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Asweriawati Sarumaha; Adelina Sembiring; Lisbet Gurning; Sri Mulati Nendah

Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

The high birth rate in Indonesia is one of the major problems and requires special attention in handling it. One form of special attention from the government in overcoming the high birth rate is implementing comprehensive family planning. The national family planning movement is prepared to build optimal human resources, characterized by increasing community participation in meeting the needs to be able to build prosperous families in the context of family planning services. The purpose of the study was to identify the relationship between family support and the participation of Women of Childbearing Age in the Family Planning Program at the Aramo Health Center, Aramo District, South Nias in 2023. The results of the cross-tabulation study showed a relationship between family support and the participation of women of childbearing age in the family planning program at the Aroma Health Center, South Nias in 2023 with a P value of 0.000 (P value <0.005), so Ho was rejected and Ha was accepted. Suggestions for midwifery services to provide education to increase family support with the participation of women of childbearing age.

Ana Aryanti; Endang Susilowati; Mupliha Mupliha

Jurnal Ilmu Keperawatan dan Kebidanan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

According to the Indonesian Ministry of Health in 2020, the number of maternal mortality rates (MMR) in Indonesia is still quite high, totaling 4,627 cases of maternal death. This number shows an increase compared to 2019 of 4,221 cases of maternal death (Indonesian Health Profile, 2021). Objective: To apply the theory that has been obtained at the academy with comprehensive midwifery care for pregnant women, laboring women, postpartum women, newborns, and family planning in practice using Varney and SOAP documentation, is there a gap between theory and practice. Research method: In this study the authors used a qualitative research method with a case study approach which was carried out by examining a problem through a case consisting of a single unit. Results: At the first pregnancy obstetric care visit, there was a problem of Chronic Energy Deficiency (CHD) where LiLA was 22.5 cm and also breech location. After being given counseling about high calorie balanced nutrition there was an increase in the size of LiLA by 2, 5 cm so that the mother did not experience SEZ. In the process of childbirth was done by Sectio Caesarea. In the postpartum period there was no complication in the postpartum period. Newborn was normal, no problems. In family planning, Mrs. M chose to use a 3-year family planning implant. Conclusion: During the assistance to Mrs. M, the health problems experienced by Mrs. M, especially the incidence of SEZ in pregnant women can be resolved, and there is a gap between theory and practice related to the size of LiLA and the height of the mother.

Eka Aftri Suryani; Hafsah Hafsah; Rianti Rianti

Jurnal ilmu Kesehatan Umum 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Background: The global maternal mortality rate (MMR) in 2022 is 91.46 per 100,000 live births with the cause of death being bleeding while the indirect causes of maternal mortality are during pregnancy wheere many pregnant women experience nutritional problems such as Chornic Energi Deficiency ( CHD) and Nutritional Anemia at 8.43% (WHO, 2022). The maternal mortality rate in ASEAN is 235 per 100,000 live births with the majority of causes of death being bleeding (ASEAN Secretariat, 2022). Until now, the maternal mortality rate in Indonesia alone in 2020 was 91.45/100,000 live births. In 2021, maternal mortality will increase to 305/100,000 live births. Meanwhile, in 2022, the maternal mortality rate will decrease by 230/100,000 live births. Within a period of 3 years, the causes of maternal death included Covid 19, bleeding, hypertension in pregnancy, and heart disease (Ministry of Health of the Republic of Indonesia, 2022). The maternal mortality rate in Central Java in 2020 was 84.6/100,000 live births, in 2021 it will be 199/100,000 live births. In 2022 there will be a decrease to 98.6/100,000 live births, hypertension in pregnancy and bleeding are still the cases of death in that year (Central Health Office, 2022). Brebes Regency shows that the maternal mortality rate in 2020 was 62 cases. In 2021 there were 105 cases and in 2022 there was a decrease to 50 cases with the causes of death being bleeding, hypertension, infection and heart disorders (Brebes District Health Office, 2021) Objective: Reduce maternal and infant morbidity and mortality rates in Brebes Regency, especially the Bumiayu Community Health Center area Conclusion: After providing comprehensive midwifery care to Mrs. S aged 32 years with Chronic Energy Deficiency (KEK) at BPM Mrs. The R working area of the Bumiayu Community Health Center from the third trimester of pregnancy, childbirth, newborns, postpartum and family planning is in good condition.

Reynaldi Don Reto; Kotan Y. Stefanus; Rafael Rape Tupen

Jurnal Ilmu Pertahanan, Politik dan Hukum Indonesia 2024 Asosiasi Peneliti dan Pengajar Ilmu Hukum Indonesia

Population growth in Kupang Regency from year to year is increasing, based on the population census data of Kupang Regency the number of residents by gender (soul), the population of Kupang Regency amounted to 372, 777 people with details of 190, 480 people for men and 182, 297 people for women. The density problem that occurred was 63 people per km2. High population growth can be a serious problem if it is not solved immediately, the high and uncontrolled population growth rate will affect the declining level of welfare of the community and family. . The family planning program began in 1968 by preparing LKBN (national family planning institution) which later became the National Population and Family Planning Agency or BKKBN, the national family planning movement aims to control the rate of population growth and also improve the quality of human resources. This research is a normative judicial research supported by an approach that uses primary data and secondary data obtained using interview methods, documentation studies and observations and the data obtained is processed using editing, coding, induction, trigulation and tabulation methods and analyzed in a qualitative descriptive manner. The results of this study show that (1) Regulation regarding the function of the district government in population control by BKKBN in Kupang Regency. In the hierarchy of legislative arrangements from the highest to the lowest level, it gives very full authority or trust to the National Population and Family Planning Agency in controlling the rate of population growth in Kupang Regency (2) In carrying out the functions of the population and family planning agency in organizing population control in Kupang Regency. The Population and Family Planning Agency has provided services and education to the public about the importance of family planning. However, the function of BKKBN has not been running well, this can happen because of the lack of public awareness, socio-cultural constraints, limited access to counter-septic tools, patriarchal gender roles, religious keyness and economic factors that make the function of BKKBN not well in controlling the population in Kupang Regency.

Dini Oktavia Putri; Wanda Hafisya; Mahesa Arya Pratama

Jurnal Hukum, Pendidikan dan Sosial Humaniora 2024 Asosiasi Peneliti dan Pengajar Ilmu Hukum Indonesia

Child abuse in Indonesia, particularly in Bintan, shows a concerning upward trend. This study aims to analyze the efforts of the Women's Empowerment, Child Protection, Population Control, and Family Planning Agency (DP3KB) in preventing and addressing cases of violence against children. The research method employed is empirical research, collecting primary data through interviews and observations, as well as secondary data from relevant literature. Findings indicate that DP3KB has implemented prevention programs that include socialization of children's rights and campaigns for reporting violence, although it still faces challenges such as limited resources and lack of inter-agency coordination. The implications of this research highlight the importance of cross-sector collaboration and increased community awareness to protect children from violence. By understanding the steps taken by DP3KB, it is hoped that this can contribute to child protection efforts and the handling of violence cases in Bintan Regency.

Okta Saprina; Hikmah Ifayanti; Nila Qurniasih

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2024 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

This research is a comprehensive midwifery care case study on Mrs. K from pregnancy to postpartum family planning conducted at the PMB Okta Saprina, S.Tr.Keb and Mrs. K's home from October-December 2023. The assessment during pregnancy found complaints of frequent urination which were addressed by counseling on reducing drinking at night. During labor, Mrs. K experienced severe pain on a scale of 8, which was reduced to moderate pain on a scale of 5 after being given lavender aromatherapy. Labor care stages I-IV were normal according to theory and without complications. The baby was born spontaneously, full-term, without complications. During the postpartum period, Mrs. K experienced breast engorgement which was treated with aloe vera compresses for 7 days until the complaint was resolved. Care for the newborn and postpartum period was according to standards. At 42 days postpartum, Mrs. K chose to use 3-month injectable contraception after being screened with the KLOP wheel. The management provided to Mrs. K was in accordance with evidence-based practice in providing comprehensive midwifery care, namely counseling for frequent urination, lavender aromatherapy for labor pain, and aloe vera compresses for breast engorgement with satisfactory results.

Hida Febrina; Hikmah Ifayanti; Hellen Febrianti

Jurnal Ventilator: Jurnal riset ilmu kesehatan dan Keperawatan 2024 Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Continuity of care (COC) or sustainable care is the care provided by a midwife to clients or patients from pregnancy, childbirth, the puerperium, newborn care, and family planning. This study aimed to provide continuity of midwifery care for a primigravida pregnant woman, Mrs. D, at a midwife practice. A case study method was used. The subject was Mrs. D, G1P0A0. Data collection was carried out from September to December 2023. The results showed that during pregnancy Mrs. D complained of sleep difficulties, during childbirth there was bloody show, in the puerperium period milk production was insufficient, the baby had diaper rash, and for family planning she wanted to use the pill. Interventions provided were health education on third trimester discomforts, normal childbirth management with 60 steps of APN, oxytocin massage, and olive oil for the baby. In conclusion, continuity of midwifery care was provided for Mrs. D with oxytocin massage and olive oil interventions. Milk production increased and the baby's diaper rash reduced.

