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Background: Posyandu cadres still lack the skills to measure anthropometry. Not all cadres received regular training. Objectives: This study aims to develop a training model to improve the skills of Posyandu cadres in conducting anthropometric measurements. Methods: This study used a research and development approach with two main stages. The first stage was the development of the training model. The second stage was field testing of the new training model, using a pretest-posttest control group design. The training model in the form of Training of trainers (ToT) was tested to 49 cadres in the treatment and control groups with expert resource persons, followed by grassroots training with 142 cadres in the treatment group and 146 cadres in the control group with resource persons from the ToT participants. The intervention lasted three months. The effect of applying the training model on changes in the ability of cadres in anthropometric measurements was analyzed using the General Linear Model with a significant p-value

Background: The stunting prevalence in Central Java Province remains high. Six key messages, i.e. iron tablet supplementation, healthy latrines, exclusive breastfeeding, Integrated Health Care Post (Posyandu) visit, hand washing, and Antenatal Care visit are the efforts to reduce the prevalence of stunting. Objectives: This study aimed to analyse the relationship between the behaviour of the six key messages and the stunting prevalence in four districts of Central Java Province. Methods: This cross-sectional study was conducted in Brebes Regency, Tegal Regency, Banyumas Regency, and Semarang City with 424 mothers who have under two-year-old children randomly selected as sample. Data were collected by interview using a structured questionnaire with the results grouped into attitude and practices categories. The body’s weight and length were measured by a digital scale and infantometer. Data were analysed using the chi-square test. Results: The findings indicated that 21.5% of children under two had stunting. Besides, behaviour regarding six key messages were mostly good. There was no association between mothers' iron tablet consumption behaviour and the nutritional status of under-two children. There was an association between maternal attitudes about exclusive breastfeeding and knowledge about hand washing with length for age index (p=0.004). There was also an association between antenatal care and Posyandu visits practice with weight for age index (p=0.004 and 0.018). There was a relationship between attitude regarding the use of latrines and the weight for length index (p=0.001). Conclusions: Only the key messages of exclusive breastfeeding attitude, antenatal care visit practice, Posyandu visit practice, and hand washing attitude were associated with the nutritional status of under-two children.

Latar Belakang: Kejadian stunting mempengaruhi kualitas sumber daya manusia suatu negara sehingga penting untuk dicegah dan ditanggulangi. Kasus stunting di Kecamatan Kalinyamatan Jepara meningkat dari 12,4% di tahun 2021 menjadi 18,9% di tahun 2022 dan menjadi 19,05% pada tahun 2023. Tujuan: Menganalisis determinan kejadian stunting pada anak bawah dua tahun di Kecamatan Kalinyamatan Kabupaten Jepara. Methods: Penelitian dengan studi kasus kontrol ini dilakukan pada 77 anak stunting dan 77 anak normal. Pemilihan subyek dilakukan di posyandu dengan pengunjung anak bawah dua (baduta) tahun terbanyak di semua 12 desa di Kecamatan Kalinyamatan Kabupaten Jepara yang memenuhi kriteria inklusi dan eksklusi. Penelitian ini dilaksanakan bulan Maret sampai April 2024. Pengumpulan data primer dengan wawancara menggunakan kuesioner terstruktur, keragaman makanan dengan food recall 2x24 jam dan data sekunder memakai buku Kesehatan Ibu dan Anak (KIA). Data dianalisis dengan uji chi square dan regresi logistik. Hasil: Tidak ada perbedaan proporsi jenis kelamin dan usia baduta, jumlah paritas dan usia ibu, serta status bekerja ayah antara anak stunting dan normal. Determinan kejadian stunting adalah riwayat anemia selama hamil (OR:2,75; 95% CI:1,31 – 5,78; p:0,007), ibu bekerja (OR: 2,81; 95% CI: 1,24-6,37; p:0,014), berat badan lahir rendah (OR: 3,98; 95% CI: 1,54-10,27; p:0,004), keragaman pangan yang kurang (OR: 3,71; 95% CI: 1,63-8,44; p:0,002), dan imunisasi yang tidak lengkap (OR: 4,02; 95% CI: 1,66-9,74; p:0,002). Kesimpulan: Faktor maternal (anemia selama hamil, ibu bekerja dan Berat Badan Lahir Rendah (BBLR)), keragaman pangan yang kurang, dan imunisasi dasar tidak lengkap merupakan determinan kejadian stunting pada baduta di Kecamatan Kalinyamatan Kabupaten Jepara.

