Pengaruh Program Pemberian Makanan Tambahan terhadap Status Gizi Ibu Hamil Berisiko Kurang Energi Kronis di Kabupaten Tegal

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2018 ABSTRAK Rika Andriani Pengaruh Program Pemberian Makanan Tambahan terhadap Status Gizi Ibu Hamil Berisiko Kurang Energi Kronis di Kabupaten Tegal xiv + 55 halaman + 13 tabel + 4 gambar + 10 lampiran Di Kabupaten Tegal, pada tahun 2016 jumlah ibu hamil kurang energi kronis (KEK) yaitu 18,7 % meningkat dari 6,5 % pada tahun 2015. Pemberian makanan tambahan berupa biskuit sandwich merupakan salah satu upaya pemerintah untuk perbaikan gizi ibu hamil. Tujuan penelitian ini menganalisis pengaruh program pemberian makanan tambahan terhadap status gizi ibu hamil KEK. Jenis penelitian ini observasi analitik dengan pendekatan kuasi eksperimen. Populasi penelitian semua ibu hamil KEK di Kabupaten Tegal. Subjek penelitian 51 responden (gakin) kelompok perlakuan dan 51 bumil KEK (non gakin) kelompok kontrol. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur, pengukuran LILA (pita LILA) dan penimbangan berat badan. Data dianalisis dengan menggunakan paired t-test, Independent-test, Mann Whitney test, wilcoxon dan GLM (General Linier Model). Terdapat peningkatan LILA pada kelompok perlakuan (p=0,001) dari 22,8±1,09 cm menjadi 23,5±1,12 cm. Terdapat peningkatan LILA pada kelompok kontrol (p=0,001) dari 22,5±0,91 cm menjadi 23,0±0,92 cm. Tidak terdapat perbedaan rerata peningkatan LILA antara kelompok perlakuan (0,70±0,64) dan kelompok kontrol (0,57±0,55) diperoleh p=0,073. Peningkatan berat badan ibu hamil KEK pada kelompok perlakuan (5,5±1,10 kg) lebih tinggi daripada kelompok kontrol (4,9±0,93 kg) dengan p<0,01. Disimpulkan bahwa pemberian makanan tambahan dapat meningkatkan berat badan ibu hamil KEK. Disarankan selama pemberian makanan tambahan dilakukan pengawasan dan meningkatkan motivasi konsumsi biskuit. Kata kunci : Pemberian Makanan Tambahan, Lingkar Lengan Atas, peningkatan Berat Badan. Kepustakaan : 51 (1999-2017) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2018 ABSTRACT Rika Andriani The Influence of a Program of Providing Supplementary Feeding towards Nutritional Status of High Risk Pregnant Women with Chronic Energy Deficiency in Tegal Regency xiv + 55 pages + 13 tables + 4 figures + 10 appendices In Tegal Regency, in 2016, a proportion of pregnant women with Chronic Energy Deficiency (CED) was 18.7% and it increased from 6.5% in 2015. Providing supplementary feeding of sandwich biscuits was one of the efforts made by the government to improve their nutritional status. This study aimed at analyzing the influence of a program of supplementary feeding towards nutritional status of pregnant women with CED. This was an observational-analytic study using a quasi-experimental approach. Research population was all pregnant women with CED in Tegal Regency. Number of samples were 51 respondents (poor families) as an intervention group and 51 pregnant women with CED (not poor families) as a control group. Data were collected by conducting interview using a structured questionnaire, measuring upper arm circumference and body weight. Furthermore, data were analyzed by performing statistical tests of paired t, independent t, Mann-Whitney, Wilcoxon, and General Linear Model (GLM). Upper arm circumference among the intervention group significantly increased from 22.8±1.09 cm to be 23.5±1.12 cm (p=0.001). Similarly, upper arm circumference among the control group significantly increased from 22.5±0.91 cm to be 23.0±0.92 cm (p=0.001). Notwithstanding, there was no difference in mean increase of upper arm circumference between these both groups (0.70±0.64 in the intervention group) and (0.57±0.55 in the control group) with p=0.073. Body weight of pregnant women with CED (5.5±1.10 kg) was higher than that of in the control group (4.9±0.93 kg) with p<0.01. To sum up, providing supplementary feeding could increase body weight of pregnant women with CED. As a suggestion, monitoring and improving consumption of biscuits need to be undertaken during providing supplementary feeding. Keywords : Providing Supplementary, Upper Arm Circumference, Increasing Body Weight Bibliography: 51 (1999-2017

