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Mery Ramadani; Promotor: Budi Utomo; Kopromotor: Endang Laksminingsih Achadi, Hartono Gunardi; Penguji: Anhari Achadi, Faisal Yunus, Besral, Bambang Wispriyono, Soewarta Kosen, Abas Basuni Jahari,
Abstrak:
Rokok merupakan masalah global dan menjadi ancaman serius bagi kesehatan ibu hamil dan janin. Studi kohor prospektif ini, dilakukan untuk menilai pengaruh pajanan pasif asap rokok ibu hamil terhadap gangguan pertumbuhan janin. Melibatkan 128 ibu hamil trimester 3, hamil janin tunggal, tidak memiliki riwayat penyakit kronis, bukan perokok aktif, bukan mantan perokok, dan bersedia terlibat dalam penelitian. Penilaian pajanan asap rokok ibu berdasarkan pemeriksaan nikotin darah tali pusat (cut off ≥1ng/ml). Pengukuran menggunakan nikotin plasma adalah metode yang paling akurat karena dapat mengukur kondisi sebenarnya dan membantu mengurangi misklasifikasi. Gangguan pertumbuhan janin dinilai dengan pengukuran berat lahir, panjang lahir, lingkar kepala, dan berat plasenta. Pengukuran dilakukan segera setelah lahir untuk menjamin ketepatan pengukuran. Analisis uji beda dua mean digunakan untuk mengetahui perbedaan rata rata ukuran gangguan pertumbuhan janin antara kelompok ibu terpajan asap rokok dan tidak terpajan asap rokok. Analisis regresi linier untuk melihat pengaruh pajanan asap rokok terhadap berat lahir, panjang lahir, lingkar kepala dan berat plasenta dengan memperhatikan variabel pengganggu seperti penambahan berat badan ibu selama hamil, BMI ibu, paritas ibu, usia dan kadar hemoglobin ibu. Hasil penelitian menunjukkan rata-rata kadar nikotin tali pusat sebesar 1,3±2,5 ng/ml. Berat lahir dan berat plasenta bayi dari ibu yang mendapat pajanan asap rokok lebih rendah dibandingkan ibu yang tidak mendapat pajanan asap rokok. Pajanan asap rokok secara signifikan mengurangi berat lahir bayi sebesar 205,6 gram (pvalue = 0,005) dan berat plasenta sebesar 51 gram (p value=0,010).
This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
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This cohort study examined the effect of secondhand smoke exposure in pregnant women on fetal growth restriction. The study recruited 128 pregnant women in the third trimester pregnancy, single pregnancy, no chronic illness, non-active smokers, non-exsmokers, and who were willing to participate in the study. Pregnant women with the secondhand smoke exposure referred to those with the umbilical cord blood nicotine level of 1ng/ml or higher. Fetal growth disorder was assessed according to the newborn weight, length, head circumference, and palcental weight measured immediately after birth. The independent t-test analysis was used to determine the difference in average size of fetal growth between two groups of pregnant women: exposed and the notexposed to the secondhand smoke. A multiple linear regression analysis was employed to find out the effect of secondhand smoke exposure on birth weight, length, head circumference, and palcental weight controlling for the birth size confounders including weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin. The study found that mean of nicotine in umbilical cord blood was 1.3±2.5 ng/ml, the birth weight and the placental weight of infants were lower among mothers who exposed than among mothers who did not expose to the secondhand smoke. Exposed to the secondhand smoke reduced the birth weight by 205.6 grams (p value = 0.005) and placental weight by 51 grams (p value=0.010).
