Analisis Penerapan Pelayanan Kesehatan Lanjut Usia di Puskesmas Pineleng pada Masa Pandemi Covid –19

Lanjut usia menurut Kementerian Kesehatan Republik Indonesia adalah seseorang yang telah mencapai usia >60 tahun. Aspek penting dalam peningkatan kualitas hidup lansia salah satunya adalah kesehatan. Di masa pandemi saat ini, lanjut usia berisiko terhadap keparahan/kejadian dan kematian penyakit Covid-19, serta penyakit kronis yang rata-rata diderita oleh penduduk lanjut usia. Upaya pelayanan kesehatan terhadap lansia dimasa pandemi Covid-19 pada pelayanan kesehatan harus dilakukan dengan manajemen yang baik. Peneilitian ini bertujuan untuk menganalisis penerapan pelayan kesehatan lansia di Puskesmas Pineleng pada masa pandemic Covid-19. Penelitian menggunakan metode kualitatif dengan wawancara mendalam kepada informan 6 orang yakni pada petugas puskesmas dan pasien lansia. Hasil penelitian berdasarkan wawancara diperoleh Pelaksanaan triase pasien di Puskesmas Pineleng sudah berjalan sesuai dengan SOP yang ada, Puskesmas Pineleng tidak memiliki poli khusus lansia tetapi dalam alur pelayanan pasien memiliki jalur khusus, Ruang tunggu, ruang pemeriksaan, laboratorium dan apotek berada di satu lantai yang sama dan terletak di lantai dasar dan jadwal pelayanan dicetak pada baliho ukuran 50cm x 100cm dan diletakkan di depan pintu masuk puskesmas, Pemberian obat rutin untuk pasien lansia yang memiliki penyakit kronis diberikan untuk 1 bulan saja, Tersedianya layanan homecare dari Puskesmas Pineleng untuk lansia yang beresiko tinggi, kerjasama lintas sektor terkait, organisasi masyarakat mulai dari tingkat desa dan kecamatan berjalan dengan baik. Kata kunci: lanjut usia, pelayanan kesehatan, pandemi Covid-19 ABSTRACTAccording to the Ministry of Health of the Republic of Indonesia, an elderly person is someone who has reached the age of >60 years. One of the important aspects of improving the quality of life of the elderly is health. During the current pandemic, the elderly are at risk for the severity/incidence and death of Covid-19 disease, as well as chronic diseases that are generally suffered by the elderly population.. Health care efforts for the elderly during the Covid-19 pandemic in health services must be carried out with good management. This study aims to analyze the application of elderly health services at the Pineleng Health Center during the Covid019 pandemic. The study used a qualitative method with in-depth interviews with 6 informants, namely healthcare center officers and elderly patients. The results of the study based on interviews obtained that the implementation of patient triage at the Pineleng Health Center has been running according to the existing SOP, Pineleng Health Center does not have a special clinic for the elderly but in the patient service flow, it has a special line, waiting room, examination room, laboratory, and pharmacy are on the same floor and is located on the ground floor and the service schedule is printed on a billboard measuring 50cm x 100cm and placed in front of the entrance to the healthcare center, Routine medication for elderly patients who have chronic diseases is given for 1 month only, Availability of home care services from the Pineleng Health Center for seniors who are at high risk, cooperation across related sectors, community organizations starting from the village and sub-district levels is going well. Keyword: the elderly, health services, the Covid-19 pandemi

HUBUNGAN ANTARA PEMBERIAN ASI EKSKLUSIF DENGAN KEJADIAN STUNTING PADA ANAK USIA 13-36 BULAN DI WILAYAH KERJA PUSKESMAS SONDER