Latar Belakang: Selama pandemi COVID-19, santri Madrasah Aliah (sederajat Sekolah Menengah Atas) tetap melaksanakan kegiatan belajar di sekolah, namun mereka dapat tinggal di rumah atau asrama. Perbedaan kondisi tempat tinggal ini dapat mempengaruhi skor keragaman pangan dan status gizi. Tujuan: Untuk membandingkan skor keragaman pangan dan status gizi antara santri yang tinggal di asrama dan rumah selama pandemi COVID-19. Metode: Penelitian dengan desain cross-sectional dilakukan pada 232 (116 asrama dan 116 rumah) santri dan santriwati berusia 16-18 tahun di 8 pesantren di Kecamatan Mranggen, Kabupaten Demak. Subjek dipilih melalui clustered random sampling berdasarkan kriteria inklusi dan eksklusi. Data dikumpulkan dengan kuesioner recall 2x24 jam untuk mendapatkan Individual Dietary Diversity Score (IDDS) serta pengukuran berat dan tinggi badan untuk menghitung skor-Z IMT/U. Data dianalisis dengan uji T Independent, Mann Whitney U, Chi Square, Rank Spearman dan General Linear Model. Hasil: Tidak terdapat perbedaan usia dan jumlah subjek yang terkonfirmasi COVID-19 antar subjek yang tinggal di asrama dan rumah. Rerata skor IDDS (p

BackgroundThe results of the 2021 Indonesian Nutritional Status Study (Studi Status Gizi Indonesia, SSGI) showed a 6.8% declining prevalence of stunting in Central Java from 2019 to 2021. However, the prevalence decreases in the regency level of Central Java varied from 0.1 to 20.3%. This study aimed to analyze the external and internal factors that influenced the stunting reduction prevalence in Central Java Province, Indonesia.MethodsThis qualitative study was conducted over 2 months, from April to May 2022. In-depth interviews were used to explore the supporting factors (external, internal, and strategies) and the challenges (internal, external, and solutions) in implementing stunting reduction acceleration programs. The supporting factors and challenges were compared between the groups with high Gro, Sra, Kla, and Pek (GSKP) and low Sur, Mag, Teg, and Pat (SMTP) reduction prevalence. Data were analyzed using internal factor evaluation (IFE) and external factor evaluation (EFE).ResultsIn quadrant II, the high-reduction group (GSKP) had IFE and EFE scores of 2.61 and 2.76, respectively. In quadrant IV, the low-reduction group (SMTP) had IFE and EFE scores of 1.86 and 1.62, respectively. The high-reduction group (GSKP) was better than the low-reduction group (SMTP) in using external opportunities and internal strengths by avoiding external threats and minimizing the weakness in the stunting reduction acceleration program in each area. The existence of superior programs and innovations were the strengths that differentiated the high and low groups. Conversely, the low-stunting reduction group struggled to overcome major challenges, especially lacking leadership capacity. From the outside, lack of program sustainability at the village level and budget restraint were the threats found in both groups.ConclusionCompared with the low-stunting reduction group, the high group could maximize their strengths and use the opportunities to implement stunting reduction programs.

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.

Tujuan penelitian untuk mengetahui gambaran pola makan, tabu, kejadian infeksi dan status gizi Balita SAD (Suku Anak Dalam) yang hidup di Propinsi Jambi. Jenis penilitian deskriptif analitik dengan pendekatan cross sectional. Jumlah sampel 33 Balita SAD nomaden dan 39 SAD menetap, dengan teknik sampling secara accidental. Data diperoleh dengan menggunakan kuesioner terstruktur, pengukuran status gizi dengan indeks BB/TB, observasi dan wawancara, kemudian diolah secara deskriptif dengan cross tabulasi dan Independent T Test. Hasil penelitian menunjukkan pola makan Balita SAD nomaden kurang lengkap, karena bahan makan pokok dari umbi - umbian dengan lauk hanya sayur, dibandingkan Balita SAD menetap makanan pokok dari beras, dengan sayur dan lauk nabati/hewani. Balita SAD nomaden mengkonsumsi nasi dan lauk saat menukarnya dengan hasil buruan. Semua Balita SAD nomaden tabu mengkonsumsi lauk hewani, seperti unggas, daging sapi, kecuali ikan yang dijumpai saat berburu. Balita SAD nomaden tidak ada yang mengalami infeksi, sedang yang menetap dijumpai 3 (7,69 %) Balita. Walaupun uji Independent T Test tidak ada perbedaan bermakna, tetapi kejadian status gizi kurang dengan indeks BB/TB lebih banyak dijumpai pada Balita SAD nomaden (42,4 %) dibanding SAD menetap (28,2 %). Kesimpulan Balita SAD nomaden konsumsi makanan tidak lengkap, tabu terhadap bahan makanan hewani kecuali ikan, cenderung menderita status gizi kurang.

Context: Aloe vera is a traditional medicinal plant that shows a wide range of biological activities. Previous studies demonstrated the antihyperglycemic effect of Aloe vera but with inconsistent results. Aims: To quantitatively summarize the effect of Aloe vera on fasting blood glucose in pre-diabetes and type 2 diabetes mellitus by a meta-analysis. Methods: PubMed, Scopus, Springer Link, Science Direct, Proquest, and Google Scholar were used to identify clinical trials evaluating the effect of Aloe vera on fasting blood glucose published between 2011 and 2021. The inclusion criteria were: (1) original research with a clinical trial design evaluating the effect of Aloe vera on fasting blood glucose in pre-diabetes and/or type 2 diabetes mellitus; (2) providing the data of the mean fasting blood glucose and standard deviation in both control and intervention group, and; (3) Aloe vera was used as the only intervention. The pooled effect of Aloe vera on fasting blood glucose was evaluated using the random effect model, and publication bias was assessed by Funnel plots and Fail Safe-N. Results: A total of 25 trials were included from 13 publications involving 642 patients. The results showed that Aloe vera significantly reduced fasting blood glucose (-0.35 [95% CI, -1454, -0.616] mg/dL; p

