Proceedings of the International Conference on Applied Science and Health
ISSN 2579-4434 (ONLINE) Proceedings of the International Conference on Applied Science and Health is a conference collection of technical papers freely accessible to scholars over the world. Articles featured vary areas of efforts to develop health and well-being for better society such as factors of illness, epidemiology, health promotion, health education, health policy, nutrition, environmental health and safety, nursing and midwifery, and other sciences related to health development. This publication is dedicated to report original research findings, best practices, and review articles presented at The International Conference on Applied Science and Health (ICASH). For now on, we are no longer able to continue conducting the conference, however, your publication are preserved and safely archieved at the Keepers Registry which archival status can be seen in this link : https://portal.issn.org/resource/ISSN/2579-4434. We provide metadata to third-party indexing services through the Open Archives Initiative. LOCKSS and CLOCKSS system has permission to collect, preserve, and serve this Archival Unit. To continue publish with us, kindly check GHMJ (Global Health Management Journal), our open-access, triannual, peer-reviewed, online journal with a strong emphasize on health and applied science in health.
Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)
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PATIENT SAFETY CULTURE IMPROVEMENT TO ENHANCE THE QUALITY OF HEALTHCARE IN HARAPAN BUNDA HOSPITAL JAKARTA
Background: One of the achievements in running health care service institutions (hospitals) is providing strategic health care services to improve health status. Harapan Bunda Hospital is a private hospital located in East Jakarta. Whose vision is to become the preferred hospital by providing the best quality service. One of the implemented programs was reporting incidents in the unit to the QPS Committee. However, the incident that occurred in Harapan Bunda Hospital is still not widely reported regularly by officers in the unit. In addition, there are many discrepancies in service delivery in the form of safety. Therefore, it is necessary to measure the Safety Culture at Harapan Bunda Hospital. Methods: This research used quantitative method with design cross sectional and used descriptive analysis to seek whole picture of all patient safety variable that had been done by Harapan Bunda Hospital. The population in this research is all staff of Harapan Bunda Hospital which around 708 staff member. Researcher used systematic random sampling with Slovin calculation formula and get 256 minimum sample needed. Instrument used is Patient Safety Culture survey refer to Agency for Healthcare Research and Quality (AHRQ). Results: The result of mean measurement patient safety culture in Harapan Bunda Hospital is 72%, it means Harapan Bunda Hospital was moderate Patient Safety Culture. There are dimensions being focused to improving patient safety culture; the overall perception of patient safety, feedback and communication about errors, communication openness, frequency of incident reporting, staffing and non-punitive responses to errors. Conclusion: Meanwhile, the other 6 dimensions of safety culture have been included in the good category of safety culture. Thus, Harapan Bunda Hospital is expected to always carry out routine monitoring and evaluation of the measurement of safety culture. Keywords: Patient Safety Culture, Hospital, Quality of Healthcare
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REDUCED LENGTH OF STAY IN CHILDREN WITH DIARRHEA FOLLOWING IMPLEMENTATION OF CLINICAL PATHWAY
Background: Diarrhea or Acute Gastroenteritis (AGE) is a dissease that common found in toddlers at emergecy room. The complication of diarrhea such as dehydration may go undetected by parents will affect the treatment and length of stay in the hospital. Decreasing the length of stay in the hospital can be done by implementing clinical pathways. This study aims to examine the effect of implementing clinical pathways on length of stay in children with diarrhea. Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases Proquest and Scopus that published between 2009-2019 and used English. By using keywords such as clinical pathway, gastroenteritis, and length of stay to find the relevant articles. Results: The search found 610 studies, of which 6 studies were included in the systematic review. These studies conducted majority in USA and 1 study in Australia. Analysis of the studies found out that implemented clinical pathway can decrease length of stay 0.4 days (95% CI 0.04 to 0.7, p <0.01). The decreased of length of stay can increased 2.5% (CI 0.25% to 4.38%) used of medical beds then the bed can be more effective and used by other patients. Conclusion: Implementing clinical pathway in the treatment process of diarrhea towards children not only reduce the length of stay in hospital but also useful in providing patient diagnosed and reduce the bed use per day and year. Keywords: Clinical Pathway, Diarrhea, Gastroenteritis, Pediatric
FACTORS RELATED TO PENDING CLAIM IN INDONESIAN NATIONAL HEALTH INSURANCE (JKN): A SYSTEMATIC REVIEW
Background: The number of Indonesian National Health Insurance (JKN) member is increasing every year. It is bringing impact to the hospital and Social Security Organizing Agency (BPJS) of health. The hospital finances will face problem if BPJS of health pending or giving a smaller number of claims paid to the hospital. The hospital will get problem with employee payroll, payment of specialist medical services, drugs availability, and maintenance of hospital facilities and medical equipment. This study aims to analyze factors related to pending BPJS claim in Indonesian National Health Insurance. Methods: This study was a systematic review used PRISMA (Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines. Data obtained from journal database of Google Scholar that published between 2014-2019. The relevant studies must include factors related to pending claim in JKN. Results: The search found out 217 studies, of which 84 studies used English and Indonesia language and only 5 studies that eligible for this study. The 5 studies showed factors related to pending claim in JKN were human resources, administration, regulation, facilities, external and evaluation factors. Human resources factor more likely appeared as cause for pending BPJS claim. Conclusion: Factors related to pending claim in JKN were human resources, administration, regulation, facilities, external and evaluation factors. Human resources was the factor that most influenced for pending BPJS claim. The hospital must create strategies to overcome the factors that cause pending claim. The government should create a policy that can help BPJS of health overcome the deficit and protect the patients from facing decrease in the quality of hospital services. Keywords: Pending claim, BPJS, National Health Insurance (JKN)
FACTORS RELATED TO THE REDUCTION OF MEDICATION DISCREPANCIES AT TRANSITION OF CARE: A SYSTEMATIC REVIEW
Background: Adverse drug events (ADE) are a leading cause of injury and death within health care systems around the world. Up to 67% of patients' prescription medication histories recorded on admission to hospital have one or more errors and 30 – 80% of patients have a discrepancy between the medicines ordered in hospital and those they were taking at home. This study aims to systematically evaluate the available literature on the medication history records as a quality improvement in reducing medication discrepancies during the transition of care. Methods: This study was used systematic review which performed according to the PRISMA method. The search included articles were obtained through databases: MEDLINE (1946), EMBASE (1966), CINAHL (1937) and PubMed (1946). Some of the key words or Medical Subject Heading (MeSH) terms used in the search were: "transition of care,” "medication discrepancies,” "medication errors,” "patient safety,” "medication history,” "patient admission,” "patient discharge,” "patient transfer,” and "hospital”. Only studies published in English were included. Exploring literature was focused on the articles published from 2009 to 2019. Results: Initially, a total of 162 potentially relevant articles were obtained. After screening tittle and reviewing abstracts, 14 full text were assessed for eligibility. Of the 10 articles met all inclusion criteria, 5 studies were randomized controlled trials, 2 quasi-experimental studies, 1 cohort study, and 2 qualitative studies with quantitative approaches. All studies found that involving best possible medication history in identifying medication discrepancies and communicating this information affected medication discrepancies in the medical record. Conclusions: The available literature such as lack of well-designed studies precluded us from concluding that no effect exists. Medication reconciliation supported by information technology was an important tool for minimizing the percentage of medications with unintentional discrepancies Keywords: Adverse drug events, Medication discrepancies, Patient safety, Transition of care
EFFECTIVENESS OF CAESAREAN SECTION CLINICAL PATHWAY TOWARDS HOSPITAL LENGTH OF STAY: A SYSTEMATIC REVIEW
Background: Improving quality and efficiency in hospital services can be done by using Clinical Pathway (CP). CP can decrease the hospital length of stay and cost. In indonsia, the increasing number of Caesarean Section (SC) affects to the Length of Stay (LOS) in hospital. This study aims to examine the effectiveness of clinical pathway in caesaren section to length of stay in the hospital. Methods: This study was a systematic review used PRISMA guidelines. Data obtained from Electronic journal databases Pubmed and ProQuest that published between 2014 until 2019 and used English language. By using keywords such as clinical pathway, childbirth labor, and length of stay to find the relevant journal. Results: The search found out 4,937, studies from 2 journal databases. The articles that not suitable with the criteria inclusion must be exclude. Totally, 6 studies were analyzed in this study. 1 study explained the affect of increasing length of stay in the National Health Insurance, 2 studies mentioned that CP was not affected to the length of stay in hospital and 3 studies mentioned that CP was reduced the length of stay in hospital. Conclusion: Clinical pathway in Caesarean section can reduced the length of stay in hospital. The hospital should implement the clinical pathway in caesarean section to increase the quality of hospital service and reduce the cost. Keywords: Clinical Pathway, Childbirth Labor, Length of Stay, Casearean Section
THE LEADERSHIP ROLE FOR A SUCCESSFUL CHANGE MANAGEMENT: A SYSTEMATIC LITERATURE REVIEW
Background: Globally there are significant concerns about the role of leadership in the disruptive era where change is inevitable. Organization needs a leader who can response those changes toward right direction to sustain. This review is to identify a more comprehensive relation between the leadership role and change management in the organization and its associated factors drawing upon systematic review of literatures published in the last ten years. Methods: This study used systematic literature review based on the PRISMA (Preferred Reporting Items for Systematic Reviews & Meta-Analyses) protocol to identify all the published articles using relevant keywords. We searched in Emerald Insight (2010-2019), Science Direct (2010-2019), and EBSCOhost (2010-2019) to retrieve relevant articles published in English language only between January 2010 and April 2019. The review used key terms and phrases associated with Leadership, Change Management, and Disruptive. The abstracts were reviewed according to inclusion criteria and quality assessment. Results: From 16,658 authors finally include 6 papers in this review. By the review, we noted that it is almost impossible to avoid change although resistance to change is real. There is a positive relation between leadership role and successful change management. The most significant subject and contributor for the successful change are the culture of change within the organization and the effective communication between leaders and their subordinates. The hindrances of change are lack of authority, uncertainly of role and lack of time and focus from the leaders. The findings of the study can be relevant for variety of settings as the study was conducted across cultures and sectors. Conclusions: Leaders need to understand and spread the ambience with their employee of 4 points; the clarity about the needs of change in their organization, the key alignments, complementary development strategies and critical enablement. The recommendation for future research is to review more leadership studies on disruptive era in health care sector only in order to get deeper understanding in homogeneity setting. For policy makers, it is suggested to design policy that enforces leaders to improve their leadership skill and updating knowledge. Keywords: Leadership Role, Change Management, Disruptive
THE CHILD'S DENTAL TREATMENT WITH SEDATION: REASONS, DENTAL TREATMENT NEEDS, MEDICAL CONDITION, AND HISTORY OF DENTAL ANXIETY AMONG CHILDREN IN YARSI DENTAL HOSPITAL
Introduction: The prevention and treatment of oral diseases in childhood and adolescence as the basis for good oral health throughout life is the aim of pediatric dentistry. The ability to care for the segment of the pediatric patients with fear and anxiety of dental treatment also with the medically compromised condition has become an important component of dental practice. Therefore, a need does exist for sedation services within the dentistry field. This study aimed to determine the reasons, dental treatment needs, medical condition, and history of dental anxiety in the analyzed group of pediatric patients. Methods: This was a cross-sectional study using secondary data from medical records data conducted by YARSI Dental Hospital from March to April 2019. About 30 data were eligible for this analysis. The dependent variable in this study was dental treatment with sedation. Independent variables consisted of reasons, dental treatment needs, medical condition, and history of dental anxiety. The data were analyzed using univariate and bivariate analysis. Results: In this study, there were 21 children (70%) doing dental treatment with sedation because of the need for dental treatment and intervention reason. There was statistically significant interaction between reason and dental treatment with sedation with p-value = 0.023 < 0.05. Another finding, children with a history of dental anxiety were more likely to use dental treatment with sedation (43.3%). With p-value 0.935 > 0.05 there was no statistically significant interaction between the history of dental anxiety with dental treatment with sedation. This study also did not reveal a statistically significant correlation between the following variables: dental treatment needs (p=0.128) as well as children's medical condition (p=0,091). Conclusions: Most of the correspondents were non-medically compromised children with a history of dental anxiety. The reasons they came to YARSI dental hospital were because of the need for dental treatment and intervention reason. Conservation was the most needed dental treatment. Of the 4 (four) variables studied, the highest influence was the relationship between reason with dental treatment with sedation. Keywords: pediatric, dental, sedation
HOSPITAL EMPLOYEES' PERCEPTION OF MARKETING STRATEGY AT H. ABDUL MANAP GENERAL HOSPITAL IN JAMBI CITY
Background: A hospital is required to be capable of maintaining its existence by developing effective marketing strategies to encounter the globalization challenges. The marketing strategy in the hospital is influential for its activities to provide appropriate services to the patient's needs. This study aims to determine the hospital employees' perception towards priority marketing strategy at H. Abdul Manap Regional Hospital. Methods: This study was used the quantitative method with the descriptive analytic research. This research conducted in 602 people while the samples were 240 people, selected by accidental sampling technique. The primary data collection was conducted by employing a questionnaire as the survey method. The data analysis carried out was univariate analysis to obtain a percentage value description for each marketing strategy. Results: The results identified that price was the top priority marketing strategy voted by 171 respondents (71.3%). On the second rank, Product was voted as the top marketing strategy by 141 people (58.8%). In the third position, Professionalism was voted by 132 people (55.0%) as the top priority for marketing strategy. Conclusions: The research concludes that the hospital employees perceived that H. Abdul Manap General Hospital needed to prioritize price, product, and professionalism in developing its marketing strategies. It is advised that H. Abdul Manap General Hospital revise its price, develop new products based on patient needs, and provide professional human resources with good communication skills. Keywords: Marketing Strategy, Perception, Hospital Employees
A DEMOGRAPHIC PICTURE ON MEDICAL CHECK UP PATIENTS AND ITS ASSOCIATION WITH PATIENT SATISFACTION LEVEL AT X HOSPITAL IN WEST JAKARTA FOR THE PERIOD OF OCTOBER 2018- FEBRUARY 2019
Background: Nowadays, the trend of non-communicable diseases is increasing around the world. The Sustainable Development Goals (SDG'S) sets the target to decrease number of mortality and morbidity from non-communicable diseases. One of the strategies to achieve the target is by doing medical checkup routine in the hospital. To do medical check-up is affecting by the patient satisfaction with the hospital services. The characteristic of patients can influence the patient to do medical check-up and will affect the satisfaction level with the hospital services. This study aims to examine the demographic characteristic of patients associated with patient's satisfaction level in hospital "X”. Methods: This study was a quantitative study used cross-sectional method. The sample in this study was 502 patients during October 2018 to February 2019. The dependent variable in this study was patient's satisfaction. The independent variables were age, gender, residential area, marital status, and patient status in hospital. The data was analysed in univariate and bivariate analysis used Chi-square. Results: The demographic characteristic of patients in hospital "X” were majority female, had aged 50 years and older, married, lived near hospital "X”, and actually old patient in the hospital. Bivariate analysis showed that age associated with patient's satisfaction level (p value = 0.000, CI 95%). Meanwhile the other demographic characteristics were not statistically significant with patient's satisfaction. Conclusion: This study showed that majority of the patients who did medical check-up in the hospital "X” had aged 50 years and older, married, lived near hospital "X”, and actually old patient in the hospital. The aged of the patient was statistically significant associated with patient's satisfaction. Therefore, the medical check-up service of hospital "X” should be improved based on existing market segment. Keywords: Medical Check Up, demographic characteristic, satisfaction
HOW EFFECTIVE IS SIMULATION-BASED EDUCATION FOR IMPROVING THE NURSES' KNOWLEDGE ON PEDIATRIC IV INSERTION: A SYNTHESIS FROM AWAL BROS HOSPITAL GROUP IN INDONESIA
Background: Simulation-based nursing education has been growing rapidly and becomes one of the most popular teaching methods for improving patient safety and patient care. One of the difficult Nursing skills to achieve is IV insertion. Due to the high complaints in the number of IV insertion attempts in the paediatric patients, the Nursing Corporate of Awal Bros Hospital Group organized an educational program emphasizing the team training, clinical decisionmaking and communication skills. These were the first internal education sessions using live rabbits and mannequins. This study aimed to evaluate the attitude of the participants, the selfconfidence level and their change in the knowledge on clinical performance in Paediatric IV Insertion after attending the educational program. Methods: The training and education sessions were conducted at Awal Bros Hospitals in Bekasi Barat and Tangerang during March and April 2019. The participants included a total of 52 Nurses. Pre- and Post-tests consisting of 20 multiple choice questions were administered to the participant before and after the 3-day simulation-based training workshop in Bekasi Barat and after the 2-day simulationbased training workshop in Tangerang. The workshop also utilized rabbits for the participants to practice their hands-on skills. Results: A total of 52 Nurses working in different Nursing units were enrolled. The mean pre-test and post-test scores were 43.81 and 87.52 respectively. In the Statistics Test table, the value of Asymp. Sig (2-tailed) was 0,000. Because the value of sig 0,000 < 0.05 was according to the statistical tests we used, then there are significant differences between before training and after training. Conclusions: Participants had positive attitude toward this new training program. They stated that this technique was more exciting and effective compared to the "traditional” techniques such as lecture, power point presentations or Q&A that they attended. Significant improvement of the knowledge on clinical performance in Nurses participating in these training and education session was observed after the participation in this simulation-based educational program. Many expressed their higher selfconfidence in doing IV insertion to the future patients, especially babies and children. More simulationbased education using pre- and post-tests are recommended. Keywords: Education, Nursing, IV Insertion
OUTCOME OF PATIENT SAFETY CULTURE USING THE HOSPITAL SURVEY ON PATIENT SAFETY CULTURE (HSOPSC) IN ASIA: A SYSTEMATIC REVIEW WITH META ANALYSIS
Background: Patient safety is a critical component of the quality of health care. In the process, it allows health services, especially hospitals, to well understanding aspects of patient safety. Hospital Survey on Patient Safety Culture (HSOPSC) was established to examines patient safety culture and the correlation between patient safety culture composite hospitals in Asia. This study aims to assess patient safety culture which using Hospital Survey on Patient Safety Culture (HSOPSC). Methods: Systematic Review and meta-analysis method by using PRISMA-P 2015 were used in this study. We were collected through searching electronic literature from Elsevier, Science Direct, PubMed, and Google Scholar by using keywords "Hospitals Survey on Patient Safety Culture" and "HSOPSC Asia" published from January 2009 to January 2019. English language papers only are used as the inclusion criteria. Results: Totally,160 articles were found and after deleting duplicates document, 126 journals left. Finally, 16 eligible journals which fulfil the inclusion criteria were reviewed. The HSOPSC overall average percentage positive response rate for HSOPSC was 53.58. Of the 12 patient safety composites evaluated, the highest average score is teamwork within unit 74.29±11.92. The bivariate analysis used Spearman correlation for correlation between patient safety composite, the composite Frequency of Event Reported the weakest correlation with teamwork within unit ( r = 0.052), and the composite teamwork across unit had the strongest correlation with teamwork within unit (r = 0.761). Conclusion: Patient safety culture is crucial toward improving overall performance and quality of services in hospitals, especially teamwork within unit. Culture safety patient at the hospital must be applied in every hospital for quality improvement, especially for increasing patient safety culture. Keywords: Patient Safety Culture Hospital, Patient Safety, HSOPSC Asia
THE IMPACT OF CLINICAL PATHWAY TO EFFECTIVENESS OF PATIENT CARE IN CURRENT MEDICAL PRACTICE IN HOSPITAL: A LITERATURE REVIEW
Background: Clinical pathway is an effective way to maximize patient outcomes by organize and standardize care processes. Clinical pathway bring impact to the patient treatment and the quality of care in hospital. This study aims to examine the impact of clinical pathway in effectiveness of patient treatment in hospital. Methods: This study was a literature review used PRISMA guidelines. Data obtained from electronic journal database ProQuest that published from January to December 2018 and used English or Indonesia language. The keywords of clinical pathway, care pathway, length of stay and mortality had been used to find relevant journal. Results: The search of electronic journal database found 1,937 articles. Articles that were not suitable with inclusion criteria must be excluded. Totally, 6 articles were relevant for this study. The 6 articles were conducted in USA, Belgium, Australia, India, and China. The analyzed from these articles showed that clinical pathway gave positive impact to the length of stay and patient outcome in the hospital if the resources of the hospital were ready to implement clinical pathway. Conclusion: Clinical pathway reduced the length of stay, improved the patient outcome, and reduced the mortality rate in hospital. To get the maximum benefit for implementing clinical pathway, the hospital must be prepared the environment and resources first before implementing clinical pathway. Keywords: clinical pathway, care pathway, patient outcome, length of stay
PATIENT SATISFACTION ON NATIONAL HEALTH INSURANCE (JKN) SERVICES
Background: The National Health Insurance (JKN) is an insurance system that guarantee all of Indonesian people can access the health services. By registered as a JKN member, people can access and get treatment in health facilities that collaborate with JKN. Measuring the quality of JKN services can be done by measure the patient's satisfaction on JKN. This study aims to determine the factor of patient's satisfaction with JKN services. Methods: This study was a systematic review used PRISMA guidelines. Data obtained from electronic database of Google Scholar that published in 2019 and used Indonesia language. The keywords that been used was satisfaction with JKN services to find the relevant articles. Results: The search found 968 articles from Google Scholar database. Articles that did not fulfil the inclusion criteria must be excluded. Totally, 7 articles that contained patient satisfaction with JKN services in hospital had been chosen to analyzed in this study. These articles showed that patient satisfaction with JKN services influenced by some factors such as tangible, reliability, responsiveness, assurance, and empathy. Conclusion: Factors influenced the patient's satisfaction with JKN services in hospital were tangible, reliability, responsiveness, assurance, and empathy. These factors influenced by the quality of the hospital services. To increase the patient's satisfaction, hospital must improve and develop facilities and quality of the hospital services. Keywords: Patient satisfaction, National Health Insurance, JKN, health services
THE EFFECT OF ANTIEMETIC FOR GALACTOGOGUE
Background: Breastmilk provides nutrition that newborn and baby need during early stage of their lives. Breastmilk production can be increased by giving the mother oxytocin or prolactin enhancement that called galactogogue during breastfeeding. Giving galactogogue to mother bring side effect such as nausea, vomit, and insomnia. The example of galactogogue are domperidone and metoclopramide. Domperidone and metoclopramide not only useful to increase the breastmilk production as galactogogue but also can be used as antiemetic to reduce the effect in the galactogogue. This study aims to examine the effect of antiemetic for galactogogue during breastfeeding. Methods: This study was a systematic review that used PRISMA guidelines. Data obtained from Electronic databases ProQuest and Google Scholar that published between 2015 and 2018. By using keywords such as effect, antiemetic, galactogogue to find the relevant journal. Results: The search found 58 studies, of which 7 studies were relevant to analyze in this study. Majority of these studies used Randomized Control Trial (RCT) and 1 study used case study. Analysis of the studies found out that domperidone and metoclopramide can be used as antiemetic for galactogogue. Domperidone was not enter the blood circulation and did not interfere the breastmilk production Conclusion: Domperidone and metoclopramide can be used as antiemetic for mother who need galactogogue treatment. Domperidone reduced the toxicity to mother and baby. The health providers should recommend domperidone and metoclopramide as galactogogue to mother who want to increase the breast milk production. Keywords: Breast milk, galactogogue, antiemetic
PROVIDING ADEQUATE INFORMATION FOR OUTPATIENTS IN RSUPN DR. CIPTO MANGUNKUSUMO JAKARTA NOVEMBER 2018 - FEBRUARY 2019
Background: Long waiting time in medical services can cause by excess patient capacity, insufficient hospital staff and resources, and long registration process. This problem common happens in hospital in Indonesia, including RSUPN Dr. Cipto Mangunkusumo, Jakarta. In 2017, the average time for waiting to get medical services in RSUPN Dr. Cipto Mangunkusumo was more than 60 minutes. However, the standard of waiting time is less than or equal to 60 minutes. Long waiting time can affect to the patient services and satisfaction. This study aims to examine the effectiveness of providing information at each service points with waiting time at RSUPN Dr. Cipto Mangunkusumo. Methods: This study was a quantitative study with cross-sectional design. Quick Win/ Electronic Health Record recapitulation was used to measure the waiting time to get medical services from registration until met the doctor for each patient. The sample was 1130 patients. The sample in this study was patient who had been recorded in electronic medical record during July 2018 to February 2019. The data analyzed in univariate and bivariate analysis used Chi-square. Results: There was association between providing information at each service points with patient waiting time (95% CI, p= 0.042). After implemented the information of how long-time services needed at each service points, the average time for patient waited has decreased 3 minutes from 120.5 minutes to 117.5 minutes. Conclusion: Providing information at each service points associated with decreasing waiting time for patient. The hospital should increase the performance of health providers and give the appreciation to the polyclinic or department that can achieve the standard of waiting time. Hopefully, giving a honor to the health providers can motivating them to give better health services to the patient and reduce the waiting time. Keywords: Patient services, waiting time, information on patient service time
