Optimum performance is achieved when teacher has been engaged with his or her work. Teacher will not feel forced to run his or her job demand and even tend to give more than his or her job demand. These are ideal condition that must be maintained in teacher profession. Efforts to do so teacher engaged with his or her work is to provide an acknowledgment and appreciation.  It can be seen from one of the government's regulations implementing teacher certification.  Observational studies have been conducted with a cross-sectional analytical approach to the teacher at SMP Negeri inNorth District of Denpasar with a sample of 147 peoples. Data were analyzed with the Mann-Whitney test with a significance level of 0.05. Research data obtained an average scores of work engagement on the certified teachers is 86.23 + 8,31 while the average scores of work engagement on uncertified teachers is 79.25 + 11,93. Comparability of test results p = 0.003, showing that the average scores of work engagement among certified teachers and uncertified teachers significantly different (p <0.05). It can be said certification is one of the variables that affect the work engagement on teacher. It was concluded that there are differences in the average scores of work engagement oncertified teacher with uncertified teacher, where work engagement scores on certified teacher is higher than uncertified teacher. It is recommended for government to certify all teachers in Indonesia.

Background: The transient period when the kidney donor was extracted until being anastomosed (total ischemic time) will aggravate many putative molecular ischemic-reperfusion injury mechanisms. Several studies have reported the risk of delayed graft function development, which can be reflected by creatinine serum (Cr) level and resistive index (RI) value. This study aims to determine the correlation of total ischemic time to Cr levels reduction in one-month post-transplantation and RI value. Methods: This was a cross-sectional retrospective study involving subjects who underwent kidney transplantation in Sanglah General Hospital. In this study, the primary parameters were total ischemic time, Cr level, and RI value. The total ischemic time is calculated using a stopwatch intraoperatively. Cr level was obtained from blood examination, and RI value was obtained from the ultrasonography test. Data analysis was analyzed statistically using SPSS 24.0, and p < 0.05 was considered significant. Results: About 17 kidney transplant subjects were included in this study. The mean total ischemic time was 105 minutes and 43 seconds. There was an insignificant negative correlation between Cr level reduction and total ischemia time (r = -0.36; p = 0.89). An analysis of the correlation of total ischemic time and RI value, there was a linear correlation, but statistically insignificant (r = 0.11; p = 0.66). Conclusion: Total ischemic time has a negative correlation with post-transplant creatinine serum level and a positive correlation with the post-transplant resistive index value, but these results are not statistically significant.

Background This study aimed to evaluate the outcomes of modified Enhanced Recovery After Surgery (ERAS) protocol and standard of care (SC) in bladder cancer patients who underwent radical cystectomy (RC). The length of stay and complications rates were the primary outcomes. Time functional recovery, bowel movement, mobilization, drain removal, and other perioperative outcomes were the secondary outcomes. Methods A cohort retrospective study was conducted to investigate the effectiveness of the modified ERAS protocol compared to SC in 61 patients who underwent RC (36 ERAS vs. 25 SC). Results The modified ERAS protocol was associated with shorter length of stay (9.3 ± 5.0 days vs. 12.6 ± 6.7 days, P = 0.032) and reduction in important postoperative milestones, including days to first solid diet (3.5 ± 1.6 vs. 5.5 ± 1.5, P = 0.000), days to first defecation (4.8 ± 2.4 vs. 7.2 ± 2.4, P = 0.001), days to first walking (4.7 ± 2.2 vs. 7.9 ± 2.4, P = 0.000), and days to drain removal (3.9 ± 1.3 vs. 5.9 ± 2.5 P = 0.001). Postoperative complications rates were lower in the modified ERAS groups, but the result was not statistically significant (P = 0.282). Also, there were no significant differences between transfusion requiring, intensive care monitoring, re-operation, and re-admission between groups. Conclusion This study demonstrated that the modified ERAS protocol for RC can accelerate postoperative recovery without any adverse effects on morbidity and mortality.