Economics of Non-Communicable Diseases in Indonesia

The Economics of Non-Communicable Diseases in Indonesia provides new data on the economic burden of NCDs in the country, and puts it in perspective by drawing a comparison with India and China. With this new addition to the series on the economics of NCDs, the World Economic Forum aims to advance the understanding of the expected economic output loss at the country level, particularly in countries in economic and epidemiological transition. The evidence presented provides a starting point in reorienting the dialogue on investing in healthy living and NCD prevention in Indonesia towards the view that a healthy population is an important factor for sustainable growth.

Use of eye care services among diabetic patients in urban Indonesia.

OBJECTIVES:

To assess the use of eye care and its predictors among diabetic patients in Indonesia.

METHODS:

Diabetic patients aged 18 years and older were recruited consecutively from a university clinic and 2 community clinics in Jakarta, Indonesia. Information obtained by questionnaire and record review included demographic and socioeconomic status, knowledge about diabetic retinopathy, and ocular and medical history. The main outcome was self-reported or record history of an eye examination by an eye care professional with dilation of the pupil within the preceding year.

RESULTS:

Among 196 participants (mean [SD] age, 58.4 [9.4] years; 61.5% female), 166 (84.7%) had not undergone ocular examination in the last year, including 100 of 119 patients (84.0%) at the university clinic. Fewer than half (82 of 166 [49.4%]) of all patients reported being told of the need for eye examinations by their physician. In regression analyses, factors associated with having an eye examination were higher diabetic retinopathy knowledge score (odds ratio = 1.52; P = .01) and years since being diagnosed as having diabetes (odds ratio = 1.71 for third vs first tertile; P = .02). Education, income, health insurance status, and diagnosis of diabetic retinopathy were not predictive of examination. The most common reasons given by subjects for not having had eye examinations concerned lack of knowledge about the need for care (97 of 160 subjects [60.6%]), while financial barriers were cited by only 22 of 160 subjects (13.8%).

CONCLUSION:

The low proportion of diabetic subjects receiving recommended annual eye examinations in Indonesia might be improved through patient and physician education.

Early assessment of visual acuity after cataract surgery in rural Indonesia.

BACKGROUND: The accuracy and impact on service uptake of early examination after cataract surgery is not known. DESIGN:   Prospective cohort study. PARTICIPANTS: Cataract patients in rural Indonesia. METHODS: Visual acuity was measured preoperatively, 1day, 1-3, 4-6 and >12weeks after surgery, and 6-8months postoperatively at an outreach examination. Acceptance of second-eye surgery and spectacles was evaluated. MAIN OUTCOME MEASURE: Presenting visual acuity in the operated eye. RESULTS: Among 241 subjects (extracapsular surgery 84%), examinations at 1day, 1-3, 4-6 and >12weeks and 6-8months were completed for 100% (241), 90.9% (219), 67.6% (163), 22.0% (53) and 80.0% (193), respectively. Among subjects at the final examination (mean age 65.8±10.6years, 51.8% male), 73.6% had bilateral preoperative presenting visual acuity≤6/60. By 4-6weeks, the proportion with good (≥6/18) or poor (≤6/60) visual acuity did not differ significantly from the final examination. Among 49 persons accepting free second-eye surgery, 69.4% (34) and 16.3% (8) returned to clinic at 4-6 and >12weeks, respectively. Among 131 patients (67.9%) paying US$7 for glasses, 94 (71.8%) and 30 (22.9%) attended 4- to 6- and >12-week examinations, respectively. CONCLUSION: Even with large-incision surgery, early assessment of postoperative vision is representative of final vision, and may help deliver postoperative services to more of those needing them. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Narrative Personae and Visual Signs: Reading Leonard’s intimate photo-memoir. a/b: Auto/Biography Studies.

