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Abstrak :
Pemanfaatan dukun beranak dipandang menjadi salah satu faktor yang menyebabkan terjadinya kematian ibu di Indonesia. Penelitian menunjukkan bahwa salah satu penyebab kecenderungan pemilihan dukun adalah adanya jampijampi dan doa-doa tertentu yang dilakukan dukun pada saat persalinan. Namun, analisis terhadap faktor-faktor yang melatarbelakangi munculnya kecenderungan ini belum banyak dilakukan. Penelitian ini dilakukan untuk menggali peran dari modal sosial terhadap pemilihan persalinan menggunakan dukun. Penelitian ini menggunakan data Indonesia Family Life Survey (IFLS) tahun 2007. Modal sosial diukur dari kohesivitas masyarakat dan kepercayaan sosial sementara faktor demografi ibu diukur dari status perkawinan, status pekerjaan, dan pendidikan. Uji Chi-Square digunakan untuk menganalisis hubungan yang diantara variabel. Untuk mengetahui efek dari variabel modal sosial dan demografi terhadap pemanfaatan dukun digunakan uji regresi logistik. Hasil menunjukkan bahwa keberadaan modal sosial di masyarakat memiliki hubungan yang bermakna dengan pemanfaatan dukun beranak di Indonesia. Untuk faktor demografi, tingkat pendidikan rendah berasosiasi dengan persalinan menggunakan dukun. Faktor yang mendorong pemilihan persalinan menggunakan dukun sangat kompleks. Pemahaman terhadap konteks sosial di masyarakat seharusnya menjadi bahan pertimbangan penting dalam menurunkan angka kematian ibu.

Using the services of traditional birth attendants (TBA) in childbirth is considered as one of the maternal mortality determinants in Indonesia. Researchers reported that mothers preferred to have the help of TBAs in childbirth because TBAs have such powers as prayers and mantras that help the delivery process. However, very little is actually known about the factors shaping their preference. This research investigates the role of social capital as to maternal preference for having TBAs in childbirth. A cross sectional data of Indonesia Family Life Survey (IFLS) 2007 was used. Social capital was measured by social cohesion and community trust. Maternal demographic factors were measured by marital status, employment status, and education. Chi-Square test was used to analyze statistical association. Finally, logistic regression was used to gauge their effects on the use of TBAs. The result showed that the existence of social cohesion and trust made a significant impact on the preference for choosing TBAs. In demographic factors, a comparable finding was found only at the educational level. The factors of having childbirth with the help of a traditional birth attendant are complex. An understanding of social context should be taken into consideration in making a serious effort to reduce the maternal mortality rate.

Abstrak :
Anemia merupakan salah satu efek samping yang paling sering dialami pasien kanker yang diterapi dengan cisplatin dosis tinggi. Penelitian ini bertujuan untuk mengamati perkembangan anemia dan menentukan faktor-faktor yang berpengaruh terhadap anemia pada pasien yang diterapi cisplatin. Dilakukan pengumpulan data pada pasien kanker kepala dan leher yang menjalani kemoterapi berbasis cisplatin antara Desember 2002 hingga Desember 2005. Insidensi dan faktor risiko anemia dianalisis dengan mencakup faktor usia, jenis kelamin, kadar Hb awal, klirens kreatinin awal, dan metastasis jauh. Stratifikasi menurut usia dan jenis kelamin dilakukan terhadap kadar Hb awal dan CrCl awal. Analisis multivariat digunakan untuk mengidentifikasi prediktor independen anemia. Dari 86 pasien, 26 (30,2%) mengalami anemia, ditandai kadar hemoglobin < 11 g/dL. Kadar hemoglobin turun secara signifikan setelah siklus pertama, dan terus menurun. Usia > 55 tahun (RR = 2.2, 95% CI, 1.2-4.0), jenis kelamin perempuan (RR = 2.0, 95% CI, 1.2-3.8), kadar Hb awal ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4) dan CrCl awal < 50 mL/menit (RR = 2.9, 95% CI, 1.7-5.1) berkorelasi dengan insidensi anemia (P < 0.05). Pada analisis multivariat, kadar hemoglobin awal dan klirens kreatinin awal merupakan faktor risiko independen anemia. Akan tetapi, terdapat efek perancu pada klirens kreatinin awal pada stratifikasi menurut usia (aRR = 2.2, 95% CI, 1.1-4.7). Kadar hemoglobin awal merupakan prediktor terkuat dari anemia. Kadar hemoglobin awal ≤ 13 g/dL ke bawah dan klirens kreatinin awal < 50 g/dL merupakan prediktor independen anemia akibat cisplatin, sehingga keduanya bernilai penting terhadap upaya prevensi anemia.

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Abstract
Cisplatin is well-known for its effectiveness against cancer, as well as its toxicity to human tissues. Of several documented side effects, anemia was reported to have significant association with decreased quality of life. This study was conducted to investigate development of cisplatin-induced anemia, and to identify independent factors contributing to anemia. Clinical data from head and neck cancer patients treated with high-dose cisplatin between December 2002 and December 2005 were obtained in this study. Incidence and risk factors of anemia were assessed in a model including age, sex, baseline hemoglobin level, baseline creatinine clearance, and occurrence of distant metastases. Multivariate logistic regression was used to define independent predictors of anemia. Among 86 eligible patients, 26 (30.2%) developed anemia, defined as Hb level lower than 11 g/dL. Age > 55 years old (RR = 2.2, 95% CI, 1.2-4.0), female sex (RR = 2.0, 95% CI, 1.2-3.8), baseline Hb ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4) and baseline CrCl < 50 mL/min (RR = 2.9, 95% CI, 1.7-5.1) were significantly correlated with incidence of anemia (P < 0.05). In multivariate analysis, baseline Hb and baseline CrCl were identified as independent risk factors for anemia. However, considerable confounding was observed in baseline CrCl after stratified by age (aRR = 2.2, 95% CI, 1.1-4.7). Thus, baseline Hb level was the strongest predictor of anemia. The findings suggested that baseline Hb and CrCl were useful to recognize cisplatin-treated patients at risk for anemia who might benefits from preventive measures.

Abstrak :
Forensic archeology is defined as the application of archaeological principles and techniques in medico-legal and/or humanity context related to buried evidence. Forensic archaeologist has two roles, as the expert who unearth buried objects systematically and reconstruct them. This paper discusses the role of archeology and archaeologists in the excavation of criminal, humanitarian and disaster victims. Archaeologist?s role to reveal paleoanthropological materials smuggled and theft is also discussed in this paper. Humanitarian missions to investigate mass grave of victims of war, political strife and genocide in the past and the present are other archaeologist?s role discussed in this paper. The existence, condition and development of forensic archaeology in Indonesia emphasize the significance of new paradigm in Indonesian archaeology. Forensic archeology not merely focusess on the study of cultural materials of the past, education and museum development, cultural resource management and its advocacy, but it also has role in medico-legal works. Forensic archaeologist also engages in disaster victim identification (DVI) that addresses issues related to victims buried by either natural or human disasters.

Abstrak :
The adhesive of composite resin has been used for direct bonding of a bracket system of bracket fixed orthodontic treatment by etching. The disanvantage of etching is enamel loss and difficult procedure. Modified glass ionomer cement has been suggested as a bracket bonding system without etching. The chemical bonding without etching can reduce enamel loss and make the procedure more efficient. The purpose of this study was to determine the shear bond strength of modified glass ionomer cement as metal Begg bracket bonding system with and without etching. The subject of this study consisted of two groups which had 15 intact extracted permanent human upper bicuspids for each group. Group I was etched with ortho phosphate acid (37%) for 20 seconds and bonded with modified glass ionomer cement. Group II was untreated and bonded with the same adhesive. The shear bond strength was measured with Pearson Pankee Equipment, and bond failure location was observed under stereo microscope. To differentiate the effects with and without etching, t test was performed, while to observe the location of bond failures, chi-square test was conducted. The results of this study indicated that the shear bond strength of modified glass ionomer cement as bonding system metal Begg Brackets with etching was significantly higher (p<0.001) than without etching. Without etching, bond failure occured between enamel and bonding agent. With etching, the bond failure was mostly found within the adhesive.

Abstrak :
Penyakit Crohn (CD) yang menjadi masalah penting bagi kesehatan masyarakat di negara maju, memiliki kemiripan gejala klinis dan gambaran patologis dengan penyakit Johne?s disease (JD) pada hewan ruminasia yang terinfeksi Mycobacterium avium subspecies paratuberculosis (MAP). Beberapa penelitian di Eropa, Amerika Serikat dan Australia menunjukkan keterkaitan antara MAP, CD, dan JD dengan produk susu dan olahannya termasuk susu bubuk. Masyarakat Indonesia mengonsumsi susu sapi dan produk olahannya yang berasal dari dalam negeri maupun impor. Adji pada tahun 2004 menemukan beberapa sapi perah lokal terinfeksi MAP lewat pemeriksaan serologis dan hal ini dapat menjadi permasalahan serius pada peternakan sapi perah maupun pada kesehatan manusia di masa mendatang. Penelitian ini bertujuan mendeteksi MAP di dalam susu formula lanjutan. Lima puluh sampel yang berasal dari 5 pabrik diambil dari supermarket di wilayah Bogor. Metode reaksi rantai polimerase (PCR) dengan menggunakan sekuen insersi 900 (IS 900) sebagai primer dan biakan pada media Herrold?s egg yolk diperkaya mycobactin J (HEYM J) sebagai baku emas digunakan dalam penelitian ini. Tidak ada bakteri MAP yang tumbuh setelah diikubasi selama 20 minggu, demikian juga tidak ada uji positif dari pemeriksaan PCR IS 900. Meskipun tidak ada sampel positif dalam penelitian ini, perlu dilakukan penelitian lanjutan yang menyeluruh, jumlah sampel yang lebih banyak dan bervariasi serta pada manusia, untuk menyediakan data MAP yang lengkap di Indonesia.

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Abstract
Crohn?s disease (CD) that becomes a public health concern in developed countries shows similarities in clinical signs and pathological features with Johne?s disease (JD) in ruminants infected by Mycobacterium avium subspecies paratuberculosis (MAP). Few researches conducted in Europe, the USA, and Australia showed relationships between MAP, CD, JD and dairy products. Indonesians consume milk and diary products from domestic and imported source. Adji in 2004 found some domestic dairy cows that were seropositive for MAP, and this could be a serious problem in dairy farm animals and human health in the future. The aim of this study was to detect MAP in the growing up formula milk. Fifty samples from five established factories were taken from supermarkets in Bogor. Polymerase chain reaction method (PCR) with insertion sequence (IS) 900 as primer and culture in Herrold?s egg yolk media with mycobactin J (HEYM J) as a gold standard were used in this study. Neither MAP grew up in HEYM J medium after 20 weeks of culture period nor positive samples by PCR IS 900 were found. Although there were no positive samples found in this study, further extensive and comprehensive studies on MAP should be done with more and varied samples, as well as in human to provide data on MAP in Indonesia.

Abstrak :
Di Indonesia, sejak lebih dari dua dekade, terjadi transisi epidemiologi. Prevalensi penyakit tidak menular (PTM) meningkat menggeser penyakit menular. Sejak tahun 2004, tiga perilaku hidup bersih sehat (PHBS) terkait PTM, yang meliputi tidak merokok, aktivitas fisik, konsumsi tinggi serat belum memenuhi target. Penelitian ini bertujuan mengetahui penggalian riwayat dan nasihat gaya hidup sehat yang dilaporkan oleh pasien dan dok- ter. Penelitian dilakukan dengan rancangan potong lintang pada 57 dokter dan 251 pasien puskesmas. Data dikumpulkan dengan kuesioner terstruk- tur dan wawancara di empat puskesmas di Kota Yogyakarta dan delapan puskesmas di Kabupaten Sleman mulai September 2011 sampai dengan Januari 2012. Hasil penelitian menunjukkan bahwa lebih banyak dokter yang memberikan nasihat tentang gaya hidup sehat daripada menanyakan- nya. Dokter lebih sering melakukan penggalian riwayat dan nasihat tentang kebiasaan merokok daripada tentang olah raga dan pola makan. Penggalian riwayat dan nasihat yang dilaporkan oleh dokter dan pasien berbeda. Menurut pasien, dokter seharusnya bertanya dan memberi nasi- hat gaya hidup sehat. Karakteristik dokter tidak berhubungan dengan peng- galian riwayat dan nasihat gaya hidup sehat yang dilakukan. Penggalian riwayat tentang hidup sehat menjadi prediktor kuat dalam memberikan nasi- hat untuk melakukan gaya hidup sehat.

Epidemiological transition has been occurred in Indonesia in the last two decades. The increasing prevalence of non communicable disease (NCD) has shifted the communicable disease. This pattern has been predicted since the 2004. National health survey reported that the Indonesian? clean and healthy behavior (PHBS) related to NCD, namely, not smoking, exer- cise and high fiber diet were still far from the target. The role of physician, particularly primary health care is crucial to overcome those health prob- lems. This cross sectional study aimed to assess history taking and advice on healthy life style reported by patient and physician. Participants were 57 physicians and 251 patients of primary health care (Puskesmas). Data were collected by structured questionnaires and interviews at 4 Puskesmas in Yogyakarta City and at 8 Puskesmas in Sleman District, started between September 2011 and January 2012. The results showed that physicians more carried out health advice on healthy life style than ask about them. Patients and physicians reported differently in the history taking and advice on healthy life style. Physician was more asking and advice about smoking habits than exercise and high fiber diet. Characteristics of physicians did not correlate with history taking and advice of healthy lifestyle. History taking of healthy life style was a strong predictor to conduct advice on healthy life style.

Abstrak :
Perubahan lingkungan memengaruhi hidup dan transmisi virus dengue dalam tubuh nyamuk. Tujuan penelitian ini adalah mengetahui pengaruh suhu, kelembaban udara (RH), terhadap transmisi virus DEN-2 pada nyamuk Aedes aegypti. Studi eksperimental dengan desain pre dan post tes control group dilakukan di laboratorium pusat kedokteran tropis, Fakultas Kedokteran, Universitas Gadjah Mada, Yogyakarta. Penelitian ini dilakukan pada kelompok Ae. aegypti betina umur 7 hari (F0). Virus DEN-2 diinfeksikan secara transovarial cara membran oral sampai generasi F2. Kelompok lain sebagai kontrol di inkubator temperatur dan suhu tertentu, waktu tertentu, jumlah telur yang dihasilkan, yang menetas dan mengandung virus dicatat. Hasil penelitian menemukan indeks transmisi transovarial generasi F0 dan F1 selama 14 hari masa inkubasi adalah 93,3% dan 82,2%, laju tetas telur dari nyamuk F0 yang terinfeksi dan tidak terinfeksi masing-masing 68% dan 85%, sedangkan laju tetas telur dari nyamuk F1 yang terinfeksi dan tidak terinfeksi masing-masing 72,6% dan 76%. Pada tiga kondisi ruang uji, nyamuk berumur 7 hari dalam ruang gelap dan lembab menghasilkan telur paling banyak dibandingkan pada kondisi normal dan pada inkubasi tanpa CO2. Nyamuk umur 14 hari menghasilkan telur tertinggi dalam ruang gelap dan lembab, dibandingkan pada kondisi ruang normal dan dalam inkubasi tanpa CO2. Virus DEN-2 dapat menginfeksi Ae.aegypti secara transovarial dengan laju infeksi lebih tinggi pada F0 daripada F1. Suhu dan kelembaban mempengaruhi kemampuan produksi telur Ae. aegypti untuk hidup dan tumbuh.

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Environmental changes influenced survival life and virus transmission of dengue virus (DEN) in a mosquito. The purpose of the present study was to define DEN-2 virus transmission dynamic and effect of temperature, relative humidity (RH), and DEN-2 virus infection on viability of Aedes aegypti (Ae.aegypti). This experimental study with pretest-posttest control group design was conducted at the Laboratory of Center for Tropical Medicine, Faculty of Medicine, Gadjah Mada University (UGM), Yogyakarta. Seventh-days old female Ae. aegypti (F0) were infected DEN-2 via oral membrane and kept until F2 generation by transovarial transmission, number of eggs produced and hatched was recorded. After 14-day incubation was found that transovarial transmission rate of DEN-2 virus infection in F0 and F1 were 93.3% and 82.2%, respectively. Egg production, hatching rates from infected and uninfected mosquitoes F0 were 68% and 85%; and F1 were 72.6% and 76%, respectively. At defined room condition tests, 7 day adult mosquitoes in dark and humid environment produced highest number of eggs, compared normal environment and in incubated without CO2. In fourteenth day old mosquitoes at dark and humid produced highest number of eggs, compare normal environment condition, and in incubated without CO2. DEN-2 virus was able to infect Ae. aegypti by transovarial transmission where the infection rate in F0 was higher than F1 generation. Temperature and humidity affected the ability of Ae. aegypti eggs to live and grow to adulthood.

Abstrak :
Perilaku seksual pranikah yang tinggi pada remaja disebabkan oleh faktor personal seperti pengetahuan kesehatan seksual, Infeksi Menular Seksual (IMS) dan HIV / AIDS, sikap terhadap seksualitas, harga diri dan efikasi diri. Penelitian ini bertujuan untuk mengetahui pengaruh faktor personal seperti pengetahuan tentang kesehatan seksual, IMS dan HIV / AIDS, sikap, harga diri dan efikasi diri terhadap perilaku seksual pranikah pada remaja di Kota Kendari yang diukur melalui kuesioner dan wawancara mendalam. Desain penelitian adalah studi potong lintang dengan jumlah sampel 200 remaja yang berasal dari empat sekolah negeri di Kota Kendari mulai dari Agustus sampai dengan Oktober 2014. Analisis regresi logistik menunjukan bahwa remaja yang memiliki pengetahuan yang rendah tentang kesehatan seksual, IMS dan HIV / AIDS berisiko sebesar 4,28 kali, sikap permisif terhadap seksualitas berisiko 5 kali, harga diri rendah berisiko sebesar 3,3 kali dan efikasi diri rendah sebesar 2,5 kali untuk melakukan perilaku seksual pranikah berisiko. Analisis kualitatif menunjukan variabel sikap sebagai faktor yang memberikan risiko terbesar di dalam berperilaku seksual pranikah yang berisiko pada remaja.

High premarital sexual behavior among teenagers are caused by personal factors, such as health sexual knowledge, Sexually Transmitted Infections (STIs) and HIV / AIDS, attitudes towards sexuality, self-esteem and self-efficacy. This study aimed to find out the influence of personal factor to premarital sexual behavior among teenagers in the Kendari City as assessed through questionnaires and in-depth interviews.The study design was cross-sectional study with a sample of 200 adolescents from four public schools in Kendari City from August to October 2015. Logistic regression analysis showed teenagers having lack of knowledge of sexual health, STIs and HIV / AIDS had 4.28 times risk having permissive attitude toward sexuality had 5 times risk, having low self-esteem had 3.3 times risk and having low self-efficacy had 2.5 times to perform premarital sexual behavior. Qualitative analysis showed that attitude variable was the factor giving the biggest risk in risky premarital sexual behavior among teenagers.

Abstrak :
Perkembangan ilmu kedokteran dan juga teknologi informasi dan komunikasi pada saat ini tidak dapat dipisahkan. Artinya adalah dengan semakin cepatnya arus informasi dan pengetahuan yang difasilitasi oleh teknologi informasi dan komunikasi, membuat perkembangan dunia kedokteran menjadi semakin pesat dan sudah menjadi sebuah keharusan bagi para aktornya untuk tetap meningkatkan skill-nya baik yang berupa soft skill maupun hard skill. Kondisi ini bukan tanpa tantangan serius, di mana tidak sedikit individu dokter yang memiliki kelebihan dibandingkan rekan sejawatnya, masih memiliki keengganan untuk berbagi informasi maupun pengetahuan khususnya yang berkaitan dengan kasus unik dan kompleks. Tujuan utama penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi motivasi seorang dokter dalam melakukan kegiatan berbagi pengetahuan dengan rekan sejawat khususnya pada rumah sakit pendidikan di Indonesia. Metode penelitian yang digunakan adalah survey langsung kepada responden melalui computer-based questionnaire. Jumlah kuesioner yang berhasil dikumpulkan dan dapat diolah lebih lanjut sebanyak 76 buah dengan tingkat partisipasinya sebesar 34,55% (dari total 220 buah kuesioner yang disebar menggunakan bantuan surveymonkey.com). Hasil pengolahan dan analisis data menggunakan PLS-SEM menunjukkan bahwa variabel yang memiliki pengaruh signifikan terhadap motivasi seorang dokter untuk berbagi pengetahuan adalah enjoyment helping others dan rewards. Kesimpulan utama dari penelitian ini adalah bahwa hal yang menentukan motivasi seorang dokter untuk berbagi pengetahuan dengan sejawat masih berasal dari motivasi pribadi bukan dikarenakan adanya stimulus yang berasal dari pihak pimpinan khususnya manajemen rumah sakit, walaupun hasil penelitian menunjukkan bahwa sebenarnya telah ada mekanisme pemberian rewards dari pihak manajemen namun bentuk maupun dampaknya belum terasa khususnya kepada peningkatan motivasi seorang dokter dalam melakukan kegiatan berbagi pengetahuan secara sukarela kepada rekan sejawat.

Motivation to Share Knowledge of Doctors in Teaching Hospital in Indonesia. The development of medical science and information communication technology recently cannot be separated. Its means that the rapid flow of information and knowledge, facilitated by information and communication technologies, makes the rapid development of medicine field and become a mandatory for all actors to keep improving their skills in the form of both soft and hard skills. This condition is followed with serious challenges, that many doctors still have a reluctance to share information and knowledge to their colleagues, especially with regard to the unique and complex cases. The main objective of this research was to determine the factors that affect the motivation of a doctor in conducting knowledge sharing with peers, especially at 4 (four) teaching hospitals in Indonesia. This research used a direct survey method through computer-based questionnaire. The number of questionnaires were collected and further processed as many as 76 examples with a participation rate of 34.55% (from a total of 220 examples of questionnaires were distributed using surveymonkey.com). The results of processing and data analysis using PLS-SEM showed that variables that had a significant influence on the motivation of doctors to share knowledge are enjoyment helping others and rewards. The main conclusion of this study is that doctors who determines the motivation to share knowledge with colleagues is coming from personal motivation and is not due to the stimulus coming from the head of the hospital's management, although the results showed that in fact there has been rewards mechanisms of the management, but the impact has not been felt particularly to increased motivation in performing activities of a doctor voluntarily sharing knowledge to colleagues.