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"Analisis praktik residensi keperawatan medikal bedah merupakan karya ilmiah akhir Ners Spesialis. Bertujuan untuk memberikan gambaran secara umum proses pelaksanaan praktik residensi keperawatan medikal bedah yang dilaksanakan dalam dua semester. Analisis ini terdiri dari kasus kelolaan utama pada gangguan sistem neurologi dengan kasus astrositoma dan 30 kasus resum menggunakan pendekatan model adaptasi Roy, penerapan evidence based nursing (EBN) dan proyek inovasi. pada kasus kelolaan masalah masalah ketidakefektifan perfusi cerebral teratasi dan pada 30 kasus resum diagnosa terbanyak yaitu risiko jatuh dan ketidakefektifan perfusi cerebral. untuk peneraan evidence based nursing tentang Tongue stretching exercises (TSE) pada pasien stroke dengan gangguan menelan dan terbukti dapat meningkatan gerakan lidah dalam proses menelan. Untuk proyek inovasi melakukan tatalaksana perawatan pasca stroke terkini. Banyak manfaat yang didapatkan selama proses praktik residensi diantaranya melatihan berpikir kritis dalam mengelola kasus sulit, melatih keterampilan praktik, dan menerapkan intervensi berdasarkan bukti ilmiah. Diharapkan bagi bagi perawat untuk memberikan intervensi keperawatan berdasarkan bukti ilmiah dan selalu berlatih dalam berpikir kritis agar memiliki tingkat sensitifitas dalam melihat fenomena masalah pada pasien.

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Analysis of practice medical surgical nursing residency is the final scientific work of Specialist Nursing. The aim is to provide an overview of the process of implementing medical surgical nursing residency practices that got in two semesters. This analysis consists of cases of major management in neurological system disorders with astrocytoma cases and 30 cases of rums using Roy's adaptation model approach, application of evidence based nursing (EBN) and innovation projects. The case of managed cerebral perfusion problems the problem is managed and in 30 cases the most common diagnoses are the risk of falls and the ineffectiveness of cerebral perfusion. For evidence based nursing information about Tongue stretching exercises (TSE) in stroke patients with swallowing disorders and is proven to increase tongue movement in the swallowing process. Innovation projects carry out the latest post-stroke care management. Many benefits got during the residency practice process include training critical thinking in managing difficult cases, practicing practical skills, and implementing interventions based on scientific evidence. Hope is expected for nurses to provide nursing interventions based on scientific evidence and always practice critical thinking in order to have a sensitivity level in seeing the phenomenon of problems in patients."

"ABSTRAKBanyak kasus maloklusi yang memerlukan bantuan elastik karet. Elastik karet digunakan untuk membantu menghasilkan gaya yang diperlukan untuk menggerakkan gigi. Pada penggunaan nya, elastik karet akan mengalami penurunan gaya seiring berjalannya waktu. Oleh karena itu perlu dilakukan penggantian pada saat tertentu, sehingga efektifitas perawatan tidak terganggu. Disamping itu, gaya elastik karet dipengaruhi juga oleh jarak peregangan. Selama pemakaian, akan terjadi perubahan jarak yang tentu saja akan mengubah gaya elastik karet.Penelitian ini merupakan penelitian deskriptif laboratorik yang meneliti pengaruh lama dan jarak peregangan terhadap gaya elastik karet . Dilakukan uji laboratorium beberapa diameter elastik karet yang direndam dalam saliva buatan dan dilakukan pengukuran gaya dengan alat ukur tegangan Correxmeter dalam berbagai lama dan jarak peregangan.Hasil penelitian dianalisis dengan uji F (Anova) menunjukkan bahwa lama dan jarak peregangan berpengaruh terhadap gaya berbagai diameter elastik karet secara bermakna (P < 0.05). Elastik karet yang diregang pada jarak yang seharusnya (3 kali diameternya) mempunyai gaya yang efektif untuk menggerakkan gigi hanya sampai 4 jam. Elastik karet yang diregang melebihi jarak yang seharusnya mempunyai gaya yang efektif untuk menggerakkan gigi dapat bertahan sampai 48 jam.

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ABSTRACT

Many malocclusion cases need the use of rubber elastics to produce the force required for tooth movement. While a rubber elastic is used, it dissipate in force accordance with the length of time. Therefore, at a certain time, it is necessary to replace it to maintain the effectiveness of the treatment. Besides, the rubber elastic force is also influenced by the stretching distance. During its use, distance changes may occur and it will certainly effect the rubber elastic force too.

This descriptive laboratory study examines the influence of stretching duration and distance on the orthodontic rubber elastics force. Several diameter of rubber elastics are soaked in the artificial saliva. The force is measured with a correxmeter tension gauge in various stretching duration and distance.

The result of this study, analyzed with the F (Anova) test, shows that the stretching duration and distance give a significant influence (P < 0,05) on the force of various rubber elastics diameters. The rubber elastic which is stretched at a certain distance (3 times the diameter size) has the effective force to move a tooth for 4 hours only. The rubber elastic which is stretched beyond that distance has the force effectiveness up until 48 hours."

"Spesimen uji lembaran baja galvanis dengan tebal 0.8 mm diberi lubang lingkaran berdiamater dan antar lubang 2.5 mm dengan pola susunan tetragonal dan heksagonal. Sifat manufaktur bahan tersebut dipelajari melalui pengujian simulatif penarikan (drawing) dan rentang (stretching). Sebagai pembanding, dilakukan pengujian terhadap lembaran sejenis tanpa lubang perforasi. Dari hasil penelitian ini diketahui perbandingan sifat manufaktur lembaran perforasi dengan pola susunan lubang tetragonal dan heksagonal serta prediksi sifat intrinsik mampu tarik lembaran perforasi dengan menggunakan asumsi kontinum ekivalen.

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Galvanized steel sheet of 0.8 mm in thickness was drilled with circle holes of 2.5 mm diameter and spacing arranged in tetragonal and hexagonal pattern. The manufacturing properties of specimen were studied through drawing and stretching simulative test. It was concluded from the results that, at high ratio of punch to hole diameter (40/2.5), the drawing properties (LDR) of both square and hexagonal perforated sheet were slightly lower than that of solid sheet, while hexagonal perforated showing LDR somewhat higher than the square one. The stretching properties (LDH) of sheet, however, were much lower than that of solid sheet while the hexagonal perforated exhibiting LDH lower than the square one. Provided the effi ciency factor was well defi ned, which was not effective in the present experiment, the intrinsic drawing properties might be indirectly determined through the simulative test by assuming the perforated materials as an equivalent continuum."

"Penelitian ini bertujuan untuk mengetahui pengaruh kondisi pelumasan terhadap mampu bentuk lembaran kuningan perforasi heksagonal dan membandingkan kekuatan mekanis dan sifat mampu bentuk kuningan perforasi dengan tanpa perforasi. Dimana sifat mampu bentuk dipengaruhi oleh nilai LDR proses deep drawing dan nilai kedalaman stretching dan distribusi regangan proses stretching."

"ABSTRAKPrevalensi gangguan muskuloskeletal akibat kerja masih tinggi. Salah satu cara mengatasinya dengan latihan peregangan otot (stretching). Penelitian ini bertujuan untuk mengetahui pengaruh latihan peregangan otot atau stretching pada pekerja. Metode penelitian menggunakan quasi eksperiment dengan rancangan pre dan post test group design with control group sebanyak 60 responden. Hasil penelitian menunjukkan adanya pengaruh latihan peregangan otot terhadap keluhan gangguan muskuloskeletal akibat kerja (pvalue 0,007). Faktor yang berkontribusi terhadap keluhan muskuloskeletal akibat kerja adalah lama kerja, IMT, dan latihan peregangan otot. Hasil penelitian merekomendasikan perlu dilakukan latihan peregangan otot sebanyak 5 kali sehari pada pekerja untuk mencegah keluhan ganggguan muskuloskeletal akibat kerja.

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ABSTRACTThe prevalence of work related musculoskeletal disorders is still high. One strategy to overcome the problem is by the muscle exercise (stretching). The purpose of this research was to examine the influence of stretching on workers. The method used was quasi experiment pre and post test group with control that involved 60 respondents. The result of this research showed that there was significant influence of stretching on work related musculoskeletal disorders (pvalue 0,007). Factors contributed to this disturbance were work length period, body mass index, and stretching exercise. This research recommended that stretching of five times a day is important to prevent work related musculoskeletal disorders among workers."

"Nyeri tungkai bawah adalah salah satu keluhan muskuloskeletal yang sering dialami para penjahit industri garmen UMKM. Menurut penelitian- penelitian yang sudah ada sebelumnya, diketahui bahwa baik stretching ataupun mini-break mampu mengurangi keluhan muskuloskeletal pada pekerja, namun belum pernah ada yang meneliti efektivitas kedua intervensi tersebut pada penjahit industri garmen. Metode: Penelitian ini merupakan penelitian Quasi Experimental, dan menggunakan desain two-group pre test-post test. Penelitian ini melibatkan 70 orang subyek penelitian, yang terbagi menjadi 33 orang pada ruang kerja 1, dan 37 orang pada ruang kerja 2. Sebelum diberikan intervensi, terlebih dahulu diambil skor VAS pre- intervensi dari seluruh subyek penelitian, kemudian para subyek mengikuti program intervensi sesuai ruang kerjanya, dimana pada ruang kerja 1 akan diberikan intervensi stretching, dan ruang kerja 2 akan diberikan intervensi mini- break. Kedua intervensi dilaksanakan oleh subyek penelitian selama 2 minggu. Setelah pemberian intervensi, akan dilakukan kembali pengukuran nilai VAS post- intervensi untuk menilai efektivitas dari program intervensi yang telah diberikan. Data-data yang diperoleh akan dianalisis dengan menggunakan uji statistik untuk menilai perbandingan efektivitas kedua kelompok intervensi. Hasil: Terdapat nilai median  selisih VAS pre- post intervensi sebesar 4 pada kelompok stretching, dan nilai median selisih VAS sebesar 2 pada kelompok mini- break. Dari hasil analisis perbedaan penurunan nyeri tungkai bawah antara kelompok intervensi stretching dan kelompok intervensi mini- break diperoleh hasil nilai p <0,001, yang menunjukkan bahwa terdapat perbedaan antara nilai median selisih VAS kelompok stretching dan selisih VAS kelompok mini- break yang signifikan secara statistik. Kesimpulan:  Terdapat penurunan nyeri tungkai bawah setelah pemberian program stretching ataupun pemberian mini- break, namun begitu, efek pengurangan nyeri setelah pemberian stretching lebih baik dibandingkan dengan pemberian mini-break

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Lower leg pain is one of the musculoskeletal problem that often felt by a sewing worker of a MSME (Micro, Small, and Medium Enterprises) garment industries. According to previous research, it is known that either stretching or mini- break were able to reduce musculoskeletal problem in workers, but there has never been any research about the effectiveness of both interventions in reducing pain, specifically in lower leg in a sewing worker of a garment industry. Methods: Quasi experimental studies was applied, and using a two group pre test- post test design. This research involved 70 subjects, that was divided into 33 persons in workroom 1, and 37 persons in workroom 2. Before intervention was given to subjects, a pre- intervention VAS were collected first, then subjects followed the intervention program, correspond to their workroom. Stretching intervention was given to subjects in workroom 1, and mini- break intervention was given to subjects in workroom 2. Both intervention were given to the subjects for 2 weeks. After the intervention has been given, the post- intervention VAS was measured to assess the effectiveness of the given interventions. Collected datas will be analyzed using a statistical test to assess the comparison of effectiveness within the intervention groups. Result: From this research, a VAS differences median score of 4 at stretching group, and VAS differences median score of 2 at mini-break group were found. From the analysis of lower leg pain reduction comparison between stretching group and mini- break group, we found a p score <0,001, which means there was a statistically significant difference between VAS difference median score of stretching group and VAS difference median score of mini- break group. Conclusion: There were reduction of lower leg pain after stretching or mini- break programs were given, however, the effect of pain reduction after stretching program was better than mini- break."

