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Pengaruh Riwayat Keluarga, Obesitas Dan Stress Psikosial Terhadap Kejadian Hipertensi Pada Ibu Pasangan Usia Subur Di Wilayah Kerja Puskesmas Simalingkar Lasria Simamora; Ninsah Putri Sembiring; Marlina Simbolon
Jurnal Ilmiah Keperawatan Vol 2 No 1 (2019): JURNAL MUTIARA NERS
Publisher : Program Studi Ners UNIVERSITAS SARI MUTIARA INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (746.055 KB)

Abstract

Hypertension a serious pubic health problem since it is directly related to morbidity and mortality rate. It is also a chronic disease which can cause complication which will eventually influence the process of women’s reproduction, especially of mother of eligible couples. It ranked the third of the top ten diseases in the working area of Simalingkar Community Health Center (“Puskesmas”), in 2016. The objective of the research was to find out which influenced of family history, obesity and psychosocial stress the incidence of hypertension of mother of eligible couples in the working area of Simalingkar Community Health Center. The research used observational analytic method with case-control study and retrospective design. The population was all productive-aged women in the working area of Simalingkar Community Health Center. The samples consisted of 68 respondents who were in the case group and the other 68 respondents in the control group, taken by using consecutive sampling technique. The data were analyzed by using univariate analysis, bivariate analysis with chi square test, and multivariate analysis with multiple logistic regression analysis. The result of the research showed that there was the influence of obesity p=0.003 (OR=2.95 CI 95% 1.438 – 6.058 and psychosocial stress p=0,008 (OR=2,63 CI 95% 1,282 - 5,426) on the incidence of hypertension, while history of family did not have any influence on the incidence of hypertension in the working area of Simalingkar Community Health Center. Obesity was the most dominant factor which influenced the incidence of hypertension of mother of eligible couples at OR= OR=2.95 (p<0.05). It is recommended that the health care providers at Simalingkar Community Health Center provide adequate information about hypertension for the people who should routinely control their blood pressure, have healthy eating pattern and lifestyle and do exercises regularly in order to avoid hypertension.
Pengaruh Pijat Perineum dalam Mengurangi Ruptur Perineum saat Persalinan Nurhamida Fithri; Lasria Simamora
Journal of Health (JoH) Vol 9 No 1 (2022): Journal of Health (JoH) - Januari 2022
Publisher : LPPM STIKES Guna Bangsa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30590/joh.v9n1.279

Abstract

A tear in the perineum is one of the various complications during labor in the second stage so it can cause reproductive organ dysfunction in women. Tension in the pelvic floor muscles often results in perineal tears, especially in primigravida. One way to reduce perineal tears is to perform perineal massage to increase blood flow and perineal elasticity through a very simple and short method. There are 2.7 million cases of perineal tears in childbirth and is estimated to increase by 6.3 million in 2050. In Asia, perineal ruptures account for 50% of perineal ruptures in the world. In Indonesia, mothers who experience perineal rupture at the age of 32-39 years are 62%. Research at the Benin Teaching Hospital, Nigeria, showed that the prevalence of perineal rupture was approximately 46.6%, especially in primigravida mothers who experienced perineal rupture. The purpose of this study was to determine the effect of perineal massage in reducing perineal rupture at the time of delivery. This research method is an experiment using a post-test-only control group design. The population in this study were all primiparous pregnant women in the third trimester who visited Mahanum clinic, while the number of samples was 32 samples with two groups, namely the intervention group and the control group. From the results of the analysis, the value of OR = 6.72 means that primiparous pregnant women who do not have perineal massage have a 6.72 times chance of perineal rupture compared to primiparous pregnant women who do perineal massage.
Pengaruh Konsumsi Biskuit Katuk , Dan Pijat Oksitosin Terhadap Keberhasilan Pemberian Asi Eksklusif Pada Ibu Menyusui Di Puskesmas Simalingkar Tahun 2019 Srilina Br Pinem; Astaria Br Ginting; Lasria Simamora
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 10, No 2 (2019): Dinamika Kesehatan Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (373.007 KB) | DOI: 10.33859/dksm.v10i2.492

