PENGARUH SENAM TERHADAP KADAR GULA DARAH PENDERITA DIABETES

Tujuan dari penelitian ini untuk mengetahui perbedaaan kadar gula darah penderita diabetes antara kelompok yang melaksanakan senam dan kelompok yang tidak melaksanakan senam. Jenis penelitian ini adalah kohor. Populasi terpapar dalam penelitian ini adalah pasien diabetes mellitus tipe II di RS.Panti Wilasa Dr.Cipto Semarang yang mengikuti klub senam diabetes, dan populasi tidak terpapar adalah yang tidak mengikuti klub senam diabetes. Sampel terpapar dan tidak terpapar masing-masing berjumlah 42 orang. Analisis data dilakukan secara univariat dan bivariat (menggunakan uji wilcoxon dengan p = 0,05). Hasil dari penelitian ini terdapat perbedaan kadar gula darah sewaktu sebelum dan sesudah intervensi pada kelompok terpapar (nilai p = 0,0001), pada kelompok tidak terpapar (nilai p = 0,0001), pada kelompok terpapar dan tidak terpapar (nilai p = 0,0001) dengan penurunan rata-rata gula darah pada kelompok terpapar 2,3 kali lebih besar daripada kelompok tidak terpapar (31,5 mg/dl berbanding 13,5 mg/dl). Kesimpulan yang dapat diambil adalah senam efektif dalam menurunkan kadar gula darah. The purpose of this study to determine the differences in blood sugar levels of diabetes among the groups who perform gymnastics and groups who not perform gymnastics. This type of research is cohort. Exposed population in this study were patients with diabetes mellitus type II in Panti Wilasa Hospital Dr.Cipto Semarang diabetes who follow gymnastics club and population unexposed were patient who do not follow gymnastics club diabetes. Samples of each exposed and unexposwd were 42 people. Data analysis was performed univariate and bivariate (using the Wilcoxon test with p = 0.05). The result of this study there is a difference in blood sugar levels before and after the intervention while the exposed group (p-value = 0.0001), in the unexposed group (p-value = 0.0001), the exposed and unexposed groups (p-value = 0.0001) with an average decline blood sugar in the exposed group 2.3 times greater than the unexposed group (31.5 mg / dl versus 13.5 mg / dl). The conclusion that can be taken was exercise effective in lowering blood sugar levels

PERMAINAN BERGAMBAR SEBAGAI METODE PENYULUHAN UNTUK MENINGKATKAN PENGETAHUAN TENTANG PENYAKIT DEMAM BERDARAH

Tujuan penelitian ini adalah untuk mengetahui apakah karakteristik individu penderita hipertensi berpengaruh dalam melakukan Senam Jantung Sehat. Jenis penelitian ini adalah penelitian penjelasan dengan desain potong lintang. Populasi pada penelitian ini adalah 31 anggota Posbindu yang menderita hipertensi. Data primer diperoleh melalui penyebaran kuesioner. Data sekunder diperoleh dari dari Dinas Kesehatan Propinsi Semarang, Puskesmas dan Posbindu. Data yang diperoleh dalam penelitian ini diolah dengan uji Korelasi dan Regresi sederhana. Hasil uji menunjukkan variabel karakteristik individu yang berpengaruh terhadap kepatuhan melakukan senam jantung sehat antara lain tingkat pendidikan (p = 0,005, CC= 0,501, regresi =0,04 ), status pekerjaan (p = 0,0001, CC= 0,572, regresi = 0,0001), dan tingkat pengetahuan (p = 0,033, CC= 0,464, regresi = 0,012). Sedangkan variabel lain yaitu umur responden, jenis kelamin, dan jarak rumah tidak ada hubungan yang signifikan. Simpulan yang dapat diambil adalah bahwa karakteristik individu yang berpengaruh terhadap kepatuhan melakukan senam jantung sehat antara lain tingkat pendidikan, status pekerjaan, dan tingkat pengetahuan. The objective of this study is aimed at investigating whether individual characteristics of hypertension sufferers significantly effect on obedience in healthy heart gymnastic exercises. This research deals with explanation research with cross sectional approach. The population of this research was 31 people of Posbindu members who hypertension suffered suffered. The primary data was gained from questionnaire, while the secondary data was gained from health department of Semarang province, Puskesmas and Posbindu. The data was calculated with corelation test and simple regress. Based on the result of test that influenced individual characteristics variable of the obedience in healthy heart gymnastic exercises as follow: educational level (p value = 0,005, CC = 0,501, regress =0, 04), job status (p value = 0,0001, CC= 0,572,regress = 0,0001), and knowledge level (p value = 0,033, CC= 0,464, regress = 0,012). While other variables were respondens age, sex, and house distance without any significant relation. From the analysis, it can be concluded that the individual characteristics which effected on the obedience in healthy heart gymnastic exercises were educational level, job status and knowledge level

Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Background Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05–10·16) and the number of tuberculosis deaths was 1·21 million (1·16–1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01–1·89) and the number of tuberculosis deaths was 0·24 million (0·16–0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1·3% [–1·5 to −1·2]) than mortality did (–4·5% [–5·0 to −4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4·0% (–4·5 to −3·7) and mortality was −8·9% (–9·5 to −8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality). Interpretation If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : an analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2.5 originating from ambient and household air pollution.Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2.5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure-response curve from the extracted relative risk estimates using the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2.5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2.5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2.5 exposure, with an estimated 3.78 (95% uncertainty interval 2.68-4.83) deaths per 100 000 population and 167 (117-223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13.4% (9.49-17.5) of deaths and 13.6% (9.73-17.9) of DALYs due to type 2 diabetes were contributed by ambient PM2.5, and 6.50% (4.22-9.53) of deaths and 5.92% (3.81-8.64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2.5.Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2.5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2.5 air pollution, 1990-2019 : An analysis of data from the Global Burden of Disease Study 2019

Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution. Methods We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals. Findings In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5. Interpretation Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes

PELAKSANAAN PEMANTAUAN WILAYAH SETEMPAT KESEHATAN IBU DAN ANAK (PWS-KIA)DI PUSKESMAS WILAYAH KOTA SEMARANG.

