Purpose: Sjögren’s syndrome (SS) is an autoimmune disease targeting exocrine glands, leading to low body fluids production, especially on the salivary and lacrimal glands. Due to the low saliva and tear production, the common symptoms of Sjögren’s syndrome are dry eyes and dry mouth, later on leading to uncomfortable sensations on the eye surface, cornea destruction, dental caries, and oral cavity infections. Several infections are known to cause similar side-effects to Sjögren’s syndrome symptoms, including low saliva flow; therefore, infection is hypothesized as one of the risk factors of Sjögren’s syndrome. Results: Based on our literature research, there are several infectious agents which cause similar disease manifestations to Sjögren’s syndrome, including infections of hepatitis C virus, Epstein–Barr virus, cytomegalovirus, and human T-lymphotropic virus-1 (HTLV-1), and these four agents are found to cause persistent infection on the salivary gland after the first infection and later lead to organ destruction, thus causing sicca syndrome in the oral cavity. Other findings show possible Heliobacter pylori infection might lead on the increasing level of anti-Ro/SSA and anti-La/SSB of infected individuals. Conclusion: Some research has shown persistent infection could trigger autoimmune disorders due to continuous T-cells and B-cells activation in an attempt of infected cells eradication, leading to autoimmune reaction and high autoreactive cells concentration around the healthy cells causing the immune cells to eradicate the healthy cells nearby. However, the results in this literature study found persistent infection is not the only risk factor of Sjögren’s syndrome but there are various unknown factors that trigger infection to develop into Sjögren’s syndrome.

Household waste is the most significant contributor to the accumulation of waste in the final processing area. Indonesia produces 65.2 million waste per year. Improper waste management practices in Indonesia require evaluation steps to achieve sustainable waste management. This study aims to formulate an evaluation instrument for the implementation of household waste management using the analysis of the Household Waste Control Index (HWCI) calculation. This study uses quantitative methods by collecting data from a survey of 548 waste bank members spread across 12 districts in Bekasi City and using the analysis of the calculation of the Household Waste Control Index. Based on the study results, it is known that the implementation of household waste management in Bekasi City is in the moderate category (5.86 out of 10), and the governance of household waste management at the community level still needs to be improved. Furthermore, based on the validation results, it is concluded that the household waste control index can be recommended as an instrument to measure, evaluate, and consider recommendations for waste management policies to realize sustainable household waste management in Bekasi City and other areas that have similar conditions to Bekasi City.

Multicriteria Decision Making (MCDM) is increasingly being utilized as an analytical research tool for sectors that require decision-making with specific objectives and constraints, such as the tourism industry. Sustainable tourism, which examines the balance of numerous aspects, including stakeholders’ interests, is the critical feature propelling the increased usage of MCDM. This paper explores the use of Multicriteria Decision Making (MCDM) methods applied in studies of sustainable tourism and its derivative term, low-carbon tourism, using a systematic literature review (SLR) search from the Scopus database. The analysis has identified 189 relevant studies published between 1987 to April 2022. After selection, screening, and synthesizing processes, we selected 135 pertinent studies, which were analysed in general descriptive data, citation impacts, geographical categorization, categorization of the methodologies’ objectives, and possible trajectories of similar research in the future. We find that highly cited authors and articles are related to sustainable tourism indicators' development and case studies. Furthermore, most relevant studies are concentrated in Asia and Europe rather than other regions. We also categorize the reviewed studies into six classifications depending on each method's intended usage and further suggest four contexts for the studies’ future trajectory.

