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Abstrak :
ABSTRAK
Latar Belakang: Terdapat dua teknik dalam reparasi robekan perineum derajat IIIb-IV yaitu teknik jahitan ujung ke ujung end-to-end dan tumpang tindih overlapping . Beberapa penelitian berbeda menunjukkan keterbatasan data untuk membandingkan teknik ujung ke ujung dengan tumpang tindih terhadap kejadian inkontinesia fekal.Tujuan: Mencari perbedaan antara kedua teknik reparasi robekan perineum derajat IIIb-IV secara Fungsional Berdasarkan Skoring Inkontinensia FekalMetode: Penelitian potong lintang ini dilakukan dengan mengulas data rekam medis RSCM periode 1 Januari 2011 ndash; 31 Desember 2015. Empat puluh delapan rekam medis dengan 39 subjek mendapatkan teknik tumpang tindih dan 9 subjek mendapatkan teknik ujung ke ujung. Dilakukan penilaian skoring inkontinensia dengan SIKC Skoring Inkontinesia Klinik Cleveland dan SSKF Skala Skoring Kontinensia Fekal dan dilakukan analisa Chi-Square dengan alternatif Fischer.Hasil: Tidak terdapat perbedaan antara teknik ujung ke ujung dengan tumpang tindih berdasarkan skoring SSKF p = 0,627 dan SIKC p = 0,627 . Berdasarkan SSKF terdapat 2,1 Inkontinensia Komplit dan 79,2 Kontinensia Komplit pada teknik tumpang tindih dan 18,8 Kontinensia Komplit pada teknik ujung ke ujung. Berdasarkan SIKC terdapat 2,1 Inkontinensia Komplit, 6,2 Kontinensia Baik, 72,9 Kontinensia Sempurna pada Teknik Tumpang Tindih dan 18,8 Kontinensia Sempurna pada teknik lainnyaKesimpulan: Didapatkan bahwa 2,1 menderita inkontinensia fekal pada teknik tumpang tindih, sementara tidak didapatkan inkontinensia fekal pada teknik ujung ke ujung

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ABSTRACT
Background There are two technique in repairing perineal ruptured grade IIIb IV which is End to End Technique and Overlapping Technique. Some studies showned differents outcome and also limited data that compare these two technique based on fecal incontinence.Purpose To show that there is a different between both technique on perineal reparation by functional based on Fecal Incontinence ScoringMethods This cross sectional was done by reviewing medical record in RSCM from January 1st 2011 until 31st December 2015. Forty nine medical record taken as sample and found that 39 with overlapping technique and 9 with end to end technique. Performed by incontinencia fecal scoring using CCIS Cleveland Clinic Incontinence Scoring and FCSS Fecal Continence Scoring Scale and analyzed by Chi Square witn Fischer as alternative.Results There is no different between overlapping technique and end to end technique by FCSS p value 0,627 and CCIS p value 0,627 . Based on FCSS there are 2,1 compkete incontinence and 79,2 complete continence in Overlapping technique and 18,8 complete continence I End to End technique. Based on CCIS there are 2,1 complete incontinence, 6,2 good continence, 72,9 perfect continence in Overlapping technique and 18,8 perfect continence in other technique.Conclusion There are 2,1 found fecal incontinence in Overlapping technique, while no fecal incontinence in End to End technique.