Abstract

Latar Belakang: Tingginya  angka  stunting  dan  AKB  di  Indonesia  merupakan  masalah  nasional.  Khususnya  di Sumatera Utara. ASI merupakan makanan yang paling tepat untuk mengatasi kedua masalah tersebut. Faktor utama ibu tidak memberikan ASI kepadaanaknya dikarenakan ibu berasumsi ASI yang diberikan tidak cukup dan produksi ASI tidak lancar hal ini terlihat dari capaian nasional pemberian ASI ekslusif masih jauh dari target 80 % .Tujuan: Tujuan penelitian ini untuk mengetahui pengaruh konsumsi biskuit katuk terhadap keberhasilan pemberian ASI Eksklusif pada ibu menyusui di Puskemsmas Simalingkar Tahun 2019.Metode: Jenis Penelitian yang digunakan adalah quasi eksperimen dengan design pre test post test one group design. Hasil:  Hasil penelitian menunjukkan nilai p= 0,000 dimana terdapat hubungan tidur tenang 2 jam akibat pemberian biskuit  katuk dan pijat oksitosin dengan pemberian ASI eksklusif, dan menunjukkan   nilai p=0,000 artimya terdapat hubungan penuruann berat badan 8%  akibat pemberian biscuit  katuk dan pijat oksitosin dengan pemberian ASI eksklusif. menunjukkan bahwa nilai p=0,000 artimya terdapat perbedaan tidur tenang sebelum dan sesudah diberi biskuit katuk dan pijat oksitosin. Terjadi peningkatan tidur tenang 2 jam setelah diberikan biskuit katuk dan pijat oksitosin setelah  hari  keempat.Simpulan: Sehingga dapat disimpulkan pemberian biskuit katuk dan pijat oksitosin efektif dalam kelancaraan pemberian ASI yang mendukung keberhasilan pemberian ASI Eksklusif. Diharapkan kepada tenaga kesehatan untuk memberikan motivasi kepada ibu untuk mengkonsumsi biskuit katuk pada ibu nifas. Kata Kunci: Katuk, ASI, Pijat Oksitosin Background: The high rate of stunting and IMR in Indonesia is a national problem. Especially in North Sumatra. Breast milk is the most appropriate food to overcome these two problems. The main factor of mothers not giving ASI to their children is because mothers assume that breast milk is not enough and production of ASI is not smooth, it can be seen from the national achievement of exclusive breastfeeding which is still far from the target of 80%.Objective: The purpose of this study was to determine the effect of katuk biscuit consumption on the success of exclusive breastfeeding in breastfeeding mothers in Puskemsmas Simalingkar in 2019.Method: This type of research is a quasi-experimental design with pre-test post test one group design.Results: The results showed a value of p = 0,000 where there was a relationship of calm sleep2 hours due to the administration of cough biscuits and oxytocin massage with exclusive breastfeeding,and showed a value of p = 0,000. exclusive breastfeeding. shows that p = 0,000 means thatthere is a difference in calm sleep before and after being given a katuk biscuit and oxytocin massage. An increase in calm sleep 2 hours after given katuk biscuits and oxytocin massage after the fourth day.Conclusion: So it can be concluded that the administration of katuk biscuits and oxytocin massage is effective in the smoothness of breastfeeding which supports the success of exclusive breastfeeding.It is expected that health workers will motivate mothers to consume katuk biscuits for postpartum mothers.Keywords: Katuk, ASI, Oxytocin Massage
Hubungan Pengetahuan, Pendapatan Dan Makanan Pantangan Dengan Pola Makan Pada Ibu Nifas Lasria Simamora; Riska Susanti P; Deby Cintia Yun
Indonesian Health Issue Vol. 1 No. 1 (2022): FEBRUARI
Publisher : PublisihingId

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.452 KB) | DOI: 10.47134/inhis.v1i1.20

