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"This randomized double-blind placebo-controlled trial aimed to compare the efficacy of daily iron supplementation and multi-micronutrient supplementation both daily and weekly basis on increasing iron status among 284 apparently healthy Indonesian infants aged 6-12 mo. Infants were randomly assigned to receive either daily 1 RDA multi micronutrient supplement (n = 72), weekly 2 RDA multi micronutrient supplement (n = 70), daily ferrous sulphate 10 mg (n = 72), or placebo (n = 70) for wk. Blood hemoglobin, plasma ferritin, plasma zinc, and plasma C-reactive protein concentrations were measured prior to intervention and after 23 wk of supplementation. At baseline, 58.1% of subjects were anemic, 28.2% were iron deficient, and 11.2% were zinc deficient. After 23 wk of supplementation, both daily 1 RDA multi micronutrient and iron supplemented groups had significantly increased blood hemoglobin and plasma ferritin concentration, furthermore reducing the percentage of anemia and iron deficiency. However, the changes of hemoglobin were not significantly different among the treatment groups. Changes of hemoglobin were significantly higher in daily 1 RDA multi micronutrient group than in placebo group when initial blood hemoglobin was low. The change of plasma ferritin concentration in both daily 1 RDA multi micronutrient and iron groups was significantly higher than in other groups. Hemoglobin and ferritin concentrations of weekly 2 RDA multi micronutrient group were not significantly increase, but there were significantly increased in the subjects with low concentration of blood hemoglobin or plasma ferritin. Proportion of infants with zinc deficiency was increased significantly in iron group Daily I RDA multi micronutrient and daily iron supplementation are efficacious in improving the concentration of blood hemoglobin and plasma ferritin and reducing the percentage of infants with anemia and iron deficiency of Indonesian infants aged 6-12 months in a rural community. However, there was an increasing proportion of infants with zinc deficiency in daily iron supplementation. The efficacy of daily 1 RDA multi micronutrient supplementation was higher among the children with blood hemoglobin < 110 g/L Efficacy of weekly 2 RDA multi micronutrient supplementation on the concentration of blood hemoglobin and plasma ferritin of all subjects was not found, but it affected in children with low concentration of blood hemoglobin or plasma ferritin."

"Air Susu Ibu (ASI) merupakan makanan sempurna untuk bayi karena mempunyai komposisi gizi paling lengkap dan ideal untuk pertumbuhan dan perkembangannya. Namun, tak jarang terdapat kasus dimana ibu harus menggantikan ASI dengan susu formula. Bayi membutuhkan kombinasi distribusi posisi asam lemak yang tepat dalam trigliserida agar lemak tersebut dapat dicerna secara optimal. Sayangnya, distribusi asam lemak pada trigliserida susu formula dapat menyebabkan konstipasi jika didigesti di dalam tubuh bayi. Oleh karena itu, penelitian ini memberikan solusi atas permasalah tersebut yaitu dengan mensintesis lemak yang memiliki trigliserida dengan distribusi posisi asam lemak mirip dengan distribusi posisi asam lemak pada ASI yang dikenal dengan Human Milk Fat Substitute (HMFS). HMFS disintesis melalui interesterifikasi dengan substrat etil oleat yang berasal dari susu sapi dengan tripalmitin yang merupakan turunan dari minyak sawit. Interesterifikasi ini dikatalis dengan lipase selektif sn-1,3. Untuk alasan teknis dan ekonomi, lipase diimobilisasi melalui metode entrapment pada karbon aktif. Enzim loading yang dihasilkan adalah 92,64%. Berdasarkan hasil penelitian, diketahui bahwa yield HMFS yang diperoleh dari reaksi yang dikatalis oleh lipase terimobilisasi memiliki hubungan positif terhadap kenaikan temperatur dan waktu reaksi. Sedangkan, untuk HMFS yang dihasilkan oleh reaksi yang dikatalis oleh lipase bebas memiliki hubungan yang berkebalikan. Sementara itu, yield HMFS yang dihasilkan dari reaksi yang dikatalis oleh lipase terimobilisasi maupun lipase bebas, memiliki hubungan positif dengan kenaikan rasio mol substrat.

