Real Evidence Research Articles

(Invited) Electrochemical Microbiosensors for Real-Time Monitoring of Reactive Oxygen Species in Living Tissues

Understanding fundamental mechanisms involved in the progression and development of diseases is of great physiological and pathological importance. Such studies require the availability of effective methods to probe biochemical processes in real time and allow accurate detection and quantification of biomarkers and mediators of injury. Study of the role and mechanism of action of these mediators is also critical to develop therapies and assess pharmacological effects. However, the presence of these chemicals at very low concentrations and variable levels and the complexity of the biological environment pose a great challenge for their detection. Using custom designed microelectrodes, electrochemistry provides unique opportunities to detect reactive species in living tissues, providing direct and real time evidence of reactive oxygen (ROS) levels with high spatial resolution. This presentation will discuss our efforts to fabricate microbiosensing platforms for investigating fundamental physiological and biochemical mechanisms in vivo and in vitro, particularly those associated with ischemia and reperfusion injury. The influence of the microelectrode design parameters including surface coatings and electrode size, and the ability of the sensor to obtain quantitative spatial and temporal analytical data of the release and distribution of oxidative stress markers will be provided with examples of applications. Advantages and limitations of these systems for measurements in real biological environments will be discussed. Our results demonstrate the potential of electrochemical techniques to generate information about biomarkers and obtain fundamental biochemical-relevant information on physiology, metabolism and disease states in living systems.

Cenobamate as add-on therapy for drug resistant epilepsies: effectiveness, drug to drug interactions and neuropsychological impact. What have we learned from real word evidence?

Background: Cenobamate (CNB) is an anti-seizure medication (ASM) approved in 2021 in Europe for adjunctive treatment of focal-onset seizures in adults who were not adequately controlled with at least two previous ASMs. Methods: seizure outcome, treatment-emergent adverse events, neuropsychological profile, and blood levels of CNB and concomitant ASM were analyzed in a real world setting in two different Italian epilepsy centers in the context of CNB early access program. All patients performed a general cognitive evaluation, while 32 patients underwent the administration of a battery of neuropsychological tests at baseline and 6months after CNB treatment. We performed CNB quantification in plasma in 31 patients at different doses in the range of 100-400mg/day (65 measures). Results: we enrolled 54 patients with a median age of 27.9years. The mean follow-up was 10.7months. Most (91%) completed the efficacy analysis. At last follow-up visit, a 69.5% median seizure reduction was registered. Thirty-two patients (59.2%) had a ≥50% reduction of seizures that was ≥75% in 20 (42.0%) cases, whilst 10 (20.2%) patients were seizure-free. The most common adverse events were somnolence (53.1%), dizziness (28.1%) and diplopia (12.5%). The correlation between CNB dose and plasma concentration, revealed a significant linear correlation (r = 0.86, p < 0.0001), and there was a significant difference in mean plasma concentration/dose administered ratio (C/D ratio) between patients taking or not at least one inducer (0.10 ± 0.04 [(μg/mL)/(mg/day)]; n = 47 vs. 0.13 ± 0.05 [(μg/mL)/(mg/day)]; n = 18, p = 0.04). CNB dose was inversely correlated (r = -0.31, p = 0.02) to the C/D ratio of Carbamazepine blood levels. and positively correlated (r = 0.74, p < 0.0001) with an increased plasma concentration of the active Clobazam metabolite N-desmethylclobazam. General Anxiety Disorder-7 showed a significant improvement of score from baseline evaluation of 6.82 to follow-up 6months evaluation of 4.53 (p = 0.03). Conclusion: In this real-world study, we registered a clinically meaningful reduction in seizure frequency after CNB administration in most patients along with a good tolerability profile. CNB treatment is correlate to a reduction in symptom severity of anxiety score. Plasma levels measurements confirm that CNB acts both as "victim" and as "perpetrator" of drug-drug interactions.

Analysis of the Effect of Life Disorders on Taste Perception

Smell disorders mostly damage the olfactory membrane of the sense of smell. This can reduce the ability to detect smells, reduce the ability to taste, or food, and even lose appetite. This research aimed to find real evidence of the influence of olfactory disturbances on taste perception carried out on the FK UKI Students’ class of 2012. This research used an experimental design; data was taken in July 2015, and 32 students were used as research subjects. The research examined participants' taste perceptions through an intervention by covering the patient's nose as a symbol of olfactory disturbance and without covering the participant's nose as a control. The data will be processed using the SPSS version 16 program and then analyzed using the t-test or independent samples T-test. The results showed that 38.7% of women and 37.5% of men had correct taste perception in the presence of olfactory disturbances. In comparison, 68.7% of women and 60% of men had proper taste perception without olfactory disturbances. Keywords: Smell physiology, Taste Physiology, Smell Disorders

Analysis of Changes in Sleep Quality and Patterns after Hip Fracture Using Real Evidence of Artificial Intelligence Linked (REAL) Hip Cohort Data.

Background and Objectives: Hip fractures are commonly found in elderly patients, and often result in chronic pain and decreased physical function, as well as worsening of overall health. It is known that early surgical intervention during the acute phase and rehabilitation are important for improving clinical outcomes for these patients. However, the importance of management for improving the quality of life of these patients is becoming more emphasized. Studies on changes in sleep patterns after hip fractures are rare overseas. Therefore, the aim of this study is to investigate the prevalence of sleep disturbance in patients with hip fractures and to analyze the changes in sleep disturbance after surgery by comparing the preoperative and postoperative results. Materials and Methods: During the period from August 2022 to January 2023, patients who underwent surgical treatment for hip fractures and were recruited into the REAL Hip Cohort were selected as research subjects. The sleep survey was conducted using the Pittsburgh Sleep Quality Index (PSQI). The PSQI is composed of 18 questions, each divided into areas of sleep quality, sleep latency, duration, efficiency, disturbance, use of medication, and daytime dysfunction. Each area is scored 0-3 points and the total is 0-21. A score greater than five indicates sleep disorder. The PSQI was surveyed during hospitalization and three months after surgery for post-fracture sleep status. To analyze changes before and after the fracture, paired T-tests and chi-square tests were performed. Results: From August 2022 to January 2023, a total of 40 patients who were recruited into the REAL Hip Cohort responded to the PSQI survey. The average age was 77.4 years and 36 were female. Sleep quality worsened from 0.75 ± 1.0 before surgery to 1.4 ± 1.0 three months after surgery (p = 0.019), and sleep efficiency also worsened from 0.4 ± 0.6 to 1.4 ± 1.0 (p < 0.001). The PSQI increased from an average of 5.2 ± 2.8 before surgery to 8.2 ± 4.2 three months after surgery (p = 0.007), and the number of patients who could be diagnosed with sleep disorders also increased from 12 (40%) to 24 (60%) (p = 0.030). Conclusions: A decline in overall sleep status was observed in patients in a survey on sleep patterns three months after hip fracture. Additional management is needed to improve their sleep patterns.

Survei Kemenarikan Taman Margasatwa Ragunan bagi Pengunjung

Ragunan Margasatwa Park is one of the forms of industrial and tourism acceleration in Indonesia. To this day the Ragunan Margasatwa Park is still operating well and has its own heritage in it. This is why Ragunan Margasatwa Park remains a favourite destination for recreation with family or close people. In order to obtain real data or evidence of the creation that exists within Ragunan Margasatwa Park, researchers will conduct surveys to the visitors by informing the activities that the researchers do through poster products. In order to find out what is of interest to visitors so choose Ragunan Margasatwa Park as their recreational destination. The results of the research we have done have produced the average level of satisfaction of Ragunan Margasatwa Park for visitors on a scale of 5 which is Very Satisfied / Very Interesting. The result of the spread of the lift, will later be the advocate of the truth of the data in the product of the article that the researchers sorted. In addition, the results of the spread of the lift also become factual data that will be informed by the researchers through video products.

