FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN PENYEMBUHAN LUKA PERINEUM PADA BIDAN PRAKTEK SWASTA DI DESA MADIUN RAJABASA TAHUN 2015

Kematian ibu pada tahun 2012 di provinsi lampung dari 171.975 ibu bersalin adalah eklamsi 33,15 %, perdarahan 22,47 %, infeksi 2,25 %, penyebab lain 42,13 % dari 171.975 ibu bersalin. Hal yang memicu terjadinya kematian karena perdarahan dan infeksi adalah karena adanya robekan perineum yang diderita ibu nifas pasca persalinan. Robekan perineum yang terjadi secara spontan maupun episiotomi. Robekan jalan lahir bisa terjadi karena partus precipitatus, kepala janin besar dan janin besar, serta perluasan episiotomi. Hal ini berisiko menyebabkan infeksi postpartum karena adanya luka pada bekas perlukaan plasenta, laserasi pada saluran genital termasuk episiotomi pada perineum,   dinding   vagina   dan   serviks.Jenis penelitian kuantitatif, desain penelitian survey analitik dengan pendekatan cross-sectional. Populasi dalam penelitian  ini adalah semua ibu nifas di BPS yang berada di Desa Madiun Rajabasa ada 56 orang ibu nifas yang mengalami luka perineum. Analisis bivariat menggunakan uji Chi Square.Hasil analisis bivariat menunjukkan bahwa ada hubungan antara usia dengan penyembuhan luka perineum dengan hasil analisis diperoleh p-value < 0,05 nilai p-value  = 0.012, ada hubungan antara cara perawatan dengan penyembuhan luka perineum dengan hasil analisis diperoleh p-value < 0,05 nilai p-value  = 0.004 dan ada hubungan antara personal hygiene dengan penyembuhan luka perineum dengan hasil analisis diperoleh p-value < 0,05 nilai p-value  = 0.003. Saran untuk tenaga kesehatan adalah Lebih meningkatkan kemampuan pelayanan sehingga dalam memberikan pelayanan kesehatan dapat lebih luas jangkauannya, termasuk pelayanan kesehatan pada ibu nifas, misalnya dengan lebih meningkatkan pendidikan kesehatan melalui pemberian penyuluhan tentang perawatan   luka perineum. Kata Kunci  : Faktor, Penyembuhan Luka Perineu

Accelerating Certification of Oil Palm Smallholders through Institutionalization of Various Incentives

Sustainable palm oil certification has become a global demand, particularly in the market. However, the implementation of both Roundtable of Sustainable Palm Oli (RSPO) and Indonesian Sustainable Palm Oil (ISPO) certification schemes is relatively slow. This study aims to analyze to what extent incentives can accelerate sustainable palm oil certification, from what sources those incentives can be arranged, and types of incentives are appropriate for palm oil smallholders. The research uses quantitative and qualitative methods based on literature reviews, in-depth interviews with key stakeholders, and a survey of 455 farmers in two Indonesian provinces (Riau and West Kalimantan). Based on quantitative analysis, the reasons behind more progressive certification achievements in Riau remain unrevealed while in West Kalimantan, Fresh Fruit Bunches (FFB) price, easiness to obtaining loans with low interest, and easiness of selling FFB have a significant influence on accelerating certification. Using a qualitative approach, smallholders show their expectation of having incentives. In Riau, incentives expected are higher FFB prices and a simpler procedure to get the Environmental Management Statement (SPPL) document. In West Kalimantan, higher FFB prices and availability of low interest loans are expected to become incentives. These incentives can be mobilized from intergovernmental fiscal transfer mechanisms such as revenue-sharing mechanisms, export levies, and environmental funds. Smallholders also expect clarity of incentives generated from ISPO certification, particularly in price and market access, which requires the government’s initiative to develop synergy with various stakeholders. To be practical, incentives were not only for smallholders but also for the government officials at the province, district, and village levels, as the position of the local government is very important in preparing, encouraging, and mobilizing farmers, as well as in strengthening institutions for improving palm oil governance. In the implementation of RSPO certification, the collaboration between the Indonesian government (through the Ministry of Cooperatives and Small and Medium Enterprises) and the RSPO becomes clear evidence of central government support. At the sub-national level, the Riau and West Kalimantan Provinces have developed the Regional Action Plans (RAD) for sustainable palm oil as a policy commitment to accelerate both RSPO and ISPO certification

Accelerating Certification of Oil Palm Smallholders through Institutionalization of Various Incentives

Sustainable palm oil certification has become a global demand, particularly in the market. However, the implementation of both Roundtable of Sustainable Palm Oli (RSPO) and Indonesian Sustainable Palm Oil (ISPO) certification schemes is relatively slow. This study aims to analyze to what extent incentives can accelerate sustainable palm oil certification, from what sources those incentives can be arranged, and types of incentives are appropriate for palm oil smallholders. The research uses quantitative and qualitative methods based on literature reviews, in-depth interviews with key stakeholders, and a survey of 455 farmers in two Indonesian provinces (Riau and West Kalimantan). Based on quantitative analysis, the reasons behind more progressive certification achievements in Riau remain unrevealed while in West Kalimantan, Fresh Fruit Bunches (FFB) price, easiness to obtaining loans with low interest, and easiness of selling FFB have a significant influence on accelerating certification. Using a qualitative approach, smallholders show their expectation of having incentives. In Riau, incentives expected are higher FFB prices and a simpler procedure to get the Environmental Management Statement (SPPL) document. In West Kalimantan, higher FFB prices and availability of low interest loans are expected to become incentives. These incentives can be mobilized from intergovernmental fiscal transfer mechanisms such as revenue-sharing mechanisms, export levies, and environmental funds. Smallholders also expect clarity of incentives generated from ISPO certification, particularly in price and market access, which requires the government’s initiative to develop synergy with various stakeholders. To be practical, incentives were not only for smallholders but also for the government officials at the province, district, and village levels, as the position of the local government is very important in preparing, encouraging, and mobilizing farmers, as well as in strengthening institutions for improving palm oil governance. In the implementation of RSPO certification, the collaboration between the Indonesian government (through the Ministry of Cooperatives and Small and Medium Enterprises) and the RSPO becomes clear evidence of central government support. At the sub-national level, the Riau and West Kalimantan Provinces have developed the Regional Action Plans (RAD) for sustainable palm oil as a policy commitment to accelerate both RSPO and ISPO certification

PENYULUHAN TUMBUH KEMBANG BALITA DI DESA JATIMULYO KABUPATEN LAMPUNG SELATAN

Tumbuh adalah bertambahnya ukuran dan jumlah sel serta jaringan interselular atau bertambahanya ukuran fisik dan struktur tubuh sebagian atau keseluruhan sehingga dapat diukur dengan satuan panjang dan berat. Berkembangan adalah bertambahnya struktur dan fungsi tubuh yang lebih kompleks dalam kemampuan gerak kasar, halus, bicara dan bahasa, serta sosialisa dan kemandirian. Tumbuh kembang balita perlu dipantau dengan cara melakukan penimbangan setiap bulannya. Dengan demikian gangguan tumbuh kembang dapat dideteksi sedini mungkin seperti retardasi mental, sindrom down, dan lain-lain. Kegiatan ini telah dilaksankan pada hari rabu tanggal 27 Januari 2016. Adapun kegiatan yang dilakukan berupa penyuluhan kepada ibu-ibu yang memiliki bayi dan balita tentang pentingnya pertumbuhan dan perkembangan bagi balita di desa jatimulyo kabupaten lampung selatan dengan metode penyuluhan menggunakan leaflet. Terdapat pengaruh signifikan pada pengetahuan ibu sebelum dan sesudah penyuluhan tumbuh dan kembang balita. Dengan demikian, pemberian edukasi dapat memberikan peningkatan pengetahuan, khususnya yang berkaitan dengan tumbuh dan kembang balit

Penerapan Metode Microwave-Assisted Extraction (MAE) Berbasis Green Solvent Senyawa Pektin Albedo Jeruk Bali (Citrus Maxima)

Buah jeruk bali atau Citrus Maxima merupakan salah satu jenis jeruk yang banyak di budidayakan di Indonesia. Pada umumnya jeruk bali dikonsumsi dalan keadaan segar, sehingga menyebabkan limbah berupa kulit atau albedo dari jeruk bali. Seperti yang diketahui albedo jeruk bali mengandung komponen nutrisi yang kaya akan manfaat, diantaranya senyawa alkaloid, flavonoid, likopen, dan yang paling dominan adalah pektin sebesar 16,68% sampai 21,95%. Pektin sendiri sangat bermanfaat dalam industry pangan maupun farmasi. Sehingga diperlukan ekstraksi pektin albedo jeruk bali menggunakan Microwave Assisted Extraction. Dalam proses ekstraksi umumnya menggunakan pelarut organic. Penggunaan pelarut tersebut memiliki dampak buruk baik kepada operator/peneliti hingga lingkungan. Maka dari itu dilakukan ekstraksi berbasis green solvent jenis baru berupa pelarut eutektik alami (NADES) karena memiliki beberapa keunggulan. Tujuan dari penelitian ini adalah (i) untuk mengetahui rasio terbaik pelarut dalam proses ekstraksi, (ii) mengetahui lama waktu optimum proses ekstraksi, dan (iii) untuk mengetahui daya terbaik pada proses ekstraksi. Hasil ekstraksi terbaik diperoleh pada rasio pelarut 1:5:18 (CAS-H2O), dengan lama waktu ekstraksi optimum pada menit ke 20, dan pada daya 50% dari daya maksimum 800 watt

Komplikasi Bayi Baru Lahir ditinjau dari Kejadian Positif Covid-19 pada Ibu Bersalin

Data on maternal mortality in Brazil 20 mothers died of COVID-19 where 12 cases were during pregnancy (60%), 3 cases were postpartum (15%), 1 case was a cesarean section delivery (5%) and 4 data were not reported. This condition illustrates the high risk of the mother during pregnancy and childbirth against Covid-19. Various efforts have been made by the government to prevent transmission of COVID-19, especially to pregnant and maternity women. This study was conducted to determine the effect of the positive incidence of COVID-19 in maternity on BBL complications at Dr. RSUD. M. Yunus Bengkulu City in 2021. This type of research is a retrospective method. The population in this study were all babies born in RSUD Dr. M. Yunus, Bengkulu city, in 2021, totaling 118 babies were born, with 22 of them experiencing complications. The sample in this study was divided into two groups, 22 cases were taken by total sampling and the control group was taken with a ratio of 1:1 by systematic random sampling. Data analysis was carried out univariate and bivariate with chi square test. The results of the chi square test showed a value of 0.015 (<0.05) meaning the effect of positive cases of covid-19 on mothers giving birth with complications in BBL. It is hoped that the hospital will prepare special detection and treatment for maternity mothers who are positive for Covid-19 to prevent and manage possible complications of BB

Proses Keterampilan Berpikir Kritis Dalam Model Problem Based Learning (PBL) Di SDN Kalideres 06 Pagi

Penelitian ini bertujuan untuk, (1) Untuk menganalisis rancangan kegiatan pembelajaran dengan menggunakan model Problem Based Learning (PBL), (2) Untuk menjelaskan proses penerapan kegiatan pembelajaran dengan menggunakan model Problem Based Learning (PBL), (3) Untuk menggambarkan keterampilan berpikir kritis setelah dilaksanakannya pembelajaran dengan menggunakan model Problem Based Learning (PBL). Metode penelitian yang peneliti gunakan adalah metode kualitatif deskriptif. Peneliti memilih metode tersebut karena sesuai dengan judul yang peneliti angkat. Sehingga hasil yang diperoleh dari wawancara, observasi, dan dokumentasi dapat dikaji oleh peneliti. Hasil dan temuan yang peneliti lakukan di SDN Kalideres 06 pagi terdapat rancangan kegiatan pembelajaran di kelas VA SDN Kalideres 06 Pagi sudah menggunakan model Problem Based Learning (PBL). Proses penerapan kegiatan pembelajaran juga sudah sesuai dengan sintak model Problem Based Learning (PBL). Peserta didik di kelas VA juga memiliki keterampilan berpikir kritis yang dapat dilihat dari beberapa indikator yaitu peserta didik sudah mampu menganalisis suatu masalah, mensintesis juga dapat dilihat dari pertanyaan yang diberikan peserta didik kepada guru yang mengandung pertanyaan HOTS, adapun peserta didik mampu menyimpulkan suatu topik permasalahan, yang hal ini dapat dilihat dari kesimpulan yang ditarik dari permasalahan secara utuh serta mampu mengevaluasi dan menilai

Pengaruh Rangsangan Puting Susu Terhadap Lamanya Persalinan Kala I Fase Aktif Pada Multigravida

Background : Prolonged labor is labor that lasts more than 24 hours in primigravidas, and more than 18 hours in multigrades, which is one of the leading causes of maternal and newborn mortality. Interventions that can be done to increase uterine contractility include acupressure, artificial membrane rupture and nipple stimulation. Nipple stimulation is a technique that can encourage an initial contraction by doing a circular motion, rubbing or gently massaging the area around the nipple. Purpose : The purpose of the study was to determine the effect of nipple stimulation on the duration of active phase I labor in multigravida in the Work Area of the Rawapitu Tulang Bawang Health Center in 2021.Methods : This type of quantitative research with a true experimental approach. The population of this study was 95 multigravida mothers with a sample of 30 people, of which 15 people will be experimented with and 15 people will be the kontrol  group. The object of this research is nipple stimulation and duration of active phase I labor in multigravida. The research was carried out in the Rawapitu Tulang Bawang Health Center in June - July 2021. The data was collected using partographs and observation sheets. Data analysis was univariate and bivariate.Result : The results of the study the average length of labor in the intervention group was 148.6 hours/minute while the average length of labor in the kontrol  group was 170.5 hours/minute. Conclusion There is an effect of nipple stimulation on the duration of active phase I labor in multigravida in the Rawapitu Tulang Bawang Health Center Work Area in 2021 with a p-value = 0.010. Suggestion: It is hoped that for the next pregnancy the patient can use nipple stimulation as an effort to increase contractions. Keywords: first stage of labor, nipple stimulation, and multigravida ABSTRAK Latar Belakang : Persalinan lama adalah persalinan yang berlangsung lebih dari 24 jam pada primigradiva, dan lebih dari 18 jam pada multigradiva, dengan angka kejadian 4,3%. Intervensi yang dapat dilakukan untuk meningkatkan kontraktilitas uterus antara lain dengan stimulasi puting susu.Tujuan : Tujuan penelitian diketahui pengaruh rangsangan puting susu terhadap lamanya persalinan kala I fase aktif pada multigravida di Wilayah Kerja Puskesmas Rawapitu Tulang Bawang tahun 2021.Metode : Penelitian kuantitatif rancangan quasi eksperimen. Populasi ibu bersalin multigravida sebanyak 95 orang dengan sampel sebanyak 30 orang, dimana sebanyak 15 orang diberikan intervensi dan 15 orang sebagai kelompok kontrol. Objek penelitian rangsangan puting susu dan lamanya persalinan kala I fase aktif pada multigravida. Penelitian telah dilaksanakan di Wilayah Kerja Puskesmas Rawapitu Tulang Bawang pada bulan Juni - Juli 2021. Pengumpulan data menggunakan partograf dan lembar observasi. Analisis data secara univariat dan bivariat.Hasil : Hasil penelitian rata-rata lamanya persalinan kelompok intervensi adalah 138,6 menit sedangkan rata-rata lamanya persalinan kelompok kontrol adalah 156,6 menit.Kesimpulan Ada pengaruh rangsangan puting susu terhadap lamanya persalinan kala I fase aktif pada multigravida di Wilayah Kerja Puskesmas Rawapitu Tulang Bawang tahun 2021 dengan nilai p-value = 0,000. Saran : Diharapkan puskesmas menerapkan asuhan sayang ibu dengan membuat standar prosedur operational (SPO) rangsangan putting susu menjadi SPO tetap di wilayah kerja Puskesmas. Kata Kunci : rangsangan puting susu, persalinan kala I fase aktif, multigravid

Combination Of Mung Bean Juice And Red Guava Juice Consumption In Treating Anemia In Adolescent

