Several studies showed that the index of nasopharyngeal carcinoma (NPC) cell growth could be used to assess the carcinogenesis interaction factor, development and prognosis of NPC. Cell proliferation index could always be assessed with Ki-67 protein expression test. This research was conducted to study the correlation between cell proliferation index with cervical lymphoid node status in NPC in clinical manifestation to asses the progressivity and prognosis on NPC patients. This study used cross sectional design. Biopsy tissue specimen were acquired from 35 NPC patients clinically divided into four criteria of cervical lymphoid node status (N0, N1, N2 and N3). Expression of Ki-67 protein was acquired by immunohistochemistry test using monoclonal rabbit antibody anti-human Ki-67 clone 901-325-091911 (Biocare Medical, LCC. 4040 Pike Line, CA 94520 USA). The measurement of Ki-67 protein was conducted by pathology consultant. Spearman statistic test was performed to asses the correlation between Ki-67 protein expression and cervical lymphoid node status. The statistical significance was defined as p<0.05. Positive expression of Ki-67 protein was found in 33 patients; 4 patients with N0 (11.43%), 5 patients with N1 (14.29%), 9 patients with N2 (25.71%), and 15 patients with N3. Negative expression of Ki-67 protein was found in 2 patients with N0 (5.71%). The Spearman test resulted at p=0.0001 with correlation coefficient of 0.758. The correlation between Ki-67 protein expression with cervical lymphoid node resulted in a significant correlation (p<0.05). In conclusion, cell proliferation index has correlation with cervical lymphoid node status in NPC patients.
A child with a hearing and speech impairment has the same right to education as all children. An equal access to education as an investment to their future. The Acceleration of Digitization and restrictions on activities that occurred during the pandemic and the fourth industrial revolution have led to a challenge of education process, especially for hearing and speech impairments students. This cross-sectional study aims to discover the quality of education and evaluate the knowledge gained from participating in an educational course by giving pre-test and post-test questionnaire. A polling method was conducted to assess the participants' attitudes and psychomotor. This study was attended by 627 respondents including SLB B teachers 267 respondents (43%), parents of students 191 respondents (30%) and the public 169 respondents (27%). The average pre-test score was 47,67 (+15,69) and the post-test average was 80,67 (+22,73). A mean difference between pretest and post-test score was significant at p < 0.0001. The principles of the education for a child with a hearing and speech impairment is to building children's independence by 293 respondents (23%), using innovative methods of teaching 143 respondents (20%) and increase the utilization of educational facilities and infrastructure 64 respondents (10%). The strategies to teach a child with a hearing and speech impairment is using innovative methods, starting with understand the children’s character and needs. One of the keys to a successful academic experience for children with disabilities is a productive and supportive relationship between parents and teachers.Keywords : Hearing impairment, speech impairment, educational, independence AbstrakAnak dengan tuna rungu dan wicara memiliki hak dasar. Salah satu hak dasar adalah mendapatkan akses pendidikan yang berkualitas untuk memberikan bekal untuk kehidupan masa depan. Pandemi, revolusi industri 4.0 terjadi percepatan digitalisasi informasi yang terjadi dan pembatasan fisik menjadi tantangan terhadap proses pendidikan untuk anak tuna rungu dan wicara. Studi cross sectional untuk menilai kualitas dan upaya peningkatan kualitas pendidikan dilaksanakan dengan seminar pendidikan dan dilakukan pre test sebelum kegiatan dan post test setelah kegiatan untuk menilai peningkatan pengetahuan. Survei jajak pendapat dilakukan untuk menilai sikap dan psikomotor peserta. Studi ini diikuti oleh 627 responden meliputi guru SLB B 267 orang (43 %), orang tua anak didik191 orang (30 %) dan masyarakat umum 169 orang (27 %). Aspek pengetahuan didapatkan hasil pre test 47,67 (+15,69). Hasil rata rata post test 80,67 (+22,73). Perbandingan hasil pre test dan post test didapatkan hasil yang berbeda signifikan (p<0,0001) sehingga didapatkan peningkatan pengetahuan sebelum dan setelah kegiatan. Sedangkan fokus pendidikan untuk anak tuna rungu dan wicara adalah menumbuhkan kemandirian anak di masa depan 293 orang (47 %), inovasi metode pembelajaran 143 orang (23 %), 127 orang (20 %) dan Penguatan sarana dan prasarana pembelajaran 64 orang (10 %). Perlu inovasi dalam metode pendidikan untuk anak tuna rungu dan tuna wicara. Inovasi dimulai dengan memahami karakter dan kebutuhan anak tuna rungu dan wicara. Kolaborasi antara segenap elemen orang tua dan guru menjadi kunci keberhasilan pendidikan untuk anak tuna rungu dan tuna wicara yang bertujuan untuk kemandirian dan bekal di masa depanKata kunci : Tuna rungu dan tuna wicara, pendidikan, kemandirian