Calidad de la consulta externa urológica en un hospital público de tercer nivel en México

IntroductionPatient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. ObjectiveTo identify the quality of care in the Urology outpatient department of a third-level hospital. Materials and methodsThe NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25minutes was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. ResultsAccording to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2hours in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11 to 20minutes in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. ConclusionsThe use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

PERAN NAHDLATUL ULAMA DALAM PENGUATAN NILA-NILAI MODERASI BERAGAMA

&lt;p&gt;&lt;em&gt;Nahdlatul Ulama is the largest Islamic organization in Indonesia. The existence of Nahdlatul Ulama always unites itself with the struggle of the nation, placing NU and all its citizens to be active in the nation-building division towards a just and prosperous society that is blessed by Allah SWT. In North Sumatra, NU is one of the largest and most influential organizations for Muslims. NU with its Ahlussunnah Wal Jama'ah understanding, which is known as moderate, stands at the forefront and becomes a bulwark for the integrity of the nation by developing the notion of moderation. However, the fact is that the application of religious moderation is still a discourse for Islamic organizational institutions, especially Islamic institutions in the city of Medan, because until now there has been no real evidence of Islamic institutions implementing religious moderation.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;The questions in this research are; 1) What is the Existence of Nahdatul Ulama in Medan City?; 2) What is the potential of the Nahdlatul Ulama Institution in Strengthening the Values &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;em&gt;of Religious Moderation in Medan City?.This research method is qualitative, which the author uses is a religious phenomenological approach while the theory approach is interaction.&lt;/em&gt;&lt;/p&gt;&lt;em&gt;The conclusion in this study is that the strengthening of religious moderation values of Nahdlatul Ulama in Medan City always displays two characters (wisdom and flexibility). For Medan City Nahdlatul Ulama, wisdom is an action that is conducive to obtaining benefits/avoiding harm, while flexibility is a compromising attitude and avoiding all forms of extremism. One of NU's national political ijtihad is the obligation to reduce or even avoid all forms of risk or bad consequences (fiqh rules: dar'ul mafasid muqaddamun ala jalbil mashalih). In addition, the potential of NU institutions in strengthening the values of religious moderation in Medan City which includes providing social assistance to all circles of society, helping each other among others is an activity in instilling the values of religious moderation. Implementation of the Values of Religious Moderation is recognizing the rights of others, respecting other people's beliefs, agreeing on differences, understanding each other.&lt;/em&gt;

Buya Hamka Character Values in forming Pancasila Student Profiles in Elementary

The application of the Pancasila Student Profile in elementary schools experiences difficulties if it is not linked to real evidence from everyday life or figures. This research aims to determine the value of Buya Hamka's character in forming Pancasila student profiles in elementary schools. The focus of the problem that will be studied by researchers is related to the many problems that occur among elementary schools, such as the decline in attitudes that exemplify Pancasila students. Strengthening character education is implemented in the process of realizing the Pancasila student profile and as an effort to shape students' positive character. This research uses a qualitative literature review research design methodology. The results of this research show that the character of buya hamka corresponds to four of the six characteristics of the Pancasila student profile, namely faith and devotion to God Almighty, mutual cooperation, critical thinking, and creativity. Buya Hamka's character is relevant to forming the profile of Pancasila Students in

Knowledge transfer in Peru microentrepreneurs. The effects on personal and business improvement