Abstrak :
Bank sentral sebagai otoritas sistem pembayaran mengalami dilema di era industri 4.0 akibat ketidakmampuan beradaptasi secara cepat terhadap disrupsi yang terjadi di sektor keuangan. Dalam merespon disrupsi di sektor keuangan, Gubernur Bank Indonesia memberikan arahan untuk melakukan transformasi menuju Bank Sentral 4.0 agar Bank Indonesia mampu mendorong inovasi ekonomi dan keuangan digital menjadi peluang dalam menciptakan pertumbuhan ekonomi yang berkelanjutan & inklusif, memperkuat daya saing & kepentingan nasional, serta mempersempit kesenjangan masyarakat. Oleh sebab itu, Bank Indonesia perlu menentukan tahapan transformasi menuju Bank Sentral 4.0. Penelitian ini bertujuan untuk menentukan tahapan transformasi organisasi Bank Indonesia menuju Bank Sentral 4.0. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Data didapatkan dari tempat studi kasus yang merupakan hasil analisis tingkat kesiapan menuju Bank Sentral 4,0 di era industri 4.0 menggunakan model SIMMI 4.0 (System Integration Maturity Model Industry 4.0), Blueprint Sistem Pembayaran Indonesia 2025 dan dokumen pendukung lainnya. Data sekunder didapatkan dari berbagai literatur yang relevan dalam menuju industri 4.0 dan Bank Sentral di masa depan serta menampilkan otoritas global yang telah berhasil menerapkan teknologi industri 4.0 sebagai acuan. Dari hasil penelitian didapatkan tingkat kesiapan Bank Indonesia berada pada tingkaat horizontal and vertical integration sehingga membutuhkan peningkatan dengan tranformasi menuju Bank Indonesia 4.0. Tahapan transformasi yang diusulkan dimulai dari menilai tingkat kesiapan organisasi, menetapkan strategi transformasi Bank Indonesia menuju industri 4.0, menyusun panduan transformasi menuju industri 4.0, dan pelaksanan panduan transformasi menuju Bank Indonesia 4.0. Pelaksanaan panduan transformasi menuju Bank Indonesia 4.0 terdiri dari 4 (empat) fase yaitu fase 1 untuk integrasi proses dan data proses bisnis internal Bank Indonesia, fase 2 integrasi vertikal, fase 3 integrasi horizontal, dan fase 4 integrasi dari ujung ke ujung serta secara paralel perlu dilakukan peningkatan kompetensi dan wawasan pegawai mengenai industri 4.0. ......The Central Bank as the payment system authority is experiencing a dilemma due to its inability to adapt to the rapid disruption of the financial sector in the industrial era 4.0. The Governor of Bank Indonesia provided directions for transforming towards a Central Bank 4.0 so that Bank Indonesia could encourage digital economic and financial innovation to become an opportunity to create sustainable & inclusive economic growth, strengthen competitiveness & national interests, and narrow the gap in society. Therefore, Bank Indonesia needs to determine the stages of transformation towards the Central Bank 4.0. The purpose of this study is to determine the stages of the transformation of the Bank Indonesia towards the Central Bank 4.0. This study uses a qualitative method with a case study approach. The data is obtained from the result of an analysis of the level of readiness to go to the Central Bank 4.0 in the industrial era 4.0 using the SIMMI 4.0 model (System Integration Maturity Model Industry 4.0), Blueprint Sistem Pembayaran Indonesia 2025 and other supporting documents. Secondary data is obtained from various relevant literature towards industry 4.0, the Central Bank in the future, and displays global authorities that have successfully applied industrial 4.0 technology as a reference. From the research results, it was found that the readiness level of Bank Indonesia was at the level of horizontal and vertical integration, thus requiring improvement with the transformation towards Bank Indonesia 4.0. The proposed transformation stages start from assessing the level of organizational readiness, determining Bank Indonesia's transformation strategy towards industry 4.0, compiling transformation guidelines towards industry 4.0, and implementing the transformation guidelines towards Bank Indonesia 4.0. The implementation of the transformation guide towards Bank Indonesia 4.0 consists of 4 (four) phases, namely phase 1 for integration of Bank Indonesia internal business processes and data, phase 2 of vertical integration, phase 3 of horizontal integration, and phase 4 of integration from end to end of the company's value chain. increase in employee competence and insight regarding industry 4.0. In parallel, it is necessary to increase the competence and insight of employees regarding industry 4.0 in Bank Indonesia.