D-395
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Elly, Nur/ Promotor: Djuwita, Ratna/ Kopromotor: Purwantyastuti; Rimbawan/ Penguji: Laksminingsih, Endang; Rini Sekartini, Besral, Mira Dewi, Noer Laily
D-396
Depok : FKM-UI, 2019
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Nurusysyarifah Aliyyah; Promotor: Haryoto Kusnoputranto; Kopromotor: Bambang Wispriyono, Laila Fitria; Penguji: Mondastri Korib Sudaryo, Umar Fahmi Achmadi, Mukono; Syafruddin
Abstrak:
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Hipertensi merupakan salah satu kondisi medis yang cukup serius karena dapat meningkatkan risiko penyakit jantung, otak, ginjal dan penyakit lainnya. Wilayah di DKI Jakarta dengan prevalensi hipertensi tertinggi berdasarkan diagnosis dokter yaitu Kota Jakarta Pusat sebesar 12,16%. Partikulat meter organik dan komponen partikulat meter dapat memicu proinflammatory effects pada paru-paru karena kemampuannya mengakibatkan stress oksidatif. Penelitian ini bertujuan untuk menyusun model pengaruh pajanan PM2,5 di udara ambien terhadap kejadian hipertensi melalui stress oksidatif dan sitokin inflamasi pada penduduk di Jakarta Pusat. Penelitian dilakukan pada penduduk dewasa (18-65 tahun) di Kota Jakarta Pusat dengan disain studi hybrid cross sectional ecology. Pengumpulan data secara cluster random sampling dengan analisis data dilakukan melalui pemodelan regresi logistik multilevel dan cox regresi proporsional hazard.
Hasil analisis menunjukkan terdapat asosiasi antara PM2,5 di udara ambien dengan biomarker stress oksidatif (IOR PM2,5: 2,185173-2,185176) dan dengan biomarker sitokin inflamasi (IOR PM2,5: 1,21-1,91). Pemodelan multivariat dengan cox regresi proporsional hazard menunjukkan bahwa variabel umur dan indeks massa tubuh merupakan confounder hubungan antara stress oksidatif dengan hipertensi dan antara sitokin inflamasi dengan hipertensi dengan nilai Rasio Prevalens adjusted (95% CI) masing-masing sebesar 1,19 (0,69-2,03) dan 0,99 (0,58-1,72). Dapat disimpulkan bahwa variabel konsentrasi PM2,5 di udara ambien memiliki peran terhadap terjadinya hipertensi, stress oksidatif dan sitokin inflamasi pada penduduk di Jakarta Pusat.
Hypertension is a serious medical condition that can increase the risk of heart, brain, kidney and other diseases. The area in DKI Jakarta with the highest prevalence of hypertension based on doctor diagnosis is Central Jakarta city about 12.16%. Organic particulate matters and particulate matter components can trigger proinflammatory efects in the lung due to their ability to cause oxidative stress. This study aims to develop a model of the Influence of PM2,5 Exposure in Ambient Air on Hypertension Occurrence through Oxidative Stress and Inflammatory Cytokines among residents in Central Jakarta. The study was conducted among adult residents (age 18-65 years) in Central Jakarta with hybrid cross sectional study design. Data collected using cluster random sampling with data analysis carried out through multilevel logistic regression modeling and cox proportional hazard regression. Results show there is an association between PM2.5 in ambient air with oxidative stress biomarkers (IOR PM2.5: 2.185173-2.185176) and with inflammatory cytokine biomarkers (IOR PM2.5: 1.21-1.91). Multivariate modeling with Cox regression proportional hazard shows that age and body mass index are confounders of the relationship between oxidative stress with hypertension and between inflammatory cytokines with hypertension with an adjusted prevalence ratio (95% CI) value of 1.19 (0.69-2.03) and 0.99 (0.58-1.72). It can conclude that concentration of PM2.5 in ambient air has a role on hypertension, oxidative stress and inflammatory cytokine among residents in Central Jakarta.
D-519
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dwi Septiawati; Promotor: Bambang Wispriyono; Kopromotor: Laila Fitria, Fathimah Sulistyowati Sigit; Penguji: Ririn Arminsih Wulandari, Besral, Yuanita Windusari, Nurjazuli, Lusyta Puri Ardhiyanti
D-641
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Novita Rina Antarsih; Promotor: Besral; Kopromotor: Rima Irwinda, Eka Budiarto; Penguji: Kemal Nazaruddin Siregar, Sutanto Priyo Hastono, Prihatin Oktivasari, Soewarta Koesen, Indra Supradewi, Omo Abdul Majid
Abstrak:
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Latar Belakang: Intrauterine Growth Restriction (IUGR) merupakan salah satu penyebab utama morbiditas dan mortalitas perinatal. Deteksi dini di Puskesmas masih menghadapi keterbatasan akses ultrasonografi, variasi kemampuan skrining, dan keterlambatan rujukan. Pemanfaatan Artificial Intelligence Clinical Decision Support System (AI-CDSS) berpotensi mendukung skrining dan pengambilan keputusan rujukan secara lebih konsisten. Tujuan: Mengembangkan model Artificial Intelligence (AI) berbasis data antenatal untuk skrining risiko IUGR di Puskesmas, menilai efikasi diagnostiknya dibandingkan metode konvensional, serta mengevaluasi dampak potensial implementasi sistem AI terintegrasi telehealth terhadap deteksi dini dan ketepatan rujukan IUGR di Puskesmas. Metode: Penelitian pengembangan dengan pendekatan multiphase mixed-methods ini dilakukan dalam lima tahap, yaitu analisis kebutuhan sistem, pengembangan model AI, evaluasi usability dan feasibility, uji efikasi diagnostik, serta evaluasi dampak potensial implementasi (simulated effectiveness). Pengembangan model menggunakan 1.761 data longitudinal dari 571 ibu hamil. Uji efikasi dan evaluasi dampak potensial melibatkan 604 ibu hamil di empat Puskesmas. Hasil: Model hybrid yang menggabungkan data maternal, tinggi fundus uteri, dan biometrik janin dari USG non-citra menunjukkan performa terbaik. AI-CDSS mencapai sensitivitas 100% (95%CI: 0,95–1,00), spesifisitas 87% (95%CI: 0,84–0,90), akurasi 89%, dan AUC 0,935 (95%CI: 0,916–0,954; p<0,001). Pada evaluasi dampak potensial implementasi, penggunaan sistem meningkatkan deteksi risiko IUGR dari 14,7% menjadi 25,8% (p=0,001) dan mengidentifikasi tambahan 67 kasus yang sebelumnya tidak terdeteksi. Kesimpulan: AI-CDSS VITA-Scan menunjukkan performa yang baik sebagai alat bantu skrining risiko IUGR di Puskesmas. Integrasi AI, aturan klinis, dan telehealth berpotensi meningkatkan deteksi dini serta mendukung ketepatan rujukan maternal.
Background: Intrauterine Growth Restriction (IUGR) remains a major contributor to perinatal morbidity and mortality. Early detection in Indonesian primary healthcare centers (Puskesmas) is often challenged by limited access to ultrasonography, variations in screening practices, and delayed referral decisions. Artificial Intelligence Clinical Decision Support Systems (AI-CDSS) may help improve screening consistency and support timely referral decisions. Objective: To develop an artificial intelligence (AI)-based antenatal screening model for identifying the risk of IUGR in primary healthcare centers, assess its diagnostic efficacy compared with conventional approaches, and evaluate the potential impact of an AI-CDSS integrated with telehealth on early detection and referral accuracy. Methods: This multiphase mixed-methods study was conducted in five stages: needs assessment, AI model development, usability and feasibility evaluation, diagnostic efficacy testing, and simulated effectiveness evaluation. Model development used 1,761 longitudinal records from 571 pregnant women. The model integrated maternal characteristics, symphysis-fundal height measurements, and non-image ultrasound fetal biometric parameters using a hybrid approach that combined machine learning and clinical rules. Diagnostic efficacy and simulated effectiveness were evaluated among 604 pregnant women from four Puskesmas. Results: The hybrid model demonstrated the best performance. The AI-CDSS achieved a sensitivity of 100% (95% CI: 0.95–1.00), specificity of 87% (95% CI: 0.84–0.90), accuracy of 89%, and an AUC of 0.935 (95% CI: 0.916–0.954; p<0.001). During simulated effectiveness evaluation, the system increased IUGR risk detection from 14.7% to 25.8% (p=0.001) and identified 67 additional cases that were not detected through routine practice. Conclusions: VITA-Scan AI-CDSS demonstrated good performance as a decision-support tool for IUGR risk screening in primary healthcare centers. The integration of AI, clinical rules, and telehealth has the potential to improve early detection and support more appropriate maternal referral decisions.
