Abstrak                 Latar Belakang: Dermatitis kontak adalah penyakit kulit yang disebabkan oleh suatu peradangan akibat paparan dari substansi asing. Berdasarkan jenisnya, dermatitis kontaki dibagi menjadi duat yaitu, dermatitis kontak alergi dan dermatitisi kontak iritan, dapat bersifat akut danlkronis. Terdapat berbagai faktor yang dapat menyebabkan Dermatitis kontak akibat kerja yaitu faktor eksogen dan faktor endogen. Tujuan: Untuk mengetahui faktor-faktor resiko terjadinya dermatitis kontak pada karyawan di Pabrik Tahu. Metode Penelitian: Penelitian ini menggunakan metode kuantitatif yang bersifat analitik observasional. Berdasarkanopendekatannya, penelitian ininmenggunakan pendekatan crosszsectional, dimana semua variabelnya dilakukan pengukuran secara bersamaan. Populasi Penelitian ini yaitu seluruhkpekerja di PabriklTahu Sun di Jl. TB Simatupang, Medan Sunggal, Kota Medan yang berjumlah 20 orang karyawan yang melakukan pekerjaan di pabrik tahu kurang dari 2 tahun dan bersedia menjadi responden  dengan menggunakan teknik nonprobability yaitu total sampling. Hasil: Dari  hasil uji  pearson Chi Square dengan alternative fisher exact test antara variable faktor-faktor (APD, personalLhygiene, lama kontak, riwayat alergi) dengan kejadian dermatitis kontak Iritan diperoleh nilai rata-rata 0,05 selain pada faktor penggunaan APD ( Alat Pelindung diri ) terdapat nilai tidak signifikan 0,438. Oleh karena p  ˂ 0,05 (α) selain penggunaan APD, maka dapat disimpulkan bahwa untuk faktor-faktor berupa lama kontak (p=0.035) , riwayatypenyakit kulit (p=0.030), dan personal hygiene (p=0.012) dapat disimpulkanjbahwa hubungannyang signifikan terhadap kejadianndermatitis kontakiiritan sedangkan untuk faktor pemakaian APD tidak memiliki hubungan yang signifikan dengan kejadianidermatitis kontakjiritan. Kata Kunci: Dermatitisskontak, APD, Personallhygiene, Lama Kontak, Riwayat Alergi, Pabrik Tahu Abstract                 Background: Contact dermatitis is a skin disease caused by an inflammation due to exposure to foreign substances. Based on the type, contact dermatitis is divided into two, namely, allergic contact dermatitis and irritant contact dermatitis, which can be acute and chronic. There are various factors that can cause occupational contact dermatitis, namely exogenous factors and endogenous factors. Objective: To determine the risk factors for contact dermatitis among employees at the Tofu Factory. Research Methods: This study uses a quantitative method that is analytic observational. Based on the approach, this study uses a cross-sectional approach, where all variables are measured simultaneously. The population of this study are all workers at the Tahu Sun Factory on Jl. TB Simatupang, Medan Sunggal, Medan City, with a total of 20 employees who work in a tofu factory for less than 2 years and are willing to become respondents using a non-probability technique, namely total sampling. Results: From the results of the Pearson Chi Square test with an alternative fisher exact test between the variable factors (PPE, personal hygiene, length of contact, history of allergies) and the incidence of irritant contact dermatitis, an average value of 0.05 was obtained in addition to the factor of using PPE (Tools). personal protection) there is an insignificant value of 0.438. Because p 0.05 (α) in addition to the use of PPE, it can be concluded that for factors such as length of contact (p = 0.035), history of skin disease (p = 0.030), and personal hygiene (p = 0.012) it can be concluded that the relationship significantly to the incidence of irritant contact dermatitis, while the use of PPE did not have a significant relationship to the incidence of irritant contact dermatitis.

Indonesia is currently struggling towards Universal Health Coverage (UHC) by the year 2019, but policy actors have difficulty in adjusting centralized health insurance management policies at the central level through Law No. 24/2011 on Social Security Provider (BPJS) and Presidential Regulation No. 12/2013 on Health Insurance, with a health service management policy whose authority more decentralized instead through Law No. 23/2014 on Local Governments and Government Regulation No. 18/2016 on Local Apparatuses. Objective: To determine the pattern of institutional relations relating to policies and regulations between the central and the local governments in the implementation of the health insurance program in Indonesia, which has been decentralized at the local level. Method: This study was an exploratory case study. Data were collected in-depth interviews and focus group discussions with 67 policymakers at the central and local levels. The data analyzed using transcripts and an open code matrix. Result: The role of the principal in the pattern of the relation of JKN policy implementation at the central and local levels tends to be weak and does not have complete control of the agent. Weak principal control requires stronger hierarchical control of the principal at the central level (central government) and greater incentives for the principal at the local level (BPJS Health). Meanwhile, principals and agents in terms of policy interpretation, share common interests. Principal control toward the agent is weak and causes asymmetrical information. Finally, in terms of policy application, the agent has more information so that the principal has a dependency on the agent. Conclusion: Implementation of JKN policy at the central level has a conflict of interest between the government as the principal and BPJS Health as the agent. The government has the goal to fulfill the quality of health services (quality control), while BPJS Health has the goal of optimizing health financing (cost control).

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Gastroesophageal reflux disease (GERD) is defined as a gastrointestinal motility disorder caused by the reflux of gastric contents into the esophagus or oral cavity. This results in symptoms or complications if persistent, resulting in a significant reduction in quality of life and morbidity. Several studies have reported an association between nocturnal GERD and sleep disturbances, which can significantly affect the quality of life. This study explores the relationship between sleep quality and the incidence of GERD in clinical clerkship students at the Faculty of Medicine, Universitas Prima Indonesia. This study is a cross-sectional observational study involving 144 clinical clerkship students. The GERDQ was used to diagnose GERD, and the PSQI questionnaire was used to measure sleep quality. Respondents who did not suffer from GERD with good sleep quality were 32 respondents (22.2%). Those who did not suffer from GERD with poor sleep quality were 65 respondents (74.8%), who suffered from GERD with good sleep quality only 1 respondent (10, 8), and 46 respondents (36.2%). There is a significant relationship between sleep quality and GERD in clinical clerkship students at the Faculty of Medicine, Universitas Prima Indonesia.

Liver cirrhosis is the result or complication of a chronic liver condition where the liver parenchyma is damaged so that its function decreases. This study aims to study the profile of patients with liver cirrhosis at the Imelda Pekerja Indonesia General Hospital in Medan for the period January 2020 - December 2021. This study is a descriptive observational study. A total of 40 samples of medical records of patients with a diagnosis of liver cirrhosis at the Imelda Pekerja Indonesia General Hospital in (IPI) Medan were included in this study. Univariate analysis in the form of frequency distribution data tabulation was used to present the data. The results showed that most patients with liver cirrhosis were male (72.5%), aged 56-65 years (32.5%), and the main complaint was nausea and vomiting (47.5%). The most physical examination results were ascites (52.5%), abnormal lab results were increased SGPT (75%), SGOT (80%), total bilirubin (85%), prothrombin time (75%) and decreased albumin (85%) and Hb (55%), most of the patients were in the category of Child-Pugh Score B (37.5%) and C (37.5%), and the most complication was hepatorenal syndrome (55%). In conclusion, the profiles of patients with liver cirrhosis are mostly male, aged 56-65 years, with the most complaints of nausea and vomiting and the most physical examination findings of ascites. There was an increase in SGPT, SGOT, total bilirubin, and prothrombin time, as well as a decrease in albumin and Hb.