Peran (DP2PA) dalam Menangani Kasus Kekerasan Seksual Anak di Kota Samarinda

Pemenuhan hak dan perlindungan khusus bagi anak telah diakui secara formal sejak kemerdekaan Indonesia, sebagaimana tertuang dalam konstitusi Undang-Undang Dasar Negara Republik Indonesia tahun 1945. Anak adalah anugerah yang tak ternilai yang dikaruniakan oleh Tuhan pada setiap pasangan manusia untuk dipelihara, dilindungi, dan dididik dengan baik. Semakin tingginya kasus kekerasan kepada perempuan dan anak serta tingginya kejadian human trafficking atau yang lebih dikenal dengan perdagangan orang di Indonesia menjadikan pembangunan bidang perempuan dan perlindungan anak sebagai isu penting. Dewasa ini, kekerasan seksual semakin banyak terjadi seiring berkembangnya akses media sosial berbasis teknologi. Kasus kekerasan seksual di Kota Samarinda selama kurun 3 tahun ke belakang kian memprihatinkan (2019-2021). Tercatat pada tahun 2021 Kota Samarinda menjadi daerah tertinggi dengan laporan 173 kasus kekerasan seksual di antara kabupaten/kota lainnya di provinsi Kalimantan Timur. Berangkat dari kasus kekerasan seksual di Kota Samarinda selama kurun 3 tahun ke belakang yang kian memprihatinkan (2019-2021) maka penelitian ini bertujuan untuk mengetahui dan menganalisis Peran Dinas Pemberdayaan Perempuan dan Perlindungan Anak (DP2PA) dalam menangani kekerasan seksual terhadap anak khususnya yang terjadi di Kota Samarinda serta mengetahui hambatan dalam menangani kekerasan seksual terhadap anak tersebut. Penelitian ini menggunakan Penelitian Deskriptif Kualitatif, dengan fokus penelitian peran DP2PA dalam menjalankan 6 layanan pokok menangani kasus kekrasan seksual anak, dengan teknik pengumpulan data melalui observasi, wawancara dan dokumentasi. Dan analisis data yang digunakan adalah teknik analisis data model interaktif dari Matthew B. Milles dan A. Michael Huberman dengan cara pengumpulan data, reduksi data, penyajian data dan penarikan kesimpulan

Investigation of engineering properties of normal and high strength fly ash based geopolymer and alkali-activated slag concrete compared to ordinary Portland cement concrete

Fly ash-based geopolymer (FAGP) and alkali-activated slag (AAS) concrete are produced by mixing alkaline solutions with aluminosilicate materials. As the FAGP and AAS concrete are free of Portland cement, they have a low carbon footprint and consume low energy during the production process. This paper compares the engineering properties of normal strength and high strength FAGP and AAS concrete with OPC concrete. The engineering properties considered in this study included workability, dry density, ultrasonic pulse velocity (UPV), compressive strength, indirect tensile strength, flexural strength, direct tensile strength, and stress-strain behaviour in compression and direct tension. Microstructural observations using scanning electronic microscopy (SEM) are also presented. It was found that the dry density and UPV of FAGP and AAS concrete were lower than those of OPC concrete of similar compressive strength. The tensile strength of FAGP and AAS concrete was comparable to the tensile strength of OPC concrete when the compressive strength of the concrete was about 35 MPa (normal strength concrete). However, the tensile strength of FAGP and AAS concrete was higher than the tensile strength of OPC concrete when the compressive strength of concrete was about 65 MPa (high strength concrete). The modulus of elasticity of FAGP and AAS concrete in compression and direct tension was lower than the modulus of elasticity of OPC concrete of similar compressive strength. The SEM results indicated that the microstructures of FAGP and AAS concrete were more compact and homogeneous than the microstructures of OPC concrete at 7 days, but less compact and homogeneous than the microstructures of OPC concrete at 28 days for the concrete of similar compressive strength

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Mutiara Hikmah dari Kisah Para Nabi

viii, 314 hlm.; 21 x 14 c