Stunting adalah gangguan pertumbuhan dan perkembangan yang anak-anak yang mengalami gizi buruk, infeksi berulang, dan stimulasi psikososial yang tidak memadai. Anak-anak didefinisikan sebagai stunting jika tinggi badan berdasarkan umur mereka lebih dari dua standar deviasi di bawah rata-rata Standar Pertumbuhan Anak WHO., secara nasional tahun 2013 sebesar 37,2%, yang berarti terjadi peningkatan dibandingkan tahun 2010 (35,6%) dan 2007 (36,8%). Prevalensi pendek sebesar 37,2% terdiri dari 18,0% sangat pendek dan 19,2% pendek. Pada tahun 2013 prevalensi sangat pendek menunjukkan penurunan, dari 18,8% tahun 2007 dan 18,5% tahun 2010. Prevalensi pendek meningkat dari 18,0% pada tahun 2007 menjadi 19,2% pada tahun 2013. Tujuan Penelitian ini untuk menganalisis hubungan antara Pemberian ASI Eksklusif Dengan Kejadian Stunting Pada Anak Usia 13-36 Bulan. Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang yang dilakukan di wilayah kerja Puskesmas Sonder, Minahasa. Populasi penelitian ini adalah seluruh anak usia 13-36 bulan. Sampel pada penelitian ini 82 balita dengan teknik teknik purposive sampling. Variabel yang diteliti adalah pemberian ASI Eksklusif pada anak usia 13-26 bulan. Analisis bivariat menggunakan uji chi square (CI=95%, α=0,05). Hasil penelitian yang dilakukan di wilayah kerja Puskesmas Sonder menunjukkan batita yang diberi ASI eksklusif berstatus gizi stunting sebesar 20,7% dan batita yang tidak diberi ASI eksklusif berstatus stunting sebesar 26,8% dengan nilai p > 0,05 yaitu p value 0.376 yang berarti bahwa tidak ada hubungan bermakna antara pemberian ASI eksklusif dengan kejadian stunting pada Usia 13-36 bulan di wilayah kerja Puskesmas Sonder.Kata kunci: ASI eksklusif, balita, stuntingABSTRACT Stunting is the impaired growth and development that children experienced from poor nutrition, repeated infection, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median. Nationally, stunting prevalency in 2013 is 37.2%, which means an increase if compared to 2010 (35.6%) and 2007 (36.8%). The short prevalence of 37.2% consists of very short 18.0% and 19.2% short. In 2013 very short prevalence showed a decline, from 18.8% in 2007 and 18.5% in 2010. The short prevalence increased from 18.0% in 2007 to 19.2% in 2013. The purpose of this study was to analyze the relationship between Exclusive Breastmilk With Stunting Incidence to Children on age 13 to 36 Months. This study is an analytic observational research with cross sectional design conducted in the working area of Sonder Community Health Center, Minahasa. The population of this study is all children on aged 13-36 months. The sample in this study were 82 children using purposive sampling technique. The variables studied were exclusive breastfeeding to children on age 13 to 36 Months. Bivariate analysis using chi square test (CI = 95%, α = 0,05). The results of research conducted in the work area of Sonder Community Health Center showed toddlers who were given exclusive breastfeeding stunting nutritional status of 20.7% and toddlers who were not exclusively breastfed with stunting status of 26.8% with p> 0,05 i.e p-value 0.376 which means that there was no significant association between exclusive breastfeeding and stunting incidence at 13-36 months of age of Sonder Community Health Center working area.Keywords: Exsclusive breastmilk, children, stuntin

Analisis Hubungan Stresor Kerja (Kondisi Pekerjaan, Hubungan Interpersonal Dan Tampilan Pekerjaan-rumah) Dengan Kinerja Pada Pegawai Puskesmas Tongkeina Kota Manado

: Problems that often arise in health centers are among others issues of medical and paramedical personnel performance which appear on the quality of work or the quality of service and achievement of the programs implemented at the PHC. Individual performance is related to the working person's behavior. Employee behavior will result in a positive long-term performance and increase the ability of personnel, or vice versa, causing a negative long-term performance and a decrease in the ability of personnel. This study aimed to determine the relationship between working stressors and employee performance at Tongkeina Health Center Manado. This was a descriptive analytical study with a cross sectional design conducted at the health center Tongkeina from August 2013 to November 2013. The results showed that there was a relationship between job condition, interpersonal relationship, and homework presentation with employee performance. Interpersonal relationship was the most dominant variable affected the performance of employees in the health center Tongkeina

