Cell Free Fetal DNA As Biomarker for Pregnancy Loss Disorders

Situation Analysis

Drug cases are currently another problem faced by all countries in this hemisphere. Several countries are both producers and distributors, such as Jamaica, Afghanistan, Guatemala, Colombia, Bolivia, Myanmar, Peru and several other countries in South Asia [1,2]. Today’s drug users are not only among adults, but many are in their teens or productive age. This is in accordance with data from the Indonesian Child Protection Commission (KPAI) which records that of the 87 million child population in Indonesia, 5.9 million of them are drug addicts. They become drug addicts because they are influenced by those closest to them. “Out of a total of 87 million children with a maximum of 18 years, there are 5.9 million who are listed as addicts,” said KPAI Commissioner for Health, Sitti Hikmawatty at a press conference at the KPAI Building, Menteng, Central Jakarta [3,4].

KPAI said it handled 2,218 cases related to health problems and drugs that befell children. As many as 15.69 percent of them were drug addicts and 8.1 percent were drug dealers. During 2020, the Regional Police (Polda Sulsel) recorded an increase in cases of drug trafficking. The South Sulawesi Police noted that only 1,996 cases were uncovered during 2019. Until the end of 2020, the number of cases rose and exceeded 2,089 cases. Of the 2,089 cases in 2020, the police managed to arrest the perpetrators and designate as many as 2,933 people as suspects, consisting of 2,698 men and 244 women. The evidence secured was in the form of 1kg of marijuana, more than 144,765 grams. There were also 32kg of methamphetamine, more than 217,739 grams. Then there were 34,616 G list drugs, 12,088 ecstasy pills, and 5kg of synthesis, more than 168,926 grams [5-7].

Specifically for drug cases, during 2020 the Parepare Police succeeded in uncovering 50 cases with 68 suspects. From the drug cases, the Parepare Police succeeded in securing evidence in the form of 1.417kg +6702 grams of methamphetamine, 1 hand-rolled cannabis leaf [8]. Based on research conducted by Agussalim et al. in 2017 concerning an ethnographic study. The causes of youth in Papua and West Papua taking drugs are caused by association, and the main predisposing factor is because the pressure in the family is too hard. Social factors provide a very large role in the use and spread of drugs among adolescents in the city of Jayapura.

Konsep Teori

Drugs are not something foreign to us. We have often heard and read news about drugs in electronic and print media. In Indonesia, drug trafficking has become a major problem that must be addressed immediately. The spread of drugs in Indonesia, especially among the younger generation, is supported by global cultural factors. Global culture is dominated by Western culture (read the United States) which develops its influence through TV screens, VCDs and films. The main characteristics of this culture are very easy to imitate and adopt by the younger generation because it suits the needs and tastes of young people.

In 2010, the prevalence of drug abuse increased to 2.21 percent or around 4.02 million people. In 2011, the prevalence of drug abuse increased to 2.8 percent or around 5 million people. Therefore, there is a demand for the participation of various parties in Indonesia who can fight drugs. One of them is that counselors as educators in the educational environment can also participate in efforts to combat these illegal drugs.

The definition of drugs according to Kurniawan (2008) is a chemical substance that can change psychological states such as feelings, thoughts, moods and behavior if it enters the human body either by eating, drinking, inhaling, injecting, intravenously, and so on. Meanwhile, according to health experts, the definition of drugs is psychotropic drugs that are used to anesthetize patients when they want to be operated on or drugs for certain diseases. But now the perception is being misused due to use that is beyond the dosage limit.

Types of Drugs

Drugs are divided into 3 types, namely Narcotics, Psychotropics and other addictive substances. An explanation of the types of drugs is as follows:

Narcotics

According to Soerdjono Dirjosisworo said that the definition of narcotics is “a substance that can cause a certain effect for those who use it by entering it into the body. This influence can be in the form of anesthesia, pain relief, enthusiasm stimulation and hallucinations or the emergence of delusions. These properties that are known and found in the medical world are intended to be utilized for treatment and human interests in the field of surgery, pain relief and others. Narcotics are classified into 3 groups, namely:
a. Narcotics class I are the most dangerous narcotics. The addictive power is very high. This class is used for research and science. Examples: marijuana, h3roin, cocaine, morphine, and opium.
b. Narcotics class II are narcotics that have strong addictive power but are useful for treatment and research. Examples: pethidine, benzetidine, and betamethadol.
c. Narcotics class III are narcotics which have mild addictive power but are useful for treatment and research. Example: codeine and its derivatives.