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Breast milk is the perfect food for babies because they have the most complete nutritional composition and ideal for the growth and development. However, there are cases when mothers have to replace breast milk with formula. Babies need an exact combination of fatty acid distribution of the triglycerides in milk fat so can be digested optimally. Unfortunately, the distribution of fatty acids on the triglyceride milk formula can cause constipation if digested in babies? small intestines. Therefore, this study provides a solution to this problem. The solution is to synthesize triglycerides with fatty acids position distribution similar to the distribution of fatty acid in human milk, known as the Human Milk Fat Substitute (HMFS). HMFS synthesized through selective interesterification of ethyl oleate derived from cow's milk with tripalmitate rom palm oil. This selective interesterification catalyzed by lipase sn-1, 3. For technical and economic reasons, lipase immobilized by entrapment method on activated carbon. The resulting enzyme loading was 92.64%.

Based on this research, it is known that HMFS yield obtained from the reaction catalyzed by immobilized lipase has a positive relationship to the increase of temperature and reaction time. Meanwhile, for HMFS resulted by reaction catalyzed by free lipase had the negative relationship. Besides, HMFS yield resulted from reaction catalyzed by immobilized lipase and free lipase, have a positive relationship with increase in mole ratio of substrates."

"Latar Belakang : Tingkat konsumsi susu formula bubuk di kalangan bayi masih tinggi sementara sosialisasi   petunjuk WHO terkait penyiapan, penyajian dan penyimpanan susu formula bubuk  formula masih sangat kurang. Susu formula bubuk walau diproduksi dengan teknologi termutakhir sekalipun,  masih belum terbebas dari kontaminasi bakteri E. Sakazakii. Kedua hal tersebut membuat morbiditas bayi terkait konsumsi susu formula bubuk akibat kontaminasi intrinsik maupun ekstrinsik seperti sepsis, enterokolitis dan meningitis tetap tidak bisa berkurang. Tujuan : Mengetahui derajat pengetahuan dan perilaku ibu dalam menyiapkan, menyajikan dan menyimpan susu formula bubuk dan faktor-faktor yang mempengaruhinya di  Kelurahan Pisangan Timur Kecamatan Pulogadung Jakarta Timur.Metode : Penelitian bersifat deskriptif potong lintang dengan pengumpulan data dilakukan secara survei dan observasi pada bulan Juli hingga Oktober 2012. Subyek penelitian adalah ibu yang memiliki anak berusia 0-12 bulan, tinggal di Kelurahan Pisangan Timur Kecamatan Pulogadung yang dipilih berdasarkan teknik purposive sampling. Data kemudian ditabulasi untuk mendapatkan derajat pengetahuan dan perilaku ibu tekait penyiapan, penyajian dan penyimpanan susu formula. Analisis statistik dilakukan untuk mencari faktor-faktor yang berhubungan dangan pengetahuan dan perilaku ibu terkait penyiapan, penyajian dan penyimpanan susu formula dengan cara uji kai kuardat (analisis bivariat) dan uji regresi logistik (analisis multivariat).Hasil : Dari 248 ibu yang mengikuti penelitian, pengetahuan kurang dalam menyiapkan, menyajikan dan menyimpan susu formula masing-masing didapati pada 68,1%, 26,2%, 87,5% ibu.  Perilaku buruk dalam menyiapkan, menyajikan dan menyimpan susu formula masing-masing didapati pada  69%, 60,9%, 84,3% ibu. Faktor yang mempengaruhi pengetahuan ibu dalam menyiapkan, menyajikan dan menyimpan susu formula adalah usia ibu, tingkat pendidikan, status ekonomi, status pekerjaan ibu.Faktor-faktor yang mempengaruhi perilaku ibu terkait perilaku menyiapkan, menyajikan dan menyimpan susu formula adalah usia ibu, status pendidikan, status ekonomi dan sumber air minum.  Hubungan pengetahuan dengan perilaku ibu dalam menyiapkan, menyajikan dan menyimpan susu formula  berturut-turut adalah kuat (r= 0,68), sedang (r= 0,52) dan kuat (r= 0,73 )Simpulan : Masih rendahnya derajat pengetahuan dan perilaku ibu dalam penyiapan, penyajian dan penyimpanan susu formula di Kelurahan Pisangan Timur membutuhkan intervensi penyuluhan dan sosialisasi lebih gencar mengenai anjuran WHO terkait penyiapan, penyajian dan penyimpanan susu formula terutama pada ibu-ibu dari golongan berusia kurang dari 25 tahun, pendidikan rendah, ekonomi kurang, tidak bekerja dan mengkonsumsi bukan air mineral kemasan. Produsen susu formula harus memperbaiki lembar informasi terkait penyiapan penyajian dan penyimpanan susu formula yang tertera pada kemasann susu formula agar lebih jelas, lengkap dan mudah dimengerti oleh ibu.