IntroductionLength for Age Z (LAZ) score determinants are complex and vary among different areas, but it is important for designing effective and efficient strategies to decrease stunting prevalence among children under 2 years. This study aimed to investigate the determinants of LAZ scores among children under 2 years in Central Java, Indonesia.MethodsThis study was conducted on the 2021 Indonesian Nutritional Status Study (INSS) dataset, which was a cross-sectional survey. Data on 3,430 children aged 6–23 months from Central Java province were derived from the 2021 INSS data. After missing data elimination, 3,238 subjects were included in the analysis. Determinant factors included direct and indirect factors. Direct factors were the mother's age, birth weight Z score (BWZ), birth length Z score (BLZ), exclusively breastfed history, dietary diversity scores (DDS), empty calorie drink consumption, unhealthy snacks consumption, and infections. Indirect factors were early initiation of breastfeeding (EIBF) and posyandu (integrated health post) utilization. Underlying factors were socioeconomic status (SES) and the mother's education. Bivariate analyses and multiple linear regressions were conducted. A path analysis with a hypothesized model based on the UNICEF conceptual framework was also performed.ResultsStunting, wasting and underweight proportions among the subjects were 19.1%, 7.6% and 12.3%, respectively. The mean LAZ scores were −0.95 ± 1.22; the mother's age was 29.7 ± 5.95 years; BWZ was −0.47 ± 0.97; BLZ was −0.55 ± 1.05; and DDS was 4.45 ± 1.51. The infection proportion among the subjects was 28%. BWZ and BLZ were positively correlated to LAZ scores, with r = 0.267 (p < 0.01) and r = 0.260 (p < 0.01), respectively. The mother's age was negatively correlated to LAZ scores with r = −0.041 (p < 0.05). Maternal education was positively correlated to SES but had no direct effect on LAZ scores. LAZ score determinants of BLZ (p < 0.001) and SES (p < 0.001) showed positive direct associations with LAZ scores, but the mother's age (p = 0.039), exclusively breastfed history (p < 0.001), and empty calorie drinks consumption (p < 0.001) had negative associations with LAZ scores.ConclusionTo prevent stunting among children aged 6–23 months in Central Java, Indonesia, intervention programs to increase the nutritional status of women at child-bearing age and nutrition education on child feeding practices should be conducted more efficiently and effectively.

Cakupan pelayanan kesehatan lansia di Kabupaten Seluma tahun 2020 sebesar 26,7% menurun dibandingkan sebelum pandemi, data tahun 2019 (47,31%). Penelitian bertujuan mendeskripsikan implementasi program posyandu lansia masa pandemi Covid-19. Jenis penelitian deskriptif dengan pendekatan kualitatif. Subjek penelitian terdiri dari 12 informan yang diplih secara purposive. Pengumpulan data melalui wawancara mendalam dan observasi dengan triangulasi sumber untuk menguji keabsahan data. Analisis data dengan metode analisis isi. Hasil penelitian menunjukkan implementasi program posyandu lansia belum optimal, terdapat ketidakpatuhan terhadap protokol kesehatan, partisipasi stakeholder minim, belum terdapat pengembangan model KIE, pelayanan posyandu lansia belum lengkap, jangkauan sasaran homecare belum maksimal karena tidak didukung upaya pemantauan kader.

Pada tahun 2018, keberhasilan ASI eksklusif di Indonesia sebesar 61,33%, DIY sebesar 74,9% pada 2017 dan Bantul sebesar 74,27% pada tahun 2017. Tujuan penelitian adalah untuk menganalisis faktor risiko kegagalan pemberian ASI eksklusif. Jenis penelitian observasi analitik, dengan desain case kontrol. Analisis data menggunakan regresi logistic. Hasilnya menunjukkan variable yang bukan merupakan faktor risiko kegagalan ASI eksklusif adalah pelaksanaan IMD, pengetahuan dan dukungan keluarga. Faktor risiko kegagalan ASI eksklusif adalah keikutsertaan Kelas Ibu Hamil, keikutsertaan KP ibu dan dukungan suami.

Anxiety in the third-trimester pregnancy can affect the physical and psychological aspects of the mother and fetus. Until now, there has been no study comparing yoga sequences that are effective in reducing anxiety levels in third-trimester primigravida. The yoga sequence will cause the heart rate to return to normal after finishing exercising, and the body will feel more comfortable. This study aims to determine the effect of antepartum yoga sequences on anxiety levels, vital sign values, and fetal heart rate in third-trimester primigravida. This study was quasi experiments with a pretest posttest control group design conducted in January-April 2022. The sampling technique used cluster sampling to determine the intervention group and control group. The intervention group was given antepartum yoga sequences for six sessions with a duration of 60 minutes, consisting of 18 respondents in A group model and 18 respondents in B group model. The control group consisting of 18 respondents, received pregnancy exercise for six sessions with a duration of 60 minutes. Data analysis using T-test. The results showed differences in the control group for anxiety (p-value = 0.042), pulse (p-value = 0.021) and respiratory frequency (0.032). In the intervention group model A, there were differences in anxiety, diastolic blood pressure, pulse, and respiratory rate with p-values ​​of 0.032, 0.005, 0.005, and 0.005, respectively. While in the intervention group model B, there were significant differences in anxiety, systolic blood pressure, diastolic blood pressure, pulse, respiratory rate, and fetal heart rate, namely p-values ​​of 0.005, 0.002, 0004, 0.005, 0.005, 0.005. The results of this study can be used by midwifery service providers as one of the complementary treatments for reducing anxiety experienced by third-trimester primigravida mothers, namely by giving antepartum yoga, which is done for 60 minutes.

Background: The occurrence of ischemia causes a loss of energy to switch to anaerobic processes resulting in acidosis due to reduced Adenosina Triphosphate (ATP). This condition makes neuron cells apoptotic. Apoptotic of several biochemical substrates in the brain, such as Glial Fibrillary Acidic Protein (GFAP) exit into the circulatory system which is associated with dysbiosis through immunological pathways. Objectives: To determine the effect of giving enteral formula containing protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels in patients with acute ischemic stroke Dr. Kariadi Hospital. Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into intervention (9 subjects) and control groups (9 subjects). The intervention group received 69 g of the powdered enteral formula three times a day for seven days. The formula contained protein (15 g), phosphatidylcholine (128 mg), phosphatidylserine (32 mg), and inulin (3 g). The subject who had diabetes mellitus received for 14 days at a dose of 34.5 g per day (7.5 g protein with additions 64mg phosphatidylcholine, 16mg phosphatidylserine, 1.5 g inulin). The control group received the standard enteral formula from the hospital, which contains (11.8 g protein without additions protein, phosphatidylcholine, phosphatidylserine, and inulin). GFAP levels by ELISA method (Enzyme-linked immunosorbent Assay) at pre and post-intervention. Results: There was a trend of decreasing GFAP levels before and after in the intervention group towards a better direction from 8.37±4.25 to 8.30±4.9 compared with the control group which experienced an increasing trend from 5.4±1.8 to 7.5±4. There was no significant difference in GFAP levels after intervention between groups (p = 0.7). Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin had no significant effect on GFAP levels.

The dietary acid load was associated with metabolic syndrome and mental health among obese college students Background: The prevalence of metabolic syndrome has been increasing every year in the young population. The western diet is one of the causes that makes excess acid in the body called a dietary acid load. On the other hand, the high dietary acid load was associated with decreased mental health status. Objective: To examine the association between dietary acid load and the risk of metabolic syndrome and mental health. Methods: This was a cross-sectional study conducted with 115 female students in Semarang aged 18-22 years. The dietary acid load was evaluated through a potential renal acid load (PRAL), the risk score for metabolic syndrome was calculated by Metabolic syndrome risk score. Mental health status was assessed through levels of self-esteem and levels of anxiety. The level of self-esteem was measured by the Rosenberg Self-Esteem Scale questionnaire, while the level of anxiety was measured by the State Anxiety Inventory questionnaire. Multiple linear regression models with adjustment for a potential cofounding variable were used to evaluate the association between dietary acid load with metabolic syndrome scores, self-esteem scores, and anxiety scores. Results: The mean PRAL score was 6.11 ± 9.72 mEq/day indicated the intake of the subjects was the dietary acid load. 13% of subjects had metabolic syndrome, and 87% had a pre-metabolic syndrome. 36.5% of the subjects have low self-esteem scores. The anxiety level score calculation shows that 59.1% of the subjects are at high risk of anxiety. Pearson test showed that PRAL scores were correlated with anxiety scores (r=0,669; p

Exposure to air pollution can increase the occurrence of oxidative stress. Research showed that guava can reduce oxidative stress in Sprague Dawley rats. This experiment investigated the effect of red guava juice on oxidative stress in toll collectors. The subjects were 20 toll collectors in the treatment group and 20 in the control group. The treatment group received 250 mL red guava juice for 21 days while the controls did not receive anything. Malondialdehyde (MDA) was measured with thiobarbituric acid (TBA) reaction, food consumption was measured by 3×24 hours’ recall. The data were analyzed by paired t-test, Wilcoxon test, independent t-test, Mann Whitney test, and general linear model. The results showed that the effect of red guava juice on the MDA level was significant in the treatment group (p

