Analisis Nilai Tambah Pengolahan Ubi Kayu Menjadi Tape Ubi (Studi Kasus: Kelurahan Baru Ladang Bambu, Kecamatan Medan Tuntungan, Kota Medan)

Tujuan penelitian ini adalah untuk mengetahui proses pengolahan ubi kayu menjadi tape ubi, menghitung dan menganalisis besarnya nilai tambah yang dihasilkan dari proses pengolahan ubi kayu menjadi tape ubi, serta menghitung dan menganalisis besarnya pendapatan USAha tape ubi di Kelurahan Baru Ladang Bambu Kecamatan Medan Tuntungan Kota Medan. Metode penelitian yang digunakan yaitu metode penentuan daerah penelitian secara purposive (sengaja) berdasarkan pertimbangan daerah tersebut memiliki banyak pengusaha tape ubi yang sesuai dengan kebutuhan penelitian. Metode pengambilan subjek penelitian menggunakan Metode Sensus, dengan jumlah subjek penelitian sebanyak 28 pengusaha. Untuk menghitung dan menganalisis nilai tambah digunakan metode nilai tambah netto. Hasil Penelitian menyimpulkan bahwa proses pengolahan ubi kayu menjadi tape ubi di daerah penelitian terdiri dari 7 tahapan, yaitu: pengupasan, pengerokkan, perebusan, pendinginan, peragian, pembungkusan, dan pemeraman. Seluruh tahapan ini terangkai dalam satu kegiatan yang berkesinambungan dan membutuhkan waktu selama 3 hari. Nilai tambah yang dihasilkan dari pengolahan ubi kayu menjadi tape ubi pada skala industri rumah tangga di daerah penelitian tergolong tinggi (58,82%). Rata-rata pendapatan pengusaha tape ubi di daerah penelitian sebesar Rp.3.548.018,78 per bulan atau lebih besar dari upah minimum Kota Medan (UMK)

MELAKSANAKAN PEMBERDAYAAN PARA KADER TENTANG TEKHNIK DETEKSI DINI KANKER SERVIKS DI KELURAHAN HELVETIA MEDAN

Most of  the people with their daily lives are not far from the risk factors for cancer.for example,on petaru who are in contact with pesticides so that it can be a risk of cancer ,or construction workers who do not use PPE (Early Protective Equipment) sp they can be exposed to buil ding asbestos. This servive aims to increasing knowledge of cervical cancer in villages ,especially in efforts to prevent cancer and early detection of (cervical) cancer .This activity also aims to facilitate monitoring and commucation regarding new cases of cancer (especially cervical cancer) through village cadres. The method used in this activity is counseling. The result of this activity is an increase in knowledge related to cervical cancer. There needs to be cervical education for cadres or motherson an ongoing basis by health workers.This incidence of cervical cancer is 90% in developing countries. Indonesia is a developing country with the sixth highest number of cervical cancer suffers in Asia and an estimated incidenceof this disea is around 17 per 100,000 population . Lack of counselingand limited information about cervical  cancer causes people’s knowledge to be low . This condition causes almost no high-risk women to detect and preventcervical cancer.It is feared that this will lead to an increase in the incidence and mortality of cervical cancer in the region the future

PEMANFAATAN LAHAN DESA UNTUK APOTEK HIDUP SEBAGAI ALTERNATIF OBAT-OBATAN TRADISIONAL

Desa keruing yang berada di kecamatan cempaga hulu banyak masyarakat yang berumur 25 tahun hingga lansia dan kebanyakan masyarakat bekerja sebagai buruh sawit maka dari itu menjadi penyebab utama dari pemanfaatan apotek hidup. Apotek hidup yang sangat banyak sekali khasiatnya dapat mengobati berbagai macam penyakit secara tradisional dengan hasil akhir dari apotek hidup berupa Jamu dan Minyak Urut. Beberapa tanaman apotek hidup seperti jahe, kunyit, lengkuas, serai, kencur, dan sirih yang dapat menjadi alternatif obat modern sebagai peningkat imunitas tubuh. Metode yang digunakan ialah metode sederhana dengan  Perencanaan dan praktik secara langsung yang didasari oleh hasil evaluasi awal sebagai landasan untuk menentukan posisi pengetahuan kelompok sasaran mengenai pemanfaatan lahan. Hasil nyata yang didapatkan dari program kerja apotek hidup ini ialah masyarakat desa keruing, kecamatan cempaga hulu, kabupaten kotawaringin timur, mampu mengetahui manfaat penggunaan tanaman obat alami yang lebih optima

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Pengaruh Perawatan Paliatif Terhadap Kualitas Hidup Pasien yang Menjalani Terapi Hemodialisa di Ruang Hemodialisa di Rsu Royal Prima Medan

ABSTRACT Palliative care (palliative care) that can be used as a closeness that develops everyone's quality  life.The development of  quality is aimed at families or patients who have problems related to criminal illnesses or which can be life-threatening.Where is a chronic disease that requires palliative care, namely chronic renal failure. The level  quality of life that each individual has because in life a person has a different quality of life depending on each person to faceto Every obstacle encountered in existence affects not only the patient but also their loved ones. The aim of this study was to evaluate the impact of palliative care on the holistic health of patients. with chronic kidney disease who perform hemodialysis treatment services.The type in this research is analytical researcher using a transversal design;the researcher uses an observational approach.This research was conducted The research was conducted in March 2023 at the Royal Prima Medan General Hospital, comprising 132 respondents, all of whom were receiving hemodialysis treatment.The study sample consisted of all CKD patients who were undergoing hemodialysis at RSU Royal Prima Medan, totaling 56 people.In this study, collect data from respondents using the observation form and the WHOQOL-BREF questionnaire which measures quality  life. In this study, the results obtained regarding the influence of palliative care on the quality. life of people undergoing hemodialysis therapy used the chi-square test.The researchers obtained statistical test results with a q value of 0.000 < 0.05. The results therefore showed that there was  effect palliative care RSU Royal Prima Medan.With the results obtained by the researchers, it was concluded that there was effect The provision of palliative care yields a favorable outcome on the well-being of both patients and their loved ones. patients undergoing hemodialysis therapy at RSU Royal Prima Medan.  Keywords: Palliative Care, Quality of Life, Hemodialysis Therapy  ABSTRAK Perawatan paliatif (palliative care) yaitu dapat dijadikan sebagai kedekatan yang mengembangkan mutu hidup setiap orang. Pengembangan kualitas mutu ini diarahkan pada keluarga atau pasien yang sedang mempunyai masalah terkait penyakit kriminal atau yang dapat membahayakan kehidupan. Dimana penyakit kronik yang membutuhkan perawatan paliatif yaitu penyakit gagal ginjal kronik. Tingkat kualitas hidup seseorang yang dimiliki setiap individu karena didalam hidup seseorang mempunyai kualitas hidup yang berbeda-beda tergantung setiap orang untuk menghadapi setiap masalah yang dialami dalam hidup baik keluarga atau pasien. Tujuan dalam penelitian ini agar dapat mengetahui pengaruh perawatan paliatif terhadap kualitas hidup pasiengagal ginjal kronik yang sedang menjalankan pelayanan terapi hemodialisa. Jenis dalam penelitian yaitu peneliti analitik menggunakan  desain cross sectional peneliti menggunakan pendekatan observasional. Penelitian ini dilaksanakan di ruangan hemodialisa RSU Royal Prima Medan. Pada penelitian ini dilaksanakan  bulan Maret 2023. Responden pada peneliti ini terdapat 132 orang. Sampel pada penelitian yaitu seluruh pasien penderita GGK yang sedang menjalankan hemodialisa di RSU Royal Prima Medan,sebanyak 56 orang. Dalam penelitian ini untuk mengumpulkan data responden menggunakan formulir observasi dan kuesioner WHOQOL-BREF yang mengukur kualitas hidup. Pada penelitian ini didapatkan hasil pada pengaruh perawatan paliatif terhadap kualitas hidup yang menjalankan terapi hemodialisa digunakan Uji Chi-Square. Peneliti mendapatkan hasil uji statistik dengan nilai p value 0,000< 0,05. Maka hasilnya terdapat pengaruh perawatanpaliatif di RSU Royal Prima Medan. Dengan hasil yang telah peneliti dapatkan maka disimpulkan adanya pengaruh perawatan paliatif terhadap kualitas hidup keluarga dan pasienyang sedang melakukan terapi hemodialisadi RSU Royal Prima Medan. Kata Kunci: Perawatan Paliatif, Kualitas Hidup, Terapi Hemodialis

Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals

Background: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. Methods: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations. Thematic and behaviour analyses using the Actor, Action, Context, Target, Time framework were undertaken. Results: Knowledge about &lsquo;antimicrobial resistance and antibiotic stewardship&rsquo; and &lsquo;people and places&rsquo; were identified themes. Influences on dental prescribing decisions related to the organisational context (such as the hierarchical influence of colleagues and availability of specific antibiotics in the hospital setting), clinical issues (such as therapeutic versus prophylactic indications and availability of sterile dental instruments), and patient issues such as hygiene in the home environment, delays in seeking professional help, ability to access antibiotics in the community without a prescription and patient&rsquo;s ability to pay for the complete prescription. Conclusions: This work provides new evidence on behavioural factors influencing dental antibiotic prescribing, including resource constraints which affect the availability of certain antibiotics and diagnostic tests. Further research is required to fully understand their influence and inform the development of new approaches to optimising antibiotic use by dentists in Ghana and potentially other low- and middle-income countries