Noise Induced Hearing Loss (NIHL) atau gangguan pendengaran akibat bising merupakan penyakit akibat kerja yang paling umum diderita di dunia. Sekitar 16 % dari total gangguan pendengaran pada orang dewasa di dunia dikaitkan dengan kebisingan akibat pekerjaan. Diperkirakan 1,3 miliar orang menderita gangguan pendengaran akibat paparan kebisingan. PT. XYZ merupakan perusahan manufaktur industri pulp and paper yang memiliki pajanan kebisingan tinggi khususnya pada SEG Operator unit recovery boiler dan SEG power boiler. Penelitian ini bertujuan untuk melakukan penilaian pajanan kebisingan dengan menggunakan pendekatan Bayesian Decision Analysis (BDA) dengan menentukan distribusi prior, distribusi likelihood dan distribusi posterior pada SEG recovery boiler dan SEG power boiler. Penelitian ini merupakan penelitian deskriptif analitik dengan pendekatan kuantitatif yang dilaksanakan pada bulan April - Mei 2023. Pengumpulan data dilakukan melalui observasi, pengukuran dosis kebisingan personal, dan expert judgment. Data dianalisis dengan menggunakan software IHData Analyst-AIHA dan EXPOSTATS. Hasil penelitian menunjukan bahwa terdapat variasi yang moderate apda kedua SEG. Distribusi probabilitas prior pajanan kebisingan pada SEG recovery boiler memiliki certainty level 1 pada kategori 4 (poor control) sedangkan pada SEG power boiler memiliki certainty level 0,995 pada kategori 4 (poor control) dan certainty level 0,005 pada kategori 3 (controlled). Distribusi probabilitas likelihood pada kedua SEG recovery boiler dan power boiler memiliki certainty level 1 pada kategori 4. Sehingga distribusi probabilitas posterior kedua SEG recovery boiler dan power boiler adalah masing-maisng pada kategori 4 (poor control) dengan certainty level 1. Hal ini menunjukan bahwa pajanan kebisingan pada kedua SEG tidak dapat diterima (unacceptable). Peneliti menyarankan untuk melakukan pengendalian segera dengan menerapkan Hearing Consevation Program secara komprehensif dan berkelanjutan, melakukan refining SEG dengan uji variasi individual compliance test dan menggunakan metode BDA dalam melakukan penilaian pajanan kerja. 

Noise Induced Hearing Loss (NIHL) is the most common occupational disease worldwide. Approximately 16% of total adult hearing impairments in the world are associated with occupational noise. It is estimated that 1.3 billion people suffer from hearing impairments caused by noise exposure. PT. XYZ is a manufacturing company in the pulp and paper industry which has high noise exposure, especially for the SEG Operator in the recovery boiler unit and the SEG power boiler unit. This study aims to assess noise exposure using Bayesian Decision Analysis (BDA) approach by determining the prior distribution, likelihood distribution, and posterior distribution in the SEG recovery boiler and SEG power boiler. This research is a descriptive analytical study with a quantitative approach conducted from April to May 2023. Data collection was carried out through observation, personal noise dose measurements, and expert judgment. The data were analyzed using the IHData Analyst-AIHA and EXPOSTATS software. The results show that there are moderate variations in the two SEGs. The prior probability distribution of noise exposure in the SEG recovery boiler has a certainty level 1 in category 4 (poor control) while in the SEG power boiler it has a certainty level of 0.995 in category 4 (poor control) and a certainty level of 0.005 in category 3 (controlled). The likelihood probability distribution for both SEG recovery boilers and power boilers has certainty level 1 in category 4. So that the posterior probability distribution for both SEG recovery boilers and power boilers is respectively in category 4 (poor control) with certainty level 1. This shows that noise exposure in both SEGs is unacceptable. Researchers suggest carrying out immediate control by implementing a comprehensive and sustainable Hearing Conservation Program, refining SEGs with individual compliance test variations and using the BDA method of conducting occupational exposure assessments.

Lansia adalah kelompok yang rentan di masa pandemi COVID-19. Oleh karena itu diperlukan pemetaan vaksinasi untuk masyarakat lansia, terutama di Pulau Jawa, sehingga dapat menganalisis cakupan vaksinasinya di tiap Kab/Kota. Sehingga tujuan dari penelitian ini adalah melakukan analisis spasial cakupan vaksinasi COVID-19 dosis 1 dan dosis 2 pada sasaran prioritas lansia di Pulau Jawa sejak awal diadakan vaksinasi pada bulan Januari tahun 2021 sampai bulan Mei tahun 2022.Analisis spasial sebagai metode peneltian yang memetakan objek berdasarkan posisi geografis menjadi alat bantu yang tepat dalam Decision Support System dalam menganalisis pemetaan cakupan vaksinasi COVID-19 dosis 1 dan dosis 2 di Pulau Jawa. Hasil yang diperoleh menunjukkan adanya autokorelasi spasial antar wilayah di Pulau Jawa. Oleh karena itu dapat disimpulkan bahwa persentase jumlah lansia yang dilakukan Vaksin dosis 1 dan Vaksin dosis 2 di 118 kabupaten/kota di Pulau Jawa cenderung berkelompok (cluster) pada lokasi yang berdekatan. Hasil ini diharapkan dapat menjadi pertimbangan bagi pemerintah daerah dan dinas kesehatan dalam mengambil langkah selanjutnya dalam memastikan cakupan vaksinasi COVID-19 yang merata untuk tiap Kab/Kota di Pulau Jawa.

