Aktivasi Komplemen pada Jejas Mekanis Pengobatan Tradisional Kerokan

Latar belakang: Masyarakat Jawa mempunyai pengobatan tradisional yang disebut kerokan. Pengobatan ini dilakukan dengan menekan dan menggeserkan benda tumpul berulang-ulang pada kulit di daerah punggung, leher dan dada dengan pelicin minyak. Perlakuan ini menyebabkan jejas mekanis pada kulit yang mengakibatkan reaksi inflamasi. Komplemen adalah mediator kimia yang berperan penting pada reaksi inflamasi. Dikenal dua jalur aktivasi komplemen yaitu jalur klasik yang tercetus oleh pengikatan C1 dengan antibodi dan jalur alternatif yang tercetus oleh pengikatan C3 dengan polisakarida bakteri. Tujuan penelitian ini adalah mengungkap jalur aktivasi komplemen pada jejas mekanis pengobatan kerokan, tujuan khususnya mengukur kadar C1q dan C3. Metoda: Penelitian ini merupakan penelitian eksperimental dengan rancangan randomized pre test – post test control group design. Penelitian dilakukan di Klinik Padma. Besar sampel 38 yang dibagi menjadi 2 kelompok, 19 sukarelawan merupakan kelompok perlakuan sedangkan 19 sukarelawan kelompok kontrol. Tes statistik yang dipergunakan adalah: Kolmogorov-Smirnov, t parametrik, Mann Whitney pada derajat kemaknaan 5%. Hasil: Tidak terdapat perbedaan yang signifikan kadar C1q dan C3 antara kontrol dan perlakuan

Gambaran Histopatologi Kulit pada Pengobatan Tradisional Kerokan

Latar belakang. Kerokan adalah suatu pengobatan tradisional Jawa dengan cara menekan dan menggeserkan mata uang logam pada tubuh berulang-ulang dengan cairan yang licin sehingga terjadi warna merah. Pengobatan ini dipercaya bermanfaat untuk keadaan yang oleh masyarakat awam disebut “masuk angin”yang ditandai dengan perut kembung,hidung berair, pegal linu, nyeri kepala dan sebagainya. Pengobatan ini ternyata tidak hanya diman- faatkan di Jawa saja melainkan oleh sebagian besar masyarakat Asia Tenggara. Mengingat luasnya pemanfaatan cara ini di masyarakat maka perlu penelitian reaksi dan adakah kerusakan pada kulit akibat tekanan dan geseran yang berulang-ulang pada kerokan. Metode: penelitian deskriptif eksploratif dengan sampel peneliti sendiri, bahan penelitian adalah jaringan biopsi kulit sesudah kerokan. Bahan diwarnai dengan pengecatan SL kemudian diperiksa di bawah mikroskop dengan pembesaran 400X Hasil: 1. erosi pada stratum corneum, 2. udem jaringan subepitel 3. kapiler melebar, 4. sebukan ringan sel in- flamasi, 5. eritrosit ekstravaskuler. Simpulan: 1. pada kerokan terjadi reaksi inflamasi, 2. tidak terdapat kerusakan kulit pada kerokan. Kata kunci: Kerokan, biopsi kulit, reaksi inflamas

Factors Associated with Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus in Surakarta, Central Java

Background: Peripheral neuropathy is the most common chronic complication and often occurs in diabetes mellitus. Peripheral neuropathy can cause morbidity, decreased quality of life,and mortality. This study aimed to analyze the determinants of peripheral neuropathy in patients with type 2 diabetes mellitus in Surakarta, Central Java.Subjects and Method: This study was an observational analytic with cross sectional design. This study was conducted at Surakarta Regional Hospital, Central Java on July 2019. A total of 200 type 2 diabetes mellitus outpatients was selected by simple random sampling. The dependent variable was peripheral neuropathy. The independent variables were age, education level, income, self-efficacy, diet, medication adherence, physical activity, health literacy, duration of illness, and fasting blood sugar. Peripheral neuropathy was measured using the Michigan Neu-black Screening Instrument (MNSI). Other variable data were obtained using questionnaires. Analysis of data used multiple logistic regression.Results: The risk of peripheral neuropathy increased with age of  ≥55 years (b = 3.61; 95% CI = 1.51 to 5.70; p= 0.001), duration of illness ≥ 5 years (b = 2.78; 95% CI = 0.51 to 5.04; p = 0.016 ), and fasting sugar ≥110 mg / dL (b= 1.64; 95% CI= -0.01 to 3.03; p= 0.052). The risk of peripheral neuropathy decreased with education level ≥senior high school (b= -2.41; 95% CI = -4.31 to -0.51; p= 0.013), income ≥ Rp 1,800,000 (b= -1.58; 95% CI= -3.12 to -0.04; p = 0.044), high self-efficacy (b= -1.67; 95% CI= -3.26 to -0.07; p= 0.040), controlled diet (b= -1.89; 95% CI= -3.64 to -0.14; p= 0.034), high medication adherence (b= -2.34; 95% CI= -4.13 to -0.56; p= 0.010), high physical activity (b= -2.33; 95% CI= -4.17 to -0.49; p = 0.013), and high health literacy (b= -1.52; 95% CI = -3.18 to 0.14; p = 0.073).Conclusion: The risk of peripheral neuropathy increases with age of ≥55 years, duration of illness ≥ 5 years, and fasting blood sugar ≥ 110 mg/dL. The risk of peripheral neuropathy decreases with a high education level, income of ≥1,800,000, high self-efficacy, controlled diet, high medication adherence, high physical activity, and high health literacy.Keywords: peripheral neuropathy, diabetesCorrespondence: Akhmad Azmiardi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]: 085245412021 Indonesian Journal of Medicine (2019), 4(4): 300-312https://doi.org/10.26911/theijmed.2019.04.04.0

