODS: An integrative review using Whittemore and Knafl's framework was conducted between February and May 2019, and updated in September 2020, through online searches of CINAHL, PubMed, Science Direct and Google Scholar databases. Grey literature was included from 2012 onwards. Results are presented narratively. A total of 17 French language preparatory resources were found. These resources were categorised into four main groups: (1) What is the NCLEX-RN© ?; (2) What do I need to do prior to writing the NCLEX-RN© ?; (3) What is assessed through the NCLEX-RN© ? and finally, (4) How can I practice before taking the NCLEX-RN© ? Limited French-language NCLEX-RN© preparatory resources exist for Francophone candidates. Furthermore, practice questions in French are few compared to what is available in English IMPLICATIONS FOR NURSING AND NURSING POLICY: Other countries may consider implementing an entry to practice exam such as the NCLEX-RN© because of its availability in both the French and English language, as well as the possibility of translating the exam to other languages, creating a potential market for this test around the globe. The lack of preparatory resources in French is a major concern to Francophone candidates undertaking such a high-stakes examination in their language. Nursing stakeholders and policy leaders should acknowledge that such gaps place Francophone writers in a disadvantaged position in comparison to their Anglophone counterparts.

A practical approach for gmp-compliant validation of real-time PCR method for mycoplasma detection in human mesenchymal stromal cells as advanced therapy medicinal product

BackgroundManufacturing of human Mesenchymal Stromal Cells as advanced therapy medicinal product (ATMP) for clinical use involves an ex vivo expansion, which leads to a risk of contamination by microbiological agents. Even if manufacturing under Good Manufacturing Practice (GMP) license minimizes this risk, contamination of cell cultures by mycoplasmas still represents a widespread problem. Furthermore, the absence of mycoplasma contamination represents one of ATMPs release criteria. Since July 2007, European Pharmacopoeia (EuPh) offers the possibility to replace official mycoplasma detection methods with Nucleic Acid Amplification techniques, after suitable validation. As an Italian authorized Cell Factory, we developed an in-house GMP-compliant validation of real-time PCR method for mycoplasma detection in human Mesenchymal Stromal Cells, according to EuPh sec. 2.6.7 and International Conference on Harmonization Q2. Materials and methodsThe study was performed in compliance with GMP international requirements with MycoSEQ™ Mycoplasma Detection Assay (Thermofisher) on QuantStudio5 real-Time PCR (Applied Biosystems). Assay validation was developed to evaluate sensitivity, interferences matrix-related, specificity and robustness. ResultsMycoSEQ™ Mycoplasma Detection Assay has been successfully validated on human Mesenchymal Stromal Cells as results comply with validation protocol acceptance criteria. ConclusionsMycoSEQ™ Mycoplasma Detection Assay is a fast, sensitive and specific PCR-based Nucleic Acid Test assay that can be used as an alternative to official mycoplasma test methods for lot release of human Mesenchymal Stromal Cells as advanced therapy medicinal product (ATMP). Moreover, our study underlines the presence of interference on real-time PCR reaction due to matrix composition, pointing out a practical approach for method validation (i.e interference removal).

Medication Error at the Prescribing Phase

Medication errors are accidental failures in a therapeutic process that lead to and have the potential to cause or harm the patient. Medication errors can endanger patient safety, inconvenience and economic burdens. Medication errors can occur at the prescribing, recording, issuing, and administering stages. Reducing the risk of medication errors is a shared responsibility among patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. This research is a quantitative research with a descriptive approach. The population taken was 912 prescriptions written by general practitioners at the PKU Muhammadiyah Cepu Hospital in March-May 2019. The sampling technique used was non-probability sampling, which was total sampling. The instrument used in this study was an observation sheet, then the collected data were processed by editing, coding, scoring, and tabulating stages which were then concluded descriptively. The results showed that the incidence of drug prescribing errors in inpatients at PKU Muhammadiyah Cepu Hospital in March 2019 found that all written prescriptions were 100% administratively incomplete. The incidence of prescription medication errors, especially the doctor's name, was 65.9%, the doctor's practice license number was 100%, the date of the prescription was 48.9%, the sign of R/70.9%, the doctor's initial 48.7% and the patient's address 97.4%. Incomplete administrative prescription writing can result in medication errors that are detrimental to health and add to the economic burden of patients.