THE VARIATION OF CAESARIAN SECTION COSTS IN INDONESIAN HOSPITALS: A NARRATIVE REVIEW
Background: In providing services, hospital, as one of the health care providers, must be able to regulate the number of costs obtained in accordance with the proportion/variation. The costs incurred by hospitals in providing complete personal health services consist of various cost components, including service fees, pharmacy costs, accommodation costs, action costs, investigation fees, and administrative costs. The cost calculation is one of the strategic steps that must be taken in marketing because it will be used for pricing. Caesarean Section (CS) surgery is one of the largest services and costs a lot in the hospital; careful planning is needed. This study aims to look at the variation in the cost components of CS services in Indonesia based on hospital level, hospital ownership. Methods: This study is a quantitative research Narrative Review by analyzing twenty hospitals in six provinces representing Indonesia from the thesis found in lib.ui database. The analysis in this study is the amount of proportion/variation in the cost components with the type of hospital and hospital ownership. Meanwhile, the criteria for selected hospitals are government-owned and private hospitals with types A, B, C and D. To be able to compare these data and avoid inflation differences, it is necessary to do data collection or valuation presentation (VP). The chosen cases were the usual CS without emergency and complication Results: There was a wide variation in CS service cost components, namely medical services (25% - 90%), accommodation (2% -39%), investigations (1% -36%) and drugs and BHP (2% -50%) both in government and private hospitals. Government-owned type B hospitals and government and private type C costs for medical services are greater than 44%. Conclusion: There are variations in the cost components of CS services at hospital types B and C. There is a need for government efforts to make regulations regarding the magnitude of the ideal cost component as a reference for all hospitals in Indonesia. Keywords: Caesarian section costs, Hospital, Indonesia
THE USE OF SOCIAL MEDIA AS HOSPITAL MARKETING TOOL
Background: The means of communication develop over time. Nowadays the internet has become the best means of communication including in modern hospital marketing. Social media connects individuals, businesses and organizations to interact and build relationships and communities online. This study aims to determine if social media is an effective tool for hospital marketing. Methods: This study was conducted in a systematic review by searching for articles and journals related to social media and hospital marketing. Literature search through the online database from University of Indonesia online library such as Scopus, Jstor, Ebsco, Proquest and Wiley on January 3th, 2019. The criteria of references are the use of social media in hospitals published within the year of 2009 to 2018 and can be accessed openly. Results: The search returned 21155 articles, of which only 4 studies were included in the systematic review. The results of the journals investigation showed that 51% - 99.41% of hospitals used social media. The average number of platforms used by a hospital in the sample was 3.3. About 71.8% updated their pages in the past 30 days, and 89.2% provided online interactions. There are significant correlations for hospitals' reputation score and total points with the number of social media followers. Conclusions: Many hospitals now use multiple social media platforms. The use of social media is affecting hospital's reputation. And because there is a high level of trust and sharing in social media communities, social media can be used as an effective tool for hospital marketing. To which extent the social media is still effective for marketing needs future studies regarding each country health regulations. Keywords : Social media, Hospital, Marketing, Communications
THE INFLUENCE OF SMARTPHONE APPLICATION ON THE HYGIENE BEHAVIOR OF EXTERNAL REPRODUCTIVE ORGAN OF FEMALE STUDENTS IN 1st SEYEGAN SLEMAN JUNIOR HIGH SCHOOL
Introduction: Adolescents is a period of the human development cycle, which is a transition between childhood and adulthood. In this transition many things must be considered one of them is the hygiene of reproductive organ. Hygiene of the reproductive organs, especially the external parts, is very closely related to prevent the reproductive organs from disease. Today is a digital era, most peoples activities used a smartphone including in finding and obtaining information. The use of smartphones at this time can affect the behavior of everyone, especially teenagers. One of them is the hygiene behavior of the reproductive organs. This research is to know the influence of smartphone application on the hygiene behavior of external reproductive organ female students of Seyegan Sleman Junior High School. Methods: This research used an experimental method with questionnaire-based survey (pre-test and post-test) was conducted in 90 teenage girls. Results: The influence of source information variables, parent's work and parent's income on behavior were significant (p <0.05). Clinically / practically for respondents exposed to electronic information sources, their behavior is higher at 3.57 compared to non-electronic ones. As for the status of parents who work privately, their behavior is higher by 2.69 compared to those of Civil Servant For the income of parents > = average minimum wage, the level of behavior is higher by 5.34 compared to the income of their parents < average minimum wage. The influence of the information source variable, the work of parents and parent'S income towards behavior is 15 percent. Conclusions: There is a significant difference between the pre and post effects of smartphone applications on the behavior and knowledge of teenage girl reproductive organs hygiene Seyegan Sleman 1 Junior High School Keywords : Adolescents, Hygiene of reproductive organ, Reproductive organ
NURSING IMPLEMENTATION IN CONTROLONG COGNITIVE AND PSYCHOMOTOR CAPABILITIES OF HALLUCINATORY PATIENTS IN KALAWA ATEI MENTAL HOSPITAL OF PALANGKA RAYA
Background: Hallucination is one of the symptoms of mental disorders in individuals that are characterized by sensory changes in perception, feeling a false sensory in the form of sound, vision, taste, touch and smell that is felt by the patient, but actually nothing. Hallucinatory can affect to the patient behaviors and sometime can endanger others. By implementing nursing of cognitive abilities and psychomotor abilities be expected to control hallucinatory among patients. This study aims to determine the implementation of cognitive abilities and psychomotor abilities in controlling hallucinatory in Atei Kalawa Menta Hospital, Palangkaraya. Methods: This study was a quantitative study. There were 32 respondents that recruited in this study used purposive sampling methods. The inclusion criteria for this study were patients in Atei Kalawa Mental Hospital who had aged 20-56 and dignosed for schizophrenia. The univariate analysis was used to describe the descriptive statistic. Results: Implementing cognitive and psychomotor abilities towards patients with hallucinatory can decrease the hallucinatory among 17 patients (53.1%) and improve the ability from 19 patients (59.4%) to communicate with others, to do schedule activities, and to follow the medication. Conclusion: By implementing cognitive and psychomotor towards patients who had hallucinatory can bring positive impact in their treatment. It is recommended for health providers to implementing cognitive and psychomotor towards patients who faced hallucinatory. Keywords: Hallucinations, cognitive abilities, psychomotor abilities
NEEDS ASSESSMENT OF LEADERSHIP TRAINING & DEVELOPMENT PROGRAM: A CASE STUDY AT INDONESIA'S NATIONAL AGENCY OF POPULATION AND FAMILY PLANNING (BKKBN)
Background: Leadership training and development (pendidikan dan pelatihan kepemimpinan or diklat kepemimpinan, mostly known its shorten Diklatpim) has become one of the most important training for Indonesia's Civil Servants (Pegawai Negeri Sipil, or PNS), not excluded civil servants of Indonesia's National Population and Family Planning Agency (Badan Kependudukan dan Keluarga Berencana Nasional, abbreviated BKKBN). This study aims to investigate the current and expected situation or condition of leadership training of BKKBN. Methods: This is a need assessment study that used mix methods to collect data from respondents. However, this issue shows the quantitative data only. The data samples were collected from 146 alumni of Diklatpim (230 alumni from year 20015-2018). The data were analysed by descriptive statistics and Priority Needs Index (PNI). Results: In BKKBN leadership and development training, Self-mastery has current mean score 4.09; expected mean score 4.56; PNI modified score 0.114. Diagnostic-reading has current mean score 3.97; expected mean score 4.51; PNI modified score 0.136. Innovation has current mean score 3.82; expected mean score 4.37; PNI modified score 0.144. Effective-team has current mean score 4.11; expected mean score 4.60; PNI modified score 0.119. Change-project has current mean score 4.21; expected mean score 4.59; PNI modified score 0.092. Conclusions: Innovation agenda has the lowest mean score, while the Change project has the highest mean score. Consequently, Innovation agenda has the highest rank in term of Priority Needs Index (PNI), while the Change project has the lowest rank. However, the ranks have no meaning that Change project is less important to be improved in the future. Keyword: needs assessment, leadership training, leadership development, Diklatpim, family planning, health management, BKKBN
LEADERSHIP SKILL AND MANAGEMENT PROCESS IN CENTER OF INFORMATION AND COUNSELING (CIC) AT UPPER SECONDARY SCHOOLS IN SOUTH JAKARTA CITY, INDONESIA
Background: Indonesian adolescent problems have increased from year to year based on data from the Indonesia Health Demographic Survey (IDHS). Center of Information and Counseling (CIC) is a nonformal education form which is established with particular purposes in order to help youth generation in the health and social sector. The high number of CIC does not guarantee the quality and the decreasing of adolescent health problems. This study is to examine the ability of leader and management implementation in CIC, to study problems that occurred in CIC, and find the best alternative solution to reduce these problems. Methods: The research used quantitative and qualitative method approach. Exploratory research design is used to analyze leadership skill and management in the Center of Information and Counseling. The number of population in this study is 117 students who are CIC members from 9 upper secondary schools. For the qualitative method, 13 students who are chairman and peer educator are selected to join in a focus group discussion (FGD). Results: Based on Pearson product-moment, there was a correlation between leadership skill and management process in significant level at 0.01 (r=.552). Technical skill and controlling function have the highest correlation compared with others. This finding is in line with the result of the focus group discussion. Some indicators have been founded that caused as obstacles. Some alternative solutions are given to overcome the problems and to increase the performance within CIC. Conclusion: Cooperation among all stakeholders both internal and external are needed in supporting dan developing the existence of the Center of Information and Counseling for youth generation. Keywords: non-formal education, adolescent reproductive health, youth leadership skill, management
REVIEW OF THE BALANCED SCORECARD IMPLEMENTATION IN HEALTH SECTOR ORGANIZATION
Background: Several studies reported that performance measurement using balanced scorecard is better than using traditional performance measurements. Balanced scorecard approach has been used in many health service sectors, both profit and non-profit, including hospitals, health service system, center for mental health, pharmacy services and health insurance company. This study aims to review the balanced scorecard implementation in health sector organization of the published literature from 2012 to 2019. Methods: This study was used literature review method by collecting data of the Balanced Scorecard in the health care sector and draws on the 6 years of published literature to January 2019. The literature were found from a search on Google Scholar as well as Thomson Reuters Web of Knowledge. The search terms were used "Balanced Scorecard”, "Health Balanced Scorecard” and "BSC” on English language only. The papers were classified by topics, research settings and research methods and data analysis techniques. Results: From 1465 papers were examined, 12 pieces of literature met inclusion criteria. From 12 pieces of literature have been reviewed, were used case study research method, eleven papers with qualitative research and one paper using the Delphi method. Based on 12 papers found that The balanced scorecard in health sector organization has been implemented in ICO, primary health care, hematology department, hospitals, home care nursing, health facilities, health systems, nutritional therapy company and clinical nutrition. Moreover, the Balanced Scorecard approach was used for health service budgeting, developing key performance indicators, improving hospital performance, assessing the baseline status, as an indicator in conducting evaluations. Conclusion: This study found that several studies consistently proved that Balanced scorecard is essential for performance and evaluation measurement in the health sector. Keywords : Balanced Scorecard, , performance measurement, health care, health services
DETERMINANT OF CHRONIC ENERGY MALNUTRITION OF PREGNANT WOMEN AT KARANG BANDAR LAMPUNG HEALTH CENTER
Background: The most common nutritional problem experienced by pregnant women is Chronic Energy Deficiency (CED), which may be caused by nutritional intake consumed, socio-economic and history of disease / infection before becoming pregnant. But the cause of CED is not only a problem of lack of food but also due to the influence of lifestyle, workload and nutritional status of the mother during pregnancy. This study aims to determine the relationship between lifestyle during pregnancy, workload during pregnancy, nutritional status during pregnancy with Genesis CED in Pregnant Women. Methodology: Quantitative research method with cross sectional design. The population of this study were all pregnant women who checked their pregnancy at the Public Health Center Karang City Bandar Lampung. Sampling technique using total population sampling is as much as 40 people. Data was collected through primary (questionnaire) and secondary (KIA book) data collection. Data analysis was performed using chi-square test. Results: Results of this study showed that there was no significant relationship between lifestyle with the CED incidence in pregnant women. Meanwhile, the results showed that workload and nutrition were significantly associated with the CED incidence in pregnant women. Conclusion: This study recommends that there is a need for coordination between puskesmas and city health offices to provide supplementary food for pregnant woman and provide education to woman about the importance of nutrition during pregnancy before marriage, such as counseling in order to prevent CED occurrence during pregnancy. Keywords: Chronic Energy Deficiency, lifestyle, workload, pregnancy
IMPROVING PATIENT SAFETY AND HOSPITAL SERVICE QUALITY THROUGH ELECTRONIC MEDICAL RECORD: A SYSTEMATIC REVIEW
Background: Examines properly implementation of Electronic Medical Records (EMR) which associated with workflows, policies and health services in enhancing patient safety. The electronic medical records have benefit to the patients due to the efficiency in the healthcare process. Therefore, the aim of this study was to examine the literatures on patients safety reporting based on electronic system review and assess the implementation. Methods: Systematic review with Prisma at the literature published between 2010 – 2019 using three large database: Proquest, Oxford Academic Journals, and Scopus. The eligible articles in this review should show an effect of patient' safety, and product quality in hospital in correlation on using EMR. It must include some effect on medication error, prescribing error, error in the use of EMR that potentially endanger patient safety. Results:The most important function of EMR implementation is to improve patient safety in hospital and to reduce the cost. EMR reduce excess cost of Hospital Acquired Condition (HAC) by 16%, reduce death due to HAC by 34%. Doctor and nurses believe that the quality of patient data would be better by using EMR as their daily routines. Conclusion: EMR can improve patient safety due to some skills in technology. Thus, it would not harm to the patients safety. However, the implementation of EMR requires the human skill resources in using technologies, computer and programs. Keywords : electronic medical record, hospital, patient safety, electronic health record
ANALYSIS OF MARKETING STRATEGIES ON MEDICAL TOURISM PROGRAMS IN DEVELOPING COUNTRIES HOSPITALS IN ASIA
Background: Recently medical tourism is a new form of niche tourism market, which has grown rapidly. The term of Medical Tourism describes tourists who travel to foreign countries to obtain health services and facilities such as medical, dental, surgical care, and so forth. It is necessary to hold a marketing strategy that is able to increase tourist interest in carrying out medical tourism activities in efforts to develop medical tourism. Therefore, the aim of this study was to analyze marketing strategies for medical tourism programs in hospitals. Methods: A systematic review through marketing strategy journals of medical tourism was conducted. Research articles accessed from the internet through databases namely: EBSCO, Emerald, Science direct, Neliti, and Research gate with the keywords medical tourism and medical tourism marketing strategy. The literature analysis from 2 journals with mix methods design, a journal with descriptive qualitative design, a journal with descriptive study design, a journal with SWOT analysis design, a journal with desk research methods design, and 2 journals with data analysis design. Results: The 11 articles that are considered to be in accordance with the objectives of the study. From 11 articles, then screening again based on feasibility according to inclusion and exclusion criteria obtained 8 articles for further review. This systematic review shows that the marketing concepts of segmentation, targeting, and positioning could compete competitively with other hospitals. The marketing strategy of a health service was able to increase the interest of tourists in conducting medical tourism activities in a country. Marketing efforts carried out by hospitals focus on domestic and foreign tourists. Conclusion: The existence of a marketing strategy can increase competitiveness between hospitals and increase the interest of domestic and foreign tourists to carry out medical tourism activities competitively. Keywords: Marketing strategy, segmentation, targeting, positioning and medical tourism
UNIVERSAL PRECAUTION OF SECTIO CAESARIA IN SURGICAL ROOM
Background:Nosocomial infection is the presence of an infection seen in patients while in the hospital or while in other health facilities, currently this is are known as Health-care Associated Infections (HAI). One of useful strategy in controlling HAI is to improve the ability of health workers in the universal precautions method. To succeed in this strategy, we need a material briefing on universal precautions so that good knowledge is obtained between healthcare staff. Therefore it is necessary to know the relationship between knowledge about universal precautions with universal precautions attitude and safety skills on healthcare staff. Methods:Article research was limited to articles from internet databases, such as ASMR, Elsevier Journal, IJCMPH, Sage Journals with the keywords universal precaution, knowledge, safety skills, attitude, and healthcare staff. Inclusion criteria, such as English articles and published from 2008- 2018,were collected and reviewed. The searching process obtained 6 articles that met requirement for inclusion and exclusion criteria. Results: There were two articles that found positive correlation between knowledge of universal precautions and safety skills or attitude, but the others showed otherwise. It shows inconsistent findings in all articles. Conclusions:Knowledge of universal precaution is not the only factor that influences the safety skills or attitude of healthcare staff. It might be other factors that influence safety skill or attitude beside knowledge of universal precaution. Keywords:Knowledge, Universal precaution, Safety Skills, Attitude, Health-care staff
EFFECT OF ULTRASOUND TECHNOLOGY ON WASTEWATER TREATMENT EMPHASIZING ON HEALTH ISSUE
Background: Wastewater and sludge have huge pathogenic substances. So far, various physical and chemical processes have been used for disinfection, including chlorination, ozone and ultraviolet radiation. The use of this type of disinfectants is currently decreasing due to the hazards that they pose such as byproducts of disinfection, including carcinogenic Trihalomethanes. Nowadays, researchers have begun to use other processes that create less risks such as ultrasound technology. Ultrasound waves by breaking the cell wall causes reducing pathogenic populations and eliminating the risk of disinfection byproducts and are one of the newest methods for disinfection in water and wastewater treatment plants. For physical, chemical and biological effects of ultrasound waves on plants, ultrasound radiation results in the rotational movement of the protoplasm in individual cells and affects the growth rate of plants. In humans, the hypothesis is that exposure to ultrasound causes subsequent electrolytic balance changes in the nerve tissue and increases blood glucose levels. Ultrasound waves cause bacterial colony damage and thinning of the cell wall and the release of the cytoplasmic membrane. Mechanical effects of ultrasound waves can be used for water and wastewater disinfection. Methods: This research is a descriptive-analytic study that was carried out in a batch experiment. The goal of this research is to investigate the effect of ultrasonic waves on disinfection in South Tehran wastewater treatment plant. Results: The results showed that by increasing the time and density of the ultrasound, the rate of removal of E.coli increased. Also, the optimal sonification time was 30 minutes and the optimal ultrasound density was 2.5 watts per milliliter at a frequency of 20 kHz. E.coli removal rate in these conditions was more than 99%. Conclusion: According to the results of this study, the use of ultrasound waves has a significant effect on the elimination capacity of Escherichia coli and can be used as an appropriate alternative for stabilization and disinfection in wastewater treatment plants. Keywords: Ultrasound, Health, Wastewater, Treatment, Cavitation
FACTORS INFLUENCING DELIVERY BY SKILLED BIRTH ATTENDANTS AND POSTNATAL HEALTH CHECK AMONG MOTHER IN HLAING-THARYAR TOWNSHIP, MYANMAR
Introduction: Complications during pregnancy and childbirth are the leading cause of death among women of reproductive age in Myanmar. It is generally believed by women in developing countries that pregnancy is a natural phenomenon and a part of women's reproductive functions. Problems or complications during pregnancy are also considered by such women as being natural to pregnancy. Low coverage of institutional deliveries, giving deliveries at homes without skilled provider and delays to reach to the health facilities are leading towards the vast majority of maternal deaths in Myanmar. Methods: The purpose of this study is to identify percentage of skilled birth attendant's utilization among ever-married women (15-49 years) in Hlaing-Tharyar Township, Yangon, Myanmar. A quantitative cross-sectional survey was conducted. A total of 300 ever-married women who had delivered at least one child were selected by simple random sampling and face to face interviews were performed to them by using a pre-tested structured questionnaire. The structured questionnaire including socio-demographic background, history of last pregnancy, accessibility of health services, women's autonomy and male involvement during pregnancy. Results: The study found that 65 percent of the sample used skilled birth attendants (SBAs) at delivery and the association between mother's education, place of residence, parity, number of antenatal care visits, women's autonomy and male involvement were significantly related with using skilled birth attendant at delivery and postnatal health check. About one-third (35%) were received care from non- SBAs during delivery and the postpartum period in that township. Accessibility to health services and availability of health care personnel were not significantly associated with the use of skilled birth attendants in the delivery and postpartum of the last child. Conclusions: Findings from this study highlighted that the majority of SBAs were providing reproductive healthcare services with a certain level of quality within the limited resource setting at the study area. There was a need to increase health education activities by SBAs for the pregnant and lactating mothers especially for utilization of maternal health care services. Awareness raising activities on the contraceptive method used should also be enhanced for all lactating women. Keywords: Skilled Birth Attendants, Postnatal health check mothers, Hlaing-Tharyar, Myanmar
PERCEPTION OF PICTORIAL HEALTH WARNING ON CIGARETTE PACKS, SMOKING BEHAVIOUR AND WANT TO QUIT SMOKING AMONG STUDENTS UNDERGRADUATE OF STATE ISLAMIC UNIVERSITY OF NORTH SUMATERA, INDONESIA
Background: Pictorial health warning on cigarette packs has been implemented since 2014, but smokers in Indonesia increase every years. Pictorial health warning on cigarette packs must be continuously evaluated regarding its effectiveness in reducing smoking behavior in Indonesia. Regulated about Regulations of pictorial health warning on cigarettes packs are expected to make smokers to quit smoking and regulations that have been in effect since 2014 should have been evaluated to see pictorial health warning on cigarettes packs that can change the behavior of smokers or prospective smokers in adolescents. This study aims to describe perceptions of pictorial health warning on cigarette packs and smoking behavior and intention to quits smoking of undergraduate student of state Islamic University of North Sumatra. Methodology: This research was conducted to students of the Islamic University of North Sumatra as many as 215 students. The study was conducted in March 2019 using a structured questionnaire that had been prepared. The data in this study will be presented in the form of frequency distributions and then the results are presented in the table. Results: The results of this study indicate that the respondents felt not fear with pictorial health warning on cigarette packs as many as 165 people (76.7%). For the smoking behavior of students it was found that as many as 147 people (68.4%) stated that they had not smoking and respondents who stated smokers as many as 68 people (31.6%), wanted to stop smoking after seeing picture health warning on cigarette packaging as many as 28 people (41.2%). Respondents who said they would continue smoking even though they had seen pictorial health warning on cigarette packs as many as 40 people (58.8%). Conclusion: The majority of students undergraduates of the North Sumatra State Islamic University (UIN SU) were not afraid when they saw pictorial health warning on cigarette packs and students undergraduates have smoking behaviour. Those who smoke said they wanted to stop smoking after seeing pictorial health warning on cigarette packs especially when looking at ppictorial health warning on cigarette packs related to smoking resulting in lung cancer. Keywords: Perception, Picture Health Warning, Smoking Behavior, Students
RISK FACTORS FOR IRON DEFICIENCY ANEMIA IN INFANTS AGED 6 MONTHS IN TEGAL REJO PUBLIC HEALTH CENTER, YOGYAKARTA, INDONESIA
Background: Anemia is a global public health problem affecting both developing and developed countries with major consequences on human health as well as social and economic development. Anemia resulting from iron deficiency that may adversely affects the infants' cognitive and motor development. The objective of this research was to find out the risk factors of iron deficiency anemia (IDA) in 6 months old infants. Methods: This was an observational research with case-control design. Population was all 6 months old infants having been examined for their hemoglobin levels in Tegalrejo public health center in Yogyakarta from 2017 to 2018. 164 samples were taken with random sampling contained of 82 infants with anemia diagnosis in case group and 82 infants with normal hemoglobin levels for control group. Dependent variable was iron deficiency anemia (IDA) assessed based on hemoglobin level less than 11 gr% and independent variables were IDA risk factors (birth weight, sex, maternal education, maternal occupation, and maternal age) obtained from medical records and direct interviews. Data were analyzed by using logistic regression. Results: the risk factor influencing IDA was exclusive breastfeeding (p<0.05). Infants who did not receive exclusive breastfeeding had 2.16 folds higher risk of having IDA than those who received exclusive breastfeeding. Other risk factors such as birth weight, sex, maternal education, maternal occupation, and maternal age did not correlate significantly to iron deficiency anemia (IDA). Conclusion: Exclusive breastfeeding was the significant risk factor toward iron deficiency anemia in 6 months old infants after controlling other risk factors. Therefore, these finding can be implemented by maternal and child health practitioners to make iron deficiency anemia prevention program by eliminating or minimizing its risk factor. Keywords: Iron deficiency, Anemia, Exclusive breastfeeding, 6-month-old infants.