The COVID 19 pandemic impacts the early detection of hearing impairment. Socialization is needed in the form of early detection education of hearing loss in the era of the COVID 19 pandemic to health workers in the front line. The purpose of educational activities is to improve the knowledge and skills of health workers to conduct early detection of hearing impairment in the era of the COVID 19 pandemic. The condition of the COVID 19 pandemic changed the interaction pattern between people, including in education and training activities in the field of health. Education with on line means is becoming a common thing to do today. This training activity is conducted on line and off line methods with limited participants. The training for health workers was carried out using an off line method and was attended by 39 participants. The average result of the pre test was 45.20 (+ 15.69), and the average post test was 80.67 (+ 22.73). Comparison of the pre test and post test results with the t-test, the results were significantly different (p < 0.0001). The training with the on line method was attended by 1,145 participants. The results of the average pre test score were 55.30 (+15.61), and the post test average score was 72.82 (+21.61). Comparison of the pre test and post test scores with the t-test results was significantly different (p < 0.0001). On line and off line methods in training activities provide significant results in increasing the knowledge of health workers so that the pandemic does not hinder the implementation of training activities to increase the knowledge of health workers in an effort to improve the quality of life of the community, in this case, hearing.
Effective communication is a pillar of excellent service in the healthcare unit. Communication among health workers, hearing impaired and speech impaired will cause obstacles to services. Sign language skills need to be possessed by health workers in communicating with people who are deaf and speech impaired. Socializing sign language and developing sign language skills for health workers in health services. After participating in the training, health workers are expected to know and have sign language skills. Community service activities in the form of sign language training for health workers in health services are carried out with lectures, quiz, discussions and practice of sign language skills. Activities are carried out through online method. The activity was attended by 1,593 participants. The most participants were midwives (570 participants-35.8%), nurses (518 participants -32.5%) and doctors (191 participants -12%). A total of 1,333 participants (83.7%) experienced communication problems with the hearing impaired and speech impaired. The training was felt to be useful by 1,215 participants (76.3%). The average result of the pre-test quiz was 33.54 (+13.11) and the average post-test quiz was 61.23 (+10.41). Comparison of pre-test and post-test results of hearing health education obtained statistically significant differences (p < 0.0001). The benefits of training activities are felt to be useful and needs to be intensified to improve the quality of services and the quality of life for people who are hearing impaired and speech impaired.
Covid-19 is a new disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The increasing number of cases of Covid-19 has made it difficult for hospitals to handle it, and health workers are at a higher risk of infection by SARS-CoV-2 and urgently need Personal Protective Equipment (PPE) to protect themselves and minimize the spread of the virus. However, the usage of PPE especially face-masks often causes discomfort. Therefore, a new type of face mask has emerged, namely the medical snorkel mask. This mask is designed to cover the entire face and is made by modifying the air circulation section by adding an air filter. The filter used is PALL Ultipor 25 with a HEPA filter capable of filtering up to 0.3 microns in size and has an efficiency of 99.99%. Medical snorkel mask that is used properly are quite efficient in preventing the transmission of Covid-19, with a fitting factor of 142 from pass level 100. This mask also has passed the CO2 toxicity test. The advantages of a medical snorkel mask include protecting the entire face from infectious droplets, preventing direct hand contact with the face, being reusable, and being equipped with an effective air filter by minimizing the potential for filtrate malfunction. Some of the disadvantages of this mask include interfering with the communication process, cannot being used in conjunction with glasses, a buildup of CO2, increasing the work of breathing, and limiting vision. However, some of these weaknesses can be minimized by modifying the mask and maintaining an optimal barrier system. Given the high level of effectiveness and efficiency, medical snorkel masks can be a novel solution to overcome the discomfort of using PPE for health workers in Indonesia. Hopefully, it can reduce the morbidity and mortality of health workers due to exposure to Covid-19.
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