: In this paper, I look at Joanne Leonard’s Being in Pictures and engage in a critical dialogue with an assemblage of visual and textual narratives that comprise her intimate photo memoir. In doing this I draw on Hannah Arendt’s take on narratives as tangible traces of uniqueness and plurality, political traits par excellence in the cultural histories of the human condition. Being aware of my role as a reader/viewer/interpreter of a woman artist’s auto/biographical narratives, I move beyond dilemmas of representation or questions of unveiling “the real Leonard”. The artist is instead configured as a narrative persona, whose narratives respond to three interrelated themes of inquiry, namely the visualization of spatial technologies, vulnerability and the gendering of memory. Key words: gendered memories, narrative persona, spatial technologies, photo memoir, vulnerability

Decentralization and Governance in Indonesia

Indonesia, over the past two decades, has embarked on a process of decentralization as part of a broader process of democratization, which followed earlier periods of centralized governance and authoritarian rule across the archipelago. The purpose of this book is to explore the connections between governance and sustainable society in a wide variety of policy fields in Indonesia,Indonesia and how reforming governance structures may contribute to societal benefits and the creation of a long-term sustainable society. The structures created may be characterized as a variable form of multi-governance, with varying types of relationships between the central government and newly empowered local governments.

Three Presidents

Pictured here from left to right are former presidents of Brock University: Dr. Alan Earp (President, 1974 - 1987), Dr. James Gibson (President, 1964 - 1973), and Dr. Terry White (President, 1988 - 1996).

Five Presidents

Pictured here from left to right are the first 4 presidents (and one of the former acting presidents) of Brock University: Dr. James Gibson (President, 1964 - 1973), Dr. Alan Earp (President, 1974 - 1987), Dr. Terry White (President, 1988 - 1996), Dr. Susan Clark (Acting President, ca. 1996 - 1997), and Dr. David Atkinson (President, 1997 - 2005). Together they have served Brock for over 40 years from 1964 - 2005.

Presidents Dining Room, Old Student Union, Chapman College, Orange, California

Presidents Dining Room, old Student Union, Chapman College, Orange, California. Furniture is from the Rankin estate; moved from the Grace Rankin Lounge in Memorial Hall.

Historie du Mexique Juárez et Maximilien. Correspondances inédites des presidents, ministres et généraux Almonte, Santa-Anna, Gutiérrez, Miramón, Mejía, Woll, etc. de Juárez, de l'empereur Maximilien et de l'emperatrice Charlotte

UANL

Father Mathew: a biography

UANL

A compilation of the messages and papers of the Presidents, 1789-1902,

UANL

Living and fishing in a marine protected area : balancing traditional fisheries with conservation in Karimunjawa National Park, Indonesia

Cette recherche a porté sur quelques enjeux importants liés à la gestion des aires marines protégées (AMP) en Indonésie en examinant comment celles-ci sont en mesure d'adapter leurs politiques afin de mieux répondre à l'évolution des conditions socioéconomiques et écologiques, quels ont été les impacts socioéconomiques de ces aires, et quelles sont les préoccupations environnementales des acteurs locaux dont les moyens de subsistance dépendent des ressources règlementées. Le «livelihoods framework » a servi de guide pour notre analyse des changements socioéconomiques dans la région, tandis que la notion d’« environmentality » d’Agrawal a fourni les bases théoriques pour l'examen de la formation de sujets environnementaux au parc national de Karimunjawa. Cette étude a montré que les changements de politique apportés au plan de la gestion du parc sont un pas dans la bonne direction, mais que les objectifs importants liés sa cogestion n'ont jamais été entièrement réalisés dans la pratique. Les résultats montrent également que d'importants changements socioéconomiques surviennent dans le parc, de nombreux pêcheurs se tournent vers des moyens de subsistance alternatifs, afin de compenser la baisse des prises de poissons. Enfin, cette étude a révélé que d'importants changements positifs dans les préoccupations environnementales sont survenus depuis la modification du zonage du parc, mais que ceux-ci ne se sont pas entièrement traduits en conformité avec les règles et règlements de l'AMP.