Perbedaan Berat Badan Lahir Bayi antara Ibu Penderita Preeklampsia dan Ibu Non Preeklampsia (Studi pada Ibu Hamil Trimester III di Rumah Sakit Umum Anutapura Palu) Sulawesi Tengah

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2018 ABSTRAK Putri Lili Heldawati Perbedaan Berat Badan Lahir Bayi antara Ibu Penderita Preeklampsia dan Ibu Non Preeklampsia (Studi pada Ibu Hamil Trimester III di Rumah Sakit Umum Anutapura Palu) Sulawesi Tengah. xv + 86 halaman + 20 tabel + 3 gambar + 13 Lampiran Preeklampsia diduga merupakan salah satu faktor risiko terjadinya berat badan lahir rendah (BBLR). Penelitian ini bertujuan membuktikan bahwa berat badan lahir bayi ibu penderita preeklampsia lebih rendah dari pada ibu non preeklampsia. Jenis penelitian observasional analitik dengan rancangan kohort prospektif. Subjek penelitian 68 orang, yang mencakup 34 ibu hamil penderita preeklampsia dan 34 non preeklampsia yang dipilih secara Purposive Sampling. Pengumpulan data dilaksanakan dengan wawancara menggunakan kuesioner terstruktur dan data sekunder dari Rumah Sakit (Berat Badan Lahir dan Panjang Badan lahir). Analisis data dilakukan dengan chi-square, Mann Whitney Test, independent T Test, dan regresi logistik. Hasil penelitian menunjukkan tidak ada perbedaan umur, pendidikan, status bekerja dan pendapatan per bulan antara ibu penderita preeklampsia dan non preeklampsia. Tidak ada perbedaan jarak kehamilan, paritas, status gizi ibu, penyakit saat hamil dan pemeriksaan Antenatal care antara ibu penderita preeklampsia dan non preeklampsia. Berat badan lahir bayi dari ibu penderita preeklampsia lebih rendah (2.650±469,1)gram, daripada ibu non preeklampsia (2.700±346,7)gram, dengan nilai p=0,022. Disarankan kepada para bidan untuk memberikan motivasi pada ibu hamil dalam melakukan pemeriksaan Antenatal care secara rutin sebagai upaya deteksi dini pencegahan preeklampsia dan BBLR. Kata kunci : Preeklampsia, Berat Badan Lahir Bayi Kepustakaan: 51 (1994-2016) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2018 ABSTRACT Putri Lili Heldawati Differences of Baby’s Birth Weight between Mothers with and without Preeclampsia (A Study on Pregnant Women Trimester III at Anutapura Public Hospital in Palu) Central Sulawesi xv + 86 pages + 20 tables + 3 figures + 13 appendices Preeclampsia is suspected to be a risk factor for Low Birth Weight Babies (LBWB). The purpose of this study was to prove that LBWB among mothers with preeclampsia was lower than mothers without preeclampsia. This was an observational-analytical study using a prospective cohort approach. Number of samples were 68 persons divided into 34 pregnant women with preeclampsia and 34 pregnant women without preeclampsia selected using a technique of purposive sampling. Data were collected by conducting interview using a structured questionnaire and collecting secondary data from a hospital (birth weight and birth height). Data were analyzed by performing tests of chi-square, Mann-Whitney, Independent T, and logistic regression. The results of this research showed that there were no differences in age, education, main occupation, and monthly income between these both groups. Similarly, there were no differences in distance of pregnancy, parity, nutritional status of mothers, disease during pregnancy, and Antenatal Care between these both groups. Mean baby’s birth weight from mothers with preeclampsia was 2,650 ± 469.1 gram lower than mothers without preeclampsia 2,700 ± 346.7 gram (p value=0.022). Midwives need to motivate pregnant women in order to undertake Antenatal Care routinely as an early detection effort to prevent preeclampsia and LBWB. Keywords : Preeclampsia, Baby’s Birth Weight Bibliography: 51 (1994-2016

Faktor Determinan Kinerja Bidan dalam Asuhan Perawatan Metode Kanguru pada Ibu Bayi Berat Lahir Rendah di Kabupaten Banyumas