D-639
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Firlia Ayu Arini; Promotor: Endang Laksminingsih Achadi; Kopromotor: Besral, Fasli Jalal; Penguji: Ratu Ayu Dewi Sartika, Kusharisupeni Djokosujono, Hartono Gunardi, Atmarita, Suwarta Kosen
Abstrak:
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Latar Belakang : Seribu Hari Pertama Kehidupan (1000 HPK) merupakan periode emas bagi pertumbuhan dan perkembangan yang menentukan kualitas kesehatan anak pada daur kehidupan berikutnya. Hambatan pertumbuhan yang terjadi pada periode tersebut terutama karena kekurangan gizi, menyebabkan janin yang bersifat plastis menyesuaikan dengan membatasi tumbuh kembang. Beberapa studi longitudinal menunjukkan bahwa pertumbuhan lebih cepat setelah terjadinya hambatan pertumbuhan dapat menjadi faktor risiko tekanan darah tinggi pada usia remaja. Penelitian ini bertujuan untuk membuktikan pengaruh pertumbuhan cepat pada anak dengan riwayat hambatan pertumbuhan di usia 0-23 bulan terhadap tekanan darah pada usia 17-19 tahun. Metode : Data pada penelitian ini menggunakan hasil dari Indonesian Family Life Survey 1997,2000 dan 2014 yang diambil pada 13 provinsi di Indonesia. Pengambilan data dilakukan secara longitudinal dengan unit sampel rumah tangga dengan anak usia 0-23 bulan pada tahun 1997 kemudian diikuti pada tahun 2000 dan 2014. Pengukuran pertumbuhan cepat ditentukan dengan perubahan nilai z skor BB/U, PB/U atau TB/U, dan BB/TB antar tahun survei, yang lebih dari 0.67 poin. Tekanan darah diukur pada tahun 2014 yaitu saat anak berusia 17- 19 tahun. Besar sampel penelitian sebanyak 671 anak yang dibagi menjadi 3 kelompok yaitu 1.) anak normal, 2.) anak dengan hambatan pertumbuhan dan tidak tumbuh cepat,3.) anak dengan hambatan pertumbuhan diikuti tumbuh cepat. Analisis multivariat menggunakan GLM univariat dan Regresi Cox dilakukan untuk menganalisis pengaruh pertumbuhan cepat setelah terjadinya hambatan pertumbuhan pada 1000 HPK terhadap tekanan darah pada usia remaja. Hasil : Hasil analisis menunjukkan, anak yang tumbuh cepat menurut TB/U setelah mengalami hambatan pertumbuhan, memiliki rata-rata tekanan darah sistolik 4,61 mm Hg (CI: 1,38-7,84) lebih tinggi dan rata-rata tekanan darah diastolik 3,89 mm Hg (CI: 0,67-7,11) lebih tinggi, serta berisiko 1,58 (CI:0,83-2,33) kali mengalami tekanan darah tinggi dibanding anak yang normal setelah dikontrol faktor karakteristik anak, orang tua dan rumah tangga. Set Kesimpulan: Pertumbuhan cepat setelah terjadinya hambatan pertumbuhan di 1000 HPK meningkatkan risiko peningkatan tekanan darah pada usia remaja. Rekomendasi : Upaya pencegahan hambatan pertumbuhan dan perkembangan pada periode 1000 HPK bersama-sama dengan menerapkan pola makan bergizi seimbang pada anak berusia 2 tahun atau lebih, merupakan pencegahan yang sangat penting dalam menurunkan hipertensi pada remaja.
Background : The First Thousand Days of Life (1000 HPK) is a golden period for growth and development that determines the quality of children?s health in the next life cycle. The growth retardation that occurs in this period is mainly due to malnutrition, causing the plastic fetus to adjust to limiting growth and development. Several longitudinal studies have shown that faster growth after growth retardation might be a risk factor for high blood pressure in adolescence. This study aims to prove the effect of rapid growth in children with a history of growth retardation at the age of 0-23 months on blood pressure at the age of 17-19 years. Method: The data in this study used the results of the 1997,2000 and 2014 Indonesian Family Life Survey which were taken in 13 provinces in Indonesia. Data collection was carried out longitudinally with a sample unit of household with children aged 0-23 months as sample unit in 1997 followed in 2000 and 2014. The measurement of Rapid growth was determined by changes in the z score values of Weight for Age, Length/Height for Age, and Weight for Height inter-year survey, which is more than 0.67 points. Blood pressure was measured in 2014 when children were 17- 19 years old. The sample size of the study was 671 children who were divided into 3 groups, namely 1.) normal children, 2.) children with growth retardation and not growing fast,3.) children with growth retardation followed by fast growth. Multivariate analysis using univariate GLM and Cox Regression was carried out to analyze the effect of rapid growth after growth retardation at 1000 HPK on blood pressure in adolescents. Results: The result of analysis showed that, children who grew fast according to Height for Age U after experiencing growth retardation, had an average systolic blood pressure of 4,61 mmHg (CI: 1,38-7.84) higher and average diastolic blood pressure of 3,89 mmHg (CI: 0.67-7,11) higher, and 1,58 times of experiencing high blood pressure (CI:0,83-2,33)higher than normal children after controlling for characteristic of children, parents and household factors. Conclusion: Rapid growth after the occurrence of growth retardation in 1000 HPK increases the risk of increased blood pressure in adolescence. Recommendation: Efforts to prevent growth and development retardation in 1000 HPK together with implementing a balanced nutritious diet in children aged 2 years or older, are very important preventions in reducing hypertension in adolescents.
D-471
Depok : FKM-UI, 2022
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Hasnawati Amqam; Promotor: Umar Fahmi Achmadi; Kopromotor: Budi Haryanto, Irawan Yusuf; Penguji: Kusharisupeni Djokosujono, Imam Subekti, Asep Nugraha Ardiwinata, Indang Trihandini, Dewi Susanna
Abstrak:
ABSTRAK Penggunaan jangka panjang insektisida klorpirifos (CPF) akan menimbulkan efek pada Thyroid Stimulating Hormone (TSH) dan hormon-hormon tiroid (triidiotironin/T3 dan tirotoksin/T4). Studi ini bertujuan untuk mengetahui pengaruh insektisida CPF terhadap kadar TSH dan hormon-hormon tiroid pada petani sayur dari tinjauan aspek genetik populasi. Studi ini dilakukan dengan desain potong lintang. Terdapat 273 petani sayur yang menjadi subjek, yang diambil pada tiga populasi suku, yaitu Jawa, Sunda, dan Makassar. Terdapat variasi genetik paraoxonase 1 (PON1) pada ketiga populasi dan alel Q banyak ditemukan pada semua populasi. PON1 dapat menjadi prediktor terjadinya gangguan pada kadar hormon-hormon tiroid dan TSH. TCP sebagai metabolit CPF merupakan biomarker kemampuan metabolisme individu terhadap CPF. Pada masyarakat petani yang terpajan klorpirifos, TCP urin yang tidak terdeteksi berperan dalam terjadinya kadar FT3 rendah dan kadar TCP urin yang rendah berperan dalam terjadinya kadar FT4 tertil rendah dan kadar TSH tinggi. Efek CPF terhadap ketiga hormon ini diduga terjadi melalui mekanisme terganggunya sistem neurotransmitter dan proses deyodinasi pada perifer dan hati.
