ABSTRACT
Background: Kupang Regency and Kupang City are two areas with a high number of infant mortality cases (including AKN) and contribute quite significantly to the number of infant and neonatal deaths at provincial and national levels and make both regions one of the regions with the number of infant and neonatal deaths is higher than other regions in Indonesia. Method: This research is a non-experimental study with a cross sectional approach. The research sample was 73 midwives in all puskesmas in Kupa City and Kupang Regency which were determined by total sampling. Result: The results showed that (a) the knowledge factor did not have a relationship with the skills of the midwife in carrying out resuscitation and stabilization in neonates who experienced respiratory distress in the delivery room of the Kupang area health center. (b) The training factor has a relationship with the skills of the midwife in carrying out resuscitation and stabilization in neonates who experience respiratory distress in the delivery room of the Kupang area health center. (c) The length of service factor has a relationship with the skills of the midwife in carrying out resuscitation and stabilization in neonates who experience respiratory distress in the delivery room of the Kupang area health center. (d) The work status factor does not have a relationship with the skills of the midwife in carrying out resuscitation and stabilization in neonates who experience respiratory distress in the delivery room of the Kupang area health center. (e) The factor of tenure is the factor that has the most dominant relationship with the skills of the midwife.

ABSTRACT
Introduction: Women who have a history of violence before pregnancy are more likely to experience violence again during pregnancy and will peak during the first three months of pregnancy and then decrease, while women without a history of violence have a lower likelihood of experiencing violence and abuse during pregnancy. A form of physical violence that is concerning during pregnancy is when the partner who commits violence targets the woman's stomach, so that it is not only the mother who is hurt, but has the potential to endanger the pregnancy as well such as abuse, beating, punching, slapping the face, kicking the stomach so that the victim experiences bruising on the abdomen and bleeding. Objective: The purpose of this study was to explore forms of domestic violence against mothers during pregnancy in West Manggarai Regency. Method: This research is a qualitative research that uses a phenomenological descriptive approach. The data analysis technique used is the Colaizzi method. Result: The results of this study indicate that there are four themes of forms of violence experienced by mothers during pregnancy. First, Experiencing physical violence so that bruises and wounds in several parts of the body. Second, their husbands are not respected and cared about and threatened. Third, forced to have sex even though they refuse and are tired. Fourth, the husband does not fulfill his monthly needs, prohibits work, and causes financial loss.

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Introduction: Forest fires are caused by natural, but most often are human made causes. Purpose: In this review the consequences of fires on human health and quality of life are displayed. Methodology: The material of the study is consisted of articles related to the subject, that were searched in Greek and international databases, in Google Scholar, and in the Hellenic Academic Libraries Association (HEAL-Link). Results: The health effects of exposure to forest fire smoke are related to the toxicity of its components, the frequency and duration of exposure and the degree of vulnerability of those exposed, such as people with respiratory problems, cardiovascular diseases, smokers, elderly, children, infants, and pregnant women. Also, during a fire the consumption of oxygen causes a feeling of drowning, symptoms of suffocation and death. Conclusions: The effects of fires on the environment and humans are irreversible. They cause, among other problems, destruction of vegetation, soil erosion, destruction of fauna and primary production of an area, and the most important, they cause problems in human health, physically and psychologically.

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Objective: To determine the frequency of primary infertility in women suffering from fibroid uterus. Study Design: Cross-sectional study. Setting and Duration: Outpatient department of gynecology and obstetrics of Bolan Medical Complex Hospital Quetta from 1st Jan 2018 to 30th Jun 2018. Sample size: The calculated sample size is 203 patients, with 95% confidence level and absolute precision of 3%, taking percentage of infertility 5% with fibroid uterus. Sampling technique: Non-probability consecutive sampling. Results: A total of two hundred and three women presented with fibroid uterus were selected during study period through out patient department of Bolan Medical Complex Hospital Quetta. 12.8% were between 18-25 years, 45.3% were between 26-32 years and 41.9% were between 33 to 40 years of age. Out of 203 patients only 9.9% had infertility, and remaining 90.1% were enjoying healthy reproductive life. In 63% cases there were multiple and in 36.9% of cases were single fibroids. Conclusion: In our study only 9.9% patients with fibroid uterus had primary infertility. The remaining patients had no issue with conception having fibroids. Having fibroid uterus may be only one reason of infertility, many other aspects need to be considered while treating infertility.

ABSTRACT
Background: Obstructive Sleep Apnea (OSA) is the primary type of sleep disorder that presents several clinical disorders. These disorders vary from simple complaints such as fatigue and lack of concentration. Some other complaints could be worse and more serious such as personality changes and heart diseases. Nevertheless, it is generally undetected, posing a significant burden on society. The most often used confirmative tool to identify patients suffering from OSA is Polysomnography (PSG), whereas its favorable treatment method is Continuous Positive Airway Pressure (CPAP). However, not every patient has access to a sleep center for detection nor has the money to own a CPAP machine. Primary health care professionals play an essential role in identifying those patients who suffer from OSA due to their first contact with patients in primary health care settings. Objective: The focus of this review paper is providing an overview of obstructive sleep apnea, OSA detection, treatment approaches, and most of all, the role of primary health care professionals in detecting, treating, or referring OSA patients. Methodology: Google Scholar search was used for articles selection using the keywords obstructive sleep apnea, OSA evaluation, diagnosis, and management. Another search was about the societal and economic burden of OSA. Also, the search comprised of the role of primary health care professionals on detection and management of OSA. Conclusion: primary health care providers play a significant role in detecting and treating OSA. They are the first contact that patients go to when sick. The high cost of detecting and treating obstructive sleep apnea may further contribute to late detection, complications deterioration, and decreasing referral and follow-ups. Increasing awareness of the primary health care providers would help to avoid such consequences. OSA remains a public health condition that requires more attention, identification, and more directed research.

ABSTRACT
Preventing healthcare-associated infections (HAIs) is one of the main issues of the six patient safety goals. Healthcare-associated infections have negative impacts, including increased length of stay, morbidity, mortality, and increased health care costs. The study aimed to examine head nurses’ strategy in nursing quality improvement to reduce the healthcare-associated infection in public hospitals Aceh, Indonesia. A descriptive study and a cross-sectional study were conducted in 11 Aceh hospitals. A proportionally stratified random sampling technique recruited 117 head nurses and collected data through questionnaires and descriptive analyses. The result shows that the overall score of head nurses’ strategy to reduce healthcare-associated infection was high (59,0%, M = 72,41, SD = 12.32). Nursing Quality improvement strategy of each step, including Plan (70,0%) and Do (55,6%), was high level, whereas Check (55,6%) and Act (49,6%) was moderate level. These findings indicated that head nurses’ strategy in nursing quality improvement to reduce the healthcare-associated infection might increased morbidity, long-term disability, healthcare costs, hospital stay, and increased antimicrobial resistance. Consequently, head nurses’ strategy in nursing quality improvement using the PDCA method was a quality improvement approach to secure patient safety while hospitalization.

ABSTRACT
Background: Vulva hygiene is a treatment on female genitals which have an important role in the status of someone's health behavior to avoid disturbances in the reproductive organs. The purpose of this study was to determine the advantages of counseling in improving female adolescents’ knowledge about vulva hygiene at SMP Negeri 11 Denpasar. Method: This study employed a comparative analytical method with a one group pretest-posttest design. The sample of this research was 124 students of VIII class at SMP Negeri 11 Denpasar. The sampling technique in this study was Proportionate Cluster Random Sampling. The instrument used was a pre-test and post-test questionnaire with 25 valid and reliable questions. The data were analyzed by using Wilcoxon test. Result: The results of the research showed that the average of pretest knowledge was 57.71 and the average of posttest knowledge after getting counseling through zoom was 83.68. The results of the Wilcoxon test showed that p value <0,001. These results indicated that there was an improvement of teenager’s knowledge about Vulva Hygiene at SMP Negeri 11 Denpasar. It is expected that schools and health centers will increase the health education.