The Correlation Between Sleep Quality and Attention as Measured by Trail-Making Tests in Medical Faculty Students

Introduction: Sleep quality is the ability of an individual to stay asleep and to get the right amount of Rapid eye movement (REM) and Nonrapid eye movement (NREM) sleep. Sleep quality is said to be good if a person gets enough sleep and does not get sleep disturbances. Sleep quality will affect a person's alertness, mood, concentration, and attention. Medical students in Indonesia have poor sleep quality; as many as 53% of students experience sleep disorders. This study aims to determine the relationship between sleep quality and attention in medical students at Yarsi University. Methods: This study is a quantitative study with a cross-sectional design. This type of research is analytically observational. The number of samples of this study was 31 respondents who were active students of the Faculty of Medicine, YARSI University, in 2019. The research instrument used to measure sleep quality is the Pittsburgh Sleep Quality Index (PSQI) and the trailmaking test (TMT) for attentional testing. The data analysis method used univariate and bivariate analysis with the Chi-square statistical test. Result: Twenty-one people had poor sleep quality. Among respondents with poor sleep quality, 12 respondents (57.1%) had poor attention, and nine respondents (42.9%) had good attention. Conclusion: Sleep quality and attention have no significant relationship with a p-value> 0.05. In the view of Islam, it follows the sleep pattern recommended by the Prophet Muhammad. Good sleep quality will improve quality of life

The Correlation Between Sleep Quality And Working Memory Using Forward And Backward Digit Span Test In Medical Faculty Students

Background: Poor sleep quality is often found in medical students as a result of which many are not aware of due to academic loads and daily learning activities. Poor sleep quality can cause several factors, one of which is reduced working memory function. Working memory is the system whose role is to remember things when performing complex tasks such as reasoning, understanding, and learning. This study aims to determine the relationship between sleep quality and working memory in medical students.Methods This research was a cross-sectional analytic observational approach using purposive sampling as a way of determining the sample. The sample in this study was 41 respondents who were students of the YARSI University Medical Faculty class of 2019. The instruments were the Pittsburgh Sleep Quality Index to measure the respondent's sleep quality and the Digit Span Test to measure the respondent's working memory level. Bivariate analysis was performed using the Chi-Square test.Results: From the results of the analysis, it was found that 26 (63.4%) respondents had poor sleep quality and 32 (78%) respondents had moderate working memory. As many as 25 (78.1%) respondents had poor sleep quality with moderate working memory. The Chi-Square test results obtained a p-value of 0.000 (0.05) which indicates a significant relationship between sleep quality and working memory.Conclusion: There is a significant relationship between sleep quality and working memory in medical students. The advice that can be given is to maintain good sleep quality for optimal memory performance

KEMAS ULANG INFORMASI SEBAGAI SOLUSI ALTERNATIF LITERASI HUKUM WAKAF UANG: SEBUAH STUDI LITERATUR

Wakaf merupakan salah satu instrumen penting yang menopang kemajuan ekonomi umat Islam. Uang sendiri belum banyak diketahui dan diterima masyarakat sebagai salah satu instrumen dalam wakaf. Padahal wakaf uang memiliki potensi yang luar biasa, khususnya bagi Indonesia sebagai negara dengan jumlah penduduk muslim terbesar di dunia. Penelitian ini bertujuan untuk memberikan gambaran pelaksanaan wakaf uang di Indonesia, mengidentifikasi permasalahan yang terjadi, serta memberikan solusi alternatif dari permasalahan tersebut dari sudut kepustakawanan. Penelitian ini merupakan penelitian deskriptif yang dilakukan dengan studi literatur. Penelitian ini menunjukkan bahwa wakaf uang di Indonesia masih jauh dari potensi yang ada. Permasalahan ini terjadi antara lain karena masih minimnya literasi hukum wakaf uang di masyarakat. Untuk mengatasi hal tersebut, salah satu solusi alternatif yang dapat dilakukan adalah dengan melakukan kemas ulang informasi hukum wakaf uang.Kata kunci: Kemas ulang informasi; Literasi hukum; Wakaf uang

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

KEKUATAN HUKUM SURAT REKOMENDASI KOMNAS HAM DALAM PROSES PENEGAKAN HAM DI INDONESIA (Studi Surat Rekomendasi Komnas HAM Nomor: 003/Humas/KH/I/2021 dalam Kasus Penembakan Laskar Front Pembela Islam)

Di Indonesia masih terdapat pelanggaran Hak Asasi Manusia dimana terdapat beberapa kasus yang dilakukan oleh aparat penegak hukum sendiri. Kasus yang penulis bahas kali ini mengenai peristiwa penembakan oleh anggota Kepolisian kepada anggota Laskar Front Pembela Islam (FPI) dimana penulis membahas bagaimana kekuatan Hukum Rekomendasi Komnas HAM dan tindaklanjut dari surat Rekomendasi Komnas HAM dalam kasus tersebut serta Pandangan Hukum Islam terkait proses pelaku pelanggaran Hak Asasi Manusia. Penelitian ini menggunakan penelitian normatif dengan pendekatan peraturan perundang-undangan dan pendekatan kasus. Dari penelitian ini tergambar bahwasannya kekuatan Hukum Rekomendasi Komnas HAM yang belum mempunyai kekuatan hukum mengikat untuk ditindaklanjuti dalam Undang-Undang Nomor 39 Tahun 1999 tentang HAM serta masih lemahnya komitmen penyelesaian  kasus pelanggaran HAM baik dari berbagai pihak  dalam menuntaskan, melindungi, dan menegakan Hak Asasi Manusia di Indonesia. Dalam Hukum Islam telah diatur didalam Al-Quran dan Hadits soal qisas berkaitan dengan kasus yang penulis angkat. Maka dari pada itu saran dari penulis, Pertama, perlunya pengaturan kekuatan hukum surat Rekomendasi Komnas HAM diatur mengikat dalam UU HAM. Kedua, penguatan kedudukan dan kewenangan terhadap Komnas HAM  dengan dibuatkan undang-undang khusus serta menjadikan Pengadilan Hak Asasi Manusia sejajar dengan peradilan lainnya

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially