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Abstrak :
Pengurangan risiko jatuh merupakan bagian dari standar sasaran keselamatan pasien yang harus diperhatikan. Untuk mengurangi risiko jatuh di rumah sakit dilakukan penilaian risiko jatuh, pada pasien anak rawat inap menggunakan instrumen penilaian Humpty Dumpty Fall Scale (HDFS) Penelitian ini bertujuan mengidentifikasi gambaran tingkat risiko jatuh pada anak yang dirawat di rumah sakit. Desain penelitian ini adalah deskriptif dengan pendekatan potong lintang. Sampel 104 responden diambil dengan menggunakan teknik simple random sampling. Data yang dikumpulkan didapat dari catatan rekam medik pasien. Hasil penelitian menunjukkan gambaran tingkat risiko jatuh tinggi menurut karakteristik pasien anak yaitu pasien anak usia toddler (44,6%), bayi (26,8%), dan anak usia prasekolah (14,3%), laki-laki (66,1%), diagnosis medis dengan perubahan oksigenasi (39,3%) dan gangguan neurologis (28,6%), dan anak yang menggunakan obat penenang (32,1%). Penelitian ini merekomendasikan perlu dilakukan penelitian lebih lanjut mengenai pencegahan, pengetahuan, sikap dan perilaku perawat terkait dengan tingkat risiko jatuh. ...... Reduction of the risk of falling is part of the standard of patient safety goals that have to be considered. To reduce the risk of falls in hospital using falling risk assessment, pediatric patients hospitalized use instruments Humpty Dumpty Fall Scale (HDFS). The aimed of this study was to identify the level of the risk of falls in chidren inpatient. The research design was a descriptive cross sectional. The sample of this study was 104 respondents who were selected with a simple random sampling technique. Data were collected using a patient medical record. The result showed a high level of the risk of falling by the characteristic of pediatric patients in which patients were children aged toddler (44.6%), infant (26.8%), and preschoolers (14.3%), male (66.1%), medical diagnosis with changes in oxygenation (39.3%) and neurogical disorders (28,6%), and children who use drugs tranquilizers (32.1%). The study recommends further research needs to be study on prevention, knowledge, attitudes and behavior of nurses associated with the risk level falls.

Abstrak :
Kebocoran plasma sistemik pada sepsis dapat mengakibatkan berbagai komplikasi dari renjatan sampai kematian. Belum ada teknik andal untuk menilai kebocoran plasma sistemik pada anak. Degradasi glikokaliks, ditandai meningkatnya sindekan-1 dalam darah, menyebabkan perubahan permeabilitas vaskular sistemik. Pada glomerulus bermanifestasi sebagai albuminuria sehingga kenaikan rasio albumin-kreatinin (ACR) urin berpotensi menggambarkan kebocoran plasma sistemik. Sampai saat ini belum ada rujukan nilai sindekan-1 dan ACR urin sebagai penanda kebocoran plasma sistemik pada anak. Penelitian ini bertujuan untuk mengetahui peran ACR urin dan nilai rujukan ACR urin sebagai penanda kebocoran plasma sistemik pada anak sepsis dan mengkaji kaitannya dengan sindekan-1. Penelitian ini terdiri atas studi deskriptif pada anak sehat dan penelitian longitudinal prospektif dengan rancangan potong lintang berulang terhadap anak sepsis, dilakukan di RSUP Cipto Mangunkusumo Jakarta, RSUP H. Adam Malik Medan dan RSUP Kariadi Semarang dalam rentang waktu Maret–Desember 2015. Dilakukan pemeriksaan sindekan-1 dan ACR urin pada pasien sepsis yang dirawat di instalasi rawat intensif anak pada hari rawatan ke-1, 2, 3 dan 7, dan mencatat skor Pediatric Logistic Organ Dysfunction pada hari rawatan ke-1 dan 3. Tiga puluh subjek sehat dan 49 subjek sepsis diikutsertakan dalam penelitian. Pada kelompok sehat didapati median ACR urin 10,5 (3–88) mg/g dan rerata sindekan-1 sebesar 27,7 (SB 2,24) ng/mL. Sindekan-1 di atas persentil 90 (41,42 ng/mL) ditetapkan sebagai batasan kebocoran plasma sistemik. Didapati 40 orang (81,6%) subjek sepsis dengan sindekan-1 > 41,42 ng/mL dan 33 orang (67,3%) menunjukkan ACR urin > 300 mg/g pada hari rawatan 1. Didapati koefisien korelasi (r) 0,32 (P < 0,001) antara ACR urin dan sindekan-1. Area under the curve ACR urin terhadap kebocoran plasma sistemik diperoleh sebesar 65,7% (95% IK 54,5–77%; P = 0,012). ACR urin > 157,5 mg/g ditetapkan sebagai cut-off point kebocoran plasma sistemik dengan sensitivitas 77,4% dan spesifisitas 48%. ACR urin dapat digunakan sebagai penanda kebocoran plasma sistemik, peningkatan ACR urin akan mengikuti peningkatan sindekan-1. ......Systemic plasma leakage during sepsis can cause several complications from shock to death. There is no feasible measurement of systemic plasma leakage in children. Glycocalyx degradation, marked by increased serum syndecan-1, alters vascular permeability. In the glomerulus this can manifest as albuminuria, therefore elevated urinary albumin-creatinine ratio (ACR) potentially provides an index of systemic plasma leakage. Nowadays. there is no reference value of syndecan-1 and urinary ACR as a marker of systemic plasma leakage in pediatric population. This study aims to analyze the role of urinary ACR and to determine its reference value as a marker of systemic plasma leakage in pediatric sepsis, by analyzing its correlation with syndecan-1. This study consisted of descriptive study on healthy children and longitudinal prospective study with repeated cross-sectional design on septic children, was conducted at Cipto Mangunkusumo Hospital Jakarta, Haji Adam Malik Hospital Medan and Kariadi Hospital Semarang from March to December 2015. We examined serum syndecan-1 and urinary ACR of septic patients in pediatric intensive care unit on day 1, 2, 3 and 7. Pediatric Logistic Organ Dysfunction (PELOD) score were recorded on day 1 and 3. Thirty healthy subjects and 49 septic subjects were recruited. In the healthy group, median of urinary ACR was 10.5 (3–88) mg/g and mean of syndecan-1 was 27.7 + 2.24) ng/mL. Syndecan-1 more than 90th percentile (41.42 ng/mL) was determined as systemic plasma leakage. Forty (81.6%) septic subjects had syndecan-1 > 41.42 ng/mL and 33 (67.3%) subjects had urinary ACR > 300 mg/g on day 1. Correlation coefficient (r) between urinary ACR and syndecan-1 was 0.32 (P < 0.001). Area under the curve of urinary ACR and plasma leakage was 65.7% (95% CI 54.5–77%; p = 0.012). Urinary ACR > 157.5 mg/g was determined as cut-off point of systemic plasma leakage with sensitivity 77.4% and specificity 48%. Urinary ACR can be used as marker of systemic plasma leakage. Increased urinary ACR would indicate increased syndecan-1.

Abstrak :
Stunting adalah menurunnya laju pertumbuhan panjang/tinggi badan dibawah minus 2 standar deviasi. Desa Cijeruk Kecamatan Kibin merupakan desa dengan angka kejadian stunting tertinggi di Kab. Serang dimana 233 (77,66%) balita menderita stunting. Tujuan penelitian ini adalah mengidentifikasi gambaran kejadian stunting pada balita di Desa Cijeruk Kecamatan Kibin Kabupaten Serang Banten tahun 2023 dan menganalisis hubungannya dengan Riwayat Penyakit Infeksi. Desain penelitian adalah potong lintang dengan pendekatan kuantitatif. Hasil penelitian didapatkan terdapat hubungan riwayat penyakit infeksi dengan kejadian stunting (p<0,01). Balita dengan riwayat penyakit infeksi berisiko 21,23 kali mengalami stunting (OR=21,23,95% CI 7,15-62,01). Variabel kovariat faktor balita yang berhubungan dengan kejadian stunting adalah jenis kelamin (p=0,038) dan riwayat penyakit infeksi (p=<0,001); faktor keluarga yaitu pendapatan keluarga (p=0,040) dan pola asuh otoriter (p= 0,004); dan faktor lingkungan yaitu stop buang air besar sembarangan (p=0,038) dan pengamanan sampah rumah tangga (p=<0,001). Variabel MP-ASI dan stop buang air besar sembarangan merupakan variabel perancu terhadap hubungan riwayat penyakit infeksi dengan kejadian stunting. Balita yang memiliki riwayat penyakit infeksi berisiko 31,30 kali lebih tinggi mengalami stunting dibanding balita yang tidak memiliki riwayat penyakit infeksi setelah dikontrol oleh variabel perancu (OR=21,28 95% CI 6,088-74,379). ......Stunting is a decrease in the growth rate of length/height below minus 2 standard deviations. Cijeruk Village, Kibin District, is the village with the highest stunting rate in Kab. Serang where 233 (77.66%) toddlers suffer from stunting. The purpose of this study was to identify the description of the incidence of stunting in toddlers in Cijeruk Village, Kibin District, Serang Banten Regency in 2023 and analyze its relationship with a History of Infectious Diseases. The research design is cross-sectional with a quantitative approach. The results of the study found that there was a relationship between a history of infectious diseases and the incidence of stunting (p <0.01). Toddlers with a history of infectious diseases are at risk of 21.23 times experiencing stunting (OR=21.23.95% CI 7.15-62.01). The covariate variables associated with stunting were gender (p=0.038) and history of infectious diseases (p=<0.001); family factors, namely family income (p=0.040) and authoritarian parenting (p=0.004); and environmental factors, namely stopping open defecation (p=0.038) and safeguarding household waste (p=<0.001). The MP-ASI variable and stopping open defecation are confounding variables for the relationship between a history of infectious diseases and the incidence of stunting. Toddlers who have a history of infectious diseases have a 21.28 times higher risk of experiencing stunting than toddlers who do not have a history of infectious diseases after controlling for confounding variables (OR=21.28 95% CI 6.088-74.379).