Abstract

Latar Belakang:Secara umum terjadi penurunan kematian ibu selama periode 1991-2015 dari 390 menjadi 305 per 100.000 kelahiran hidup. Walaupun terjadi kecenderungan penurunan angka kematian ibu, namun tidak berhasil mencapai target MDGs yang harus dicapai yaitu sebesar 102 per 100.000 kelahiran hidup pada tahun 2015. Hasil supas tahun 2015 memperlihatkan angka kematian ibu tiga kali lipat dibandingkan target MDGs. Kekurangan gizi pada ibu nifas atau ibu menyusui menimbulkan gangguan kesehatan pada ibu dan bayinya.Gangguan pada bayi mudah sakit, mudah terkena infeksi, kekurangan zat-zat esensial menimbulkan gangguan mata, tulang dan pertumbuhan dan pada ibu nifas akan memperlambat proses penyembuhan luka perineum. Bila ibu tidak memperoleh makanan dengan gizi yang seimbang dapat mengakibatkan ibu kekurangan gizi dan kekurangan darah dan ibu akan memberikan ASI dengan jumlah yang sedikit kurangnya pemenuhan gizi ibu nifas atau menyusui di sebabkan banyak faktor diantaranya adanya pantangan makan pada ibu nifas. Tujuan: Menganalisis hubungan Pengetahuan, Pendapatan dan Makanan Pantangan ibu dengan Pola makan pada Ibu Nifas. Metode: observasional kuantitatif kepada seluruh ibu nifas yang berkunjung di klinik bersalin Citra sebanyak 32 orang, Tekhnik sampel yang digunakan adalah total sampling. Hasil:ada hubungan pengetahuan dengan pola makan (p=0,019), ada hubungan pendapatan dengan pola makan ibu nifas (p=0,017), tidak terdapat hubungan yang signifikan antara dukungan keluarga dengan pola makan (p = 0,3811). Kesimpulan: Terdapat hubungan pengetahuan dan pendapatan dengan pola makan ibu nifas, sementara dukungan keluarga tidak berhubungan dengan pola makan ibu nifas. Background: In general, there was a decrease in maternal mortality during the period 1991-2015 from 390 to 305 per 100,000 live births. Although there is a tendency to decrease maternal mortality, the MDGs target that must be achieved is 102 per 100,000 live births in 2015. The results of the 2015 SUPAS show that the maternal mortality rate is three times higher than the MDGs target. Malnutrition in postpartum mothers or breastfeeding mothers causes health problems for mothers and their babies. Disturbances in babies are easy to get sick, susceptible to infection, lack of essential substances causes eye, bone and growth disorders and in postpartum mothers it will slow down the healing process of perineal wounds. If the mother does not get food with balanced nutrition, it can result in the mother being malnourished and lacking in blood and the mother will give breast milk in a small amount, the lack of fulfillment of nutrition for postpartum or breastfeeding mothers is caused by many factors, including dietary restrictions in postpartum mothers. Purpose: Analyzing the relationship between Knowledge, Income and Food Abstinence of Mothers with Diet in Postpartum Mothers. Methods: there is a relationship between knowledge and diet (p = 0.019), there is a relationship between income and postpartum mother's diet (p = 0.017), there is no significant relationship between family support and diet (p = 0.3811). Conclusion: There is a relationship between knowledge and income with the postpartum mother's diet, while family support is not related to the postpartum mother's diet.
THE EFFECTIVENESS OF CELERY BOILED WATER ON LOWERING BLOOD PRESSURE IN THE ELDERLY WITH HYPERTENSION IN THE WORKING AREA OF THE SIMALINGKAR PUBLIC HEALTH CENTER IN 2020 Lasria Simamora; Ninsah M.P Br. Sembiring; Asnita Sinaga
International Journal of Midwifery Research Vol. 2 No. 1 (2022): International Journal of Midwifery Research
Publisher : Department of Midwifery, Faculty of Nursing and Midwifery, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47710/ijmr.v2i1.26