STRATEGY FORMULATION FOR HOSPITALS IN REMOTE AREAS: CASE STUDY OF X HOSPITAL, WEST BORNEO PROVINCE, INDONESIA, 2019
Background: Located in remote area, X Hospital is facing various challenges as a private non-profit class C hospital. Therefore, it needs to develop an appropriate strategic plan for the year 2020-2024 to overcome challenges and achieve its vision. This study is aimed at identifying the strengths, weaknesses, opportunities and threats from internal and external strategic factors, determine strategic positioning, and formulate alternative strategies for X Hospital. Method: This is a preliminary study with qualitative - exploratory design. Data were collected through in-depth interviews, group discussions and observation. The interviews were conducted with 7 key informants holding strategic management positions. This study was conducted in two in-depth stages using Consensus Decision Making Group (CDMG) method to avoid bias. Data were analyzed using Internal Factor Evaluation (IFE) and External Factor Evaluation (EFE) matrixes at the input stage and Internal External (IE) and Threat Opportunity Weakness Strength (TOWS) matrixes at the matching stage. This study was conducted at X Hospital, West Borneo Province, Indonesia, from March to April 2019. Results: The IFE final score was 2.38 with strength (1.68) greater than weakness (0.70) and EFE score of 2.16 with threats (1.10) greater than opportunities (1.06). Such input stage results indicate that X Hospital has average response in utilizing its internal and external strategic factors where strengths are more prominent than weaknesses but the threats are still overshadowing its opportunities. Consequently, the results of matching stage place X Hospital on the position of hold or maintain strategies and formulate 11 alternative strategies that focus on market or product development. Conclusions: X Hospital is currently on a strategic position to develop its services as the basis for the five-year strategic planning. A new policy should be made to encourage the establishment of a network with private hospitals to promote healthcare in remote areas. Keywords: strategic plan, remote area, hospital, IE matrix, TOWS matrix
LEAN METHOD IMPLEMENTATION TO REDUCE OVERCROWDING IN THE EMERGENCY DEPARTMENT: A SYSTEMATIC REVIEW
Background: Throughout the world, emergency departments (ED) are characterized by overcrowding and excessive waiting times. Furthermore, the related delays significantly increase patient mortality and make inefficient use of resources to the detriment of the satisfaction of employees and patients. Lean thinking is a philosophy that focuses on eliminating waste or non-value added elements from the processes so that customers are given greater value. Therefore, many Emergency Departments have begun to apply lean as a way to fight against the problems of crowding, delays and medical incidents. Methods: Eligible studies for this systematic review constitute result summarized that lean method implementation was capable of reducing overcrowding in Emergency Departement. The journal employed in this systematic review sourced from ProQuest, Pubmed, and Google Scholar, whereas the analyzed journals were seven journals. Results: From the total of seven journals reviewed, the studies analyzed the result after implementing the lean method in the Emergency Department. In addition, all of the studies were reported successful in implementing lean intervention. Several studies explained that lean method implementation was capable of reducing waiting time, staying length, and the proportion of patients leaving without being seen in the emergency department. One study suggested that reducing radiography transportation time can reduce turnaround time and can help improve the Emergency Department flow. Conclusion: Lean method implementation can contribute to a decrease in waiting time, stay length, and the proportion of patients leaving without being seen. According to the results of the study, the lean implementation identifies that the lean is capable of decreasing waiting times, stay length, and the proportion of patients leaving without being seen. There must be a policy that governs the lean process. Lean can inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem-solving. Keywords: Lean, hospital, emergency department, crowds
HALAL FOOD SUPPLY MOTIVATION FOR MUSLIM PATIENTS
Background: The obligation of consuming halal food for muslims as a religious requirement. Unfortunately in Indonesia not all hospital provide health service that are capable of providing halal food and offering Halal certification food. This might cause patient to feel distrust and discomfort. Therefore, all reliable stakeholder are expected to have the motivation and commitment to guarantee halal food in the hospital services. This study aimed to analyze the providers' (hospitals') motivation to provide halal food for their Muslim patients according to Islamic rule. Methods: This study employed a systematic review to observe articles related to halal food awareness and halal food certification in Indonesia and other countries that serve Muslim consumers, which have been published online in the accredited journal, such as Scopus journals, ProQuest journals, and Google Scholar. The inclusion criteria employed in this study were halal Food, certification, academic journals, and full papers. This searching was limited to articles in the last ten years, except the articles which are not related to the theme. PRISMA method was implemented to assess the selected articles critically. The article searching was based on Halal Food keywords in ProQuest, Scopus, and Google Scholar. The full inclusion tests resulted in one thousand three hundred seventy articles; however, after conducting the inclusion and exclusion, the researcher obtained five articles. Results: The researchers found that hospitals, both in the Muslim majority and minority places, were not fully aware of halal food services. Nevertheless, few Islamic hospitals have Halal Assurance certification in providing their food due to the Sharia accreditation requirement. The low interest in obtaining the Halal Guarantee certification was due to several problems, such as lack of knowledge about halal, financial problems, and government support. Conclusions: The need of awareness of hospital as a health service provider to provide a halal food for muslim patient by participating in the implementation of Halal Food Guarantee Certification. Keywords: halal food, certification, motivation
SPECIAL DENTAL CASE SHEET AS A MEDICAL AND FORENSIC COMMUNICATION TOOL
Background: The implementation of the International Classification of Diseases, Tenth Edition (ICD-10 codes) in the medical records serving as the humanitarial tools for practitioners is to establish treatment procedures for re-admitted patients in a hospital. Medical records serves as a tool in determining the appropriate treatment for each patient. But in reality, has never the ICD-10 been applied to the Electronic Medical Record Management. For it to be used as a humanitarian tool, it has first to be used as legal evidence in the court as a written legal system in Indonesia. However, the implementation by the lawyers and relevant officers is under the progress. The result of the previous research showed on the Dental Professionals' Medical Record Form in 2014 at FKG Usakti [29] had determined the need for special dental case sheets as a humanitarian tool between practitioners and dentists. The Special Sheet should meet the specific requirement to be utilized in a class A hospital and it also needs to be standardized with the Indonesian National Police. Methods: In this Systematic Review, the researchers conducted a Proquest database published from January 2012 to June 2019. 10 relevant studies of the medical records were selected as a humanitarian tool in Disaster Victim Identification (DVI) done by the dentist. Results: From 10 present studies and previous studies [29] conducted by the researcher, it had succesfullyidentified the importance of medical record management as a humanitarian tool between practitioners and dentists in hospitals. Conclusion: Special Dental Case Sheet is required for the implementation of collective information which serve as a general humanitarian tool among health professionals. It is required as a comparative data in the identification process if the related patients are the disaster victims. Keywords: Medical Record, Humanitarian Tool, Health Professionals, Dental Professional Teaching Hospital
ANALYSIS EFFECTIVITAS RELATING TO THE WAITING TIME IN CT SCANNING PROCEDURE BASED ON THE MALCOM BALDRIDGE APPROACH ON OUTPATIENT TREATMENT PATIENTS AT THE RADIOLOGY INSTALLATION OF THE CENTRAL POLICE HOSPITAL R. SAID SUKANTO
Introduction: Hospitals have the mission to provide excellent, comprehensive and standardized medical services in the context of improving people's health conditional through among others reduced waiting time. Waiting time is the time used by a patient to receive health services beginning from at the registration counter to the doctor's examination room. Method: This research used the Qualitative study. The research was conducted from April 2019 through May 2019 at the Outpatient Treatment Unit of the Radiology Installation of the Central Police Hospital R. Said Sukanto Jakarta The informants in this research were chosen based on the principle of suitability and sufficiency namely 8 informants; they were head of the Radiology Installation, a radiologist, a senior supervisor or radiographer, a registration counter officer, a nurse and 3 selected patients. The data collected in this study was primary data namely through in-depth interviews and direct observation, while secondary data was obtained through document reviewing. Analysis using Malcolm Baldrige framework Results: The result of this study indicates that the waiting time in CT Scanning procedures average 3 hours 1 minute and 25 seconds, which exceeds the standard stipulated by the Ministry of Health of the Republic of Indonesia the standard time ≤ 3 hours. Assessment aspect of Malcolm Baldrige the best is aspect organization profile, leadership and customer/ patient focus, an aspect have substantial effect on the waiting time in CT Scanning procedures. Mismatch between the theory and the result of this study may be caused by limitation in the research. Conclusion: In principle, services are already good except for few matters that need improvement namely on customer/patient care, strategic planning, measurement of analysis and management of knowledge as well as results in the organization. Keywords: Malcolm Baldrige criteria, CT Scanning procedure, waiting time
THE ROLE OF HOSPITAL MARKETING MIX TO THE SELECTION OF THE HOSPITAL CONSUMER
Background: The significant growth of hospital both of private and public hospital, additions requiring productive marketing strategy to sustained and increase consumers. Concept of 7p was developed from concept of 4p to create transparent communication between hospital and its customers. The given information will become the reason for customers to make their health related decision. This review is to see the role of each 7p concepst (person, place, promotion, physic, price, product and proses) in marketing and maintaining of hospitals. Methods: Full articles available at PubMed and Google Scholar, published from 2010-2018, and the student thesis were considered to explore the hospital marketing with mix marketing approach. Results: Of 412 full articles available at the searching tools, 10 articles have been selected for further discussion and analysis. From the results, it is noted that the 7p concepts of the costumer satisfactions present significant effects to the customers' trust to the hospital. Conclusion: This systematic review even only answer four out of seven P concept including proses, promotion, person and product, the findings may present the references to the hospital marketing in delivering the significant result for increasing customers' satisfaction. Keywords: Marketing mix, hospital marketing, customers' satisfaction.
TRAVEL MEDICINE MANAGEMENT FOR THE ANTICIPATION OF INFECTIOUS DISEASES IN SOUTHEAST ASIA: A SYSTEMATIC REVIEW
Background: Travelling abroad have various health risks such as sudden and significant changes in altitude, humidity, temperature and exposure to a variety of infectious diseases. Travel medicine concept is needed to provide information to professional health services not only on risk of infectious diseases but also to ensure the personal safety of travellers and to minimize environmental risk during travel. The Objective of this study is to investigate the practices of travel medicine management for the anticipation of infectious disease spread by travellers. Methods: This study used systematic literature review based on PRISMA (Prefered Reporting Items for Systematic Reviews & Meta-Analyses)protocol to identify all the published articles using relevant keywords.We searched in Scopus (Elsevier), Science direct (Web of Science), Cochrane library and Pubmed. Period of study was between 2005 and 2018. In total, there were eight studies that discussed travel medicine management regarding the anticipation of infectious diseases in Southeast Asia, which includes the spread and narrative synthesis. Results: From 126 authors finally include 8 papers in this review. Almost all of the management of travel medicine can reduce the risks of travel-related diseases. The travel medicine management explained how to effectively prevent the spread of infectious diseases, for example dengue, malaria, rabies, zika virus, diarrhea and respiratory syndrome. Those diseases can easily spread when the travellers body immunity decreases or when they are exhausted during the trip. Thus, it is necessary for the travellers to anticipate the spread of diseases by knowing the information of particular diseases in a country or a region that will be visited and having prophylaxis or vaccination before travelling. Conclusions: The travel medicine management can significantly impact on the anticipation of infectious diseases spread by travellers since the practices require the latest facts and information about the epidemiology of infectious health risks worldwide.The recommendation for future research is to review more travel medicine management studies in order to get deeper understanding.For Policy maker, it is suggested to design policy to improve and updating knowle
infectious disease, travel medicine, Southeast Asia, management
SYSTEMATIC REVIEW: DETERMINANTS OF PATIENT SATISFACTION WITH HOSPITAL SERVICES
Background: Satisfactory and quality service will shape patient or customer loyalty, and satisfaction is closely related to "word of mouth". The next effect will be on the process of forming an image of an increasing hospital. This is due to very tight competition conditions. So each hospital will try to put itself as best as possible in the eyes of patients / customers to be trusted to meet their needs in the health sector. Usually health care satisfaction is the highest level of satisfaction above 85%. Research is needed on the determinants of patient satisfaction with hospital services as a reference for improving the quality of hospital services. Objectives: To determine the determinant of patient satisfaction with hospital services. Method: A systematic review through journal review regarding the determinants of patient satisfaction with hospital services. Search articles accessed from internet databases, namely: ProQuest for English language publications, overall from abroad, last 12 months, using a combination of search terms " Patient satisfaction, determinants, hospital ", article selection using screening. Qualitative thematic analysis is used for synthesis. Result:. The similar key findings from the 10 papers are empathy or interpersonal relations becomes a determinant that dominates the increase in patient satisfaction with hospital services. Empathy is a channel of efficient communication with patients and is also considered an important determinant of clinical outcomes. Conclusions: 10 studies included in this systematic review show the similar key findings. empathy or interpersonal relations becomes a determinant that dominates the increase in patient satisfaction with hospital services. As a recommendation for further research, it is necessary to search for the determinants of patient satisfaction with hospital services through several data bases to obtain more information about the determinants of patient satisfaction with hospitals.
Patient satisfaction, determinants, hospital
FACTORS AFFECTING THE COMPLIANCE AND UTILISATION OF ANTENATAL CARE (ANC) IN BOTH HIGH INCOME COUNTRIES AND LOW-MIDDLE INCOME COUNTRIES: A SYSTEMATIC REVIEW
Background: Every pregnancy has its own risk related to unwanted complication. ANC or antenatal care is a program to help the improvement of both pregnancy experience and ensure the health of a baby. ANC itself has been practiced since 100 years ago, a heritage process from the European community, which facilitates pregnant women during the pregnancy to have 12 visitations to nearby health facility. However, reasoning behind such intervention was unknown. As time goes by, many researches, evaluation, and review have been done regarding the content of visitations, amount of attendance each pregnant women need to do during pregnancy period, and further outcome of ANC program. This review is done to clarify ANC program throughout countries with high, middle and low income in the world and gather knowledge from such experience. Methods: Review was done by using databases such as PubMed, Springerlink, and proquest with keyword factors related to utilization of ANC as intervention and mother's compliance, years of publication and PRISMA method. Results: Out of all 33 articles obtained, 12 articles were chosen as other article did not comply to the selection criteria such as year of publication and the content. Variations among different countries in such studies occurred in factors such as the program itself, subject compliance towards the study, and the number of attendees. Furthermore, technologies such as instant messages and internet was also utilized in some programs. Among many factors related to the utilized and compliance of pregnant mother, each country policies, lifestyle, education level, and family incomes played a major role in such differentiation. Furthermore, perception of mother towards the program will also affect her motivation. Conclusion: Although the implementation of ANC in many countries still varies, there were many positive evidences to support the utilization of ANC. Surrounding communities could implement the program if it is suitable to the individuals. Monitoring and evaluation of such program also need to be done.
ANC, compliance, utilization, attendance, content.
TURNAROUND TIME OF DIAGNOSTIC LABORATORY RESULTS AS A QUALITY IMPROVEMENT TO PATIENT SATISFACTION: A SYSTEMATIC LITERATURE REVIEW
Background: Laboratory information is increasingly recognized as a crucial factor to reduce diagnostic uncertainty and enhance quality care. Medical diagnoses and effective treatments depend on the accurate and timely reporting of laboratory test results, and the trend toward disease prevention and personalized care calls for more complex and effective tests and biomarkers. Today's clinical laboratory provides essential information for the diagnosis, monitoring, screening, prevention, early diagnosis, tailored treatment and more effective monitoring of human diseases. Response Time is an action that is carried out quickly and precisely to handle patients. While an ability for fast (responsive) service is the response time taken to the patient when the patient arrives to get a response. Response time is one indicator of service quality that affects patient satisfaction. The laboratory turnaround time is the starting point for the time of for receiving the sample, the time for registration, or the analytical sampling time and end point for analytical completion, the time for verification of results, the transfer of results to the time for medical record, and the time for report printing. Methods: In this systematic review, we searched Pubmed, Science Direct, and Scopus database published from January 2010 to March 2019. The included studies were broadly classified as reporting from healthcare/hospital and international survey. There were 21 studies that met keywords searching criteria. Then we analysed based on the content of studies, matching to our objectives Results: Out of 21 identified studies, we recognized 6 scholarly journals of turnaround time diagnostic laboratory results as quality improvement of medical care and medical diagnoses and that affects patient satisfaction. These studies concluded that turnaround time becomes a key element to patient safety that contributes to patient satisfaction. Conclusion: Turnaround time as one of quality indicator in a laboratory setting. Improvement in this parameter could give benefit to the patient and deliver service excellence. Standardized reporting method is mandatory as it will not only allow the accreditation of clinical laboratories according to the International Standard but also to assure guidance for promoting improvement processes and guaranteeing quality care to patients and patient satisfaction.
diagnostic laboratory; turnaround time, quality
THE ACCURACY OF DIAGNOSIS, PROCEDURES AND CODING COMPLETENESS AND THEIR CORRELATION WITH INA-CBG CLAIMS
Background: Since 1 January 2014, the INA-CBG system has been applied as a method of payment for outpatient and inpatient services. Indonesian-Case Based Groups (INA-CBG) tariff is the amount of payment claimed by the Health Social Security Administering Agency (BPJS) to the hospitals for a package of services based on the classification of diagnoses and procedures of diseases. The inequality in the number of claims received by the hospital compared to the resources used will be unbeneficial to the hospital. The purpose of this study is to identify the correlation of incompleteness and inaccuracy of diagnosis, procedures, and coding to the number of INA-CBG claims at hospitals in Indonesia. Method: The research method is the literature review. The authors found five articles cited by Google Scholar published in journals and two theses taken from the Library of Universitas Indonesia that include ”factors that influence INA-CBGs claim amounts at hospitals” or related concepts in the title or abstract. Articles and theses published from 2014 to 2018 were search using the following terms in the title or abstract: "accuracy, completeness, diagnosis, coding, INA-CBG claims.”. Result: The authors found seven articles that met our criteria: Two studies used qualitative approach, three studies were quantitative studies, two studies used a mix method. From these studies, there were five practical considerations that were considered as the factors that influenced the number of INA-CBGs claims at hospitals in Indonesia: completeness of filling a medical resume, accuracy of coding, accuracy in filling medical resumes, the accuracy of information systems, and completeness of claim administration document. Conclusion: The study has indicated the factors that influence the amount of INA-CBG claims in hospitals in Indonesia, mainly, the factor of completeness of medical resumes and the factor of accuracy in coding by the coders. The completeness of a medical filling resume which is highly dependent on physician compliance and accuracy coding. All the human resources who have a role in coding and claims, need to improve their capability on it, through a workshop, or any other education funded by the hospital. Coder certification must be done. Hospital has to develop hospital management information system for acceleration in coding and claim.
coding, inaccuracy, incompleteness, INA-CBG claim
THE INFLUENCE OF MARKETING MIX TO PATIENT SATISFACTION IN HOSPITALS: NARRATIVE REVIEW
Background: Hospitals, as service providers, have a large role in meeting people's needs regarding their health. The increasing growth of hospitals adds to the menu of choices for people to utilize health services according to their needs. This competition has changed the mechanism by which customers are not only users of health services but as determinants of the future and the continuity of a hospital. Marketing activities can help hospitals improve and win the competition. Marketing managers must be able to combine the marketing mix variables appropriately so that all variables can increase consumer's decision and patient satisfaction. Aims. The purpose of this study was to determine the effect of mix marketing on patient satisfaction at the hospital. Method: This study was conducted in a literature review by searching for articles and journals related to hospital mix marketing. Search journal articles are done through Google Scholar database with the search year 2010 until 2018. The keywords used are "marketing mix and "hospital." So that six articles will be reviewed. Results: In the six studies reviewed there was one study that showed that all the mix marketing variables namely product, price, people, place, promotion, process, and the physical evidence had a significant influence on patient satisfaction and the hospital for medical treatment. The significant results are known from the results of statistical tests showing that p-value <0.05. In several other studies, it shows that there are significant variables and some that are not significant for consumer decision and patient satisfaction. Conclusion: The Marketing mix has an important cost for the decision to choose a hospital. The mix marketing has varied significant influence on consumers' decision and satisfaction to choose the hospital for medical treatment. By knowing the mix marketing variable that affects customer satisfaction, hospital management, namely the marketing department, can optimize and develop marketing types that can increase public interest so that the target profit of the hospital is achieved.
Marketing mix, 7P, Patient satisfaction, Hospital
DETERMINANT OF UNWANTED PREGNANCY IN INDONESIA 2017 (A SECONDARY DATA ANALYSIS OF 2017 IDHS)
Background: The unwanted pregnancy will cause some problems, not only increasing the population but also affecting reproductive health among woman. The unwanted pregnancy can cause miscarriage or abortion, obstructed labour, bleeding and maternal mortality. Based on 2017 Indonesian Demographic and Health Survey (IDHS), the prevalence of unwanted pregnancy is 14% from total pregnancy. This number is increasing compare with Riskesdas in 2013 there was 5.8% unwanted pregnancy. This study aims to examine the determinant of unwanted pregnancy in Indonesia. Methods: This study was a cross sectional design used secondary data analysis of 2017 IDHS. The sample of this study was woman who had aged 15-49 years old and had been pregnant in (...). Totally, 1,997 respondents were recruited in this study. The data was analyzed in univariate and bivariate analysis used Chi-square. Logistic regression analysis was used to analyzed in multivariate. Results: The prevalence of woman who had unwanted pregnancy was 12.8% from total pregnancy. Bivariate analysis showed aged less than 20 years old and more than 35 years old, lived in rural area and had more than 3 children associated with having unwanted pregnancy. Multivariate analysis showed that respondents who had age less than 20 and more than 35 years old (p=0.0001; OR= 1.826) more likely had unwanted pregnancy. Conclusion: This study showed that woman who had risky reproductive aged, lived in rural area and had children more than 3 were statistically significant with unwanted pregnancy. The risky reproductive aged was the most influenced factor for having unwanted pregnancy. So that, the government must support the National Population and Family Planning Board to promote the use of contraceptive among woman in reproductive aged especially in the risky reproductive aged.
ANALYSIS OF PROVIDER-INITIATED HIV TESTING AND COUNSELING IN TUBERCULOSIS PATIENT AT A PRIVATE HOSPITAL IN JAKARTA
Background: Stigma, lack of knowledge about HIV risks to oneself, openness, limited access to health services and aspects of gender inequality are determinants that influence the willingness to take HIV tests in the context of VCT. However, studies in the context of PITC have not been widely publicized in Indonesia, particularly studies in private hospitals. Analysis related to the reason that influence the willingness of health workers to carry out PITC in TB patients is important to do. The purpose of this study is to analyze the reason that influence the willingness of health workers to carry out PITC in TB patients. Methods: This study is a quantitative study with cross-sectional design. The study was conducted at a private hospital in Jakarta. The sampling technique used total sampling techniques, where the entire population was sampled. the research sample obtained is 30 doctors who have TB patients in the private hospital during March to April 2019. Results: The majority of doctors (46.7%) were sometimes willing to do the PITC in TB patients. The proportion of doctors who are always willing to do the PITC in TB patients is still low at 20%. On the other hand, there were 33.3% doctors were never willing to do the PITC on TB patients. The reason that influences the doctor's willingness to do PITC on TB patients is the possibility to explain (66.7%), automatically as requested in the rules (20,0%) and the severity of the TB case (13,3%). Conclusions: The biggest reason that influences the doctor's willingness to do PITC on TB patients is the possibility to explain. Doctors are often difficult to explain the importance of HIV testing for TB patients due to the thick negative stigma associated with HIV testing. the government should encourage socialization regarding the importance of HIV testing for both TB patients and high-risk HIV groups. The key challenge to improving health care delivery is to improve the implementation and monitoring of effective interventions.
Provider-Initiated Hiv Testing (PITC), TB-HIV, Private Hospital
PREVENTION AND MANAGEMENT FOR THE COMPLICATION OF THIRD MOLAR SURGERY : A SYSTEMATIC REVIEW
Background: Impacted third molar surgery is one of the most common procedures performed by maxillofacial surgeons and it is often attended by complications. Although clinical conditions associated with retained third molars are well understood, little is known about the impact of those conditions on the quality of life among affected patients. There is growing recognition that the impact of oral conditions on quality of life is an important outcome that can be quite useful in making treatment decisions. All the information in this review could be useful for the clinicians in order to show the surgical and pharmacologic parameters that may influence the postoperative discomfort in the third molar surgeries. Methods: This systematic review followed the recommendations in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Some of the key words or Medical Subject Heading (MeSH) terms used in in the two data bases (Proquest and Google Scholar) were: (1) Third Molar Surgery, (2) Complication, (3) Prevention. The articles were published in English from 2009 to 2019. Results: Studies were eligible if they evaluated prevention and management for the complication of third molar surgery, and eight studies for qualitative synthesis. Of the eight articles, all studies were selected with Randomized Control Trial. Eight studies were included because they discussed the prevention and management of third molar surgery complication. Almost all of the practices of prevention and management of third molar surgery complication described that analgetic ibuprofen and paracetamol were used for decreasing the pain, and also amoxicillin tablet was used as an antibiotic for preventing high risk complication. According to studies, prophylactic use of chlorhexidine mouth rinse in third molar surgery are equally effective in keeping post operative infection to a minimum level in medically competent patient. Conclusions: All studies revealed that the most common complications of third molar surgery were pain, trismus, swelling, alveolar osteitis, and dry socket. Those studies discussed the prevention and management third molar surgery complication. Ibuprofen and paracetamol were used to decrease the pain, amoxicillin (1g) and amoxicillin/clavulanate (875/125mg) had similar efficacious in preventing infection after retained third molar extraction, but amoxicillin and clavunate (875/125mg) produced more gastrointestinal discomfort. Prophylactic use of chlorhexidine mouth rinse and gel in third molar surgery were equally effective in keeping post operative infection. Corticosteroid had a significant and sustained antiinflammatory effects.
Third Molar Surgery; Complication; Prevention.
