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Low access to credit in the agricultural sector is also caused by problems of agricultural sector actors (especially farmers) and financial institutions. Farmers are still having difficulty in accessing credit (accessibility and unbankable) and the limited financial institutions that channel credit to the agricultural sector. Therefore, the government must issue a policy in growing the agricultural sector, especially in anticipation of access credit constraints by farmers. The agricultural sector as a high-risk business, therefore formal institutions are less interested in financing the agricultural sector on the grounds of high transaction costs, asymmetric information, low profits, lack of collateral, education of farmers is relatively low. In addition, most banks do not want to finance agriculture due to fluctuating production and uncontrolled price risk. While the constraints of the farmers in obtaining formal credit is a complex procedure, there should be collateral as well as high payment delay fees, long distances and less information about capital.

The impact of the COVID-19 pandemic on glycemic control in Type 1 Diabetes Mellitus (T1DM) patients is still evolving. This study aims to assess the negative effect of the COVID-19 pandemic on mean glucose and glycated hemoglobin (HbA1c) in patients with T1DM. This meta-analysis study using the PRISMA framework method with the search strategy according to the population, intervention, control, and outcome (PICO) model. Relevant articles were searched in 4 databases. The results identified the HbA1c and mean glucose. The COVID-19 pandemic caused an increase in the HbA1c levels (%) compared to the pre-COVID group with a mean difference of -1.06 (95% CI: -1.44, -0.69; p<0.00001). Meanwhile, the mean glucose (mg/dL) decreased during-COVID-19 pandemic with a mean difference of -2.32 (95% CI: -4.40, -0.23; p=0.03). Ten studies with a total of 1615 subjects contributed for HbA1c analysis (during-COVID-19, n = 615; pre-COVID, n = 1000). A total of 1164 patients from six studies with a mean glucose analysis were included (during-COVID-19, n = 418; pre-COVID, n = 746). This study found that the COVID-19 pandemic significantly increased the levels of HbA1c and decreased mean glucose in patients with T1DM, but further studies need to be evaluated.

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Introduction: Ventilator is used as one of the most frequent life-supportive technology in Pediatric Intensive Care Unit (PICU). There are only few studies from Asian Countries, especially Indonesia regarding the use of ventilator in PICU. The aim of this study was to describe the demographic, indications, length of use, complication, and outcome of patients with ventilator in PICU Dr.Soetomo Hospital, Surabaya.Methods: This is a descriptive study. Collecting data was done retrospectively using medical records of patients using ventilator in PICU Dr. Soetomo General Hospital from January-December 2017 . Statistical analysed was performed using Microsoft Excel 2016.Results: 59 patients met the inclusion criteria. Of the 59 patients, 34 (57.63%) were female and 27 (45.76%) were infant (1-12 months). Common indication of ventilator were status epilepticus and shock that happened in 17 (28.81%) patients. 44 (74.58%) patient was using ventilator >48 hours. There are only 4 (6.78%) of 59 patients that happened to had Ventilator Associated Pneumonia (VAP) as a complication of using ventilator. Mortality occurred in 40 (67.80%) patients and mostly happened in female (60%) and infant (50%). Mortality occurred in 10 (90%) of 11 patients with cardiac failure as the indication of ventilator and in 11 (73.33%) patients who used ventilator ≤48 hours.Conclusion: Status epilepticus and shock was the most common reason for ventilation. Incidence of VAP as the complication of ventilator is relatively low. Relatively high mortality found in age group infants, patients with cardiac failure as indication of ventilator and in patient with short duration use of ventilator.