Purpose This study aims to analyze the effects of microentrepreneurs’ knowledge transfer (KT) on personal improvement (PI) and business improvement (BI). Design/methodology/approach The study was developed in two stages: a literature review based on KT and the learning process in microenterprises to have managerial competence and PI and BI to acquire the managerial competence that entrepreneurs need. The second stage was constructing a structural model based on 107 questionnaires and bootstrapping of 5,000 replications of microentrepreneurs who went through a training program (quantitative) and a focus group (qualitative). This study had a mixed approach, exploratory scope and experimental design. Findings The research showed real evidence about the performance level of microentrepreneurs when they passed through the process of KT and its impact on PI and BI. This research considers their managerial competencies, and the findings show a relationship between the theory of individual and organizational learning. Research limitations/implications This study considered Peruvian microentrepreneurs who participated in a virtual training program that included several courses related to their current environments and topics of interest. The analyzed period covered the years affected by COVID-19. Practical implications The model reveals that KT is relevant to PI and BI. Performance was measured regarding growth, income, innovation, productivity and responsibility before and after the program. Social implications This research analyzed the need for training microentrepreneurs for personal and private reasons under a COVID-19 scenario to foster their businesses and assume financial responsibilities. This study considered Peru’s reality, a country in which 94.9% of companies are microenterprises. The study revealed that microentrepreneurs improved their personal and professional lives and addressed relevant social problems that affect their environments because of the KT effects. Originality/value This study bridges the gap in the literature on how the theory of KT can be applied to entrepreneurs. This study revealed significant findings in terms of PI and BIs. The impact of KT indicates the relevance of managerial competencies related to the performance level obtained in terms of growth, income, innovation, productivity and responsibility.

Kebijakan Pemerintah Daerah Terhadap Dinamika Perjuangan Organisasi Papua Merdeka (OPM) di Kabupaten Puncak Jaya

Organisasi Papua Merdeka (OPM) is considered the group most associated with various forms of community resistance throughout the Papuan landscape. The policy direction of the central and regional governments that ignores the Papuan people is also seen as the source of strengthening the separatist movement. This study uses a qualitative method that seeks to analyze the local government policies of Puncak Jaya Regency regarding the dynamics of the OPM struggle. The results showed that there had been a decrease in OPM sympathizers and members, including deciding to return to the Republic of Indonesia. This reduction was achieved through the Puncak Jaya regency government policy which concentrated on development planning until its realization. Real evidence of development, especially in the interior of Puncak Jaya, makes people feel the state is present in their midst. That the state is not ignorant of them. The most recent policy of the Puncak Jaya regency government is to collect sympathizers or OPM members who wish to join the Republic of Indonesia, provide adequate accommodation, livelihoods and livelihoods, as well as some others are appointed and given the opportunity to become state civil servants. This persuasive approach to development seems to be able to reduce the resistance of the separatist movement (OPM) significantly compared to other military and violent approaches.

Konstruksi Reforma Pajak Bagi Pemilik Tanah Dati Di Kota Ambon Dalam Perspektif Keadilan

Introduction: The land owner does not have real and legal evidence that has legal force, so Village Officials assume that the land still belongs to the village and can be given or sold by the Village.Purposes of Devotion: This service can produce a legal product in the form of a state regulation and even state regulations regarding the construction of tax reform for dati landowners in the perspective of justice, so that dati landowners can know the tax collection model that can be used as proof of tax payment so that there is proof of ownership that is legally and has legal protection for dati landowners. Method of Devotion: The implementation of this service uses the extension method, through discussion in which the presenter explains material related to the service and is followed by questions and answers between the presenter and the participants.Results of the Devotion: The owner of the Dati lands in Soya Village is state land granted by the Official, so it is necessary to prove ownership of the land under Indonesian law so that it does not become a dispute in the future, the speaker provides information regarding the payment of Land and Building Tax to protect the rights of the villagers including the ulayat rights of indigenous peoples, especially the owners of dati lands. In fact, the land owner in Soya Village has never paid his land tax (traditional land tax) to the tax office related to land tax or regional tax due to the lack of information and understanding regarding the Tax Payment Model which can be used or as proof of ownership and can be used as legal protection in the event of a dispute in the future. As for the gap, namely whether the form of tax reform construction can cover the process of paying taxes on customary lands in Ambon City. in accordance with state regulations in order to create justice.

