Critical issue in the identification of Down syndrome and its problems in Central Java, Indonesia: The fact of needing health care and better management.

We conducted a cross-sectional study to describe the health care problems of children with Down syndrome in Central Java, Indonesia. A total of 162 children (81 boys, 81 girls) with Down syndrome were included. Congenital heart defects and hypothyroidism were found in about 50%, followed by vision and hearing problems in 27.7% and 17.3%, respectively. Almost half of cases were diagnosed after the first month of age. Advanced maternal age was identified in more than 50%, and less than 10% was based on karyotype analysis. This study describes the essential issues such as critical co-morbidities, delayed diagnosis, advanced maternal age, and lack of (accessibility to) genetic testing facilities; thus, better health care and management is needed.

Linking Disaster Risk Reduction and Healthcare in Locations with Limited Accessibility: Challenges and Opportunities of Participatory Research.

Disaster risk reduction and healthcare support each other, including the mitigation of further harm after illness or injury. These connections are particularly relevant in locations which have permanent or temporary limited accessibility. In these circumstances, people are required to be self-sufficient in providing emergency and long-term healthcare with limited resources. Planning and preparing to mitigate further harm after illness or injury from disasters (disaster risk reduction) must include people living and working in locations with limited accessibility, meaning that participatory research can be used. The challenges and opportunities of enacting participatory research in such contexts have not been thoroughly examined. The research question of this paper is therefore, "What challenges and opportunities occur when participatory research links disaster risk reduction and healthcare to mitigate illness and injury in locations with limited accessibility?" To answer this research question, the method used is a qualitative evidence synthesis, combined with an overview paper approach. Two principal themes of challenges and opportunities are examined: defining the data and collecting the data. The themes are explored in theory and then through contextual examples. The conclusion is that an overarching challenge is divergent goals of research and actions that, when recognized, lead to opportunities for improved connections between disaster risk reduction and healthcare.