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"The majority of female batik workers uses non-ergonomic chairs (dingklik) that pose risks of musculoskeletal disorders.This study aimed to design an ergonomic chair and evaluate its effectiveness in reducing musculoskeletal disordersamong the workers. This is a quasi-experimental study (using one group pre and post-test design) on 50 female batikworkers selected by quota sampling. Musculoskeletal disorders were measured among the samples before and after theuse of the designed ergonomic chair which they were asked to use for two months. T-test, ANCOVA, Wilcoxon test,McNemar test and Chi Square test were used for the analysis. The study found statistical significant differences of riskfactor against musculoskeletal disorders among the workers before and after their use of the designed ergonomic chair(p< 0.05); and of musculoskeletal disorders before and after using the ergonomic chair (p= 0,035). Body Mass Index(BMI) was identified as a confounding factor, and statistical significant difference of musculoskeletal disorders werealso found among the workers with <25 and >25 BMI even before and after using the ergonomic chair (p=0.033 andp=0.015 respectively). By ANCOVA statistical test, after controlling BMI, another statistical difference ofmusculoskeletal disorders was also identified before and after using the ergonomic chair (p=0.033). It is concluded thatthe designed ergonomic chair is effective to reduce the risk of musculoskeletal disorders."

"The majority of female batik workers uses non-ergonomic chairs (dingklik) that pose risks of musculoskeletal disorders.This study aimed to design an ergonomic chair and evaluate its effectiveness in reducing musculoskeletal disordersamong the workers. This is a quasi-experimental study (using one group pre and post-test design) on 50 female batikworkers selected by quota sampling. Musculoskeletal disorders were measured among the samples before and after theuse of the designed ergonomic chair which they were asked to use for two months. T-test, ANCOVA, Wilcoxon test,McNemar test and Chi Square test were used for the analysis. The study found statistical significant differences of riskfactor against musculoskeletal disorders among the workers before and after their use of the designed ergonomic chair(p< 0.05); and of musculoskeletal disorders before and after using the ergonomic chair (p= 0,035). Body Mass Index(BMI) was identified as a confounding factor, and statistical significant difference of musculoskeletal disorders werealso found among the workers with <25 and >25 BMI even before and after using the ergonomic chair (p=0.033 andp=0.015 respectively). By ANCOVA statistical test, after controlling BMI, another statistical difference ofmusculoskeletal disorders was also identified before and after using the ergonomic chair (p=0.033). It is concluded thatthe designed ergonomic chair is effective to reduce the risk of musculoskeletal disorders.Pengaruh Pemakaian Kursi Ergonomis terhadap Gangguan Muskuloskeletal pada Pekerja Wanita Batik Tulisdi Kabupaten Sragen. Sebagian besar posisi kerja pekerja batik tulis di Sragen tidak ergonomis, sehingga berisiko terjadigangguan muskuloskeletal. Penelitian ini bertujuan untuk mendesain kursi ergonomis dan menilai efektifitas desainkursi terhadap gangguan muskuloskeletal pekerja wanita batik tulis. Jenis penelitian adalah eksperimental quasi denganpendekatan one group pre and posttest design. Populasi adalah seluruh pekerja industri Batik Sragen. Teknik samplingquota random sampling. Sampel sebanyak 50 orang diukur tingkat risiko keparahan gangguan muskuloskeletalnyasebelum dan sesudah menggunakan kursi ergonomis. Selanjutnya, dilakukan uji Wilcoxon test, McNemar test, dan ChiSquare test. Perbedaan tingkat risiko keparahan muskuloskeletal sebelum dan sesudah menggunakan kursi ergonomis(p< 0,05). Terdapat perbedaan keluhan muskuloskeletal sebelum dan sesudah menggunakan kursi ergonomis (p=0,035).Indeks massa tubuh teridentifikasi sebagai confounding factor karena terdapat hubungan yang signifikan terhadapgangguan muskuloskeletal, baik sebelum maupun sesudah menggunakan kursi ergonomis (masing-masing p=0,033 danp=0,015). Melalui uji Ancova, confounding factor dikendalikan, diperoleh hasil uji yang tetap signifikan (p=0,033).Kursi kerja ergonomis menurunkan risiko keparahan gangguan muskuloskeletal."

"Latar Belakang: Pekerja kantor dengan komputer berisiko untuk mengalami nyeri leher dan bahu. Bila nyeri leher dan bahu ini tidak ditangani dengan baik akan dapat mengganggu aktivitas pekerja baik di tempat kerja maupun di luar pekerjaan. Oleh karena itu diperlukan suatu penanganan yang tepat pada kasus nyeri leher dan bahu ini. Laporan ini dibuat untuk memperoleh bukti apakah latihan leher dan bahu efektif dalam mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer.Metode: Pencarian literatur dilakukan secara online dengan menggunakan database Pubmed dan Cohrane library. Judul dan abstrak yang didapatkan kemudian ditapis berdasarkan kriteria inklusi dan eksklusi. Telaah kritis dilakukan dengan menggunakan kriteria oleh Center-for Evidence Based Medicine, University of Oxford yang mencakup validity, importance dan applicability.Hasil: Didapatkan enam artikel yang relevan. Semua studi merupakan randomized controlled trial. Secara keseluruhan semua studi cukup valid, walaupun ada studi yang memiliki angka drop-out yang tinggi. Dari enam studi, aspek importance hanya dapat dinilai pada tiga studi karena tidak diketahui berapa effect size pada tiga studi lainnya. Pada tiga studi yang dapat dinilai aspek importance, walaupun ada hasil yang menunjukkan efek perbaikan yang bermakna secara statistik, namun efeknya secara klinis hanya minimal sampai sedang. Oleh karena tingkat kepentingannya yang rendah, maka tidak dilanjutkan lagi penilaian applicability.Kesimpulan: Belum ditemukan bukti yang cukup kuat bahwa latihan leher dan bahu efektif dalam mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer. Oleh karena itu kita belum dapat menyarankan latihan leher dan bahu ini sebagai terapi untuk mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer.

