Angka Kematian Dan Faktor Risiko Stroke Sebagai Penyebab Dasar Kematian Di Kabupaten Padang Pariaman Provinsi Sumatera Barat

Mortality data are one of important indicators for the publich health The aim of this study is to know about the death rate, characteristics and risk factors of stroke as underlying cause of death in Padang Pariaman district. The mortality data in 2010 was analyzed using SPSS 16. The results showed that the entire death data was amount of 2642 and crude death rate was 6.71. Proportion of stroke in the district was 19.3% and stroke mortality rate was 1.29 per 1000 population in the year 2010, The risk factors of stroke as underlying cause of death after adjusted with education, employment and place of death were age and gender. The age of 40 – 64 years had the risk with OR of 6.45 (95% CI 2.77 – 14.28, p < 0.0001) and age of > 65 years had the risk of 10.29 (95% CI 4.47 – 23.69, p < 0.0001) compared to 20 – 39 year old. Women had greater risk than that of men with OR of 1.43 (95% CI 1.16 – 1.76, p < 0.001). The mortality rate of stroke as an underlying cause of death is high, so it is necessary to prevent the disease by appropriate intervention program

Kesehatan Anak Dan Bayi Baru Lahir Di Kota Bekasi (Newborn and Child Health in Bekasi Municipality)

Newborn and child health is a main principle issue to be examined due to its close relationship to newborn and child mortality and morbidity, as well as maternal health during pregnancy, labor or puerperal period. The National Household Health Survey 1995 revealed a low prenatal mortality rate in Indonesia(48 per 1000 births). This particular indicator allows in assessing the health status of children and newborn, as well as to assess reproductive health services in relation to the development policies or inhealth service practices. The assessment of reproductive health is important to be conducted, taking into account the coverage of weighted newborn, prevalence of LBW and abortion, as well as the coverage of breastfeeding practices and supplementary food consumption. This study also aims to provide baseline data and considerable inputs for policy makers. Survey was conducted in Bekasi municipality (September 2002), with a cross-sectional study design. Samples are 210 mothers who have been pregnant and delivered within a year before time of interview. The results show that 95% infants were weighed after delivery, 95% mothers had breastfed and 71% of those still breast feed until time of interview. In terms of supplementary food consumption, 44% children consume a combination of rice, vegetables, and fish/meat, while 33% received bottled milk. The prevalence of abortion is 12%. It is found that health services for children and newborn should be improved, by promoting the importance of breastfeeding and supplementary food consumption. Inter sector collaboration across programs should be endorsed, to increase health status of mother and child

Transisi Kesehatan Di Indonesia (Kajian Data Surkesnas)

Demographic transition followed by the epidemiological transition have yielded to the transition in health, shown by the changes of mortality pattern due to diseases, number of total fertilities and population Life expectancy. To examine Indonesian health transition, analysis of National Health Survey is conducted, consisting of Morbidity and Mortality studies, Demographic Health Survey, and the 2004 TB Prevalence Survey. The results show the delayed transition with some polarization pattern. Number of infectious disease is still high, resulting from the new-emerging and re-emerging diseases, along with the increase of non communicable diseases. The transitions vary across region. In Java Bali and Surnatera region, non-communicable diseases as population cause of death could be obviously found, whereas in Eastern Indonesia, the causes of death are still dominated by the infectious disease. Behavioral and risk factors for the non communicable disease tend to incline according to the 2001 and 2004 NHHS. Furthermore, a significant relationship is found between those risks factor and the occurrence of non-communicable diseases. The analysis reveals the risk of developing hypertension in smokers is 2.5 times higher than in non smokers. Moreover, the risk of getting hyperglycemia and hypercholesterolemia is 2.2 and 1.4 times, respectively, higher in less active respondents than in those who have adequate physical activities. Therefore, prevention programs are necessarily required since the increase of the risk factors will represent the emergence of diseases in the future

Evaluating the impact of continuing professional development courses on physician behavioral intention: a pre-post study with follow-up at six months

Abstract Background Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians’ intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. Methods In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin’s integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data was collected only six months after courses and responses to open-ended questions were analyzed using the Theoretical Domains Framework. Results A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of whom 78/192(40.6%) were female; 59/192(30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialist physicians. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74(SD = 1.52) and 6.35(SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from − 0.31(p = 0.17) to 2.25(p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p < 0.0001), and beliefs about consequences (β = 0.11, p = 0.04) influenced post-course intention. Post-course intention was correlated with behavior six months later (DM = 0.63; p = 0.02). Qualitative analysis showed that facilitators to behavior adoption after six months were most often related to the TDF domains of beliefs about capabilities. Most frequent barriers to adoption related to lack of resources. Conclusions Overall, scores for intention to adopt targeted behaviors increased after the courses. CPD providers could increase participants’ intention by including interventions that emphasize beliefs about capabilities, moral norm and beliefs about consequences

Identification of environmental impacts on the Ton-dano Coastal tourism area as the basis for the de-velopment of environmental documents

Environmental documents are the main requirement in development. The environmental document is prepared as a study in monitoring the quality of the environment both at the activity location and in the area around the development. The development of tourist areas certainly requires a study of the identification of environmental impacts. This research is an initial effort to identify environmental impacts on the coastal tourism area of Lake Tondano as the basis for the preparation of environmental documents, including AMDAL, UPL-UKL and SPPL. Identification is carried out starting from the pre-construction stage, construction stage, and operational stage, so that by identifying all impacts, management efforts can immediately be carried out to reduce the impact of damage that will occur.The focus of the research is on the tourist area on the coast of Lake Tondano. The research method is descriptive qualitative, preceded by field observations of the types of tourism that exist and then described according to the stage of the identification of environmental impacts. The results of the research around Tondano are lake nature tourism, culinary tourism, historical tourism and trade

Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review

BackgroundContinuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory–informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory–informed tool that evaluates the impact of CPD activities on clinicians’ behavioral intentions. ObjectiveWe aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals’ intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. MethodsWe conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants’ completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. ResultsOverall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%). ConclusionsThe use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. Trial RegistrationPROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=11649