Multilevel Student Movement
Posted by | Published on September 29th, 2006Beberapa dekade terakhir, dunia menunjukkan perkembangan global yang, pada beberapa hal, telah memudahkan hidup sebagian ummat manusia. Meskipun juga tidak bisa dipungkiri realitas negatif dari perkembangan tersebut sebagai bias dari pembangunan. Berbagai perkembangan yang dimaksud adalah misalnya perubahan paradigma pembangunan ke arah pembangunan yang berwawasan kesehatan lingkungan, gerakan bangsa-bangsa maju dalam pengentasan kemiskinan global dan upaya meningkatkan derajat kesehatan masyarakat kelas menengah ke bawah yang tersebar hampir di seantero dunia. Selain itu, terlepas dari beragam kepentingan politis dan ideologis di baliknya, juga bagaimana memahami konsepsi demokrasi secara proporsional, saat ini pertumbuhan “demokrasi” tengah berlangsung pesat, terutama dimotori negara-negara benua Eropa dan Amerika, dengan memberi proporsi lebih besar untuk pengembangan dunia ketiga.
Konsepsi demokrasi yang diperluas menjadi tema kajian yang cukup menarik untuk disimak lebih lanjut. Munculnya gagasan besar Unifikasi Eropa dan terakhir adalah Uni Asia-Australia, merupakan kelanjutan pengembangan gagasan terpadu menuju kehidupan dunia yang lebih egaliter dalam frame interkoneksitas.
Perubahan konstelasi politik dan sosio-demografis di banyak belahan dunia telah melahirkan kesadaran komunal untuk menggunakan system yang disebut sebagai Multilevel Government, sebuah gambaran kehidupan berkebangsaan yang menekankan pada relasi mutualisme antar negara-negara sepaham pada sebuah kawasan geografis terpadu. Memang jika melihat tantangan ke depan bagi bangsa-bangsa yang memiliki beragam kekhasan tersendiri, model Multilevel Government (MLG) ini menjadi alternatif yang cukup akomodatif untuk tetap mempertahankan eksistensi suatu komunitas bangsa di tengah derasnya perkembangan globalisasi saat ini.
Menggunakan model MLG – meskipun cukup rentan dikatakan mirip dengan model MLM (Multilevel Marketing) yang tengah ngetrend saat ini – mengantarkan kita pada sebuah dinamika baru berkehidupan yang secara sosiologis sesungguhnya dapat dijadikan contoh untuk merajut mutual-simbiosis komunitas-komunitas sepaham pada banyak tempat dan kondisi.
Tidak terkecuali dalam kehidupan kemahasiswaan yang dikenal memiliki kecakapan dialektis yang relatif dinamis. Dunia kemahasiswaan sebagai sebuah “proses”, atau dengan istilah lain – meminjam ungkapan Asta Qauliyah1 – sebagai “aquarium citra diri”, merupakan fase non-statik yang kita jalani. Karena itulah maka dalam dunia kemahasiswaan, inisiatif akan perubahan dan sikap yang anti-kemapanan menjadi ikon yang seharusnya selalu dapat ditegakkan, tidak terkecuali dalam berbagai mekanisme internalnya, baik yang mewakili metodologi pergerakan maupun pada sistem peremajaan (baca: kaderisasi) yang menjadi “denyut nadi” gerakan kemahasiswaan.
Perubahan paradigma masyarakat kita dewasa ini, selain harus dimaknai sebagai upaya adaptif terhadap derasnya serangan global yang masuk dalam rumah-rumah hidup mereka, juga mesti dijadikan sebagai sebuah “warning point” untuk sedapat mungkin kita menyusun serangkaian upaya antisipasi atas segala kemungkinan yang dapat meruntuhkan idealitas-idealitas dan nilai/norma lokal yang telah tumbuh dan berkembang di dalamnya.
Sebagai sebuah proses dan aquarium citra diri, hidup bermahasiswa menuntut kita untuk secara arif dan selektif, menyusun langkah-langkah strategis meningkatkan “imunitas ideologis” agar tetap dapat melanggengkan peran sebagai “agent of change”, “agent of social critism”, dan sejumlah amanah mulia lainnya. Pelajaran demokrasi, seperti yang tengah berkembang di belahan Eropa dan Amerika, pada prinsipnya mesti dipahami sebagai sebuah ikhtiar dalam mengawal proses berkehidupan supaya tetap egaliter, humanis dan mengedepankan pada kepentingan moral dan kearifan terhadap sesama manusia.
