Search

River water is one of type water surface which is a lot of finding in South Kalimantan. Generally, this water used by the citizen for cooking and bathing. But along with era growth, this river becomes as disposal of various industrial waste. The contamination of heavy metal like Fe, Mn, Pb, Cd, and turbidity enhance progressively and degrade the water quality. Some natural substance which can be used to improve river water quality is active charcoal from Musa paradisiaca and Manihot utilissima shell which is easy to get. Target research is determined to find optimum dose of active charcoal from Musa paradisiaca and Manihot utilissima shell that capable to degrade heavy metal contamination and turbidity in water river. It used experimentally with pretest and post-test with control group design. A result of research showed the optimum dose of active charcoal Musa paradisiaca shell was 15 gram , it could absorb Pb 28,8% and Mn 24,6%, but 10 gram can degrade turbidity until 83,8 %, while the optimum dose of Manihot utilissima shell to 25,4% Pb and degraded 77,5% of turbidity was 15 gram. Statistical test result with Kruskal Wallis got the p-value less than 0,05 it meant there was a difference between the treatment of active charcoal from Musa paradisiaca and Manihot utilissima shell in degrading the contamination. A conclusion is those active charcoal having a potential to enhance the water river quality. Suggested to use another activator to the potential like stirring, time of contact and the different mass.

A preliminary study showed that most health workers in primary health care (PHC) claimed that they need a refreshing course because of their lack of updated knowledge and skill. This study enrolled 27 primary healthcare workers recruited from the PHC. The intervention used were classic lectures and workshops. The knowledge was evaluated using a paper-based test and practice, while the skill was evaluated using a practice test. Multiple questions (pre-test and post-test) based on current emergency management for pediatric were used for paper-based evaluation. Semi-structured interviews were conducted to confirm the subject's perspective on the intervention. A paired t-test was used for evaluating the pre- and post-test results, which was confirmed by a triangulation approach. There was a significant difference between the pre- and post-test results (p

Low Back Pain et causa Spondylosis Lumbar is a degenerative process that occurs in the corpus and the intervertebral disc due to a decrease in the density of the corpus intervertebra and narrowing of the corpus intervertebral caused thinning of the disc, along with lower back pain due to stress back muscles, tendons, ligaments with symptoms such as Local pain not accompanied by tingling, weakness or neurological disorders. Problems of physiotherapy include pain silent press and motion in the lower back spasm, decreased trunk muscle strength, range of motion limitations trunk, decreased functional activity. In this case the selected intervention technologies to overcome the above problems by using ultrasound modality, transcutaneus electrical nerve stimulation and William's flexi exercise. Design research with descriptive method used in the preparation of scientific papers is a case study. The taking of scientific papers is done in RSUD Kraton Pekalongan. Based therapy that has been done obtained the following results: (1) decrease in silent pain becomes T6 T1 = 8 = 2, the tenderness T1 = 2 to T6 = 1, and the motion pain becomes T1 = 4.8 T6 = 1, (2) a decrease in muscle spasm at T1 = spasm, at T6 = spasm but decreases, (3) an increase in muscle strength m. Flexor trunk T1 = 2 to T6 = 3, at m. extensor trunk T1 = 2 to T6 = 3, (4) an increase in the scope of flexion trunk T1 = 4 to T6 = 6, the extension trunk T1 = 4 to T6 = 6, lateral dextra trunk T1 = 3 to T6 = 8, lateral sinistra Trunk T1 = 8 to T6 = 9 (5) an increase in functional activity T1 = 18% to T6 = 2%. With the results obtained it can be concluded that the use of the modalities of physiotherapy with ultrasound, transcutaneus electrical nerve stimulation and William's flexi physiotherapy exercise can help the problems arising from low back pain lumbar spondylosis et causa.&nbsp

Oral health has improved, but the prevalence of dental caries, especially in children remains a significant clinical problem. In order to reach the target teeth healthy in 2010 according to WHO standards, we need a preventive measure. This paper will discuss the identification and assessment of risk factors for early caries, caries prevention based caries risk factors. Whole precautions either primary prevention, secondary or tertiary should be based on clinical and radiographic examination. Early detection and caries risk assessment provides an opportunity for the dentist to perform preventive dental disease before it is evident. The conclusion of this paper is that the caries risk assessment is a method to identify the risk of caries. Precautions should see the main cause of dental caries indicator.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic airway inflammation with resulting progressive airflow limitation that has a high incidence, morbidity, and mortality. Roflumilast is an oral phosphodiesterase-4 inhibitor as a therapy to decrease the risk of COPD exacerbations in patients with moderate-severe COPD with a history of chronic bronchitis. Roflumilast can be given orally once daily as a single or combination drug. It can be used as COPD moderate-severe but also more beneficial as COPD mild treatment. The efficacy of Roflumilast can prevent exacerbations of repetition and can fixed lung function both in terms of FEV1 and vital capacity to force. The incidence of side effects, which are diarrhea and digestive disorders. The cost-effectiveness showed that Quality of life patient with Roflumilast is better than the group without additional. This paper aimed to review systematically Roflumilast as COPD treatment for the clinical application.Keywords : COPD, Roflumilast, phosphodiesterase-4 inhibitorCorrespondence : fauna@staff.ubaya.ac.id