Effect of Psychological Factors and Workload on Midwife Performance in the Integreted Antenatal Care in Pati, Central Java

Background: One of the sensitive population health indicators is maternal mortality rate (MMR). One of the MMR determinants is antenatal care (ANC) coverage. This study aimed to determine the effect of psychological factors and workload on midwife work performance in the integrated antenatal care in Pati, Central Java.Subjects and Method: This was analytic observational study with cross sectional design. This study was conducted in Pati, Central Java. A total of 130 midwives was selected for this study by stratified random sampling. The dependent variable was work performance. The independent variable motivation, self eficacy, self actualization, workload, and midwife peer group as the contextual variable. The data were collected by a set of questionnaire. The data were analyze by linear multilevel multiple regression model.Results: Motivation (b=0.15; 95% CI =0.01 to 0.29; p=0.035), self actualization (b=0.21; 95% CI=- 0.01 to 0.40; p=0.031), and self efficacy (b=0.15; 95% CI =-0.01 to 0.31; p=0.048) had positive and statistically significant effects on work performance. Workload (b=-0.26; 95% CI=-0.53 to 0.01;p=0.056) had negative and nearly significant effect on work performance. There was a contextual effect of midwife group on work performance. ICC=17.51%; likelihood ratio=- 262.55; p=0.006.Conclusion: Motivation, self actualization, and self efficacy have positive effects on work performance. Workload has negative effect on work performance. Midwife group has a contextual effect on work performance.Keywords: psychological factors, workload, work performance, midwife.Correspondence: Siti Marfuah. Academy of Midwifery Bakti Utama, Pati, Central Java. Email: [email protected]. Mobile: 085729885380Journal of Maternal and Child Health (2016), 1(3): 138-145https://doi.org/10.26911/thejmch.2016.01.03.0

Meta-Analysis of the Effect of Internet-Based Self- Management on Blood Glucose Control in Type 2 Diabetes Mellitus Patients

Background: Diabetes mellitus is a chronic metabolic disorder or disease with numerous etiologies characterized by high blood glucose levels accompanied by lipid, protein, and carbohydrate metabolism disorders. Type 2 diabetes is the most common type of diabetes with about 90% of all diabetes cases. The International Diabetes Federation (IDF) estimates that the number of diabetics in the world can reach 783.7 million people while in Indonesia it is estimated to reach 28.57 million people in 2045. This number is an increase of 46% compared to 536.6 million in 2021. The study aims to discover how much influence internet-based self-management has on blood glucose control in type-2 diabetes mellitus patients.Subjects and Method: It was a meta-analysis study using PRISMA flowchart guidelines with the PICO formulation. P = type 2 diabetes mellitus patients. I = Internet-based self-management. C= No internet-based self-management. O= HbA1C. This study was conducted by searching for articles obtained from the MEDLINE/PubMed, Google Scholar, ProQuest, Science Direct, and Spinger Link databases with keywords and operators “Boolean electronic health record" OR "computerized" OR "healthcare system information" OR "mobile health" OR "mobile app" OR "Telehealth" AND "self-management" AND "Diabetes" OR "diabetes mellitus" OR " type 2 diabetes mellitus" OR "Type 2 diabetes. Based on the database, 10 articles met the inclusion criteria. The analysis was performed using Revman 5.3 software.Results: There were 10 articles from Asia, America, and Europe. A meta-analysis using Randomized Controlled Trials indicated that internet-based self-management significantly reduced HbA1c levels by 0.45 units (SMD= -0.45; CI 95%= -0.57 to -0.33= p<0.001).Conclusion: Internet-based management can reduce HbA1c levels of type 2 diabetes mellitus patients.Keywords: internet-based self-management, hba1c, type 2 diabetes mellitusCorrespondence:Moh Maulana. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +628-851 5667 1759Journal of Health Policy and Management (2023)https://doi.org/10.26911/thejhpm.2023.08.02.0