The elders are a vulnerable group during the COVID-19 pandemic. Therefore, it is necessary to map out vaccinations for the elderly, especially in Java, to analyze the vaccination coverage in each district/city. The purpose of this study is to conduct a spatial analysis of the coverage of COVID-19 vaccination doses one and dose two at the elderly priority targets on Java Island since the initial vaccination was held from January 2021 until May 2022. Spatial analysis is research method that maps objects based on geographical position. This method becomes the suitable tool in the Decision Support System to analyze the mapping of COVID-19 vaccination coverage doses one and two on the island of Java. The results obtained indicate that there is a spatial autocorrelation between regions in Java. Therefore, it can be concluded that the percentage of the elderly who received dose one and dose two vaccines in 118 districts/cities on the island of Java tended to be clustered in adjacent locations. This result is expected to be a consideration for local governments and health offices in taking the next step in ensuring equitable COVID-19 vaccination coverage for each district/city on the island of Java.

Peningkatan angka persalinan sectio caesarea (SC) mendorong optimalisasi Vaginal Birth After Caesarean (VBAC). Keputusan ibu untuk menjalani VBAC tidak hanya dipengaruhi oleh pertimbangan klinis, tetapi juga oleh keterampilan komunikasi tenaga kesehatan. Penelitian ini bertujuan mengeksplorasi keterampilan komunikasi tenaga kesehatan dalam memengaruhi ibu mengambil keputusan VBAC di Klinik BWCC Bekasi. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus. Pengumpulan data dilakukan melalui wawancara mendalam kepada 6 ibu hamil dengan riwayat SC, 2 suami dari ibu hamil dengan riwayat SC, 3 bidan, 1 dokter spesialis kandungan, dan 1 penanggung jawab maternal, serta observasi non-partisipatif terhadap 3 bidan dan 2 dokter spesialis kandungan. Informan dipilih secara purposive sampling. Hasil penelitian menunjukkan keterampilan openness ditunjukkan oleh tenaga kesehatan melalui penyampaian informasi yang jujur dan seimbang; other-orientation melalui penggalian kebutuhan dan preferensi pasien; empathy melalui respons terhadap kondisi emosional ibu hamil; supportiveness melalui pemberian motivasi dan pendampingan; serta equality melalui komunikasi dua arah yang partisipatif dan pelibatan suami/keluarga. Proses shared decision making berlangsung melalui choice talk yang dimulai sebelum konsultasi tatap muka, option talk melalui penyampaian informasi berbasis bukti, dan decision talk yang menghormati otonomi pasien. Dengan demikian, keterampilan komunikasi tenaga kesehatan memegang peranan penting dalam memengaruhi ibu dalam mengambil keputusan untuk menjalani VBAC.

The increasing rate of caesarean section births has highlighted the need to optimize Vaginal Birth After Caesarean as an alternative mode of delivery. A mother's decision to undergo VBAC is influenced not only by clinical considerations but also by the communication skills of healthcare providers. This study aimed to explore the communication skills of healthcare providers in supporting mothers' decision-making regarding VBAC at BWCC Clinic Bekasi. A qualitative study with a case study design was employed. Data were collected through in-depth interviews with six pregnant women with a previous caesarean section, two husbands of pregnant women with a previous caesarean section, three midwives, one obstetrician, and one maternal care coordinator, as well as through non-participant observation involving three midwives and two obstetricians. Informants were selected using purposive sampling. The findings showed that healthcare providers demonstrated openness by providing honest and balanced information; other-orientation by exploring patients' needs and preferences; empathy by responding to the emotional conditions of pregnant women; supportiveness by offering motivation and continuous assistance; and equality by fostering participatory two-way communication and involving husbands and family members. The shared decision-making process occurred through choice talk, which began prior to face-to-face consultations; option talk, which involved the provision of evidence-based information; and decision talk, which respected patients' autonomy. These findings indicate that healthcare providers' communication skills play a crucial role in supporting mothers in making informed decisions to undergo VBAC.