Architecture and other Architectures: Mapping the Production of Insular Space in the Pearl River Delta (China) and Jakarta (Indonesia)

Globalization is widely regarded as the rise of the borderless world. However in practice, true globalization points rather to a “spatial logic” by which globalization is manifested locally in the shape of insular space. Globalization in this sense is not merely about the creation of physical fragmentation of space but also the creation of social disintegration. This study tries to proof that global processes also create various forms of insular space leading also to specific social implications. In order to examine the problem this study looks at two cases: China’s Pearl River Delta (PRD) and Jakarta in Indonesia. The PRD case reveals three forms of insular space namely the modular, concealed and the hierarchical. The modular points to the form of enclosed factories where workers are vulnerable for human-right violations due to the absent of public control. The concealed refers to the production of insular space by subtle discrimination against certain social groups in urban space. And the hierarchical points to a production of insular space that is formed by an imbalanced population flow. The Jakarta case attempts to show more types of insularity in relation to the complexity of a mega-city which is shaped by a culture of exclusion. Those are dormant and hollow insularity. The dormant refers to the genesis of insular– radical – community from a culture of resistance. The last type, the hollow, points to the process of making a “pseudo community” where sense of community is not really developed as well as weak social relationship with its surrounding. Although global process creates various expressions of territorial insularization, however, this study finds that the “line of flight” is always present, where the border of insularity is crossed. The PRD’s produces vernacular modernization done by peasants which is less likely to be controlled by the politics of insularization. In Jakarta, the culture of insularization causes urban informalities that have no space, neither spatially nor socially; hence their state of ephemerality continues as a tactic of place-making. This study argues that these crossings possess the potential for reconciling venue to defuse the power of insularity.

Local food security and principle of organic farming (from farm to fork) in context of food culture in Indonesia: Minangkabau's case study

