Mendorong Keikutsertaan Suami dalam Program Keluarga Berencana Melalui Perbaikan Pemahaman tentang Metode Kontrasepsi

Partisipasi pria merupakan salah satu masalah yang masih dihadapi dalam program keluarga berencana di beberapa negara termasuk Indonesia. Program keluarga berencana yang berfokus pada kaum perempuan di tengah masyarakat yang menganut sistem patriarki menyebabkan adanya kesan bahwa perempuanlah yang memiliki tanggung jawab dalam hal pengaturan kehamilan. Program pengabdian masyarakat ini bertujuan untuk mendorong keikutsertaan suami dalam program keluarga berencana melalui perbaikan pemahaman tentang metode kontrasepsi. Setelah mengikuti kegiatan ini, diharapkan para suami memiliki wawasan yang luas tentang metode kontrasepsi. Pengabdian kepada masyarakat ini dilakukan terintegrasi melalui kegiatan Pengalaman Belajar Lapangan (PBL) Fakultas Kesehatan Masyarakat Universitas Ahmad Dahlan tahun 2020 di Dusun Modalan, Banguntapan, Bantul pada tanggal 19 sampai dengan 20 Februari 2020. Pendekatan yang dilakukan adalah melalui musyawarah masyarakat desa sebagai bentuk community engagement dan edukasi tentang mitos dan fakta seputar metode kontrasepsi dan keluarga berencana. Program pengabdian kepada masyarakat ini terbukti secara signifikan mampu meningkatkan pengetahuan pria dalam isu keluarga berencana (Mean difference=27,40; 95%CI=12,64 – 42,17; p-value=0,001). Keterlibatan masyarakat mulai dari proses penentuan prioritas masalah menjadikan intervensi yang dilakukan benar-benar merupakan kebutuhan masyarakat. Hal ini secara tidak langsung menyebabkan sasaran berpartisipasi secara aktif selama kegiatan berlangsung, sehingga pengetahuannya tentang keluarga berencana meningkat.Kata Kunci: kontrasepsi; keluarga berencana; partisipasi suami. Encouraging Male Participation in the Family Planning Program Through Improving Understanding of the Contraception MethodsABSTRACTMale involvement is one of the challenges of the family planning program in many countries, including Indonesia. The family planning program, which focuses on women in a society that adopts a patriarchal structure, causes the perception that women have responsibilities in regulating pregnancy. This community engagement initiative was developed to promote husbands' involvement in family planning programs through an increased understanding of contraceptive methods. After engaging in this activity, it is hoped that the husbands will have broad insights into contraception methods. This community development was carried out through the Field Study Experience (PBL) of Faculty of Public Health Universitas Ahmad Dahlan in Dusun Modalan, Banguntapan, Bantul, from 19 to 20 February 2020. Through village group meetings, the approach taken was a medium of community involvement and education about the rumors and truth about contraception and family planning practices. This community service initiative has been shown to substantially increase male knowledge on family planning issues (mean difference = 27.40; 95% CI = 12.64-42.17; p-value = 0.001). Community involvement in the process of determining priority problems makes interventions become a community need. This indirectly causes the target to engage actively during the activity, consequently increasing their understanding of family planning.Keywords: contraception; family planning; male involvement.

Evaluation of a collaborative pharmacy service initiative for people with intellectual disabilities in residential care homes

Introduction People with Intellectual Disabilities (ID) often have complex care needs and increased likelihood of premature death.1 The NHS has committed to improving the use of psychotropic medicines in people with ID with the Stopping the Over-Medication of People with Learning Disabilities (STOMP) programme.2 In the Wirral a cross-sector, collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmaceutical care reviews for ID care home residents, which included an evaluation of the initiative. Aim This study aimed to determine the number and type of pharmacists’ interventions and GP recommendations in this service initiative. Methods Pharmacists provided pharmaceutical care reviews for ID care home residents using a framework and where applicable made interventions or recommendations to residents’ GPs or consultant psychiatrist. The framework was devised by the lead Consultant, Mental Health Trust lead pharmacist and Local Pharmaceutical Committee representatives to align with national ID priorities.1 Pharmacists were recruited via expressions of interest and direct recruitment by the mental health trust. Using anonymised, aggregated, Clinical Commissioning Group data, an Oversight Group divided all ID care homes in the locality into two groups: homes with residents with low psychotropic medicines use were primarily assigned to community pharmacists, whilst those with higher psychotropic use were assigned to the specialist mental health pharmacist. Pharmacists contacted care home managers and arranged reviews with all residents, sharing learnings in weekly reviews. Community pharmacists identified residents who would benefit from specialist mental health pharmacist review and referred them. Data collected included patient demographic details, medication history, results of assessments completed and interventions/recommendations. Following institutional ethical approval, this data was downloaded from PharmOutcomes into Microsoft Excel and personally identifiable data removed. The data underwent descriptive statistical analysis in SPSS, including frequency counting interventions by type. Results The pharmacists conducted reviews with 160 residents (76 by community pharmacists and 84 by the specialist mental health pharmacist) from November 2019 – May 2020, reflecting all residents in visited care homes. These residents were prescribed 1207 medicines, 74% were prescribed 5 or more medicines (i.e. polypharmacy) and 507 interventions or recommendations were made, averaging 3.3 per resident. Table 1 shows that the highest proportion (30.4%) of these were public health related, whilst changing and stopping medicines accounted for 17.9% and 12.8% respectively. The majority (63%) of interventions made by community pharmacists were public health related, whilst those made by the mental health specialist pharmacist most frequently concerned changing medicines (25%), stopping medicines (18%), and blood monitoring (13%). Conclusion The study findings indicate a high level of polypharmacy among the ID residents and a high number of interventions / recommendations were needed to improve care, in line with national priorities.1,2 The small scale of the study is acknowledged, and further research is warranted. However, the findings suggest that this service model may be an effective use of the respective skill sets of the pharmacists involved and suitable for wider adoption, with community pharmacists focusing on holistic care and specialist mental health making specialist medicines interventions. References 1. University of Bristol Norah Fry Centre for Learning Disability Studies. The Learning Disability Mortality Review (LeDeR) Programme Annual Report 2018. Available at: https://www.hqip.org.uk/wp-content/uploads/2019/05/LeDeR-Annual-Report-Final-21-May-2019.pdf (last accessed 12/10/20). 2. NHS England. Stopping over medication of people with a learning disability, autism or both (STOMP). https://www.england.nhs.uk/learning-disabilities/improving-health/stomp/ (last accessed 12/10/20).

Patient Safety of Older Adults with Cognitive Impairment: Evaluation of a Service Improvement Initiative

<b>Background </b><p>The safety of older adults with cognitive impairment is linked to falls and to aggressive incidents, therefore patient safety is an important aspect of care for this group of older adults. Environmental changes to create a more ‘dementia-friendly’ setting can create a safer space for patient care. The Kings Fund Healing the Healthy Environmental tool was used to make small changes to a ward environment. The changes included; large face clocks, identification of bed spaces, lavender oil diffusor, and viewing gardens, to improve patient safety. </p> <p>Research Objectives </p> -To assess the impact of environmental changes on patient reportable events (falls and aggression) in older persons’ wards, through a comparative analysis of incidents in the wards – one (Ward A) with environmental changes and the other (Ward B) with usual environment. -To obtain staff perspectives of the changes implemented in the service initiative. <b>Method </b><p>A practice-based impact evaluation using mixed methods was undertaken to evaluate the service initiative. The methods included an analysis of data from an established database that captured reported falls and aggressive behaviour (quantitative data), and a survey of healthcare staff about the effectiveness of environmental changes (qualitative data). </p> <b>Results </b><p>The results show that the environmental changes implemented through the service initiative reduced the number of reported falls and aggressive incidents in Ward A in the high visible room. Following the environmental change, the rate of falls per 100 nights in Ward A high visible room was 2.43 compared with a rate of 3.23 times in Ward B. The number of aggressive incidents was 10 in Ward A and 9 in Ward B. The survey findings indicated staff valued the environmental changes particularly the large face clocks. </p> <b>Conclusion </b><p>While the quantitative data results are not statistically significant the results indicate that the environmental changes implemented (large face clocks, identification of bed spaces, lavender oil diffusor, and viewing gardens) led to a lower number of reportable events for falls in Ward A. Any reduction in the numbers of falls and aggressive behaviour is clinically significant given the impact of such events on patient health and length of stay. The dementia-friendly environmental changes implemented were shown to be an effective service initiative. </p> <b>Clinical and research implications </b><p>Wards that cater for older people with cognitive impairment should consider implementing low-cost environmental changes such as introducing large face clocks, clear identification of bed spaces, lavender oil diffusors, and viewing gardens. Further research using a larger patient population (a longer time frame or several wards) is required to obtain an adequately powered study. </p>

Patient Safety of Older Adults with Cognitive Impairment: Evaluation of a Service Improvement Initiative

<b>Background </b><p>The safety of older adults with cognitive impairment is linked to falls and to aggressive incidents, therefore patient safety is an important aspect of care for this group of older adults. Environmental changes to create a more ‘dementia-friendly’ setting can create a safer space for patient care. The Kings Fund Healing the Healthy Environmental tool was used to make small changes to a ward environment. The changes included; large face clocks, identification of bed spaces, lavender oil diffusor, and viewing gardens, to improve patient safety. </p> <p>Research Objectives </p> -To assess the impact of environmental changes on patient reportable events (falls and aggression) in older persons’ wards, through a comparative analysis of incidents in the wards – one (Ward A) with environmental changes and the other (Ward B) with usual environment. -To obtain staff perspectives of the changes implemented in the service initiative. <b>Method </b><p>A practice-based impact evaluation using mixed methods was undertaken to evaluate the service initiative. The methods included an analysis of data from an established database that captured reported falls and aggressive behaviour (quantitative data), and a survey of healthcare staff about the effectiveness of environmental changes (qualitative data). </p> <b>Results </b><p>The results show that the environmental changes implemented through the service initiative reduced the number of reported falls and aggressive incidents in Ward A in the high visible room. Following the environmental change, the rate of falls per 100 nights in Ward A high visible room was 2.43 compared with a rate of 3.23 times in Ward B. The number of aggressive incidents was 10 in Ward A and 9 in Ward B. The survey findings indicated staff valued the environmental changes particularly the large face clocks. </p> <b>Conclusion </b><p>While the quantitative data results are not statistically significant the results indicate that the environmental changes implemented (large face clocks, identification of bed spaces, lavender oil diffusor, and viewing gardens) led to a lower number of reportable events for falls in Ward A. Any reduction in the numbers of falls and aggressive behaviour is clinically significant given the impact of such events on patient health and length of stay. The dementia-friendly environmental changes implemented were shown to be an effective service initiative. </p> <b>Clinical and research implications </b><p>Wards that cater for older people with cognitive impairment should consider implementing low-cost environmental changes such as introducing large face clocks, clear identification of bed spaces, lavender oil diffusors, and viewing gardens. Further research using a larger patient population (a longer time frame or several wards) is required to obtain an adequately powered study. </p>

The development of aboriginal brain injury coordinator positions: a culturally secure rehabilitation service initiative as part of a clinical trial

Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage ‘on their own’ following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role of Aboriginal Brain Injury Coordinator (ABIC) to assist in navigating information and services, particularly after discharge from hospital. Eight positions for this role have been instigated across metropolitan and rural regions in the state. Healing Right Way’s aim is to enhance rehabilitation services and improve quality of life for Aboriginal Australians after brain injury. The ABIC’s role is to provide education, support, liaison and advocacy services to participants and their families over a six-month period, commencing soon after the participant’s stroke or injury has occurred. This paper outlines the development of this role, the partnerships involved, experiences to date and identifies some facilitators and barriers encountered that may impact the role’s ongoing sustainability. Details of components of the planned full Process Evaluation of Healing Right Way related to the ABIC role and the partnerships surrounding it are also provided. In combination with the trial’s ultimate results, this detail will assist in future service planning and provide a model of culturally secure care for stroke and brain injury services that can also inform other sub-acute and primary care models.

IMPLEMENTATION OF AN IMMUNISATION PROJECT FOR THE REFUGEES USING THE LOGIC MODEL

Refugees worldwide have been a challenge to many countries. Threats of preventable immunisable diseases amongst children that disrupt the herd immunity have been a concern as many countries lack a structured national policy to administer full vaccines to these refugees. Full immunisation coverage not only protected the refugees but also safeguarded the children of the home country. We designed a collaborative university-based community service partnership with UNHCR and International-Organisation-for-Migration, implemented a practice-integrated immunisation service initiative with the local community. This paper described the implementation process of an immunisation project for the refugees using the evaluative Logic Model. This model diagrammatically shows the relationships between the program's objectives, program activities, process indicators, outcomes, and resources used. It applies to program planning, operation, evaluation and address questions for decision making. The aim was to provide refugees' children below 18-years the complete doses of the national scheduled immunisation. The immunisation was given in six refugees-learning-centres in a total of 31 visits. The workflow includes administering the immunisation, health education, triaging, data collection, and monitoring the children immunised. A total of 1116 children received full immunisation within a period of eighteen months. Vaccines given were Pentavalent, Hepatitis B, Tetanus-Diphtheria, and Mumps-Measles-Rubella. This project has achieved more than 80% immunisation coverage for all the vaccines except Pentavalent (<50%). The Logic Model is useful for developing, implementing, and evaluating knowledge co-production partnerships in the context of a community delivery system in this project.

Consolidation of Aeolus FMA and FMB datasets in the DSI X-PReSS Consortium: Methodology used to generate Master Datasets and the results that have been achieved

&lt;p&gt;We present the methodology and results of the Aeolus VC01 and L0 FM-A and FM-B datasets consolidation performed by the X-PReSS team as part of the ESA (European Space Agency) Data Service Initiative (DSI) managed by ESA&amp;#8217;s Ground Segment Operations Division. The goal of this activity is to generate master datasets and gap lists as well as assess data completeness for both future ESA reprocessing campaigns and data preservation activities. The consolidation was carried out first by removing fully overlapping products, products completely covered by other products (inside) and black-listed products. Secondly, remaining products HDR and DBL files were scanned to detect filename misalignments with specifications, intra-products and inter-products gaps and corrupted products. Ancillary data from several Aeolus facilities (KSAT, DISC, FOS, PDGS) were used for gaps justification and blacklisted products identification. For FM-A VC01, 4219 products were analysed. Out of these, 3927 were classified as Master, 142 as inside, 3 as Duplicates and 147 as Blacklisted. 57 gaps were found. No data corruption was found. No duplicated source packet data was found. Consolidation results are available at ESA and includes: list of gaps with metadata and known justification, &amp;#160;list of duplicated events with metadata, list of Instrument Function IDs with metadata, master dataset list and a list of discarded products including known justification.&lt;/p&gt;

Evaluation of a structured preceptorship programme

Preceptorship is a period in which newly qualified staff nurses receive support from an experienced nurse to smooth their transition into the service. District nurses (DNs) from the authors’ trust informally expressed the need for a better transition between the completion of district nursing education and entry into the workforce. Hence, a structured preceptorship programme was developed and delivered. This article describes this service initiative and its evaluation by preceptors (n=14) and preceptees (newly qualified DNs; n=13). Both groups valued having a structured preceptorship programme. Preceptees agreed that having a named preceptor was very important, and preceptors felt that the role which they played was rewarding. Both groups felt that the role of the DN was a specialist role and that the preceptorship programme helped to support newly qualified staff make the transition into qualified DNs, clinical team leaders and, ultimately, caseload holders. A large-scale study of DN practice is required to develop a national consensus on the structure and content of preceptorship programmes for district nursing.

Development of a Drug Information Service Collaborative in Academia

Evidence-based medicine (EBM) has been positively accepted by clinicians; however, there are barriers to practicing EBM that create gaps between EBM and current clinical practice. A pharmacist-led drug information (DI) service initiative was established to overcome common barriers to practicing EBM. The service utilizes technology and a collaborative model among otherwise independent academic DI centers to provide efficient high-quality service to health care professionals. It was piloted at a large health care system with positive user satisfaction. The unique technological collaborative has shown several benefits, including increased efficiency and peer learning among DI pharmacists.