SCIENCE FOR MANKIND: TRANSLATING RESEARCH RESULTS INTO POLICY AND PRACTICES
SYNTHESIS OF NANOMATERIALS AND ITS BIOMEDICAL APPLICATIONS FOR HUMAN'S HEALTH
THE IMPLEMENTATION OF INTEGRATED-APPROACH ON GERD (IAGE) PROJECT IN FISHERMEN AS A MODEL OF INTERRELATION OF RESEARCH-BASED HEALTHCARE AND TEACHING
THE EFFECT OF ASPHYXIA ON THE QUALITY OF LIFE OF CHILDREN AGED 2-4
THE ROLE OF HEALTH POLYTECHNIC OF PALANGKA RAYA AS A LEADING CENTER FOR ADOLESCENT HEALTH IN CENTRAL KALIMANTAN
NEGLECTED TROPICAL DISEASES : FOCUS IN INDONESIA
TRANSLATING FUTURE MILLENNIAL: STRUCTURING DISRUPTIVE HEALTHCARE
BRINGING MEDICAL GENETICS TO THE PUBLIC: THE CHALLENGES FOR INDONESIAN MEDICAL FACULTIES
AN EVALUATION OF VIDEO MATERIALS WITH A HEALTHRELATED MESSAGE AVAILABLE IN INDONESIA
Background: A core component of health promotion involves education. When we educate children and their parents about health, we need to use words that they can understand and ways to teach them that they find interesting. In schools in Uganda we have found that many children learn important facts from music videos recorded by celebrities that include a health message. This study looked at video material with a health message that is available on-line in Indonesia for those involved in health promotion to use to educate parents and children. Methods: A google question was generated and the videos the respondents suggested were then viewed on YouTube to identify the health topics that they contained. From this search, the availability of other videos with similar or related messages was evaluated. Results: Nine respondents suggested videos with a health message; 8 were female and 1 male, all had a bachelor's or master's degree. Four of the videos identified contained general health related messages, the remainder were specific to one of two areas, handwashing and hygiene (3) or tooth brushing and oral health (2). Importantly, when viewing these videos, a large number of related videos in various formats (message for adults/parents, message for children, educational material, songs, cartoons) were cross linked with the targeted video. Conclusion: In Indonesia, a broad range of videos exist that can be used either to educate parents and children about the key health topics that these videos cover, or to act as a model for producing similar materials for newly identified health promotion issues. Engaging and educating parents and children is an important health promotion strategy and community empowerment approach to improving the determinants of health. Key words: education, handwashing, health promotion, oral health, videos
FACTORS AFFECTING WORK PERFORMANCE OF FAMILY PLANNING FIELD WORKERS OF NATIONAL AGENCY OF POPULATION AND FAMILY PLANNING (BKKBN) IN EAST JAVA PROVINCE, INDONESIA
Background: In a company or institution the most important asset is human resources. One of the functions of human resource management is training and development. The problem of family planning field worker in East Java Province that often faced is during the implementation of training activities, trainees showed high enthusiasm. However, based on data from BKKBN of East Java Province through Radalgram (program control meeting) in August 2018 explained that their performance achievements were still 73,41% of target more than 90%. This research was conducted at East Java Province to get an overview of the factors that affect the work performance of family planning field workers. Methods: The research design was a quantitative method used surveys. Measurement tool of this research is a questionnaire. The data were analyzed using descriptive statistics, Pearson's Correlation, Stepwise Multiple Regression analysis. Results: Overall of the level of importance of factors affecting work performance of family planning of BKKBN in East Java Province, Indonesia were at high levels. The finding also revealed that there was a positive correlation between personal factor, training factors, organizational factors, and work performance. Teaching techniques had the highest influence on work performance, it could predict 38.6% of work performance. The second factor that effects work performance was self-directed learning which is could increase the prediction rate by 7.5 %. Furthermore, the third factor that affects performance is organizational support, then the fourth and fifth factors are curriculum and training facilities that could increase the predictive rate of 3.7%, 1.8% and 1.0% respectively. Conclusions: Based on the result of this research, the highest influence factors to the work performance of family planning field workers of BKKBN in East Java Province, Indonesia are teaching techniques. The second highest factor is self-directed learning, then the third factor is organizational support. Other factors that affect performance in fourth and fifth are curriculum and training facilities. The researcher suggest that BKKBN pay more attention to facilitators so they can add competency in teaching, support family planning field workers by providing online learning programs and library. Moreover, BKKBN is expected to be able to make policies that provide fair assesment and appreciation for family planning field workers who have good performance. In addition, BKKBN should design a curriculum that is up to date and in accordance with the content of the training program, revitalizing training facilities in education and training center, so that family planning field workers are more comfortable to learn both independently and in groups. BKKBN expects that every family planning field workers to always learn independently and improve their competence in order to create innovative activities in carrying out work tasks in the area. Keywords: Family planning field workers, self-directed learning, training, perceived organizational support, work performance
ASSOCIATION AMONG STATIN, TELOMERE LENGTH AND CARDIOVASCULAR DISEASES
Background: Recent evidence has shown associations between cardiovascular diseases (CVDs) and telomere length (TL). Many factors affect telomerase activity (TA) and TL, and statin was recently found to be associated with TA and TL. This systematic review and meta-analysis was conducted to summarize the evidence on the effect of statin on TA and TL, and update the knowledge of association between TL and CVDs. Primary objective is to determine the effect of statin on TA and TL; Secondary objective, to assess the associations between TL and CVDs. Methods: The MEDLINE and Scopus databases were searched to identify eligible studies and extracted data. Meta-analysis was done to see effects of statin on TA/TL [i.e., standardized/unstandardized mean difference (SMD/USMD)] and TL on CVDs using random-effects and fixed-effects model according to heterogeneity assessed by Q test and I2. Results: Five and 18 studies were selected for the primary and secondary objectives, respectively. Pooled TA showed effect of statin on TA with SMD [95% confidence interval (CI)] of 1.90 (1.16, 2.64) TA. However, no significant effect on TL was seen. Increased risk of CHD among participants with shorter TL was estimated by a pooled risk ratio of 1.58 (1.19, 2.09). However, pooled hazard ratios (HRs) for CHD and stroke were non-significant; but shorter TL was significantly increased risk for unspecified CVDs with pooled HR of 1.33 (1.04, 1.70). Conclusions: Our study showed association between statin and TA, but not for TL. In addition, shorter TL is more likely to be higher risk for CHD and unspecified CVDs. However, results were still inconclusive based on different pooled parameters. More studies are required to confirm the association of statin with TL, possibly to elucidate its protective effect on CVDs. Keywords: Telomere, Telomerase, Statin, Cardiovascular diseases
FACTORS AFFECTING GRADE 11 STUDENTS' ACHIEVEMENT IN LEARNING POPULATION EDUCATION IN SCHOOL POPULATION AWARENESS, INDONESIA
Background: School population awareness program (SSK) is a school program of teaching and learning strategies of population education developed at school level with the pilot project in Sukabumi, Indonesia. Prior this study, there was no research had been conducted to see the effectiveness of the program from the perspective of the students, on how the students perceived, their learning achievement, and whether the teaching and learning population under the SSK program contribute as the factor affecting learning achievement, which all of this could draw a conclusion whether the SSK program effective for students. Further, it would also give a valuable input for teacher and school sectors on how to improve the students' learning achievement. This study has a purpose to investigate the attitude of student toward five aspect of learning situation of population education, which are the subject, method of teaching, activity of teaching, media of instruction, and class environment. Students' learning achievement was also assessed in this study including the factors that affecting the students' learning achievement in population education Methods: A descriptive cross-sectional study was applied using a quantitative research method. The sample size was 188 of eleventh grade students studying at three pilot projects of School Population Awareness in Sukabumi, Indonesia. Data were collected through a survey using close-ended questionnaire which distributed purposively. Results: Students' attitudes were at high level, and their learning achievements were also high. Three predictive factors of learning achievement in population education were found: the attitude towards subject, activity of teaching, and method of teaching. Conclusion: From the result it was reveal that all of the predictive factors found were associated with the teaching and learning strategies of population education under the SSK program which draw a conclusion that the program is effective for the students. For BKKBN as the government institution who developed the SSK program it is recommends to advocate the Ministry of Education and Culture of Indonesia and other senior high schools to implement the SSK program based on the model of SSK implemented in Sukabumi. For the respective teachers and school sectors it is suggested to emphasize the students with the importance of learning population education, adding more real-life activities, and provide more group work in the learning process in order to improve the students' learning achievement in population education. Keywords: Students' attitude, population education, learning achievement, school population awareness program/ Sekolah Siaga Kependudukan (SSK)
FAMILY PLANNING FIELD WORKERS' EXPECTATIONS AND PERCEPTIONS ON SERVICE QUALITY OF TRAINING AND EDUCATION AT NATIONAL POPULATION AND FAMILY PLANNING BOARD IN PROVINCE OF CENTRAL SULAWESI, INDONESIA
Background: Training and education for employees are the important thing to develop their knowledge, skill, performance as well as career. It is important to improve the quality of training and education service in National Population and Family Planning Board (BKKBN), specially training and education for field workers. Performance achievement of family planning field workers in province of Central Sulawesi until November 2018 was low, it was only 57,8% from 95% as a target for a year even though BKKBN province of Central Sulawesi implemented 10 training and education to them for improve the performance. This study aims to compare between trainees expectations and perceptions of service quality and then set up the guidelines to improve the trainig and education for family planning field workes at National Population and Family Planning Board, Province of Central Sulawesi, Indonesia. Method: This research method uses quantitative and qualitative with desciriptive design. 169 respondents filled the questionnaire with 22 statements which was pertaining with five dimensions of service quality (tangible, reliable, responsive, assurance and empathy). Moreover, focus group discussion has been used as one of qualitative methods with the management of BKKBN as participants who conduct the training and education. Conclussions: Level of expectation is in the highest level and level of perception in the highest level. Trainees expectation beyond their perceptions means that trainees did not satisfy with training and education, because perception was related with satisfaction. There was a significant differences between expectations and perceptions for tangible, reliability, responsive and assurance (p<0.05). All dimension had negative gap between expectations and perceptions (SQ= P-E). According to this gap, organiser who conduct training and education may be able to find the problem solving to improve the quality and reduce the gap between trainees expectations and perceptions and make the guidelines. Keywords: Service quality, Expectations, Perceptions, Family Planning Field worker
ADDRESSING GENDER INEQUALITY TO IMPROVE MATERNAL HEALTH IN INDONESIA: A NARRATIVE LITERATURE REVIEW
Introduction: High maternal mortality ratio (MMR) remains a pressing public health issue in Indonesia. Despite many studies have been conducted to identify the associated factors from medical and sociocultural perspectives, fewer studies and discussion appeared to focus on another social dimension such as gender norms, which is not explored deeply in the context of Indonesia. Aims: This paper aimed to discuss how gender inequality affects maternal health in Indonesia and practical strategies needed to address gender inequality in improving maternal health outcomes in Indonesia. Methods: This was a narrative literature review, based on several types of documents: research article, literature review, systematic review, books, and reports from institutions. Those would be reviewed and adjusted with the context of Indonesia in terms of how gender inequality affects maternal health, followed by the synthesis of argumentative ideas related to the practical strategies needed to address this issue. Results: The well-maintained patriarchal system and gender norms in Indonesia leads to gender inequality as one of the social factors contributing to maternal health outcomes. Gender inequality works to influence maternal health outcomes through structural and individual level factors, in which, influence women's power and ability in the decision-making process and impact on women's demand for maternal health service utilization. In addition, implemented maternal health programmes have not fully addressed gender inequality in Indonesia so far. Conclusion: To address gender inequality in order to improve maternal health, some strategies are suggested, such as women empowerment, men engagement to be supportive, and strengthening the protection of women's reproductive rights. Keywords: gender inequality, maternal health, maternal mortality ratio, patriarchy, Indonesia
THE EFFECTIVENESS OF LEMON JUICE (Citrus limon) ON PURKINJE CELL OF WHITE MALE MICE (Mus musculus) CEREBELLAR CORTEX THAT EXPOSED BY MONOSODIUM GLUTAMATE (MSG)
Introduction: A number of studies have indicated that excessive MSG (Monosodium glutamate) consumption can lead to the formation of free radicals that can have a negative effect on purkinje cells in the cerebellar cortex. Lemon fruit is a plant that has benefits as a natural antioxidant because it contains compounds such as flavonoids, vitamin C, citric acid and other substances. This study aims to examine the effect of lemon juice (Citrus limon) to purkinje cells of the cerebellum cortex on male white mice (Mus musculus) which exposed of monosodium glutamate. Method: This research is an experimental laboratory with a post test only control group design. The research subjects were 30 white male mice divided into 5 groups: normal control given standard feed, negative control given MSG dose 4mg / grBW, group of dose I , dose II , and dose III that were each given lemon juice with doses 3.33ml / kgBW, 6.67ml / kgBW, 13.33ml/ kgBW respectively. The number of purkinje cells is calculated in the cerebellar cortex by HE staining. The results of the study were analyzed by One Way ANOVA followed by the Bonferroni Post hoc test. Results: The average number of purkinje cells in administration of lemon juice with dosages of 3.33 ml/kgBW, 6.67 ml/kgBW and 13.33 ml /kgBW were 14.10 cells, 16.73 cells and 17.50 cells respectively. Based on the Post Hoc test, the average number of purkinje cells at the dose of 13.33 ml / kgBW was higher than the negative control (p = 0.021) Conclusion: Lemon juice could be used to reduce negative effect of MSG on purkinje cells of white male mice. Moreover, this finding could be used as reference on further research of benefit of lemon juice. Keyword: Citrus limon, purkinje cell, monosodium glutamate (MSG)
THE EFFECTIVENESS OF LEMON JUICE (Citrus limon) TOWARD PYRAMIDAL NEURON CELLS OF MALE WHITE MICE'SCEREBRAL CORTEX THAT EXPOSED BY MONOSODIUM GLUTAMATE (MSG)
Background: The consumption rate of Monosodium Glutamate (MSG) in Indonesia remains high. Lemon is an antioxidant and neutralizer of free radicals which contains vitamin C and phytochemicals to prevent the long-term effects of MSG to pyramida cells. This study aims to test the effect of oral administration of lemon juice (Citrus limon) to the number of pyramidal neuron cells. Methodology: This experimental study employed 30 male white mice aged 2.5 to 3 months. Those mice were randomly divided into five control-groups: Normal Control (KN), Negative Control (K-) was treated with 4 mg/grBB MSG, Dose Group 1 (KD1) was treated with 3.33 ml/kgBB lemon juice, Dose Group 2 (KD2) was treated with 6.67 ml/kgBB lemon juice, and Dose Group 3 (KD3) was treated with 13.33 ml/kgBB lemon juice. Kruskal Wallis test was used to determine the difference in distribution between groups, followed with Post hoc Mann Whitney test. Results: After 28 days of treatment, the average number of pyramidal neuron cells in dose group 1 (637 cells) was higher than in negative control (589.5 cells) (p=0.078). The average number of pyramidal neuron cells in dose group 3 (482,5 cells) was lower than in the negative control (589.5 cells) (p=0.016). The statistical result shown that there were groups with a significant difference in pyramidal cells number. Mann-Whitney analysis of pyramidal cells number had shown that there was a significant difference between group KD3 and KD1, KD3 and K (-), KD3 and KD2. Conclusion: Lemon juice (Citrus limon) in precise dose has a beneficial effect to reduce the excitotoxic effect of MSG. Further studies is needed to validate the active compound and toxicity effect of lemon juice. Keywords: Pyramidal neuron cells, monosodium glutamate, lemon (Citrus limon)
THE RELATIONSHIP BETWEEN KNOWLEDGE, ATTITUDE, AND BEHAVIOR OF BREASTFEEDING AND INTAKE OF COMPLEMENTARY FEEDING WITH NUTRITIONAL STATUS OF CHILDREN AGED 6-24 MONTHS AT KESUNEAN HEALTH CENTER CIREBON
Background: The insufficient nutrient intake in the certain time may affect physical growth and development of children. The percentage of babies with exclusive breast feeding are only 37.3%. It is still under the national target. This research aims to examine the correlation of knowledge, attitude, and behavior of breastfeeding and intake of complementary feeding with nutritional status of children. Methodology: This study was a cross sectional research conducted in Kesunean Health Center, Cirebon City. Totally 100 mothers of children aged 6 to 24 months was selected by consecutive sampling. The nutritional status was calculated based on weight of age whereas the predictors (knowledge, attitude, behavior) was asked by 31 questions. The statistical analysis used Spearman test. Results: The results of this study found that knowledge (p=0.001 and r=0.561), attitude (p=0.001 and r=0.498), and behavior (p=0.001 and r=0.606) had a correlation with nutritional status in Kesunean Health Center. Conclusion: Knowledge, attitude, and behavior of mother had correlation with nutritional status. Public health center should promote the importance of breast milk and provide the counseling to the mother. Keywords: breastfeeding, intake of complementary feeding, nutritional status of children
ANTIDIABETIC EFFECT OF COMBINED Muntingia calabura L. LEAF EXTRACT AND METFORMIN ON RATS
Background: Diabetes mellitus is a disease that causes blood glucose levels to increase. There are several therapies that can be done to reduce blood glucose levels in diabetes such as metformin, biguanides medicine and kersen (Muntingia calabura L.) leaves as an alternative. Treatment with combination of both is expected to further reduce blood glucose levels. This study aims to measure the effectiveness of the combination of metformin and Muntingia calabura L. leaf extract on blood glucose levels. Methods: This was an experimental research with pretest-posttest control group. The samples were 24 Sprague-Dawley rats divided into 4 groups, first group (K1) negative control was given only aquadest, second group (K2) positive control (+) was given 45 mg/kgBW metformin, third group (K3) was treated with 300 mg/kgBW Muntingia calabura leaf extract, and the fourth group (K4) was given the combination of 300 mg/kgBW Muntingia calabura leaf extract and 45 mg/kgBW metformin. Blood glucose levels were measured and analyzed using paired t-test and one-way ANOVA. Results: The combination of 300 mg/kgBW of Muntingia calabura extract and 45 mg/kgBB of metformin reduces 131.77 ± 3.57 mg/dl of blood glucose levels (p<0.05). This result is better than only metformin (92.68 ± 3.10 mg/dl) or only Muntingia calabura leaf extract (91.70 ± 4.40 mg/dl). There is a possibility that the synergistic effect of Muntingia calabura leaf extract and metformin caused the increased effectivity in reducing blood sugar level. Conclusion: The combination of Muntingia calabura and metformin is more effective in reducing blood glucose levels compared to a single dose of metformin or Muntingia calabura L. extract alone. Keywords: Diabetes mellitus, M. calabura leaf extract, blood sugar levels.
THE CORRELATION BETWEEN ANTENATAL CARE, PARITY AND MATERNAL AGE AMONG PREGNANT WOMEN WITH ANTEPARTUM HEMORRHAGE INCIDENCE AT GONDOSARI COMMUNITY HEALTH CENTER, KUDUS
Background: Antepartum hemorrhage is one of the main cause of maternal mortality. The Maternal Mortality Rate (MMR) in Indonesia currently reaches 305 every 100,000 live births which is still quite high from the MDGs target. Risk factors for antepartum hemorrhage will increase with increasing age and maternal parity, while, the cause of maternal death can be prevented via regular Antenatal Care (ANC). This present study aimed to determine the correlation between the frequency of antenatal care, parity, and age of pregnant women with the incidence of antepartum hemorrhage in the Community Health Center, Kudus City. Method: This was an observational analytic study with cross-sectional design. This study used secondary data obtained from maternal cohort books and Local Area Monitoring of Mother and Child Health (PWS-KIA) databooks. Using simple random sampling technique, a total of 323 individuals were recruited. Univariate analysis, bivariate analysis and multivariate analysis were performed on the data obtained. Results: The Spearman's correlation test showed that there was significant correlation between frequency of Antenatal Care (ANC) (p=0.001), parity (p= 0.001) and age (p=0.001) with antepartum hemorrhage. The correlation coefficient showed that antenatal care (ANC) has a strong negative correlation with antepartum hemorrhage (r= -0.541), parity has a medium correlation with antepartum hemorrhage (r= 0.418) and age has a medium correlation with antepartum hemorrhage (r= 0.465). Multivariate analysis showed that age had the strongest influence on the incidence of antepartum hemorrhage (PR= 274.573), while other variables had the weakest influence smaller effect on the incidence of antepartum hemorrhage (ANC, PR= 0.001 and parity, PR= 0.041) Conclusion: The frequency of antenatal care (ANC), parity and age have correlation with antepartum hemorrhage in the working area in Gondosari Community Health Center, Kudus. Age is the most influential factor in the incidence of antepartum hemorrhage. Keywords: Antenatal Care, Antepartum Hemorrhage, Maternal Age, Parity.
