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"ABSTRAKBy 2015, 68% of deaths in Indonesia are due to non-communicable diseases (NCD) and are forecast to increase to 74% by 2030. Riskesdas data of 2013 show that 69.6% of cases of diabetes mellitus and 63.2% of cases of hypertension have not been diagnosed. The government has been trying to proactively make efforts to prevent NCD through the implementation of Posbindu (Integrated Health Post) NCD, but visit Posbindu NCD in the work area of Pasir Mulya Puskesmas, Bogor City is very diverse. The purpose of this study is to analyze the factors of management, communication, partnership, and innovation in the implementation of Posbindu NCD and determinants of the implementation of Posbindu NCD. We conducted in-depth interviews, focus group discussions, document review and observation at two Posbindu NCD with the highest number of visits and the lowest in Gunung Batu Village, Bogor City in 2017. We interviewed 15 informants, consisting of cadres, in charge of NCD Puskesmas, in charge of Puskesmas Pembantu and supervisor of Posbindu NCD. This research found 4 factors, namely management (human resources, fund, and facilities), innovation, communication and partnership that influence the result of Posbindu implementation. Therefore, to run effectively the Posbindu NCD program, then 4 of those factors need to be optimized.ABSTRAKPada tahun 2015 sebanyak 68% kematian di Indonesia disebabkan penyakit tidak menular (PTM) dan diproyeksi meningkat menjadi 74% tahun 2030. Data Riskesdas tahun 2013 menunjukkan bahwa 69,6% kasus diabetes melitus dan 63,2% kasus hipertensi belum terdiagnosis. Pemerintah proaktif melakukan upaya pencegahan PTM melaluipelaksanaan Posbindu PTM. Data kunjungan Posbindu PTM di wilayah kerja Puskesmas Pasir Mulya, Kota Bogor menunjukkan jumlah yang sangat beragam. Tujuan penelitian adalah menganalisis faktor manajemen, komunikasi, kemitraan, dan inovasi dalam pelaksanaan Posbindu PTM dan faktor penentu pelaksanaan Posbindu PTM. Disainpenelitian adalah studi kualitatif dengan metode wawancara mendalam, focus group discussion (FGD), telaah dokumen, dan observasi di dua Posbindu PTM dengan jumlah kunjungan tertinggi dan terendah di Kelurahan Gunung Batu, Kota Bogor tahun 2017. Informan penelitian sebanyak 15 orang yang terdiri dari kader, penanggung jawab program PTM Puskesmas, penanggung jawab Puskesmas Pembantu dan pembina Posbindu PTM. Penelitian menemukan terdapat perbedaan manajemen (SDM, dana, dan sarana), inovasi, komunikasi dan kemitraan antara Posbindu RW 1 dan RW 7 yang memengaruhi hasil pelaksanaan Posbindu PTM. Keempat faktor tersebut pada Posbindu dengan kunjungan terbanyak berjalan lebih optimal dibandingkan dengan Posbindu dengan kunjungan terendah. Agar program PosbinduPTM dapat berjalan efektif maka perlu optimalisasi faktor manajemen, inovasi, komunikasi dan kemitraan."

"Pada tahun 2015 kematian akibat PTM sebanyak 68 dan diproyeksikan di tahun 2030 meningkat menjadi 74 . Indonesia tahun 2013 berdasarkan data Riskesdas menunjukkan bahwa 69,6 dari diabetes melitus dan 63,2 dari hipertensi masih belum terdiagnosis. Upaya proaktif pemerintah ialah melalui pelaksanaan Posbindu PTM dimana menunjukkan jumlah kunjungan yang sangat berbeda di wilayah binaan Puskesmas Pasir Mulya. Tujuan penelitian ini adalah mengetahui lebih dalam gambaran manajemen, komunikasi, kemitraan dan inovasi dalam pelaksanaan Posbindu PTM dan faktor yang menentukan hasil evaluasi pelaksanaan Posbindu PTM. Penelitian ini merupakan studi kualitatif dengan metode wawancara mendalam, focus group discussion FGD, telaah dokumen dan observasi di dua Posbindu PTM dengan kunjungan tertinggi dan terendah pada masyarakat dengan karakteristik yang hampir sama. Hasil penelitian ini menunjukkan bahwa manajemen SDM menjadi faktor yang memberikan banyak kontribusi dalam pelaksanaan Posbindu PTM, kemudian komunikasi dan inovasi perlu didukung oleh kemitraan. Pelaksanaan Posbindu PTM didukung oleh optimalisasi faktor-faktor manajemen, komunikasi, kemitraan dan inovasi yang saling berkaitan dalam meningkatkan keberhasilan pelaksanaan.

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By 2015 the deaths due to PTM are 68% and projected in 2030 to increase to 74%. Indonesia in 2013 based on Riskesdas data shows that 69.6% of diabetes mellitus and 63.2% of hypertension are still undiagnosed. The government's proactive efforts are through the implementation of Posbindu PTM which shows a very different number of visits in the target area of the Pasir Mulya Public Health Center. The purpose of this study is to know more in the description of management, communication, partnership and innovation in the implementation of Posbindu PTM and the factors that determine the results of the evaluation of the implementation of Posbindu PTM. This study is a qualitative study with in depth interviews, focus group discussions FGD, document review and observation at two Posbindu PTM with the highest and lowest visits to people with similar characteristics. The results of this study indicate that human resource management is a contributing factor in the implementation of Posbindu PTM, communication and innovation need to be supported by partnership. The implementation of Posbindu PTM is supported by the optimization of management, communication, partnership and innovation factors that are interrelated in improving the successful implementation. "

"Pada tahun 2015 kematian akibat PTM sebanyak 68% dan diproyeksikan di tahun 2030 meningkat menjadi 74%. Indonesia tahun 2013 berdasarkan data Riskesdas menunjukkan bahwa 69,6% dari diabetes melitus dan 63,2% dari hipertensi masih belum terdiagnosis. Upaya proaktif pemerintah ialah melalui pelaksanaan Posbindu PTM dimana menunjukkan jumlah kunjungan yang sangat berbeda di wilayah binaan Puskesmas Pasir Mulya. Tujuan penelitian ini adalah mengetahui lebih dalam gambaran manajemen, komunikasi, kemitraan dan inovasi dalam pelaksanaan Posbindu PTM dan faktor yang menentukan hasil evaluasi pelaksanaan Posbindu PTM. Penelitian ini merupakan studi kualitatif dengan metode wawancara mendalam, focus group discussion (FGD), telaah dokumen dan observasi di dua Posbindu PTM dengan kunjungan tertinggi dan terendah pada masyarakat dengan karakteristik yang hampir sama. Hasil penelitian ini menunjukkan bahwa manajemen SDM menjadi faktor yang memberikan banyak kontribusi dalam pelaksanaan Posbindu PTM, kemudian komunikasi dan inovasi perlu didukung oleh kemitraan. Pelaksanaan Posbindu PTM didukung oleh optimalisasi faktor-faktor manajemen, komunikasi, kemitraan dan inovasi yang saling berkaitan dalam meningkatkan keberhasilan pelaksanaan.

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By 2015 the deaths due to PTM are 68% and projected in 2030 to increase to 74%. Indonesia in 2013 based on Riskesdas data shows that 69.6% of diabetes mellitus and 63.2% of hypertension are still undiagnosed. The government's proactive efforts are through the implementation of Posbindu PTM which shows a very different number of visits in the target area of the Pasir Mulya Public Health Center. The purpose of this study is to know more in the description of management, communication, partnership and innovation in the implementation of Posbindu PTM and the factors that determine the results of the evaluation of the implementation of Posbindu PTM. This study is a qualitative study with in-depth interviews, focus group discussions (FGD), document review and observation at two Posbindu PTM with the highest and lowest visits to people with similar characteristics. The results of this study indicate that human resource management is a contributing factor in the implementation of Posbindu PTM, communication and innovation need to be supported by partnership. The implementation of Posbindu PTM is supported by the optimization of management, communication, partnership and innovation factors that are interrelated in improving the successful implementation."

"Bervariasinya penerapan SIMPUS IHIS dan e-Health di Kabupaten Bantul membuat laporan SP2TP sebagai keluran dari SIMPUS menjadi terhambat. Dalam penerapan SIMPUS IHIS dan e-Health di Kabupaten Bantul terdapat hambatanhambatan yang perlu diperhatikan dan ditangani dengan baik agar tidak semakin kompleks. Evaluasi SIMPUS di Kabupaten Bantul dengan menggunakan metode HOT-fit digunakan untuk mengetahui sejauh mana penerapan dan kendala dalam implementasi. Metode penelitian dengan menggunakan pendekatan penelitian campuran yaitu penelitian kualitatif dan penelitian kuantitatif. Pengumpulan data dilakukan dengan wawancara mendalam, kuesioner, observasi pada Puskesmas dan dokumentasi tertulis kegiatan penerapan SIMPUS IHIS dan e-Health. Hasil penelitian menunjukkan SIMPUS IHIS dan e-Health sudah digunakan seluruh Puskesmas di Kabupaten Bantul. Faktor organisasi memberikan pengaruh terhadap berjalannya sistem, komitmen Kepala Puskesmas tidak dijabarkan dalam bentuk operasional teknis seperti pembentukan tim SIK dan tidak dibuatnya SOP dalam penerapan SIMPUS IHIS dan e-Health.

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The variations in the application of SIMPUS IHIS and e-Health in Bantul detain SP2TP reports as the output of SIMPUS. There are obstacles in the application of SIMPUS IHIS and e-Health in Bantul that need to be considered and dealt with in order not to become more complex. The evaluation of SIMPUS in Bantul using HOT-fit method is used to determine the effectiveness of implementation and the constraints in implementation. The research uses both qualitative research and quantitative research. Data was collected through in-depth interviews, questionnaires, observation and written documentations on the SIMPUS IHIS and e-Health application. The results shows that SIMPUS IHIS and e-Health have been used in all Puskesmas in Bantul. Organizational factors impact the run of the system, head of the health center's commitment is not described in technical operations such as forming SIK team and SIMPUS IHIS and e-Health SOP is not determined."

"The National Health Insurance (NHI) Program was implemented in Indonesia on January 1st 2014. This program definitely brings some changes into managerialaspect in public health center (PHC). This study aimed to determine an impact of NHI policy in the implementation of health promotion programs at PHCin South Tangerang City, Indonesia. This study was conducted using qualitative method during February and March 2016. The impact of NHI is seen on policy,budget, equipment, human resource and implementation of health promotion program. With purposive sampling method, six policy makers, eight serviceproviders and eight service users were selected for in-depth interview. 17 documents were analyzed. Observation was conducted at four selected PHC’s.Data analysis used thematic content analysis. There was no difference of PHC’s functions before and after NHI period. Budget expended for health promotionprograms increased after NHI was implemented which could represent an opportunity for PHC to innovate, procure materials and implement better healthpromotion programs. Capitation budget which could be used for executing health promotion program and some recently implemented health promotion programsin the NHI era evidences that NHI policy has a positive impact on the implementation of health promotion programs at PHC.Jaminan Kesehatan Nasional (JKN) telah diimplementasikan di Indonesia pada 1 Januari 2014. Hal tersebut membawa beberapa perubahan pada aspekmanajerial pada pusat kesehatan masyarakat (puskesmas). Penelitian ini bertujuan untuk mengidentifikasi dampak dari kebijakan JKN terhadap implementasiprogram promosi kesehatan di puskesmas di Kota Tangerang Selatan, Indonesia. Penelitian menggunakan metode kualitatif. Data dikumpulkan padaFebruari – Maret 2016. Dampak program dilihat dalam hal kebijakan, pendanaan, fasilitas, sumber daya manusia dan pelaksanaan program promosi kesehatan.Dengan menggunakan metode purposive sampling, enam pengambil kebijakan, delapan pemberi layanan dan delapan penerima layanan diambil sebagaiinforman dalam penelitian ini. Pada analisis dokumen, 17 dokumen telah dianalisis. Observasi dilakukan dengan melihat kegiatan yang dilakukan diempat puskesmas. Analisis data menggunakan analisis konten tematik. Tidak terdapat perbedaan dari fungsi puskesmas sebelum dan setelah adanya JKN.Dana yang digunakan untuk kegiatan promosi kesehatan telah mengalami peningkatan setelah implementasi kebijakan JKN dimana dana tersebut dapat digunakanuntuk berinovasi, memberi peralatan dan melakukan promosi kesehatan dengan lebih baik. Dana kapitasi yang dapat digunakan untuk melaksanakanprogram promosi kesehatan dan beberapa kegiatan promosi kesehatan yang baru dilaksanakan pada saat era JKN menjadi bukti bahwa kebijakan JKN memilikidampak positif terhadap pelaksanaan program promosi kesehatan di puskesmas"

"Graves disease is an autoimmune disorder which affect thyroid gland. Graves disease is the most common cause of hyperthyroidism and thyrotoxicosis. Understanding of disease pathophysiology, diagnostic and treatment strategies, and prevention of disease relapse are important for all clinicians especially internal medicine specialist to give optimal and comprehensive management for Graves disease patients. This article highlights clinical points to treat Graves disease patients from reviews and latest guidelines from American Thyroid Association (ATA), European Thyroid Association (ETA), and Japan Thyroid Association/ Japan Endocrine Society."

"AbstrakDeclining environmental quality is one of population caused by household consumption behavior. Some of the highest contaminant contributions are domestic waste, waste, and company waste. Waste contamination will lead to dead fish, decreased water quality and disease transmission. Community approach can be done to solve the waste problem, especially at the household level. This study uses quantitative methods to analyze the effect of intervention and waste management training on changes in household waste management knowledge and practices. This type of research uses quasi experiment with one group of pre and post test design. The results showed that there was an increase of knowledge about waste management after being given intervention by the researcher because the p value ≤ 0,05. The results also show that there is an increasing practice on waste management after being given intervention by researchers because the p value ≤ 0.05. Based on the research results, it can be concluded that the provision of intervention is effective for improving knowledge and practice in the household waste management."

"Based on our knowledge, the study of gastrointestinal reflux disease (GERD) among certain profession has never been conducted. The aim of this study is to determine the prevalence and risk factors of GERD among Indonesian doctors.

Methods: A consecutive study involving 515 doctors was conducted in October 2015.The GerdQ score was used to the diagnosis of GERD and determined its impact on daily life. All possible risk factors were also analyzed.

Results: A total of 515 subjects completed the questionnaire. The mean age of them was 41.37±11.92 years old. Fifty-five percent of them were male and 60.6% general practitioners. The prevalence of GERD was 27.4% of which 21.0% was had GERD with low impact on daily life, and 6.4% was GERD with high impact on daily life. The statistically significant risk factors of GERD was found in age >50 y.o (p = 0.002; OR 2.054), BMI >30kg/m2 (p = 0.016; OR 2.53), and smokers (p = 0.031; OR 1.982). Sex and education level were not found significant statistically as the risk factors of GERD.

Conclusions: The prevalence of GERD among Indonesian physician was 27.4%. We found that age over 50 y.o, obesity and smoking habit were the risk factors of GERD in Indonesian doctors."

"Toddler is a group at risk of undernutrition in which World Health Organization stated that toddler mortality because of undernutrition was 54% in 2002. InIndonesia, its prevalence increased from 17.9% in 2010 to 19.6% in 2013. In Tangerang City, there was 1.43% of toddlers suffering from undernutrition in2013. This study aimed to prove in valid the relation between Hearth Program, which covered behaviors of food providing, toddler’s hygiene, health care seekingand toddler parenting, with undernutrition incidence among toddlers. This study was quantitative, cross-sectional, using primary data, analyzed in univariate,bivariate and multivariate within September 2015. Samples were taken by total sampling as many as 60 toddlers suffering from undernutrition in TangerangCity. Results showed that 12 (20%) of 60 toddlers suffered from very underweight nutrition and the remaining 48 toddlers (80%) suffered from underweightnutrition. There was a relation between food-providing behavior and health-care seeking behavior with undernutrition among toddlers. Variable food-providingbehavior was the dominant factor influencing undernutrition among toddlers with OR = 4.655 (CI = 1.052 – 20.6) after controlled by the variable healthcare-seeking behavior.Kelompok yang rentan terhadap gizi kurang adalah anak bawah lima tahun (balita). World Health Organization menyatakan kematian balita akibat gizi kurangsebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% tahun 2010 menjadi 19,6% tahun 2013. Di KotaTangerang, terdapat 1,43% balita yang mengalami gizi buruk tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan Program PosGizi yang meliputi perilaku pemberian makan, kebersihan balita, pencarian pelayanan kesehatan dan pengasuhan balita dengan kejadian gizi kurang padabalita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta dianalisis secara univariat, bivariat, dan multivariat selamabulan September 2015. Sampel diambil secara total sampling sebanyak 60 balita yang mengalami gizi kurang di Kota Tangerang. Hasil menunjukkanbahwa dari 60 balita yang mengalami gizi kurang, sebanyak 12 balita (20%) mengalami gizi sangat kurus dan sisanya sejumlah 48 balita (80%) mengalamigizi kurus. Terdapat hubungan perilaku pemberian makan dan pencarian pelayanan kesehatan dengan gizi kurang pada balita. Variabel perilaku pemberianmakan merupakan faktor dominan yang memengaruhi gizi kurang pada balita dengan OR = 4,655 (CI = 1,052 – 20,6) setelah dikontrol oleh variabel perilakumencari pelayanan kesehatan."