Abstract

Hypertension or high blood pressure is an increase in systolic blood pressure of more than 140 mmHg and diastolic blood pressure of more than 90 mmHg on two measurements with an interval of five minutes in a rest/quiet state. The management of hypertension can basically be done pharmacologically and non-pharmacologically. One non-pharmacological treatment is to use celery. Celery contains the flavonoid apigenin, vitamin C, apiin, calcium, and magnesium which can reduce hypertension. This study aims to analyze the effectiveness of celery boiled water in lowering blood pressure in patients with hypertension. This study used a pre post experimental design. The number of respondents at the Simalingkar Health Center workplace as many as 20 respondents who were given celery boiled water with a significance level of <0.05. The results showed that the P value of 0.00 (<0.05) means that celery boiled water is effective in reducing systolic and diastolic blood pressure in hypertensive patients. The average difference between systolic and diastolic after drinking celery boiled water found an average difference between systolic and diastolic 15 mmHg and 10 mmHg, so it can be concluded that celery boiled water is effective for reducing hypertension.
EFEKTIFITAS PIJAT MARMET UNTUK MELANCARKAN AIR SUSU IBU DI PRAKTEK MANDIRI BIDAN ETRAWATI TAHUN 2022 Lasria Simamora; Etrawati Etrawati; Dewi Sari Br.Pasaribu; Padhilah Pasmi; Maria Siahaan; Henni Rista
Prosiding Konferensi Nasional Pengabdian Kepada Masyarakat dan Corporate Social Responsibility (PKM-CSR) Vol 5 (2022): PERAN PERGURUAN TINGGI DAN DUNIA USAHA DALAM AKSELERASI PEMULIHAN DAMPAK PANDEMI
Publisher : Asosiasi Sinergi Pengabdi dan Pemberdaya Indonesia (ASPPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37695/pkmcsr.v5i0.1829

Abstract

Background: Mother's milk is a natural food that is good for babies because breast milk has many advantages containing important substances that make babies develop optimally. Along with the development of medical science, experts find ways to increase milk production, namely pharmacological and non-pharmacological methods. One of the non-pharmacological methods is the marmet technique. Marmet technique is a technique used to express breast milk. This technique provides a relaxing effect and also reactivates the milk ejection reflex (MER) so that the milk begins to drip. With the activation of MER, the milk will often spray out by itself. The purpose of this activity is to increase knowledge and understanding of the benefits of the marmet technique on the smooth flow of breast milk. Methods: service is carried out using counseling methods, demonstrations and observations of the marmet technique. Results: from education conducted on 20 postpartum mothers, it was found that there was an increase in knowledge of postpartum mothers from poor knowledge to good and 20 postpartum mothers experienced an increase in breast milk expenditure from 20 postpartum mothers experienced an increase in milk production by 18 people (90%).
HUBUNGAN KARAKTERISTIK DAN PENGETAHUAN IBU DENGAN KUNJUNGAN ANTENATAL CARE DI WILAYAH KERJA PUSKESMAS GALANG TAHUN 2021 Nur Fatimah Sam Pohan; Lasria Simamora; Edy Marjuang Purba
Jurnal Rumpun Ilmu Kesehatan Vol. 2 No. 3 (2022): November : Jurnal Rumpun Ilmu Kesehatan
Publisher : Politeknik Pratama Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.515 KB) | DOI: 10.55606/jrik.v2i3.572