ABSTRACT Long-term use of chlorpyrifos (CPF) insecticide will affects Stimulating Thyroid Hormone (TSH) and thyroid hormones (triidiotironin/T3 and tirotoksin/ T4). This study aimed to assess the effect of insecticide CPF on levels of TSH and thyroid hormones of the vegetable farmers as the reviews of population genetic aspects. This study was conducted with a cross-sectional design. There were 273 vegetable farmers as subjects, taken in three population, namely Java, Sunda, and Makassar. There was genetic variation of paraoxonase 1 (PON1) in a population of in the three populations and Q alleles found in all populations. PON1 may be a predictor of causing interference to the levels of thyroid hormones and TSH. TCP as CPF metabolite was a biomarker of individual metabolic capabilities toward CPF. In exposed CPF farming communities, undetected TCP urine played a role in occurrence of low FT3 levels while low levels of TCP urine play a role for lower tertile FT4 level and high TSH level. CPF effect to the hormones possiblyoccured through the mechanism of disruption of neurotransmitter system and deiodinase process in peripheral and liver
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D-348
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Putri Ayuni Alayyannur; Promotor: Doni Hikmat Ramdhan; Kopromotor: L. Meily Widjaja, Tri Martiana; Penguji: Laila Fitria, Mila Tejamaya, Robiana Modjo, Iting Shofwati
Abstrak:
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Pendahuluan: Pajanan panas pekerjaan sebagai salah satu faktor risiko indikasi gangguan fungsi ginjal di berbagai studi. Nelayan dan pekerja pemindang termasuk pekerja berisiko terpajan panas. Studi ini akan mengembangkan model kontribusi pajanan panas pekerjaan pada indikasi gangguan fungsi ginjal pada pekerja di sektor perikanan Jawa Timur. Metode: Desain penelitian ini adalah cross sectional pada pekerja sektor perikanan Kabupaten Lamongan di Desember 2022-Februari 2023. Besar sampel 150 nelayan dan pemindang yang didapat dengan rumus uji hipotesis untuk proporsi populasi tunggal. Variabel yang diteliti meliputi faktor personal (usia, jenis kelamin, penyakit komorbid, antropometri, konsumsi obat. waktu istirahat, konsumsi air putih, konsumsi minuman manis, konsumsi minuman bersoda, konsumsi minuman berenergi, konsumsi kopi, konsumsi teh, konsumsi legen, dan konsumsi tuak), faktor pekerjaan (jenis pekerjaaan, masa kerja, beban kerja, dan pakaian kerja), faktor iklim (temperatur, kelembaban, dan kecepatan angin), pajanan panas, tekanan panas, dan indikasi gangguan fungsi ginjal (eGFR CKD-EPI dan uKIM-1). Pengumpulan data menggunakan sampel urin, sampel darah, heat stress monitor, sphygmomanometer, oximeter, microtoise, timbangan badan, dan kuesioner. Analisis data bivariat menggunakan t-test sampel independen dan uji ChiSquare, sedangkan uji multivariat menggunakan cox regression. Hasil: Usia, konsumsi air putih, konsumsi teh, jenis pekerjaan, masa kerja, beban kerja (%CVL), pakaian kerja, tekanan panas, dan dehidrasi (BJU) berhubungan dengan indikasi gangguan fungsi ginjal eGFR (CKD-EPI). Konsumsi air putih, konsumsi minuman manis, dan beban kerja (observasi) berhubungan dengan indikasi gangguan fungsi ginjal uKIM-1 . Model yang terbentuk adalah HeGFR(t) = h0 (t) exp (0,393 pajanan panas pekerjaan + 0,551 konsumsi air putih + 0,339 konsumsi kopi + 1,446 beban kerja (%CVL) + 0,865 pakaian kerja) Kesimpulan: pajanan panas pekerjaan merupakan faktor risiko terjadinya indikasi gangguan fungsi ginjal eGFR (CKD-EPI), dengan turut mempertimbangkan faktor yang lain yaitu konsumsi air putih, konsumsi kopi, beban kerja (%CVL), dan pakaian kerja. Oleh karena itu, perlu aktivasi Pos UKK untuk memberdayakan pekerja dalam melakukan kegiatan keselamatan dan kesehatan kerja.