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Background: Computer office workers are at risk to have neck and shoulder pain. If neck and shoulder pain is not controlled properly, it can disrupt the worker?s activities both at work and outside work. Therefore proper treatment is needed for neck and shoulder pain. This report aims to obtain evidence whether neck and shoulder training is effective in reducing neck and shoulder pain among computer office workers.

Method: A literature search was conducted online using database of Pubmed and Cochrane library. Titles and abstracts were obtained and then screened based on inclusion and exclusion criteria. Critical appraisal was conducted using criteria by Center-for Evidence Based Medicine, University of Oxford include validity, importance and applicability.

Results: Six articles were found to be relevant. All studies are randomized controlled trials. Overall, all studies are quite valid although there are studies which have high drop-out rate. From six studies, aspect of importance only can be assessed in three studies because the effect size in three other studies was unknown. In the three studies where aspect of importance could be assessed, although there are outcomes that were statistically significant, the clinically improvement were only minimal to moderate. Because the level of importance is low, assesment of applicability was not conducted.

Conclusion: No sufficient evidence was found that neck and shoulder training is effective in reducing neck and shoulder pain among computer office workers. Therefore neck and shoulder training as therapy for reducing neck and shoulder pain among computer office workers can not be recommended."

"Perkembangan teknologi dapat membantu meningkatkan efektivitas dan produktivitas dalam dunia usaha. Akan tetapi, perkembangan ini dapat berdampak negatif apabila tidak sesuai dengan karakteristik dan kemampuan pekerja. Salah satu risiko akibat ketidaksesuaian tersebut adalah Musculoskeletal Disorders (MSDs). Penelitian ini menilai postur pada pekerja di Sentra Industri Tas PATRIA tahun 2013 yang bekerja dengan posisi duduk dengan jumlah responden 20 orang. Faktor lain yang berkaitan dengan postur adalah durasi, frekuensi dan beban yang dinilai menggunakan RULA. Penilaian ini dilengkapi menggunakan QEC untuk mendapatkan skor per bagian tubuh. Penelitian ini juga menggambarkan karakteristik individu seperti usia, jenis kelamin, masa kerja, IMT, perilaku merokok, perilaku olahraga yang berkontribusi terhadap terjadinya MSDs. Penelitian ini menilai keluhan MSDs menggunakan kuisioner NBM. Penelitian ini bersifat deskriptif observasional dengan disain studi cross sectional. Hasil penelitian ini menunjukkan risiko MSDs sangat tinggi pada seluruh proses pembuatan tas dan agenda yaitu pemotongan, penempelan, penjahitan pola dan finishing. Keluhan terbanyak adalah pada bagian leher bagian atas (60%), bahu kanan, punggung dan pinggang (masing-masing 50%). Untuk itu diperlukan upaya pengendalian secara ergonomi berupa perbaikan disain tempat kerja dan administrasi seperti pembatasan jam kerja, penyuluhan cara bekerja yang ergonomi dengan melibatkan pemiliki usaha dan Puskesmas setempat serta melibatkan pekerja secara aktif untuk menurunkan tingkat risiko dan keluhan MSDs.

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Technological development can help improve the effectiveness and productivity. However, these developments could have a negative impact if it is not in accordance with the characteristics and capabilities of workers. One such discrepancy is due to the risk of Musculoskeletal Disorders (MSDs). This study assesses posture on workers in industrial centers PATRIA bag in 2013 working in a sitting position with the number of respondents 2013. Another factor is related to postir duration, frequency and workload was assessed using RULA. This assessment was completed with using the QEC to get a risk index score on the body. This study also present the individual characteristics such as age, gender, years, body mass index, smoking and exercise behaviors that contribute to the occurrence of MSDs. This assessment also assessed MSDs complaints using a questionnaire NBM. This study is a descriptive observational cross-sectional study design. the results of this study showed a very high risk of MSDs in the whole process of bag making and agenda that is cutting, pasting, sewing and finishing. Most complaints are on the upper neck (60%), right shoulder, back, and waist (50%). for it, necessary control measures with improved ergonomic design and administrative work such as restrictions on hours of work, work ergonomics extension method involving local business owners and health centers as well as actively involving workers ringkat to reduce the risk of MSDs and complaints."