Influence of social media influencers and testimonials on consumer attitudes and purchase decisions for Scarlett Whitening products

Product marketing through influencers on social media is a new phenomenon in the marketing industry. Therefore, marketing through social media is carried out by a company to reach a certain target market through people who have great influence on social media or are called influencers. These influencers are adjusted to the values of the product to be marketed in order to find suitable potential customers. Influencers will also provide new information and demonstrate their skills to influence consumer attitudes or behavior in making purchasing decisions. Apart from influencers, there are also testimonials that are used to attract customers to make a decision before making a purchase. These testimonials are real evidence shared by consumers who have felt satisfied or disappointed with the products or services they bought on social media. The method used in this study is data collection in the form of a questionnaire given to 56 respondents by providing structured questions, and using variable data, namely data on the dependent variable (Y) and the independent variable (X). The results of data processing obtained from 56 respondents who are USI economics students who use social media, it can be concluded that social media influencers and testimonials of a beauty product called Scarlett Whitening are quite significant in influencing consumer behavior and determining consumer satisfaction. Because the results of the percentage of answer scores that each indicator have are in the strong category, namely 3.24% for the influencer variable, 2.98% for the testimonial variable, and 3.23% for the consumer behavior variable.

De Legé v. the Netherlands: The ECtHR adopts a line of reasoning similar to that of the United States Supreme Court on compelled production of real or physical evidence

In de Legé v. the Netherlands, a decision characterized as a key case, the ECtHR addressed once again the problematic relationship between the right against self-incrimination and the compelled production of real or physical evidence. In its judgment, the Court held that the use of the evidence submitted by the defendant to the authorities does not fall within the scope of the right against self-incrimination when the evidence in question concerns pre-existing documents of whose existence the authorities were already aware. By developing this argument, the European Court has adopted a line of reasoning similar to the ‘foregone conclusion’ doctrine of the United States Supreme Court. This article aims to critically analyse the decision of the ECtHR. It will be argued that the ECtHR does not sufficiently support its reasoning. Moreover, it does not take into account the rationale of the right against self-incrimination, which, as will be stated, can be considered opposed to the ‘foregone conclusion’ doctrine, at least in the European context.

The Role of Village Government in Maintaining Security Stability in Harefa Village, North Nias Regency

The study aims to find out the role of the village government inining stability in the village, why there are still cases of crime and how the government is dealing with crime in the Northern District of Harefa. The purpose of the descriptive approach is to describe the process of conducting research that begins with observation. The research instrument used in this study is the researcher himself using his cell phones as a tool to record all the conversations, the results of images as real evidence, and the notebook that serves to record conversations with data sources or informants. The data collection techniques used are interviews, observations, and documentation. The results of the research and discussions concluded that: First, the role of the government of Harefa village inining the stability of the security of the village is to establish a good relationship of cooperation with the security authorities and the village people, the village government as a facilitator to resolve the crime cases that occurred, the three government of village sanctions for the perpetrators of crimes are either customary sanctions or government sanctions. And the four heads of village as the leader in the village will try their best to create security for the people. And the third effort of the village government in dealing with crime cases is to start from itself to create security, the second to socialize about order and security, and the third village government will provide aid to the people.

The Ability of PPKn Teachers In Implementing Higher Order Thinking Skills (HOTS) Based Learning At The 2 Gunungsitoli State High School