Implementation of Mediation as an Alternative for Medical Dispute Resolution in Hospitals Based on Law No. 36 of 2009 concerning Health

The Law on Health does not explicitly explain mediation in resolving a dispute between a doctor and a patient, so there are still many disputes that go directly to litigation, so the number of cases piles up in court. The method used in this paper uses a normative legal type method, with a statutory approach, using primary legal materials, by collecting data by literature study, then analyzed using qualitative methods. Disciplinary sanctions imposed on violations of physician discipline as stated in Law No. 29 of 2004 article 69 in the form of a written warning, revocation of the registration certificate or practice license, and the obligation to attend medical or dental education.

The study of mixed assets allocation based on Black–Litterman model

With Private Funds having a new type of license for asset allocation practice in China, comprehensive asset allocation cross private equity and stock market has received more attention. However, most of the studies focus more on the stock market, and asset allocation models for private equity market that are mainly made based on experience. Thus, the joint allocation of assets crosses both markets making it a challenging research topic. This paper introduces the Black–Litterman model into the private equity market, realizing the transition from qualitative models to quantitative models. It lays a solid quantitative ground for the mixed asset allocation model in both the markets.

Introducing a Structured Blended Medical Educational Program to Family Medicine Physicians in Sudan Medical Specialization Board (SMSB)-Sudan-2019

Introduction: This project is a learning program; medical teaching-learning and innovation (MTLI). MTLI is a spirited, dynamic, innovative, and up to date educational process depending on the advanced technology and learner’s preference. One of the requirements of this course to write a medical education project. Continuing medical education (CME) is any activity that serves to preserve, boost, or raise the knowledge, skillfulness and professional performance and relationships that physicians use to supply services to all patients. Continuing professional development (CPD) is the central part of requirements for recertification, earning and renovation of a license of practice in several countries. Purposes: We observe the current methods of learning are deficient because of misunderstanding and misuse of technology, the time factors of learners, lack of flexibility and simplicity of learning tools and the lack of communication between the educator and students thereby. The main issue is the learning to assess the Sudanese family physicians’ learning needs in SMSB, to meet the learning needs, to earn new knowledge, approaching the diagnosis, new laboratory tests, medicine, skills, and procedure by discussing the major/professional, governmental agencies and associations/societies and case base problem. The overall objective to cover the professional practice gap. Perspectives: Enhancing critical thinking of physicians for the up-to-date major/professional, governmental agencies and associations/societies through introducing a structured blended-learning program, self-directed education plus group discussion of family medicine physicians to improve clinician knowledge, strengthen clinician skills, best clinician performance, and perfect clinical outcomes. The potential impact of the project: The combination of different methods of teaching is something each professional teacher should not only know but also implement in their classroom so, we need to use multiple methods of learning for the best learning effectiveness to serve as a resource for all health professionals responsible for providing primary care to patients, especially those who may not have been adequately trained in the large variety of areas that make up comprehensive primary care for the organization, patients and physicians’ benefits. Conclusion: A single method of medical teaching and learning has a little impact, it is not enough to get benefits so, teaching should encompass multimedia, multiple instructional techniques, and numerous exposures whenever possible.

Nurse Practice License Policy (Study on the Implementation of the Nurse Practice License Policy in Lamongan Regency)

The implementation of nursing practice is regulated in Law No. 38 of 2014 concerning Nursing. Nurses who work must have a Nurse Practice License, which is abbreviated as SIPP (Surat Izin Praktik Perawat). Nurses are required to have SIPP1 to work in health care agencies and are required to have SIPP2 if they practice independent nursing. Researchers noticed some problems related to the license policy. The purpose of this study was to analyze and develop a model for implementing a nurse practice license policy in Lamongan district. The researcher used George Edward III's theory of public policy implementation.The research method used was descriptive qualitative design with a phenomenological approach. The source of data were obtained from informants and document studies. Informants in this study were policy implementers, namely from professional organizations, health offices, licensing offices and policy recipients, namely nurses. The data were collected through in-depth interviews and observations.The results showed that the communication factor between policy implementers was running well, but communication between implementers and policy recipients was still not optimal. In the resource factor, there were nurses with different educational backgrounds and different levels of competence. The disposition factor showed a commitment from the local government to support the implementation of the nurse practice license policy in Lamongan district. Regarding the bureaucratic structure, there were already local regulations governing the policy for nurse practice license.Supporting factors for the implementation of the nurse's practice license policy were in the form of laws and regulations regarding nursing. Inhibiting factors are gray areas in nursing practice, community perceptions of nurse practices, nurse competence according to the type of nurse and educational background.In conclusion, the implementation of the nurse practice license in Lamongan Regency has been running but not optimal. The researchers recommend an evaluation towards the nurse's practice license policy and carry out research findings. Keywords: Policy, Nurse Practice License DOI: 10.7176/PPAR/10-11-03 Publication date: November 30 th 2020