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2018 ABSTRAK Naluri Widyaningsih Syamsiedi Faktor Determinan Kinerja Bidan dalam Asuhan Perawatan Metode Kanguru pada Ibu Bayi Berat Lahir Rendah di Kabupaten Banyumas xv + 99 halaman + 33 tabel + 6 gambar + 18 lampiran Bayi Berat Lahir Rendah merupakan salah satu penyebab tingginya AKB di Indonesia. Salah satu upaya untuk menyelamatkan bayi BBLR dari kematian adalah Perawatan Metode Kanguru (PMK). Pelaksanaan PMK di Kabupaten Banyumas belum optimal. Tujuan penelitian ini adalah menganalisis faktor-faktor yang berhubungan dengan kinerja bidan dalam memberikan asuhan kepada ibu bayi BBLR tentang PMK. Penelitian ini menggunakan metode kuantitatif dan kualitatif dengan responden 80 bidan yang dipilih secara clustered random sampling. Informan utama penelitian kualitatif adalah 3 bidan yang tidak melakukan PMK, kasi kesehatan keluarga, programer anak kabupaten, kepala puskesmas dan bidan koordinator. Pengumpulan data kuantitatif dilakukan dengan menggunakan wawancara terstruktur dan kualitatif dengan wawancara mendalam. Analisis data kuantitatif dengan menggunakan korelasi rank spearman dan regresi logistik untuk kualitatif dengan menggunakan content analysis. Hasil penelitian menunjukkan bahwa kinerja bidan dalam asuhan PMK masih kurang pada 41,2%, pengetahuan kurang 36,2%, persepsi kurang 45,0%, motivasi kurang 50,0%, sikap kurang 45,0%, supervisi kurang 47,5% dan kepemimpinan kurang 46,3%. Terdapat hubungan positif antara pengetahuan dengan kinerja bidan dalam asuhan PMK (r=0,37; p=0,001). Bidan dengan pengetahuan baik mempunyai kinerja asuhan PMK 5 kali lebih baik daripada bidan dengan pengetahuan kurang (Exp (B)=5,021). Persepsi, motivasi, sikap, supervisi dan kepemimpinan tidak memiliki hubungan dengan kinerja bidan dalam asuhan PMK. Kendala bidan dalam melakukan PMK adalah baju kanguru terbatas, keluarga bayi menolak dan kurangnya motivasi bidan. Penyebab bidan tidak melakukan PMK adalah kurangnya pengetahuan, motivasi, komitmen dan penolakan dari ibu/keluarga bayi. Direkomendasikan kepada Dinas Kesehatan untuk meningkatan pengetahuan dan kinerja bidan serta reward dan punisment terkait kinerja bidan. Kata kunci : Bayi Berat Lahir Rendah, Perawatan Metode Kangguru, Kinerja bidan. Kepustakaan : 69 (1964 – 2017) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2018 ABSTRACT Naluri Widyaningsih Syamsiedi Determinant Factors of Midwife’s Work Performance in the Kangaroo Care Method on Mothers of Low Birth Weight Babies in Banyumas Regency xv + 99 + 33 tables + 6 figures + 18 appendices Low birth weight babies (LBWB) are one of the main causes of Infant Mortality Rate in Indonesia. One of the efforts to save them from death is the use of the Kangaroo Care Method (KCM). The KCM in Banyumas Regency had not been optimally implemented. This study was to analyze factors related to midwife’s work performance in providing care to mothers of LBWB using the KCM. This study used quantitative and qualitative methods. Number of respondents were 80 midwives selected using a technique of clustered random sampling. For a qualitative study, main informants consisted of three midwives who did not perform the KCM, head of family health section, a programmer of child at a regency level, head of health center, and coordinator midwife. Quantitative data were collected using a structured questionnaire. On the other hand, qualitative data were collected by conducting indepth interview. Furthermore, quantitative data were analyzed using Spearman’s Rank correlation test and logistic regression test whereas qualitative data were analyzed using content analysis. The results of this research showed that the respondents had low work performance (41.2%), low knowledge (36.2%), bad perception (45.0%), low motivation (50.0%), negative attitude (45.0%), lack of supervision (47.5%), and lack of leadership (46.3%). The factor of knowledge significantly positively related to the midwife’s work performance (r=0.37; p=0.001). Midwives who had good knowledge was 5 times as likely to have good work performance than those who had low knowledge (Exp (B)=5.021). In contrast, the factors of perception, motivation, attitude, supervision, and leadership did not relate to the midwife’s work performance. Midwives had some barriers in implementing the KCM namely number of Kangaroo clothes were limited, baby’s family rejected, and midwife’s motivation was low. The causes of midwife to not implementing the KCM were low knowledge, low motivation, low commitment, and rejection from mother/family of a baby. Health Office needs to improve knowledge and midwife’s work performance and to provide a reward and a punishment related to midwife’s work performance. Keywords: Low Birth Weight Babies, Kangaroo Care Method, Midwife’s Work Performance Bibliography: 69 (1964-2017

Diversity, Dynamics and Therapeutic Application of Clostridioides difficile Bacteriophages

