Research Trends in Molecular Biological Studies on Oral Squamous Cell Carcinoma: A Bibliometric Analysis.

Background: Since the discovery of PCR and ELISA, in vitro research in the realm of molecular biology pertaining to oral squamous cell carcinoma (OSCC) has witnessed significant expansion. Objective: to provide a comprehensive overview of molecular biology research on OSCC through visual mapping techniques. Methods: We conducted an analysis of publications within the "oral squamous cell carcinoma" category from Scopus' core collection. On 20 January 2023, we screened these publications using an advanced search employing the keywords "oral squamous cell cancer" and "cell line." Data analysis was performed using Microsoft Excel 2010 and VOSviewer, facilitating the examination of author contributions, journal productivity, institutional affiliations, and contributions by nations. VOSviewer was further utilized for co-occurrence and reference analysis of keywords. Results: A total of 781 papers spanning from 1992 to 2023 were collected. Notably, Japan, China, and the United States emerged as significant contributors in this field. The Osaka University Graduate School of Dentistry (Japan) ranked first with 21 publications. Chae J-I of Chonbuk National University (South Korea) emerged as the most prolific author, with 14 publications. The International Journal of Oncology and the Journal of Oral Pathology and Medicine were identified as the two most prolific journals. The central themes that emerged were epidermal growth factor receptor, invasion, epithelial-mesenchymal transition, angiogenesis, apoptosis, and metastasis. Conclusion: The rate of publications focused on the molecular biology of OSCC has seen a remarkable increase. Research priorities have shifted from topics such as "radiation, RANKL, cyclin D1, RNA interference, and matrix metalloproteinase" to encompass areas such as "chemoresistance due to cisplatin, other therapeutic agents (metformin and monoclonal antibody), autophagy, inflammation, microRNA, cancer-associated fibroblasts, and STAT3 (with roles in cell migration and tumorigenesis)." These seven significant future research areas hold promise in identifying reliable biological markers for oral cancer detection and treatment, thereby improving clinical outcomes.

Comparison of hs-CRP in Adult Obesity and Central Obesity in Indonesia Based on Omega-3 Fatty Acids Intake: Indonesian Family Life Survey 5 (IFLS 5) Study.

Obesity and central obesity are associated with dire conditions, such as metabolic syndrome, in which low-grade inflammation plays a part. C-reactive protein (CRP) is an inflammatory marker found to be elevated in those conditions. Omega-3 fatty acids work against inflammation and lower CRP levels in obese individuals. This study compared high-sensitivity CRP (hs-CRP) in adult obesity and central obesity in Indonesia based on omega-3 fatty acid intake using Indonesian Family Life Survey (IFLS) 5 data. Secondary data from household questionnaires were obtained from the IFLS 5 online database. Data from 3152 subjects were used; 76.65% of the subjects were female, with a mean age of 45.27 ± 15.77 years. Subjects were classified into five modified categories of obesity and central obesity based on body mass index (BMI) and waist circumference (WC). Omega-3 fatty acid intake was categorized into "low" and "adequate" based on dietary recommendations from the Mediterranean Diet Foundation (2011). There is a significant difference in hs-CRP based on modified obesity categories (p < 0.05). There was no significant difference in hs-CRP between low and adequate omega-3 intake (p > 0.05). These data suggest that hs-CRP is related to overweight, obesity, and central obesity. Meanwhile, omega-3 fatty acids are unrelated to hs-CRP. Further studies are needed to confirm these results.

Effects of Indonesian Shortfin Eel (Anguilla bicolor) By-Product Oil Supplementation on HOMA-IR and Lipid Profile in Obese Male Wistar Rats.

The prevalence of people being overweight and obese has increased globally over the past decades. The use of omega-3 fatty acids-a compound usually primarily found in fish oil-has been known to improve the metabolic profile of obese patients. As the demand for eels increases, the number of waste products from the eels increases and creates environmental problems. This study was conducted to investigate the effect of a newly discovered Indonesian Shortfin eel by-product oil supplementation on the Homeostasis Model Assessment-Estimated Insulin Resistance (HOMA-IR) and lipid profiles of obese male (Lee index ≥ 0.3) Wistar rats (Rattus norvegicus). The oil was extracted from waste products (heads). Fifteen obese rats were divided into three groups and were administered NaCl (C), commercial fish oil (CO), and Indonesian shortfin eel by-product oil (EO). All groups had statistically significant differences in total cholesterol, LDL, and triglyceride levels (p < 0.05). The CO and EO group showed a significant decrease in total cholesterol, LDL, and triglyceride after treatment. However, no significant difference was found in HDL levels and HOMA-IR. The supplementation of Indonesian shortfin eel by-product oil significantly improved lipid profile while effectively mitigating environmental challenges.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study.

Iron deficiency anemia (IDA) in adolescent girls is a problem that has not been resolved. This study aimed to explore the critical aspects of an integrated health care system model for preventing IDA in adolescent girls in a rural area of Indonesia. This qualitative research employed a grounded theory approach in order to build a substantive theory. This study used in-depth interviews with adolescents, parents, teachers, health workers, and persons in charge of adolescent programs at the health office, education office, and ministry of religion. Purposive sampling was performed until data saturation was achieved. Codes, categories, and themes were generated through thematic data analysis to develop a substantive theory. Data analysis was performed using MAXQDA 2022 software. A total of 41 people participated in this study. This investigation generated twenty-two categories and seven themes. These themes relate to policymaker commitments, stakeholder governance, quality, adolescents' lifestyles, adolescents' self-factors, adolescents' access to health services, and social support. The themes identified become fundamental aspects of the integrated health care system model for preventing IDA in adolescent girls. The model of the integrated health care system consists of several essential points, which include awareness and efforts from policymakers and adolescent girls, supported by parents, teachers, and the community.

The Effect of Mobile Health (m-Health) Education Based on WANTER Application on Knowledge, Attitude, and Practice (KAP) Regarding Anemia among Female Students in a Rural Area of Indonesia.

Female students, as adolescent girls, are more at risk of anemia because of high nutritional requirements. Health education through mobile applications influences the knowledge, attitude, and practice (KAP) of anemia in adolescent girls. Based on our previous study, several adolescents experienced anemia. This study aims to analyze the effect of health education through mobile applications, namely the WANTER application, on increasing KAP. This study was quasi-experimental with a pretest−posttest design; the sample was divided into an intervention (WANTER application) and a control group (booklet). The study was conducted in a rural area of Indonesia. There were 162 adolescent girls included in the intervention group and as many as 115 adolescent girls in the control group. Our study showed that adolescents' knowledge and attitude increased significantly in three months after the intervention of WANTER and booklets toward preventing anemia with p < 0.001; however, there was no significant difference in KAP between the control and intervention groups. In addition, there was no improvement in practice, either in the control or intervention groups. Knowledge, attitudes, and practices to prevent anemia need to be continuously improved. Health education through appropriate media for adolescents is very important to make interventions more effective.

Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study.

The study aims to explore the implementation outcome variables of Indonesia's national policy convergence action in the stunting reduction intervention at district, sub-district, and village levels. The study design was qualitative with an implementation research approach at District Cirebon, Indonesia. Data were collected through in-depth interviews, focus group discussions, study documents, and 6 months of participant observation. We recruited 172 respondents. The assessment instrument used was formed on was implementation outcomes variables. Data were analyzed through coding, categorizing and thematic content analysis based on a predetermined theme. Comparative cross district activity-site analysis was applied between sub-districts and villages. The implementation outcome variables for the convergence action policy were performed well at the district level, in line with the central government's adequate regulation, control, and budget. Meanwhile, the sub-district and village levels only performed aspects of acceptability, appropriateness, and coverage for specific interventions. The acceptability level in the village was only partially running. The barriers at the sub-district and village levels were issues of commitment, staff capacity, and poor coordination. Superficial understanding and capacity weaknesses drove the convergence of the stunting reduction responsibility back into the burden of the health sector at the forefront. Local politics also colored the implementation in the village.

Impact of Point of Care Quality Improvement Training and Coaching on Quality Perceptions of Health Care Workers: Implication for Quality Policy.

Background: The quality of infant healthcare service is one of the essential factors in preventing infant mortality. The purpose of the study was to analyze the quality performance in primary healthcare centers (PHC) and hospitals before and after the point of care quality improvement (POCQI) training for Infant Healthcare Services (IHS). Methods: This is a mixed-method study design with convergence triangulation strategy, conducted at six public PHCs and four hospitals in two districts of West Java Province, Indonesia. One hundred health care workers (HCWs) were involved for quantitative study at baseline and end of intervention. An additional 40 patients participated as informants for qualitative study. Quantitative data analysis was performed by Rasch modeling and independent t-test for all variables, followed by content analysis for qualitative data. Results: There were significant changes in the variables of POCQI skill (mean diff: 5.14, p=0.001), quality improvement (QI) understanding (mean diff: 1.2; p=0.001), and QI engagement (mean diff: 1.7; p=0.001) in the PHC group. Although there was an increase in process and outcome variables, the changes were not significant. There was a significant change in all variables in the hospital group which were outcome (mean diff: 2.32 (p=0.19); POCQI skill (mean diff: 2.80, p=0.001); process (mean diff: 1.48, p= 0.01); QI understanding (mean diff: 1.01; p=0.01), and QI engagement (mean diff: 1.52; p=0.03). Patient perception in the qualitative study showed that PHCs and Hospitals' services improved. Moreover, health care workers found they have a better understanding of service quality and created quality changes and improved POCQI steps. Conclusion: Implementation of POCQI in PHC and hospitals improved the performance of the quality of his, therefore assuring that POCQI is an appropriate approach and tool to be adopted in the policy for strengthening the health system.

Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life.

Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.

The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia.

An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents' QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls' quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents' QoL scores were physical health 44 (25-81), psychological domain 56 (19-94), social relationships 56 (19-94), and environmental domain 56 (31-100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents' QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents' nutrient intake in order to improve their QoL.

Iron Deficiency Anemia and Associated Factors Among Adolescent Girls and Women in a Rural Area of Jatinangor, Indonesia.

Background: Iron deficiency anemia is a common problem among adolescent girls and women, with significant consequences on personal health. One of the causes of iron deficiency anemia is inadequate nutritional intake. This study explores iron-deficiency anemia and associated factors among adolescent girls and women in a rural area of Jatinangor, Indonesia. Methods: A cross-sectional study was conducted with 95 adolescent girls and 85 women between April and November 2018. Cluster random sampling was used to select the participants from seven villages in the Jatinangor district. After obtaining informed consent, we collected sociodemographic data, menstrual histories, and related data, including nutritional intake using 24-hour dietary recall. Anthropometrics were gathered to determine the body mass Index (BMI), and venous blood samples were analyzed for complete blood count and hemoglobin levels. Descriptive statistics followed by bivariate and multivariable logistic regression were used to identify anemia-associated factors. Results: The prevalence of iron deficiency anemia among the girls was 21.1% and 9.4% among women, with an average hemoglobin level in adolescents of 10.75 g/dL (± 0.79) and in adults 11.20 g/dL (± 0.61), whereas MCV was 74.49±8.22 fL in adolescents and 7.61±8.62 fL in adults. The majority of our samples were not stunted in growth and were also within a normal weight range. Multivariate logistic regression analysis showed that protein intake (OR=0.25; 95% CI 0.11-0.58) was a positively associated factor with anemia. Conclusion: The prevalence of iron-deficiency anemia in this study represents a mild public health problem in the study sample. Based on the hemoglobin level, anemia, can be classified as moderate in adolescents and mild in adults. Low levels of MCH indicate iron-deficiency anemia. Sufficient protein intake did not prevent anemia due to macronutrient and micronutrient intake.

The Magnitude of Anxiety and Depressive Symptoms Among Tuberculosis Patients in Community Health Centers Setting During the Peak of COVID-19 Pandemic.