"ABSTRAKBackground: obesity and osteoarthritis have strong inter-relationship with multi-factorial mechanism thatcaused pain and leads to decreased quality of life. Exercise has been identified as prevention and managementagainst obesity and joint pain. This systematic review aims to assess the effect between exercises compared to dietgroup for chronic pain management, physical and mental function in obese patients with chronic musculoskeletalproblem. Methods: we performed a systematic search of Randomized Control Trial studies from Cochrane CentralRegister of Controlled Trials (CENTRAL); MEDLINE; EBSCO; SCIENCEDIRECT (Elsevier); SCOPUS, greyliterature, trial registry, ongoing study for published studies, and from the ClinicalTrial.gov, thesis of rehabilitationmedicine in RSCM, and proceeding books for unpublished studies that was last updated on November 2016. Riskof bias was assessed using Cochrane risk-of-bias tool and data were analyzed using Review Manager 2014.Results: one study showed no difference in pain reduction (assessed using VAS) between two groups. Two studiesshowed improvement in physical function measured using 6MWT in exercise group at 6 and 18 months with meandifference 28.12 [11.20, 45.04] and 26.21 [9.01, 43.41]. There was no significant effects observed for Mental andPhysical Function based on SF-36 after 6 months (1 study) and 18 months (2 studies) observation, with meandifference 1.10 [-0.79, 2.99] and 0.08 [-1.53, 1.70] respectively for Mental Function score and -0.30 [-2.54, 1.94]and -0.36 [-2.30, 1.57] respectively for Physical Function score. Conclusion: exercise can improve physicalfunction objectively, but could not reduce pain in obese patients with chronic musculoskeletal problem subjectively.Keywords: exercises intervention, chronic pain management, functional score, quality of life, systematic review."

"ABSTRAKThe accreditation of health centers is an endeavor by the Ministry of Health to improve the quality and performance of health centers regulated by Permenkes No. 4/2015. Of the 38 health centers in Brebes, only 10 has been accredited. We wish to discover how prepared are the health centers to be accredited based on the resources available and pre-accreditation survey. Data was obtained through in-depth interviews and documentary research. Results indicated that there was sufficient funds, facilities and equipment for the accreditation. However, the assessment scores for human resources sufficiency and documentary completeness was low.ABSTRAKAkreditasi Puskesmas merupakan upaya peningkatan mutu dan kinerja pelayanan puskesmas yang diatur oleh Permenkes Nomor 46 Tahun 2015. Dari 38 puskesmas di Kabupaten Brebes, hanya 10 puskesmas yang sudah terakreditasi. Penelitian ini bertujuan untuk mengetahui seberapa siapkah Puskesmas di Kabupaten Brebes untuk menghadapi akreditasi berdasarkan variabel sumber daya dan tahapan kesiapan survei pra-akreditasi. Data dikumpulkan melalui wawancara mendalam dan telaah dokumen. Hasil penelitian menunjukkan bahwa ketersediaan dana, sarana dan prasarana dinilai cukup siap untuk mendukung penilaian akreditasi puskesmas, namun hasil skoring assessment pada keterpemenuhan kompetensi SDM dan kelengkapan dokumen masih rendah."

"ABSTRAKSurgery is one of medical procedures that can be a stressor causing anxiety in patient. In Mamuju district hospital, informed consent is considered as medical procedure.This study was aimed to determine the influence of informed consent provision towards the level of anxiety in pre-operative patients at Mamuju District Public Hospital. The population in this study was pre-operative patients. Accidental sampling approach was applied to obtain a total of 32 samples. This quantitative study used quasi experimental design with a non-equivalent time sample design which was analysed using the Wilcoxon statistical test. The results showed that there was the effect of provision of informed consent on the level of anxiety in pre-operative patients at Mamuju District Public Hospital. Informed consent can reduce anxiety in pre-operative patient at Mamuju District Public Hospital."

"Abstrak"

"AbstrakUpper Respiratory Infection (URI) is a major cause of morbidity and mortality of infants and toddlers in developing countries. The high infant morbidity and mortality rates in Indonesia are associated with the low exclusive breastfeeding ability. Breast milk is a natural drink for newborns in the first month of life that is beneficial not only for the babies, but also for mothers. The aim of study was to determine exclusive breastfeeding and decrease in incidence of URI among infants aged 6-12 months. This study was conducted by using case control design. Samples were taken by using cluster random sampling. Subject of study consisted of 162 cases and 162 control with infants aged 6-12 years. Cases were 162 infants aged 6-12 months suffering from URI within one last month and taken by mothers to primary health care that was selected location of study, while control was mothers who took their infants aged 6-12 months who did not suffer from URI within one last month to the selected primary health care. Data analysis included univariate, bivariate, stratification, and multivariate analysis with logistic regression. Results of study found that infants who were not exclusively breastfed were 1.69 times (95% CI: 1.02-2.80) more at risk of increasing URI incidence compared to infants who were breastfed exclusively after controlled by smoker in house and immunization variables. Health promotion of 6-month exclusive breastfeeding, provision of immunization, and anti-smoking program need to be implemented continuously to decrease the rates of morbidity and mortality due to URI disease."