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Background: Until to day, the consumption rate of powdered infant formula is still high, neverthenless socialization of WHO’s guidance related to the preparation, serving and storage of powdered infant formula are very limited. Eventhought manufacturend by the latest technology, powder infant formula, cannot be free from E. Sakazakii contamination, hence the potential risk for infant morbidity caused by intrinsic or extrinsic contamination such as sepsis, enterocolitis and meningitis never been low . Objective: To know the degree of mother’s knowledge and behavior in preparing, serving and storing powdered infant formula and their related factors in Pisangan Timur Village, Pulogadung District, East Jakarta. Methods: The study was a crossectional-observation data survey which conducted fom July until October 2012. Subjects were mothers of children aged 0-12 months, living in Pisangan Timur Village, Pulogadung District which selected by purposive sampling technique. The data was then tabulated and calculated to meassure the degree of knowledge and maternal behavior about preparation, serving and storage of infant formul., Chi Square (bivariat) and logistic regression (multivariates) analysis was performed to elaborate factors that related to mother’s knowledge and behaviour in preparation, serving and storage of infant formula. Results: The study was conducted on 248 mothers. Lack of knowledge in preparing, serving and storing infant formula, was found in 68.1%, 26.2%, 87.5% mothers respectively. Unappropriate behavior regarding to WHO guidance in preparing, serving and storing infant formula was found in 69%, 60.9%, 84.3% mothers respectively. Factors related to maternal knowledge in preparing, serving and storing infant formula were the mother's age, education level, economic status, employment status. Factors related to maternal behavior in preparing, serving and storing infant formula were educational level, economic status and source of drinking water. The relationship between mothers’s knowledge to mother’s behavior in preparing, serving and storing infant formula respectively were strong (r= 0,68 ), moderate (r= 0,52 ) and strong (r= 0,73 ). Conclusion The lack of mother’s knowledge and inapproriate mother’s behavior in the preparation, serving and storage of infant formula in the Pisangan Timur Village requires intervention, counseling and socialization of WHO’s recommendation about preparation, serving and storage of infant formula more intensively, especially to the mothers that less than 25 years, low education level, low economic’s status , jobless and not consume bottled mineral water whoose giving their baby infant formula. Manufactures should changed and standardized their instruction so it can be easily understand by mother."

"ABSTRAKSkripsi ini membahas mengenai analisis yuridis pemberian dan promosi susuformula pada bayi baru lahir di rumah sakit. Permasalahan dalam skripsi iniadalah bagaimana pelaksanaan informed consent dalam hal pemberian susuformula pada bayi baru lahir oleh dokter dan perawat di rumah sakit danbagaimana tanggung jawab dokter dan perawat dalam promosi susu formuladilihat dari segi etik dan hukum. Dalam penelitian ini penulis menggunakanmetode penelitian kepustakaan yang bersifat yuridis-normatif dan tipe penelitianbersifat deskriptif. Kesimpulan atas permasalahan tersebut adalah bahwa setiaptindakan medis khususnya pemberian susu formula harus menggunakan informedconsent dan adanya tanggung jawab dokter dan perawat dari segi etik dan hukumatas promosi susu formula pada bayi baru lahir di rumah sakit. Sehingga perlunyapenegakan oleh pemerintah khususnya kementerian kesehatan untuk memberikansanksi pada dokter dan perawat yang terbukti melakukan promosi susu formulapada bayi baru lahir di rumah sakit. Kementerian kesehatan perlu menegakan danmengefisienkan waktu dalam proses pemberian sanksi terhadap dokter danperawat dari teguran lisan hingga pencabutan izin praktik perawat.

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ABSTRACTThis article discusses the juridical analysis of the provision and promotion ofinfant formula on new born baby in hospital. The problem examined in thisarticle is about how the informed consent, in the case of formula feeding innew born by doctor and nurse in the hospital, is implemented, and how thedoctor?s and nurse?s responsibility in promoting infant formula is conductedin terms of ethics and law. In this study, the author uses juridical-normativelibrary research methods and descriptive type of research. The conclusion onthe matter is that every medical act, particularly formula feeding, must useinformed consent, and the presence of doctor?s and nurse?s responsibility interms of ethics and law on infant formula promotion on new born in thehospital. Thus, there is the need for law enforcement by government,especially the Ministry of Health, to give sanction on doctors and nurses whoare convicted in doing infant formula promotion on new born in hospital. TheMinistry of Health needs to enforce and optimize the time in the process ofgiving sanction towards doctors and nurses from verbal warning to practicelicense revocation."

"Laporan magang ini menganalisis pengendalian internal pada siklus pengeluaran perusahaan PT ZXC yang bergerak di bidang penjualan susu formula bayi. Penjualan susu formula bayi tidak dapat diperjualbelikan secara bebas karena terdapat peraturan-peraturan dari para pemangku kepentingan. Aktivitas bisnis yang tidak taat peraturan akan membebani pengeluaran perusahaan. Cakupan analisis berfokus pada siklus pembayaran jasa medis dan reimbursement pegawai menggunakan COSO Framework 2013, berikut solusi perbaikan kekurangan yang ada sesuai dengan cakupan kerja penulis saat melakukan program magang. Hasil analisis menunjukkan hampir semua komponen COSO Framework 2013 terpenuhi kecuali beberapa prinsip dari komponen COSO Framework 2013 yang kurang teraplikasikan.

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This internship report analyzes internal controls in company namely PT ZXC rsquo s payment cycle company engaged in the sale of infant formula product. The sales can not be traded freely as there are regulations of the stakeholders. Non compliance business activities will burden corporate spending. Analysis focus on the payment cycle of medical services and reimbursement of employees using the COSO Framework 2013, following solutions of existing deficiencies in accordance with the author 39 s scope of work while doing the internship program. The analysis results show that almost all COSO Framework 2013 components are met except for some of principles that are less implemented."

"Fungsi paru bayi pada usia awal kehidupan dapat memprediksi penyakit pernapasan dan perkembangan fungsi paru di kemudian hari. Penelitian ini bertujuan mengetahui karakteristik fungsi paru pada bayi di Indonesia dan membandingkannya dengan populasi di negara barat. Penelitian potong lintang dilaksanakan di RS Budi Kemuliaan, Jakarta. Dengan menggunakan automated single occlusion technique, peneliti mengukur fungsi paru pada 124 bayi. Data komplians (Crs) dan resistensi (Rrs) total dari sistem pernapasan kemudian dibandingkan dengan data dari studi WHISTLER di Belanda. Hasil penelitian ini menunjukkan bahwa selain faktor usia, berat badan, dan panjang badan, polusi udara juga merupakan faktor determinan penting pada fungsi paru bayi di Indonesia.

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Infant lung function in early life can predict respiratory disease and later lung development. We aimed to understand the characteristics of lung function in Indonesian healthy infant and to compare these with a Western population. We performed a cross-sectional study in Budi Kemuliaan Hospital in Jakarta. Using the automated single occlusion technique we measured lung function in 124 infants. The data of compliance (Crs) and resistance (Rrs) of the respiratory system were compared with data from the WHISTLER study in Neatherlands. Our results suggest that besides age, weight and height, air pollution is an important determinant of infant lung function in Indonesian children."

"Bayi dengan asfiksia perinatal sangat rentan mengalami komplikasi baik jangka pendek seperti disfungsi multi organ maupun komplikasi jangka panjang dengan terjadinya gangguan perkembangan. Tujuan penelitian ini adalah untuk mengetahui hubungan riwayat asfiksia perinatal dengan perkembangan bayi usia 6 sampai 12 bulan. Desain penelitian ini menggunakan ?cross sectional?, yang melibatkan 56 bayi dengan riwayat asfiksia berat, sedang dan ringan di Kabupaten Banyuwangi. Hasil penelitian menunjukkan ada hubungan yang signifikan antara riwayat asfiksia perinatal dengan perkembangan bayi (p value=0,026, α=0,05). Rekomendasi dari penelitian ini adalah perlu dilakukan deteksi dini penyimpangan perkembangan khususnya bayi dengan risiko tinggi serta mengoptimalkan peran serta orang tua dalam proses perkembangan anak sehingga perkembangan anak tercapai dengan optimal.

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Infant with perinatal asphyxia history is very susceptible to have both short-term complications such as multiple organ dysfunctions and long-term complications with development disorder. The purpose of this research is to know the relation of perinatal asphyxia history with infant?s development age 6 to 12 months old. The design of this study uses ?cross-sectional?, which involves 56 infants with severe, moderate and mild asphyxia histories in Banyuwangi Regency.

The result of this research shows that there is significant relation between perinatal asphyxia history with infant?s development (p value=0.026, α=0.05). The recommendations of this research is that it is so necessary to be detected early about the development disorder especially for high-risk infants and to optimize the participation of parents in a child's development process that child?s development is achieved optimally."

"Nama : Irwan MuryantoProgram Studi : Doktor EpidemiologiJudul Disertasi : Faktor ndash; Faktor Yang Memengaruhi Perkembangan Bayi :Studi longitudinal Pada Bayi Usia 0 hingga 6 Bulan DiKabupaten Kuantan Singingi Provinsi RiauPembimbing : Prof. Dr. dr. Sudarto Ronoatmodjo SKM, M.ScPrevalensi keterlambatan perkembangan bayi di Indonesia berkisar antara 12,8 -28,5 . Penelitian ini bertujuan untuk mengetahui faktor yang memengaruhiperkembangan bayi dengan merekrut bayi baru lahir yang dikunjungi dalam waktu24 jam setelah kelahiran sebanyak 474 bayi. Penilaian perkembangan pada usia 2,4 dan 6 bulan menggunakan kuesioner Ages Stages Questionnaires, ThirdEdition ASQ - 3 . Hasil penelitian menunjukkan bahwa faktor ndash; faktor yangmemengaruhi perkembangan bayi pada usia 2 bulan meliputi : inisiasi menyusu dini komunikasi, motor kasar dan motor halus , panjang lahir komunikasi dan motorkasar , status gizi komunikasi , stimulasi semua ranah , kepadatan isi rumah komunikasi , sosial ekonomi pemecahan masalah . Pada usia 4 bulan meliputi :ASI eksklusif komunikasi, motor kasar, motor halus dan personal sosial , statusgizi personal sosial , diare motor kasar, motor halus dan personal sosial , stimulasi komunikasi, pemecahan masalah dan personal sosial , kepadatan isi rumah motorhalus dan pemecahan masalah , jumlah saudara personal sosial . Sedangkan padausia 6 bulan meliputi : inisiasi menyusu dini motor kasar dan pemecahan masalah ,ASI eksklusif komunikasi dan motor halus , panjang lahir personal sosial , ISPA komunikasi, motor kasar dan personal sosial , stimulasi komunikasi, motor halusdan personal sosial , pendidikan ibu personal sosial dan sosial ekonomi komunikasi dan motor halus .Dapat disimpulkan bahwa faktor stimulasi merupakan faktor yang dominanmemengaruhi perkembangan bayi, diikuti oleh faktor inisiasi menyusu dini dan ASIeksklusif.

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Name : Irwan MuryantoStudy Program : Doctoral Program in EpidemiologyTitle : Factors Affecting Infant Development : Longitudinal Studyof Infants at 0 ndash; 6 Months in Kuantan Singingi District RiauProvinceCouncellor : Prof. Dr. dr. Sudarto Ronoatmodjo SKM, M.ScThe prevalence of delayed infant development in Indonesia 12.8 - 28.5 . Thisstudy aims to determine the factors that affect the development of infants byrecruiting newborns who visited within 24 hours after the birth of 474 babies.Assessment of development at ages 2, 4 and 6 months using the Ages StagesQuestionnaires, Third Edition ASQ - 3 questionnaire.The results showed thatfactors affecting infant development at 2 months of age included: earlybreastfeeding initiation communication, gross motor and fine motor , birth length communication and gross motor , nutritional status communication , stimulation all domains , density of home content communication , socioeconomic problemsolving . At 4 months of age include: exclusive breastfeeding communication,gross motor, fine motor and personal social , nutritional status personal social ,diarrhea gross motor, fine motor and personal social , stimulation communication,problem solving and personal social , density of home contents fine motors andproblem solving , number of siblings personal social . While at the age of 6 monthsinclude: early breastfeeding initiation gross motor and problem solving , exclusivebreastfeeding communication and fine motor , length of birth personal social ,ISPA communication, crude motor and personal social , stimulation communication, fine motor and personal social , maternal education personalsocial and socioeconomic communication and fine motor .It can be concluded that stimulation factor is the dominant factor influencing infantdevelopment, followed by early breastfeeding initiation and exclusivebreastfeeding factor."