THE CORRELATION OF ADOLESCENT'S KNOWLEDGE AND ATTITUDE TO DRUGS WITH ADOLESCENT'S DRUG ABUSE BEHAVIOR IN THE COMMUNITY HEALTH CENTER OF KESUNEAN, CIREBON
Background: The reports on the number of drug abuse in Indonesia by the National Narcotic Agency (NNA) showed 3.3 million drug users in 2008 and 3.8 million drug users in 2014 in which its number keeps increasing year after year. The number of teenagers who become drug users in Cirebon is quite high, i.e. 25% compared to unemployed people of 19%, and followed by private employees and government employees of 56%. Data from community health center show that drug users who underwent treatment and were sent to rehabilitation center in 2017 were 32 people; it was higher than in 2016, i.e. 10 people. Adolescence is a transition period between childhood and adulthood. There are several factors influencing mental abilities, knowledge, and attitudes. It makes adolescents may consume narcotics, psychotropic abuse and other drug addictive substances. The community health center of Kesunean has an Integrated service post (ISP) program called REMPONG PISAN (an ISP who cares for HIV/AIDS and Narcotics) aiming to make adolescent understand about HIV/AIDS and drugs and to make them healthy. This ISP program is conducted once a month with one of the activities is education about HIV/AIDS and drugs. Aim: To observe the correlation of adolescent's knowledge and attitudes to drugs with drug abuse behavior among adolescents at the ISP. Method: This research was an observational analytic study with a cross-sectional design. The sample was determined using consecutive sampling technique during the implementation of the ISP at the 2 neighborhood in the community health center of Kesunean. The data were analyzed using Pearson correlation to determine the correlation of adolescent's knowledge and attitudes to drugs with drug abuse behavior among adolescents. Results: Statistical analysis shows that there was no significant correlation between knowledge and drug abuse behavior (p = 0.180 and; r = -0,201), there was no significant correlation between attitudes with drug abuse behavior (p = 0.264; r= -0,168), however, there was a significant correlation between knowledge and attitudes towards drug abuse (p = 0.000; r = 0,710**). Conclusion: The better the adolescent's knowledge about drugs, the better their attitude will be. In this case, good teen behavior is influenced by good knowledge and attitude. Keywords: NNA, Drug, Knowledge, Attitude, Drug Abuse Behavior
THE EFFECT OF LEMON JUICE (Citrus limon) IN LIVER HISTOPATHOLOGIC APPEARANCE OF MALE MICE (Mus musculus L.) EXPOSED BY MONOSODIUM GLUTAMATE (MSG)
Background: Excessive consumption of MSG can cause the formation of free radicals in the body. Continuous use of MSG will cause free radical accumulation and oxidative stress in the liver. An antioxidant is one of the substances that has an ability to eliminate free radicals and protect the liver from oxidative stress. Lemon is a fruit that has benefits as a natural antioxidant. This study aims to determine the effect of administering lemon juice on the histopathological appearance of the liver exposed by MSG. Methodology: This post-test only control group design experimental study used 30 male white mice which were randomly divided into five groups: NC group, C(-) group, D1 group, D2 group, and D3 group. After 7 days of adaptation and randomized grouping, the mice were treated differently based on their group. All groups, except the NC group, were exposed to 4mg/gBW dose of MSG orally for 14 days. On the 15th day, MSG exposure was stopped and after that D1 group, D2 group, and D3 group were given lemon juice with a dose of each group 3.33ml/kgBW, 6.67 ml/kgBW, 13.33 ml/kgBW. The lemon juice was given once a day for 14 days using the gastric sonde. Histopathology examination was analyzed by pathologist in Gunung Jati Hospital, Cirebon, Indonesia. Results: Significant differences of liver histopathology were obtained between the normal control group with the dose 3 group (p = 0.005), the normal control group with the dose 2 group (p = 0.019), the normal control group with the dose group (p = 0.019) and between the negative control groups with dose 3 group (p = 0.027). Dose 3 group has higher liver damage compared to a normal control group and negative control group characterized by the form of parenchymatous degeneration. Conclusion: Lemon juice has a negative effect on the histopathology appearance of male white mice's (Mus musculus L.) liver exposed by monosodium glutamate (MSG). Further studies are needed to validate the effect of the active compound and toxicity of lemon juice and to reveal the precise mechanisms on how lemon juice affects the hepatocytes. Keywords: Monosodium Glutamate (MSG), Citrus lemon, Histopathology Liver
THE COMPARISON OF DIARRHEA INCIDENCE BETWEEN 0-6 MONTHS OLD INFANTS WHO WERE EXCLUSIVELY BREASTFED, NON-EXCLUSIVELY BREASTFED AND GIVEN MILK FORMULA IN CIREBON CITY, INDONESIA
Background: Infant diarrhea is one of the major health issues in Indonesia due to its high incidence and mortality. In 2015, the mortality rate of diarrhea and gastroenteritis in infants under one year in hospitals in Cirebon was 21%. Inappropriate infant feeding practice is one of the risk factors of diarrhea in infants. WHO recommends that every infant should get exclusive breastfeeding during the first 6 months of life and continued breastfeeding until 24 months of age. The aim of this study is to find out the difference in diarrhea incidence between 0-6 months old infants who were exclusively breastfed, non-exclusively breastfed, and given infant milk formula. Methods: This was an observational study with cross-sectional design. A total of 89 infants aged 0-6 months old were recruited by purposive sampling. The primary data were obtained using questionnaires that were filled by the mother or caregiver of the infants. The data were analyzed using the Chi-Square test and Prevalence Ratio was calculated. Results: The Chi-Square test showed a significant difference in diarrhea incidence between 0-6 months old infants who were exclusively breastfed, non-exclusively breastfed and infant milk formula (p=0,028). Infants who were not breastfed have 4 times higher risk of diarrhea (PR=4.145; CI95%= 1.198-14.400) compared to infants who were breastfed. Infants who were not exclusively breastfed has 3 times higher risk of diarrhea incidence compared to the infants receiving exclusive breastfeeding (RP=3.286; CI95%=1.144-9.434) Conclusion: Proper breastfeeding practice can decrease diarrhea incidence in infants aged 0-6 months. Mothers should be encouraged to exclusively breastfeed her baby during the first 6 months of life. Keywords: Diarrhea, breastfeeding, infant milk formula, infant feeding practice
CALCULATING COLONY OF Candida spp. AMONG CHILDREN WITH INTELLECTUAL DISABILITY IN CIREBON
Background: Children and adults with Intellectual Disability and Autism Spectrum Disorders (ASD) have decreased intestinal permeability and enzyme activity, causing gastrointestinal (GI) problems that are more frequent and more severe than in children from the general population. The immune system which is part of the intestinal barrier in children with Intellectual Disability (ID) experiences various disorders and becomes more susceptible to fungal invasion, such as Candida spp. This present study aims to calculate the colony of Candida spp. in the digestive tract of Children with Intellectual Disability (ID) in the city of Cirebon. Method: This is an observational study with cross-sectional design using purposive sampling. The study was conducted in November 2018-February 2019. The sample (ID) group consists of 31 individuals from Special Needs School and 60 individuals from National elementary school (non-ID) in the city of Cirebon. The inclusion criteria were children ages 6-12 years and the exclusion criteria were children under antifungal treatment and children under cytotoxic or immunosuppressive drugs. The fecal samples from the ID group and non-ID were examined at the Laboratory of the Faculty of Medicine, Universitas Swadaya Gunung Jati Cirebon, Indonesia using Digital Colony counter. Collected data were stored and analyzed using computer aided Statistical program. Mann-Whitney analysis of variance techniques were used to test the hypotheses. Results: The results showed that there are significant differences in the colonies of Candida spp. between the ID group and non-ID group. Median colony of Candida spp. in the ID group is 39.00 with mean colony of 126.90 while the median colony of non-ID group is 3.00 with mean colony of 40.93 (p<0.001). Conclusion: There are significant differences between the Candida spp. colonies in the ID group with the non-ID. Keywords: Intellectual Disability (ID), Candida spp., Gastrointestinal
THE CORRELATION BETWEEN EDUCATION, WORK, AND MATERNAL KNOWLEDGE ON COMPLEMENTARY FEEDING WITH 6-24 MONTHS' NUTRITIONAL STATUS
Background: Indonesian Basic Health Research in 2018 reported that the prevalence of malnutrition in Indonesia was 17.7% which consists of 13.8% malnutrition and 3.9% severe malnutrition. In West Java Province, the prevalence of malnutrition and severe malnutrition is still high at 15.6%. The aim of this study is to examine the correlation between education, work, and maternal knowledge about complementary feeding with baby nutrition status aged 6-24 months. Methodology: This was a cross sectional study. The sample of this study was 100 mothers of infants aged 6 to 24 months in the Tegalgubug Health Center, in Cirebon City which selected by cluster sampling. Data have been collected from questionnaires and anthropometric measurement of weight for age Z (WAZ). Nutritional status was categorized into malnutrition status if z score <-2 SD up to <-3 SD, and good nutrition status if z score -2 SD to 2 SD. The analysis of the study was tested by Spearman correlation. Results: From 100 respondents,51% of them were low educated mother, 55% were working mother, 51% had good knowledge, and 83% had good nutrition's babies. The bivariate analysis showed that education, working status, and mother's knowledge about complementary feeding were statistically significant correlated with nutritional status of infants (p=0.021, p=0.020, p=0.013, respectively). Conclusion: Education, working status, and knowledge were significant correlated with nutritional status of infants aged 6 to 24 months. Malnutrition of infants can be greatly reduced by educating maternal about complementary feeding and given accurate information about nutritional status of infants. Keywords: Education, complementary feeding knowledge, nutritional status
INFLUENCE OF GIVING BREADFRUIT (Artocarpus altilis (Park) Fosberg.) LEAVES EXTRACT TO DECREASE URIC ACID LEVELS IN WISTARS RATS HYPERURICEMIC
Background: Hyperuricemic is a condition where the uric acid levels in blood more than 7 mg/dl. In 2010, Hyperuricemic was included as one of non-communicable disease with incidence rate up to 30% and can cause the mortality. This study aims to examine the effective dose of breadfruit (Artocarpus altilis (Park) Fosberg.) leaves extract to decrease uric acid levels in Wistar rats Hyperuricemic. Methodology: This study was an experimental with pre-posttest with control group design. 30 Wistar rats aged three months was divided into 2 control groups (K1 and K2) and 3 treatment groups (K3, K4, and K5). Control groups were given purine (K1= standard, K2=high) and aquadest. Differently, treatment groups were given high purine and breadfruit leaf extract (K3=0.25g /KgBW, K4=0.5g /KgBW, K5=0.75g/KgBW). All the treatments were given one time daily in the morning for 7 days. Data were analyzed by the Shapiro-Wilk test followed by the One-Way ANOVA test and then Post-hoc Tamhane test. Result: The control groups revealed negative average reduction of uric acid in mg/dl (K1= -0.05, K2= -0.09) whereas the treatment groups revealed the positive average reduction of uric acid in mg/dl (K3=2.19, K4= 4.26, K5=5.87). The significant differences (p<0.05) of uric acid levels before and after treatment in each treatment groups had meaning that giving the Breadfruit leaf extract could reduce the uric acid level rats. Post-hoc Tamhane test result showed that the mean decrease of each group was significantly different. Particularly, K5 was the most effective treatment compared with others. Conclusion: Breadfruit leaves extract with dose of 0.75g/KgBW was the most effective treatment to reduce the uric acid level in blood. Stakeholders in health field should promote the Breadfruit as the traditional medicine method to reduce the uric acid in blood. Keywords: Breadfruit leaves, uric acid, Hyperuricemic, Wistar rats, flavonoids
DESCRIPTIVE STUDY OF DIETARY PATTERNS AND PHYSICAL ACTIVITIES AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS IN COMMUNITY HEALTH CENTER OF KESUNEAN, CIREBON
Background: The prevalence of Diabetes Mellitus (DM) remains high in Indonesia. The Basic Health Research of Indonesia in 2018 revealed that 2% of 250 million population were diagnosed of DM. Unbalanced dietary patterns and lack of physical activities contributed as the risk factors of DM type 2. Particularly, this study wants to find out the description of dietary patterns and physical activities among patients in the community health center of Kesunean, Cirebon. Methodology: This descriptive study used 89 people with DM type 2 aged 45-65 years as the respondents. Consecutive sampling was used as the sampling technique, while recall questionnaire of 24-hour food consumption and food frequency for diet and Baecke questionnaire for physical activity were used as data collection techniques. Results: The results of frequency distribution analysis showed that 64 (71.9%) respondents had unbalanced diets, while 25 (28.1%) of them had balanced diets. Regarding physical activities, 51 (57.3%) respondents had low intensity of physical activities and 38 (42.7%) patients had moderate intensity of physical activities. Conclusion: Most of the respondents with DM type 2 had unbalanced diets and low intensity of physical activities. Community Health Center of Kesunean should provide communication, information and communication about the importance of balanced diets and physical activities in order to prevent the incidence of DM type 2. Keywords: Physical activity, diet, type 2 diabetes mellitus
THE CORRELATION BETWEEN MOTHER'S KNOWLEDGE, EDUCATION AND FAMILY INCOME WITH NUTRITIONAL STATUS OF TODDLER (AGED 1-5 YEARS)
Background: The role of mothers in the growth and development of toddlers is very important. Mothers must know and understand what is needed for that process because this will affect the nutritional status of toddlers. This relates to knowledge, education, and mother's income which will affect the provision of food intake for infants. Nutritional status of children is still one of the problems in the world. The incidence of malnutrition in the world reached 104 million children and malnutrition is one-third causes of child mortality worldwide. Basic Health Research in 2007, the prevalence of toddler malnutrition in Indonesia was 18.4%, an increase from 2013 to 19.6% and decreased again in 2018 to 17.7% in the year. Aims: To find out the correlation between mothers' knowledge level, education and family revenue with nutritional status of toddler. Methods: This research used Cross Sectional design, used Accidental sampling techniques. The samples were taken 289 toddlers (1-5 years). The data obtained were analysed using spearman test. Results: Spearman test results showed there is no significant correlation (p> 0.05) between mother's knowledge level, education and family revenue with nutritional status of toddler. Conclusion: There is no correlation between mother's knowledge level, education and family revenue with nutritional status of toddler in Kalitanjung Cirebon Health Center. Keywords: Knowledge level, Mother's education, Revenue, Nutritional status of toddler
THE CORRELATION OF ANXIETY IN DEALING WITH OBJECTIVE STUDENT ORAL CASE ANALYSIS (OSOCA) EXAMINATION ON THE CASE OF FUNCTIONAL DYSPEPSIA IN THE FIRST SEMESTER MEDICAL STUDENTS
Background: Anxiety is a psychological reaction caused by a variety of factors, one of which is when a student has an examination. Objective Student Oral Case Analysis (OSOCA) is one of the examinations that is a main indicator of learning achievements of medical students in the faculty of medicine. Anxiety can cause a variety of other health problems, such as functional dyspepsia. This study aims to analyze the correlation of anxiety in dealing with objective student oral case analysis (OSOCA) examination and the cases of functional dyspepsia in the first semester medical students. Methods: This research was an observational study with a cross-sectional design. A total of 132 medical students were recruited as respondents. Zung Self-rating Anxiety Scale (ZSAS) questionnaire was used to asses anxiety and a questionnaire based on Rome III criteria that was previously validated was used to measure functional dyspepsia. The data were analyzed using Spearman correlation test and prevalence ratio was determined. Results: The result based on Spearman correlation test showed significant weak positive correlation between anxiety and functional dyspepsia with r=0,295 (p=0,001). Student with moderate anxiety scales have 5 times greater risk of functional dyspepsia than student who have mild anxiety scales (PR=5,300). Conclusion: There is a significant correlation between anxiety and functional dyspepsia. Students with moderate anxiety scales have 5 times greater risk of functional dyspepsia than students who have mild anxiety scales. Keywords: Anxiety Scale, Functional dyspepsia, OSOCA.
COMPARISON OF SOIL-TRANSMITTED HELMINTH EGG INFESTATION IN FECES OF INTELLECTUAL DISABILITY (ID) CHILDREN WITH NON-ID CHILDREN
Background: The worm infestation is considered as one of the causes of cognitive function disruption. It also can aggravate the condition in children with intellectual disability (ID). This greatly affects health conditions, such as abdominal pain, bloating, diarrhoea, constipation and other digestive disorders. Indigestion may increase aggressive behaviour, mood change and malnutrition so that it leads to chronic malnutrition which is the cause of major morbidity and premature death in the ID population. This study aimed to compare soil-transmitted helminth egg infestation in stool samples between ID children and non-ID children. Methodology: This present study was a descriptive study with a cross sectional design. Stool samples was collected from 30 students from Special Need School and 60 students from Elementary School in the Cirebon City. The floating method was used to identify the egg of soil-transmitted helminth. The stool samples were examined in the Laboratory of the Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia Results: The laboratory test found positively Soil-transmitted Helminth eggs in 9 of 30 stool sample of ID students. Among them, it was found 5 stool samples with Ascaris lumbricoides, 2 stool samples of Trichuris trichiura, and 2 stool samples of Necator americanus. Regarding their levels, 4 students (44.4%) had mild intellectual disability and 5 students (55.6%) had moderate intellectual disability. However, there was not found any Soil-transmitted Helminth eggs in stool samples of non-ID children. Conclusion: Soil-transmitted helminth eggs was found only in stool samples of ID children. The hygiene and sanitation in the school should be guaranteed to prevent the transmission of Soil-transmitted Helminth. Key words: Soil-Transmitted Helminth, Intellectual Disability (ID), Feces
THE EFFECT OF ORALLY ADMINISTERED CATFISH (Clarias gariepinus) SKIN AND MEAT ON EPITHELIALIZATION THICKNESS AND COLLAGEN DENSITY IN INCISION WOUND OF WISTAR RAT (Rattus norvegicus)
Background: Alternative medicine using animal is still rare whereas Indonesia have a lot of potential natural resources. Catfish is easily found animal in Indonesia and is common consumed as nutriment sources contains albumin, amino acid and fatty acids which plays an essential role of wound healing process. This study will determine effect of orally administered catfish (Clarias gariepinus) skin and meat on epithelialization thickness and collagen density in incision wound of white male rat (Rattus norvegicus). Methods: This experimental post-test only group design used 30 white male rat (Rattus norvegicus), that randomly divided into 4 tratment goup and one control group. The treatment group was given 12,5 mg/g W, 25 mg/g W, 37,5 mg/g W and 50 mg/g W dose of catfish (Clarias gariepinus) skin and meat flour, in the other hand the contol group were given aquades. Non-parametric analyses using Kruscall- Wallis and Mann Whitney test were used to compare epithelization thickness and collagen density. Result: The comparison results of epithelialization thickness between group C with TGI, C with TG2, C with TG3 and C with TG4 showed significant differences (p<0.05). TG4 was the thickest of all groups. Significant differences were also observed in collagen density result between C with TGI, C with TG2, C with TG3 and C with TG4 (p <0,05) TG4 showed the highest density of all groups. Conclusion: Catfish (Clarias gariepinus) skin and meat flour with 50 mg/200g W dose is effective for wound healing and increasing epithelial thickness and collagen density in Wistar rat (Rattus norvegicus) incision wounds. Keywords: Epithelial thickness, Collagen density, Wound, Catfish (Clarias gariepinus)
CORRELATION BETWEEN ANXIETY LEVEL AND SELF DIRECTED LEARNING READINESS (SDLR) WITH STUDENT PEFORMANCE IN PROBLEM BASED LEARNING (PBL)
Background: The pattern of medical education in Indonesia has changed from teacher-centered learning to student-centered learning. This change has an impact on methods, learning activities, and learning achievements of medical students. Problem Based Learning (PBL) is one of the main learning methods used in the faculty of medicine. PBL is a learning method that requires students to play an active role and facilitate collaborative learning. Due to the change of learning method, new medical students experience a lot of stress from in doing Problem Based Learning such as anxiety and may affect their PBL results as can be evaluated using Self-Directed Learning Readiness (SDLR). There are very few studies found to date investigating this phenomenon. Aims: This research aims to see the correlation between anxiety level and SDLR with student's performance participating in first-year PBL in the Musculoskeletal and Locomotory System block in the faculty of medicine Universitas Swadaya Gunung Jati Cirebon. Methods: This is a cross-sectional observational study with total sampling. The samples were recruited from 167 first-year 2018 intake students of the faculty of medicine Universitas Swadaya Gunung Jati. Zung Self Rating Anxiety Scale questionnaire is used to measure anxiety levels and the SDLR questionnaire is used to measure Self Directed Learning Readiness (SDLR). Results: The Spearman test showed a medium negative correlation value of -0.49 (p>0.05) for the level of anxiety. It means that there is no significant effect of anxiety on the PBL performance. In addition, it shows a weak positive correlation value of 0.196 (p <0.05) for SDLR (self-directed learning readiness) showing a significant influence on PBL performance. Conclusions: The level of anxiety does not significantly influence PBL performance while SDLR has a significant effect on PBL performance. Keywords: Anxiety Level, Self-Directed Learning Readiness, Problem Based Learning.
THE EFFECT OF SELF DIRECTED LEARNING READINESS (SDLR) AND LEARNING APPROACH TOWARD MEDICAL STUDENT ACHIEVEMENT
Background: Learning approach and Self Directed Learning Readiness (SDLR) are important factors that influence student learning achievement. The world of medical education has experienced a paradigm shift from Teacher-Centered Learning (TCL) to Student-Centered Learning (SCL) that is applied through the Problem Based Learning (PBL) methods that expected the student to have the ability to learn independently or what is called Self Directed Learning (SDL). This study aimed to analyzed the effect of SDLR and learning approach on medical student achievement. Methods : this study uses a cross-sectional design. The sample was students of the Faculty of Medicine, Swadaya Gunung Jati University, 2016, 2017 and 2018 as many as 181 people. The sampling technique uses stratified random sampling. Spearman test, chi-square test and linear regression test were used to analysed the effect of the age, SLDR and learning approach on medical student achievement Results : The chi square test result in this study showed that age (P = 0.001; rs = 0.359), SDLR (P = 0.001; rs = 0.516) and the learning approach (P = 0.001; rs = 0.308) had a significant effect on medical students' learning achievement. However, there was no significant difference in the learning approach between 2016, 2017 and 2018 classes. The linear regression test results showed that SDLR was the most influential variable in the learning achievements of medical students. Conclusions : Self Directed Learning Readiness (SDLR) and learning approach could be the effective learning methods. SDLR as the most effective method to increase the learning achievements of medical student could be applied on many medical schools. Keywords : SDLR, learning approaches, learning achievement
INHIBITORY OF SOURSOP LEAVES (Annona muricata L.) EXTRACT AGAINST Malassezia furfur GROWTH
Background: Malassezia furfur in certain conditions can turn into a pathological phase, from the yeast phase to the mycelia phase that attacks the stratum corneum. Malassezia furfur is one of the causes of Pityriasis versicolor. The prevalence of pityriasis versicolor in Indonesia is quite high at around 40- 50%. Several studies suggested that soursop leaves (Annona muricata L.) contains active substances with anti-fungal properties. This study aims to determine the inhibition of soursop leaves (Annona muricata L.) extract against the growth of Malassezia furfur. Methods: This study was an experimental study with Post-test Only Control Group Design. Malassezia furfur fungi is used as subject in this study and ethanol extract of soursop leaves as a natural antifungal against Malassezia furfur. The concentrations of extract tested were 100%, 80%, 60%, 30%. Miconazole 2% was used as a positive control while DMSO 10% was used a negative one. The result of the study was analyzed by descriptive analysis which showed by increasing average diameter of antifungal. Results: The results showed that soursop leaves (Annona muricata L.) extract had inhibitory effect on the growth of Malassezia furfur fungi at 100% concentration of 2.50 mm, 80% at 1.50 mm, 60% at 0.47 mm, 30% concentration at 0.25 mm and positive control of 14.50 mm. While as negative control, no inhibition zones were formed on SDA media. Conclusion: Soursop leaves (Annona muricata L.) extract can inhibit the growth of Malassezia furfur, but the formed inhibition zone is weak. Further research is needed to found the best type of antifungal metabolites to maximize antifungal effects. Keywords: Soursop leaves extract, Annona muricata L. , Malassezia furfur
EFFECTIVENESS OF ORALLY USE TILAPIA (Oreochromis niloticus) ON WOUND LENGTH AND FIBROBLAST DENSITY ON INCISION WOUND OF WISTAR RAT (Rattus norvegicus)
Background: The incidence of a wound in Indonesia has increased from 7.5 percent in 2007 to 8.2 percent in 2013 according to Riskesdas. Wound care that widely used is povidone-iodine, but in case, it has a toxic effect on healthy cells around the wound. The albumin, amino acids, and fatty acids in Tilapia (Oreochromis niloticus) are the potential substances to accelerate the wound healing process. This study aims to investigate the efficacy of Tilapia (Oreochromis niloticus) on wound length and fibroblast density on the incision wound of Wistar rat (Rattus norvegicus). Methods: The study was conducted in the Food and Nutrition PAU Laboratory and Pathology Anatomy Laboratory of Universitas Gadjah Mada, Yogyakarta. This post-test only control group design experimental study used 30 male white rats that randomly divided into five groups, i.e. control group K, and treatment group P1, P2, P3 and P4 that were each given Tilapia with a dose of 12.5 mg/200gBW, 25 mg/200gBW, 37.5 mg/200gBW dan 50 mg/200gBW. The length of the wound was measured by a ruler each day. The rats were terminated on the 10th day to obtain wound tissue for H&E stained histopathological sections to observe fibroblast density. One Way ANOVA, Tamhane, Kruskal-Wallis and Mann Whitney tests were used to compare the wound length and fibroblasts density. Results: Incision wounds in this study showed the best wound healing on the 10th day. Based on the theory, on the 10th day, a proliferation and remodeling phase occurs. There is an effect of giving Tilapia (Oreochromis niloticus) orally at a different dose. Tilapia at dose 37.5mg/200gBW is more effective compared with the dose of 12.5mg/200gBW, 25mg/200gBW, and 50mg/200gBW to accelerate wound healing for wound length and fibroblast density in Wistar rat (Rattus norvegicus). Conclusion: Consuming Tilapia (Oreochromis niloticus) could be a new alternative for wound healing treatment. The antimicrobial ability of Tilapia should be analyzed. Keywords: wound healing, wound length, fibroblast density, Tilapia, Oreochromis niloticus
EFFECTIVENESS OF ORALLY USE CATFISH (Clarias gariepinus) SKIN AND MEAT ON WOUND LENGTH AND FIBROBLAST DENSITY IN INCISION WOUND OF WISTAR RAT (Rattus norvegicus)
Background: Treatment for wounds that are currently often given is use povidone-iodine. But, this antiseptics also kills fibroblast tissue which is useful for forming new tissue. One of the other ways to treatment for wounds is use catfish. The contents found in catfish (Clarias gariepinus) is albumin which is a globular protein that is useful in the formation of body tissues, such as postoperative wounds and burns. This study aims to determine the effect of skin and meat of catfish (Clarias gariepinus) on wound length and fibroblast density in incision wounds of Wistar rat (Rattus norvegicus). Methodology: This study is an experimental study with Post Test Only Control Group Design using Wistar rats which are divided into five groups. The control group (aquadest) and treatment groups 1, 2, 3 and 4 are given the skin and meat of catfish (Clarias gariepinus) orally at a dose of 12.5 mg / 200 g BW, 25 mg / 200 g BW, 37.5 mg / 200 g BW, and 50 mg / 200 g BW. After 10 days, the rats are killed to take the wound tissue for histological preparations to observe fibroblast density. Then, it is analyzed by ANOVA test or the alternative. Results: There is an effect of giving catfish skin and meat (Clarias gariepinus) orally at different dose. The administration of catfish skin and meat (Clarias gariepinus) at a dose of 37.5 mg / 200 g BW and 50 mg / 200 g BW is better than other doses assessed from wound length and fibroblast density in Wistar rat incision wounds (Rattus norvegicus). Conclusion: The use of catfish for wound healing can be applied. This method can reduce wound length and increase fibroblast density at certain doses. Keywords: Fibroblasts, incision wounds, catfish, Clarias gariepinus, wound healing
INHIBITORY TEST OF DAYAK ONION (ELEUTHERINE BULBOSA MILL.) ESSENTIAL OIL TO THE GROWTH OF MALASSEZIA FURFUR
Background: Certain fungi are normal flora on human mucosa and skin, and they require lipids for growth. One of them is Malassezia furfur, which can develop into an opportunistic infection and will take a long time to treat. The fungus may cause pityriasis versicolor, which cause scaly and discoloration of the skin. It is estimated that 40-50% from population in the tropical country is infected. Dayak onion (Eleutherine bulbosa Mill.) essential oil have the potential to treat fungal infections. This research aims to see the inhibitory potential of dayak onion essential oil (Eleutherine bulbosa Mill.) in inhibiting the growth of Malassezia furfur. Methods: This is an experimental study with a post-test control group design. The samples grouped into 7 groups. The first five treatment (P1 to P5) was given dayak onion (Eleutherine bulbosa Mill.) essential oil with a concentration of 3.125%,6.25%, 12.5%, 25%, and 50%, P6 (positive control) was given ketoconazole, and P7 (negative control) was given 10% DMSO. The inhibitory effect is measured from the diameter of the inhibitory zone, then analyzed using Kruskal-Wallis and Mann-Whitney tests. Result: The result showed that average diameter on 50% concentration is 9.25mm, 25% concentration is 7.5mm, 12.5% concentration have diameter of 4.5mm, 6.25% concentration have diameter of 3mm, 3.125% concentration with diameter of 1.75mm, positive control group with diameter of 20mm, and negative control group with diameter 0mm. Conclusions: Essential oil of dayak onion (Eleutherine bulbosa Mill.) shows inhibition of the growth of Malassezia furfur. The smallest inhibition zone diameter was 1.75 mm with concentration of 3.125%. The largest inhibition zone at a concentration of 50% with diameter of 9.25 mm. This finding showed potential effects towards antifungi treatment. Keywords: Eleutherine bulbosa Mill, Malassezia fufur, pityriasis versicolor.