Psychotropic

Psychotropic are non-narcotic substances or drugs, both natural and synthetic, which have psychoactive properties through a selective effect on the central nervous system which causes characteristic changes in normal activities and behavior. Psychotropic are further classified into 4 groups, namely:
a. Class I psychotropic is those with very strong addictive power, their benefits for treatment are not yet known and their efficacy is being studied. Examples: MDMA, LSD, STP, and ecstasy.
b. Class II psychotropics are psychotropics with strong addictive power and are useful for treatment and research. Examples: amphetamine, methamphetamine, and metqualone.
c. Class III psychotropics are psychotropics with moderate addiction power and are useful for treatment and research. Examples: lumibal, buprenorsina, and fleenitrazepam.
d. Class IV psychotropics are psychotropics that have mild addictive power and are useful for treatment and research. Example: nitrazepam (BK, mogadon, dumolid) and diazepam.

Other addictive substances

Other addictive substances are substances other than narcotics and psychotropic which can cause dependence on the user, including:
a. Cigarette
b. Alcohol and other drinks that are intoxicating and addictive.
c. Thinner and other substances, such as wood glue, liquid eraser and acetone, paint, gasoline which when inhaled can be intoxicating (Alifia, 2008). Those are the types of drugs, henceforth the factors that cause narcotics abuse.

Causal Factors of Drug Abuse

Factors causing drug abuse can be divided into two factors, namely:
i. Internal factors are factors that come from within the individual such as personality, anxiety, and depression as well as lack of religiosity. Most drug abuse begins or occurs during adolescence, because adolescents who are experiencing rapid biological, psychological and social changes are individuals who are vulnerable to abusing these illegal drugs. Children or adolescents with certain characteristics have a greater risk of becoming drug abusers.
ii. External factors are factors that come from outside the individual or environment such as the presence of substances, family conditions, weak laws and environmental influences.
iii. The factors mentioned above do not always make someone later become a drug abuser. However, the more of the above factors, the more likely a person is to become a drug abuser. This has to be studied case by case.
iv. Individual factors, family environment factors and peers/ associations do not always play the same big role in causing someone to abuse drugs. Due to social factors, it is possible for a child who comes from a harmonious and communicative family to become a drug abuser.

Signs of Early Symptoms of Drugs Abuse Victims

According to Ami Siamsidar Budiman (2006: 57-59) early signs or early symptoms of someone who becomes a victim of drug addiction include:
i. Physical signs of drug abuse , decreased physical health and self-appearance and irregular body temperature, staggering, slurred speech, apathetic (indifferent), sleepy, aggressive, shortness of breath, slow heart rate and pulse, palpable skin cold, slow/stop breathing, watery eyes and nose, constant yawning, diarrhea, pain all over the body, fear of water so lazy to bathe, convulsions, decreased consciousness, unhealthy appearance, not caring about health and hygiene, teeth are not maintained and porous , for injection marks on the arm or other body parts (in users with syringes).
ii. Signs of drug abuse at home Disobedience to parental reprimands, does not want to care about family rules, begins to forget routine responsibilities at home, lazy to take care of himself, often falls asleep and gets angry easily, often lies, avoids meeting with other family members a lot because afraid of being found out that he is an addict, being rude to other family members compared to before, sleeping pattern changes, spending his savings and always running out of money, often steals money and valuables at home, often harasses his family to ask for money for various reasons, changes friends and rarely wants to introduce his friends, often comes home after curfew and stays at friends’ houses, often goes to discos, malls or parties, when asked his attitude is defensive or hateful, occasionally found in a drunken state.
iii. Signs of Drug Abuse at school, Learning performance at school suddenly drops noticeably, attention to the environment is not there, often looks sleepy at school, often leaves class during class time with the excuse of going to the bathroom, often comes late to class after rest hours; is easily offended and angry at school, often lies, abandons his previous hobbies (for example, extracurricular activities and sports that he used to enjoy), complains because he thinks his family at home does not give him freedom, begins to often hang out with children who are “not right “ in school.