This research aims to find out how the ability of teachers in applying learning based on Higher Order Thinking Skills (Hots), the obstacles encountered by teachers and to know the efforts made by the teacher in overcoming obstacles in Applying Learning based on Hots in the State High School 2 Gunungsitoli. This research uses a descriptive approach with qualitative methods. The purpose of the use of a description approach is to find meaning that begins from the facts by performing observations recording all facts holistically scientifically with the observed problem. The research instrument used in this study was the researcher himself using his cell phones as a tool to record all the conversations, the results of images as real evidence, and a notebook that serves to record conversations with data sources or informants. The data collection techniques used are interviews, observations, and documentation. The results of the research and discussion concluded that: First, Teacher's Ability to Apply Higher Order Thinking Skills (Hots) in Higher High Schools (State Secondary Schools) is Ability in Preparing Learning Plans, Hots-driven Learning Design Ability, Asking Questions that Drive High Level Thinking, Supporting Students in Hots Thinking Processes, and Evaluating Hots Skills. Second, The obstacles faced by Teacher PPKn in Applying Higher Orders Thinking skills (HOTS) in high schools are The deep understanding of the concept of Hots learning material is still limited, The curriculum and evaluation are not supported, The time is limited because Hots Learning often requires longer time because it involves more in-depth thinking and complex, the availability of insufficient resources such as reading, learning materials, media or technology. Thirdly, the efforts made by Master PPKn in Applying Learning Based on Higher Order Thinking Skills (Hots) overcome the obstacles of providing training and development to teachers on Hots learning concepts and strategies, further providing learning resources and learning materials that support the application of Hots as well as monitoring and evaluation of implementation of learning Hots.

Implementation of The Independent Learning Curriculum at SMK Negeri 1 Lahewa in The 2022/2023 Academic Year

This study aims to determine how the implementation of the independent learning curriculum is, to find out the obstacles faced in implementing the independent learning curriculum and to find out the efforts made in overcoming the obstacles to implementing the independent learning curriculum at SMK Negeri 1 Lahewa in the 2022/2023 academic year. This research uses a qualitative method with a descriptive approach. The purpose of using a descriptive approach is to find meaning starting from facts by making observations recording all facts in a holistic scientific manner with the problems observed. The research instrument is the researcher himself, using a mobile phone as a tool to record all conversations, pictures as real evidence, and a notebook that serves to record conversations with informants. The data collection techniques used were interviews, observation, and documentation. The results of the research and discussion concluded that: First, the implementation of the independent learning curriculum has been implemented but not fully implemented. Of the three categories of independent curriculum implementation, SMK Negeri 1 Lahewa uses the independent learning category option, which means that schools are given the authority to use the 2013 curriculum structure but apply several principles of the independent learning curriculum in the learning process and assessment. Second, the obstacles faced in implementing the independent learning curriculum at SMK Negeri 1 Lahewa are that teachers do not have experience in accordance with this independent learning curriculum. Then there are difficulties in obtaining material references, and including inadequate facilities and infrastructure and internet facilities. Third, the efforts made to overcome the obstacles to the independent learning curriculum are preparing teachers by participating in online-based socialisation to have experience in implementing the independent curriculum, then utilising social media to obtain material references according to the independent curriculum such as modules, books provided by the government and the implementation of facilities and infrastructure and facilities that support the education process by collaborating with the government.

Efforts To Foster Students' Character Through School Literacy Movement At SMK Negeri 1 Tuhemberua

This study aims to determine the efforts made to foster student character through the literacy movement and to find out the obstacles faced in fostering character and the obstacles faced by teachers in fostering student character through the school literacy movement. This research uses a qualitative method by taking a descriptive approach. The research instrument in this study is the researcher himself by observing, asking, listening, asking and taking research data using a cellphone as a tool to record all conversations, pictures as real evidence, and a notebook that serves to record conversations with data sources or informants. The data collection techniques used are interviews, observation, and documentation. The results of the research and discussion concluded that: first, a very important aspect in fostering students' character through the school literacy movement is by providing students with reading materials containing ethical values, local, national and global wisdom, which are delivered according to the development of students, direct practice in the environment, Implementation of monitoring and evaluation of GLS (School Literacy Movement) activities using indicators of the achievement of each stage. Second, the obstacles faced include some elements in the school that are not ready to participate in literacy activities carried out to realize literacy activities, the cooperation and participation of every element in the school is important to realize quality school literacy activities. Third, the obstacles faced by teachers are at the habituation stage, development, Teachers do not understand the purpose and objectives of the School Literacy Movement, Students are difficult to manage, the room is not large enough, the library schedule, the library is not large enough, and there are not many books.