FAKTOR-FAKTOR RISIKO KEJADIAN ISPA PADA BALITA DI WILAYAH KERJA PUSKESMAS AMURANG TIMUR KABUPATEN MINAHASA SELATAN

Infeksi Saluran Pernapasan Akut (ISPA) merupakan masalah kesehatan yang utama di Indonesia karena masih tingginya angka kejadian ISPA terutama pada balita. Data jumlah kasus ISPA di Sulawesi Utara tahun 2014, terdapat 58.328 kasus pada balita usia 1-4 tahun dan di Wilayah Kabupaten Minahasa Selatan tahun 2014 jumlah kejadian ISPA pada balita usia 1-4 tahun berjumlah 3693 kasus. Tujuan dari penelitian ini untuk menganalisis hubungan faktor-faktor risiko kejadian ISPA pada balita di wilayah kerja Puskesmas Amurang Timur Kabupaten Minahasa Selatan. Penelitian ini adalah penelitian survey analitik dengan desain case control study, yang dilaksanakan pada bulan Januari-Maret 2016 di wilayah kerja Puskesmas Amurang Timur kabupaten Minahasa Selatan. Jumlah sampel sebanyak 150 responden terdiri 75 responden yang pernah menderita ISPA dan 75 responden yang tidak pernah menderita ISPA. Instrumen yang digunakan dalam penelitian ini adalah metode pengamatan (observasi) dan wawancara (kuesioner). Secara statistic nilai probabilitas yang diperoleh berdasarkan hasil uji chi square yaitu kepadatan hunian (p = 0,021; OR = 0,32; CI 95% = 0,11-0,87), ventilasi (p = 0,41; OR = 0,38; CI 95% = 0,14-0,98) dan merokok (p = 0,006; OR = 2,62; CI 95% = 1,30-5,27) dengan kejadian ISPA di wilayah kerja Puskesmas Amurang Timur Kabupaten Minahasa Selatan Terdapat hubungan antara kepadatan hunian dengan kejadian ISPA, ventilasi dengan kejadian ISPA, dan merokok dengan kajadian ISPA.Kata Kunci: Kepadatan Hunian, Ventilasi, Merokok, Kejadian ISPAABSTRACTISPA (Infeksi Saluran Pernapasan Akut) or URI (Upper Respiratory Tract Infection) is become the main problem in Indonesia because the number of patient is still high especially toddler. Based on data the number of ISPA or URI there are 58.328 cases for toddler beetwen 1-4 years in North Sulawesi, while in South Minahasa District there are 3693 cases both in 2014. The purpose of this research is to analyze the risk of factors of ISPA or URI cases in Puskesmas South Minahasa District. The methodology that used in this research is research analytic survey with case control study design which held on January-March 2016 in Puskesmas district South Minahasa District. The total sample in this research is 150 respondents, 75 for they who bas been suffered ISPA and 75 for those who did not suffered ISPA. The instrument for this research is observation and questionnaire. Statistically value probability based on test result chi square ie density of dwelling (p = 0,021; OR = 0,32; CI 95% = 0,11-0,87), ventilation (p = 0,41; OR = 0,38; CI 95% = 0,14-0,98) and smoking (p = 0,006; OR = 2,62; CI 95% = 1,30-5,27) with events ISPA in the work area Puskesmas Amurang East South Minahasa District. There are interrelated by Dwelling Density with events ISPA, Ventilation with inciden ISPA, and Smoking with events ISPA.Keywords : Dwelling Density, Ventilation, Smoking, Events ISP

HUBUNGAN ANTARA LAMA KERJA (DURASI) DAN SIKAP KERJA DENGAN KELUHAN MUSKULOSKELETAL PADA PETANI TANAMAN PADI DI DESA PONOMPIAAN KECAMATAN DUMOGA KABUPATEN BOLAANG MONGONDOW

ABSTRAKKeluhan muskuloskeletal adalah salah satu masalah kesehatan yang secara umum dapat dijumpai pada pekerja informal. Penyebab dari keluhan ini dapat disebabkan oleh berbagai faktor. Salah satu faktor yaitu adanya sikap kerja yang tidak ergonomis yang dilakukan secara terus menerus dengan jam kerja melebihi batas optimal. Tujuan penelitian ini untuk mengetahui hubungan antara lama kerja (durasi) dan sikap kerja dengan keluhan muskuloskeletal. Jenis penelitian yaitu jenis penelitian cross sectional. Populasi yang diambil pada penelitian ini adalah petani yang aktif bekerja. Jumlah petani yang aktif berjumlah 40 orang. Data yang diperoleh dari hasil wawancara, kuesioner NBM dan REBA dengan uji statistik menggunakan Rank Spearman dengan nilai kemaknaan 95% (p 0,05). Hasil uji bivariat antara sikap kerja dengan keluhan muskuloskeletal menunjukan p value = 0,000 (p<0,05). Kesimpulan penelitian ini adalah tidak terdapat hubungan antara lama kerja (durasi) dengan keluhan muskuloskeletal serta terdapat hubungan antara sikap kerja dengan keluhan muskuloskeletal pada petani tanaman padi di Desa Ponompiaan Kecamatan Dumoga Kabupaten Bolaang Mongondow. Kata Kunci: Lama Kerja (Durasi), Sikap Kerja, Dan Keluhan Muskuloskeletal. ABSTRACTMusculoskeletal complaints are one of the health problems that can generaly be found in informed workers. These complaints can be caused by various factors. One of the factors is the work attitude which is not ergonomic that conducted simultaneously with over exceeded work length. The purpose of this study to determine the correlation between work length (duration) and work attitude with musculoskeletal complaints. This type of research is cross sectional. The population is the entire population of the farmers with 40 farmers as the sample. Data obtained from survey interviews with NBM and REBA. Statistical test using the Rank Spearman correlation test. The results showed the work length (duration) less than 8 hours 31 people (77.5%) over 8 hours 9 people (22.5%). Low category work attitude 1 person (2.5%), moderate cattegory 36 people (90%), and high category 3 people (7.5%). 39 people have experience musculoskeletal complaints (97.5%), while respondents who haven’t experience musculoskeletal complaints have p value = 0,597 (P value ≥0,05) and work attitude with musculoskeletal complaints have p value = 0,000 (P value <0,05). There is no correlation between work length (duration) with musculoskeletal disorders and there is correlation between work attitude with musculoskeletal complaints. Keywords: Work Length, Work Attitude, Musculoskeletal Complaints

