Public Health

The length of exclusive breastfeeding (EBF) recommendation has been debated for the last decade between four and six months. Experts’ opinion divided around what so called “weanling dilemma” and safety or concern on milk substitutes sanitation, furthermore, it also related to the target community, whether they are develop or developing nations. For each nation, developing recommendation or national program
on EBF should be based on the strongest evidence found preferably from systematic review of randomized control trials. A review involving adequate and proportional evidence from either developed or developing countries reveals the beneficial value of six compare to four months EBF.  Considering  its  strength  and  limitations,  the  review  has  a  good  objectivity.  The  applicability  of  the  review  in  developing  six  months EBF recommendation for Indonesian population is regarded to be suitable because the results of the review are seen to be cost effective and appropriate with less harm, and even protective against diarrhea. This is a critical appraisal of a systematic review written by Kramer and Kakuma (2002).

Tuberculosis is one the main health problems faced by all counties around the world, in 1996, WHO showed that 10–15% of the TB victims were children under 15 years old. One of the health problems that emerge is malnutrition; this is the effect of bad eating habits. In fact, malnutrition drives someone to be easily infected since malnutrition weaken the immunity system of the body. The objective of this study is to
delineate the relation of street children’s life style in Insani Foundation and the possibility that they are about to be infected by TB disease. This is an analytic research that aims to adorn the correlation of certain factor influences TB infection process and how far does the factor works. To support the research, there are 37 selected children performed as the sample which collect with simple random sampling methods. The data is analyzed analytically and bivariatly with statistic examine of Chi Square with ingenuous level up to 90%. The results of the research is
there is a relation between eating habit and the TB infection process with risk level 7,33. Meanwhile, activity period factor and smoking habit doesn’t have relation with TB infection process. For personal hygiene (sport habit), we find relation of sport habits and TB infection process. Since risk level is 0,267. Based on the results, we can figure out that there should be more improvement of eating habits among street children
in Insani Foundation since bad eating habits will endanger their bodies to be infected by Tuberculosis. By enhancing the positive activities in Insani Foundation thoroughly will reduce the possibility of TB infection toward the children, especially sport habit since it able to maintain the stamina and the immunity of the body.

In Indonesia, the village health post (Posyandu) is a community driven organization that provides basic health and family planning services such as maternal and child health (MCH), nutrition, family planning, immunization and diarrhea disease control (BKKBN, 2004). During 1997 to 2000, or during the monetary crisis, it was revealed from the IFLS study that there was a 12% drop in the usage of Posyandu for both boys and girls (Strauss, et al. 2002). Almost all Posyandu services decline rapidly, the coverage of child growth monitoring dropped by 14% between 1997 to 2000, and the possession of growth monitoring cards (KMS) dropped by 24% (Marks, 2003). However, Strauss, et al. (2003 cited in Marks 2003) reveal that during the period when Posyandu coverage and attendance were decreasing rapidly, child height increased which indicated a better health and nutritional status (Marks, 2003). This literature review aims to give a better insight of understanding the paradox using three factors approach, which are: intrinsic, extrinsic and macro-environmental factors. The limitation of internal factors within Posyandu believed to be the key of declining coverage. Among intrinsic factors are: the quality of kader, and the displacement of the family planning program (Rusydi, 2005). The role of private health care providers or NGOs, and shifts in consumer preferences are thoughtto be responsible for the improved child health indicated by increased height for age index. Broader macro-environmental factors also have had a significant impact, the monetary crisis that hit Indonesia in 1998 resulted in a reduction of both men and women participation in a variety of community development activities such as neighborhood improvement projects and the Posyandu (Frankenberg, Thomas and Beegle,1999). Even with a broad spectrum of variability among Indonesian, nonetheless, this approach could be regarded as a template for site to site evaluation.Key words: child, height for age, coverage, posyandu, intrinsic, extrinsic, macro-environmental factors

It is undeniable that the epidemic and the global burden of disease are shifting from infectious to degenerative diseases. The conventional way of understanding health and illness in society can no longer merely rely on depth clinical investigation, but should be collaborated with sociology, anthropology and other social sciences. To achieve a more comprehensive understanding of the risk of the disease, and health related behavior in the community, it is necessary for biomedical scientist to embrace the use of social science or at least bring social researchers into play. In the course of such integration, public health interventions would be far more effective with high degree of coverage or compliance. Through several examples and highlight evidences, this critical analysis reveals invaluable contribution of social science to the success of public health investigations and interventions.Key words: social sciences, contribution, public health, investigations, intervention

Scientific facts show that smoking is a leading cause of degenerative disease in the worlds can be prevented. The success of smoking cessation program have a great influence on the improvement of public health. The smoking habit cause addiction to nicotine. Therefore, that have physical addiction to nicotine may use nicotine patch which is relatively bring less danger to avoid tobaccos smoke such as carbon monoxide, tar, etc. There is a significance improvement of knowledge in participant about the smoking hazards and nicotine patch therapy information after health education is conducted. However there is a difference between mild and heavy smoker regarding their level of knowledge about nicotine patch. Heavy smokers tend to have lower level of knowledge than mild smokers. Most participants interested about the nicotine therapy but they have doubt about going through it because the lack of information and the complexity of the treatment it self.

Background and Objectives:
More than one-quarter of under-five children in the developing world are stunted,
and those with poor nutrient intake are at risk of irreversible cognitive impairment. The purpose of this study was to determine the relationship between dietary diversity
and child stunting in an Indonesian context
Methods and Study Design:
Dietary diversity was assessed using a maternal-reported checklist of 12 food groups,
summed as a Household Dietary Diversity Score. Stunting was defined as ≤-2.0 height-for-age z-score by WHO-Anthro 2005. Trained interviewers administered the household dietary diversity questionnaire to 768 households with children aged <5 years in East Java, Indonesia. Logistic regression models were
constructed to test the association between dietary diversity and child stunting.
Results:
The prevalence of child stunting was 39.4%, and the percentage  of  households  consuming  food  groups  high  in  protein  and  calcium,  like  dairy  products  (41%),  and meat/poultry, (65%) was lower compared with other food groups. The unadjusted model revealed that higher dietary diversity scores were associated with lower likelihood of child stunting (OR=0.89; 95%CI=0.80–0.98). This relationship remained significant after adjustment for family size, maternal literacy, food expenditure, breastfeeding, energy,  and protein intake  (OR=0.89;  95%CI=0.80–0.99).
Conclusions:
The  dietary  diversity  score  was moderate, with consumption of dairy products and meat/poultry lowest among 12 food groups. Hence, population
interventions should focus on promoting food groups currently lacking in maternal and child diet, including those rich in growth-promoting nutrients like dairy, meat/poultry. These results, from an Indonesian context, confirm
the widely observed protective relationship between dietary diversity and child stunting

Various kind of molluks (Bivalves) are source of animal protein. Moreover, Bivalves are sea biota which act as heavy metal biomonitor at coastal area. This research was conducted to investigate cadmium, protein and organoleptic level in Bivalves; also to prove the descent of their level by vinegar's soaking. This research was a laboratory experimental research with pre and post test design. Research had been done during the period of April – December 2007. Kerang batik (Paphia undulata) and kerang darah (Anadara granosa) were taken as samples because those kind of Bivalves were easy to be found and were generally consumed by people around Surabaya. Heavy metal cadmium was analysed by AAS with destruction method and quantity of protein was observed by determining total nitrogen (N) with Kyedahl desctruction method. While organoleptic examination was done with sensory modality of eyes, nose, and skin. From laboratory result, it was figured out that heavy metal cadmium level in Anadara granosa was more than its cut off value. Based on laboratory work, it was known that Paphia undulata and Anadara granosa were very potential protein sources. Shellfish organoleptic smells putrid, the texture was soft but rubbery. Anadara granosa colored red-brownish while Paphia undulata colored white-brownish. After vinegar's soaking, heavy metal level in both of those Bivalves were decreased and so their protein. Their organoleptic condition was changed into vinegar's aroma, harder and rubberer while the color was relatively paler. As conclusion, soaking process with vinegar 12,5% or 25% had decrease heavy metal level in Paphia undulata and Anadara granosa with no different of protein content. To know vinegar's potential as chelating agent, it is advised to soak Bivalves with clean water as contol. Protein contents in Bivalves should be more analysed with more specific method. Sanitation and hygiene were very important while cooking Bivalves to get safe and nutricious food.

ABSTRAK Diabetes Mellitus (DM) adalah penyakit degeneratif yang disebabkan oleh gangguan insulin dalam tubuh, obesitas dan gangguan metabolisme zat gizi makro seperti karbohidrat, protein dan lemak. Perubahan gaya hidup termasuk perubahan pola konsumsi seperti tinggi karbohidrat dan lemak serta kurangnya konsumsi serat pangan dapat menyebabkan seseorang terkena risiko DM. Oleh karena itu, penelitian ini bertujuan untuk mengetahui hubungan antara tingkat konsumsi dietary fiber (serat pangan) dengan kadar gula darah pada penderita DM. Penelitian dilakukan dengan rancangan cross sectional dengan pendekatan kuantitatif. Populasi penelitian adalah pasien DM tipe 2 di Instalasi Rawat Jalan Poli Diabetes Mellitus di RSUD dr. Soetomo. Sebanyak 35 sampel dipilih dengan metode simple random sampling. Penelitian menggunakan food recall 2x24 hours dan semi quantitative food frequency untuk menilai tingkat konsumsi dietary fiber dan mendapatkan gambaran mengenai pola konsumsi sampel penelitian. Hasil penelitian menunjukkan bahwa tingkat konsumsi dietary fiber sebagian besar responden masih kurang dari anjuran yaitu 25-30 gram/hari. Sebagian besar responden memiliki kadar gula darah tinggi (>110 mg/dL). Rata-rata umur responden yaitu lebih dari 65 tahun baik responden laki-laki maupun perempuan. Berdasarkan uji korelasi Pearson (p>0.05) diketahui bahwa tidak ada hubungan antara tingkat konsumsi karbohidrat, lemak dan dietary fiber terhadap kadar gula darah puasa baik berdasarkan hasil semi quantitative food frequency dan food recall. Saran yang dapat diberikan untuk penderita DM tipe 2 adalah melakukan pengaturan pola makan tinggi dietary fiber untuk mempertahankan kadar gula darah normal dan mencegah komplikasi dari DM. Kata-kata kunci : Tingkat konsumsi dietary fiber, karbohidrat, lemak, kadar gula darah, diabetes mellitus

ABSTRAK Hasil penelitian pendahuluan menyatakan osteoporosis pada wanita usia >50 tahun mencapai 32,3% sementara pada pria >50 tahun mencapai 28,8%. Kelompok lakto ovo vegetarian yang hanya mengkonsumsi susu, telur dan produk nabati dapat memiliki risiko mengalami osteoporosis apabila memiliki pengetahuan gizi yang kurang dalam pemenuhan menu seimbang yang dapat berakibat pada permasalahan status gizi kelompok lakto ovo vegetarian. Tujuan penelitian ini untuk menganalisis hubungan pengetahuan gizi dan asupan zat gizi dengan status gizi dan risiko osteoporosis pada kelompok lakto ovo vegetarian. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Jumlah sampel sebanyak 31 orang yang didapatkan dengan teknik simple random sampling. Data dianalisis menggunakan uji korelasi Pearson, Spearman dan uji Chi-Square yang disesuaikan dengan skala variabel. Hasil penelitian menunjukkan bahwa prevalensi risiko osteoporosis tinggi sebesar 38,7%, sebagian besar memiliki status gizi normal (84%), tingkat pengetahuan gizi sedang (64,9%) dan kecukupan zat gizi yang tergolong kurang. Terdapat hubungan antara pengetahuan gizi (p=0,002), asupan protein (p=0,006), asupan kalsium (p=0,046), dan asupan fosfor (p=0,021) dengan indeks massa tubuh. Selain itu terdapat hubungan antara pengetahuan gizi (p=0,000), asupan protein (p=0,001), asupan kalsium (p=0,005), asupan fosfor (p=0,002) dan indeks massa tubuh (p=0,000) dengan skor ORAT kelompok lakto ovo vegetarian. Lebih lanjut, perlu adanya peningkatan pengetahuan gizi kelompok lakto ovo vegetarian terkait pentingnya asupan zat gizi (protein, vitamin D, kalsium, dan fosfor) untuk kesehatan tulang.Selain itu penyuluhan mengenai menu seimbang asupan zat gizi untuk pembentukan status gizi normal dan mengurangi risiko osteoporosis pada kelompok lakto ovo vegetarian. Kata-kata Kunci : lakto ovo vegetarian, risiko osteoporosis, status gizi, asupan zat gizi, pengetahuan gizi. ABSTRACT Based on the analysis of Department of Health Center for Nutrition, it was found that osteoporosis reached 32.3% in women aged> 50 years reached 32.3% and 28.8% in men> 50 year. The llacto ovo vegetarians, who only eat milk, eggs and vegetable products, may have a high risk of osteoporosis especially if they have lack of nutrition knowledge such as nutrient intake of protein, calcium, vitamin D and phosphorus. Lack of nutrition knowledge may be associated with the lack of fulfillment a balanced diet that will lead to problems of the nutritional status of lacto ovo vegetarian. The aim of this research was to analyze the relationship between nutrition knowledge and nutrient intake with nutritional status and the risk of osteoporosis of lacto ovo vegetarian.

Lack of knowledge and attitude might lead to a state of poor behavior in society. Results of nutritional awareness family (KADARZI) survey in 2015 showed 24.09% families and increased to 24.15% in 2016 of families who not aware of nutrition. The aim of the study was to analyze the relationship between knowledge and intention with mother of children under five malnutrition. This was a cross sectional study with 58 samples selected by simple random sampling. Subject in this study was the mother of malnourished children under five. The data were collected through interview using questionnaires, and analyzed using pearson correlation. Of the five indicators, families who weighing weight every months (74.14%), consume a variety of foods (55.1%), iodized salt (100.0%), exclusive breastfeeding (51.72%), and nutritional supplements (100.0%). Most families were having medium level knowledge (53.4%) and poor knowledge (46.6%). There were association between family income (p = 0.040), knowledge (p = 0.033) and intention (p = 0.048) to the behavior of mother towards KADARZI. While attitude, subjective norm, and perceived behavioral control did not have relationship to the behavior of mother toward KADARZI. Knowledge and intention was related to enactment of KADARZI. ABSTRAK Salah satu faktor rendahnya perilaku kesehatan di masyarakat karena pengetahuan dan sikapnya yang kurang. Hasil data survei KADARZI pada tahun 2015 keluarga yang belum KADARZI sebesar 24,09% dan meningkat pada tahun 2016 sebesar 24,15%. Untuk menganalisis hubungan antara pengetahuan dan niat ibu dengan perilaku KADARZI ibu balita gizi kurang. Penelitian ini menggunakan desain cross sectional dengan besar sampel 58 responden yang dipilih menggunakan simple random sampling. Subjek dalam penelitian ini adalah ibu yang memiliki balita gizi kurang. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner. Uji statistika yang digunakan adalah uji pearson correlation. Dari lima indikator KADARZI, keluarga yang menimbang berat badan setiap bulan (74,14%), konsumsi aneka ragam makanan (55,17%), garam beryodium (100,0%), ASI eksklusif (51,72%), dan suplemen gizi (100,0%). Pengetahuan sedang (53,4%) dan kurang (46,6%). Pendapatan keluarga (p = 0,040), pengetahuan ibu mengenai KADARZI (p = 0,033) dan niat ibu melakukan KADARZI (p = 0,048) mempunyai hubungan yang signifikan dengan perilaku KADARZI. Sedangkan sikap, dukungan suami, dan kontrol perilaku tidak mempunyai hubungan yang signifikan dengan perilaku KADARZI. Pengetahuan dan niat ibu melakukan KADARZI mempunyai hubungan yang signifikan dengan perilaku KADARZI. Kata kunci: Keluarga sadar gizi, perilaku KADARZI, balita gizi kurang, pengetahuan, niat.

Latar Belakang: Obesitas yang terjadi di Indonesia pada perempuan dewasa > 18 tahun angka prevalensinya mencapai 14,80% pada tahun 2007, namun pada tahun 2013 naik menjadi 32,90%. Hasil baseline data pada bulan Mei 2016, dari 102 orang karyawan perempuan di Instalasi Gizi RSUD Dr. Soetomo, 65% diantaranya menderita obesitas. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan pengetahuan gizi dan aktivitas fisik dengan kejadian obesitas pada karyawan perempuan di Instalasi Gizi RSUD Dr. Soetomo Surabaya. Metode: Penelitian ini adalah penelitian deskriptif analitik dengan rancang bangun cross sectional. Besar sampel adalah 57 responden. Pemilihan sampel menggunakan teknik simple random sampling. Pengumpulan data dengan kuesioner, pengukuran antropometri, dan food recall. Analisis data dilakukan secara bivariat dan multivariat untuk mengetahui hubungan variabel dependen dan variabel independen dengan menggunakan tabulasi silang dan uji statistik regresi linear. Hasil: Penelitian ini menunjukkan bahwa status gizi obesitas sebesar 75,40%, pengetahuan gizi terbanyak kategori kurang (90%), aktivitas fisik terbanyak kategori sedang (76%). Ada hubungan antara pengetahuan gizi (p = 0,03) dan aktivitas fisik (p = 0,03) dengan kejadian obesitas, sedangkan asupan energi, protein, lemak, karbohidrat tidak berhubungan dengan kejadian obesitas (p = 0,37). Kesimpulan: Ada hubungan antara pengetahuan dan aktivitas fisik pada karyawan perempuan di Instalasi Gizi RSUD Dr. Soetomo dengan kejadian obesitas. ©2018 Jurnal Berkala Epidemiologi. Penerbit Universitas Airlangga. Jurnal ini dapat diakses secara terbuka dan memiliki lisensi CC-BY-SA (https://creativecommons.org/licenses/by-sa/4.0/) Kata Kunci: aktivitas fisik; asupan zat gizi makro; obesitas; pengetahuan gizi ABSTRACT Background: The prevalence of obesity in Indonesia had been reported as 14,80% in 2007, and increased to 32,90% in 2013. Moreover, there were 102 female workers in the nutritional division of the public hospital Dr. Soetomo Surabaya in May 2016 reported being obese. Purpose: This study aimed to analyze the relationship between knowledge and physical activity with obesity in the female worker in nutritional division of RSUD Dr. Soetomo Surabaya.