Background: Breast screening reduces breast cancer-associated morbidity and mortality, a means to early detection, also increases the chances for successful treatment and cure of the disease. This study was conducted to assess the husband's permission as a determinant of breast cancer screening among women of childbearing age in The Southwest zone, Nigeria. Method: Ex-post facto research design was used for this paper. A total sample of 768 women of childbearing age in The Southwest zone, Nigeria from a population of 8,261,284 were selected through multi-stage sampling procedures of simple random sampling, proportionate, and systematic sampling techniques. Out of the 768 copies of the questionnaire distributed, 762 were valid for analyses. Inferential statistics of a one-sample t-test was used to test the data collected at 0.05 level of significance. Results: The results revealed that husband’s permission is a determinant of breast cancer screening among women of childbearing age was significant with a t-value of 4.921 and a p-value of 0.001 at 0.05 level of significance. Conclusion: It was concluded that the husband's permission was a determinant of breast cancer screening among women of childbearing age in The Southwest zone, Nigeria. Based on the conclusion, it was recommended that husbands should be encouraged and enlightening on breast cancer and its screening in other to allow their wives to go for screening by governmental and non-governmental organizations through mass media, community, and town campaign of breast cancer screening.

Within the last few years there have been an increasing number of patients with end stage renal desease (ESRD). But the increase is not offset by the amount of the maximum service ESRD therapy. Compared with countries in the world, a renal transplant in Indonesia is still far behind. One of the hurdles is still weak due to regulatory support renal transplant in Indonesia. This article aims to look at the policy issues become an obstacle in the implementation of a renal transplant in Indonesia. This paper uses methods of regulatory reviews and articles related to a renal transplant. The analysis shows that the legal basis for a renal transplant in the form of existing legislation. However, the absence of specific regulations for a renal transplant and the decease donor in the form of technical instructions and guidelines for implementation rules became one of the obstacles in the development of renal transplantation in Indonesia. Renal transplants are covered by government funding, but still found gaps allocation of the amount of financing required a renal transplant so that implementation of clinical pathways on budgetary renal transplant is needed.

Background: Social isolation is a condition of loneliness felt by the individual being unable to make contact with other people. Social isolation can result in further on the issue of fulfillment of basic needs, so it would appear hallucinations that endanger themselves and others. Objective: The purpose of writing scientific papers to describe social changes, and socialization capabilities in social isolation’s patients using nursing care management of psychiatric specialist. Methods: Nursing orders given to 22 clients using nurses action, Social Skills Training (SST), and Cognitive-Behavioral and Social Skills Training (CBSST). Result: Results obtained reduction in social symptoms of social isolation mark that includes withdraw behaviour, interaction difficulties, refuse to communicate with others, fail to interact with others nearby, disabillity to participate in social activities, ignoring the environtment, and mistrust with others. The result also shown the improvement of socialization patient ability. Conclusion: : There were reduction in symptoms of social isolation obviously showed on social aspects as well as an increase in the client's ability to socialize. Recommendations of this study was to use a combination of measures such as nurses and specialist nurses Social Skills Training and Cognitive-Behavioral and Social Skills Training on clients with social isolation. Key Words : Social Skills Training, Cognitive-Behavioral and Social Skills Training

PENGARUH PENGENCERAN ASAM SULFOSALYSIL TERHADAP PEMERIKSAAN POSITIF PROTEIN URIN Rahma W, S.Si, M.Kes. blue4rahma@gmail.com Prodi D3 Analis Kesehatan UM Surabaya Abstract The examination of urinary protein, there are several kinds of methods that can be used is 20% sulfosalysil acid method, stick, acetate acid, bence jones, and Esbach. Sulfosalysil acid method is a non-specific indicator, the method is sensitive to the protein in a concentration of 0.002%. In the laboratory there are health centers that use sulfosalysil acid reagent for examination of urinary protein, in addition to using a stick of urine (strip dye). Reagent consumption is expected to have economic value, it is necessary dilution reagent. Dilution reagent can reduce the level of Corrosiveness to laboratory personnel, the smaller the concentration of reagent concentrations the less the level of corrosive. So it apost prandialears a formulation of the problem in this research is "Are there sulfosalysil acid dilution effect of the positive examination of urinary protein?". This type of research used in writing this paper is an experimental study. The population in this study were patients with positive urine protein urine in hospitals Dr.Soetomo Surabaya in the first week of June 2011. Samples were taken from patients with positive urine protein urine in hospitals Dr.Soetomo Surabaya in the first week of June 2011 were taken randomly . To supost prandialort this research, we used a statistical test friedman test, the results obtained friedman test p = 1.000. So there is no significant difference between giving a urine protein levels sulfosalysil acid 20%, 15%, 10%, 5%, and 1%. In this test, from acid dilution sulfosalysil same statistical results obtained, it is caused by the acid-sensitive protein sulfosalysil in a concentration of 0.002%. Therefore, when the protein concentration