Contextual Effect of Health Centers and Quality Dimensions of Antenatal Services on Patient Satisfaction in Klaten, Central Java

Background: Puskesmas plays an important role in reducing maternal and neonatal morbidity and mortality. Contextual health centers and dimensions of service quality can improve maternal and child health services. This study aimed to analyze the factors that influence patient satisfactionSubjects and Method: A cross sectional study was conducted in Klaten Regency, Central Java. A sample of 200 pregnant women at the community health centers was selected by simple random sampling. The dependent variable was patient satisfaction. The independent variables were reliability, tangible, empathy, responsiveness, and assurance. The data were analyzed by multiple multilevel linear regression using the Stata 14 application.Results: Patient satisfaction was influenced by reliability (b=0.30; 95% CI= -0.48 to -0.13; p= 0.001), tangible (b= 0.28; 95% CI= 0.14 to 0.42; p<0.001), responsiveness (b= 0.17; 95% CI= 0.07 to 0.27; p= 0.001), and assurance (b= 0.16; 95% CI= 0.04 to 0.28; p= 0.007), while empathy has no effect on patient satisfaction (b= -0.02; 95% CI= -0.28 to 0.23; p= 0.837). Health center had strong contextual effect on patient satisfaction with ICC= 36.4%.Conclusion: Patient satisfaction is influenced by reliability, tangible (physical evidence), responsiveness, and assurance, while empathy has no effect on patient satisfaction.Keywords: satisfaction, puskesmas, multilevel linear regressionKorespondensi:  Leny Rahmawati. Program Magister Kesehatan Masyarakat, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: [email protected]. Ponsel: +6288981023493

Multilevel Analysis of Community Health Center, Performance of Health Personnel: Evidence from Ngawi, East Java

Background: Quality health services are one of the priorities and development goals in the health sector. Community Health Center as the first-line public services in the health sector are expected to provide quality services for the community. The quality of health services in community health center can be seen from the performance of the health personnel. This study aims to determine the factors that determine the performance of health personnel in health centers.Subjects and Method: This study used an observational analytic method with a cross sectional approach. The study was conducted in 24 community health center in Ngawi, East Java on June-July 2019. The total sample of 216 health personnel of the community health center was selected based on proportional random sampling. The dependent variable of this study was the perform­ance of health personnel. The independent variables in this study were accreditation status, edu­cation, income, work length, motivation, satisfaction, and workload. The data collections used questionnaires and were analyzed using multilevel linear regression test with Stata 13.Results: The performance of health personnel significantly improved with good accreditation status (b = 2.87; 95% CI= 0.03 to 5.71; p= 0.048), high education (b= 0.63; 95% CI = 0.13 to 1.13; p= 0.013), and high workload (b= 0.86; 95% CI= 0.34 to 1.39; p= 0.001). There was a contextual effect of the performance health personnel (ICC= 53.69%).Conclusion: Good accreditation status, higher education and high work responsibilities increase the performance of the health personnel. There was a contextual effect of health centers on the health personnel.Keywords: performance of health personnel, community health center, multilevel linear regressionCorrespondence:Rahayu Zulaikah, Ngawi Health Office, Jl. S. Parman 25 A, Ngawi, East Java. Email: dokter­[email protected]. Mobile phone: 081946059306Journal of Health Policy and Management (2020), 5(1): 13-22https://doi.org/10.26911/thejhpm.2020.05.01.0

Is Cognitive Impairment a Risk Factor for Post-Stroke Depression? A Meta-Analysis Study

Background: Depression is a psychiatric complication of stroke that often occurs and had a negative impact. Every year, 15 million people who experience strokes globally are at risk of developing post-stroke depression. Cognitive disorders are often associated with the presence of post-stroke depression. Understanding of risk factors for post-stroke depression can help in clinical identification and provide early intervention to improve stroke rehabilitation better. Therefore, it is very important to identify patients at risk for depression. This study aims to analyze cognitive impairment factors in the incidence of post-stroke depression.Subjects and Method: The meta-analysis was conducted from Pubmed, Science Direct, and Springer Link databases using "stroke", "depression", "post-stroke depression AND risk factor" keywords. The article chosen was an article published from January 1, 2009 to September 30, 2018. The data were analyzed using RevMan 5 program.Results: 6 studies consisting of 3140 patients were selected for this study. The results of a meta-analysis showed that cognitive impairment was a risk factor for post-stroke depression. Cognitive disorder was positively and significantly associated with post-stroke depression (OR = 1.24; 95% CI= 1.03 to 1.49; p = 0.02).Conclusion: Cognitive disorder is a risk factor for post-stroke depression.Keywords: depression, post-stroke, cognitive impairment, risk factor, meta-analysisCorrespondence: Dinda Ika Pratiwi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]: +6281290610504.Journal of Epidemiology and Public Health (2019), 4(2): 81-87https://doi.org/10.26911/jepublichealth.2019.04.02.0

