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"Kuantitas dan kualitas asupan protein belum sepenuhnya diketahui perannya terhadap kualitas hidup. Prognostic Nutritional Index (PNI) juga belum diketahui dapat mencerminkan kualitas hidup dan apakah bisa ditingkatkan dengan asupan protein. Penelitian dengan desain potong lintang ini bertujuan untuk mengetahui korelasi antara asupan protein dengan PNI dan kualitas hidup serta korelasi PNI dengan kualitas hidup pada pasien kanker kepala leher dengan radioterapi di Departemen Radioterapi Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Sebanyak 61 subjek didapatkan dari consecutive sampling. Rerata usia subjek adalah 46,3 ± 12,4 dan 65,6% subjek berada pada kanker stadium IV dan mendapatkan terapi kemoradiasi. Sebanyak 32,8% subjek yang memiliki status gizi kurang. Median asupan protein adalah 1,42 (0,26-4,11) g/kg/hari. Nilai PNI pada subjek penelitian memiliki median 45,9 (29,4-54,2). Hasil penelitian menunjukkan adanya korelasi bermakna antara kuantitas asupan protein berdasarkan Food Frequency Questionnaire (FFQ) semikuantitatif dan beberapa aspek gejala pada kualitas hidup yaitu pada aspek pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37;p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). Kualitas asupan protein tidak berkorelasi bermakna dengan kualitas hidup. PNI berkorelasi bermakna terhadap 1 aspek fungsional yaitu physical function (r=0,378; p=0,003) dan 2 aspek gejala yaitu opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Meskipun tidak signifikan secara statistik, namun PNI memiliki arah korelasi yang positif terhadap aspek fungsional lainnya dan memiliki arah korelasi negatif terhadap aspek gejala lainnya yang berarti semakin tinggi PNI maka aspek fungsional semakin baik dan gejala semakin ringan. Studi ini tidak menemukan adanya korelasi bermakna antara asupan protein, baik kualitas maupun kuantitasnya, terhadap PNI. Hasil ini diduga berkaitan dengan penemuan bahwa sebagian besar penderita masih memiliki pola asupan yang mampu mencukupi kebutuhan kalori dan protein harian. Diperlukan studi prospektif yang menelusuri aspek prognostik kanker kepala leher dari segi kualitas hidup untuk mengetahui apakah PNI dapat memprediksi aspek kualitas hidup dengan lebih rinci.

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Quality and quantity of protein intake has not been well understood that it can affect quality of life. Moreover, Prognostic Nutritional Index (PNI) also has not been well studied upon its usage to reflect quality of life of head and neck cancer patients undergoing radiotherapy. This cross sectional study was aimed to determine the correlation between protein intake and PNI and also the correlation between PNI and quality of life in head and neck cancer patients undergoing radiotherapy at Radiotherapy Department, dr. Cipto Mangunkusumo General Hospital, Jakarta. Total of 61 subjects were recruited with consecutive sampling method with mean age of 46,3 ± 12,4 years old and 65,6% subjects were on stage IV cancer and were getting a combination of chemo and radiotherapy. Only 32,8% subjects were on low nutritional status. Median of total protein intake was 1,42 (0,26-4,11) g/kg/day. Median of PNI was 45,9 (29,4-54,2) among subjects. The result of the study showed a significant correlations between quanitity of protein intake based on semiquantitative Food Frequency Questionnaire (FFQ) with several aspects of quality of life, that were pain (head and neck) (r=-0,32; p=0,01), swallowing (r=-0,37; p=0,004), social eating (r=-0,29; p=0,02), dry mouth (r=-0,41; p=0,001), sticky saliva (r=-0,32; p=0,01), fatigue (r=-0,28; p=0,03), nausea and vomiting (r=-0,26; p=0,04) dan appetite loss (r=-0,3; p=0,01). This aspects were all symptomatics. PNI was significantly correlated with 1 functional aspect, which was Physical function (r=0.378; p=0,003) and 2 symptomp aspects, which were opening mouth (r=-0,325; p=0,01) dan dyspnea (r=-0,257; p=0,045). Although not statistically significant, but there were positive direction of correlation with other functional aspects and negative direction of correlation with other symptomps aspects. This implicates that the higher the PNI, the lower the symptoms and the better the functional status of head and neck cancer patients undergoing radiotherapy. This study did not show a significant correlation between quality and quantity of protein intake with PNI. An adequate intake of calorie and protein in most subjects were found in this study which might explain the result. More studies, preferably prospective one, may be needed to show the usage of PNI to reflect quality of life, especially involving quality of life progresivity."