Alfa mangostin, gamma-mangostin and xanthone group compounds are secondary metabolites contained in mangosteen (G. mangostana L.) which can be isolated from the fruit, bark, leaves and rind of mangosteen. All three compounds were shown to inhibit stronger against Mycobacterium tuberculosis. Alfa mangostin also active against Staphylococcus aureus and Enterococcus bacteria that are resistant to vancomisin and methicillin. Objective of this study to determine the antibacterial activity of methanol extract of mangosteen rind against Staphyllococcus aureus and Escherechia coli in vitro. Antibacterial activity test used is the diffusion wells and paper disc diffusion method. The test results obtained antibacterial activity of methanol extract of mangosteen rind can inhibit the growth of Staphyllococcus aureus at a concentration of 16%, but below its resistance zone diameter Cyprofloxacin. As against Escherichia coli, the methanol extract of mangosteen rind could not inhibit the growth of bacteria.

Background: The government issued a Delivery social insurance program (Jampersal) to reduce the Maternal and Infant Mortality Rate (MMR and IMR). Choice of aid delivery is a midwife or paraji (TBAs) in District Cirinten, Lebak, Banten. This paper reviews the diversity in the system of Maternal and Child Health Service. Methods: descriptive study, conducted in 2012 in the village Cirinten. Conducted in-depth interviews to the midwife and paraji as well as observations of the activities of service delivery by both. Results: Coverage deliveries by health workers in Cirinten health centers was 50.4% in 2011. The concept of ‘traditional’, ‘local’ and ‘modern’ is used to describe the differences between plural MCH system in a community. Three factors related to health seeking behavior that is healing factors, psychological, and sociological. Cirinten community has a continuous historical experience in a belief system that affects the choice of TBAs (paraji). Cultural contact with the medical system affect the view of society through the traditional health care system. Conclusion: Paraji as TBAs in the remote area has a role to be a mediator between the traditional and modern MCH systems. Recomendation: Utilizing paraji to advocate the health care/MCH system to public who still believe in traditional health system through establish communications between them.

Background- As an institution that has been certified by ISO 9001:2008, at the end of each semester, Responsible for Academic Administration to the Study Program/Department of Semarang Health polytechnic need to conduct surveys of students satisfaction to lecturers. Currently, the surveys are carried out with reference to the process ”paper based” so that the management takes time and requires a fee for copying questionnaire. The purpose of research- This study aims to develop an effective and efficient internet-based system administration on the implementation of student satisfaction surveys to the lecturers in terms of both energy and costs. Research Methods- This research is a quasi experiment with cross-sectional research design involving 10 Responsible for Academic Administration and 90 students in each Department/Study Program in the Semarang Health Polytechnic. Data was collected using a set of questionnaires. Results- The data analysis shows 70% of Responsible for Academic Administration said that internet-based system administration is ”effective” to conduct the implementation of student satisfaction surveys to the lecturers. Moreover, 62.2% of student respondents have a perception "good" on the implementation of the online survey system. Suggestion- It is suggested that the researcher need to explain the effectiveness and efficiency of online survey to all of Heads of Department/Program Study Chairs, it is important for the Heads of Department/Study Program Chairs and Director to support on the implementation of student satisfaction surveys to the lecturers, responsible for Academic Administration should avail the facility of online survey to enhance the effectiveness of time and cost efficiency in the implementation of student satisfaction surveys to the lecturers and it is important to do other researches on the effectiveness of online survey in Semarang Health Politechnic in an effort to optimize resources and improve performance to the organization

Background:Tobacco consumption can lead to the diseases that can cause death. Calculation of the experts in the Global Burden of diseases – Generating Evidence, Guiding Policy (IHME and the University of Washington), smoking is a second highest risk factor after high blood pressure (12% mortality) that results in loss of 8 years of age healthy living (8 DALY) for each individual. Tobacco atlas in 2007 referencing that Indonesia is the fourth largest tobacco-consuming country in the world after China, Russia and the United States. Indonesia has made the implementation of the National Social Security health policy in force since January 2014, an insurance that doesn’t see the participants’ risk factors because having the principle of mandatory participation. This paper would like to analyze the pattern of tobacco consumption on the health insurance participants, askes, jamsostek and jamkesmas based on Riskesdas, 2013, as a risk factor on the incidence of disease that will be borne by BPJS. Method: Bivariate analysis on Riskesdas 2013 data.Result: Jamsostek has the highest proportion of participants who consume tobacco every day as many as 26.2% of them followed by Jamkesmas (25.9%) and Askes participants (16.3%). Askes participants consume 13.6 cigarette per day, Jamsostek participants consume 12.1 stems per day and participants Jamkesmas 11.9 stems per day. Thus, if the average price of 1 stem of cigaretteis Rp 750, then the participants of Jamkesmas, Jamsostek and Askes in a month to pay as much as Rp.267.255, Rp. 273 781, and Rp. 307 412, - for cigarettes. Costs incurred by Jamkesmas participants for tobacco consumption in a month is almost 14 times the value of dues paid by the government. Rupiahs that burned into smoke and create risk factor of self and others death in Indonesia in a month in 2013 of 5.4 Trillion Rupiah in which three-quarters of amount came from Jamkesmas participants. Conclusion:The cost of tobacco consumption among smokers per day can pay the class 1 dues to 4 people’s health care. Cross-subsidies from people who are at risk and not at risk needs to be re-evaluated. Suggestion: Dues paid by the government should be examined in order not to burden the government budget.