Pada beberapa waktu terakhir, harus dimahfumi jika gerakan mahasiswa sementara mengalami titik nadir, jika tidak enak disebut “vakum”, sebagai akibat ketidakseimbangan kekuatan internal perkembangan yang dihadapkan dengan serangan globalisasi yang perlahan masuk pada wilayah-wilayah personal diri mahasiswa. Dari sini dapat ditarik benang merah mengapa sikap kritik mahasiswa yang dulu pernah “garang” kini memudar, seiring dengan semakin meningkatnya budaya hedonisme dan sikap poitik-pragmatis di kalangan mahasiswa.
Jika dianalisa lebih dalam, beberapa realitas secara terang telah menunjukkan betapa “metodologi” pergerakan mahasiswa yang secara substansial tidak pernah berubah sejak dahulu, kini tidak lagi menjumpai relungnya. Dengan demikian, maka tidak bisa dinafikkan bahwa, gerakan mahasiswa kini sudah saatnya “memoles diri” sebagai upaya “adaptif ideologis” untuk tetap dapat merespons segala perkembangan yang terjadi tetapi tidak juga menyurutkan nilai-nilai idealitas yang selama ini dijunjung tinggi.
Dalam konteks ini, menjadi urgen memikirkan adaptasi metodologi pergerakan, dengan terutama tidak lagi secara “egosentris” mengkotak-kotakkan diri pada lokus-lokus kecil yang hanya disekati oleh dinding-dinding fakultatif, tetapi secara perlahan harus mulai membuka diri terhadap kemungkinan “kolaboratif”, tetapi dalam frame “interkoneksitas”, yang barangkali bisa diawali melalui pendekatan kesamaan disiplin keilmuan. Pendekatan seperti ini, jika tak berlebih dapat kita istilahkan sebagai model “Multilevel Student Movement” (MSM).
Ide ini akan berarti lebih jika kita juga bisa memahami prediksi bahwa ke depan –meskipun juga memang tidak boleh dinafikkan pentingnya komprehensifitas gerakan, tanpa memandang perbedaan disiplin keilmuan mahasiswa– gerakan mahasiswa akan berlangsung berdasarkan disiplin profetik sehingga relatif lebih fokus dan “mengerti betul akar persoalan”, berbeda dengan model gerakan sebelumnya yang cenderung “sapu rata”. Untuk komprehensifitas gerakan, maka level Multilevel Student Movement ini dapat diterapkan untuk tingkat lebih tinggi, mungkin saja antar kesatuan (unifikasi) disiplin profetik keilmuan yang ada.
MSM di Unhas
Untuk skala lokal, sekaligus sebagai pilot project, kita bisa memulai ikhtiar ini berdasarkan kompleks-kompleks disiplin keilmuan yang ada dalam sebuah Universitas. Di Unhas, kondisi objektif fakultas-fakultas sesungguhnya mengkondusifkan terwujudnya sebuah model Multilevel Student Movement (MSM). Relatif terkategorisasikannya disiplin keilmuan di kampus ini, pada satu sisi telah banyak membantu penyederhanaan berbagai persoalan kemahasiswaan selama ini, meskipun tak bisa dipungkiri bahwa kondisi ini juga secara tidak langsung menyebabkan tingginya tembok-tembok arogansi mahasiswa sebuah fakultas ketika berhadapan dengan mahasiswa fakultas lain.
Dalam konteks seperti ini, pemahaman mendasar tentang apa dan bagaimana model Multilevel Student Movement (MSM) itu menjadi sangat perlu dimiliki oleh para mahasiswa, juga semua civitas akademika universitas. Sebagaimana dijelaskan sebelumnya, model MSM mensyaratkan kesadaran komunal yang secara demokratis diwujudkan melalui interaksi yang bersifat “kolaboratif” dalam bingkai “interkoneksitas”.
Tujuan besar dari model MSM adalah menyiasati degradasi gerakan mahasiswa saat ini dengan menghadirkan bentuk baru pergerakan yang lebih riil dan mudah direalisasikan. Pada gilirannya, jika pada masing-masing kompleks keilmuan pada sebuah universitas telah terbangun struktur gerakan dengan system koordinasi terpadu antar beberapa fakultas sedisiplin ilmu, maka akan menjadi mudah mengolaborasikan sebuah tatanan gerakan mahasiswa pada tingkat universitas, termasuk pembentukan lembaga kemahasiswaan di tingkat perguruan tinggi dan agenda-agenda “besar” kemahasiswaan lainnya.