THE INHIBITION TEST OF FLAVONOID AND TANNIN IN NONI FRUIT (Morinda citrifolia Linn) COMPARED TO CEFTRIAXONE TOWARDS Escherichia coli IN VITRO
Background: Escherichia coli is one of the causatives of infection agents. Noni fruit that contains the antibacterial ingredients was predicted as an alternative medicine to reduce the resistance of antibiotics. Noni fruit extract can inhibit the growth of Escherichia coli. The absence of research on the active substances contained in this fruit which plays a role in inhibiting the growth of Escherichia coli encourages the researcher to conduct this research. Methodology: The research was an experimental laboratory with post-test only control group design. The Escherichia coli grown on Mac conkey agar. Flavonoid and tannin in noni fruit (Morinda citrifolia Linn.) diluted with 3 concentrations, 50%, 70%, 100% and 2 control groups, positive control with ceftriaxone and negative control with Dimethylsulfoxide 10% (DMSO). The treatment group were incubated for 24 hours, then the inhibitory zone formed was measured in mm. Results: The Kruskall-Wallis test showed significant difference in all concentration. The results obtained from this research showed that the average of inhibition towards Escherichia coli on positive control (22.83 mm) had the largest inhibition zone among flavonoid 100% (18.83mm), flavonoid 70% (14.67 mm), flavonoid 50% (6 mm), tannin 100% (17.33 mm), tannin 70% (10.83 mm), tannin 50% (7.50 mm), and negative control (2 mm). Conclusion: Flavonoid and tannin in noni fruit (Morinda citrifolia Linn) were effective for inhibiting the growth of Escherichia coli. The 100% concentration is the most effective concentration that can be promoted as an alternative medicine. Keywords: Noni fruit, Flavonoid, Tannin, Escherichia coli, Inhibition test
IMPACT OF OBESITY AND DIABETES MELLITUS TYPE II WITH INCIDENCE OF HYPERTENSION IN AGE 45-65 YEARS OLD
Background: Hypertension is one of the main causes of mortality and morbidity in Indonesia. Hypertension is also the third biggest risk factor for early deaths. Several previous researches have shown that obesity and diabetes mellitus type II (DM type II) are the factors in the occurrence of hypertension. Previous research did not include the stage of obesity and DM type II, by this reason the research was aimed to analyze the correlation between the stage of obesity and stage of DM type II with hypertension. Methodology: This research used observational analytic with cross-sectional design. This study involved 161 patients who were selected by consecutive sampling method. The inclusion criteria of the sample were aged 45-60 years old, obese, and have been diagnosed of DM type II and hypertension in Waled Regional General Hospital. Results: The result revealed that stage of obesity and stage of DM type II were significantly associated with hypertension (p<001, p<01, respectively). Other variables that also significantly associated with hypertension were age and gender. Conclusion: There was the strong correlation between stage of obesity and hypertension. Public health policy maker may promote to prevent the obesity in order to decrease the incidence of hypertension. Keywords: Obesity, DM type II, Hypertension
THE CORRELATION OF EDUCATION AND SOCIAL ECONOMIC LEVELS WITH ANTIBIOTIC SELF-MEDICATION IN THE COMMUNITY OF CIREBON
Background: People in developing countries, like Indonesia, often conduct self-medication. One of the most common drugs used in self-medication is antibiotics. Antibiotics should be used with caution since it can cause antibiotic resistance and possible unwanted side effects of the drug. There are several factors that influence self-medication behavior such as education and socio-economic levels. This research aims to find the correlation between education and social economic levels with antibiotic selfmedication in the community of Cirebon. Method: This study was an analytical survey with cross-sectional method. This study was conducted from December 2018 to February 2019. A total of 300 respondents were recruited as samples using consecutive sampling technique. The respondents were recruited from 5 different pharmacies from each sub-district in Cirebon City and a validated questionnaire were used to obtain data. The collected data are analyzed using the Spearman correlation test. Results: The results of this study show that there was a significant but weak positive correlation of education level (r=0.224, p=0.001) and socio-economic (r=0.210, p=0.001) with self-medication using antibiotics. Conclusion: There is a significant positive correlation between education and socio-economic levels with antibiotic self-medication. Keywords: self-medication, education level, socio-economic level
DOES BEETROOT JUICE LOWER BLOOD PRESSURE?: A SYSTEMATIC REVIEW
Background: Hypertension or high blood pressure has been a common global health problem for several years. The content of nitrate within beetroot helps to increase production of nitric oxide (NO) which serves as a vasodilator and has potency to reduce blood pressure. This study aims to determine the potential effect of beetroot juice on reducing blood pressure. Methods: This study was a systematic review based on the PRISMA protocol as a writing guideline. Data were obtained from PubMed, Science Direct, and Google Scholar databases. Keywords used consisted of "beetroot”, "beetroot juice”, "blood pressure”, and "hypertension.” The eligibility criteria were research written in English, years of publication from 2014 and above, and Randomized controlled trials of beetroot juice interventions on reducing blood pressure. Results: The literature search resulted in 376 records, and only 9 studies were in the systematic review. Six out of 9 studies showed significant results of blood pressure reduction, but the other three studies confirmed otherwise. A significant reduction of blood pressure was mostly observed in healthy subjects. The efficacy of beetroot juice supplementation is influenced by several factors, including gender, age, nutritional status (BMI), initial blood pressure, duration of supplementation, dose, and concentration of nitrate. Conclusions: Beetroot juice supplementation is not so useful on reducing blood pressure because it only has an acute effect in lowering blood pressure and its effects were also influenced by several factors. Key Words: beetroot juice, blood pressure, hypertension, a systematic review
ASSESSMENT OF RESIDENCE SANITATION CONDITION AND LIFE QUALITY OF CONSTRUCTION WORKERS, CHONBURI PROVINCE, THAILAND
Background: Thailand economic has grown for last decade in all enterprise. Especially, construction is one industry composed by various important factors such as technology finance worker and etc. Workers in construction industry are the human resources that need welfare to promote life quality of workers. One of important welfare is the residence during constructing. Camps or residence need good sanitary management for supporting for supporting life quality of worker. Aim of this study was to assess sanitation condition of residence and life quality of construction workers. Methodology: To survey residence sanitation, Questionnaire for life quality in 3 aspects, for samples of workers in 3 camps A B C of 3 construction sites, Analyze and compare data by as percentage and criteria that provided as 4 level of sanitation condition and life quality. Results: Camp A sanitation was 78.70% indicating the residence sanitation was in good level meanwhile 3 aspects of life quality were during 67.45 - 70.53 % defining that samples lived and worked full effective. Camp B was 62.50 % indicating fair level of sanitation meanwhile life quality were during 63.83 - 66.89 %. Camp C was 66.00 % indicating same camp B, meanwhile life quality ranged during 63.83 - 66.89 % that same Camp A and B. Conclusion: Good sanitation management of residence influence good life quality of worker. This study could be used as tool and evidence to evaluate not only sanitation condition and life quality, these also could be used to test the consistent of both. Keywords Construction workers residence; Construction workers life quality; Outside job welfare
POTENTIAL OF HERBAL PLANTS AS ANTIHYPERTENSIVE THERAPY: A REVIEW
Background: Hypertension has become a significant health problem in the world which the sufferer increases every year. Herbal treatment for lowering blood pressure that has been widely used in many countries shows the potential as an anti-hypertensive. This study aims to provide an overview of the herbs that have the effect of lowering blood pressures as the treatment of hypertension. Methods: This study used a systematic review based on the PRISMA (Preferred Reporting Items for Systematic Reviews & Meta-Analyses) protocol as a writing guideline. Electronic databases used in this study were Science Direct, PubMed, and Google Scholar. Only articles using interventions research design and containing full text both in English and Indonesian language were included in this study. Results: Of 207 articles recorded in the searching literature, only fourteen articles were included in this study. Study found that herbs which had the effect as antihypertensive therapy were Apium graviolens, Allium sativum, Centella asiatica, Orthosiphon stamineus benth, Beta vulgaris, and Vitis vinifera. The main components of those herbs consisted of n-butylphthalide, apigenin, potassium, flavonoids, triterpenoid, polysulfide, sinensetin, nitrate, and polyphenols. Conclusions: Many herbal plants found potentially lowering the blood pressures and considered as complementary treatment without any side effects. Further research is still needed on the effects of herbs in lowering the blood pressure to the human subject and its reversible effects, as well as the safety of herbs to human health when it is used for a long time. Keywords: Herbs, blood pressure, antihypertensive therapy
Background: Caesalpinia sappan L, synonym Biancaea sappan L., is a medicinal plant used in Asia, especially India, China, and Southeast Asia. In Indonesia, Sappanwood (Secang) is traditionally consumed as herbal drink to boost immune system, kill bacteria, treat diarrhea, and tumor. Caesalpinia sappan L. contains homoisoflavonoids and phenols such as brazilin, brazilein, and other active ingredients. Aim: The aim of this study is to report phytochemical contents and benefits of Caesalpinia sappan L for medicinal use. Methods: The method used in finding articles was a literature review, using the keywords. Search was conducted electronically using several databases, including Science Direct and Google Scholar. Results: Medicinal benefits from Caesalpinia sappan L have been proved by several studies. These medicinal effects are caused by the presence of Caesalpinia sappan's active ingredients such as brazilin, brazilein, 3-deoxysappanchalcone, sappanchalcone, Caesalsappanins A, G, H, and I. Conclusion: Caesalpinia sappan L has medicinal benefits and could be applied to treat several diseases. Keywords: Caesalpinia sappan L, traditional use, medicinal use
INDONESIAN HERBS WITH ANTIFERTILITY EFFECTS ON MEN: A SYSTEMATIC REVIEW
Background: The attention and implementation of family planning programs in Indonesia tends to focus on women. Meanwhile, male contraception method has fewer types than female ones. Various herbs in Indonesia have showed potential antifertility effects on men. The objectives of this study is to identify and analyze the results of studies on the effects of Indonesian herbs on male antifertility. Methods: This was a systematic review using several articles obtained from Science Direct, PubMed, Wiley Online Library, Google Scholar, and Garba Rujukan Digital databases. The inclusion criteria in this study were experimental research of the effects of herbs on antifertility; samples of studies included male mice, long-tailed male monkeys, and human sperm; and full-text article available. Results: The literature search returned 1420 articles, of which 37 studies were included in the systematic review. Different Indonesian herbs were observed, such as Carica papaya (n = 8), Momordica charantia (n = 7), Piper betle (n = 5), Hibiscus rosa (n = 5), Curcuma domestica (n = 4), Areca catechu (n = 4), and Andrographis paniculata (n = 4) have been identify with different effects. Antifertility effects observed including antispermatogenic, sperm quality reduction, and the changing of the histology of reproductive organs. Conclusions: Indonesian herbs are portentially used as new contraceptive methods for male subjects such as Carica papaya, Momordica charantia, Piper betle, Hibiscus rosa, Curcuma domestica, Areca catechu, and Andrographic paniculata. Further research is needed regarding the effects of herbs on human subjects, reversibility effects, and the safety of herbs on health in a long-term use. Keywords: male antifertility, herbs, systematic review
CONTROLLING DIET EXPERIENCE OF DIABETIC PATIENTS IN BUKITTINGGI, INDONESIA
Background: In 2015, the International Diabetes Federation reported that there were 415 million adults aged 20 to 79 with diabetes. Indonesia is among the 10 countries with the high number of diabetic patients and is ranked 7th in the world with the number of patients reaching 10.2 million. Diabetes management can be done through controlling blood sugar through 4 pillars, namely education, diet, exercise, and medication. However, the current phenomena show that many diabetics have poor dietary control so they fail maintain their blood sugar within its normal limits and are at greater risk for diabetes complications. However, we can still find diabetic patients who are able to improve their diet and control their blood sugar. Therefore, getting information from them, especially related to their experience in controlling their diet, is expected to provide hope and motivation for others. Hence, this study aims to find out and expolore the experience of diabetics with controlled blood sugar and diet Methods: This study uses a qualitative research method with a descriptive phenomenology approach. The selection of participants was carried out by using a purposive sampling technique. The number of participants in this study were 5 and data were processed through Colaizzi method. Result:.There are four themes obtained in this study namely: Self-commitment to discipline and dietary compliance, Fruit as an alternative appetite suppresant, Controlling hunger as a habit, and Channelling hunger to activities. Controlling diet for participants has been succesfully done by created a new habit through controlling their hunger, so that they could keep their commitment dan disclipline for dietary compliance, choosing fruits as alternative suppresant and doing activity for channeling the hunger. Therefore it is important for the nurses to educate the diabetic patients about how to deal with diet issues through controlling a hunger as a habit Keywords: Diabetes, Diet, Patients' Experience
USING SCORECARD TO ANALYSE RISK FACTORS OF STROKE IN WEST SUMATERA INDOENSIA
Background: Stroke is one of the most frightening diseases because it may cause major deaths in Indonesia. Recently, it has caused the death for about 21.1% of all ages. The World Health Organization (WHO) predicts that deaths caused by stroke will increase”every 45 seconds a person has a stroke, and”every 4 seconds there is a death caused by stroke. At this time, there is a shift in the phenomenon; stroke does not only suffer the elderly patients, but it has now attacked the productive age or young age also.The purpose of this study was to identify the proporsion of risk of stroke in productive age of Bukittinggi population based on Risk Scorecard. Method: The study used a survey analytic study design with approach cross-sectional. This was a population – based survey of adult households in Indonesia is about 24130 individu. The sample of this study was 322 respondents where they were taken by using simple random Sampling technique. The subjects were visited at their homes for recruitment and data collection. In each household, one or more eligible subject above the age of 18. The subject were exclude if they were mentally unable to answer the questionnaire, were not a resident in Bukittinggi, or directly declined to participate. Result: Individuals at high risk of stroke are 20.5%, 22.4% in case of caution, and 57.1% respondents at low risk of stroke. The results of this study represent the risk of stroke with the highest frequency of distribution was in low risk respondents. It was then followed by caution respondents. The lowest frequency was scored for high risk respondents. Conclusion: The proportion of stroke of risk found in the productive age population of Bukittinggi that were based on risk scorecard. Keywords: Proportion, Stroke Risk, Individuals at risk
STORIES OF MOTHERS WITH INTELLECTUAL DISABILITY CHILDREN IN WEST SUMATERA, INDONESIA
Background: Children with intellectual disability are rejected not only by other individuals around them but also by their own family. Even though they need support from the mother to achieve accurate conformity. The form of mother social support can be in the form of emotional support, appreciation, instrumental and informative. However, the parents of Children with intellectual disability often refuse the presence of their children. The purpose of this study was to obtain qualitative data on the experience of mothers who have intellectually disabled children Methods: This study is a qualitative research conducted by interview using the semi-structured interview method. The participants were selected by using purposive sampling technique. The data were qualitative analyzed by employing Collaizi model. The participants in this study were 6 mothers who have children with intellectual disability Results: Participants have a positive perception about the educational needs of children with intellectual disability. However, due to financial issues, participants do not provide education for their intellectually disabled children. They mentioned that if their intellectually disabled children were properly, they would be able to take care of themselves and would no longer depend on others. Conclusion: In this study, the researchers found five themes of mothers' stories with intellectual disability child in West Sumatera, Indonesia, including (1) their unawareness of their intellectually disabled children condition; (2) disappointment as the initial response knowing their children status; (3) anxiety and worry about their children future; (4) financial issues as a factor in obstructing education, and (5) religious worship as a source of strength. The results of this study can be used in nursing practice so that families can maintain the sources of strength to accept the fact that they have children with intellectual disability and that education is very important for children with intellectual disability. Keywords: Intellectual Disability, Education, Mothers' Experience, Mothers' stories
ANTIMICROBIAL STEWARDSHIP STRATEGY TO REDUCE LENGTH OF STAY AND COST OF ANTIBIOTIC CONSUMPTION: A SYSTEMATIC REVIEW
Background: Reducing the cost of care and length of stay for patient in hospital are important to monitor the benefits of implementing an antimicrobial management program. An antimicrobial management program is a strategy to decrease Antimicrobial Resistance (AMR) that affect to the treatment of the patient. One of the antimicrobial management programs is Antimicrobial Stewardship Programs (ASP). This study aims to determine the appropriate strategies in the application of Antimicrobial Stewardship Programs (ASP) that can reduce the length of stay and cost of antibiotic consumption for patient in hospital. Methods: This study was a systematic review that used PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Data obtained from Electronic databases ProQuest and Medline (PubMed) that published five years times span. By using keywords such as antimicrobial stewardship, antimicrobial resistance, length of stay, length of the hospital and patient cost to find the relevant journal. Results: The search found 3,541 studies, of which 26 studies were included in the systematic review. After excluded the article review, there were 9 studies that used quasi-experimental, observational cohort studies and Randomized Control Trial (RCT). These studies conducted majority in Europe and USA, only 1 study that conducted in Asia. Analysis of the studies found out that 6 of 9 studies mentioned if ASP can reduce the length of stay of the patient in hospital. Only 3 of 9 studies that examined the effect of ASP in cost of care and these 3 studies mentioned ASP can reduce the cost of care. Conclusion: This study showed that implementing ASP can reduced the length of stay and antibiotics consumption among patient in hospital by manage the antimicrobial use, conduct audits and feedback in an appropriate step, and intravenous to oral switch program. Keywords: Antimicrobial stewardship, length of stay, cost of care
Anak Agung Istri Agung Sri Stuti Damayanti
PATIENTS SAFETY CULTURE DEVELOPMENT IN JAMBI PUBLIC HOSPITAL
Background: Patient safety is a serious issue in a healthcare organization. Building a patient safety culture is the first step in the improvement of safety. As patient safety culture is an inherent component of organizational culture; therefore, a study of organizational culture is required to develop it. This study aims to analyze the patient safety culture and identify the profile of the organizational culture in the hospital to find strategies to improve the patient safety culture. Methods: This study was used the quantitative study using a cross-sectional research method, followed by a qualitative method to get descriptive information. This research conducted in Jambi Public Hospital, Indonesia with 128 respondents. Data were obtained from a survey by the HSOPSC (Hospital Survey on Patient Safety Culture) questionnaire and OCAI (Organizational Culture Assessment Instrument. Focus Group Discussion was conducted to identify obstacles and expectations in the implementation of patient safety culture. Results: The highest positive perceptions are organizational learning and continuous improvement (90.6%) and teamwork within units (78.91%). While "staffing" (39.25) and "non-punitive responses to errors" (38.54 %) are the weakest dimension of patient safety. The most dominant type of organizational culture, followed by a hierarchy with a minimal score difference. This cultural assessment serves as a guide for changes with a quality strategy of clan culture and hierarchy culture were decided in the development of patients safety culture in this hospital. Conclusion: The patient safety culture belongs to the moderate culture category, the reporting culture dimension is the weakest. A management's commitment and staff empowerment, as well as system development, are all needed on the development of a patient safety culture. Further research is required to investigate various factors to develop the reporting culture. Keywords: Patient Safety Culture, Organizational Culture, Hospital
FACTORS AFFECTING MEDICAL DOCTOR TURNOVER IN THE HOSPITAL: A SYSTEMATIC REVIEW
Background: Among others, healthcare professional is one of the main drivers in the hospital. Medical doctor plays an important role in patient-centered care system in the hospital, leading health services to patients, cooperating with other healthcare professionals. Medical doctor shortage and high turnover in the hospital has become a problem in many countries. High turnover of medical doctor can lead to an inadequate supply of health services, thereby compromising people's access to health care and endangering the quality of patient care and safety. The objective of this study is to get an overview of the factors that affect medical doctor turnover in the hospital. Methods: A systematic review of articles published between 2014 and 2019 that contain information from all relevant published articles were extracted and analyzed. Results: The literature search and screening process resulted in 9 (nine) studies. From the selected studies, overtime, job satisfaction, and work stress are among the things that affect the turnover of medical doctor in the hospital. Conclusions: Consequences of high medical doctor turnover in the hospital are including financial loss, low patient satisfaction, and poor organizational practices. Factors affecting medical doctor turnover in the hospital are long work hours, job satisfaction, work stress, workplace condition, and hospital management. Keywords: medical doctor; physician; turnover; hospital.
THE REBORN OF EXCLUSIVE BREASTFEEDING METHOD: ANTENATAL BREAST EXPRESSION (ABE) : A LITERATURE REVIEW
Background: Antenatal Breast Expression (ABE) is believed as a potential method to improve colostrum secretion upon labor which the complex content of colostrum can prevent the infection, obesity, diabetes and malignant diseases among newborns. This study aims to to analyze and provide detailed description on the practice of ABE to support the exclusive breastfeeding program. Method: Literature review was conducted in this study using the PRISMA protocol guidelines. Data were obtained by accessing electronic resources from Science Direct, Sage Publications, PubMed, and Google Scholar with ‘antenatal breast expression', ‘antenatal milk expression', and ‘colostrum secretion' as the keywords. The articles analyzed in this study were published from 2009 to 2018 and written in English. Results: There were eighty articles recorded, of which eight articles were included in the systematic review. ABE was performed every day when the pregnancy reaches 37 weeks. The average secretion time of this practice was 5-10 minutes each for 1-4 times a day, preferably during showers. The ABE affected babies in that it allowed them to get timely nutritional intake in order to stabilize blood sugar and to prevent icterus. Even though the practice of ABE was viewed differently among women of reproductive age, it nonetheless helped to improve self-confidence among breastfeeding mothers, to reduce transition interval from Early Initiation of Breastfeeding (EIB) to full lactation, to improve lactation performance, and to induce natural delivery. However, it was not yet widely practiced as it was still under consideration by the International Board Certified Lactation Consultant (IBCLC). Conclusion: ABE has proven to benefit both mothers and babies, despite existing pros and cons. Therefore, there is a need for more systematic review using other keywords and methods on the safety and efficacy of ABE practice to ensure its benefit for breastfeeding. Keywords: Antenatal breast expression, colostrum secretion, exclusive breastfeeding
THE EFFECT OF MUSIC THERAPY FOR PREGNANT WOMEN : A LITERATURE REVIEW
Background: Psychological problems among pregnant women such as anxiety and depression potentially have an impact on the fetus and are associated with a risk of preeclampsia. One of therapy to decrease psychological problems during pregnancy is music therapy. The aim of this study was to identify and summarize the benefits of music therapy for decreased psychological problems among pregnant women. Methods: This was a literature review using several documents obtained from some databases, including Science Direct, Pubmed, Proquest, Taylor and Francis, Garuda Ristekdikti and Google Scholar. The literature search was conducted using keywords "music therapy in pregnant women” and literature published from 2008 to 2019 were selected. Results: Out of 263 published literature identified, only 10 were included in this literature review. The music therapy was observed with positive impacts on pregnant women. Music therapy serves as relaxation for pregnant women which helps reduce anxiety, depression, blood pressure, and psychological stress. Conclusion: Music therapy has several benefits for pregnant women's health, particularly on reducing psychological problems and blood pressure. Keywords: Music Therapy, Anxiety, Blood Pressure, Pregnant Women
THE EFFECTIVENESS OF ACUPUNCTURE ON WOMEN WITH POLYCYSTIC OVARY SYNDROME: SYSTEMATIC LITERATURE REVIEW
Background: Women with polycystic ovary syndrome (PCOS) experience metabolic disorders and hyperandrogenism. The acupuncture is an alternative medicinal treatment and complimentary for the women with PCOS. The aim of this research was to identify acupuncture effectiveness for metabolism problem and hyperandrogenism for the women with PCOS. Methods: This was a systematic review using several published literature obtained from direct electronic data of science, PubMed, and other sites through the PRISMA method using the Boolean operator's system (AND). The inclusion criteria consisted of the studies with Randomized controlled trial (RCT) published in 2009 to 2019, women with PCOS aged 18 to 45 years old as the subjects, the intervention using all of the kind of acupuncture that was compared to placebo, physical training, sham, and medicines. Meanwhile, exclusion criteria were studies with systematic review and meta-analysis, focusing on intervention, medicines, and physical training by using experimental animals. The measurement value of HOMA-IR, LH, FSH, ratio LH/FSH, TT, FT, SHBG, and DHEA-S. Results: The search resulted in 509 studies, of which a total of 6 studies were included in this systematic review. The acupuncture has effects on metabolism problem and hyperandrogenism for the women with PCOS, such as the decrease of HOMA-IR (3 studies) and LH tense (2 studies), LH/FSH ratio reduction (3 studies), as well as, the decline of TT tense (4 studies) and FT tense (4 studies), but the increase of SHBG tense (3 studies), and the decrease of DHEA-S (2 studies). However, the tense of LH had no significant change in all of the studies. Conclusions: The acupuncture can be effective in solving the metabolism problem and hyperandrogenism of women with PCOS. Keywords: Acupuncture, Polycystic Ovary Syndrome (PCOS), Hormone, Alternative medicinal treatment
IS THE MULTIPLE MICRONUTRIENTS BETTER TO REDUCE ANEMIA IN PREGNANCY COMPARED TO IRON- FOLATE ACID SUPLEMENTATION? A SYSTEMATIC REVIEW
Background: Prevalence of anemia continues to increase among pregnant women in Indonesia. The micronutrients that are needed to reduce the anemia is still lacking to be accessed by pregnant women. This study aims to analyze the effectiveness of multiple micronutrients (MMN) compared to the iron-folic acid to reduce the incidence of anemia among pregnant women. Methods: Systematic review was used in this study using the electronic databases Google Scholar, Science Direct, and PubMed. The articles included in this study were published in 2009-2018 and were written in English language. Results: In total, 380 papers were identified and six articles were included in this study. Study found that the MMN and iron-folic acid had the same effect in influencing the anemia status among pregnant women. However, the MMN had a potential to increase the average of body weight, to reduce the incidence of low birth weight (LBW) and preterm birth among pregnant women. Conclusions: The effectiveness of multi micronutrients in pregnant women is as good as iron-folic acid in reducing the anemia during pregnancy. Further studies need to be conducted to see the effects of MMN on pregnant women by considering other factors such as maternal nutritional status, gestational age, and duration of supplementation
ANTIMICROBIAL ACTIVITY OF KERSEN (Muntingia calabura L.) LEAVES: A SYSTEMATIC REVIEW
Background: Many kinds of antibiotics are being used for treating the infections, but bacterial resistance is a main therapeutic problem. Medicinal plants are one of sources of therapeutic aid for relieve human illness. Muntingia Calabura is a medicinal plant that might have pharmacological value. Muntingia Calabura, is called throughout the world as "Jamaican cherry” and in Indonesia, it is known as "Kersen” or "Talok”. This study aims to analyze the antimicrobial activity of Muntingia calabura leaves. Methodology: This systematic review was conducted from December 2018 to February 2019 using PRISMA reporting guidelines. Literature has been retrieved from MEDLINE, Science Direct, Google Scholar, PubMed, Springer Link, and IEEE Xplore, use key words Muntingia calabura, phytochemical, pharmacological, and antimicrobial. The articles written by English. Results: From 9 studies, the antibacterial test for Muntingia calabura leaves was carried out on 18 types of microorganisms. Muntingia calabura leaves proved to be effective against S. aureus and P. aeruginosa bacteria. 4 studies showed negative results use Muntingia calabura in certain types of bacteria. Conclusion: Therefore, this plant can be used for treatment of bacteria. This study is also presented to help guide researchers to plan their future studies related to this plant for preventing the bacterial infection, especially in obstetrics and gynecology. Keywords: Muntingia calabura, antimicrobial activity, pharmacological activities
UPDATE: METABOLIC DISORDERS OF PREECLAMPSIA A REVIEW