Background:Pneumonia in children under five years old is a health problem in Indonesia. It is associated with high morbidity and mortality due to pneumonia. One of the control efforts are in recognition of the determinant factors of pneumonia in children under five, so the reduction and prevention of this disease can be done properly. This paper aims to outline some of the determinant factors of pneumonia in children under five years old in the province of East Nusa Tenggara include immunization status, nutritional status and healthy home. Methods:The data used are secondary data Provincial Health Office of East Nusa Tenggara in 2012 include data cases, nutritional status, immunization, exclusive breastfeeding and healthy home were analyzed. Results: The results indicate the scope of discovery and handling pneumonia in children under five in 2012 amounted to 19.2%, a factor of determination relating to pneumonia incidence was 59% complete immunization status, Nutritional status is less their 12.6%, 1.4% severe malnutrition, coverage exclusive breastfeeding is 49.7%, and 61.1% coverage of a healthy home. Conclusion: Cases of pneumonia in children under five in NTT has increased in 2012. The condition factor of immunization status, coverage Exclusive breastfeeding, nutritional status be a factor supporting the occurrence of pneumonia in under five. Recommendation: Suggested an improve in education about pneumonia, exclusive breastfeeding, toddler nutrition and the importance of immunization and growth monitoring sessions mobilize the community in a way increased participation posyandu cadres so as to improve immunization status and improvement of nutritional status of children under five years old.

Nyamuk Aedes aegypti dan Anopheles aconitus merupakan beberapa vektor penting pada penyakit tropis di Indonesia, antara lain seperti penyakit demam berdarah dan malaria. Salah satu cara pemberantasan nyamuk yang paling sering digunakan adalah dengan menggunakan insektisida. Penggunaan insektisida kimiawi yang bertujuan untuk membunuh nyamuk dewasa juga menimbulkan permasalahan tersendiri yaitu timbulnya resistensi nyamuk dan efek toksik pada manusia. Oleh karena itu, diperlukan insektisida alternatif yang lebih aman terhadap lingkungan yang berasal dari tanaman. Salah satunya dengan menggunakan ekstrak buah Leunca (Solanum nigrum). Buah Leunca mengandung glikoalkaloid yang beracun. Penelitian ini bertujuan untuk membuktikan ekstrak buah Leunca mempunyai potensi sebagai insektisida alami terhadap nyamuk Aedes aegypti dan Anopheles aconitus. Penelitian ini merupakan penelitian eksperimental laboratoris dengan rancangan true experimental-post test only control group design. Sampel yang digunakan adalah nyamuk Aedes aegypti dengan konsentrasi ekstrak 20%, 40%, 60%, dan 80% dan nyamuk Anopheles aconitus dengan konsentrasi ekstrak 5%, 10%, 20% dan 40%. Dilakukan penyemprotan pada glass chamber kemudian diamati sampai 20 menit, setelah itu nyamuk dipindah ke dalam paper cup dan diamati selama 24 jam. Pengulangan dilakukan sebanyak empat kali. Uji yang digunakan adalah uji Oneway Anova dengan nilai p < 0,05 dan analisis probit.Hasil uji Oneway Anova diperoleh nilai signifikansi < 0,05. Hasil penelitian menunjukkan bahwa ekstrak buah Leunca memiliki efek insektisida terhadap nyamuk Aedes aegypti dan Anopheles aconitus. Hasil analisis probit nyamuk Aedes aegypti LC50 terletak antara 69,890% dan 156,417% dengan estimasi 91,128% dan LC90 terletak antara 337,934% dan 5842,532% dengan estimasi 785,398%, sedangkan nyamuk Anopheles aconitus LC50 terletak antara 19,809% dan 33,570%. Dengan estimasi 24,767% dan LC90 terletak antara 96,540% dengan 450,875% dengan estimasi 169,046%. Peneliti menyimpulkan bahwa ekstrak buah Leunca (Solanum nigrum L.) memiliki efek insektisida terhadap nyamuk Aedes aegypti dengan konsentrasi 80% dan Anopheles aconitus dengan konsentrasi 40%.Kata Kunci: Ekstrak buah Leunca (Solanum nigrum), insektisida, Aedes aegypti, Anopheles aconitus

