Introduction: Dietary diversity is a global challenge in complementary feeding. Despite more women joining the workforce in developing countries, there are limited studies on the beliefs of working mothers and their experiences in relation to the provision of dietary diversity as recommended by the World Health Organization. Methods: This qualitative study explored the behavioural, normative and control beliefs of working mothers on dietary diversity practices, based on the Theory of Planned Behaviour (TPB). A total of 25 mothers of different occupational levels were recruited from workplaces in Jakarta. Results: Working mothers at the lower occupational levels showed a lack of understanding of the importance of dietary diversity and reported poor practices. These included the late introduction of animal protein as a food source, and few types of feeding instant foods. Due to their limited knowledge of nutrition, these working mothers tended to accept poor dietary diversity practices as normal. Conclusion: Working mothers at the lower occupational levels practised poor dietary diversity owing to work-related factors. Efforts should be undertaken to provide correct nutritional information related to complementary feeding at workplaces, especially to working mothers in the unskilled occupations.

Introduction: Food insecurity remains a global challenge, especially among vulnerable indigenous populations. Coping strategies to maintain food security among indigenous groups can be unique and complex, being influenced by cultures. This study aimed to explore the coping strategies employed by food secure and food insecure households in times of food insufficiency, in the Kaluppini indigenous population of South Sulawesi, Indonesia. Methods: The study recruited mothers of children aged below 5 years, who agreed to participate in the study’s focus group discussions (FGDs) and in-depth interviews. All information was recorded, transcribed verbatim and analysed. Results: A total of 61 mothers participated in 22 in-depth interviews and six FGDs. Five coping strategies were used by the Kaluppini people i.e. additional income generation, dietary alteration, access to alternative food sources, access to alternative cash sources, and, traditional ways of coping. Both food insecure and secure households reported making dietary changes, such as reducing consumption or substituting foods, borrowing food or money, and practising traditional coping strategies, such as food sharing after performing rituals. In order to generate income, food insecure households reported seeking additional work in the neighbourhood areas, while food secure households migrated in search of work to the other islands or other countries. Conclusion: Food insecure and food secure households changed their diets, borrowed food or money from relatives and relied on traditional coping mechanisms such as food sharing. It is suggested that food insecure Kaluppini households be encouraged to grow essential foods in their gardens to enhance food security.

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

Objectives: One of the most widely used pesticides today is chlorpyrifos (CPF). Cytochrome P450 (CYP)2B6, the most prominent catalyst in CPF bioactivation, is highly polymorphic. The objective of our study was to evaluate the role of CYP2B6*6, which contains both 516G>T and 785A>G polymorphisms, in CPF toxicity, as represented by the concentration of 3,5,6-trichloro-2-pyridinol (TCPy), among vegetable farmers in Central Java, Indonesia, where CPF has been commonly used. Methods: A cross-sectional study was conducted among 132 vegetable farmers. Individual socio-demographic and occupational characteristics, as determinants of TCPy levels, were obtained using a structured interviewer-administered questionnaire and subsequently used to estimate the cumulative exposure level (CEL). TCPy levels were detected with liquid chromatography-mass spectrometry. CYP2B6*6 gene polymorphisms were analyzed using a TaqMan® SNP Genotyping Assay and Sanger sequencing. Linear regression analysis was performed to analyze the association between TCPy, as a biomarker of CPF exposure, and its determinants. Results: The prevalence of CYP2B6*6 polymorphisms was 31% for *1/*1, 51% for *1/*6, and 18% for *6/*6. TCPy concentrations were higher among participants with CYP2B6*1/*1 than among those with *1/*6 or *6/*6 genotypes. CYP2B6*6 gene polymorphisms, smoking, CEL, body mass index, and spraying time were retained in the final linear regression model as determinants of TCPy. Conclusions The results suggest that CYP2B6*6 gene polymorphisms may play an important role in influencing susceptibility to CPF exposure. CYP2B6*6 gene polymorphisms together with CEL, smoking habits, body mass index, and spraying time were the determinants of urinary TCPy concentrations, as a biomarker of CPF toxicity.

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement.