Abstract

Angka Kematian Ibu merupakan salah satu indikator untuk melihat keberhasilan upaya kesehatan ibu. Hal ini terkait dengan fase kehamilan, persalinan dan nifas pada ibu dan fase tumbuh kembang pada anak. Berdasarkan data profil kesehatan Kabupaten Deli Serdang tahun 2019 Cakupan K1 di Kabupaten Deli Serdang mengalami penurunan bila dibandingkan dengan tahun 2018 menjadi 98,58% pada tahun 2019. Demikian juga dengan cakupan K4 yang menurun menjadi 93,04%. Penelitian ini bertujuan Untuk mengetahui Hubungan Karakteristik dan Pengetahuan Ibu Dengan Kunjungan Ante Natal Care Di wilayah kerja Puskesmas Galang Tahun 2021. Jenis Penelitian ini adalah deskriptif kuantitatif yang bersifat observasional analitik dengan menggunakan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh ibu hamil TM II yang berkunjung sebanyak 36 orang dengan menggunakan teknik total sampling. Berdasarkan uji bivariat didapatkan pengetahuan mempunyai nilai p-value sebesar 0,005<0,05 demikian juga tentang karakteristik umur nilai p-value 0,036 dan paritas mempunyai nilai p-value 0,907 sedangkan karakteristik pendidikan mempunyai nilai p-value 0,036<0,05. Dari hasil uji tersebut dapat disimpulkan bahwa ada hubungan pengetahuan dengan kunjungan antenatal care, karakteristik pendidikan mempunyai hubungan yang signifikan dengan kunjungan antenatal care di wilayah kerja puskesmas Galang tahun 2021. Diharapkan kepada tenaga kesehatan dapat memberikan konseling/penyuluhan untuk meningkatkan pengetahuan ibu hamil mengenai pentingnya pemeriksaan kehamilan dan meningkatkan mutu pelayanan terutama dalam pelayanan antenatal sehingga ibu dapat termotivasi dalam melakukan pemeriksaan kehamilan khususnya dimasa pandemi Covid-19.
HUBUNGAN PENGETAHUAN IBU DENGAN PEMBERIAN IMUNISASI DASAR PADA BAYI DI WILAYAH KERJA PUSKESMASMOMPANG KABUPATEN MANDAILING NATAL Lasria Simamora
JIDAN: Jurnal Ilmiah Kebidanan Vol. 3 No. 1 (2023): Edisi Januari 2023
Publisher : UNIVERSITAS HAJI SUMATERA UTARA

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Abstract

Latar belakang : Persentase anak usia 0 sampai 11 bulan yang mendapat imunisasi dasar lengkap tercapai 75,5% dari target 92,9%, dengan capaian kinerja 75,34% (Dinas Kesehatan Sumatera Utara,2020). Cakupan Imunisasi Dasar Lengkap (IDL) di Provinsi Sumatera Utara tahun 2019 sebesar 85,17% (Profil Sumatera Utara, 2019). Kabupaten Mandailing Natal merupakan kabupaten dengan urutan ke delapan yang mempunyai capaian IDL terendah di Sumatera Utara yakni sebesar 68,27%. Penelitian ini bertujuan untuk menganalisis Hubungan Pengetahuan Ibu Dengan Pemberian Imunisasi Dasar di wilayah kerja puskesmas Mompang Kabupaten Mandailing Natal Tahun 2022. Metode: Jenis penelitian adalah analitik dengan desain cross-sectional. Penelitian dilakukan di wilayah kerja Puskesmas Mompang, Kabupaten Mandailing Natal Provinsi Sumatera Utara, Penelitian dilakukan Mei s/d Juni 2022. Populasi dalam penelitian adalah seluruh ibu yang memiliki bayi berusia 1 tahun yang tercatat di wilayah kerja Puskesmas Mompang 42 orang dan menggunakan tekhnik total sampling. Analisa data dalam penelitian ini meliputi Analisa Univariat dan Analisa Bivariat dengan uji chi square, menggunakan derajat kemaknaan 5% (p value <0,05). Hasil: Hasil penelitian menunjukkan mayoritas pengetahuan ibu adalah cukup sebanyak 24 orang (57,1%) dan mayoritas bayi mendapat imunisasi dasar lengkap sebanyak 28 orang (66,7%). Hasil uji statistik menunjukkan p value 0,001 <0,05 artinya ada hubungan yang signifikan antara pengetahuan dengan pemberian imunisasi dasar pada bayi di Wilayah Kerja Puskesmas Mompang. Kesimpulan: P value = 0,001 <0,05 yang artinya Ha diterima dan Ho ditolak yang artinya ada hubungan yang signifikan antara pengetahuan dengan pemberian imunisasi dasar pada bayi di Wilayah Kerja Puskesmas Mompang tahun 2022. Diharapkan kepada Ibu yang memiliki bayi untuk meningkatkan wawasan, kepedulian tentang imunisasi dasar pada bayi, mengenai program imunisasi sesuai jadwal dan pemberian imunisasi secara lengkap. Kata kunci: Pengetahuan, Imunisasi Dasar, Puskesmas
Pemberdayaan Kader Dalam Upaya Peningkatan Pengetahuan Ibu Hamil Tentang Imunisasi Tetanus Toxoid Di Desa Bandar Setia Lasria Simamora; Ninsah Mandala Putri; Isyos Sari Sembiring; Marlina Simbolon; Henny Rista; Astaria Br Ginting
Jurnal Pengabdian kepada Masyarakat Nusantara Vol. 4 No. 3 (2023): Jurnal Pengabdian kepada Masyarakat Nusantara (JPkMN)
Publisher : Sistem Informasi dan Teknologi (Sisfokomtek)