Introduction: Occupational heat exposure can pose a significant risk to workers' health, especially regarding their kidney function. Studies have shown fishermen and pemindang workers are particularly vulnerable to heat exposure. To address this issue, a study is being conducted to develop a model that examines the impact of occupational heat exposure on kidney function in workers within the East Java fisheries sector. Method: This research design is cross-sectional among fisheries sector workers in Lamongan District in December 2022 to February 2023. The sample size is 150 fishermen and pemindang was obtained using the hypothesis testing formula for a single population proportion. The variables studied included personal factors (age, gender, comorbid diseases, anthropometry, drug consumption, rest time, water consumption, consumption of sweet drinks, consumption of fizzy drinks, consumption of energy drinks, consumption of coffee, consumption of tea, consumption of legumes, and consumption of palm wine), work factors (type of work, length of work, workload, and work clothing), climate factors (temperature, humidity, and wind speed), heat exposure, heat stress, and indications of impaired kidney function (eGFR CKD-EPI and uKIM-1). Data collection uses urine samples, blood samples, heat stress monitor, sphygmomanometer, oximeter, microtoise, body weighing, and questionnaires. Bivariate data analysis uses the independent samples t-test and Chi-Square test, while the multivariate test uses cox regression. Results: Age, water consumption, tea consumption, type of work, years of work, workload (%CVL), work clothing, heat stress, and dehydration (BJU) were associated with indications of impaired kidney function eGFR (CKD-EPI). Water consumption, consumption of sweet drinks, and workload (observation) are associated with indications of impaired uKIM-1 kidney function. The model formed is HeGFR(t) = h0 (t) exp (0.393 occupational heat exposure + 0.551 water consumption + 0.339 coffee consumption + 1.446 workload (%CVL) + 0.865 work clothes) Conclusion: occupational heat exposure is a risk factor for indications of impaired kidney function eGFR (CKD-EPI), taking into account other factors, namely water consumption, coffee consumption, workload (%CVL), and work clothing. Therefore, it is necessary to activate the Pos UKK to empower workers to carry out occupational safety and health activities.
D-498
Depok : FKM-UI, 2024
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Satria Pratama; Promotor: Haryoto Kusnoputranto; Kopromotor: Bambang Wispriyono, Faisal Yunus; Penguji: Fatma Lestari, Besral, Elisna Syahruddin, Inswiyasri, Sonny Warouw
D-338
Depok : FKM-UI, 2016
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Retno Windya Kusumaningtyas; Promotor: Trini Sudiarti; Kopromotor: Diah Mulyawati Utari, Noer Laily; Penguji: Besral, Endang Laksminingsih, Ratu Ayu Dewi Sartika, Sri Anna Marliyati, Dwi Nastiti Iswarawanti
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Defisiensi vitamin D pada ibu hamil di Indonesia masih tinggi yaitu lebih dari 60%, berkaitan dengan berbagai risiko kesehatan ibu dan dampak pada janin seperti gangguan pertumbuhan tulang dan berat lahir rendah. Fortifikasi vitamin D pada produk olahan perikanan diharapkan dapat meningkatkan asupan vitamin D sehingga memperbaiki status vitamin D ibu hamil. Tujuan penelitian adalah mengetahui pengaruh intervensi sup teri (Stolephorus indicus) instan fortifikasi vitamin D terhadap kadar kalsidiol ibu hamil, berat lahir, dan panjang lahir bayi di Kabupaten Tangerang. Penelitian diawali dengan produksi tepung teri, optimasi formula sup teri instan, pengujian mutu kimia dan sensori untuk menentukan formula terbaik. Intervensi dilakukan pada ibu hamil trimester kedua menggunakan desain two groups pre–post test dengan purposive sampling. Kelompok perlakuan diberi sup teri instan fortifikasi vitamin D, kelompok kontrol diberi sup instan tanpa teri dan tanpa vitamin D. Sup dikonsumsi empat kali per minggu selama 5 bulan atau hingga persalinan. Kadar kalsidiol ibu diukur awal dan akhir intervensi. Food Recall (FR) 24 jam dilakukan di awal, pertengahan, dan akhir intervensi. Analisis data menggunakan jumlah subjek dengan tingkat kepatuhan konsumsi produk intervensi >=80% (n=65), terdiri dari kelompok perlakuan (n=30) dan kelompok kontrol (n=35). Kelompok perlakuan memiliki rerata kadar kalsidiol akhir lebih tinggi yaitu 26,51±4,25 ng/mL dibandingkan kelompok kontrol yaitu 23,61±7,56 ng/mL. Setelah dikontrol dengan kalsidiol awal dan kecukupan vitamin D baseline, intervensi berhubungan signifikan dengan peningkatan kalsidiol akhir dengan selisih adjusted mean 5,14 ng/mL (95%CI: 0,023–10,259; p=0,049). Model multivariat berat lahir signifikan dengan R²=0,688, p < 0,001 dengan faktor yang berperan adalah kelompok perlakuan, panjang lahir, kalsidiol awal, pertambahan berat badan ibu selama hamil, dan kecukupan protein baseline. Model multivariat panjang lahir juga signifikan dengan R²=0,505; p < 0,001 dengan faktor yang berhubungan adalah berat lahir. Produk sup teri instan terfortifikasi vitamin D ini berpotensi untuk dikembangkan sebagai salah satu alternatif makanan tambahan untuk ibu hamil berbasis produk hasil laut yang enak, praktis dan mudah disajikan.
Vitamin D deficiency among pregnant women in Indonesia remains high, affecting more than 60% of pregnant women, and is associated with various maternal health risks and adverse fetal outcomes, including impaired bone growth and low birth weight. Vitamin D fortification in fish-based processed products is expected to improve vitamin D intake and consequently enhance vitamin D status among pregnant women. This study aimed to determine the effect of vitamin D-fortified instant anchovy (Stolephorus indicus) soup intervention on maternal calcidiol levels, birth weight, and infant birth length in Tangerang Regency. The study began with anchovy flour production, optimization of instant anchovy soup formulation, and chemical and sensory quality evaluations to determine the best formula. The intervention was conducted among second-trimester pregnant women using a twogroup pre–post test design with purposive sampling. The treatment group received vitamin D-fortified instant anchovy soup, while the control group received instant soup without anchovy and without vitamin D fortification. The soup was consumed four times per week for five months or until delivery. Maternal calcidiol levels were measured at baseline and endline. Twenty-four-hour food recall assessments were conducted at baseline, midline, and endline. Data analysis included subjects with ≥80% compliance to the intervention product consumption (n = 65), consisting of the treatment group (n = 30) and the control group (n = 35). The treatment group had a higher mean final calcidiol level of 26.51±4.25 ng/mL compared to the control group of 23.61±7.56 ng/mL. After controlling for initial calcidiol and baseline vitamin D adequacy, the intervention was significantly associated with an increase in final calcidiol with a mean adjusted difference of 5.14 ng/mL (95%CI: 0.023–10.259; p=0.049). The multivariate model for birth weight was significant with R²=0.688, with contributing factors including treatment group, birth length, initial calcidiol, weight gain during pregnancy, and baseline protein adequacy. The multivariate model for birth length was also significant with R²=0.505; Associated factors was birth weight. This vitamin D-fortified instant anchovy soup showed promise as an alternative seafood-based nutritional supplement for pregnant women due to its palatability, convenience, and ease of preparation.
D-648
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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