Background: Preeclampsia is one of the contributors to the increased maternal morbidity and mortality rates in Indonesia. One of the disorders caused by the preeclampsia is metabolic disorders. The purpose of this study is to provide an overview of metabolic disorders that accompany preeclampsia. Methods: This was a literature review using electronic databases Science Direct and PubMed. Keywords used in searching literature were ‘preeclampsia' and ‘metabolism disorder of preeclampsia' with the year limit between 2010 and 2018. Articles published in English was chosen in this study. Results: The search found 3,823 articles, of which 14 articles were included in this study. Metabolic disorders that happened in the group of preeclampsia were higher RDW (Red blood cell distribution width), MTT (Biomarker), ADA (adenosine deaminase), CA-125 serum, triglycerides (TG), Angiotensin, cytokinin, CEC (Circulating endothelial cells), lipoprotein and cholesterol. Meanwhile, studies also found that preeclampsia caused the lower selenium serum, aromatase, and thiol-disulphide in the body. Conclusion: Preeclampsia proved causing the disorders of metabolic, mostly in the form of inflammation, endothelial cell damage and oxidative stress. Potential targets are needed for treatment of metabolic disorders in preeclampsia group both medically and non-medically especially for the lipid levels in preeclampsia. Keywords: Preeclampsia, metabolic disorders
EFFECTS OF HEGU POINT SUPPRESSOR (LI 4) AND BIRTH BALL TECHNIQUE ON LABOR PAIN: A REVIEW
Background: Pain in labor is the cause of fear, anxiety and childbirth trauma among pregnant women so that it affects the health condition of the mother and the fetus. Non-pharmacological methods such as pressing the hegu point (LI 4) and birth ball technique are believed in reducing the intensity of labor pain without side effects. This study aims to analyze the effect of pressing hegu point (LI 4) and technique birth ball on labor pain. Methods: This was a literature review using PRISMA-P (Preferred Reporting Items for Systemic Review and Meta-Analysis Protocols) to identify all published articles with ‘point hegu (L1 4)', ‘birth ball', and ‘labor pain' as the keywords. Electronic databases such as Google Scholar and Science Direct were used in searching the articles that were published between 2011 and 2019. Other criteria were articles that used experimental research design and written in English and Indonesian language. Results: There were 18,072 articles recorded, of which 10 articles were included in the systematic review. By pressing hegu points (LI 4) for 20 minutes to 240 minutes, it helped mothers to reduce labor pain. Sitting on a birth ball by wiggling the pelvis relieved the labor pain, improved the self-control, as well as felt satisfied with birth experiences. Conclusion: Methods of pressing hegu points (LI 4) and birth ball techniques can effectively reduce the intensity of labor pain. Further study can be conducted using other keywords and methods. Keywords: Hegu point (LI 4), birth ball, labor pain
SYSTEMATIC REVIEW METABOLIC DISRUPTION IN GESTATIONAL HYPERTENSION DISORDER
Background: Gestational hypertension is one of the diseases responsible for increased morbidity and 18% of maternal deaths in the world. Gestational hypertension has complex causes and symptoms, so pathogenesis is difficult to determine. Complications of gestational hypertension will cause Preeclampsia. This study aims to explain the metabolic disorders experimented by women with gestational hypertension. This description can be used as an early detection tool for hypertension so that complications can be prevented. Methodology: Searching articles for this research is done by searching in the google scholar, science direct and PubMed databases. Only full text and written by english will be included in this study. The keyword that is used "Risk Factor” or "Metabolic” and "Gestational Hypertension” or "Blood Pressure” or "Pregnancy Hypertension” with the year limit between 2009 – 2019. A systematic review of PRISMA was used in this study. The study focused on the discussion about gestational hypertension in pregnant women. Results: 12 research articles were foundit is known that pregnant women with gestational hypertension have serum calcium, magnesium, nitric oxide, vitamin D, cobalt and iodine which tend to be lower than normal pregnant women. Whereas cadmium levels tend to be high can stimulate oxidative stress which is able to worsen the condition leading to preeclampsia. Conclusion: Health checks on pregnant women can be used as a basis for screening and treatment. Methods of checking calcium levels that allow as medium for screening in detecting the severity of hypertension and predicting disease risk. Keywords: Hypertension, Pressure, pregnant women
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) IN THE FIRST STAGE OF LABOR PAIN: A LITERATURE REVIEW
Background: Excessive pain in labor leads to the side effects on the maternal and neonatal health. Many strategies for labor pain management have been studied, including complementary therapies, yet the comparison of the effectiveness among them needs to be explored more. This study aims to analyze he effectiveness of complementary therapies to reduce pain in the first stage of labor. Methods: This was a literature review using electronic databases from Google Scholar, PubMed, Science Direct, EBSCOhost and text books. The keywords of searching literature were ‘complementary therapy', ‘pain', and ‘first stage labor'. All articles reviewed in this study were written in English and Indonesian language with the published year 2010 until 2018. Results: In total, there were 44 out of 232 publications included in this study. Complementary therapies that can be used to reduce first-stage labor pain were aromatherapy, acupressure, and hypnotherapy. Using lavender aromatherapy, pressing the point of L14, SP6, BL32 as well as the use of hypnobirthing showed significant influence in reducing the pain at the first stage of labor among pregnant women. Conclusion: Acupressure is more effective in reducing the pain at the first stage of labor than other alternative techniques. In order to effectively manage the pain at the first stage of labor, a combination of complementary therapies and pharmacological treatment is needed. Keywords: complementary and alternatives medicine, first stage labor pain
COMPLEMENTARY THERAPIES FOR LABOR INDUCTION AND THEIR LEGALITY IN INDONESIA: A LITERATURE REVIEW
Background: Labor induction is performed using two methods of pharmaceuticals and complementary therapies. The complementary therapies for labor induction in particular, have to be reviewed comprehensively as to come up with the most relevant therapies allowed to be performed by midwives in Indonesia in accordance with the applicable law. This study aimed to identify the effectiveness and safety of complementary therapies for labor induction that can be performed and also allowed by the applicable law. Method: This was a literature review based on the PRISMA protocol guidelines. The full-text articles were obtained from several databases, such as Elsevier, Cochrane, PubMed, and local journals. These chosen articles were then reviewed to figure out the most effective interventions for labor induction. They were then further reviewed for compatibility with applicable midwifery law. Results: Out of 1153 studies obtained, 44 studies were included in this review. The most effective complementary therapies for labor induction are acupuncture and acupressure. The current law does not allow midwives to perform acupuncture, but it states that acupressure can be administered. Acupressure has proven to be a successful intervention when it is coupled with aromatherapy or hypnobirthing. Conclusion: Considering the effectiveness and safety of complementary therapies for labor induction, acupressure along with aromatherapy or hypnobirthing can be used after being administered in accordance with the applicable law. There is a need for further studies focusing on either the holistic therapy alternatives or the legal side of holistic therapy. Keywords: Complementary therapies, labor induction, midwifery law
NON PHARMACOLOGICAL TREATMENTS FOR BREAST ENGORGEMENT: A SYSTEMATIC REVIEW
Background:. Mothers often suffer breast engorgement at the beginning of postpartum, and one of the causes is early breastfeeding cessation. Management of breast engorgement should be done well to support the success of exclusive breastfeeding. This study aimed to review and identify the nonpharmacological treatments that have potential effects on reduced breast engorgement Methods:This was a systematic review prepared according to the standard guidelines of the Joanna Briggs Institute (JBI). Article search used electronically. The two databases used were the PubMed and Cochrane library. English-language articles, and full text using the keywords of "treatment breast engorgement” OR "lactating” OR "cabbage compress". The inclusion criteria were the studies with Randomized controlled trial (RCT) published from 2009 to 2019, the respondents were postpartum mothers who breastfed their babies, and intervention was non-pharmacological action research and not a medical action. Results: Out of 5,927 articles resulted from the literature search, there were 5 articles that met the inclusion criteria and included in this systematic review with a total number of 882 participants. The treatment used in dealing with breast engorgement varied, such as 2 studies used cold cabbage leaf and the remaining studies used these non-pharmacological treatments, respectively: hot herbal compresses, cold hollyhock herbal compress, the intervention of Gua sha. All the results of the study stated that the intervention was effective in reducing breast pain and engorgement. Conclusions: Herbal compresses, leaf compresses hollyhock, cabbage compresses and Gua sha therapy can be used to treat breast engorgement during lactation, but more rigorous follow-up studies are needed to see which interventions are most effective using larger samples. Keywords: Breast engorgement, breastfeeding, a non-pharmacological, systematic review
THE EFFECT OF LOVING TOUCH STIMULATION THERAPY FOR INFANTS' WEIGHT GAIN
Background: Low Birth Weight (LBW) is one of the risk factors that have a high contribution to infant mortality. Increasing the baby's weight is used as an indicator to determine LBW growth. In LBW babies, touch therapy is a form of stimulation to increase endurance, digestive function activities, and vagus nerve activity. Objective: This study aims to determine the effect of Loving Touch Therapy (LTT) as one of the effective non-medical methods to increase body weight in LBW that can be done by parents during home care. Method: This study was a quantitative study using an experimental design and Randomized Controlled Trial (RCT) design. This research conducted in 15 respondents in the intervention group with four weeks' LTT and 15 respondents in the control group who were given Tactile Kinesthetic Stimulation (TKS). Data were obtained from measurements of body weight before and after the intervention then the data were analyzed using independent t-test with significance level p-value <0.05 and multivariate analysis using linear regression. Results: 19 respondents female (63.3%) and 11 respondents male (36.6%) was participated in this research by the frequency distribution of the gender. It was a significant increase in body weight in LBW with LTT carried out by his mother for 28 days compared with TKS stimulation. The differences in the average weight gain are 197 grams. The difference is statistically significant. Conclusions: It can be concluded that LTT is more effective in increasing body weight in LBW posthospital care because the technique is simple and sequential from the front to the back of the baby's body which makes it easier for parents to understand and physiologically doesn't lose much an energy. Keywords: Low Birth Weight Baby, Loving Touch Stimulation Therapy, Male and Female Body
ACUPRESSURE AND YOGA COMBINATION CAN REDUCE ANXIETY DURING PREGNANCY: A SYSTEMATIC REVIEW
Background: Untreated anxiety during pregnancy causes the health problems among mothers and the fetus. Complementary and Alternative Medicine (CAM) such as acupressure and yoga is seen as the alternatives to deal with this anxiety. This study aims to determine if the combination of acupressure and yoga is effective to reduce anxiety during pregnancy. Method: This study was a systematic review using the guidelines of the PRISMA. Articles were obtained from electronic databases Scopus, Science Direct, and PubMed by identifying published articles from January 2013 to March 2019. Articles were identified using keywords ‘acupressure', ‘prenatal yoga', and ‘anxiety in pregnancy'. All articles included in this study were only those who used intervention research design in the form of an RCT and pilot study. Results: Ten of 1186 articles met the intended criteria in this study. The results showed that acupressure and yoga have significant benefits in reducing anxiety among pregnant women. It was also found that this combination potentially prevented the postpartum depression. Conclusion: Acupressure and yoga interventions can be combined as non-pharmacological therapy to reduce anxiety during pregnancy. Further research with more specific interventions is needed to provide evidence of reducing anxiety during pregnancy. Keywords: acupressure, prenatal yoga, anxiety during pregnancy
EFFECTIVENESS OF PRENATAL YOGA ON PREGNANCY ANXIETY AND DEPRESSION: A SYSTEMATIC REVIEW
Background: Physiological and psychological changes during pregnancy process can cause discomfort to pregnant women. During pregnancy, pregnant women from developed and developing countries tend to have an increase in anxiety and symptoms of depression. If not properly managed, those situations can adversely affect maternal and infant health. This systematic review is to explore the effectiveness of yoga in order to reduce anxiety and depression in pregnant women. Methods: This systematic review was based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA Protocol). Publication screening was carried out by filtering the 2009-2019 English and Indonesian articles from electronic data sources, namely PubMed, PsycINFO, Google Scholar and Science Direct. The keywords used in the literature searching were ‘anxiety', ‘depression in pregnancy', ‘prenatal yoga', ‘yoga in pregnancy', ‘pregnancy', and ‘complementary and alternative medicine in pregnancy'. Results: The search identified 368 record, of which 8 articles were included in this study. Studies regarding to the effect of yoga in pregnant women has been shown to reduce anxiety scores, pregnancy depression, anger, sleep disorders, lower maternal cortisol hormones, improve maternal immunity and neonatal outcomes. Conclusion: Yoga could be applied as a complementary therapy that was easy, low cost, and useful for reducing anxiety and depression in pregnant women. Keywords: Anxiety, yoga in pregnancy, depression in pregnancy, prenatal yoga
DETERMINANT OF EARLY MENARCHE AT MUARA MEGANG ELEMENTARY SCHOOL SOUTHERN SUMATRA
Backgrounds: High rate of early menarche is one of the problems that should be the focus of government attention because the health impact will be in the future. The purpose of this study was to determine the effect of diet, physical activity and exposure to mass media on early menarche at Students Elementary School Muara Megang Southern Sumatra 2017. Methods: This research used a quantitative study with cross sectional design. Purposive sampling technique was done in the fifth and sixth graders with total population of 69 people. After selecting those who experienced early menarche, thirty respondents were eligible in this study. Univariate, bivariate correlation test, and multivariate multiple linear regression were employed to analyze the data. Results: The correlation test resulted in the score of diet (p-value=0.001), physical activity (pvalue= 0.040<0.05) and exposure to mass media (p-value=0.454). It was concluded eating patterns and physical activity had significant correlation with early menarche among students. Meanwhile, the mass media exposure had no significant influence to incidence of early menarche. Multivariate test results were obtained from the results of multiple linear regression tests of eating patterns (0.011<0.05) affecting the incidence of early menarche while physical activity (0.463>0.05) and exposure to mass media (0.733>0.05) had no effect on the incidence of early menarche. Conclusions: This study recommends a need of coordination between health center and the health office to conduct counseling or form peer consultants involving young women to be more able to get to know themselves. Keywords: Physical Activity, Mass Media Exposure, Early Menarche, Dietary Habit
EFFECTIVENESS OF BROWN SEAWEED (Sargassum sp.) AS NATURAL ANTIOXIDANT FOR ENDOTHELIAL CELL PROTECTION IN PREECLAMPSIA: A LITERATURE REVIEW
Background: Seaweed as one of the natural resources has many potential bioactive ingredients. One of them is Phaeophyceae which shows the highest antioxidant activity among other seaweed. Sargassum sp has many potential bioactive ingredients in the pharmaceutical field which has been supported by several scientific studies. This study aims to expose all information related to abilities Sargassum sp as an antioxidant for endothelial cell protection in preeclampsia in a comprehensive and systematic manner. Methods: This study was a systematic review that used the prism protocol. Data obtained from Electronic databases Science Direct, Springer, DOAJ, NCBI and Google Scholar that published between 2009 and 2019. By using keywords such as an antioxidants of Sargassum sp, preeclampsia and antioxidants, as well as antioxidants and endothelial cells to find the relevant journal. Results: The search found 963 articles, of which 215 articles were included in the inclusion and exlusion criteria. The final results obtained 8 articles that are suitable for this literature review. Majority of studies used the same method namely experimental, 3 other studies uses meta-analysis randomized controlled trials, and a case-control study. Analysis of the studies found out that Sargassum sp contains phenolic compounds which function as antioxidants in fighting free radicals and as protection against endothelial cells in preeclampsia. Conclusion: Sargassum sp is proven to have the value of high antioxidant effect that is able to fight free radicals and is able to protect endothelial cells in preeclampsia. Therefore, this study is presented to assist researchers in planning their future studies related to seaweed in preventing preeclampsia in the fields of obstetrics and gynecology and with the hope of potential future drug development. Keywords: Sargassum sp, Antioxidants, Endothelial Cells, Preeclampsia
COMPREHENSIVE THERAPY FOR POLYCYSTIC OVARY SYNDROME: KEY POINTS TO IMPROVE QUALITY OF LIFE
Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that affects the hypothalamus, pituitary, and ovary. PCOS prevalence has increased from 4 –6% to 8 –10%. This syndrome results in both physical illnesses and psychological disorders. Women with PCOS tend to be more prone to psychological disorders compared to healthy women. PCOS increases the risk of anxiety by 7 folds. This study aims to analyze measures to reduce psychological disorders caused by PCOS based on numerous psychological disorder parameters and hormonal biomarkers with psychological therapies. Methodology: This study is based on the PRISMA protocol guidelines. The literature review was performed by accessing ScienceDirect, PubMed, Sage Publications and Google Scholar. The inclusion criteria for the articles are full-text papers written by English from 2009 to 2018. The keywords used to find suitable articles are "anxiety, stress, distress, depression, and quality of life management in polycystic ovary syndrome”. Nine articles were subsequently reviewed. Results: Psychological therapies that can be applied for PCOS include holistic yoga, acupuncture, spiritual guidance, mindfulness stress management, relaxation, and guided imagery, progressive muscle relaxation and administration of herbal, probiotic and selenium medication. Those therapies have proven to lower anxiety, stress, depression, and psychological fatigue as they were measured using instruments of Montgomery í…sberg Depression Rating Scale (MADRS-S), Brief Scale for Anxiety (BSAS), Swedish Short-Form36 (SF-36), PCOS Questionnaire (PCOSQ), Beck Depression Inventory, DASS 21 and STAI. Meanwhile, observed biomarker responses include lower levels of cortisol, adrenalin, testosterone, and malondialdehyde (MDA) and a higher level of endorphin. Conclusion: Psychological therapies for PCOS have proven to lower psychological disorders as measured by numerous parameters and biomarkers. Therefore, psychological therapies have to be further developed to decrease psychological disorders because of Polycystic Ovary Syndrome. Such as symptoms of anxiety and prevent deterioration of social mental health. Keywords: Anxiety, stress, distress, depression, and quality of life management in polycystic ovary
EFFECT OF MORINGA LEAVES AND VITAMIN C CAPSULE COMBINATIONS IN INCREASEING HEMOGLOBIN LEVELS OF YOUNG WOMEN WITH ANEMIA
Background: The prevalence of anemia suffered by girls aged 10-18 years according to the Household Health Survey (SKRT) is 57.1%. The highest contributor of anemia cases in Central Java is Grobogan district, especially in Tanggungharjo Community Health Center, with increasing prevalence of anemia among young women in 2017 from 5.4% to 25.7%. Based on background, researcher wants to determine the effect of Moringa leaf combination dozed 250 mg x 2 / day and vitamin C 50 mg x 2 / day on hemoglobin level changes of young women suffering anemia to decrease anemia in young women Methodology: This quasi experimental research with pretest-posttest control group design involved young women aged 14-19 years suffering anemia. The method of sampling selection was purposive sampling with total 22 respondents assigned as intervention group and other 22 respondent assigned as intervention group. The data analysis used Mann-Whitney test. Results: The average of hemoglobin level in the intervention group increased from 9.37 to 12.10. It proved statistically that there was effect of giving Moringa leaf and vitamin C combination to increase level of hemoglobin of young women suffering anemia. Conclusion: Moringa leaves could significantly increase hemoglobin levels in blood of young women suffering anemia. Raising awareness of anemia and its prevention and treatment among young women should be recommended. Keywords: Anemia, young women, Moringa leaf, Vitamin C, hemoglobin
USING THE SMARTPHONE APPLICATION FOR PREGNANCY CARE: A LITERATURE REVIEW
Background: Smartphones are new media that provide greater benefits than conventional health education. It provides ease and quick access information for users and they may repeat any time. This study aims to analyze the use of various applications related to assessment care, including pregnancy. Methodology: The literatures was collected from e-databases such as Science direct, PubMed, and Google Scholar. Journal criteria used by using RCT (Randomized Controlled Trials (RCTs) techniques and English-language journals. 5 international journal articles were found by using the keywords "smartphone applications” and "pregnancy care”. The journal had to be conducted in 2014-2019. Results: The smartphone application was a medium that used to get information easier, faster and efficient. Those 5 journal articles were conducted in Indonesia (1 journal), Australia (3 journals), and USA (1 journal). It has been proven in 5 research articles to show effectiveness results in information acquisition, management of anxiety, weight management, management of antenatal care visits and management of childbirth preparations, thus helping pregnant women to optimally care for pregnancy. Overall, all of the applications were effective as the health promotor media. Conclusion: The future recommendations are needed to improve the materials and the information in term of pregnancy. The usage of application as health education media should be develop for low middle-income household. Keywords: Smartphone, Pregnancy, Application
WHAT HAPPENS IF THE BROMELAIN IN Ananas comosus L. Merr. GIVEN TO PEOPLE LIVING WITH HIV/AIDS (PLWHA) ? : A REVIEW
Background: Human immunodeficiency virus /Acquired immunodeficiency syndrome (HIV/AIDS) is a global problem that requires serious treatment. Antiretroviral therapy (ART) has the potential to cause side effects and drug resistance for people living with HIV/AIDS (PLWHA). Alternative therapies using combination of bromelain and ART to maintain and improve immunity of PLWHA. The objective of the study was to describe the potential of bromelain in pineapple (Ananas comosus (L.) Merr) to increase the immune system of people living with HIV/AIDS. Methodology: The research method used a systematic literature review. The literature that this study used was search through in the Science Direct and Google Schoolar database. The article search used the keyword Ananas comosus (L.) Merr, HIV/AIDS healing pathway or bromelain enzyme healing pathway HIV/AIDS and Pineapple "bromelain enzyme" for HIV/AIDS. Obtained 4 articles from 219 articles published between 2010 until 2019. The article used in this study written in English and Indonesian. Results: The results showed that the bromelain enzyme in pineapple have proteolytic properties that can destroy the protein layers of the HIV viruses. The other benefit are immunomodulators that can increase the immune system of PLWHA by increasing CD4 counts or maintaining the stability of the CD4 count and reducing viral load levels even undetectable. Conclusion: The conclusion of this study is bromelain in pineapple can be used as an alternative cure for PLWHA which do not have side effect and can destroy the HIV virus protein layer and increasing the immune system of PLWHA as well. Keywords: bromelain against PLWHA, Ananas comosus (L.) Merr. immune system of PLWHA
FOOT REFLEXOLOGY FOR WOMEN AND FETAL WELLBEING IN LABOR : A REVIEW
Background: The secretion of catecholamine and epinephrine due to excessive fear and anxiety during labor will increase the intensity of pain and potentially prolonged labor. Reflexology massage leads to release endorphins and enkephalins which have an analgesic effect five times greater than morphine, creates a deep feeling of comfort and balance of mind so the stress symptoms are reduced, and improves the outcomes of labor. This study aims to analyze the effects of foot reflexology for women and fetal wellbeing in labor. Methodology: This systematic review used PRISMA-P (Preferred Reporting Items for Systemic Review and Meta-Analysis Protocols). The keywords used were reflexology or foot feflexology, pain relief, labor pain, primiparaous, effect or effectiveness. Articles were searched through databases PubMed, Google Scholar, and Science Direct. Inclusion were articles that discusssed about reflexology and its effects in labor, experimental research and written in English. The selected articles were excluded for irrelevant titles and abstracts, non-full text, research under 2009 and duplicate articles. From 78 articles, only 8 articles were included in this systematic review. Results: This study found that foot reflexology can reduce the intensity of labor pain. It was also decreased duration, anxiety, hemorrhage rate, systolic and diastolic blood pressure, pulse and increased uterine contractions, Apgar scores and maternal satisfaction with a highly statistical significant. Conclusion: Foot reflexology could decrease the intensity of labor pain, anxiety, duration, maternal complications and increase uterine contractions. In addition to improve labor outcomes and mother satisfaction. It is recommended as non pharmacological method which can be applied in maternity hospitals to improve women and fetal wellbeing during labor. Keywords: Reflexology, labor, maternal and fetal wellbeing
THE INFLUENCE OF GALBLADDER ACUPRESSURE POINT 21 (JIAN JING) AND STOMACH 18 (RU GEN) IN INCREASEING BREASTMILK PRODUCTION
Background: The breast milk is the best food for the babies containing white blood cells, proteins and immune substances which are suitable for them. Various treatments have been applied to increase breast milk, including pharmacological and nonpharmacological methods. Among the nonpharmacological methods are complementary acupressure treatments which include gallbladder 21 (Jian Jing) and stomach 18 (Ru Gen).This study aims to determine the effect of acupressure points gallbladder 21 (Jian Jing) and stomach 18 (Ru Gen) on breast milk production in postpartum period. Methodology: This study used quasi experimental design with pretest posttest with control group design. The population of this study all postpartum mothers around the researcher's work area in Ngesrep and Pegandan Health Center, Semarang City in May-June 2017 who met the inclusion criteria. The number of samples are 22 postpartum mothers who are in 3-7 postpartum days. The sampling technique is purposive sampling. Results: The results showed that the difference of average baby weight as an indicator of breast milk production before and after intervention was 2889 grams to 2776 grams with a difference of 112 grams in the treatment group and 2901 grams to 2683 grams with a difference of 246 grams in the control group. The statistical independence tests showed that there was an effect of acupressure point gallbladder 21 (Jian Jing) and stomach 18 (Ru Gen) on breast milk production in postpartum period (p<0.001). Conclusion: From the results study, it is expected that acupressure can be socialized and applied among health workers as one of the techniques to facilitate breast milk production in postpartum period. Keywords: acupressure, gallbladder 21, stomach 18, breast milk, postpartum period
FACTORS AFFECTING IRON AND FOLICACID CONSUMPTION AMONG ADOLESCENTS: A LITERATURE REVIEW
Background: Adolescents who experience anemia in 2018 reach 48.9%. The Indonesian government's program on taking blood tablets is done once a week. Anemia in adolescents in 2013 to 2018 has increased by 11.8%. This study aims to determine factor that related to iron and folic acid supplement consumption. Methodology: Research articles are reviewed from several sources, which is Pubmed, Science Direct, and Google Scholar. The article written by English with key words for compliance with iron tablets and folic acid, side effects and other influencing factors. This article search starts from 2009 to 2019 and related books. Results: Anemia in adolescents is still a problem. Factors that influence the regularity of drinking iron and folic acid supplementation include the side effects caused, how to consume the iron and folic acid supplement correctly without combine with other drinks, socio-cultural factors, and difficulties swallowing tablets. Conclusion: Policies that need to be implemented are health promotion by increasing knowledge about anemia, the importance of iron and folic acid and conducting periodic supervision. This supervision can be done by carrying out the movement of taking iron tablets and folic acid simultaneously at the same time and day that is directly supervised by the school teacher. Keywords: anemia of adolescents, iron tablets, folic acid
SELF-INTERNALIZATION FACTORS FOR CONDOM USE AMONG COMMERCIAL SEX WORKERS (CSW) IN PREVENTING HIV / AIDS TRANSMISSION
Background: The existence of localizations of commercial sex worker (CSW) may increase the HIV/AIDS cases. It might be due to individual's perception to prevent HIV/AIDS transmission remains low. STI (Sexually Transmitted Infections) such as Gonorrhea and Chlamydia are the diseases which is caused of sexual intercourse. This study aims to describe the internalizations factors to apply condom as the preventive approaches and to investigate the correlation between cognitive level and attuite with condom application. Methodology: This descriptive cross-sectional study was enrolled by 65 of 258 CSW's clients in Sadar alley, Banyumas Regency, Indonesia. Accidental sampling was used to select the respondents. Inclusion criteria were CSW's clients, willing to be respondents, and had sexual intercourse in the alley. The dependent variable was condom application and the independent variables were cognitive level and attitude. The data analysis was done by Spearman Rank. Results: More than a half of respondents had a good cognitive level to prevent HIV/AIDS transmission and more than three fourth had a support attitude. Among 65 respondents, 48 of them had intension to use condom. The cognitive level and attitude were found with strong correlation with condom applications (p <0.001). Conclusions: Cognitive level and attitude had an important role related to condom applications. Public health promotor should take an action to educate CSW and CSW's clients to prevent HIV/AIDS transmission. Keyword: HIV/AIDS, Attitude, Cognitive Level, Condom Application
COULD HERBAL MEDICINE BE A COMPLEMENTARY THERAPY IN LEUCORRHEA TREATMENT AND CARE?
