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Analysing trends and levels of the burden of disease at the national level can mask inequalities in health-related progress in lower administrative units such as provinces and districts. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to analyse health patterns in Indonesia at the provincial level between 1990 and 2019. Long-term analyses of disease burden provide insights on Indonesia's advance to universal health coverage and its ability to meet the United Nations Sustainable Development Goals by 2030.We analysed GBD 2019 estimated cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 286 causes of death, 369 causes of non-fatal health loss, and 87 risk factors by year, age, and sex for Indonesia and its 34 provinces from 1990 to 2019. To generate estimates for Indonesia at the national level, we used 138 location-years of data to estimate Indonesia-specific demographic indicators, 317 location-years of data for Indonesia-specific causes of death, 689 location-years of data for Indonesia-specific non-fatal outcomes, 250 location-years of data for Indonesia-specific risk factors, and 1641 location-years of data for Indonesia-specific covariates. For subnational estimates, we used the following source counts: 138 location-years of data to estimate Indonesia-specific demographic indicators; 5848 location-years of data for Indonesia-specific causes of death; 1534 location-years of data for Indonesia-specific non-fatal outcomes; 650 location-years of data for Indonesia-specific risk factors; and 16 016 location-years of data for Indonesia-specific covariates. We generated our GBD 2019 estimates for Indonesia by including 1 915 207 total source metadata rows, and we used 821 total citations.Life expectancy for males across Indonesia increased from 62·5 years (95% uncertainty interval 61·3-63·7) to 69·4 years (67·2-71·6) between 1990 and 2019, a positive change of 6·9 years. For females during the same period, life expectancy increased from 65·7 years (64·5-66·8) to 73·5 years (71·6-75·6), an increase of 7·8 years. There were large disparities in health outcomes among provinces. In 2019, Bali had the highest life expectancy at birth for males (74·4 years, 70·90-77·9) and North Kalimantan had the highest life expectancy at birth for females (77·7 years, 74·7-81·2), whereas Papua had the lowest life expectancy at birth for males (64·5 years, 60·9-68·2) and North Maluku had the lowest life expectancy at birth for females (64·0 years, 60·7-67·3). The difference in life expectancy for males between the highest-ranked and lowest-ranked provinces was 9·9 years and the difference in life expectacy for females between the highest-ranked and lowest-ranked provinces was 13·7 years. Age-standardised death, YLL, and YLD rates also varied widely among the provinces in 2019. High systolic blood pressure, tobacco, dietary risks, high fasting plasma glucose, and high BMI were the five leading risks contributing to health loss measured as DALYs in 2019.Our findings highlight that Indonesia faces a double burden of communicable and non-communicable diseases that varies across provinces. From 1990 to 2019, Indonesia witnessed a decline in the infectious disease burden, although communicable diseases such as tuberculosis, diarrhoeal diseases, and lower respiratory infections have remained a main source of DALYs in Indonesia. During that same period, however, all-ages death and disability rates from non-communicable diseases and exposure to their risk factors accounted for larger shares of health loss. The differences in health outcomes between the highest-performing and lowest-performing provinces have also widened since 1990. Our findings support a comprehensive process to revisit current health policies, examine the root causes of variation in the burden of disease among provinces, and strengthen programmes and policies aimed at reducing disparities across the country.The BillMelinda Gates Foundation and the Government of Indonesia.For the Bahasa Indonesia translation of the abstract see Supplementary Materials section.

Critical thinking skills are instrumental for nurses to address patients complex situations and needs to ensure continuity of care. It's aimed to identify the relationship between nurses critical thinking and clinical decision-making abilities with the quality of nursing handover. A cross-sectional, descriptive correlational study was conducted with 205 nurses. Simple random sampling was used for participant recruitment. Data were collected by a questionnaire analyzed using Pearson's correlation test. In this study, nurses had good critical thinking, clinical decision-making abilities and handover quality. There is a strong relationship between critical thinking and clinical decision-making and the quality of nursing handover (p = 0.001; r = 0.384; r = 0.247). This study confirms the relationships of nurses critical thinking and clinical decision-making abilities with the quality of nursing handover. Education level appears to have the largest influence, the results imply a need for nurses to have higher education.

Nursing delegation is one component that can improve the quality of nursing services. This study was to identify the factors associated with delegating the head nurse, as perceived by implementing nurses at the Military Hospital in Jakarta. This cross-sectional study with 227 nurses who were selected using the purposive sampling technique. The data was analyzed using the Pearson correlation test, ANOVA, and T-tests to determine the relationship between variables influencing the head nurse delegation and linear regression tests to assess the variables related most. Factors related to nurses' perceptions of head nurse delegation were age (p=0.045), education level (p=0.002), management function (p=0.020), planning function (p=0.043), workforce function (p=0.002), control function (p=0.019), leadership style (p=0.02) and communication (p=0.030). Education level emerged as the most dominant variable. This result was to provide a reference for developing standard operating procedures regarding nursing delegation based on related factors.

Knowledge of earthquake disaster mitigation is part of the preparedness efforts that all communities need, including students of vocational health The purpose of this study was to determine the relationship between knowledge of mitigation and attitudes toward disaster preparedness for students in Jakarta. The design of this study was cross-sectional study design with a sample size of 107 regular students from four departments at the Jakarta Ministry of Health Polytechnic I. The average age of the study sample was 19.94 years and most of them were women, who had never attended lecture material and seminars/training related to disasters. This research showed that there was a meaningful relationship between knowledge of mitigation and preparedness in facing earthquake (p = 0.01; α = 0.05). The results of this study recommend the importance of instilling awareness of mitigation to improve earthquake preparedness.

The objective of study is to explore the experience of the new case managers in carrying out their duties in the hospital. This study used a phenomenological approach by in-depth interview to 10 case managers (in a referral hospital in Jakarta, Indonesia) and Colaizzi's analysis method were used. Results of the study are new case managers go through a challenging adaptation process; carrying out the case manager role and functions requires extensive knowledge and skills; case managers work in a highly-structured and systematic way; case managers work to fulfill the needs of patients and families holistically. A hospital that has just established a case manager system needs to increase support case manager's skills and knowledge upgrading; Newly-Appointed Case Managers need skill in inter-professional collaboration, service coordination, and a holistic patient care approach.

Stroke may cause extensive brain damage that can hamper a patient's mobility performance to carry out their daily activities. This study aimed to examine the links between mobility performance and the self-efficacy and characteristics of stroke patients. A cross-sectional survey was undertaken at a hospital in Bandung, Indonesia. A total of 106 respondents, recruited by using consecutive sampling, filled out the Stroke Self-Efficacy and Barthel Index, together with socio-demographic questionnaires. Stroke onset, stroke type, employment status, and education level were found to have significant relationships with mobility performance (p

In this study, the composition of (1-x-y) BaTiO3-xBiFeO3-yKVO3 (x = 0.15; y = 0.01, 0.025) were successfully synthesized using a calcination at 700 °C for 2 h of mixed BaTiO3, BiFeO3, and KVO3. Previously, BaTiO3, BiFeO3, and KVO3 powders were respectively synthesized through oxalate co-precipitation, solid state reaction, and sol–gel self-combustion method. The substitution of 1 mol% and 2.5 mol% doped KVO3 successfully reduce the sintering temperature become ≈1050 °C from generally reported 1400⁰C-1500⁰C. The XRD pattern reveals the presence of a secondary phase which is also indicated by SEM images. Furthermore, the increase of KVO3 causes an increase of secondary phase then decrease the value of relative permittivity (er) and dissipation factor (tan δ).