Background: The contradictory evidence of greater life expectancy among Indonesian female while our 2007 National Health Report, Riskesdas 2007 showed that female leads male almost in all morbidity needs explanation. Differences in health and illness patterns of men and women are attributable both to sex, or biology, and to gender, that is social factors such as powerlessness, access to resources, and constrained roles. Methods:The paper use gender perspective to analyse phenomena from the Riskesdas 2007 report. Two gender related hypotheses, one with risk factors exposure approach developed by Lois Verbrugge, and the other on female sub-ordination developed by Amartya Sen were applied to explain the health phenomena between female and male health as shown in the Riskesdas 2007 report. Results:Equal nutritional status between under-five female and male and equal access to health service in the Riskesdas 2007 report provides evidence of no gender inequality in Indonesia. Indonesian males are indeed more exposed to death relate drisk behavior, especially smoking and accidents, while Indonesian female engaged in more pro healthy behavior. But higher female morbidity and mortality related to diaorrhea demands more study exploration. Conclusion:Health status in Riskesdas 2007 shows no gender inequality in Indonesia. Higher exposure to death related risk behavior lead to higher mortality in Indonesia male, which reflects in the lower life expectancy in Indonesian male. Recommendation: Indonesian males should be more engaged in pro healthy behavior to increase their life expectancy and health promotion should be targeted to reduce death related risk behavior.

Background: Vitamin A supplementation program for postparum mothers has been implemented in lndonesia since 1996. The objective is to improve vitamin A status of postpartum mother and newborn through improvement of vitamin A status in breastmilk. However, Riskesdas 2010, across-sectional nationwide health study, reveals that the coverage is lower than in children underfives. In order to improve the coverage, there is a need to analyze factors associated with high or low coverage. The objective of this paper is to assess vitamin A coverage for postpartum mothers and factors of household, mother, access to health services that favour or limit the coverage. Methods: Riskesdas 2010 collected information on whether 19,000 samples mother 10-59 years having living children underfives received vitamin A capsules during postpartum period of the last child. A multivariate logistic regression was used to measure odd ratio. Vitamin A supplementation coverage among mother (in pospartum period) was 56.1%, varies 35-70% among provinces, higher in urban (61.4%) than in rural areas (50.8%). Gdd ratios of mothers who didn't receive capsule are significantlyassociated with not having neonatal care (AGR = 2,334, 95% CI 2,156-2,530), not receiving iron tablet during pregnancy (AGR = 2,076,95% CI 1,874-2,298), ANC 3 times or less (AGR = 1.252,95% CI 1,095-1,431), without ANC (AGR = 1,355, 95% CI 1,217-1,510), not receiving TT immunization (AGR = 1,245, 95% CI 1, 156-1,341). The coverage is also significantly associated with not attending Posyandu, low education, did not know Polindes with AGR slightly above 1, but not associated with age and marital status. Results: The analysis shows that factors significantly associated with the coverage are mostly assessibility of health care of mothers during pregnancy and delivery High coverage of vitamin A supplementation should be improved by increasing access of women during pregnancy and delivery in community and health education on importance of vitamin A supplementation. Key words: vitamin A supplementation, post-partum mothers, acces to health services, household characteristics ABSTRAK Program suplementasi kapsul vitamin A pada ibu nifas di lndonesia sejak 1996 bertujuan meningkatkan status vitamin A ibu nifas dan diteruskan ke bayi melalui ASI. Riskesdas 2010 menunjukkan hanya satu dari 2 ibu nifas mendapatkan kapsul vitamin A, lebih rendah dibanding cakupan balita. Tulisan ini bertujuan menganalisis faktor rumah tangga, ibu, dan akses pelayanan kesehatan yang berperan dalam cakupan kapsul vitamin A pada ibu nifas. Penelitian menggunakan data sekunder Riskesdas 2010, mencakup 19.000 ibu 10-59 tahun yang ditanyakan mendapat kapsul vitamin A saat masa nifas anak terakhir yang lahir pada periode lima tahun terakhir. Analisis regresi logistik multivariat dilakukan untuk mengetahui odd rasio cakupan kapsul vitamin A. Cakupan suplementasi vitamin A ibu nifas 56,1% bervariasi 35-70% antar provinsi, lebih tinggi di perkotaan (61,4%) dibandingkan perdesaan (50,8%). Analisis multivariat menunjukkan odd rasio ibu nifas tidak menerima kapsul vitamin A berhubungan nyata jika bayinya tidak mendapatkan pemeriksaan neonatus (AGR = 2,334 95% CI 2, 156-2,530), ibu tidak mendapatkan pil besi (AGR = 2,076,95% CI 1,874-2,298), periksa hamil 1-3 kali (AGR = 1.252,95% CI 1,095-1,431), atau tidak periksa hamil (AGR = 1,355, 95% CI 1,217-1,510), tidak imunisasi TT (AGR = 1,245,95% CI 1, 156-1,341). Cakupan juga berhubungan nyata dengan tidak ke posyandu, tidak tahu lokasi polindes atau RS, pendidikan ibu rendah, tinggal di perdesaan walaupun dengan nilai AGR mendekati nilai 1, tetapi tidak nyata dengan umur dan status perkawinan ibu. Nilai AGR menunjukkan akses pelayanan kesehatan sejak kehamilan sampai persalinan merupakan faktor utama tingginya cakupan suplementasi vitamin A. Cakupan masih perlu ditingkatkan dengan perbaikan akses pelayanan kesehatan bumil dan persalinan di masyarakat dan penyuluhan bumiI. Kata kunci; suplementasi vitamin A, ibu nifas, akses pelayanan kesehatan, karakteristik rumah tangga

Background: Poor environmental sanitation affects the spread of disease Acute Respiratory Infection (ARI). ln the Basic Health Survey (Riskesdas) data Acute Respiratory Infections (ARI) asked without known cause. The aim of this paper is to describe of the relationship raising poultry as one of environmental sanitation variables with the incidence of ARI in high prevalence provinces in lndonesia. Methods: The crosss sectional study used from Basic Health Survey (Riskesdas) data at 2007. Respondents ISPA is the respondents who had been diagnosed with ARI by medical personnel and have symptoms of respiratory infection during 12 months ago. Results: Ofthe 266,302 respondents, 25.703 (9.6%) of respondents diagnosed and had symptoms of ARI. Tendency of the risk of ARI varies each determinant variable. Among others, the risk propensity of respondents who have caged birds without having the risk 0.97 times (ORA = 1.01, 95% CI = 0.97 to 1.06) were the respondents who raise poultry are caged outside the house would be risky 1.01 (ORA = 1.04, 95% CI = 1.01 to 1.21) were the respondents who raise poultry are caged in the home would risk 1.14 (ORA = 1.08, 95% CI = 1.02-1, 14), as a comparison is respondents who did not have poultry Conclusion: Respondents with poultry at risk of being exposed toARI after ajusted by province, age, regional administration, house near high ways, landfill, factory, terminal, repair shop, slaughter house. Key words: Livestock, poultry, accute respiratory infection, Basic Health Survey 2007 ABSTRAK Sanitasi lingkungan yang jelek berpengaruh terhadap penyebaran penyakit Infeksi Saluran Pernapasan Atas (ISPA). Data tentang penyakit infeksi saluran pernapasan atas (ISPA) ditanyakan pada Riskesdas 2007 namun tidak diketahui penyebabnya. Tujuan dari tulisan ini adalah untuk mengukur hubungan pemeliharaan unggas sebagai salah satu variabel sanitasi lingkungan dengan kejadian ISPA pada provinsi prevalensi tinggi di lndonesia. Metode penelitian Studi crossectional. Data yang dipakai adalah data riskesdas tahun 2007. Responden ISPA adalah responden yang pernah didiagnosa menderita ISPA oleh tenaga medis dan mempunyai gejala ISPA dalam kurun waktu 12 bulan yang lalu. Dari 266.302 responden, 25,703 (9,6%) responden terdiagnosa dan punya gejala ISPA. Kecenderungan risiko terkena ISPA bervariasi setiap variabel determinan. Antara lain kecenderungan risiko responden yang mempunyai unggas yang tanpa dikandangkan mempunyai risiko 0,97 kali (ORa = 1,01; 95% CI = 0,97-1,06) sedang responden yang memelihara unggas yang dikandangkan diluar rumah akan berisiko 1,01 (ORa = 1,04;95% CI = 1,01-1,21) sedang responden yang memelihara unggas yang dikandangkan didilam rumah akan berisiko 1,14 (ORa = 1,08; 95% CI = 1,02-1,14), sebagai pembanding adalah responden yang tidak mempunyai unggas. Kesimpulan bahwa responden dengan ternak unggas mempunyai risiko terkena ISPA setelah diajust dengan provinsi, umur, daerah administrasi, jalan raya, TPA, pabrik, terminal, bengkel, rumah potong hewan. Kata kunci: Ternak unggas, kejadiaan ISPA, data riskesdas 2007

Individual research is not enough to provide inputs for policy improvement. In order that research results can be used for policy inputs, a synthesis from a number research results and packaging them into actionable messages are important methodologies that have to be mastered by researchers. By conducting synthesis of research results with the use of systematic review and packaging it in the form of actionable messages (policy brief and policy paper), a more comprehensive and balanced fact can be presented for policy makers. Systematic review comprises quantitative technique (meta-analysis) and qualitative technique (meta-synthesis). However, systematic review should be distinguished with a review that is not systematic (traditional review). Both quantitative and qualitative review possess a systematic and sequential step as that of general research methodology. Quantitative approach is identified as meta-analysis, whereas qualitative approach is identified as meta-synthesis. Within meta-synthesis, there are at least two approaches, i.e. meta-ethnography and meta-aggregation. Within the perspective of research translation, meta-aggregation is an important method in comprehending a number of qualitative research results, for providing more comprehensive and balanced facts to policy makers. Key words: systematic review, meta-analysis, meta-synthesis, meta-ethnography, meta-aggregation

Puskesmas (Pusat Kesehatan Masyarakat = Health Center) is the frontline institution responsible for providing health services to the community. A preliminary survey held in January 2008 showed the averaging low managerial skill of Head of Health Center in Blitar Regency. This research aims to assess need of training program for Head of Health Center in Blitar Regency through individual analysis of Head of Health Center. This is a survey research conducted from May 2008 until June 2008 in Blitar Regency by way of measuring the necessity of training for Head of Health Center through their individual characteristics. Done cross sectional, the information sources are 23 Head of Health Center. 5 Subheads of Blitar Regional Health Office, 21 Heads of District (Camat), 130 Staff of Health Center. and 150 Village Integrated Health Post (Posyandu) cadres. The total samplings are the Head of Health Center. Subheads of the Regional Health Office, and the Heads of District. For health personnel, the sample is taken by simple random sampling method; meanwhile the VIHP cadres are taken by cluster/area random sampling. The research result showed the managerial skill of Head of Health Center in Blitar Regency as follows: the managerial skill to manage Health Center was 39.1% in category insufficient and moderate (conceptual and technical skill); the ability to comprehend tasks and assignments as a Head of Health Center was 91.3% in category insufficient and moderate; the managerial skill in planning was 52.1% in category insufficient and moderate (conceptual, technical and human skill), the ability to implement and to control was 52.1% (conceptual, technical and human skill); the ability to supervise and reporting-recording was 43.4% (conceptual, technical and human skill); the managerial skill based on the assessment of the Subheads was 83.3% in category insufficient and moderate (conceptual,technical and human skill); the managerial skill based on: a) the assessment of the Heads of District was 95.6% in category insufficient and moderate (conceptual, technical and human skill); b) the assessment of the Health Center staff was 51.1% in category insufficient and moderate (conceptual, technical and human skill); and c) the assessment of Posyandu cadreswas 79.3% in category insufficient and moderate (technical and human skill). The completion of paper work (reporting/recording) for the overall performance of Health Center was 26.0% in category insufficient and moderate. Head of Health Center motivation was 43.4% in category insufficient and moderate. Key words: training needs assessment, head of health center, managerial skill

Background: The increasing number of children and young adults exposed to tobacco usage in the world is alarming. Indonesia is the third biggest tobacco consumer in the world after China and India. Smoking harms nearly every organ of the body, it reduce quality of life and life expectancy. Smoking causes illnesses, big economic lost and premature death. Tobacco use was the leading cause of preventable death. Smokers began at early age; they became the target of massive tobacco campaigns. Youth were vulnerable to tobacco advertising, once they began to smoke, it was difficult to quit. The Objectives of this paper is to identify tobacco usage among the Indonesian youth, to explore health problems, regulations related to tobacco consumption and efforts to implement the WHO Framework Convention on Tobacco Control. Methods: Method used is by reviewing studies and campaign information provided by researchers and practitioners in tobacco control programs. Result: Data shows that among people aged 10 to 24 years in Indonesia the current smokers were 23.7% daily smokers, 5.5% occasional smokers while the average cigarettes consumed daily were 12.2. Among lndonesian aged 13-15 years, there were 41% boys and 3.5% girls that were current cigarette smoking and 10.3% boys and 3,1% girls that had current tobacco other than cigarette. It is important that this preventable epidemic becomes a top public health issue in all countries. A complete ban on all tobacco advertising, promotion and sponsorship is a powerful tool to protect the world's youth and Indonesia should ratify tobacco ban. Key words: Indonesia, tobacco, youth, advertisement

This is a exploration study with the objective to analyze the development of Health Reproductive Center in Health Policy and System Research and Development Center in Surabaya. Data which was collected included Health Reproductive Center's programs, its capabilities and stakeholders expectanctes. Data was collected using questionaires, secondary data and assessing papers by fasilitators on the health reproductive workshop. Results of this study was that the development of the Health Reproductive Center must be done to support the health reproductive program of Health Department. Expectancies of stakeholders is that Health Reproductive Center should do their functions comprehensive, holistic in accordinative partnership. The recommendation was that Health Reproductive Center should be facilitated by Health Policy and System Research and Development Center to perform as the stakeholder's expectancies that is health reproductive information center to do advocacy and proposals development.Key words: health reproduction, development of health reproductive center, stakeholder expectancy

