Pemetaan Kondisi Terumbu Karang Yang Terkait Dengan Sebaran Fosfat Dan Nitrat Di Perairan Pantai Desa Karimunjawa Dengan Menggunakan Metode Sistem Informasi Geografis

Desa Karimunjawa merupakan desa dengan kepadatan penduduk tertinggi yang terdapat di Kawasan Taman Nasional Karimunjawa, didukung dengan keberadaan dua dermaga penting bagi masyarakat Kepulauan Karimunjawa yaitu Dermaga Perintis dan Dermaga Syahbandar yang menjadikannya pusat perekonomian masyarakat kepulauan Karimunjawa. Perairan Pantai Desa Karimunjawa banyak dipengaruhi oleh aktivitas manusia yang tinggi dan berpotensi dalam peningkatan kandungan nitrat (NO3-) dan fosfat (PO43-) perairan yang dapat memberikan tekanan pada ekosistem terumbu karang, sehingga diperlukan kajian untuk mengetahui kualitas air perairan pantai desa Karimunjawa khususnya nitrat, fosfat dan kondisi ekosistem terumbu karang. Penelitian ini menggunakan metode penelitian deskriptif eksploratif menggunakan metode Manta Tow untuk kondisi terumbu karang dan analisis spasial pada ArcGIS 10 untuk sebaran kualitas air. Materi yang digunakan berupa sebaran dan kondisi terumbu karang dan kualitas air perairan pantai Desa Karimunjawa. Hasil penelitian menunjukkan bahwa luas terumbu karang di perairan pantai Desa Karimunjawa yang padat penduduk adalah 149,50 m2berdasarkan analisa satelit Landsat-8 dan kondisi terumbu karang masuk dalam kategori sedang (26-50%). Kandungan fosfat perairan berkisar antara 0,12-2,19 mg/l dan kandungan nitrat perairan berkisar antara 0,04-1,33 mg/l

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely