Pengukuran Antropometri Balita dan Perempuan Usia Subur Pasca Bencana Erupsi Gunung Sinabung di Desa Pertenguhen Kecamatan Simpang Empat Kabupaten Karo

<em>Indonesia is a country that is very prone to natural disasters. Nutritional problems that usually arise in natural disasters are malnutrition in the age group of infants and toddlers who do not get breast milk (ASI) because the child is separated from his mother when a natural disaster occurs. The worsening nutritional status of a group of people due to frequent delays in food aid and limited food availability in evacuation sites can exacerbate existing conditions. Nutrition problem is essentially a public health problem, however, the prevention cannot be done with a medical approach and health services. The cause of the emergence of nutritional problems is multi-factor, therefore the tackling approach involves various related sectors. Emergency nutrition management during a disaster becomes the first priority where food and nutrition services are an integral part of emergency management. Nutrition counseling provided by nutrition officers during a disaster emergency has significant meaning. Extension is an effort to change human behavior, both individuals and society so that it can create mental attitudes and the ability to solve problems it faces in order to improve and maintain good nutrition. The hope of this effort is that people can understand the importance of food and nutrition, so that they are willing to behave and act according to nutritional norms.</em>

Kolaborasi Perawat dan Ahli Gizi dalam Penanganan Masalah Gizi Balita di Wilayah Kerja Puskesmas Halmahera Barat.

ABSTRACTBackground: Nutritional status is the body's needs in the growth and development of toddlers. A recent sector study on nutrition development in Indonesia shows that the problem of child nutrition is still quite high in the community. North Maluku Province is the fourth place among the provinces which contributing nutrition problem in 2019 with a percentage of 20.9%. Good nutritional status itself is necessary to the growth and the development of toddlers. Since the number of nutritionists in North Maluku Province is still limited, this study was conducted to explore the collaboration between nutritionists and nurses in handling nutritional problems among toddlers in this province.Methods: This study used a qualitative research method and was conducted in 5 Primary Health Care Centers within the region of West Halmahera District. This research involved 15 participants consisting of nurses, nutritionists and the Heads of Primary Health Care Center. The data collection used in-depth interviews for each participant with a total of research duration of about 2 months.Result: The results showed that the collaboration between nurses and nutritionists was mainly to perform vital body examination and to give supplementary feeding for toddlers. Primary Health Care has a Plan of Action for this program of collaboration. Other than that, sometimes they provide some health education about exclusive breastfeeding, good nutritional intake and the importance of bringing toddlers to the integrated service center called Posyandu.Conclusion : Nurses and nutritionists in West Halmahera collaborate to improve toddlers nutritional status but the collaboration is still limited.

Combining Fuzzy Logic and k-Nearest Neighbor Algorithm for Recommendation Systems

Recommendation systems are a type of systems that are able to help users finding relevant and personalized content in a wide variety of possibilities. To help computers perform recommendations, there are several approaches used nowadays such as the Content-based approach, the Collaborative filtering approach and the Hybrid recommendation approach. However, these approaches are sometimes inappropriate for use cases where there is no prior large datasets of users’ feedbacks or ratings needed for training Machine Learning models. Thus, in this work, we proposed a novel approach based on the combination of Fuzzy Logic and the k-Nearest neighbor algorithm (KNN). The proposed approach can be applied without any prior collected feedbacks of users and performs good recommendations. Moreover, our proposal uses Fuzzy Logic to infer values based on inputs and a set of rules. Furthermore, the KNN uses the output values of the Fuzzy Logic system to do some retrieval tasks based on existing distance measures. In order to evaluate our approach, we considered an expert system of food recommendation for people suffering from the two deadliest diseases in Cameroon: HIV/AIDS and Malaria. The obtained results are closed to the recommendation made by nutritionists. These results demonstrate how effective our approach can be used to solve a real nutrition problem for people suffering from Malaria or HIV/AIDS. Furthermore, this approach can be extended to other fields and even be used to perform any recommendation task where there is no prior collected user’s feedback or ratings by using the proposed approach as a framework.

Association between Infectious Disease and Hygiene Practice on Stunting Toddler Aged 24-59 Months

Background : Child nutrition problem is still a major health problem in Indonesia. Toddlers are a period where children experience rapid growth and development, so they need a high nutrient. The problem of malnutrition can be identified from the children’s slow growth, one of which is in terms of body length or height. A condition where a children’s length or height is not optimal is called stunting. The incidence of stunting affected by several factors, such as infectious disease and bad hygiene practices.Method : The method of this study is observational research with case control research design. The sample of this study was grouped into two, case group and control group, with the number of each group is 28 respondents. The case group was a group of toodlers with stunting ages 24 – 59 months, while the control group was a group of toodlers ages 24 – 59 months with no stunting case. The study was conducted in Bulak Banteng Public Health work area from January - May 2019. Data collection was carried out by collecting questionnaire about infectious disease and hygiene practices which were carried out by interview and observation method. Results : The result showed that there was an influence between the incidence of infectious disease (p=0,000) (OR= -3.402), and hygiene practices (p=0,000) (OR= -2.442) on stunting.Conclusion : The conclusion in this study is that there is a significant relationship between infectious diseases and hygiene practices with the incidence of stunting in toddler aged 24-59 months (in Bulak Banteng Health Center, Surabaya).

Preoperative Nutrition Support May Reduce the Prevalence of Postoperative Pancreatic Fistula after Open Pancreaticoduodenectomy in Patients with High Nutritional Risk Determined by NRS2002

Background. Clinically relevant postoperative pancreatic fistula (CR-POPF) is a severe complication which may be caused by a perioperative nutrition problem. We aimed to study whether patients with high nutritional risk ( NRS 2002 score ≥ 5 ) might benefit from preoperative nutrition support regarding the risk of CR-POPF after open pancreaticoduodenectomy. Methods. Consecutive patients undergoing open pancreaticoduodenectomy with complete record of NRS2002 at two Chinese institutions between 2013 and 2018 were analysed. CR-POPF was diagnosed following the 2016 ISGPS criteria. Nutrition support included oral nutrition supplement and enteral and parenteral nutrition. Clinical and economic outcomes were analysed. Results. 522 cases were included. 135 cases (25.9%) were at high nutritional risk ( NRS 2002 score ≥ 5 ), among which 41 cases (30.4%) received preoperative nutrition support. The CR-POPF rate was significantly lower in the preoperative nutrition support group compared with the no nutrition support group (12.2% versus 28.7%, P = 0.038 ). Multivariate analysis showed that preoperative nutrition support was a protective factor for CR-POPF in patients at high risk [OR 0.339, 95% CI (0.115-0.965), P = 0.039 ]. Higher albumin and a larger diameter of the main pancreatic duct were found to be other protectors for CR-POPF. Conclusions. Patients with high nutritional risk ( NRS 2002 score ≥ 5 ) may profit from preoperative nutritional support manifested in the reduction of CR-POPF.

HUBUNGAN ASUPAN MAKANAN DAN KARAKTERISTIK IBU HAMIL DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS (KEK) PADA IBU HAMIL DI KOTA MATARAM

Masalah gizi di Indonesia saat ini masih merupakan salah satu masalah kesehatan yang perlu diperhatikan. Wanita umumnya mudah menderita masalah gizi terutama selama kehamilan dan laktasi karena selama periode waktu tersebut kebutuhan gizi meningkat (Rao, et al. 2010). Kekurangan Energi Kronik (KEK) adalah keadaan kekurangan asupan energi dan protein pada Wanita Usia Subur (WUS) yang berlangsung secara terus menerus dan mengakibatkan gangguan kesehatan (Depkes, 2002). Data Pemantauan Status Gizi (2017) mencatat ibu hamil resiko mengalami KEK di Nusa Tenggara Barat (NTB) adalah 17.40%. Capaian tersebut tidak sesuai dengan target yang diharapkan yaitu tidak lebih dari 15,5%. Berdasarkan data Dinas Kesehatan Kota Mataram (2016), rata-rata prevalensi ibu hamil KEK di Kota Mataram yaitu 6.09% mengalami peningkatan menjadi 13.3% pada tahun 2017. Penelitian ini bertujuan untuk menganalisis hubungan asupan makanan dan karakteristik ibu hamil dengan kejadian KEK pada ibu hamil di Kota Mataram. Metode penelitian yang digunakan adalah desain penelitian observasional dengan rancangan pengumpulan data menggunakan crossectional. Metode pengumpulan data yang digunakan adalah survei dan menggunakan kuesioner. Hasil uji statistik multivariat didapatkan variabel yang paling dominan berpengaruh tentang KEK adalah asupan makanan (OR 3.76). Kesimpulan yang diperoleh adalah terdapat hubungan yang bermakna antara asupan makanan dan pendapatan dengan KEK pada ibu hamil di Kota Mataram Tahun 2020 (p <0.05).Nutrition problem is one of the health problems that need attention in Indonesia. Women are generally prone to suffer from nutritional problems especially during pregnancy and lactation because nutritional needs increase during this period (Rao, et al. 2010). Chronic Energy Deficiency is a state of lack of energy and protein intake in Fertile Women which continues and causes health problems (Depkes, 2002). Nutrition Status Monitoring Data (2017) noted Chronic Energy Deficiency in pregnant women in West Nusa Tenggara (NTB) approximately 17.40%. This achievement did not reach the expected target that is not more than 15.5%. Based on the data from the Health Office of Mataram City (2016), the average prevalence of Chronic Energy Deficiency in pregnant women in Mataram City is about 6.09%. The cases increased into 13.3% in 2017. The aim of this study is to analyze the relationship of food intake and characteristics of pregnant women with incidence of Chronic Energy Deficiency in pregnant women in Mataram city 2020. The design of this study was observational with a cross-sectional design. A survey wethode collected the data using questionnaires. Results of statistical analysis found food intake as the most variable influencing Chronic Energy Deficiency (OR 3.76). There was a significant relationship between food intake and income with KEK in pregnant women in Mataram City in 2020 (p <0.05).

Water, Sanitation Dan Hygiene Analysis, and Individual Factors for Stunting among Children Under Two Years in Ambon

BACKGROUND: Nutrition problem is a problem that is still a threat in various countries around the world, one of which is stunting that occurs since the baby is in the womb and in the early period after the baby is born, but only appears after the child is 2 years old. AIM: This study aimed to analyze the water, sanitation and hygiene (WASH), and individual factors for the incidence of stunting in children aged 7–24 months in the slums of Ambon City. METHODS: The research was an analytical observational study using a case control study design. The population in this study was all children aged 7–24 months who suffered from stunting in Ambon. The samples were 150 child with a ratio of 1:1 for the case and control groups. RESULTS: The results showed that WASH (OR=2.7, CI 95%: 1.379–5.566) dan status Berat Badan Lahir Rendah (OR=5.1; CI 95%: 2.279–11.445) was a stunting risk factor. Meanwhile, diarrhea status (OR=2.4; CI 95%: 0.793–7.302), immunization (OR=1.4; CI 95%:0.622–3.260), and smoking history of household members (OR=1.1; CI 95%: 0.540–2.086) are risk factors, but statistically not significant. Maternal education (OR=1.0) is not a risk factor for stunting in children aged 7–24 months. CONCLUSION: The conclusion of this study is that the WASH condition and low birth weight status are risk factors for stunting in children aged 7–24 months in Ambon.

Prevalence of Geriatric Syndromes and the Need for Hospice Care in Older Patients of the Emergency Department: A Study in an Asian Medical Center

Background. The prevalence of geriatric syndromes and the need for hospice care in the emergency department (ED) in Asian populations remain unclear. This study was conducted to fill the data gap. Methods. Using a newly developed emergency geriatric assessment (EGA), we investigated the prevalence of geriatric syndromes and the need for hospice care in older ED patients of a tertiary medical center between September 1, 2016, and January 31, 2017. Results. We recruited a total of 693 patients with a mean age of 78.0 years (standard deviation 8.2 years), comprising 46.6% of females. According to age subgroups, 37.4% of patients were aged 65–74 years, 37.4% were aged 75–84 years, and 25.2% were aged ≥85 years. The prevalence rates of geriatric syndromes were as follows: delirium (11.4%), depression (23.4%), dementia (43.1%), deterioration of activities of daily living (ADL) for <1 year (29.4%), vision impairment (22.2%), hearing impairment (23.8%), sleep disturbance (13.1%), any fall in <1 year (21.8%), polypharmacy (28.7%), pain (35.1%), pressure ulcer (5.6%), incontinence or retention (29.6%), indwelling device or physical restrain (21.6%), nutrition problem (35.7%), frequent use of medical resources (50.1%), lack of advance care planning (84.0%), caregiver problem (4.6%), socioeconomic problem (5.5%), and need for family meeting (6.2%). The need for hospice care was 11.9%. Most geriatric syndromes increased with advancing age except depression, sleep disturbance, polypharmacy, pain, nutrition problem, lack of advance care planning, caregiver problem, and socioeconomic problem. Conclusion. Geriatric syndromes and the need for hospice care were common in the older ED patients. Further studies about subsequent intervention for improving geriatric care are needed.

Program SANATA (Sayang Anak Balita) di Wilayah Posyandu RW 08 Srondol Kulon

Prevalence of malnutrition among under five years old children still high. Results of nutrition problem analyzed among under five years old children at RT 01, 02, and 03 RW 08 Srondol, Semarang City showed that overweight and stunting proportions among under five years old children were still high. This community nutrition program had objective to optimized Integrated service post (POSYANDU) function to monitor growth and development of under-five years old children (D/S ) with contribution of stakeholder, increasing maternal knowledge about complementary feeding and feeding practice for children, increasing feeding practice for under-five children, and increasing nutritional status (W/H) of under-five years old children. These community service programs were being held in December 2018 with community relation methods. This program involved stakeholders, POSYANDU cadre, and mother of overweight and stunting children at RW 08 Srondol Kulon, Banyumanik District, Semarang City. The result of “SANATA: sayang anak balita” includes : 1) there was the participation of local government for programs, increasing of POSYANDU participation (D/S) from 32,5% - 37,1%. There was an increased in mother knowledge and feeding practice. Nutritional intake of under five years old children increased and get 80-110% sufficiency for macronutrient. None children had decreased on W/H nutritional status and increasing of nutritional status (W/H) occur on 5 from 10 stunting children. We hoped that there was a sustainability of the program with knowledge updating for mothers. Reward from RW/posyandu for mother with normal nutritional status of children, haved good nutritional knowledge, and had the capability to child feeding practice would give support from them to optimized nutritional status.Keywords: nutritional status, overweight, stunting, improving nutritionAbstrak. Prevalensi masalah gizi buruk, gizi kurang, stunting, dan gizi lebih pada balita masih cukup tinggi. Hasil analisis masalah gizi pada balita di RT 01, 02, dan 03 RW 08 Srondol, Kota Semarang yaitu masih tingginya proporsi status gizi lebih dan status gizi pendek (stunting) pada balita. Program pengabdian kepada masyarakat ini bertujuan untuk mengoptimalkan fungsi posyandu dalam pemantauan tumbuh kembang anak (cakupan D/S) dengan melibatkan stakeholder terkait, meningkatkan pengetahuan ibu tentang MP-ASI dan pemberian makan pada balita, meningkatkan pola asuh ibu balita dalam pemberian makan balita sesuai kebutuhan, dan meningkatkan status gizi BB/TB pada balita. Program pengabdian kepada masyarakat ini dilaksanakan pada bulan Desember Tahun 2018 dengan metode community relation. Program melibatkan tokoh masyarakat, kader posyandu, dan ibu balita berstatus gizi lebih dan gizi pendek di wilayah RT 01, 02 dan 03 RW 08 Kelurahan Srondol Kulon Kecamatan Banyumanik, Kota Semarang. Hasil dari program SANATA: sayang anak balita ini adalah adanya partisipasi tokoh masyarakat dalam program, meningkatnya angka partisipasi posyandu (cakupan D/S) di Posyandu Mawar RW 08 yaitu dari 32,5 % menjadi 37,1 %. Terdapat peningkatan pengetahuan ibu tentang MP-ASI dan pemberian makan pada balita. Asupan zat gizi pada balita yang dilihat dari perubahan pola makan balita dapat mencapai kecukupan 80-110% zat gizi makro. Tidak terjadi penurunan status gizi BB/TB (pada 10 balita) dan terjadi peningkatan status gizi BB/TB pada 5 dari 10 balita stunting. Diharapkan adanya upaya menjaga keberlanjutan program dengan pengkayaan materi (update pengetahuan) pada ibu balita secara berkala. Penghargaan/reward/apresiasi dari pihak RW/posyandu bagi ibu yang memiliki balita berstatus gizi baik, memiliki pengetahuan gizi yang baik, serta mampu melaksanakan pola pengasuhan dan pemberian makan yang baik bagi balita akan lebih menyemangati para ibu balita dalam mengoptimalkan gizi balitanya.Kata Kunci: gizi balita, gizi lebih, stunting, perbaikan gizi