Background: Mental health problems can occur in patients with chronic diseases such as tuberculosis, and the stress of a pandemic exacerbates the condition. The study aims to explore the magnitude of anxiety and depressive symptoms in tuberculosis (TB) patients in community health centers (CHCs) settings during the COVID-19 pandemic. Methods: The study design was quantitative and cross-sectional. Subjects were TB patients who were recruited from TB services by doctors in CHCs. TB patients (n=74) were screened for anxiety and depressive symptoms over 4 months. Screening results are uploaded on a cloud-based digital platform and analyzed. Non-TB patients, as a comparison, were recruited and screened from the same cloud-based digital platform (n=245) during the same period. Analysis was carried out using Rasch modeling for data transformation. Data was analyzed then for frequency distribution for both groups and the logistic binaries to measure the burden of the mixed anxiety and depressive symptoms among the TB patient age's sub-group. Results: In both groups, there were 48.9% of mild, moderate, and severe categories of anxiety and 63.9% of depressive symptoms. In the TB-patients group, anxiety occurred at 48.7%, of which 23% were in the moderate and severe categories, compared to 13.4% for non-TB patients. Depressive symptoms were present in 71.6% of the TB patient group, of which 28.4% were in the moderate and severe categories, compared to 15.5% of non-TB patients. TB patients aged less than 20 years experienced moderate-severe anxiety with depressive symptoms simultaneously (mixed) as much as 16.3% or 4.6 times more than those aged over 20 years (p<0.05). Conclusion: Moderate and severe anxiety and depressive symptoms were shown higher in the TB patients' group. Adolescents with TB are more susceptible to mental and emotional disorders.

Factors Affecting Payment Compliance of the Indonesia National Health Insurance Participants.

BACKGROUND: The study aims to explore factors that affect the compliance of Indonesia National Health Insurance (INHI) in paying the premiums. METHODS: The study design was qualitative with grounded theory research approach and constructivism paradigm. The study was conducted in 2018 and carried out for 3 months. We recruited 22 respondents from four different cities/districts. Triangulation was carried out through 26 informants from various stakeholders. Data were analyzed through coding, categorizing and pattern matching to obtain substantive theory. RESULTS: The resulting substantive theory consists of 6 constructs and 14 categories. Compliance with paying insurance premium depends on the intention to pay for contribution. Meanwhile, the intention to pay is related to internal and external factors of INHI participants. To improve payment contribution of independent participants, INHI program has to pay attention for factors originating internally from the participants themselves (understanding of INHI program, financial ability and self-attitude) and also externally such as operational system and the quality of health care. CONCLUSION: Compliance of paying insurance premium is related to internal and external factors of participants. Thus, interventions to improve compliance to pay premium should take these factors into account, and not merely on increasing the knowledge of participants.

Effect of Eel Cookie Supplementation on the Hemoglobin Status of Pregnant Women with Anaemia: A Pilot Study.

BACKGROUND: Anaemia in pregnancy is a major global health problem. Iron and folic acid (IFAS) and animal-based supplement consumption could improve the hemoglobin status of pregnant women. This study is aimed at determining the effect of eel cookie supplementation on hemoglobin levels of pregnant women. METHODS: This pilot study with pretest-posttest design was conducted in Tamanjaya Public Health Center, Geopark Ciletuh, Sukabumi District, West Java Province, Indonesia. A total of 40 voluntary pregnant women were divided into two groups: an intervention group that received 11 pieces of eel cookies and control group that received the same number of cookies without eel. The women's hemoglobin level was analysed using t-test, Mann-Whitney, Wilcoxon, and analysis of covariance tests. RESULTS: After consuming the eel cookies for 1 month, there was a significantly greater increase in the hemoglobin levels in the intervention group than those in the control group, which were 1.69 and 0.69 g/dL, respectively. Improvement in percentage of mean hemoglobin was higher in the intervention group than in the control group, which was 17.21% and 6.53%, respectively. CONCLUSIONS: Supplementation with eel cookies and IFAS for 1 month could improve the hemoglobin status in pregnant women with anaemia.

Initiating a district-based public-private mix to overcome tuberculosis missing cases in Indonesia: readiness to engage.

BACKGROUND: District-based public-private mix (DPPM) is a variant of a relatively new PPM strategy of addressing missing cases in the tuberculosis (TB) care cascade in Indonesia. We aimed to determine the readiness of various stakeholders to engage in implementing the DPPM strategy. METHODS: The research design was sequential exploratory mixed methods. A qualitative study in the first stage was carried out through in-depth interviews, FGD and study documents. Data were analyzed through coding, categorizing, pattern matching and theorizing. The second stage was a survey conducted using instruments built in the first stage. Data were analyzed using Rasch modeling and logistic regression. RESULTS: District TB case detection rate (CDR) has improved from 35% (2018) to 104% (2019). The contribution of private hospitals has increased considerably. However, there were almost none from the private primary healthcare facilities. The substantive theory generated indicates that awareness and concern of the TB problem, TB program comprehension and involvement, and institutional support are behind the readiness of facilities to engage the TB program (the readiness to engage). The measurement results indicate the significant correlation of all dimensions on readiness to engage. Concern of the TB problem and institutional support are variables that influence readiness to engage (p < 0.05). CONCLUSIONS: Engaging private and public facility stakeholders is a challenge for local government. Intervention is through a personalized approach, encourages institutional support of health facilities for the TB program and system approach.

Online Mental Health Survey for Addressing Psychosocial Condition During the COVID-19 Pandemic in Indonesia: Instrument Evaluation.

BACKGROUND: Regular monitoring of the pandemic's psychosocial impact could be conducted among the community but is limited through online media. This study aims to evaluate the self-rating questionnaire commonly used for online monitoring of the psychosocial implications of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: The data were taken from the online assessment results of two groups, with a total of 765 participants. The instruments studied were Self-Rating Questionnaire (SRQ-20), post-traumatic stress disorder (PTSD), and Center for Epidemiological Studies Depression Scale-10 (CESD-10), used in the online assessment. Data analysis used Rasch modeling and Winsteps applications. Validity and reliability were tested, and data were fit with the model, rating scale, and item fit analysis. RESULTS: All the scales for outfit mean square (MnSq) were very close to the ideal value of 1.0, and the Chi-square test was significant. Item reliability was greater than 0.67, item separation was greater than 3, and Cronbach's alpha was greater than 0.60; all the instruments were considered very good. The raw variance explained by measures for the SRQ-20, PTSD, and CESD-10 was 30.7%, 41.6%, and 47.6%, respectively. The unexplained eigenvalue variances in the first contrast were 2.3, 1.6, and 2.0 for the SRQ-20, PTSD, and CESD-10, respectively. All items had positive point-measure correlations. CONCLUSION: The internal consistency of all the instruments was reliable. Data were fit to the model as the items were productive for measurement and had a reasonable prediction. All the scales are functionally one-dimensional.

Training and Assessing Model for the Ability of Community Health Volunteers in Anthropometric Measurement Using the Rasch Stacking and Racking Analyses.

Background: Inappropriate anthropometric measurements of infants and toddlers lead to a misclassification in nutritional status and loss of important interventions. Considering the practice conducted in this program within a country, its impact on millions of children must be considered. This study assesses the ability of community health volunteers (CHVs) before and after anthropometric training on infants and toddlers. Methods. This study used a quantitative approach with a quasiexperimental and pretest-posttest design. The pre- and posttraining assessments of CHVs were conducted by standardized trainers using instruments developed according to WHO standards. There were 11 and 13 statement items for infants' and toddlers' indicators of assessment in anthropometric measurements, respectively. The result of the assessment was then analyzed using Rasch modeling with stacking and racking data analysis techniques. Results: The CHVs' skills before training were far from adequate. Although widely varied, all trainees improved their abilities. Stacking analysis showed that the skills of all CHVs in measuring infants and toddlers increased by 2.68 and 3.34 logits (p < 0.01), respectively. Racking analysis showed a decrease in the perceived difficulty of all items by 2.61 and 3.07 logits for infant and toddler measurements, respectively (p < 0.01). The results of the racking analysis showed that the difficulty in measuring the anthropometrics of infants decreased more than that of toddlers. Conclusions: CHVs' capacity to monitor child growth must be refreshed regularly. Standardized and proper training and assessment were developed to make CHVs reliable in taking anthropometric measurements of infants and toddlers.

Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia.