This paper describes internal quality system petformance at three Indonesian nursing schools and examines the match of the existing accreditation programmes with the developing internal quality system. A cross sectional study is used with self-administered questionnaires and applied to selected nursing schools. The questionnaire was designed according tocategories of framework of total quality management model. Interview and discussion with respondents including snowball sampling to other teachers and staffs were petformed to clarify and validate data and to enriched the information The activities measured were the enabling and the results factors. The enablers were including Leaderships, strategy, resources, human resources, educational management, teaching teaming process, research and development and also evaluation mechanism, while the results were covering students and personnel satisfaction and partnership.Results shows that some enabling factors were not included in the accreditation, while several indicators in the sub component of accreditation did not explicitly reflect internal quality system petformance. The school stratum as the outcome result of a quality measure is analogue to customer satisfaction, which would depend on direct influence of internal factors such as quality of schools leadership, strategy and educational management. Since the total accreditation score affects school strata and public recognition, it is necessary to use more objectives and relevant indicators by incorporating the internal and external factors as a measure of school quality petformances. Key words: accreditation, education, quality system evaluation, nursing

Background: At present, malaria diagnosis was based on clinical sign and symptoms confirmed with microscopy examination. Since Plasmodium falciparum was resistance to one or more/multi-drug and spreading out almost all over thecountry, and P. vivax resistance occurred in several endemic areas, the need of accuracy of the diagnosis was becomingincreasingly important. Methods: This paper discusses malaria laboratory situation analysis in two endemic areas. Two endemic areas representing Western and Eastern Part of Indonesia (Lampung and East Nusa Tenggara province) were selected. The respondents were laboratory microscopist from Province-Health Laboratories, Provinces had sufficient laoatory knowledge, except in Province Hospital laboratories. Results: The East Nusa Tenggara Province Hospital, Lampung District Health Office and Health Center (HC) laboratories had not enough light and space to work, nor running water supply. The Guideline manual for malaria examination is very limited and only available in HC. Cross check mechanism did not work well due to budget limitation. Recomendation: It was conclude that the skill and capability of the malaria microscopist in the two provinces were varying and have not met the administrative level of the laboratory yet. Cross check mechanism did not performed well, and the situation as well as condition of most laboratories were not favorable to work. We suggest that improvement of the skill and capacity of the malaria microscopist should be done periodically. Meanwhile, laboratory conditions as well as cross check mechanism should also be improved to maintain the quality of the examination results. Key words: malaria, microscopy, laboratory

Telah lama disadari bahwa menjembatani penelitian untuk perubahan kebijakan dan praktek (linking research into action) adalah masalah laten pada dunia penelitian. Untuk mengatasi masalah ini, tiada cara lain kecuali dengan mendorong produsen penelitian ke dalam dunia kebijakan dan praktek, dan juga membawa para penentu kebijakan dan praktisi ke dalam dunia penelitian. Artikel ini menyajikan bagaimana Puslitbang Sistem dan Kebijakan Kesehatan (PSKK) berusaha menjembatani penelitian untuk perubahan kebijakan dan praktik. Untuk meningkatkan implementasi hasil penelitian, PSKK mengaplikasikan manajemen penelitian dengan prinsip-prinsip CORA (Client Oriented Research Activities), yakni duduk bersama antara peneliti dengan klien mulai dari penetapan agenda riset, proposal dan protokol penelitian, sampai dengan diseminasi dan advokasi hasil penelitian (rekomendasi kebijakan atau paper kebijakan) pada forum-forum khusus kebijakan. Beberapa contoh penelitian orientasi CORA yang pernah dilaksanakan PSKK adalah penelitian pengembangan sistem kesehatan daerah, evaluasi kebijakan implementasi desentralisasi kesehatan, penelitian untuk akselerasi penurunan AKI dan AKB, dan evaluasi program Askeskin. Namun demikian, untuk menilai seberapa jauh hasil-hasil penelitian tersebut telah mempengaruhi kebijakan adalah suatu hal yang sulit, karena hasil penelitian bukanlah satu-satunya input kebijakan. Ke depan, tampaknya perlu dikembangkan koordinasi dan sinergi yang lebih mantap antara produsen penelitian dan klien (Unit Utama Depkes dan Pemerintah Daerah) sedemikian rupa sehingga penelitian menjadi alat manajemen untuk perbaikan manajemen pembangunan kesehatan baik level nasional maupun lokal. Keywords: CORA (Client Oriented Research Activities), research producers, research users

This paper describes perceptions on pregnancy - delivery and to infuence on delivery assistant in Jember. Data were collected using focus group discussion and interview with pregnant women, breast-feeding women, husbands and parents or parents in law of pregnant women, informal leaders, and health status. Pregnant women complaints, antenatal care, perception on normal pregnancy influence by socio-economic-cultural and etno-obstetri determined delivery assistant. Closeness to family, relatively cheap tariff, longer pasca delivery treatment and the same outcome of living infant were reasons for selection of traditional birth attendants. Midwife assistant was needed for un-normal delivery or complicated delivery. Fulfill the needs, better budgeting management of free treatment for poors, qualified antenatal care with minimally K4 (Presentation 4 times during pregnancy), CIE (Communication Infomafion Education) on safe delivery and pregnant women nutrition, people empowerment, and also timely pregnant-women referral may cause reduce maternal and infant death. Key words: Jember, perception on pregnancy, delivery assistant, reduce maternal death