Background: The frequency of using the antibiotics and antifungals as a treatment of leucorrhea may cause the bacterial and fungal resistance. Therefore, a treatment is not always optimal and sometimes leads the infection to be worsen. The herbal medicine is needed as an alternative treatment. This study aims to examine the effectiveness of using various herbal medicine in the management of leucorrhea. Methodology: The literature review was conducted in several electronic databases i.e., Google Scholar, Science Direct, and PubMed. The protocol for this study was PRISMA. The keywords such as "herbal medicine" and "leucorrhea" or "vaginal infection" were used to select the literatures. This study only selected the studies conducted during 2000 to 2019, presented in English and used clinical trial research design. Results: This study obtained 10 of 5184 total publications from electronic databases. The publication about herbal medicine for leucorrhea, both of herbal medicine and placebo, herbal medicine compared to conventional medicine and herbal medicine combined with conventional medicine showed that herbal medicine could reduce the symptoms and complaints of leucorrhea which had the ability to be an antimicrobial agent. In contrast, 2 studies revealed the side effects of herbal medicine, i.e., irritation, vomiting, and dry vagina. Conclusion: Herbal medicine was effective as a treatment of leucorrhea and had the prospect to develop as a complementary therapy for treating the leucorrhea. Keywords: Leucorrhea, complementary therapy, herbal medicine
ATTITUDES TOWARDS HIV AIDS AMONG MIDWIFERY STUDENTS IN YOGYAKARTA
Background: The incidence of Human Immunodeficiency Virus (HIV) infection in the world remains high as a challenge in achieving some targets of Sustainable Development Goals (SDGs). Midwifery students have very important role to prevent the mother to child transmission of HIV. Attitude was one indicator of a person's behavior or often also called close behavior. Negative attitude may lead stigma and discrimination for managing HIV/AIDS patient. The aim of this study was to determine the factors related midwifery student's attitude towards HIV/AIDS. Methodology: This cross-sectional study was conducted among 130 applied science midwifery students in Yogyakarta who were selected by proportional sampling. A self-administered questionnaire was used in this study. Knowledge was measured through true and false statement questions and attitude towards HIV measured through Likert scale. The analysis of univariate, bivariate, and multivariate were analyzed by computer. Results: More than three fourth of the respondents were 21 years or older. The bivariate analysis found HIV information from lecturer, HIV information from clinical instructors, experience managing HIV patient, and level of knowledge were significantly associated with attitudes towards HIV/AIDS. After adjusted to other variables in multivariate analysis, the level of knowledge had the association with attitude. Particularly, poor knowledge students were 2.26 times more likely to have negative attitude towards HIV/AIDS compared to those had good knowledge. Conclusion: Knowledge was the most influencer factors of attitude toward HIV/AIDS. The midwifery education curricula may consider to have more specific information about HIV/AIDS in order to increase the student's knowledge. Keywords: Human Immunodeficiency Virus (HIV), midwifery, knowledge
SCRAPBOOKING RELATED TO PERSONAL HYGIENE HABITS AND PREVENTION BEHAVIOR OF PATHOLOGICAL LEUCORRHOEA
Background: Leucorrhoea is the vaginal secretion in term of physiological or pathological. Around 90% of girls in Indonesia have the potential to experience leucorrhoea. Personal hygiene habit is one of the factors that play an important role in avoiding infections that can cause vaginal discharge. Scrapbooking is the art of attaching photos or images on print media and decorating them into creative works. This concept was developed in this study as an alternative media for teenagers to make it easier to remember the health messages. This study aims to determine the effect of scrapbooking on personal hygiene habits and prevention behavior of pathological leucorrhoea for Islamic boarding students (santri). Methodology: The design of this study was a quasi-experimental design with pre-posttest design with control group. The research subjects were 150 female students (75 as a control group and 75 as an experiment group) from the Islamic Boarding School (PP) Ali Maksum Bantul, PP. Salman Al Farisi Sleman and PP. Bina Umat Sleman. Data was analyzed by using univariate and bivariate (paired t-test and independent sample t-test). Results: Most of students have experienced pathological leucorrhoea (80%). Scrapbooking and giving leaflets both have a significant influence on improving personal hygiene habits (p = 0.000) and prevention behavior of pathological leucorrhoea (p = 0.001). There was a scrapbooking effect on personal hygiene habits (p = 0.029) and prevention behavior of pathological leucorrhoea (p = 0.000). Conclusion: There was an effect of scrapbooking on personal hygiene habits and prevention behavior of pathological leucorrhoea. The Boarding school officials can actively participate to motivate students for maintaining personal hygiene through various media that make more interesting. Health workers can use various media to provide counseling about personal hygiene and leucorrhoea prevention. Keywords: Scrapbooking, Personal Hygiene Habits, Leucorrhoea
HEALTH LITERACY AND DIABETES RISK FACTORS SCORE
Introduction: Health literacy is an ability of people to get, process and understand the health information and services to make a health decision. Diabetes Mellitus (DM) is known as one of major health problem around the world. Decreasing the new cases of DM can be done by applying healthy lifestyle. Health literacy affects to people's life style. This study aims to examine health literacy level of civil administration servant in Central Kalimantan with Diabetes risk factors score. Methods: Totally 42 respondents were recruited in this study. HLS-EU-Q16 was used to measure health literacy level and Finnish Diabetes Risk Score (FINDRISC) questionnaire was used to measure diabetes risk factors score. The data was analyzed in univariate and bivariate analysis used Chi-square. Results: Majority of respondents had aged under 45 years old (85.7%) and male (54.8%). The health literacy level of respondents was high (59.5%) and most of them had low risk of diabetes (69.0%). By using Chi-square, health literacy level was statistically significant with diabetes risk factors score (p=0.028). The risk factors for diabetes that mostly found were overweight, low physical activity, family history of diabetes and not consumed fruit and vegetables every day. Conclusion: Health literacy level was statistically significant with diabetes risk factors score. The government should promote healthy lifestyle to decrease the risk of getting non-communicable disease such as Diabetes Mellitus not only for civil servant but also general population. Keywords Health literacy, Diabetes risk factors, Civil servant, Central Kalimantan
KARUNGUT MUSIC REDUCES ANXIETY OF ADOLESCENT PREGNANT MOTHER
Background: Adolescent pregnancy is being a problem in Indonesia. Adolescent pregnancy can bring problem not only to the baby's health but also the mother's health as well. It can cause problem in society too. The pressure from family and society towards adolescent who got pregnant, especially if they get pregnant without marriage can lead the mother to face anxiety during the pregnancy. The anxiety during pregnancy can bring negative impact to the baby and mother. This study aims to determine the effect of Karungut music to the anxiety level among pregnant adolescent in Kapuas Regency, Indonesia. Methods: This study was an analytical study with a quasi-experimental. Totally 60 respondents were recruited in this study used simple random sampling. 30 respondents were chosen to be experimental group meanwhile the rest as control group. The data was analyzed in univariate and bivariate analysis. binary logistic regression was used to analyze in multivariate level. Results: Majority of the respondents in this study were did the Antenatal Care regularly (55%), had high motivation for pregnant (51.7%), got families support (71.7%) but not from the health workers (83.3%). The multivariate analysis showed that heard Karungut music can reduce the anxiety level among pregnant adolescent (OR= 3.33) after controlling other variables. Conclusion: Listening Karungut music during pregnancy can reduce the anxiety among pregnant woman. It can be considered as an alternative way to improve the health status among pregnant adolescent by reducing one of risk factor that can affect to the pregnancy. Supporting from family and health workers also important during pregnancy to reduce the anxiety. Keywords: Anxious, Music Karungut, Pregnant Adolescent
MICROENCAPSULATION OF KARAMUNTING LEAF EXTRACT (Rhodomyrtus tomentosa) AS AN INSTANT DRINK POWDER
Backgrounds: Karamunting (Rhodomyrtus tomentosa), a local wild plant from Central Kalimantan, Indonesia is believed by the Dayak tribe to treat diabetes mellitus. Based on the literature review, there have been no studies related to Karamunting focused on processed products in practical dosage forms in the form of instant powder, which has the longest shelf life. This study aims to explore the solubility and percentage of insoluble solids of Karamunting leaf powder that has been encapsulated with the addition of Maltodextrin. In addition, an assessment of the sensory attributes of Karamunting leaf drinks was also carried out. Methods: This study was used an experimental with applied the Randomized Block Design (RBD) design with 2 factors, comparing the number of Karamuting leaf extracts and the concentration of Maltodextrin to produce a formula of 0.5L:5%, 0.5L:10%, 0.5L:15%, 1L:5%, 1L:10% and 1L:15%. This research conducted in the Laboratory of Agricultural Product Technology, Gadjah Mada University, Yogyakarta, Indonesia from November to December 2018. Results: The application of spray dryer produced fine powder of Karamunting drink. It has a distinctive aroma and its color was ranged from bright cream to slightly brownish. Addition of Maltodextrin significantly accelerated powder's solubility and decreased its yield (p<0.05). Panelists tend to prefer products with 1 L of Karamunting leaf extract and 10% Maltodextrin. Conclusions: Solubility rate of Karamunting leaf extract is strongly influenced by the concentration of Maltodextrin. The higher the concentration of Maltodextrin, the faster the product will be dissolved. Addition of Maltodextrin significantly reduced the total of insoluble solids. However, antidiuretic activity of Karamunting drink should be investigated to prove its health claim. Keywords: Karamunting Leaves, Maltodextrin, Instant Drink Powder, Encapsulation
GUIDELINES USING POTENTIAL STAKEHOLDERS IN ENHANCING REPRODUCTIVE HEALTH AND IDEAL MARRIAGE AGE EDUCATION IN NATIONAL POPULATION AND FAMILY PLANNING BOARD'S YOUTH INFORMATION AND COUNSELLING CENTER
Background: Reproductive health education in school seemed less concerned by the Government in Indonesia. Reproductive health was not yet inserted in the curriculum, as a result, it was implemented through the youth center inside the school, like YICC. Participation of stakeholders may contribute for enhancing this YICC,moreover, in decentralisation era in Indonesia today. Furthermore, less research about stakeholder analysis made this research was necessary to do. Aims: To map stakeholders and explore guidelines from potential stakeholders in enhancing reproductive health and ideal marriage education in National Population and Family Planning Board of Indonesia (so-called BKKBN)'s Youth Information and Counselling Center in Jakarta Province, Indonesia. Methodology: This research applied the descriptive qualitative method and used Power versus Interest grid mapping model. 27 organizations were asked in-depth interviewed and Focus Group Discussion with semi-structured questions about their power and interest to YICC in two cities in Jakarta: Center of Jakarta and East of Jakarta. Result: The results were in mapping and guidelines. In mapping stakeholders, from the 27 stakeholders in the mapping model, most of the stakeholders were in the area 3 who were placed by stakeholders in provincial and local level with characterised low power and high interest, while stakeholders in national level placed in area 1 was in high power and low interest. The guidelines recommended actions based on the area on the mapping model. These findings were prominently recommended for inputting the appropriate YICC into the system of the school for the sustainability of the programs. Conclusion: The power versus interest grid model pictured that the engagement of national stakeholders was less than provincial and local stakeholders in YICC. This program should be run under regulations between Ministry of Education and Culture for the sustainability of the YICC programs. Also, the YICC should be continuously monitored in the practical context. Keywords: Reproductive health and ideal marriage education, stakeholders analysis, Youth Information and Counselling Center
DENGUE HEMORRHAGIC FEVER (DHF) EDUCATIVE GAME TO IMPROVE KNOWLEDGE AND SKILL OF ELEMENTARY SCHOOL CHILDREN IN DHF PREVENTION
Background: The Ministry of Health of the Republic of Indonesia released data on the number of dengue fever sufferers in Indonesia on January 29, 2019 there are 13,683 cases and increased to 16,692 cases on February 3, 2019. The Director General of Disease Prevention and Control said that 90% of cases of dengue fever were children under age of 15 years.The Ministry of Health noted the number of cases of dengue hemorrhagic fever (DHF) in January 2019 increased to 121.8% compared to January last year. This study aims to examine the effect of educational games on increasing the knowledge and skills of elementary school age children about the prevention of dengue fever. Methods: To test the hypothesis, this study uses experimental research methodology to determine the results of treatment of a particular group to produce an innovation and recommendations for prevention of dengue fever in children. Results: This educational game can increase children's interest in learning to prevent dengue fever and improve their ability to prevent dengue fever. Educational games methods for elementary school age children can influence children's understanding and skills in preventing dengue fever at the age of elementary school children. This study was able to describe the effect of educational game with clean and healthy behaviour that more effective to prevent the incidence of dengue fever in elementary schoolaged children. Conclusion: This educational game needs to be continuously applied and developed to reduce the incidence of dengue fever in children under 15 years of age. In the future, researchers should have to developed more modern design it can be like a virtual game that more atractive for the children. So, the goals of this research can be achieved. Keywords : Game, Mosquito, Elementary school children
THE RELATIONSHIP BETWEEN AGE, GENDER, AND BODY MASS INDEX TO THE PREVALENCE OF FLATFOOT IN PRIMARY SCHOOL CHILDREN IN LAWEYAN
Background: Flatfoot is is a postural deformity relating to the collapse or flattening of the medial longitudinal arch. It often appears with symptoms and varying degrees of deformity and disability. Flatfoot can be influenced by two factors; internal and external factors. The purpose of this study is to estimate the correlation between age, sex and body mass index (BMI) with the prevalence of flatfoot in primary school children in Laweyan. Methods: This study was an analytic observational study with cross sectional approach. A sample of 285 subjects was obtained through the sample size calculation with the research formula for the proportion of one group. The subjects were 68 students of SDIT Insan Mulia and 217 students of SDIT Nur Hidayah which obtained by stratified random sampling. Inked foot print test and Chippaux Smirak Index were used to identify the flatfoot. Result: There were 172 people (60.4%) experienced flatfoot with the highest number at age 7 years (67.9%) and there was no association between age and flatfoot (p>0.05). The prevalence of flatfoot was higher in male than female and 78.7% of obese children had flatfoot with p<0.05. The prevalence of flatfoot grade 1, grade 2, and grade 3 were 82%, 11%, and 6,4% respectively. Conclusion: There was correlation between gender and BMI with flatfoot, but there was no correlation between age and flatfoot. The association between flatfoot and BMI does not mean BMI is a contributing factor to the occurrence of flatfott in children. Keywords: Age, gender, BMI, flatfoot
PREVALENCE OF SKIN DISEASES IN THE COASTAL AREA OF TELUK NIBUNG NORTH SUMATRA
Background: In an observational study of The Global Burden Disease stated skin diseases contributed to 1.79% of lost productive days worldwide due to itching, scratching, or secondary infections which accompanying. Skin diseases are among the three biggest diseases in Tanjung Balai City with 7.230 cases in 2017. Tanjung Balai is a coastal region on the East Coast of North Sumatra with Teluk Nibung as the largest Subdistrict which had characteristics of tropical climates, high density, the lack of basic sanitation and personal hygiene and it caused the population susceptible to skin diseases.The study is to find out the prevalence of skin diseases in Teluk Nibung2018. Methods:This was an observational study using data sourced from surveillance of infectious diseases in Teluk Nibung Health Center regarding the 10 biggest diseases in the one Primary Health Care (Puskesmas) in 2018. The study was conducted in April 2019. Data were analyzeddescriptivelyusing univariate analysis with table and graphs of skin diseases frequency and distribution Results: Skin disease wasthe third largest disease in Teluk Nibung Subdistrict with 2.208 casesin 2018. Disease trends increased throughout 2018 with significantly increased in May. The proportion of skin diseases wasbigger among the female group, which is 56%. The environmental conditions in Teluk Nibung reflected coastal areas with high-density population, unhealthy settlement conditions, and the lack of basic sanitation and personal hygiene. Conclusions:Skin Disease is still a major health problem in Teluk Nibung due to the climate, weather, and the lack of environmental health factor. It needsfor researchers conducted research on skin diseases related to basic sanitation, personal hygiene among society in the coastal area and stakeholders need to create policy improved health environment. Keywords: Skin disease, coastal area, North Sumatra
THE BUSINESS STRATEGIC PLAN FOR RSD KOLONEL ABUNDJANI BANGKO YEAR 2019 – 2023
Background: The progress of the hospital industry now requires effective management to improve the quality and quality of service appropriate to the standard goals. Preparation of this business strategic plan should involve decision-maker in hospitals and existing organizational resources efficiently and effectively by taking into account current conditions. This study aims to provide a comprehensive review of the process of preparing a hospital business strategic plan so that an alternative strategy can be obtained for the next 5 years. Methods: This study was used operational research, qualitative method with in-depth interviews and hospital performance reports analysis. External and internal environment factors included finance, customer, demographics, geography, policy, marketing, information system, human resources, physical facility and organization were used as evaluated variables. SWOT analysis and Balanced Scorecard framework were used to identify critical success management factors. The Consensus Decision Making Group (CDMG) matrix were used to determined factor evaluation matrix as a final score. Results: Based on an analysis of external and internal environmental factors, alternative strategies that are suitable for current hospital conditions are market penetration and service product development. In order to realize this strategy there are several things that must be of particular concern, namely the limited resources that are available which include the availability of human resources and financial support and there is no available integrated hospital information system. Conclusion: The business strategy plan recommended for developing RSD Kolonel Abundjani Bangko's services for the next 5 years is market penetration and service product development. In order to realize this strategic plan requires a strong commitment from all human resources in the hospital and related stakeholders. Keywords: Hospitals, strategic plans, business strategy
PERCEPTION OF WOMEN OF REPRODUCTIVE AGE TOWARDS LONG-ACTING CONTRACEPTIVE (LAC) COUNSELING OF FAMILY PLANNING COUNSELORS: A QUALITATIVE STUDY
Background: Long-acting contraceptive (LAC) is one kind of birth control method for preventing, spacing pregnancy or stopping the fertility for an extended period. Increasing the number of LAC user can be done by providing a good quality of LAC counseling. This study aims to explore the perception of reproductive woman in LAC counseling by family planning counselors. Methods: This study was a qualitative study with Rapid Assessment Procedure (RAP) design. This study conducted in Bontomatene, Selayar Island on April 2019. There were 6 samples that represent 3 samples used LAC and 3 samples used non-LAC. The in-depth interview was used to get the information and the interactive model analysis was used in analyzed the data. Results: 5 of 6 respondents mentioned when the family planning counselor explained LAC used native language was easier to understand. The counseling by family planning counselor was already good because the counselor explained in detail information about LAC, visited the house of respondents to give information and did not push the respondents to select contraceptive methods. Conclusions: The reproductive woman in Bontomatene, Selayar Island feel more comfortable with LAC counseling held by family planning counselor if using native language, explain in detail information and not force respondent to use LAC methods. Keywords : Counseling, Long-Acting Contraceptive, Perception of Woman Reproductive Age
ANALYSIS OF CST (CASE, SUPPORT AND TREATMENT) AT H ABDUL MANAP HOSPITAL IN JAMBI CITY IN 2018
Background: The CST clinic of H. Abdul Manap, the regional public hospital is the only type-C a hospital which provides ARV (Anti Retro Viral) treatment service in Jambi City. However, in the past five years, the trend of CST clinic utilization has tended to decrease. This research aims to analyze the factors affecting the decrease in the utilization of the CST clinic of H. Abdul Manap regional public hospital, Jambi City. Method: This study was used the qualitative method with purposive sampling technique. This research conducted in 37 participants were employed to obtain the primary data sources from observation and in-depth interviews with key informants. Those key informants included the management team (3 people), CST Clinic team (7 people), PLWHAs (18 people) and peer counselors (8 people) as well as FGDs (Focus Group Discussions). Results: The commitment of the concerned stakeholders, especially the chairman of the hospital and the CST team members in administering the CST service, has not been maximum. The budget allocation for CST clinic in the hospital was only for and limited to staff incentives. There had been no position for team leaders and case managers, while the doctors and staffs had not received any CST training. Some staffs even served double jobs. Conclusion: The service SOP, as well as the scheduled and continuous monitoring on SOP implementation and progress evaluation according to CST Clinic performance indicators, are required. The necessary of regional policies related to CST service, especially for the provision of CD4 reagents and tariffs; and the hospital director's decree to instruct not to refuse to treat PLWHA are also required. The Implication is a strong commitment from all stakeholders, especially the chairman of the hospital and the CST team members are required to improve the clinic utilization. Keywords: Analysis, Service System, CST Clinic
THE IMPLEMENTATION OF CODE STEMI PROGRAM TO AFFECT THE QUALITY OF HEALTHCARE IN ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) PATIENTS: A SYSTEMATIC LITERATURE REVIEW
Backgrounds: The Clinical importance of coronary artery disease manifests as Acute Coronary Syndrome with the highest mortality is known as ST-Elevation Myocardial Infarction (STEMI). Delay in STEMI management not only affect mortality and complications, but also healthcare quality. The CODE STEMI program was developed to shorten the time and reduce delay in treatments for STEMI patients. This study aims to review the effect of CODE STEMI program implementation on clinical outcome and healthcare quality in STEMI patients. Methods: This study was a systematic review of literature that used meta-analysis (PRISMA) protocol. Data obtained from Electronic databases Google Scholar, PubMed, and MEDLINE that published over several years and we began on May 2019. Assessment of healthcare quality was based on Donabedian theory that consists of 7 main components, efficacy, effectiveness, efficiency, optimality, acceptability, legitimacy and equity. Analysis between studies was reported as descriptive narration. Results: The search found 15 studies, of which 4 studies as the final results that are suitable for this literature review through the keyword findings CODE STEMI, STEMI, and quality of healthcare. Studies in several countries over the globe reported a decrease of door-to-balloon/ diagnosis-to-wire time. Some studies reported reduced mortality, complications, and cost after implementation of CODE STEMI program, while others only found insignificant trends. Conclusions: Implementation of CODE STEMI protocol made a better Quality of Healthcare. However, it needs further study to review and evaluate the effect of CODE STEMI implementation, especially on the quality of healthcare in STEMI patients. Keywords: CODE STEMI, STEMI, Quality of Healthcare, Donabedian Theory
THE STANDARDS OF MEDICAL CARE WITH SELF CARE FOR DIABETES MELLITUS OUTPATIENTS
Background: Diabetes mellitus (DM) is a chronic disease that will be carried for life. DM management requires the participation of doctors, nurses, nutritionists, and other health workers. Based on this, Diabetes mellitus (DM) requires awareness, self care and collaboration from all health workers. The awareness, self care and collaboration of health workers on the importance of carrying out two-way services in patients with diabetes mellitus are the supporting forces in the DM case control program according to the standard of medical care. This study is to find out the standard of medical care with self care for diabetes mellitus outpatients. Methods: A systematic review through an article review to find out the standard of medical care with self care for diabetes mellitus outpatients. The inclusion criteria for the articles used were diabetes mellitus outpatients self care, while the exclusion criteria were abstract articles, articles that did not use English and the non full text articles. Article search is limited to articles in English accessed from internet searches from databases, namely: NCBI and Knowledge E with the keyword standard medical care, self care, and diabetes mellitus. Results: Based on the 7 articles with the same title, the screening was carried out according to the criteria for inclusion and exclusion, obtained 5 articles for further review. Self care in diabetes is a series of skills that are very important to improve the effectiveness of self management in diabetes awareness of the patient itself and collaboration with health workers. Nurses deal with collaborative problems both between health workers and patients by using doctor's provisions and prescribed interventions, to minimize complications from the occurrence. Conclusion: One of the most factor that need to be improved to decreased the case of DM is how to maintain the self care of DM outpatients. It is very important because the self care is helping the outpatient with DM to maintain their own health. Because of that, the important recommendation for DM outpatient is to maintain and increasing their standard of medical care with self care. Keywords: the standard of medical care, diabetes mellitus, self care