Pendapatan Daerah, Pembiayaan Kesehatan, dan Gizi Buruk pada Balita: Studi Korelasi Tingkat Kabupaten/Kota

Pendanaan kesehatan merupakan salah satu faktor penting dalam memengaruhi derajat kesehatan, termasuk salah satu masalah gizi pada Balita yang disebut gizi buruk. Oleh karena itu, penelitian ini bertujuan mendeskripsikan pendapatan daerah dan pembiayaan kesehatan serta korelasinya dengan gizi buruk pada Balita di tingkat kabupaten/kota di Indonesia tahun 2007. Penelitian ini merupakan studi ekologi/korelasi. Data pendapatan daerah dan pembiayaan kesehatan didapat dari Kementerian Keuangan, sedangkan data gizi buruk menggunakan data Riset Kesehatan Nasional tahun 2007. Sebanyak 250 kabupaten/kota yang diteliti dengan tidak mengikutsertakan kabupaten/kota yang datanya tidak lengkap atau tidak valid. Secara nasional, hanya persentase pendapatan asli daerah (PAD) per total pendapatan yang berkorelasi dengan gizi buruk, meskipun korelasinya lemah (r = 0,22). Berdasarkan kawasan di Indonesia, Kawasan Indonesia Barat dan Kawasan Indonesia Timur menunjukkan persentase PAD per total pendapatan berkorelasi lemah dengan gizi buruk (r = 0,20 dan r = 0,53). Terlihat kecenderungan bahwa semakin tinggi persentase pendapatan daerah dan pembiayaan kesehatan, semakin rendah persentase gizi buruknya. Korelasi antara pendapatan daerah, pembiayaan kesehatan dan masalah status gizi tidak dapat diabaikan. Data yang lebih lengkap dan valid diperlukan untuk dikembangkan penelitian selanjutnya.Health financing is one of the factors which contribute important role in influencing health status, including nutritional problem among children under five, called severely wasted. Therefore, the aim of this study was to describe districts income and health financing and examine it correlations with the prevalence of severely wasted among children under 5 years at regencies/ municipalities level in Indonesia in 2007. This research was an ecological study. Data on revenue and health financing were obtained from Ministry of Finance, and severely wasted data were obtained from the Indonesian Basic Health Research (Riskesdas) 2007. There are 250 regencies/municipalities were being objects of this research, while the others were excluded due to incomplete/missing or invalid data. Result shows nationally, only the percentage of local revenue by total district income had correlation with severely wasted, although it is weak (r = 0,22). By regions, in the Western Region Indonesia and the Eastern Region Indonesia, those variable had weak correlation with severely wasted (r = 0,20 and r = 0,53). The graphics trend shows higher percentage of local revenue and health financing, related to lower number of the prevalence of severely wasted. The correlation between district income and health financing for poor nutritional status cannot be ruled out. More valid and complete data on district income and health financing is needed for further research

Assessment of Road Network Connectivity in Support of New Capital Development

The shifting of the capital of Indonesia from Jakarta to East Kalimantan, or East Borneo, is underway. There are certain to be new issues that arise as a result of this migration. The state of the nation's current transportation infrastructure is one of the most prominent right now. The new capital of Indonesia, Jakarta, is situated in the midst of a jungle. For this reason, the road network should be established before, or at least concurrently with, the IKN construction. It is critical to understand the direction of future growth in the IKN region before developing a road network architecture. Potential partner locations might potentially benefit from enhanced access and connection to the existing road network in this situation as well. To ensure that the IKN is able to work properly and link additional nodes, many partner area points are being considered. A literature review, a focus group discussion, and in-depth interviews were conducted to come up with a development plan for IKN partner regions and highlight areas of special concern. It was also determined if the addition of a new node had a positive impact by utilizing a connection matrix and the accessibility index. Most linkages are found at five of the 26 nodes in the complete connectivity matrix of national highways around IKN in East Kalimantan. Node 3 and Node 7 are the most accessible and easy-to-access component nodes of the road network, compared to other nodes. Doi: 10.28991/CEJ-2022-08-10-011 Full Text: PD

Pengaruh Nilai K pada Metode K-nearest Neighbor (Knn) terhadap Tingkat Akurasi Identifikasi Kerusakan Jalan

Melihat kelemahan dari metode penilaian kerusakan jalan secara visual, salah satunya hasil identifikasi yang bisa bersifat subyektif, maka perlu dibuat suatu algoritma atau metode untuk mengidentifikasi jenis kerusakan jalan. Langkah awal dari proses algoritma berupa pengambilan gambar dengan jenis kamera digital, dihasilkan citra digital. Citra tersebut digunakan untuk pengolahan citra dengan software Matlab untuk menentukan jenis kerusakan jalan secara tepat dan cepat. Pengolahan citra pada penelitian ini meliputi dua tahap, yaitu proses ekstraksi dengan tahapan: wiener filtering dan thresholding, sedangkan proses klasifikasi dengan metode KNN. Hasil yang diperoleh yaitu jenis kerusakan jalan yang dapat diidentifikasi meliputi retak dan retak kulit buaya. Tujuan penelitian adalah berapa besar pengaruh nilai k dari metode KNN terhadap tingkat akurasi jenis kerusakan retak dan retak kulit buaya. Ditemukan bahwa dengan uji coba nilai k yang berbeda-beda, yaitu 1, 8, dan 15, menghasilkan tingkat akurasi yang berbeda untuk tiap jenis kerusakan