Objectives: This study aimed to examine the impact of work schedule and work position on fatigue levels among employees at a private geothermal firm in Indonesia during the COVID-19 pandemic. The company has modified its work schedule considering the COVID-19 epidemic to ensure a continuous supply of energy and meet the needs of the public. Methods: In this cross-sectional study, the dependent variable is fatigue, which is classified as a latent variable. Fatigue is assessed using the Indonesian version of the Swedish Occupational Fatigue Inventory (SOFI). Fatigue is a condition that has five dimensions: lack of energy, physical exertion, physical discomfort, sleepiness, and lack of motivation. The observed variables in this study include work schedule and work position, which serve as independent variables. Using structural equation modeling (SEM), we assessed the impact of the independent variables on each dimension of fatigue. This approach allowed for the analysis of both the measurement and structural models. Results: The investigation employed total sampling, involving 132 workers from the company who willingly participated in the study. According to the findings, workers' main fatigue dimension was lack of energy. However, the statistical analysis did not establish a significant influence of work schedule and work position on fatigue. Conclusion Based on the findings of the SEM analysis, it is evident that there is no statistically significant correlation between work schedules and job positions with various dimensions of fatigue assessed using the SOFI questionnaire. These dimensions include lack of energy, physical exertion, physical discomfort, sleepiness, and lack of motivation. While this outcome suggests that work schedules and job positions may not directly influence fatigue levels as measured in this study, it underscores the importance of implementing occupational health and safety management systems. Additionally, promoting good work practices such as offering flexible working hours may help address potential fatigue concerns among employees. However, further research is necessary to explore additional variables that could potentially impact fatigue levels in the context of the COVID-19 pandemic and beyond.
Work Schedule ; Personnel Staffing and Scheduling

Objective: The objective of our study was to determine the genotype frequencies of CYP2C19*2 and *3 gene polymorphisms among Javanese farmers exposed to chlorpyrifos (CPF) in Central Java, Indonesia. Methods: This cross-sectional study was conducted from July to October 2020 in Central Java, Indonesia, involving 151 vegetable farmers aged 18-65 years who used CPF for at least one year. CYP2C19*2 and *3 gene polymorphisms were analyzed using PCR-RFLP. Direct calculations were applied to calculate allele and genotype frequencies. The difference in genotype frequencies among the sex and cumulative exposure level (CEL) group was performed using the Chi-square test. In contrast, the proportion difference of allele frequencies was analyzed using Z-test. Results: The frequency of CYP2C19 genotypes *1/*1, *1/*3, *1/*2, and *2/*2 were 64 %, 7 %, 23 % and 6 %. We observed no significant difference in the genotype distribution according to sex group and CEL group. Conclusion In summary, the prevalence of toxicologically relevant CYP2C19 polymorphisms was determined in the Javanese agricultural population. The CYP2C19 genotype may be helpful as an essential biomarker of genetic susceptibility towards CPF exposure. Nevertheless, further studies to confirm the role of CYP2C19 in this context are still needed.
Cytochrome P-450 CYP2C19 ; Pesticides

Objective: The objective of this study was to assess factors related to renal function in crane operators at a port container terminal in Indonesia. Methods: A cross-sectional study on crane operators in Medan Container Terminal, Indonesia, was conducted. Renal function was measured through Glomerular Filtration Rate (GFR). Individual characteristics such as age, nutritional status, fluid consumption, hydration status, and physical activity level were collected. Fluid consumption was obtained from a 24-h food recall questionnaire. Physical activity was measured based on the Bouchard questionnaire. Association was determined by calculating the odds ratio (OR) and its 95% confidence interval (CI). Results: A total of 87 subjects were involved. All were male with the median age of 30.1 ± 2.4 years old. The prevalence of decreased renal function was 49.4%. Inadequate fluid consumption (OR = 6.1, 95% CI 2.1 -17.7; p<0.001) significantly increase the risk of renal function decreased, while being overweight/obese (OR 3.3, 95% CI 0.7 -11.7;p<0.125) and dehydration (OR 2.3, 95% CI 0.8-26.9; p=0.111) also increase the risk although not significantly. Conclusion Inadequate fluid consumption increases the risk of decline in the renal function of crane operators in the container terminal. A company should regularly monitor and evaluate the kidney function of this group of workers through annual medical checkups and provide easier access to drinking water and convenient toilets to improve fluid consumption of the workers.
Dehydration