Hanya saja, mewujudkan model MSM, selain membutuhkan keberanian mengevaluasi pola-pola lama gerakan mahasiswa, juga terlebih dahulu perlu dilakukan upaya penyadaran demokratif dan mewacanakan pentingnya kerjasama “trans-disiplin” keilmuan dalam sebuah universitas. Harus juga dicamkan dalam-dalam bahwa model MSM bukanlah bentukan baru “arogansi kompleksitas keilmuan yang diperluas”, tetapi upaya sadar yang secara demokratif didesain sebagai wujud kesadaran eksistensial disiplin profetik dan hadirnya “tenggang rasa keilmuan”. Tanpa ini, sepertinya berat untuk menggulirkan pembentukan MSM di Unhas, juga di tempat lain.
Prospek
Secara sederhana dapat digambarkan bahwa model MSM merupakan sebuah pendekatan trans-disiplin, yang jika direalisasikan dengan baik, akan dapat menguatkan tradisi gerakan yang dapat dipertanggungjawabkan secara moral, terlebih secara intelektual, karena berakar dari kesadaran kompleksitas keilmuan yang coba disederhanakan secara andragogik dan demokratif.
Persoalan bangsa dan sejumlah problem kerakyatan saat ini, jika dianalisa lebih jauh, sesungguhnya menunjukkan perlunya pendekatan “trans-disiplin” untuk menuntaskannya. Pendekatan yang dimaksud adalah yang secara intelektual bisa dipertanggungjawabkan, terutama dalam upaya merumuskan solusi alternatif untuk menuntaskan persoalan tersebut. Saling menghargai eksistensi masing-masing disiplin profetik/keilmuan akan banyak membantu meningkatkan “gairah” dan kreativitas untuk “menggerakkan” segala potensi dan sumber daya intelektual. Diyakini, kondisi “tenggang rasa keilmuan” seperti ini akan dapat menumbuhkan nuansa profesionalitas dalam menyelesaikan tanggung jawab masing-masing pihak.
Iklim “tenggang rasa keilmuan”, jika dirunut kembali, hanya dapat terbangun jika dari awal sudah dikondisikan lahirnya. Model Multilevel Student Movement (MSM) sebenarnya merupakan sebuah upaya untuk menumbuhkan sedini mungkin iklim “tenggang rasa keilmuan” pada level mahasiswa. Pada akhirnya, jalinan gerakan intelektualitas dan moralitas yang senantiasa diarak beramai-ramai oleh kalangan mahasiswa, akan tetap dapat menemui “relung hidupnya”, meskipun aktor-aktornya telah “cabut” dari kampus. Mengapa? Karena moralitas yang terbangun secara sadar dan dilandasi oleh “intelektualitas yang saling menyapa” tidak akan pernah punah.
Pada konteks inilah Multilevel Student Movement (MSM) menjadi perlu diwujudkan, setidaknya, mulai diwacanakan secara “dewasa” agar dapat dimengerti banyak pihak, sebelum barangkali, menolaknya mentah-mentah. []
Popularity: unranked [?]
September 29th, 2006 at 7:01 pm
Hai…
[reply to this comment]
October 5th, 2006 at 9:56 pm
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* wheezing, hoarseness, or cough
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
[edit]
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient’s medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a histopathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Typical immunohistochemistry results Positive Negative
EMA (epithelial membrane antigen) CEA (carcinoembryonic antigen)
WT1 (Wilms’ tumour 1) B72.3
Calretinin MOC-3 1
Mesothelin-1 CD15
Cytokeratin 5/6 Ber-EP4
HBME-1 (human mesothelial cell 1) TTF-1 (thyroid transcription factor-1)
[edit]
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening[3].
[edit]
Staging
Once the diagnosis is confirmed, the doctor may need to assess the stage to help plan treatment.
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
[edit]
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than “feathery fibers” (chrysotile or white asbestos fibers)[4]. However, there is now evidence that smaller particles may be more dangerous than the larger fibers.[1][2] They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. “We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately,” said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for “World Trade Center syndrome” or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.[3]
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
* Neurofibromatosis type 2 at 22q12
* P16INK4A
* P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
* Inactivation of tumor suppressor genes
* Activation of oncogenes
* Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
* Activation of DNA repair enzymes, which may be prone to error
* Activation of telomerase
* Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos may also possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer (LAK) cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-? (TGF-?) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
[edit]
Epidemiology
[edit]
Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades[5]. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[4] Between 1973 and 1984, there has been a three-fold increase in the diagnosis of pleural mesothelioma in caucasian males. From 1980 to the late 1990s, the rate of deaths from mesothelioma increased from 2,000 to 3,000 a year. in the late 1990se in annual deaths from mesotheilioma. [5], with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
[edit]
Risk factors
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and asbestos exposure significantly increases a person’s risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking current cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma[
[reply to this comment]
March 28th, 2008 at 9:47 pm
Busyet, panjang amat tulisannya…. Mana ada komen gak nyambung lagi. Duh…
[reply to this comment]