"Kelompok umur yang rentan terhadap kekurangan gizi adalah kelompok bayi dan balita. Karena status gizi yang baik sangat diperlukan untuk pertumbuhan dan perkembangan saat bayi dan balita, maka sangat penting untuk mengetahui status gizi dimulai sejak bayi. Status gizi menunjukkan seberapa besar kebutuhan fisiologis individu tersebut telah terpenuhi. Status gizi dipengaruhi oleh berbagai faktor.Penelitian ini bertujuan untuk mengetahui sebaran status gizi bayi usia 1,5-8 bulan di Jakarta Pusat dan hubungannya dengan jenis kelamin bayi, pendidikan terakhir ibu, pekerjaan ibu, penghasilan ibu, usia ibu saat melahirkan, morbiditas diare dan Infeksi Saluran Napas Atas (ISPA), dan pemberian Air Susu Ibu (ASI). Juga diketahuinya sebaran ibu bayi.Penelitian menggunakan studi crosssectional dan dilakukan pada 92 responden yang memiliki bayi usia 1,5 hingga 8 bulan di Jakarta Pusat. Data didapatkan berupa status gizi bayi, jenis kelamin bayi, usia ibu saat melahirkan, tingkat pendidikan ibu, penghasilan ibu, morbiditas diare dan ISPA, dan pemberian ASI yang akan diteliti hubungannya dengan status gizi bayi yang diuji dengan uji Chi-Square (p<0,05).Dari hasil penelitian didapatkan status gizi non-wasted sebesar 94,6%, sedang sebesar 5,4%. Persentase hasil yang didapatkan masing-masing ialah jenis kelamin bayi laki-laki 46,7%, dan perempuan 53,3%, pemberian ASI eksklusif sebesar 33,7%, ibu bekerja 18,5%, diare dan ISPA bayi dalam kurun waktu 2 minggu terakhir masing-masing 10,9% dan 70,7% tingkat pendidikan ibu rendah 33,7%, sedang 50,0%, dan tinggi 16,3%, tingkat penghasilan keluarga sedang 27,2% dan tinggi 72.8. Semua variabel tersebut tidak memiliki hubungan yang bermakna dengan status gizi bayi.

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Age Group that is most vulnerable to malnutrition condition is infant and chidlren under five years. A Good nutritional status is necessary for growth and development in infant and children under five years, so it is important to know the nutritional status since early childhood. Nutritional status of someone shows how big the individual physiological needs have been met. Nutritional status is influenced by various factors.This study is intended for the purpose of knowing the nutritional status of infants aged 1.5 to 8 months in Central Jakarta and the relationship with the infant's sex, maternal last education, working mother, family income, maternal age at birth, morbidity of diarrhea and Upper Respiratory Tract infection (URTI), and breast milk.This research is conducted using crosssectional study with 92 respondents who have a baby aged 1.5 to 8 months in Central Jakarta. Data obtained includes the nutritional status of the baby, the infant's sex, maternal?s education, working mother, maternal age at birth, maternal education level, family income, morbidity of diarrhea and Upper Respiratory Tract infection (URTI), and breast milk will be related to the nutritional status of infants tested with the Chi-Square test (p <0.05).Results obtained from research are non-wasted nutritiona status of 94.6% and high of 5.4%. The percentage of each result accomplished by baby?s sex: boy is 46.7% and girl is 53.3%, the provision of exclusive breastfeeding is 33.7%, 18.5% from working mother, diarrhea and URTI in infants during the last two weeks respectively is 10.9% and70.7%, lower maternal education level is 33.7%, moderate 50.0%, 16.3% and higher, moderate level of family income is 27.2% and 72.8 high. All these variables have no meaningful relationship with the nutritional status of infants."