Post-Institutionalism. The Criticism of Philosophical and Methodological Foundations of “Alternative” Studies of Institutions

The paper examines the phenomenon of "post-institutionalism" in relation to the philosophical and methodological issues surrounding the foundations of scientific research. While its proponents highlight several genuine problems in classical institutionalism that pertain to the complexities of modern institutions, the author has reservations regarding whether this metatheory can truly deliver on its promised breakthrough in research methodology. Understanding the complexity of an object requires abstracting its features and aspects, as well as employing antithesis as an artificial but reflective tool. However, the adoption of an "unsealed" approach makes it difficult to apply general logical and concrete scientific methods. The refusal to establish cause-and-effect relationships and laws, along with the substitution of concepts with metaphors, may result in a displacement of genuine research by purely descriptive activities and rhetoric. Studies that employ this particular conceptual framework (assemblage, bricolage, kluge) often fall short of advancing beyond interpretation or formulating testable theoretical propositions. Despite the increasing use of this vocabulary, doubts persist regarding the quantity and quality of studies based on real empirical evidence and the construction of successful predictive models. The author contends that the underlying reason for this lack of progress can be attributed to the influence of postmodern philosophy, which rejects classical scientific approaches in general, including the principles of classical institutionalism (such as rationality, optimality, efficiency of institutions, and their functional analysis).

Level Of Patient Satisfaction With Pharmaceutical Services In The Outpatient Pharmaceutical Room, Mandiraja Community Health Center 1

Background: Pharmaceutical services are direct and responsible services to patients with the aim of improving the patient's quality of life. Satisfaction is a feeling of pleasure or disappointment that arises after comparing product performance with expected performance. Satisfaction and service are two things that cannot be separated, with the satisfaction of related parties, they can correct each other how far the improvement in the services that have been provided. Measurement of satisfaction uses five dimensions of service quality, namely tangible evidence (Tangible), responsiveness (responsiveness), assurance (assurance), empathy (Emphaty) and reliability (Reliability). Objective: This study was to describe the level of patient satisfaction with pharmaceutical services in the outpatient pharmacy room at Puskesmas Mandiraja 1. Methods: The type of research was descriptive using a cross sectional approach with the sampling technique of accidental sampling and data collection using questionnaires. Results: Based on the results of calculations on each research indicator the level of patient satisfaction with pharmaceutical services in the outpatient pharmacy room at Mandiraja 1 Health Center is generally categorized as satisfied with the percentage of 75%. The real evidence dimension is 74.15%, the responsiveness dimension is 75.01 %, assurance dimension of 77.44%, the empathy dimension is 75.15% and reliability dimension of 71.07%. Conclusion: Based on the results of the study, the level of patient satisfaction with pharmaceutial services in the outpatient pharmacy room at Puskesmas Mandiraja 1 was in the satisfed category

VACCINE ACCEPTANCE AMONG LATE RECIPIENTS OF COVID-19 VACCINATION IN KEDAH, MALAYSIA: AN EXPLORATORY STUDY

COVID-19 vaccine availability has helped many countries around the world in alleviating the health and economic crisis caused by the pandemic. However, the smoothness of its implementation was slightly affected due to several issues such as hesitancy and even total refusal, due to several specific factors. To establish herd immunity, an adequate amount of immunization is necessary, and this issue needs to be addressed appropriately to avoid failure in efforts to curb the spread of the disease. In identifying appropriate and effective strategies to deal with this, it is important to know the factors that can influence such individuals to change their minds and eventually agree to be vaccinated. This study explores the reasons behind COVID-19 vaccine acceptance among nineteen (n=19) late vaccine recipients who initially delay or refuse to be vaccinated, using an in-depth interview method and thematic analysis. Four themes and eight subthemes were identified, emphasizing the significant role of real evidence, health risk-related perceptions, peer recommendations, and higher authority enforcement in influencing the participants to finally make a U-turn. The findings of this study can be used to formulate strategies to increase vaccine acceptance rates, especially among individuals who are still reluctant.