Consequences of Drug Abuse

Definition of Drugs

Drug use can cause negative effects that will lead to mental and behavioral disorders, resulting in disruption of the neurotransmitter system in the central nervous system in the brain. Disturbances in the neuro-transmitter system will result in disruption of cognitive (thought), affective (feelings, moods, or emotions), psychomotor (behavior) and social aspects.

Various efforts to overcome the development of drug addicts have been made but collided with the weakness of the law. Some evidence of the weakness of the law against narcotics is that the punishment is very light for dealers and addicts, even alcoholic drinks above 40 percent (minol 40 percent) are given many conveniences by the government. As a comparison, in Malaysia if a dealer or addict is found carrying 5 grams of drug and above, the person will be sentenced to death.

Golden Generation

Building a Golden Generation with Character in Efforts to Improve Smart and Character Individuals. Character is a way of thinking and behaving that is characteristic of each individual to live and work together, both within the family, community, nation and state. Individuals with good character are individuals who can make decisions and are ready to take responsibility for any consequences of the decisions they make.

With character education that is applied systematically and continuously, a child will become emotionally intelligent. But for some families, perhaps the process of systematic character education for the golden generation above is very difficult, especially for some parents who are stuck in a busy routine. Therefore, character education should also be given when children enter the school environment, especially since play groups and kindergartens. This is where the role of the teacher, which in Javanese philosophy is called digugu lan imitated, is at stake because the teacher is the spearhead in the class.

This emotional intelligence is an important provision in preparing children for the future, because a person will more easily and successfully face all kinds of life challenges, including challenges to succeed academically. High intelligence will be able to manipulate elements of the conditions faced to succeed in achieving goals. Ability, namely individual characteristics that are displayed in the form of behavior to meet certain needs/demands. Manipulation, namely active and intentional behavior to see and organize in forming relationships between elements that exist in a condition. We all realize that only through education will our nation progress and be able to catch up with other nations, both in the fields of science and technology and in the economy

Intelligent People and Strong Character

Indonesian people with character are people who have relatively stable personal characteristics in the individual who become the basis for the performance of behavior according to high standards of values and norms. Individuals who have attitudes and mindsets that are based on strong and correct morals. Character indicators that are manifested in human behavior with character are faith and piety, self-control, patience, discipline, hard work, tenacity, responsibility, honesty, defending truth, decency, politeness, obedience to rules, loyalty, democracy, togetherness, deliberation, mutual cooperation, tolerance, orderly, peaceful, anti-violence, frugal, consistent.

People who behave with character should be accompanied by smart actions and smart behavior should also be filled with smart efforts. Character and intelligence are united in cultured behavior. A life with character without being accompanied by an intelligent life will lead to various gaps and irregularities as well as inefficiencies. Smart Indonesians are comprehensively intelligent people, namely spiritually intelligent, emotionally intelligent, socially intelligent, intellectually intelligent, and kinesthetically intelligent. Spiritual intelligence, namely self-actualization through heart/heart exercise to grow and strengthen faith, piety and noble character including noble character and superior personality. Emotional intelligence, namely self-actualization through feeling exercise to increase sensitivity and appreciation of the subtlety and beauty of art and culture, as well as the competence to express it. Socially intelligent, namely self-actualization through social interaction that (i) fosters and fosters reciprocal relationships, (ii) democratic, (iii) empathetic and sympathetic, (iv) upholds human rights, (v) cheerful and confident, (vi) respect diversity in society and state.

Intellectually intelligent, namely self-actualization through thought process to gain competency and independence in science and technology; actualization of intellectual beings who are critical, creative, innovative and imaginative. Kinesthetic intelligence, namely self-actualization through sports to create healthy, fit, enduring, alert, skilled and agile people; as well as the actualization of superhuman beings. Competitive Indonesian people, namely people who have superior personality and are passionate about excellence, highly motivated, independent, never give up, network builders and builders, friendly with change, innovative and agents of change, productive, quality conscious, global oriented, lifelong learners, and be a mercy to the universe.