BACKGROUND: Inflammation plays an important role in the atherosclerotic process. High-sensitivity C-reactive-protein (hs-CRP) is commonly used as inflammatory biomarker. It is well known that regular physical activity lowers hs-CRP levels, while prolonged exercise induces hs-CRP elevations. However, the relationship of training and exercise characteristics with hs-CRP levels remains not well elucidated. We evaluated baseline and post-exercise hs-CRP levels and its association with training and exercise characteristics. METHODS: Eighty-eight male endurance cyclists were involved. Demographic data, health condition and training characteristics were collected. Baseline and postexercise blood-samples were collected to determine hsCRP concentrations. A hs-CRP cut-off point of 3 mg/L was used. Blood-cell count and biochemical parameters were measured at baseline. Heart rate (HR) was measured during exercise. RESULTS: Cyclists performed 7.3 hours (interquartilerange (IQR) = 5.4-7.5) of endurance exercise at intensity of 81.8 % (IQR = 74.9-85.8). Cyclists with baseline hsCRP ≥ 3 mg/L reported higher body mass, body mass index (BMI), waist-circumference and total-cholesterol. An increase in hs-CRP was following endurance exercise. Cyclists with any elevation of hs-CRP reported a higher BMI, HR during exercise and exercise intensity. Binary logistic regression analysis showed BMI (OR = 1.24, 95% CI = 1.04-1.48) and cycling distance (OR = 0.22, 95% CI = 0.06-0.76) were associated with post-exercise hs-CRP elevations. CONCLUSION: Body mass, BMI, waist-circumference, total- and HDL-cholesterol are associated with baseline hsCRP, whereas BMI and cycling distance were associated with hs-CRP elevations. These findings suggest that anthropometry parameters and lipid levels attributed to baseline hs-CRP, while anthropometry parameters and cycling intensity attributed to post-exercise hs-CRP elevations. KEYWORDS: C-reactive-protein, exercise, endurancecycling, inflammation, acute-phase-response

Background: Efforts to increase the coverage of exclusive breastfeeding require extraordinary innovation supported by many parties, such as community leaders, including Housewives Peer Group activist living as a neighborhood of lactating mothers. The aim of this study was to analyze the effect of a short course on the knowledge and practice of Housewives Peer Group activists as assistance to lactating mothers in providing exclusive breastfeeding. Methods: The method of the research was pre and post-test of quasi-experimental. The population was Housewives Peer Group activists in the working area of Tlogosari Wetan Community Health Center, Semarang City. Samples were chosen using purposive random sampling to 37 Housewives Peer Group activists. The intervention given was a short course which should be attended by the group, and the post-test was assessed 1 month after conducting the pre-test. Results: The results of the Wilcoxson Match Paired test showed differences in knowledge (P < 0.05) and practice (P < 0.05) of the Housewives Peer Group activists before and after attending a short course regarding exclusive breastfeeding and lactation management. At the end of the study, the knowledge and practice of the Housewives Peer Group activists increased by 4.21 points and 3.73 points, respectively. Conclusions: Short course on exclusive breastfeeding and lactation management significantly influences the increased knowledge and practice of Housewives Peer Group activists that further improve the quality of transferred information, monitor public health, especially to increase the coverage of exclusive breastfeeding and lactation management for breastfeeding mothers.

Latar Belakang: Penyakit kusta merupakan masalah di Indonesia yang menempati urutan ke-3 di dunia. Anak dari pasien kusta mempunyai risiko tinggi tertular penyakit kusta. Kadar antibodi IgM anti Phenolic Glicolipid-1 (PGL-1) dapat digunakan untuk mendiagnosis kusta subklinik. Tujuan: Mengevaluasi hubungan lingkungan fisik dan nonfisik rumah dengan kadar antibodi IgM anti-PGL-1 pada anak dari pasien kusta di perkampungan kusta Jepara. Metode: Penelitian observasional analitik potong lintang dengan subjek penelitian 41 anak dari pasien kusta yang berusia 6-14 tahun dan metode consecutive sampling. Pengumpulan data mengunakan kuesioner terstruktur untuk menilai intensitas kontak dan lama kontak, mengukur kelembapan, pencahayaan, suhu dan kepadatan rumah, dan pemeriksaan sampel darah untuk diperiksa kadar antibodi IgM anti-PGL-1 secara Enzyme Linked Immuno Assay (ELISA). Analisis data mengunakan korelasi rank Spearman dan Fishers’s Exact test. Hasil: Terdapat 10 anak (24,4%) yang mengalami kusta subklinik (kadar antibodi IgM anti-PGL-1 ≥ 600 m/ML). Terdapat hubungan lingkungan fisik rumah: kelembapan (r=-0,366 ; p=0,009) dan suhu rumah (r=0,342 ; p=0,014) dengan kadar antibodi IgM anti-PGL-1. Pencahayaan, kepadatan rumah, ventilasi, jenis lantai, dinding rumah, dan lingkungan nonfisik tidak berhubungan dengan kadar antibodi IgM anti-PGL-1. Simpulan: Faktor lingkungan fisik rumah suhu dan kelembapan berhubungan dengan kadar antibodi IgM anti-PGL-1, semakin tinggi suhu rumah semakin tinggi kadar antibodi IgM anti-PGL-1 dan semakin rendah kelembapan rumah semakin tinggi kadar antibodi IgM anti-PGL-1.

Total-Cholesterol (TC) to HDL-Cholesterol (HDL-C) ratio in athletes is well-known to be better than sedentary people. However, information about comparison of TC/HDL-C in different groups of cyclists based on cycling touring characteristics and anthropometry parameters is lacking. This study aimed to compare TC/HDL-C ratio between groups based on the type of tour in cyclists population. Eighty-eight participants were recruited in this cross-sectional study. Mean differences of parameters between groups was analyzed by One-Way Anova and independent t-test, whereas multivariate analyses was conducted by binary logistic-regression. P value

Background: Malondialdehyde (MDA) levels produced by oxidative stress in type 2 diabetes mellitus (T2DM) is higher than in non diabetes patients. Vitamin C and E inhibit oxidative stress and MDA production. The purpose of this study was to prove the effects of combined vitamin C and vitamin E on MDA plasma levels in T2DM patients. Methods: This double blind randomized pre post test control group design was carried out on 35 patients with T2DM without complication (age 40-60 yr) in Makassar. The treatment group (n=18) received vitamin C 250 mg/day plus vitamin E 400 IU/day and the control group (n=17) received placebo (seaweed powder 250 mg), for six weeks. Vitamin C was consumed before meal and vitamin E after meal. MDA levels were measured before and after supplementation by using TBARs method. Food intake and activity were derived from 24-hour recall method. Results: There was no different on MDA levels at baseline (p=0.151). At the end of the study, MDA levels increased in control group (5.8±2.74 to 7.2±3.00 nmol/ml; p=0.044) but not in the treatment group (7.2±2.88 to 7.7±2.02 nmol/ml; p=0.490). There was no difference in MDA alteration between the goups (p=0.316). There was no different in MDA levels at the end of the study (p=0.061) and confirmed after controlling the confounding variables: vitamin E intake and fasting blood glucose (p=0.809). Conclusion: Combined vitamin C 250 mg and vitamin E 400 IU for 6 weeks did not reduce MDA levels, but inhibit MDA production in T2DM patients.

Background : In 2013, the prevalence of stunting and severe stunting in Brebes reached 26.9 % and 16.8 %. These prevalences of stunting were higher than the stunting prevlence in Central Java Province (11.0%). This study aimed to determine risk factors of stunting among children aged 12-24 months in Brebes District. Methods: This research was conducted with a case-control design on 77 cases (stunting) and 77 controls (normal) in Brebes Subdistrict. Data on birth weight, birth length, infection history, pesticide exposure were obtained through interviews, using structured questionnaires. The analysis was conducted by calculating Odd Ratios and logistic regressions. Results : Multivariate results showed that the risk factors of stunting in children aged 12-24 months in Brebes subdistrict were low energy adequacy levels (OR =7.71; 95%CI: 3.63-16.3; p=0.001), low protein adequacy levels (OR=7.65 ; 95%CI:3.67-15.9, p=0.001); low zinc adequacy levels (OR=8.78; 95%CI:3.53-21.5, p=0,001); low birth weight (OR=3.63; 95%CI:1.65-7.96; p=0.002) and high exposure to pesticides (OR=8.48; 95%CI:3.93-18.28; p=0,001). These three variables are contributing to stunting of 45 %. Low compliance of vitamin A capsule consumption, the frequencies of diarrhea respiratory infection were not the risk factors for stunting in this study. Conclusions: The risk factors of stunting among children aged 12-24 months were low energy adequacy levels, low protein adequacy levels, low zinc adequacy levels, low birth weight and high exposure to pesticides. The highest risk was the high pesticide exposure.

Background: Anemia is the most common nutritional problem found in the world, whichal sooccurred in under five children. Anemia is one of themain nutritional problems in Indonesia. Anemia treatment by iron (Fe) supplementation the community level were not successfull yet. This research aimed to investigate the effect of sprinkle supplementation on hemoglobin level of malnourished children aged 3-5 years. Method: Randomized pretest - posttest control group design was implemented on 66 anemic malnourished children aged 3-5 years. Study was conducted in Lewimunding subdistrict. Subjects were divided into two groups, treatment and control groups. Sprinkle supplementation and nurition education were given to treatment group for 2 months, while control group were only recieved nutrition education. All subjects treated by 400 mg Albendazol before supplementation. Data were nutrient intake collected by 24 hour Recall method. Hb was measured by Cyamethaemoglobin. Data were analyzed by Mann-Whitney, Independent Sample Test, Wilcoxon Signed Ranks, Paired Test and linear regression method. Result: There was no difference in energy, protein, iron, vitamin B6, vitamin B12 and vitamin C on both treatment and control groups. There is no difference in hemoglobin levels between the groups before supplementation (p=0.290). Hemoglobin increased on treatment group from (11.14±0.85 mg/dl) to (12.31±0.55 mg/dl) with p=0.001. Hemoglobin also increased from (10,95 ± 0,71 mg/dl) to (11,81 ±0,53 mg/dl) in the control group (p=0.001). Sprinkle supplementation increased by hemoglobin level 0.69 mg/dl higher than the control group (p=0.001). Multivariate analysis that hemoglobin level increased by 0.66 mg/dl higher compared to the control group after controlled by initial hemoglobin. Conclusion: Sprinkle supplementation for two months increase hemoglobin level of anemic malnourished children.

Background In 2013, the prevalence of stunting in Central Sulawesi province was 41%, which was higher than the national prevalence of 37.2%. Complementary feeding practice, infectious disease, history of exclusive breastfeeding, birth weight and birth length were assumed to contribute to the prevalence of stunting. The objective of the present study was to identify the risk factors for stunting among children aged 12 to 24 months. Methods This study was conducted using a case control design. Subjects were children aged 12-24 months, consisting of 58 cases and 58 controls. Data were obtained with a body length infantometer. Data on complementary feeding practices, history of exclusive breastfeeding, and history of infectious diseases were obtained using questionnaires. Nutrient intakes were measured by semi quantitative food frequency questionnaires. Data on birth weight and birth length were obtained from the buku KIA (maternal and child health record). Data were analyzed by chi-square and logistic regression tests. Results There was no difference in sex, BMI, and parental education between cases and controls (p>0.05). After controlling for history of exclusive breastfeeding and birth weight, the risk factors for stunting were inappropriate complementary feeding practice in terms of quantity and quality (OR=8.26; 95% CI: 2.69-25.44), history of diarrhea (OR=4.73; 95% CI: 1.08-20.69), birth length (OR=5.11; 95% CI: 1.69-15.46) and respiratory tract infection (OR=5.30; 95% CI: 1.03-27.23). Inappropriate complementary feeding practice was the most dominant factor for stunting. Conclusion Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.

Background Pre-eclampsia is the largest direct cause (42%) of maternal mortality death in Brebes district in 2013. The cause of pre-eclampsia is not known with certainty, oxidative stress being one of its causes. The aim of this study was to determine macro- and micronutrient intakes that do not correspond to the needs, as pre-eclampsia risk factors in post-partum women. Methods The research was an observational study of case control design. Study subjects were 20-35 year-old post partum women consisting of 55 cases (pre-eclampsia) and 55 controls (non-pre-eclampsia). Nutrient intakes were measured using semi-quantitative food frequency questionnaires and data on levels of pesticide exposure, body mass index (BMI), mid-upper arm circumference (MUAC) and education were collected from structured interviews. Data was analyzed by chi-square tests and multiple logistic regression. Results There was no difference in age and MUAC between the cases and controls. Low vitamin C intake (OR: 20.93; 95% CI: 2.72 – 161.36), high polyunsaturated fatty acid intake (OR: 10.50; 95% CI: 2.47 – 44.57), and low vitamin E intake (OR: 8.57; 95% CI: 2.07 – 35.46) were pre-eclampsia risk factors after controled for pesticide exposure, BMI and education. Low vitamin C intake played the most important role in the incidence of preeclampsia. Conclusion Low vitamin C intake played the most important role toward pre-eclampsia. Greater caution is needed when issuing recommendations regarding the consumption of vitamin supplements in pregnancy, as high doses of some vitamins may be deleterious.

Background : the low dietary intake in hospitalized patients impact on low level of energy and protein adequacy. Short nutritional message and nutrition education could influence the patient’s eating practice in order to increase score of knowledge, attitude, level of energy and protein adequacy. Objective : to analyze the effects of short nutritional message and nutrition education on eating practice in hospitalized patients at Salatiga general hospital. Method : this was a quasi experimental study with control group pre-test post-test design. The treatment group (38 respondents) received hospital food (3 days) and nutritional short message and education nutrition from the nutritionist (2 days), meanwhile the control group (38 respondents) received hospital food (3 days) only. Score of knowledge and attitude were obtained from interview with questioner. Energy and protein adequacy level come from hospital food intake and recall. Results : there were no differences in nutritional knowledge score, attitude, protein and energy adequacy level before intervention in both group. Score of knowledge, attitude, level of energy and protein adequacy could be increased by short nutritional message and nutrition education (p=0,00, p=0,00, p=0,00, dan p=0,00). Short nutritional message and nutrition education was no effect on energy and protein adequacy level from food outside hospital (p=0,76 and p =0,86). Conclusion: Short nutritional message and nutrition education was increasing nutritional knowledge and attitude score, energy and protein adequacy level from hospital food and total intake.

Hyperglycemia in diabetes mellitus results in oxidative stress and increases complication development. Experimental studies have shown that chlorophyll has antioxidant activity and papaya leaves contained chlorophyll more than the other green vegetables. This study aimed to evaluate the antioxidant and hypoglycemic role in chlorophyll rich in papaya leaves on diabetic rats. Thirty six rats were randomly divided into 4 groups: without treatment (technique control/TC), diabetic (negative control/NC), diabetic with treatment A (100.3 mg/200 g BW of extract) and diabetic with treatment B (200.6 mg/200 g BW of extract). Diabetic induction was conducted by injecting streptozotocin 40 mg/kg BW intraperitoneally. Extract was given by nasogastric tube. Blood glucose level was measured using enzymatic colorimetric GOD-PAP test at before, after 20 and 40 days of treatment. Hepatic superoxide dismutation (SOD) level was measured after 40 days of treatment. Blood glucose levels in 3 diabetic groups were significantly raised after seven days of induction. In Anova and post hoc LSD analysis, both treatments had lower hepatic SOD level than TC (p=0.0001), and blood glucose level also decreased after given the treatment (p=0.0001). Treatment B had a better antioxidant and hypoglycemic role than treatment A.