The basic idea behind improving local food security consists of two paths; first, accessibility (price, stock) and second, availability (quantity and biodiversity); both are perquisites to the provision of nutrients and a continuous food supply with locally available resources. The objectives of this thesis are to investigate if indigenous knowledge still plays an important role in traditional farming in the Minangkabau`s culture, thus supporting local food security. If the indigenous knowledge still plays a role in food culture in the Minangkabau`s culture which is linked to the matrilineal role and leads to a sound nutrition. Further, it should be tested if marantau influences traditional farming and food culture in Minangkabau`s, and if the local government plays a role in changing of traditional farming systems and food culture. Furthermore this thesis wants to prove if education and gender are playing a role in changing traditional farming system and food culture, and if the mass media affects traditional farming systems and food culture for the Minangkabau. The study was completed at four locations in West Sumatera; Nagari Ulakan (NU) (coastal area), Nagari Aia Batumbuak (NAB) (hilly area), Nagari Padang Laweh Malalo (NPLM) (lake area), Nagari Pandai Sikek (NPS) (hilly area). The rainfall ranged from 1400- 4800 mm annually with fertile soils. Data was collected by using PRA (Participatory Rural Appraisal) to investigate indigenous knowledge (IK) and its interactions, which is also combining with in depth-interview, life history, a survey using semi-structured-questionnaire, pictures, mapping, and expert interview. The data was collected from June - September 2009 and June 2010. The materials are; map of area, list of names, questionnaires, voices recorder, note book, and digital camera. The sampling method was snowball sampling which resulted in the qualitative and quantitative data taken. For qualitative data, ethnography and life history was used. For quantitative, a statistical survey with a semi-structured questionnaire was used. 50 respondents per each site participated voluntarily. Data was analyzed by performing MAXQDA 10, and F4 audio analysis software (created and developed by Philip-University Marburg). The data is clustered based on causality. The results show that; the role of IK on TFS (traditional farming system) shown on NPLM which has higher food crop biodiversity in comparison to the other three places even though it has relatively similar temperature and rainfall. This high food crop biodiversity is due to the awareness of local people who realized that they lived in unfavourable climate and topography; therefore they are more prepared for any changes that may occur. Carbohydrate intake is 100 % through rice even though they are growing different staple crops. Whereas most of the people said in the interviews that not eating rice is like not really eating for them. In addition to that, mothers still play an important role in kitchen activities. But when the agriculture income is low, mothers have to decide whether to change the meals or to feel insecure about their food supply. Marantau yields positive impact through the remittances it provides to invest on the farm. On the other hand, it results in fewer workers for agriculture, and therefore a negative impact on the transfer of IK. The investigation showed that the local government has a PTS (Padi Tanam Sabatang) programme which still does not guarantee that the farmers are getting sufficient revenue from their land. The low agricultural income leads to situation of potential food insecurity. It is evident that education is equal among men and women, but in some cases women tend to leave school earlier because of arranged marriages or the distances of school from their homes. Men predominantly work in agriculture and fishing, while women work in the kitchen. In NAB, even though women work on farmland they earn less then men. Weaving (NPS) and kitchen activity is recognized as women’s work, which also supports the household income. Mass media is not yielding any changes in TFS and food culture in these days. The traditional farming system has changed because of intensive agricultural extension which has introduced new methods of agriculture for the last three decades (since the 1980’s). There is no evidence that they want to change any of their food habits because of the mass media despite the lapau activity which allows them to get more food choices, instead preparing traditional meal at home. The recommendations of this thesis are: 1) The empowerment of farmers. It is regarding the self sufficient supply of manure, cooperative seed, and sustainable farm management. Farmers should know – where are they in their state of knowledge – so they can use their local wisdom and still collaborate with new sources of knowledge. Farmers should learn the prognosis of supply and demand next prior to harvest. There is a need for farm management guidelines; that can be adopted from both their local wisdom and modern knowledge. 2) Increase of non-agricultural income Increasing the non-agricultural income is strongly recommended. The remittances can be invested on non-agricultural jobs. 3) The empowerment of the mother. The mother plays an important role in farm to fork activities; the mother can be an initiator and promoter of cultivating spices in the backyard. Improvement of nutritional knowledge through information and informal public education can be done through arisan ibu-ibu and lapau activity. The challenges to apply these recommendations are: 1) The gap between institutions and organizations of local governments. There is more than one institution involved in food security policy. 2) Training and facilities for field extension agriculture (FEA) is needed because the rapid change of interaction between local government and farmer’s dependent on this agency.

Soil fertility and nutrient status of traditional Gayo coffee agroforestry systems in the Takengon region, Aceh Province, Indonesia

Little is known about the traditional coffee cultivation systems in Central Aceh, Indonesia, where coffee production is a major source of income for local Gayo people. Based on field observations and farmer interviews, 14 representative agroforestry coffee plantations of different age classes (60-70 years, 30-40 years, and 20 years) as well as seven adjacent grassland and native forest sites were selected for this study, and soil and coffee leaf samples collected for nutrient analysis. Significant differences in soil and coffee leaf parameters were found between former native forest and Sumatran pine (Pinus merkusii) forest as previous land cover indicating the importance of the land use history for today’s coffee cultivation. Soil pH as well as exchangeable Na and Ca concentrations were significantly lower on coffee plantations compared to grassland and forest sites. Soil C, N, plant available P, exchangeable K, and Mg concentrations showed no consistent differences between land use groups. Nitrogen (N), phosphorus (P), and potassium (K) concentrations of coffee leaves were in the sufficiency range, whereas zinc (Zn) contents were found to be consistently below the sufficiency threshold and significantly lower in coffee plantations of previous pine forest cover compared to those of previous native forest cover. While the results of this study provided insights into the nutrient status of coffee plantations in Central Aceh, the heterogeneity of site conditions, limited sampling size, and scarcity of reliable data about the land use history and initial soil conditions of sampled sites preclude more definitive conclusions about the sustainability of the studied systems.