Latar belakang :Prevalansi anemia remaja putri di Indonesia adalah 57,1%, Remaja merupakan salah satu kelompok rentan gizi. Angka kejadian anemia di Lampung pada tahun 2013 mencapai 57,1%. usia sekolah sebesar 26,5%, Dikarenakan pada masa ini adalah masa yang pertumbuhan yang sangat pesat.Tujuan : mengetahui efek pemberian konsumsi jus kacang hijau dan jus jambu biji terhadap peningkatan kadar Hb pada remaja putri dengan anemia di Yayasan Pondok Pesantren Al-Ishlah Sukadamai Kecamatan Natar Kabupaten Lampung Selatan Tahun 2020Metode :Jenis penelitian kuantitatif dengan rancangan penelitian Quasi Eksperimen. Populasi penelitian seluruh remaja di Yayasan Pondok Pesantren Al-Ishlah Sukadamai Kecamatan Natar sebanyak dengan sampel sebanyak 40 orang teknik sampling purposive sampling. yang dibagi menjadi dua kelompok, terdiri dari 20 orang kelompok intervensi (diberikan jus kacang hijau dan jus jambu biji) dan 20 orang kelompok kontrol (hanya diberikan tablet Fe 200 mg ferro sulfat) yang dilakukan pengukuran Hb pre dan post intervensi. pengumpulan data dengan lembar observasi. Analisa data univariat dan bivariat uji t (t-test).Hasil: Hasil penelitian Rata-rata Hb pada kelompok sebelum intervensi adalah 10,4 gr/dl, setelah intervensi 11,1 gr/dl peningkatan sebesar 0,70 gr/dl. Rata-rata-rata Hb pada kelompok kontrol adalah 10,4 gr/dl, pengukuran kedua sebesar 10,7 gr/dl peningkatan sebesar 0,33 gr/dl.Kesimpulan: Ada pengaruh pemberian konsumsi jus kacang hijau dan jus jambu biji terhadap peningkatan kadar Hb pada remaja putri dengan anemia di Yayasan Pondok Pesantren Al-Ishlah Sukadamai Kecamatan Natar Kabupaten Lampung Selatan (p–value < 0,05).Saran: mengkonsumsi jus kacang hijau dan jambu merah dapat menghindarkan remaja dari kejadian anemia Kata kunci: Kadar Hb, Konsumsi jus kacang hijau dan jus jambu biji merah, Remaja ABSTRACT Background: The prevalence of anemia in adolescent girls in Indonesia is 57.1%. Adolescents are one of the nutritionally vulnerable groups. In Lampung, the incidence of anemia in 2013 reached 57.1%, with 26.5% school age because this period is a period of very rapid growth.Purpose: This study aims to know the effect of consuming mung bean juice and guava juice on increasing Hb levels in adolescent girls with anemia at the Al-Ishlah Sukadamai Islamic Boarding School Foundation, Natar Sub-district, South Lampung Regency in 2020.Methods: This quantitative research used a quasi-experimental research design. The research population was all adolescents in the Al-Ishlah Sukadamai Islamic Boarding School Foundation, Natar Sub-district, with a sample of 40 people using the purposive sampling technique. They were divided into two groups, 20 people in the intervention group (given mung bean juice and guava juice) and 20 people in the control group (only given Fe tablets), measured the Hb in pre-and post-intervention. Data collection employed observation sheets. Then, data analysis was carried out by univariate, bivariate, and t-test analyses.Results: The mean Hb in the group before the intervention was 10.4 gr/dl, and after the intervention was 11.1 g/dl, with an increase of 0.70 g/dl. Meanwhile, the mean Hb in the control group was 10.4 gr/dl in the first measurement and was 10.7 gr/dl in the second measurement, with an increase of 0.33 gr/dl.Conclusion: There is an effect of the consumption of mung bean juice and guava juice in increasing Hb levels in adolescent girls with anemia at the Al-Ishlah Sukadamai Islamic Boarding School Foundation, Natar Sub-district, South Lampung Regency (p-value <0.05).Suggestion: Mung bean dan guava combination can increase hemoglobin level, and this food consumption routinely will avoid anemia. Keywords: Consumption of mung bean juice and guava juice, Hb levels, adolescent

STUDY OF REPLACEMENT COST OF INVESTMENT FOR FOREST LAND USE IN THE CONTEXT OF SUSTAINABLE WASTE MANAGEMENT: NAMBO CASE STUDY

The high dependence of the community on forest resources led the state forest areas in Java managed by Perhutani to apply Community Based Forest Management approach (Pengelolaan Hutan Bersama Masyarakat) programme. In this programme, forest farmers become the member of Forest Village Community Institution (Lembaga Masyarakat Desa Hutan) to carry out upland rice and maize intercropping. Production forest area in the village of Nambo and Lulut are categorized as the class of pine bussines that produce gondorukem, turpentine, and timber, as well as upland rice and maize from intercropping. Utilization of 40 ha forest area for the processing and final waste area (TPPAS) in Nambo area for 35 years must be required to pay replacement cost of investment due to the opportunity loss to invest in pine plantations and intercropping businesses. The replacement cost is calculated by using the loss opportunity of interest (LOI) method. The resuts are shown that the replacement cost for pine plant investment of Perhutani amounted to Rp5,492,318,000 and the replacement cost for upland rice and corn crops investment of LMDH members amounted to Rp798,947,520