Clostridioides difficile causes antibiotic-induced diarrhoea and pseudomembranous colitis in humans and animals. Current conventional treatment relies solely on antibiotics, but C. difficile infection (CDI) cases remain persistently high with concomitant increased recurrence often due to the emergence of antibiotic-resistant strains. Antibiotics used in treatment also induce gut microbial imbalance; therefore, novel therapeutics with improved target specificity are being investigated. Bacteriophages (phages) kill bacteria with precision, hence are alternative therapeutics for the targeted eradication of the pathogen. Here, we review current progress in C. difficile phage research. We discuss tested strategies of isolating C. difficile phages directly, and via enrichment methods from various sample types and through antibiotic induction to mediate prophage release. We also summarise phenotypic phage data that reveal their morphological, genetic diversity, and various ways they impact their host physiology and pathogenicity during infection and lysogeny. Furthermore, we describe the therapeutic development of phages through efficacy testing in different in vitro, ex vivo and in vivo infection models. We also discuss genetic modification of phages to prevent horizontal gene transfer and improve lysis efficacy and formulation to enhance stability and delivery of the phages. The goal of this review is to provide a more in-depth understanding of C. difficile phages and theoretical and practical knowledge on pre-clinical, therapeutic evaluation of the safety and effectiveness of phage therapy for CDI

Self-avoiding walks and connective constants in small-world networks

Long-distance characteristics of small-world networks have been studied by means of self-avoiding walks (SAW's). We consider networks generated by rewiring links in one- and two-dimensional regular lattices. The number of SAW's $u_n$ was obtained from numerical simulations as a function of the number of steps $n$ on the considered networks. The so-called connective constant, $\mu = \lim_{n \to \infty} u_n/u_{n-1}$, which characterizes the long-distance behavior of the walks, increases continuously with disorder strength (or rewiring probability, $p$). For small $p$, one has a linear relation $\mu = \mu_0 + a p$, $\mu_0$ and $a$ being constants dependent on the underlying lattice. Close to $p = 1$ one finds the behavior expected for random graphs. An analytical approach is given to account for the results derived from numerical simulations. Both methods yield results agreeing with each other for small $p$, and differ for $p$ close to 1, because of the different connectivity distributions resulting in both cases.Comment: 7 pages, 5 figure

The Spectacle of Crime, Digitized

International audienceOne of the most significant features of the television series CSI: Crime Scene Investigationis its central preoccupation – forensic evidence – and the profession practised by its major characters – forensic science. Scientific inscriptions consistently allow the crime scene investigators (CSIs) to determine 'evidence' and 'truths' that otherwise elude them. At the same time, the dazzling digital effects used to punctuate key moments in each episode inevitably reference scientific technologies and the knowledge about reality that these promise. The success of the CSIs in every episode is premised upon knowledge guaranteed by scientific inscriptions and is itself an inscription of ways of seeing human bodies and the social body, represented by police scientists working to ensure public safety – a healthy social body. And it is also about how bodies, individual and social, are constituted as information, made knowable and validated by scientific instruments and procedures used to produce evidence

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Fine-Scale Mapping of the 4q24 Locus Identifies Two Independent Loci Associated with Breast Cancer Risk

Background: A recent association study identified a common variant (rs9790517) at 4q24 to be associated with breast cancer risk. Independent association signals and potential functional variants in this locus have not been explored. Methods: We conducted a fine-mapping analysis in 55,540 breast cancer cases and 51,168 controls from the Breast Cancer Association Consortium. Results: Conditional analyses identified two independent association signals among women of European ancestry, represented by rs9790517 [conditional P = 2.51 × 10−4; OR, 1.04; 95% confidence interval (CI), 1.02–1.07] and rs77928427 (P = 1.86 × 10−4; OR, 1.04; 95% CI, 1.02–1.07). Functional annotation using data from the Encyclopedia of DNA Elements (ENCODE) project revealed two putative functional variants, rs62331150 and rs73838678 in linkage disequilibrium (LD) with rs9790517 (r2 ≥ 0.90) residing in the active promoter or enhancer, respectively, of the nearest gene, TET2. Both variants are located in DNase I hypersensitivity and transcription factor–binding sites. Using data from both The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC), we showed that rs62331150 was associated with level of expression of TET2 in breast normal and tumor tissue. Conclusion: Our study identified two independent association signals at 4q24 in relation to breast cancer risk and suggested that observed association in this locus may be mediated through the regulation of TET2. Impact: Fine-mapping study with large sample size warranted for identification of independent loci for breast cancer risk