Analisis Lama Waktu Tunggu Pelayanan Pasien Rawat Jalan Di Balai Kesehatan Mata Masyarakat Propinsi Sulawesi Utara

: Hospital has a mission to provide qualified health services and affordable by the community in order to improve public health; one of them was the short waiting time of patients. This study aimed to analyze the waiting time length (the arrival process, service, human resources) of outpatient services in the Public Eye Health Department of North Sulawesi. This study used a qualitative method by conducting interviews at 7 informants as the primary data; the secondary data were obtained from direct observation / observation in the Public Eye Health Department of North Sulawesi. The results showed that the patients' arrivals occurred before the registration counter was opened and most patients came with their families. During the service process there were some problems inter alia the patient did not bring his/her file/guarantee completely; the number of the registration booths were limited due to lack of staff; disrupted internet connection; as well as limited human resources who were experts in the field of refraction and medical records. Conclusion: The waiting time in the Public Eye Health Department of North Sulawesi was still quite long (> 60 minutes) due to the overload patients, lack of personnel at the registration booth, disrupted internet connection, delayed of distribution of medical record files, limited available rooms, and limited human resources that were expertised in the field of refraction and medical record

Hubungan antara Pengetahuan dan Sikap dengan Screen Time pada Peserta Didik di SMP Kristen Taraitak Kecamatan Langowan Utara Kabupaten Minahasa

Kemudahan teknologi yang ditawarkan disaat ini membantu dalam memberikan informasi dan menjalin hubungan dengan orang lain. Perilaku peserta didik yang menghabiskan waktu di depan layar media elektronik lebih dari 2 jam dapat mengalami masalah waktu tidur, depresi, kecemasan, perilaku hidup sendentary, dan terpapar oleh konten yang agresif. Pengetahuan dan sikap merupakan faktor-faktor yang dapat memengaruhi tindakan peserta didik dalam menggunakan media elektronik. Tujuan penelitian ini yaitu Untuk menganalisis hubungan antara pengetahuan dan sikap dengan screen time pada peserta didik di SMP Kristen Taraitak. Penelitian dilakukan dengan desain studi potong lintang, berlokasi di SMP Kristen Taraitak. Sampel penelitian yaitu peserta didik dengan jumlah keseluruhan  75 peserta didik, pada bulan Agustus 2020 sampai April 2021. Data penelitian dianalisis dengan menggunakan uji chi ssquare. Berdasarkan hasil analisis diketahui bahwa sebanyak 81,3% peserta didik menghabiskan waktu di depan layar media elektronik lebih dari dua jam. Untuk pengetahuan diketahui bahwa sebanyak 49,3% peserta didik berada pada kategori tingkat pengetahuan kurang baik dan hasil uji dua variabel pengetahuan dengan screen time nilai ρ value 0,033. Untuk sikap diketahui bahwa 45,3% peserta didik memiliki sikap yang kurang baik, dengan hasil uji dua vatiabel sikap dengan screen time nilai ρ value 0,498. Terdapat hubungan yang bermakna antara pengetahuan dengan screen time. Tidak terdapat hubungan antara sikap dengan screen time pada peserta didik di SMP Kristen Taraitak Kecamatan Langowan Utara Kabupaten Minahasa. Kata Kunci: Pengetahuan, sikap, screentime ABSTRACTThe ease of technology offered at this time helps in providing information and establishing relationships with other people. The behavior of students who spend time in front of electronic media screens for more than 2 hours can experience sleep problems, depression, anxiety, sedentary life behavior, and bullae exposure to aggressive content. Knowledge and attitudes are factors that can influence the actions of students in using electronic media. The purpose of this study is to analyze the relationship between knowledge and attitudes with screen time on students at Taraitak Christian Middle School. This research was conducted with a cross-sectional design, which was conducted at Taraitak Christian Middle School. The research sample was students with a total of 75 students, which was conducted from August 2020 to April 2021. The research data were analyzed using the chi s-square test. Based on the results of the analysis, it is known that as many as 81.3% of students spend more than two hours in front of electronic media screens. For knowledge, it is known that 49.3% of students are in the category of poor knowledge level and the results of the test of two knowledge variables with a screen time of value of 0.033. For attitude, it is known that 45.3% of students have a bad attitude, with the results of the two attitude variables test with a screen time of value of 0.498. There is a significant relationship between knowledge and screen time. There is no relationship between attitudes and screen time on students at Taraitak Christian Middle School, North Langowan District, Minahasa Regency. Keywords: Knowledge, Attitude, Screentim

A two-way interaction between methotrexate and the gut microbiota of male Sprague Dawley rats

Methotrexate (MTX) is a chemotherapeutic agent that can cause a range of toxic side effects including gastrointestinal damage, hepatotoxicity, myelosuppression, and nephrotoxicity and has potentially complex interactions with the gut microbiome. Following untargeted UPLC-qtof-MS analysis of urine and fecal samples from male Sprague–Dawley rats administered at either 0, 10, 40, or 100 mg/kg of MTX, dose-dependent changes in the endogenous metabolite profiles were detected. Semiquantitative targeted UPLC-MS detected MTX excreted in urine as well as MTX and two metabolites, 2,4-diamino-N-10-methylpteroic acid (DAMPA) and 7-hydroxy-MTX, in the feces. DAMPA is produced by the bacterial enzyme carboxypeptidase glutamate 2 (CPDG2) in the gut. Microbiota profiling (16S rRNA gene amplicon sequencing) of fecal samples showed an increase in the relative abundance of Firmicutes over the Bacteroidetes at low doses of MTX but the reverse at high doses. Firmicutes relative abundance was positively correlated with DAMPA excretion in feces at 48 h, which were both lower at 100 mg/kg compared to that seen at 40 mg/kg. Overall, chronic exposure to MTX appears to induce community and functionality changes in the intestinal microbiota, inducing downstream perturbations in CPDG2 activity, and thus may delay MTX detoxication to DAMPA. This reduction in metabolic clearance might be associated with increased gastrointestinal toxicity

Development of Core Outcome Measures sets for paediatric and adult Severe Asthma (COMSA)

BACKGROUND: Effectiveness studies with biological therapies for asthma lack standardised outcome measures. The COMSA (Core Outcome Measures sets for paediatric and adult Severe Asthma) working group sought to develop Core Outcome Measures (COM) sets to facilitate better synthesis of data and appraisal of biologics in paediatric and adult asthma clinical studies.METHODS: COMSA utilised a multi-stakeholder consensus process among patients with severe asthma, adult, and paediatric clinicians, pharmaceutical representatives and health regulators from across Europe. Evidence included a systematic review of development, validity, and reliability of selected outcome measures plus a narrative review and a pan-European survey to better understand patients' and carers' views about outcome measures. It was discussed using a modified GRADE Evidence to Decision framework. Anonymous voting was conducted using predefined consensus criteria.RESULTS: Both adult and paediatric COM sets include forced expiratory volume in 1 s (FEV1) as z scores, annual frequency of severe exacerbations and maintenance oral corticosteroid use. Additionally, the paediatric COM set includes the Paediatric Asthma Quality of Life Questionnaire, and Asthma Control Test (ACT) or Childhood-ACT while the adult COM includes the Severe Asthma Questionnaire and the Asthma Control Questionnaire-6 (symptoms and rescue medication use reported separately).CONCLUSIONS: This patient-centred collaboration has produced two COM sets for paediatric and adult severe asthma. It is expected that they will inform the methodology of future clinical trials, enhance comparability of efficacy and effectiveness of biological therapies, and help assess their socioeconomic value. COMSA will inform definitions of non-response and response to biological therapy for severe asthma.</p