Faktor Risiko Stunting Usia 6-23 Bulan di Kecamatan Bontoramba Kabupaten Jeneponto

Stunting adalah retardasi pertumbuhan linier kurang dari -2 SD standar WHO pertumbuhan anak panjang badan menurut usia. Penelitian ini bertujuan untuk menganalisis faktor risiko stunting anak usia 6-23 bulan di Kecamatan Bontoramba Kabupaten Jeneponto. Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional study. Populasi penelitian ini sebanyak 410 set e-files data survei gizi & kesehatan ibu dan anak Kecamatan Bontoramba, Kabupaten Jeneponto 2014 dengan sampel sebanyak 350 set data yang diambil denganteknik exhaustive sampling. Data dianalisis dengan uji chi square dan regresi logistic. Hasil penelitian menunjukkan bahwa faktor risiko stunting dalam penelitian ini adalah (OR; p value), berat badan lahir rendah (OR=3,651; p=0,002), usia anak 12-23 bulan (OR=2,708; p=0,000), tinggi badan ibu <150cm dengan (OR=1,970; p=0,006), pengasuh tidak mencuci tangan menggunakan sabun (OR=1,765; p=0,021) dan imunisasi dasar yang tidak lengkap (1,640; p=0,037). Faktor risiko stunting dominan pada anak usia 6-23 bulan di Kecamatan Bontoramba Kabupaten Jeneponto adalah berat badan lahir rendah, usia anak 12-23, tinggi badan ibu <150cm, pengasuh tidak mencuci tangan menggunakan sabun dan imunisasi dasar yang tidak lengkap

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Exploration of Nutritional Knowledge Aspects of Pregnant Adolescents in Javanese Ethnicity in Ponorogo Regency, East Java

Maternal health problems are one of the main indicators of health status, namely maternal mortality. Maternal mortality is still a major public health challenge around the world, including in Indonesia. The purpose of this study was to explore aspects of nutritional knowledge related to healthy food, balanced nutrition, exclusive breastfeeding and care during teenage pregnancy for Javanese ethnicity in Ponorogo, East Java. This type of research is qualitative with a phenomenological approach. This research was conducted in June - July 2020. The main informants in this study were pregnant women aged 10-19 years in the working area of ​​the Balong Community Health Center, Ponorogo Regency. The source of the informants was determined by snowball sampling. The snowball sampling technique is a form of judgment sampling. Data collection is more emphasized through in-depth interviews (in-depth interviews), namely individual dialogue with informants obtained directly from pregnant women. The results of the study of 6 informants who were teenage pregnant women in the Balong PKM work area, Ponorogo Regency, all informants had underweight nutritional status (BMI / age) and Chronic Energy Deficiency (KEK). The knowledge explored in the form of: food for pregnant women, balanced nutrition, exclusive breastfeeding, risk of teenage pregnancy and pregnancy care. Based on the results of the interview, the informant said that foods that are good for pregnant women to consume are fruits, vegetables, milk and vitamins. Regarding balanced nutrition, all informants did not know at all what balanced nutrition for care during pregnancy, the informant said there was no difference in pregnancy care except health checks at health services, treatments such as maintaining cleanliness and regular exercise

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)