BACKGROUND: Health care personnel (HCP) who demonstrated close contact with Corona virus disease (COVID-19) patients might experience a higher risk of infection and psychological problems. This study aims to explore depressive, anxiety, and burnout symptoms among HCP with a higher risk for psychological trauma. METHODS: This study was a cross-sectional study using secondary data from an online assessment, which was conducted 1 month after the COVID-19 outbreak. A total of 544 respondents from 21 provinces in Indonesia were included. Data on depressive, anxiety, and burnout symptoms were transformed first using the Rasch model and then categorized. Data from HCP in the higher risk group and the lower risk group were analyzed. RESULTS: A higher percentage of HCP experiencing depressive symptoms (22.8%), anxiety (28.1%), and burnout (26.8%) are found in the higher risk group. The chance for the higher risk group's HCP to present with moderate and severe depressive symptoms, anxiety, and burnout are: 5.28 (Confidence interval (CI): 2.01-13.89; p < 0.05), 1.36 (CI: 0.09-1.96; p >  0.05), and 3.92 (CI: 2.08-7.40; p < 0.05) times higher, respectively. The probability for patient-induced burnout is 2.13 (CI: 1.51-3.007; p < 0.05) times higher and highest among the other burn out dimensions. The depressive symptoms complained were similar between groups: loneliness, sleep disturbances, difficulty concentrating, and inability to initiate activities. Loneliness demonstrates the highest logit value among the symptoms. CONCLUSIONS: HCP with direct contact and responsibility to treat COVID-19 patients exhibit a higher risk to experience depressive symptoms and burnout. Communication with peers and staying in contact with family needs to be encouraged. Psychological well-being should be considered for high-risk HCP. Incentive or insurance guaranteed by the government or institution is essential as a reward and compensation during this period.

The effects of eel biscuits on nutritional intake of hospitalized children.

BACKGROUND AND OBJECTIVES: Support from fortified food during hospitalization is an important factor to increase nutritional intakes of patients to meet nutritional needs and nutritional status. The objective of the study was to analyze the effects of eel biscuits on the nutritional intake of sick children. METHODS AND STUDY DESIGN: The study had an experimental post-test design, and included 40 hospitalized children at Dr. Hasan Sadikin Hospital, Bandung, who were selected by consecutive sampling. The inclusion criteria were children aged from 1 to 18 years old who received standard hospital food. The exclusion criteria were patients with fish allergies and those undergoing special diet therapy. The intervention was conducted for 5 days, in which the intervention group was given eel biscuits while the control group was given standard hospital snacks. The food intake was assessed using the food record and 24-hour recall methods. Unpaired t-test and Mann-Whitney test were used in data analysis. RESULTS: There was an increase in nutritional intake from snacks in the intervention group, namely energy (p<0.001), protein (p<0.001), fat (p<0.001), carbohydrate (p=0.005), zinc (p=0.012), and vitamin A (p=0.046) intake. There was also a positive impact on the main meal intake, especially in protein (p=0.037), fat (p=0.032), and zinc (p=0.037) intake. CONCLUSIONS: Consumption of eel biscuits to hospitalized children could increase their nutrient intake. Eel biscuits could be given as a snack to fulfill the nutritional requirements for sick children.

Poor dietary diversity and low adequacy of micronutrient intakes among rural Indonesian lactating women from Sumedang district, West Java.

Information on micronutrient adequacy of diets of rural Indonesian lactating women is lacking, despite their high nutrient requirements. This is of concern because deficits in micronutrient intakes may compromise the health of both mothers and infants. This study aimed to assess micronutrient adequacy and dietary diversity (DD) among rural lactating women and explore relationships between micronutrient adequacy, DD, and intakes of energy and food groups consumed. We measured in-home 12-h weighed food records and 12-h recalls over three non-consecutive days from 121 exclusively breastfeeding women at 2-5 months postpartum. Next, we calculated intakes of energy and 11 micronutrients and estimated probability of adequacy (PA) for usual intakes of 11 micronutrients for each women taking into account national fortification of wheat flour with thiamin, riboflavin, folate, zinc, and iron. We assessed DD from nine food groups consumed. Energy and macronutrient balance were within recommended ranges, yet population prevalence of adequacy was less than 50% for niacin, vitamins B6 and C, and less than 60% for calcium, vitamin B12 and vitamin A, all micronutrients not targeted by the national wheat flour fortification program. In contrast, population prevalence of adequacy for the fortified micronutrients was at least 60%, with iron and zinc attaining 79% and 97%, respectively. Overall mean population prevalence of micronutrient adequacy was 57% and mean (±SD) DD score was 4.3±1.2. Mean PAs, a composite measure based on individual PAs over 11 micronutrients, were strongly correlated with energy intakes and with DD scores. In the multivariate models with maternal education and wealth index as covariates, organ meats were the most important determinant of mean PA after controlling for energy intake. In conclusion, despite wheat flour fortification, lactating mothers remained at risk of multiple micronutrient inadequacies. Increasing intakes of animal source foods including organ meats, and fruits and vegetables should be considered.