Background: Stunting is associated to the developmental delays of gross motor and fine motor skills. Previous studiedstate that micronutrient supplementation has a positive effect on both motor skills development in children aged under24 months.Objective: The aim of this study was to analysis the effect of micronutrient sprinkle on motor development amongstunted children aged 24 to 48 months.Methods: A quasi-controlled experimental group study with a total of 63 stunting age 24-48 months are divided intotreatment group (31 children) and controls (32 children). Treatment group received micronutrient sprinklesupplementation once in two days for two months. Fine and gross motor development was measured by DDST II beforeand after intervention.Results: There was no difference in age, sex, energy intake, protein, zinc, folic acid and developmental delaypercentage before treatment. The percentage of fine motor delays before treatment was 48.4% in the treatment groupand 53.1% in the control group, while the percent of gross motor delay was 32.3% in the treatment group 34.4% in thecontrol group. After intervention, the percentage of fine motor developmental delays significant decreases 25.8%, in thetreatment group and 34.4% in the control group, while the percentage of gross motor delay in the control groupsignificant decreased to 12.5%, but not significant decreased to 16,1% in the treatment group. Confounding variablesin this study were include energy adequacy level, protein adequacy level, zinc, iron and folic acid. There was nodifferences percentage of developmental delays on fine motor (p= 0,514) and gross motor (p= 0,571) after theintervention and after controlling with confounding variables.Conclusion: Micronutrient sprinkle supplementation for two months did not influence the development of fine motorskills gross motor skills on stunting preschooler children age 24 to 48 months

Pemerintah Kabupaten Kebumen telah mengadakan pelatihan Contraception Technology Update (CTU) bagi Bidan. Namun tetap saja pemakaian kontrasepsi Intra Uterine Device IUD) masih di bawah target. Penelitian ini merupakan penelitian observasional dengan metode survey analitik dengan pendekatan kuantitatif dan pendekatan waktu cross sectional. Pengumpulan data menggunakan kuesioner terstruktur pada 80 responden bidan di wilayah Kabupaten Kebumen. Analisa data dilakukan dengan analisis univariat, bivariat dan multivariate. Pengetahuan, motivasi, akses, ketersediaan sumberdaya dan kebijakan dalam kategori baik, namun masih terdapat 40% bidan yang motivasinya kurang karena lebih memilih melayani kontrasepsi yang praktis, dan 31% tempat pelayanan responden tidak terdapat lembar balik. Pelayanan kontrasepsi IUD berhubungan dengan pengetahuan bidan, motivasi bidan, dan ketersediaan sumberdaya. Sedangkan akses pelayanan dan kebijakan tidak berhubungan dengan pelayanan kontrasepsi IUD. Motivasi bidan dan ketersediaan sumberdaya berpengaruh terhadap pelayanan kontrasepsi IUD.

Abstract Background: Several studies have shown that hospital patients tend to have a decrease in their nutritional status during their hospitalization period. Patient satisfactions to the food service in the hospital will influence the food intake and this food intake will have an effect on the nutritional status. Objectives: To analyze the correlation between patients satisfaction to the hospital food service, food intake, and the change in the nutritional status of patients in Sunan Kalijaga Hospital, Demak. Method: This study was an analytic observational research with a cross sectional approach. This study was done on 85 subjects of inpatients in the first, second, and third classess of Sunan Kalijaga Hospital. The dependent variable was the change in nutritional status. The independent variables were the patient satisfactions to the hospital food service and food intake. Data on patient satisfactions to the hospital food service were collected by interviews using structured questionnaires. Data on food intake of the hospital food were collected by Comstock method of the food remains after the consumption, while on food intake from of hospital were collected by 3 x 24 hour recall. The changes in nutritional status were measured by the change in BMI. Data were analyzed by correlation tests. Result: Most of subjects (97,3%) satisfied to the foodservice in the hospital. The average energy adequacy level of the hospital was 76,5 ± 9,4% and protein adequacy level was76,1± 10,3%. The average energy adequacy of out hospital food was 6,5± 6,7% and protein adequacy level was 6,7± 6,9%. The average BMI at first day were 20,0 ± 3,4 kg/m2 and at the end of hospitalization were 19,7± 3,4 kg/m2. The average decreased in this study was 0,3 ± 0,2 kg/m2. There was correlation between foodservice satisfaction and the energy (p =0,009) and protein adequacy level (p=0,015). There were correlation between food intake and energy (p= 0,0001) and protein adequacy level(p= 0,038) to the change in subjects nutritional status. There was a correlation between hospital foodservice satisfaction and the change in nutritional satisfaction (p = 0,003). Conclusion: The higher level of hospiotal foodservice satisfaction, the higher of food intake and result in smaller decrease of the nutritional status Keywords : hospital, foodservice,satisfaction, nutrition

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33,905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while high HDL (POR=0.60; 95% CI: 0.46-0.78 higher education (POR=0.64; 95% CI: 0.53-0.78) and unmarried (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions:. The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while high HDL (POR=0.60; 95% CI: 0.46-0.78 higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions:. The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity among DM subjects; while high HDL (POR=0.60; 95% CI: 0.46-0.78 higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions:. The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.