"Latar Belakang: Operator crane merupakan pekerjaan yang memiliki resiko tinggi mengalami gangguan muskuloskeletal. Studi epidemiologi yang dilakukan oleh Kuswaha et al menunjukkan bahwa dari 90% operator crane, 63% mengalami nyeri leher.1 Operator crane melakukan sebagian besar aktivitas kerja mereka dengan postur tubuh yang janggal pada leher, bahu dan punggung. Prevalensi nyeri leher yang tinggi dikaitkan dengan derajat fleksi leher yang tinggi serta postur statis dan janggal saat duduk. Postur membungkuk yang terus menerus dapat menyebabkan ketegangan dan tekanan pada jaringan lunak di sekitar tulang belakang. 2 Bekerja mengoperasikan crane dalam posisi duduk statis dan membungkuk ke bawah dan dalam waktu yang lama merupakan bagian dari tuntutan pekerjaan yang tidak dapat diubah secara teknis, sehingga perlu dilakukan kontrol, salah satunya dengan program peregangan. Penelitian ini bertujuan untuk membuktikan apakah peregangan yang dilakukan dalam waktu dua minggu (lebih singkat dari studi referensi) mampu menurunkan nilai VAS nyeri leher pada operator crane, serta untuk mengetahui berapa nilai penurunan VAS tersebut. pengukuran sebelum peregangan dan setelah peregangan.Metode: Studi analitik dengan desain within group experiment with repeated measurement. Dilakukan terhadap 25 orang responden yang dipilih secara consecutive sampling dengan mempertimbangkan kriteria inklusi dan eksklusi penelitian. Penelitian dilakukan dengan pemberian edukasi gerakan peregangan yang dilakukan dalam durasi sekitar lima menit, dilakukan dua kali dalam sehari yaitu sebelum dan setelah bekerja, dilakukan lima hari dalam satu minggu, selama dua minggu. Kemudian dilakukan pengukuran nilai Visual Analog Scale (VAS) sebelum dilakukan peregangan dengan sesudah dilakukan 5 hari peregangan dan 10 hari peregangan.Hasil: Didapatkanya nilai prevalensi nyeri tengkuk sebanyak 39,6% serta terdapat penurunan signifikan dari nilai nyeri sebelum dilakukan peregangan (VAS = 5 (3-7)) dengan nilai nyeri setelah dilakukan peregangan (VAS = 3 (1-5)) dengan nilai p<0,01 dari uji wilcoxon. Tidak didapatkannya perubahan yang bermakna terhadap faktor individu yang dinilai, baik berdasarkan variabel umur, status gizi, kebiasaan olahraga, dan kebiasaan merokok.Kesimpulan: Peregangan otot dapat menurunkan nilai nyeri tengkuk leher pada subjek penelitian operator crane, yang diukur berdasarkan Visual Analogue Scale (VAS) dengan intervensi peregangan dilakukan  selama 2 minggu.      

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Background: Working to operate a crane in a sitting position for a long time with the back and neck bent is considered to be associated with an increased risk of neck and back pain disorders in crane operators, and is part of the job demands that cannot be changed technically. It is necessary to control the incidence of neck pain in crane operators, one of which is by stretching. The purpose of this study was to prove whether stretching that was carried out within two weeks (shorter than the reference study) was able to reduce the VAS value in neck pain in crane operators.

Methods: This study used an analytical study in the form of within group experiment with repeated measurement design. This research was conducted at the X container terminal located in North Sumatra, carried out when there were still social restrictions on the Covid-19 pandemic in October 2020. This study involved 25 respondents, who were obtained through consecutive sampling. Interventions were carried out by providing education for the McKenzie stretching movements which were about five minutes duration, twice a day, before and after work, for five days a week, in two weeks. Then the Visual Analog Scale (VAS) value was measured before stretching, 5 days of stretching and 10 days of stretching. The stretching and VAS measurement activities were monitored by the company doctor as well as the research team whose perceptions were matched.

Results: The prevalence value of neck pain was 39,6% and there was a statistically significant decrease in VAS levels from VAS = 5 (3-7) before stretching to VAS = 3 (1-5) after stretching for 2 weeks with p values 0.000. There were no significant changes in individual factors that could potentially be confounding factors, such as age, nutritional status, exercise habits, and smoking habits during the experiment.

Conclusion: Muscle stretching can reduce the value of neck pain in crane operator research subjects, which was measured based on the Visual Analog Scale (VAS) with stretching interventions carried out for 2 weeks."