PWS-KIA sebagai salah satu sistem surveilans kesehatan masyarakat seharusnya dievaluasi tiap periode waktu tertentu. Evaluasi tersebut meliputi rekomendasi untuk meningkatkan mutu, efisiensi, dan kegunaan. Diketahui bahwa pencapaian cakupan indikator PWS-KIA di Kota Semarang dari tahun 2000 sampai dengan tahun 2003 cenderung meningkat setiap tahunnya. Namun, angka pencapaian pada indikator deteksi ibu hamil berisiko oleh masyarakat dan indikator deteksi ibu hamil berisiko oleh tenaga kesehatan masih di bawah target. Tujuan evaluasi PWS-KIA ini adalah untuk memastikan bahwa indikator PWS-KIA telah dimonitor secara efisien dan efektif. Metode penelitian ini termasuk dalam penelitian survei deskriptif dengan pendekatan cross sectional. Instrumen dalam penelitian ini berupa kuesioner dan lembar observasi. Pengambilan data dilakukan dengan wawancara terhadap pengelola PWS-KIA di puskesmas dan observasi terhadap kegiatan pelaksanaan PWS-KIA. Pengumpulan data PWS-KIA bersumber pad ajumlah penduduk hasil cacah jiwa per kelurahan dan laporan hasil kegiatan program KIA. Dalam pengumpulan data masih terdapat perbedaan dalam pendefinisian kasus. Pengolahan data PWS-KIA meliputi editing, entri data, penghitungan cakupan, dan penjumlahan dibantu dengan alat kalkulator dan software Excel. Dalam penyajian data PWS-KIA masih terdapat pengelola PWS-KIA yang tidak mengisikan rangking dan tren. Hanya 8 dari 37 pengelola PWS-KIA yang telah menganalisis grafik PWS-KIA sesuai dengan pedoman PWS-KIA. Pelaporan PWS-KIA secara vertikal digabungkan dengan pelaporan SP3 dan telah dilaksanakan tepat waktu. Pelaporan secara horisontal dalam mini lokakarya belum dilaksanakan secara tepat waktu, sedangkan pelaporan secara horisontal dalam rapat koordinasi dengan kecamatan diganti dengan pengambilan laporan PWS-KIA setiap bulan oleh kantor kecamatan. SEbagian besar pengelola PWS-KIA (56,8%) tidak membuat rencana tindak lanjut PWS-KIA. Pelaksanaan PWS-KIA masih terbatas pad akegiatan pelaporan belum dimanfaatkan sebagai bahan pertimbangan pengambilan tindak lanjut. Diduga fenomena tersebut terjadi karena sebagian besar (78,4%) pengelola PWS-KIA di puskesmas wilayah kota Semarang belum pernah mengikuti pelatihan yang berkaitan dengan PWS-KIA dan beban kerja sebagai pelaksanan kebidanan yang banyak menyita waktu dan tenaga pengelola PWS-KIA. Kata Kunci: surveilans, PWS-KIA,   LOCAL AREA MONITORING OF MOTHER AND CHILD HEALTH CARE (PWS-KIA) IN THE PRIMARY HEALTH CENTERS OF SEMARANG MUNICIPALITY Abstract PWS-KIA a part of public health surveillance should be evaluated periodically, and the evaluation should include recommendations for improving quality, efficiency, and usefulness. It is known that the attainment of PWS-KIA coverage indicator from year 2000 up to 2003 in Semarang tends to increase every year. But, the attainment of risk pregnancy detection by society and risk pregnancy detection by health officer still under goals. The purpose of this evaluation is to ensure that PWS-KIA coverage indicator is monitored efficiently and effectively. This research method is include in descriptive research survey using the approach of cross sectional study. Instrument of this research are the forms of kuesioner and observation sheets. Datas were taken by interviewing the PWS-KIA organizer in public health center and observing the activities of PWS-KIA. The datas of PWS-KIA are gathered from the total population of villages and the reports of PWS-KIA activities. Some problems occured in collecting data, because there are some definitions cases. Data processing covering editing, entry data, coverage enumeration, and quantifying assisted by calculator ang Excel software. In presentation of data PWS-KIA, there are organizers of PWS-KIA which do not fill the rangking and trend. Only 8 from 37 respondens analysed the graph PWS-KIA as according to guidance PWS-KIA. Reporting PWS-KIA vertically is integrated with SP3 and have been executed periodically. Reporting horizontally in mini workshop uncommitted on schedule, while reporting horizontally in meeting co-ordinate with the subdistrict changed with the report PWS-KIA each month for subdistrict office. Mostly organizer PWS-KIA (56,8%) do not make the PWS-KIA follow-up planning. Execution of PWS-KIA still limited to reporting activity not yet been exploited upon which consideration of follow-up. The phenomenon happened because most (78,4%) organizer of PWS-KIA in the primary health centers of Semarang municipality never followed the PWS-KIA training and the work load as midwifery job which is a lot of confiscating time and energy of PWS-KIA organizer. Keyword : surveillance, PWS-KI

Mapping disparities in education across low- and middle-income countries

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe

Burden of injury along the development spectrum : associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

Background The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.Peer reviewe

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments