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Archive for the ‘Public Health Administration’ Category

Public health focuses its action from the perspective of the state with the interests he represents in the various forms of social and political organization of populations. In more traditional design, is the application of knowledge (medical or otherwise) in order to organize health systems and services, to act on conditioning factors and determinants of health-disease process by controlling the incidence of disease in populations through surveillance activities and government interventions. Not to be confused with the broader concept of health.

“The art and science of preventing disease, prolonging life, promoting health and physical and mental efficiency through organized community effort. Covering the environment sanitation, control of infections, the education of individuals on the principles of personal hygiene, the organization of medical services and nursing for early diagnosis and prompt treatment of diseases and the development of a social structure that ensures everyone in society a standard of living adequate for health maintenance. “

The persistent use of this definition is reinforced by the widespread distribution of health definition of the World Health Organization – international organization that proposed the holding of the World Health Conference with integration of all countries in the persistent pursuit of complete physical well-being, psychological and social.

The low number of mother’s milk exclusively cited as the causes of high child mortality. The statement was not a figment. UNICEF statistics show every year there are approximately 30 thousand deaths under five in Indonesia and 10 million under five deaths worldwide. The data also noted that only fourteen percent of infants in Indonesia who received mother’s milk exclusively from the mother until the age of six months. This phenomenon seems to describe a significant relationship between low rates of exclusive breastfeeding with high rates of infant mortality in Indonesia.
Seeing this reality, it is questionable what the cause of the low number of mother’s milk exclusively in infants in Indonesia. According to dr. Utami Roesli, Sp.A, MBA, IBCLC, Chairman of the Indonesian Lactation Center, one reason is the rampant promotion of formula milk in Indonesia.
Right Start Child Missing mother because no more idea about the benefits of mother’s milk so the mother thought that infant formula is better than mother’s milk. This rhythm is also described by dr. Large Sanyoto Dien, Sp.A, IBCLC, Coordinator of the Working Increased Use of BMS. He said that the incessant promotion of formula milk to be one cause of the low number of mother’s milk exclusively in infants.

Profanity promotion of formula milk
Riot promotion of formula milk are actually a chronic problem. If judging Further, there are many violations that have been done by formula milk companies. Package containing gifts for the mother formula, formula feeding to infants born to poor families, until the board names new born baby from formula milk companies are some violations that have been done. This was clearly inhibited the baby to get mother’s milk from his mother.
In addition to blocking of BMS indirectly, the hospitals are also hindering directly. The fact is that many newborns immediately separated from their mothers and formula-fed from the sponsoring party at the hospital. These conditions will certainly minimize the possibility of infants received mother’s milk from his mother. Responding to that, that newborns fed formula milk would be reluctant to drink mother’s milk. As a result the baby will be malnourished and more susceptible to disease. Furthermore, would pose a threat of loss of generation.
Although clearly stated in the form of infringement, but in reality, many public hospitals and Maternal and Child Hospital who collaborated with the company’s infant formula. Cooperation unhealthy it solely for the benefit of the hospital and the company’s own formula. These problems became more complicated because basically hospitals need funds and companies need consumers. That’s what ultimately pave the violation. Coupled with the ignorance of consumers, families and mothers of infants, about such cooperation. Seeing it was Dien spoke, “less than five Maternal and Child Hospital in Jakarta that really work in a clean run.”
Forms violation apparently not limited to health care facilities. Like do not want to miss, formula milk companies were actively promoting their products to the public through television advertisements, newspapers, internet, jumbo posters (billboards), to the clinic signage. However, sometimes they give information which may mislead the public. For example, advertising of formula milk is always illustrate that formula-fed babies will grow up healthy and smart. Yet mother’s milk is much better than formula milk. Even the position of mother’s milk can not be replaced by anything, including infant formula. These ads are duping the public at the same time to launch a covert campaign.
Profanity is likely to persist as long as there is no regulation with strict sanctions governing the promotion of formula milk in Indonesia. Regulation that was already referring to the International Code made by the World Health Assembly (WHA) on the marketing of BMS. But it turns out sanctions provided for violations committed by only a reprimand, not a strict form of punishment. So its application in any field is not visible and the more covert campaign launched by formula milk companies.
International Code which is a reference to regulations in Indonesia, aims to promote nutritional adequacy and safety of babies. This was done by way of mother’s milk protect and maintain the feasibility of marketing co-BMS (BMS are). The code applies to all products marketed as BMS are totally or partially. Which includes of BMS include infant formula, milk continued, special milk, cereal, juice, mixed vegetables, and tea baby. In addition to organizing the marketing of BMS, this code also regulates the marketing of baby bottles and pacifiers.
Cow’s milk for baby cows, milk the mother to the baby’s mother
In addition to the lack of binding regulations, vigorous promotion of formula milk was also associated with the arrival information has not been right about the importance of mother’s milk and breastfeeding in public. In fact, the provision of mother’s milk is important for babies to get optimal nutrients that promote health and intelligence of babies. Not to mention other benefits such as immunoglobulins contained in mother’s milk and affection from the mother during breastfeeding.

1. Understanding anxiety dealing with menopause

a. Understanding anxiety. One of the symptoms experienced by all
people in life is anxiety. Being anxious to some degree to
considered as part of a normal response to cope with daily problems.
However when anxiety is excessive and not proportional to
a situation, it is regarded as an obstacle and is known as a problem
clinical.
According to Byrne (1966), that anxiety is a feeling
experienced individuals, such as when he experienced fear. On anxiety
These feelings are vague, unrealistic or unclear object while
the fear object clearly.
According Hurlock (1990), anxiety is a form of feeling worried,
anxiety and other feelings that are less pleasant. Usually
These feelings are accompanied by a sense of lack of confidence, inability to feel
inferior, and unable to deal with a problem.
According Kartono (1997), ketidakberanian individual in the face
a problem and coupled with the worries of the things that are not
clearly a sign of anxiety in individuals.
Another expert opinion Havary (1997), argued that anxiety
is a psychological reaction to the mental condition of individuals who are depressed. If
people realize that things could not walk well on situation
will end up not feeling certain they would be worried. The conditions or
stressful situations will bring anxiety.
From the above description was taken to a conclusion that anxiety is
a psychological condition of individuals in the form of tension, anxiety,
concerns as a reaction to the existence of something that is threatening.

b. Understanding menopause. According Kartono (1992), that “men” means
month, “pause, pausa, pausis, paudo” means the period or stop sign, loss of
menopause defined as cessation of menstruation definitively.
Mappiare (1983), suggests menopause as a result of
physical and psychological changes that marked the cessation of egg production
and loss of ability to bear children which also marked the cessation of
menstruation.

Women going through menopause is marked by cessation of circulation
menstruation and is also followed by a downturn in production and emerging symptoms of organ
aging in some parts of the body. (Ibrahim, 2002)
Pakasi (1996), explains the definition of menopause is not only in terms of physical
namely the cessation of menstruation, but in terms of age is assumed to start at the end of
menopause and end in early elderly (senium) which is about 40-65 years.
Based on the description above, it can be concluded menopause is a phase
of the woman’s life is marked by cessation of menstruation, cessation of
egg production, loss of ability to bear children, and bring
changes and setbacks both physically and psychologically.

c. Understanding anxiety dealing with menopause. Burn (1988), that
Most menopausal women often suffer from depression and anxiety where
anxiety that appears to cause insomnia or can not sleep.
Everyone has beliefs and expectations vary.
Because of the differences that there are no two people will react
Similarly, although it seems as though they would react in a way that
same. Situations that create anxiety is a situation that contains the problem
which will trigger a certain anxiety in a person and does not occur in
others. (Tallis, 1995)
Kartono (1992), suggests psychological changes that occur
at menopause will lead to different attitudes among other
namely the existence of a crisis which is manifested in psychological symptoms
such as: depression, irritability, and easily become angry, and overwhelmed
a lot of anxiety.

Physical changes that occur in connection with the menopause
contains a deeper meaning for her life. Cessation of the cycle
menstruation is perceived as the loss of her feminine nature because it is the core
unable to bear children again. Further result is the emergence of feelings
valuable, does not mean that in life so there is a sense of worry that there
the possibility that the people he loved and turned
meningggalkannya. The feeling that is what is often perceived women during
menopause, which often cause anxiety. (Muhammad, 1981)
Based on the above description can be concluded that anxiety
dealing with menopause are feeling anxious, worried of the physical changes, social and sexual relation with menopause.

2. Factors that cause anxiety dealing with menopause
A problem occurred there as the background,
so that problems arise as well as the anxiety experienced by
someone, there are causes that lie behind them.
According Kartono (2000), anxiety caused by impulses
sexual satisfaction and not get blocked, so that
resulted in a lot of inner conflict.
According Hartoyo (2004), that stressors can trigger anxiety
grouped into two namely:

a. The threat to physical integrity, including the inability of physiological
will come or reduced capacity to perform activities of living
daily.
b. The threat to the system itself, could endanger the identity, self esteem,
and function of social integrity. Internal and external factors may threaten
self-esteem. External factors include the loss of self worth due to death,
divorce, or change positions. Internal factors include interpersonal difficulties
at home or workplace.

According to Carpenito (1998), there are several factors related to
the emergence of anxiety, namely:
a. Pathophysiological, that each factor related to basic needs
humans for food, water, comfort and safety.
b. Situational (people and environment)

Dealing with the threat of self-concept to change the status, the presence of
failure, loss of objects that are owned, and less appreciation of the people
other.
a). Associated with losing the people closest to death,
divorce, cultural pressures, displacement, and a farewell
temporary or permanent.
b). Dealing with the threat of biological integrity: the disease, affected
sudden illness, dying, and medical countermeasures against
ill.
c). Associated with changes in its environment for example:
environmental pollution, pensions, and the danger to security.
d). Associated with changes in socioeconomic status, such as unemployment, new jobs, and promotion.
e). Dealing with the anxiety of others towards individuals.

From the description above can be concluded that the factors
cause anxiety dealing with menopause is a problem that does not
resolved, concern about something that has not happened, the motives
social and sexual motives.

3. The symptoms of anxiety when dealing with menopause
Each individual must have felt a sense of discomfort, fear wary
will be a thing in his life, one of them is feeling anxious.
There are several symptoms of anxiety according to Morgan (1991), namely:
a. Physiological symptoms: trembling, tension, muscle aches, fatigue, unable to relax, eyelid
vibrating eyes, furrowed brow, strained face, can not be silent, easily startled,
sweating, heart pounding, feeling cold, moist palms, mouth
dry, dizziness, mild, tingling, nausea, feeling of heat flow
cold, frequent urination, diarrhea, discomfort in the pit of the stomach, esophagus
congestion, red face and pale, the pulse and rapid breathing time
break.

b. Psychological symptoms: excessive worry about things that will
come, such as anxiety, worry, fear, think again and again, imagining
of impending misfortune to himself and others, vigilance
excess, such as excessive environmental observing
attention resulting in easily distracted, difficulty concentrating, feel
pain, and difficulty sleeping.

The psychological symptoms of anxiety faced
menopause when viewed from several aspects, according to Blackburn and Davidson
(In Zainuddin, 2000) are as follows:
a. Mood, which is a state that shows compused psychic, such as:
irritability, feel very tense.
b. Mind, namely the uncertain state of mind, such as: worry, difficult
concentration, empty mind, to exaggerate the threat, see themselves
as very sensitive, feeling helpless,.
c. Motivation, namely the drive to achieve something, such as: avoiding
situation, high dependency, wanting to escape from reality.
d. Behavior that is agitated state of self that are not controlled such as: nervousness,
Excessive alertness, very sensitive and agitation.
e. Biological reactions that are not controlled, such as: sweating, trembling,
dizziness, palpitations, nausea, dry mouth.
According to Freud (in Hall, 1980), said of the symptoms
anxiety experienced by the individual usually becomes dry mouth breathing
faster, the heart is beating fast.

4. Period menopause
Women are born with a large number of eggs that are gradually
will expire unused. The ovary is not capable of making new eggs, so that
so egg-owned since birth expires, the ovulation will stop at
once. So there is a kind of hormone deficiency that causes some
major problems that occur around menopause or who develop
thereafter.
Estrogen and progesterone in women is called sex hormones (sex hormones). Esrtogen in women showing signs of femininity, such as the skin smooth, gentle voice, enlarged breasts. In each month, surging levels of estrogen and progesterone, alternating up and down. The wave that results in menstruation in women. As with the estrogen produced by the ovaries only diving supplies egg cells still exist. The task is to finalize the actual estrogen egg cell prior to release. Therefore, estrogen subs are still there, the egg will still be produced.

Then after a woman aged about 45 years, when the egg supply
low, ovaries begin to stop production of estrogen as a result of menstruation is not
appears again. In the woman stepped on menopause, which means
the cessation of fertility.
Based on the above description can be concluded that the period of
menopause when the egg supply runs out, the ovaries begin to stop
estrogen production as a result of menstruation did not appear again. In the woman’s
stepping on menopause, which means the cessation of future fertility.