A Relationship Model between Accident Factors and the Traffic Accident Severity Using Logistic Regression Model

The present paper purposes to develop the relationship model between the factors of accidents and severity level of traffic accidents by using multinomial logistic regression model approach, for a case study the traffic accident in Makassar City, Indonesia. In further, the study evaluates the traffic accident factors which significantly influence the traffic accident severity level. In this regard, the outcome variable is the severity level of the traffic accident which has three attributes, i.e., death, serious injury, and minor injury. The explanatory variables involve victim characteristics and traffic accident characteristics. The present study used the traffic accident database during 2012 – 2015 which recorded by the traffic police agency in the city. The model calibration results show that the relationship model has a good accuracy level. The victim position and the collision types significantly influence the severity accident level. The results provide basic information for efforts in reducing traffic accidents.

Neck Dissection in Patients with Oral Squamous Cell Carcinoma in Dharmais Hospital, Jakarta

Oral squamous cell carcinoma (OSCC) is one of the rarest cancers worldwide. In Indonesia, the incidence is less than five thousands per year, and the mortality rate is almost 50%. More than 50% patients with OSCC have lymph node metastasis; the proportion of occult metastasis is 24-42%. Those with lymph node metastatishave the worst possibility of survival. This study aimed to estimate the survival of OSCC patients with neck dissections. We conducted a retrospective cohort study of 78 patients with OSCC who were treated in Dharmais National Cancer Hospital between 1 January 2003 and 31 January 2013. The three years survival rate postdiagnosis, post neck dissection was calculated using Kaplan —Meier survival curves and statistically tested using a log-rank test. Cox proportional hazard models were applied to assess the prognostic significance of neck dissections. Of the total patients in this study (n=78), 53.8% of patients had surgery. Of patients who underwent surgery, 71.4% had a neck dissection surgery. These patients were in either early or advanced stages of cancer. Overall survival showed that patients who received neck dissections had better survival rates (58.2%) than patients who did not receive neck dissection (32.2%). Stratification at every stage of cancer (I, II, III, and IV) showed better survival in patients with neck dissections. The risk of patients without neck dissections is higher than patient with neck dissection to die, Hazard Ration(HR)=2.19 (CI95% 1.04-4.62, p=0.028). Adequate neck dissection surgery increases chances of survival in patients with OSCC. Keywords: Neck Dissection, Squamous Cell Carcinoma, Oral Cancer, Surviva

Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Investigating severe maternal morbidity (near-miss) is a newly recognised tool that identifies women at highest risk of maternal death and helps allocate resources especially in low income countries. This study aims to i. document the frequency and nature of maternal near-miss at hospital level in Damascus, Capital of Syria, ii. evaluate the level of care at maternal life-saving emergency services by comparatively analysing near-misses and maternal mortalities.</p> <p>Methods</p> <p>Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005) including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR), maternal near miss ratio (MNMR), mortality indices and proportion of near-miss cases and mortality cases to hospital admissions.</p> <p>Results</p> <p>There were 28 025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100 000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52%) and haemorrhage (34%) were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60%) while sepsis had the highest mortality index (7.4%). Most cases (93%) were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%), primary (5%) and secondary (10%) healthcare unites and private practices (11%). 26% of near-miss cases were admitted to Intensive Care Unit (ICU).</p> <p>Conclusion</p> <p>Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to prevent/manage post-partum haemorrhage and training health care professionals to manage infrequent but fatal conditions like sepsis. An urgent review of the referral system and the emergency obstetric care in Syria is highly recommended.</p

Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda

<p>Abstract</p> <p>Background</p> <p>Every pregnant woman faces risk of life-threatening obstetric complications. A birth-preparedness package promotes active preparation and assists in decision-making for healthcare seeking in case of such complications. The aim was to assess factors associated with birth preparedness and complication-readiness as well as the level of male participation in the birth plan among emergency obstetric referrals in rural Uganda.</p> <p>Methods</p> <p>This was a cross-sectional study conducted at Kabale regional hospital maternity ward among 140 women admitted as emergency obstetric referrals in antenatal, labor or the postpartum period. Data was collected on socio-demographics and birth preparedness and what roles spouses were involved in during developing the birth plan. Any woman who attended antenatal care at least 4 times, received health education on pregnancy and childbirth danger signs, saved money for emergencies, made a plan of where to deliver from and made preparations for a birth companion, was deemed as having made a birth plan. Multivariate logistic regression analysis was conducted to analyze factors that were independently associated with having a birth plan.</p> <p>Results</p> <p>The mean age was 26.8 ± 6.6 years, while mean age of the spouse was 32.8 ± 8.3 years. Over 100 (73.8%) women and 75 (55.2%) of their spouses had no formal education or only primary level of education respectively. On multivariable analysis, Primigravidae compared to multigravidae, OR 1.8 95%CI (1.0-3.0), education level of spouse of secondary or higher versus primary level or none, OR 3.8 95%CI (1.2-11.0), formal occupation versus informal occupation of spouse, OR 1.6 95%CI (1.1-2.5), presence of pregnancy complications OR 1.4 95%CI (1.1-2.0) and the anticipated mode of delivery of caesarean section versus vaginal delivery, OR 1.6 95%CI (1.0-2.4) were associated with having a birth plan.</p> <p>Conclusion</p> <p>Individual women, families and communities need to be empowered to contribute positively to making pregnancy safer by making a birth plan.</p

Investigating Local Resources and Wisdom in Partner Regions Surrounding the Nation's Capital for Road Network Development

The development of the New Indonesia’s Capital, called the IKN, will undoubtedly draw many people to come and engage in the IKN region, although not inside the IKN area, since the development is confined to a small area with smart city, blue city, and forest city ideas merged. Restrictions on mobility inside the IKN area will almost definitely create issues for road network connectivity across IKN's surrounding areas, so it was deemed essential to have a road network development model that maintains IKN as a limited area while also functioning as a catalyst for economic growth in partner areas. The focus of this research is to provide a model for developing a road network based on local wisdom and the resources of each partner region surrounding IKN. The method employed in this study is based on gathering secondary data of the surrounding areas, which has local resources and local wisdom. The resources and the local wisdom are considered a trip attractor. The IKN masterplan data was also employed in this study as the main subject. Principles and road network development theory were used to analyze the data. The findings of this research led to the development of a new road network in various regions, including Senoni, Gusig, and Tukuq. This road network is deemed necessary to be developed, due to its trip attraction potential. It is hoped that the implementation of these new road networks will also have positive impacts on the development of partner areas surrounding IKN. Doi: 10.28991/CEJ-2022-08-05-06 Full Text: PD

Jenis Histologik Dan Umur Pada Kanker Serviks Uteri Di Rumah Sakit Kanker Dharmais

Berbagai penelitian terhadap kanker serviks uteri telah dilakukan, khususnya di negara barat. Dari penelitian tersebut didapatkan adanya variabel-variabel yang kemudian dikenal sebagai faktor-faktor resiko yang kemudian diketahui peranannya terhadap kanker serviks uteri.Sebagai negara yang terletak di Asia dimana angka kejadian kanker serviks uteri, khususnya pada stadium lanjut masih tinggi dan semakin meningkat, maka pengetahuan terhadap kanker pada umummnya dan kanker serviks uteri pada khususnya haruslah semakin baik.Untuk mendapatkan angka survival dari penderita kanker serviks uteri dan mengevaluasi faktor prognostik jenis histopatologik, umur pada penderita kenker serviks yang berobat di Rumah Sakit Kanker "Dharmais", Jakarta.Penelitian ini merupakan penelitian kohort retrospektif dari penderita kanker serviks uteri. Data didapat berdasarkan catatan medik penderita yang berobat di Rumah Sakit Kanker "Dharmais", Jakarta pada tahun 1993/4 - 1997. Tercatat sebanyak 710 kasus tetapi hanya 175 kasus yang dapat dilakukan pemantauan selama 2 tahun. Karsinoma sel skuamosa 128 kasus (73,12%) dan adenokarsinoma (termasuk adenoskuamokarsinoma) 14 kasus (8%), 33 kasus tidak dinyatakan jenis histopatologi sel kankernya).Dari 175 kasus yang dapat dievaluasi didapatkan jenis histopatologik adenokarsinoma tinggi pada stadium I dan residif juga pada kelompok umur muda (< 40 tahun), perbedaan tidak bermakna (p = 0,342 dan p = 0,396). Stadium mempengaruhi survival : stadium awal (IA-IIA) 85,2%, stadium lanjut (IIB-IV) 50,4% dan residif 36,7% (p = 0,001). Kelompok umur muda (< 40) dan jenis histopatologik yang mengandung kelenjar mempunyai nilai survival 2 tahun yang lebih baik dibandingkan kelompok umur yang lebih tua, jenis histopatologik skuamosa.Stadium awal (IA-IIA), jenis histopatologik yang mengandung kelenjar dan kelompok umur muda (< 40 tahun) mempunyai angka survival yang lebih baik selama 2 tahun "follow up