Efforts to Increase People Who are Intelligent and Strong Character

Education is a process in which a nation prepares its young generation to live life and to fulfill life goals effectively and efficiently. Education is a process in which a nation or country fosters and develops self-awareness among individuals. Character determines the moral quality and direction of each young generation in making decisions and behavior. Character is an integral part that must be built, so that the younger generation as the hope of the nation, as the nation’s successor who will determine the future must have an attitude and mindset that is based on strong and correct morals in efforts to build the nation.

Intelligence will be able to manipulate the elements of the conditions encountered to successfully achieve goals. Ability, namely individual characteristics that are displayed in the form of behavior to meet certain needs/demands. Manipulation, namely active and intentional behavior to see and organize in forming relationships between elements that exist in a condition. The elements, namely the results of sorting/separating the parts of a certain unit. Goals, namely conditions that are expected to occur through the appearance of abilities in the form of business. Success is a condition whose elements match the expected criteria. With character education that is applied systematically and continuously, a child will become emotionally intelligent.

This emotional intelligence is an important provision in preparing children for the future, because a person will more easily and successfully face all kinds of life’s challenges, including challenges to succeed academically. There are nine pillars of character derived from universal noble values, namely: first, the character of love for God and all of His creation; second, independence and responsibility; third, honesty/trustworthiness, diplomatic; fourth, respectful and polite; fifth, generous, likes to help and mutual cooperation/cooperation; sixth, confident and hardworking; seventh, leadership and justice; eighth, kind and humble, and; ninth, the character of tolerance, peace, and unity.

Building A Golden Generation

In order to prepare for the rise of Indonesia’s golden generation, it is necessary to develop education in a future perspective, namely, to create a quality, advanced, independent and modern Indonesian society, as well as to increase the dignity of the nation. Success in building education will make a major contribution to achieving national development goals as a whole. In such a context, the development of education includes a very wide variety of dimensions, namely social, cultural, economic and political dimensions [9].

From a social perspective, education for the golden generation with character will give birth to educated people who have an important role in the process of social change in the mobility of society. From a cultural perspective, education is an important vehicle and an effective medium for teaching norms, socializing values, and instilling ethos among citizens. From an economic perspective, education will produce reliable human beings to become subjects for driving regional and national economic development [10-13].

Therefore, education must be able to produce quality graduates who are knowledgeable, master technology, and have adequate technical skills and life skills. From a political perspective, education must be able to develop individual capacities to become good citizens, who have an awareness of rights and responsibilities in the life of society, nation and state.

Problem Solving Framework

The increase in drug cases in all regions of the Republic of Indonesia, including in the province of South Sulawesi, which really needs to get serious and more targeted treatment. Handling the distribution and consumption of drugs that are dominantly carried out by productive age, especially school-age adolescents, must be handled more intensively. The following is the conceptual framework for handling drug cases in Parepare City

Problem Solving Realization

This community service activity will be carried out during March-June 2022 involving several lecturers and students which will be carried out for high school and vocational school students grades 1, 2 and 3 in Parepare City. This activity is carried out through promotive and preventive efforts with the aim of increasing the understanding of high school students in Parepare City. This activity will be assisted through funding from the DIPA Poltekkes Kemenkes Makassar in collaboration with the BNN and the Education Office.

Target Audience

The target of this activity is expected to be students in the high school environment, namely grades 1, 2 and 3. This activity is also expected to help disseminate information to the school’s teachers. It is hoped that this activity will have a greater impact by forming students to prevent drug cases at the high school level.

Methods Used

The method used is the initial school location survey method and gathering information about the situation of the school Furthermore, it was carried out by distributing leaflets, providing education in the school environment, simulations, and forming an anti-drug student movement in high schools which were the locations for community service activities..

Time and Place of Execution

The planned activities will be carried out in March-June 2022 in several Public High Schools (SMU) and Vocational High Schools (SMK) in the city of Parepare. This activity is planned to be carried out in accordance with the Community Service Timetable in the 2018 community service guidelines.

Timetable

Community service activities are scheduled to be completed according to the timetable outlined in the 2021 community service manual, namely in March but are expected to be completed in June 2022.

Equipment

The equipment needed is leaflets, banners, infocus and demonstrations or examples of the effects of drug use obtained from BNN South Sulawesi Province.

Realization of Implementation

Community service activities are carried out in four high schools namely
a. SMK Bahari Parepare, activities at this school will be held on June 8, 2022, attended by more than 50 students.
b. SMK Negeri 2 Parepare was held on June 9, 2022, in the meeting hall of SMK Neg 2 Parepare which was attended by more than 50 students.
c. State Senior High School 3 parep-pare was held on June 10, 2022, with 60 students attending.
d. MAN 2 Parepare was held on June 11, 2022, which was attended by more than 50 students.

Evaluation of Activity Implementation

Evaluation of the activities carried out at SMK Bahari Parepare where when the evaluation of satisfaction with the performance of the activities was carried out, data was obtained that around 85% stated that they were very satisfied and 15% stated that they were satisfied with the activities carried out, while at SMK Negeri 2 Parepare as many as 90% stated that they were very satisfied and 10 Percent expressed satisfaction, this is the same as the implementation of activities at SMU state 3 parepare. A very surprising thing happened at MAN 2 Kota Parepare where they all expressed 100% satisfaction with the activity.

The high number of students’ satisfaction with the activity is due to the understanding of those who say this is the first thing done in their school. They say that the material given is very simple and can be applied in everyday life. The material is also given in the form of heart-warming which is very touching.

Evaluation of Activity

The evaluation carried out on the presenters by the school and the students gave the assessment that around 96% of them were very satisfied with the presenters and 4% were satisfied with the presenters from the Parepare Police Criminal Investigation Unit and Parepare Nursing Study Program, the Makassar Ministry of Health Polytechnic. This is because the presenters bring the material very interactively and also with a method that is very simple and easy for the participants to understand.

Limitations of Implementation of Activities

The implementation of this community service activity has limited consequences. The time is very short, and the funds are limited so that it cannot cover all high schools in the city of Parepare.

Conclusion

The implementation of this community service activity was carried out by involving Bareskrim, Parepare City Police and 4 high schools as the venue for the activity. This is done considering the need that is currently considered very urgent in creating a golden generation in the city of Parepare. It is hoped that this activity can continue and be carried out in other areas in the city of Parepare or other districts around the city of Parepare.

The implementation of this community service is expected to bring benefits and continuity of application by students, so that it can continue continuously and provide the principle of sustainability benefits for the future. This activity is expected as a form of contribution of higher education institutions to the community.

In the future this community service can be carried out in several areas which are expected to provide benefits for people or youth to become the front bumper in preventing the spread and use of narcotics among the community.

References

• https://news.okezone.com/read/2018/03/06/337/1868702/5-9-juta-anak-indonesia-jadi-pecandu-narkoba .
• https://international.sindonews.com/read/1285549/45/10-negara-pemasok-narkoba-terbesar-di-dunia-1519725612 .
• Indra Djati Sidi (2003) Towards a Learning Society: Initiating a New Paradigm of Education. Jakarta: Paramadina
• Masnur Muslich (2011) Character Education Responding to Multidimensional Crisis Challenges. Jakarta: Earth Script.
• Notoatmodjo, Soekidjo. (2003) Health Research Methodology. Jakarta: PT Rineka
• Suriasumantri (2003) Philosophy of Science. A Popular Introduction. Jakarta: Sinar Harapan Library.
• co.id, 2020, https://fajar.co.id/2020/12/30/kasus-narkoba-di-sulsel-meningkat-selama-2020/
• Berita news, 2020, https://berita.news/2020/12/31/selama-2020-polres-parepare-tangani-490-kasus/
• Muhammad Ali (2009) National Education for National Development. Towards an Independent and Highly Competitive Indonesian Nation. Bandung. PT Imperial Bhakti Utama.
• Abdul Asri Harahap (2004) New Paradigm of Indonesian Tax Perspective. Ekananzi-Politics. Jakarta: Integrita Dinamika Press.
• Shah, Muhibbin (2003) Learning Psychology. Jakarta: Rajagrafindo.
• Bashiruddin Usman (2007) Media Education. Jakarta: Ciputat Press, Indonesia.
• Hudojo, Herman (2003) Curriculum Development and Mathematics Learning. JICA.