"Latar belakang: Musculoskeletal disorders (MSDs) berkontribusi 42-58% dari total penyakit akibat kerja dan 40% dari total biaya kesehatan kerja secara global. Tingginya angka gangguan musculoskeletal pada pekerja khususnya nyeri bahu menuntut adanya metode terapi dan pencegahan agar terhindar dari penyakit akibat kerja dan peningkatan produktivitas kerja, terutama nyeri bahu di antara pengemudi bus. Untuk mengurangi penyakit terkait pekerjaan dan untuk meningkatkan tingkat produktivitas, dipilih Active Isolated Stretching (AIS). Dengan pelatihan sistematis dan pengamatan untuk melakukan AIS setiap hari, studi di antara pengemudi bus kampus terbukti mengurangi rasa sakit dan meningkatkan fleksibilitas bahu.Metode: Penelitian ini merupakan quasi-eksperimen. Penelitian dilakukan di salah satu kampus universitas di Jakarta selama 14 bulan berturut-turut. Mulai mengumpulkan data sebelum melakukan AIS (T1), 18 supir bus kampus sebagai subyek penelitian dilatih dan diamati oleh perawat terlatih untuk melakukan AIS secara teratur sebelum memulai mengemudi. Data dikumpulkan setiap 2 minggu oleh dokter medis yang terlatih (T1-T5). Prosedur pengumpulan data dilakukan dengan pemeriksaan fisik, observasi, kuesioner, pemeriksaan neurologis dan wawancara.Hasil: Ada 18 pengemudi bis yang memiliki rata-rata VAS (Visual Analogue Score) dari T1 (rata-rata awal VAS) adalah 5,5 (0-10) dan meenurun secara bertahap menjadi 2 (0-6) pada minggu ke-8. Hasil rata-rata Apley Scratch Test (AST) T1 adalah (-9,122+11302) dan menjadi lebih baik secara bertahap ke T5 (-3,833+9,133). Semua ROM bahu memiliki peningkatan yang signifikan dari T1 ke T5. Pada Fleksi ada peningkatan rata-rata dari (166,22+7,697) menjadi (177,94+2,838). Abduksi dari 165 (160-180) menjadi 177 (165-180), Abduksi endorotasi dari 168,5 (150-165) menjadi 180 (170-180), Abduksi eksorotasi dari (162,56+4,605) menjadi (173,39+5.521), Ekstensi dari (42,11+6,747) menjadi (54,89+8,366), Adduksi dari 25 (20-40) menjadi 39 (30-45), Endorotasi dari (62,67+8,717) menjadi (80,67+10,738), Eksorotasi dari (71,28+9,670) menjadi (89,22+5,694). Ada juga korelasi yang signifikan antara kelompok usia dengan endorotasi bahu ROM p <0,05 dan r-0,474 dan abduksi eksorotasi bahu dengan p <0,05 dan r-0,477.Kesimpulan dan saran: Hasil analisis menunjukkan bahwa ada penurunan rerata VAS dan peningkatan rerata ROM dan rerata Apley Scratch Test. Hasil ini menunjukkan bahwa AIS terbukti sebagai terapi dan pencegahan nyeri bahu, tetapi penelitian lebih lanjut pada populasi masyarakat pekerja lain diperlukan.

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Background: Musculoskeletal disorders (MSDs) contribute 42-58 % of total occupational illnesses and 40% of total occupational healthcare costs globally. There were high numbers of MSDs among workers, those need special treatment for therapy and prevention, especially of shoulder pain among bus drivers. To reduce work related illnesses and to increase productivity rate, active isolated stretching (AIS) was selected to be aplicated in every day. By systematic trainings and observations to do AIS every day, the study among campus bus drivers proved to reduce the pain and to increase the shoulder flexibilities.Method: This research was a quasi-experiment. The study was conducted in a campus of University in Jakarta for 14th months continuously. Started to collect the data before did the AIS (T1),18 campus bus drivers as study subjects were trained and observed by trained nurse to do AIS regularly before start the day. Data were collected every 2 weeks by trained medical doctors (T1-T5). The data collection procedures was done by an observation check list, questionnaire, neurological examination and interview.Result: There were 18 bus drivers who had average VAS (Visual Analogue Score) of T1 (initial VAS average) was 5,5 (2-10) and reduce gradually to 2 (0-6) at week 8th (p<0,05). The results of average Apley Scratch Test (AST) of T1 was (-9,122+11,302) and became better gradually at T5 to -3,833 +9,133) p<0,05. All shoulder ROMs have a significant improvement from T1 to T5. On Flexion there is an average increase from (166,22+7,697) to (177,94+2,838). Abduction from 165 (160-180) to 177 (165-180), Abduction of endorotation from 168.5 (150-165) to 180 (170-180), Abduction of exorotation from (162.56+4,605) to (173,39+5,521), Extension from (42,11+6,747) to (54,89+8,366), Adduction from 25 (20-40) to 39 (30-45), Endorotation from (62,67+8,717) to (80,67+10,738), The exorotation from (71.28+9.670) to (89.22+5.694) p<0,05. There was also significant correlations between ages group with shoulder endorotation ROM p<0.05 and r -0.474 and abduction of shoulder exorotation with p <0,05 and r-0,477.Conclusion and suggestion: The experimental study proved that there was a decrease of average VAS and an increase of average ROM and average Apley Scratch Test. These results suggest that AIS is best used as a therapy and prevention of shoulder pain, but further research on other working populations is needed."

"Latar belakang: Nyeri Punggung Bawah (NPB) merupakan masalah kesehatan kerja yang dilaporkan sebagai alasan umum ketidakhadiran operator dump truck di Industri Pertambangan PT.X. Operator alat berat memiliki risiko untuk terjadi NPB karena aktivitas pekerjaan. Sementara latihan peregangan membantu mencegah NPB dengan meningkatkan fleksibilitas neuromuskuler dan mengurangi rasa nyeri. Manfaat latihan peregangan untuk operator alat berat khususnya dump truck belum banyak diteliti dan perlu dilakukan intervensi berupa latihan peregangan terhadap operator dump truck yang mengalami NPB.Tujuan: Mengetahui efek latihan peregangan saat bertugas terhadap NPB pada operator dump truck di industri pertambangan PT.XMetode: Penelitian quasi experiment dengan pendekatan control group pretest-posttest melibatkan 76 operator yang mengalami NPB, masing-masing 38 operator dipilih secara purposive sampling untuk kelompok kontrol dan intervensi. Kelompok kontrol hanya menerima video edukasi pencegahan NPB dan kelompok intervensi menerima intervensi standar dan Latihan Peregangan Punggung Bawah. Penelitian dilakukan selama 4 minggu. Tingkat nyeri dan fleksibilitas diukur setiap minggunya. Tingkat nyeri dan fleksibilitas punggung bawah dinilai dengan Numeric Rating Scale (NRS) dan V-Sit and Reach Test. Data yang diperoleh dianalisis menggunakan analisis univariat, bivariat, dan general linear model (GLM).Hasil Penelitian: Selama latihan peregangan, terdapat penurunan signifikan tingkat nyeri dan peningkatan fleksibilitas setiap minggunya. Pada akhir intervensi, terdapat perbedaan yang signifikan antara tingkat nyeri punggung bawah dan fleksibilitas pada kelompok kontrol dan intervensi (p<0,001). Tidak ada hubungan signifikan antara penurunan nyeri dan peningkatan fleksibilitas selama latihan peregangan.Kesimpulan: Latihan peregangan punggung bawah secara signifikan dapat mengurangi tingkat nyeri dan meningkatkan fleksibilitas pada NPB. Latihan peregangan ini dapat digunakan sebagai salah satu program latihan peregangan di tempat kerja untuk pencegahan NPB. Diperlukan penelitian lebih lanjut mengenai pengaruh latihan peregangan pada operator alat berat lainnya.

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Background : Lower Back Pain (LBP) is an occupational health problem that is reported as a common reason for the absence of dump truck operators in the mining industry of PT.X. Heavy Eequipment Vehicle (HEV) operators are at risk for LPB due to work activities. Stretching exercises help prevent LBP by increasing neuromuscular flexibility and reducing pain. The benefits of stretching exercises for HEV operators, especially dump trucks, haven’t been studied yet and interventions need to be carried out regarding the effects of stretching exercises on dump truck operators who experience LBP

Purpose: Determine the effect of stretching exercises especially pain level and flexibility in lower back while on duty towards low back pain in dump truck operators at the coal mining industry PT.X.

Methods: A nonrandomized controlled trial with a pretest-posttest control group approach involved 76 dump truck operators who experienced LBP, each of which 38 operators were selected by purposive sampling for the control and intervention groups. The control group only received LBP prevention education videos and the intervention group received standard intervention and Lower Back Stretching Exercises. This study were performed for 4 weeks. Pain and flexibility levels were measured at the start of the program, weekly, until the end of the program. Low back pain and flexibility were assessed using the Numeric Rating Scale (NRS) and the V-Sit and Reach (VSR) test. The data obtained were analyzed using univariate, bivariate, and general linear models (GLM).

Results: During stretching exercises, there was a significant reduction in pain levels and a significant increase in flexibility each week. At the end of the intervention, there was a significant difference between the level of pain and flexibility on LBP in the control and intervention groups (p<0.001). There is no significant relationship between reduced pain and increased flexibility during stretching exercises.

Conclusion: Lower back stretching exercises can significantly reduce pain levels and increase flexibility in LBP. This stretching exercise can be used as one of the stretching programs at work for the prevention of LBP. Further research is needed on the effect of stretching exercises on other heavy equipment operators."

"Latar belakang: Gangguan muskuloskeletal akibat kerja merupakan masalah kesehatan utama di tempat kerja dan memerlukan perhatian dan tindakan pencegahan untuk memastikan bahwa gangguan tersebut tidak mempengaruhi produktivitas kerja. Tujuan: Untuk mengetahui karakteristik responden, mengetahui selisi gejala musculoskeletal disorder sebelum dan sesudah perlakuan pada kelompok intervensi dan kelompok kontrol, untuk mengetahui perbandingan hasil gejala musculoskeletal disorder setelah perlakuan pada kedua kelompok. Metode: Penelitian ini menggunakan desain quasi-eksperimental dengan pendekatan pretest-posttest two groups design, Non-randomized control trial, control grup pre-test and post-test design.Hasil: Uji perbandingan sebelum dan sesuda perlakuan pada kelompok intervensi sebelum perlakukan mayoritas berada pada kategori sedang (91.7%), setelah perlakuan terdapat perubahan gejala ke kategori ringan (79.2%) dan sebelum perlakuan pada kelompok kontrol mayoritas kategori sedang (50.0%), setelah perlakuan terdapat perubahan kategori ringan (50%). uji Chi Square sebelum dan sesuadah pada kedua kelompok p (<0.005) terdapat pengaruh yang signifikan. Hasil uji Perbandingan Setelah perlakuan pada kelompok intervensi dan kelompok kontrol menunjukan mayoritas perubahan gejala musculoskeletal disorder dengan kategori ringan pada kelompok intervensi (79.2%) nilai p (0.012) p (<0.005) sehingga dapat disimpulkan bahwa Stretching exercise dan guided imagery signifikan mempengarhi perubahan gejala musculoskeletal disorder. Studi ini menunjukkan bahwa terapi kombinasi stretching exercise dan guided imagery setelah perlakuan pada kelompok intervensi dan kelompok kontrol signifikan mempengaruhi gejala musculoskeletal disorder. Sehingga perlu diaplikasikan ditempat kerja sebagai upaya promotif dan preventif untuk mencegah gajala musculoskeletal disorder.

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Background: Work-related musculoskeletal disorders are a major health problem in the workplace and require attention and preventive measures to ensure that these disorders do not affect work productivity.

The aim is to find out the characteristics of the respondents, to find out the differences in musculoskeletal disorder symptoms before and after treatment in the intervention group and the control group, to find out the comparison of the results of musculoskeletal disorder symptoms after treatment in the two groups.

This research method uses a quasi-experimental design with a pretest- posttest two groups design approach, non-randomized control trial, control group pre-test and post- test design.

The results of the study show that there is a difference in musculoskeletal disorder symptoms before and after treatment in the intervention group before treatment. the majority were in the moderate category (91.7%), after treatment there was a change in symptoms to the mild category (79.2%) and the majority of respondents in the control group before treatment were in the moderate category (50.0%), after treatment there was a change in the mild category (50%). Chi Square test before and after in both groups p (<0.005) there was a significant effect. Comparison of the results of musculoskeletal disorder symptoms after treatment in the intervention group and the control group shows that the majority of musculoskeletal disorder symptoms are in the mild category (79.2%) p value (0.012) p (<0.005) so it can be concluded that stretching exercise and guided imagery significantly influence changes in musculoskeletal symptoms disorders. This study shows that the combination therapy of stretching exercise and guided imagery after treatment in the intervention group and control group significantly affects the symptoms of musculoskeletal disorders. This is because researchers did not examine further psychological factors such as anxiety, stress and respondents' pain responses, so further research needs to be carried out to understand the role of psychological factors in the symptoms of musculoskeletal disorders.

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