Latar belakang: Pengelolaan lingkungan rumah sakit (RS) secara berkelanjutan menjadi sangat penting dalam rangka meminimalisasi konstribusi negatif terhadap pemanasan global. Tujuan penelitian ini adalah 1) menyusun atribut green hospital di Indonesia, dan 2) menganalisis status keberlanjutan pengelolaan lingkungan RS di Indonesia. Metode: Penelitian ini menggunakan dua pendekatan yakni pendekatan kualitatif dan kuantitatif. Jenis data yang dikumpulkan merupakan jenis data primer dan data sekunder. Metode pengumpulan data terdiri atasstudi pustaka, survei, wawancara mendalam, dan pendapat pakar. Metode analisis data yang digunakan adalah analisis deskriptif dan inferensial dengan pendekatan Multidimensional Scalling (MDS) Rap GreenHospital. Hasil: Hasil analisis diperoleh, atribut green hospital RS di Indonesia terdiri dari enam dimensi yakni dimensi ekologi, ekonomi, sosial, teknologi, kesehatan lingkungan dan kelembagaan. Keenam dimensi tersebut terdiri dari 42 atribut dan 151 sub atribut. Status keberlanjutan pengelolaan lingkungan RS dalam kategori cukup berkelanjutan (yellow hospital) dengan skor 71.233%. Faktor pengungkit keberlanjutan pengelolaan lingkungan RS meliputi: a) Pengelolaan limbah non medis; b) Pengelolaan limbah B3; c) Lingkungan dalam bangunan; d) Lingkungan Luar bangunan; e) Mitigasi dan adaptasi bencana; f) Sumber dana; g) Kinerja anggaran; h) Budaya ramah lingkungan;i) pengembangan partisipasi masyarakat; j) Tingkat kepuasan; k) Teknologi konservasi energi;l) Teknologi pengolahan limbah padat, cair dan gas; m) Infeksi nosokomial;n) Fasilitas sanitasi; o) Promosi kesehatan, p) Kepemimpinan; q) Sumberdaya manusia; dan r) Dokumen lingkungan. Simpulan: Atribut green hospital rumah sakit di Indonesia terdiri atas enam dimensi yakni dimensi ekologi, ekonomi, sosial, teknologi, kesehatan lingkungan dan kelembagaan. Keenam dimensi tersebut terbagi dalam 42 atribut dan 151 sub atribut. ABSTRACT Title: Attribute Assessment of the Sustainability of Hospital Environmental Management Towards Green Hospital in Indonesia Background: Sustainable management of the hospital environment is very important in order to minimize the negative contribution to global warming. The purpose of this study is 1) to compile the attributes of green hospitals in Indonesia, and 2) to analyze the sustainability status of hospital environmental management in Indonesia. Methods: This study uses two approaches namely qualitative and quantitative approaches. The type of data collected is a type of primary data and secondary data. Data collection methods consist of study literature, surveys, in-depth interviews, and expert judgment. The data analysis method used is descriptive and inferential analysis with the Multidimensional Scaling (MDS) Rap Green Hospitalapproach. Results: The analysis results obtained, the attributes of green hospital hospitals in Indonesia consist of six dimensions namely the dimensions of ecology, economics, social, technology, environmental health and institutional. The six dimensions consist of 42 attributes and 151 sub attributes. Status of environmental management of hospitals in the category of sustainable enough (yellow hospital) with a score of 71,233%. Factors for the sustainability of hospital environmental management include: a) Non-medical waste management; b) Hazardous Poison Materials waste management; c) The environment in the building; d) Outside environment of buildings; e) Disaster mitigation and adaptation; f) Sources of funds; g) Budget performance; h) green culture; i) development of community participation; j) Level of satisfaction; k) Energy conservation technology; l) Solid, liquid and gas waste treatment technology; m) Nosocomial infections; n) Sanitation facilities; o) Health promotion, p) Leadership; q) Human resources; and r) Environmental documents. Conclusion:The attributes of green hospital in Indonesia consist of six dimensions, are ecology, economic, social, technology, environmental health, and institutional. The six dimensions are divided into 42 attributes and 151 sub attributes.

The Indonesian National Police (POLRI) has succeeded in suppressing illegal artisanal small-scale gold mining (ASGM) that has been taking place in Mount Botak, Buru Regency, Maluku Province, Indonesia. However, POLRI has only succeeded in creating a temporary absence of illegal ASGM. This study aims to analyse an additional role POLRI could play in achieving social and ecological justice by promoting a positive and functioning social order. We used a case study method to collect data from documentation and literature studies on illegal ASGM cases in Mount Botak. The findings of this study reveal that pressure by POLRI against national and local governments may have a positive impact on the absence of illegal ASGM. This study recommends that POLRI should, in addition to the performance of its formal role in enforcing the law against illegal ASGM and maintaining security and order, play a role as a pressure group acting on national and local governments to promote social order and to achieve social and ecological justice for communities around local mining areas.

A paradigm shift is required to transform current natural resource management (NRM) in Indonesia’s decision to move into low-carbon development to achieve the greenhouse gas emission target. No study has been conducted to assess whether or not the current approaches are reliable in anticipating the conundrum of the new juncture. We reviewed 10 cases of NRM practices in Indonesia from 2019–2023 collected from the Scopus dataset by integrating the prisoner’s dilemma approach into the socio-ecological framework to analyze the practices and the anticipated gaps. Our finding revealed that socio-economic governance is the dominant view in interpreting the competition between personal and collective interests in NRM. Seeing NRM as an allocation problem and the excessive use of the legal normative approach in interpreting and addressing the problem are flaws in the approach. Combining the prisoner’s dilemma approach with the socio-ecological governance framework enabled us to address the flaws. Promoting polycentric governance that accommodates social trust, reciprocities, and socio-ecological beliefs and reduces uncertainties about ownership and the resources necessary to reduce defective behavior is a solution to transform the structure of the competition. Revising the socio-economic payoff into a socio-ecological value-oriented institution is the strategy to address the conundrum.