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Abstract

Pada tahun 2021 menunjukkan 7.389 kematian ibu di Indonesia. Salah satu penyebabnya yakni infeksi yang disebabkan oleh bakteri Clostridium tetani. Sebagai upaya pengendaliannya maka dilaksanakan program imunisasi Tetanus Difteri (Td) bagi Wanita Usia Subur. Cakupan imunisasi Td2+ pada ibu hamil tahun 2021 sebesar 46,4%. Cakupan ini lebih rendah dibandingkan tahun 2020 sebesar 54,7%. Salah satu faktor penyebab rendahnya adalah rendahnya pengetahuan ibu hamil tentang imunisasi TT. Penulis bertujuan melakukan pengabdian kepada masyarakat dengan melakukan Pemberdayaan Kader Dalam Upaya Peningkatan Pengetahuan Ibu Hamil Tentang Imunisasi Tetanus Toxoid di Desa Bandar Setia. Pengabdian dilakukan dengan tahapan persiapan, pelaksanaan dan Evaluasi. Hasil pretest dan posttest menunjukkan ada peningkatan pengetahuan kader tentang imunisasi TT. Diharapkan dengan adanya pengabdian ini, dapat mengubah pengetahuan ibu hamil dan perilaku sehingga bersedia dilakukan imunisasi TT.
Pengaruh Pelaksanaan Usaha Kesehatan Sekolah Terhadap Perilaku Hidup Bersih Dan Sehat Di SMP Negeri 2 Kualuh Leidong Kabupaten Labuhan Batu Utara Sriana Ningsih; Paikem Paikem; Lasria Simamora; Henny Rista
Jurnal Ilmu Kedokteran dan Kesehatan Indonesia Vol. 3 No. 3 (2023): November : Jurnal Ilmu Kedokteran dan Kesehatan Indonesia
Publisher : Amik Veteran Porwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jikki.v3i3.2185

Abstract

Behavior about clean and healthy living in educational institutions is an effort to empower students, teachers and the community in the school environment to know, want to do and be able to practice a set of behaviors on the basis of awareness as learning outcomes, so that they are independently able to prevent disease, improve their health, and play an active role in creating a healthy environment . Behavior regarding clean and healthy living is an indicator of achievement in improving health in the 2015-2030 Sustainable Development Goals (SDGs) program. In the SDGs, behavior regarding clean and healthy living is one of the prevention strategies with short-term impacts for improving health in regional settings, namely schools, families and communities. During the COVID-19 pandemic, school-age children and adolescents were at risk of contracting COVID-19 due to their high activity and tendency to group. However, due to their good immune system, often COVID-19 in this group shows no symptoms or only mild symptoms, so they are often ignored and have the potential to spread to people around them. The impact of COVID-19 on school-age children and adolescents can affect their physical and mental health. Based on the description above, the authors conducted research on the effect of implementing UKS activities on Clean and Healthy Behavior. This research is a quantitative research with a correlation study design with the type of research used is Analytical Observational. The research was conducted at Middle School 2 Kualuh Leidong, North Labuhan Batu Regency, North Sumatra Province in March -May 2022 with a sample size of 70 respondents. Sampling in this study used a probability sampling technique with proportional stratified sampling. Data analysis in this study includes Univariate and Bivariate Analysis with the provision that if ρ ≤ α 0.05 then there is an influence or relationship between the two variables. The results of the study obtained a p value of 0.000 which means that there is an influence of the School Health Business program on Clean and Healthy Behavior. It is hoped that the puskesmas staff will socialize the school health program and activity plan, complete facilities that support clean and healthy behavior and further increase school involvement and collaboration with parties related to the implementation of activity programs or clean and healthy living in the working area of the Tanjung Leidong community health center.