Contextual Effect of Village on the Risk of Postpartum Depression after Earthquake in Lombok, Indonesia

Background: Postpartum depression is a feeling disorder experienced by the mother after giving birth that can occur at any time within one year. According to the WHO, the post-disaster of most of the affected population have normal psychological reactions and around 15 to 20% will expe­rie­n­ce men­tal disorders that refer to Post Traumatic Stress Disorder (PTSD). 3 to 4% experience severe dis­­or­ders such as psychosis, major depression and high anxiety. This study aims to analyze the vil­la­ge contextual influence on postpartum depression post earthquake.Subjects and Method: This was observational analytic study with cross sectional approach, conducted in 25 villages in East Lombok district, Indonesia in March to April 2019. The total sam­ple of 225 postpartum mothers was selected using stratified random sampling. The dependent va­ri­able was postpartum depression. The independent variables were age, parity, education, em­ploy­ment, income, obstetric history, social support, stress coping, government support, the role of he­a­lth personnel, and the level of loss. The data collection was conducted using questionnaires and ana­lyzed using multilevel multiple logistic regression analysis.Results: Postpartum depression was affected by age 35 years (b = 1.79; 95% CI = 2.85 to 13.37; p = 0.001), parity 4 (b = 1.45; 95% CI = 0.37 to 2.53; p = 0.008), high income (b = -1.68; CI 95% = -2.75 to -0.61; p = 0.002), there was an obstetric history (b = 1.03; CI 95% = -0.03 to 2.11; p = 0.059), strong social support (b = -1.62; 95% CI = -2.76 to -0.48; p = 0.005, good coping stress (b = -3.95; 95% CI = -5.42 to -2.47; p <0.001), strong government support (b = -1.26; 95% CI = -2.34 to -0.18; p = 0.022), the role of health personnel (b = -2.06; CI 95% = -3.29 to -0.83; p = 0.001), and the rate of loss (b = 2.69; 95% CI = 1.46 to 3.92; p <0.001) Postpartum depression was not influenced by higher education (b = -0.60; 95% CI = -1.63 to 0.42; p = 0.250) and low employment (b = 0.57; 95% CI = -0.44 to 1.59; p = 0.272). Villages has a contextual in­flu­en­ce on postpartum depression after the earthquake (ICC = 8.36%).Conclusion: Age, parity, income, obstetric history, social support, stress coping, government sup­port, the role of health personnel, and the level of loss have an influence on postpartum depression af­ter the earthquake. There is a contextual influence between the villages on average on the in­ci­den­ce of postpartum depression after the earthquake.Keywords: postpartum depression, stress coping, post earthquake, multilevel analysisCorrespondence: Baiq Tuhu Abdiani, Public Health Master’s Program, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Jawa Tengah. Email: [email protected]. Mobile: 081999546500.Journal of Maternal and Child Health (2019), 4(5): 380-391https://doi.org/10.26911/thejmch.2019.04.05.1

Utilization of Health Insurance for Outpatient in the Community: A Meta-Analysis

Background: Health insurance is the answer to the uncertainty of the occurrence of illness and the need for health services. To ensure that the need for health services can be adequately financed, a person or small group of people transfers risk to another party called an insurer/insurer, or an insurance agency.Subjects and Method: This was a systematic review and meta-analysis conducted with PRISMA flow diagrams. Search articles through journal databases including: Google Scholar, MEDLINE/ PubMed, Science Direct and Spinger Link by selecting articles published in 2000-2021 The keywords used are “health care”AND “outpatient” OR “insurance” AND “private health insurance” AND “outpatient” OR “health insurance” AND “private health insurance” AND “utilization of public health care” AND “inpatient service” AND “outpatient service” AND “logistic regression aOR”. The inclusion criteria were full paper articles with retrospective study cohort research methods, the analysis used was multivariate with adjusted Odds Ratio (aOR), the intervention provided was health insurance, the research subjects were private health insurance users. Eligible articles were analyzed using the RevMan 5.3 application.Results: A meta-analysis of 9 articles showed that people with private health insurance were 1.98 times more likely to use outpatient services than those without health insurance, and the effect was statistically significant (aOR = 1.98; 95% CI = 1.39 to 2.81; p&lt;0.001).Conclusion: The use of private health insurance has a statistically significant effect in increasing outpatient use.Keywords: health insurance, private health insurance, outpatient, meta analysis.Correspondence: Sulaiman Putra Nagaring. Masters Program in Public Health. Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected] Mobile: 085855533027Journal of Health Policy and Management, (2022), 07(02): 158-165https://doi.org/10.26911/thejhpm.2022.07.02.07