Andi Nurfitriana; Dahlia Manurung; Mediana Sembiring

Jurnal Ilmu Kesehatan 2024 Lembaga Pengembangan Kinerja Dosen

The development of men's participation in family planning, especially in the use of contraception, over the last 12 years in Indonesia has not shown a significant increase. Meanwhile, based on data from the 2019 BKKBN, it is stated that men's participation in family planning programs is much lower. The aim of this study was to determine the factors that influence men's participation in using the vasectomy contraceptive method. The type of research used in this research is quantitative research with a cross sectional study design. Based on the research results, it shows that the majority of the sample tribe supports the use of vasectomy contraception, namely 31 people (63.3%) and the minority of the sample does not support the use of vasectomy contraception, namely 18 people (36.7%). Bivariate analysis found that there was no relationship between ethnicity and participation in the use of the vasectomy contraceptive method in the Polebungin District Health Center Area.  Bontomanai District. Selayar Islands, South Sulawesi in 2024

Sonia Novita Sari; Putri Maharani; Imarina Tarigan

Jurnal Ilmu Kesehatan 2024 Lembaga Pengembangan Kinerja Dosen

The subcutaneous contraceptive device (AKBK) is an effective and efficient hormonal contraceptive device in the form of a rod that is implanted under the skin, namely the upper arm and the protection period can reach five years. The aim of the research is to study the relationship between side effects and the incidence of dropouts in the use of subcutaneous contraceptives. The research method is a quantitative analytical survey with a cross sectional approach. The population in this study were all family planning acceptors who visited PMB Erna Wati, Lawe Sumur District, Southeast Aceh Regency, both those who used AKBK and those who dropped out, namely 45 acceptors. Chi square data analysis technique. The conclusion of this research is that there is a relationship between side effects and the incidence of dropouts in the use of under-the-skin contraceptives (AKBK). There is a relationship between side effects and the incidence of drop-outs in the use of under-the-skin contraceptives (AKBK) in 2024. It is hoped that this will serve as input for Health Officers to improve the implementation of providing education to mothers regarding use. AKBK

Theresia Rina Novia Sinaga; Rumondang Sitorus; Eva Dona Sinaga

Jurnal Riset Ilmu Farmasi dan Kesehatan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

The still high population growth is one of the polemics that occurs in Indonesia, so that Indonesia is still called a developing country. Therefore, the government's effort to suppress population growth is by establishing the Family Planning Family Planning program. The aim of this research is to analyze the effect of 3-month birth control injections on increasing body weight at the Family Planning Extension Center in Parpaudangan Village, North Labuhan Batu in 2023. This research is quantitative with a case control research design carried out at the Parpaudangan Family Planning Extension Center. The population in this study was 35 mothers who came to visit the family planning extension center. The sampling technique used was purposive sampling. In this research, the instruments used were primary data and secondary data as well as bivariate analysis using the Chi Square test with a confidence level of 95%. In conclusion, the statistical test results show an OR (Odds Ratio) of 2.310 with calculated X2 (2.089) < X2 Table (3.841) or p (0.148) > α (0.050) and CI (0.872; 6.118). The results of this research show that 3-month contraceptive injections are not a significant factor as the main cause of weight gain, but acceptors of 3-month contraceptive injections are likely to experience weight gain 2 times greater than non-acceptors of 3-month contraceptives, at the Parpaudangan village family planning extension center in 2023 .    

Renaldy Zadrian Elimanafe; Saryono Yohanes; Yohanes G. Tuba Helan

Konsensus : Jurnal Ilmu Pertahanan, Hukum dan Ilmu Komunikasi 2024 Asosiasi Peneliti Dan Pengajar Ilmu Sosial Indonesia

The objectives of this research are to understand and analyze the regulation of the duties and authority of the Department of Women's Empowerment and Child Protection in protecting children, and to identify and understand the inhibiting factors in carrying out these duties and authority. The research methodology used is normative juridical research, obtained through interviews and observations, and empirical juridical research, obtained through literature studies. The research results show: (1) The regulation of the duties and authority of the Department of Women's Empowerment and Child Protection in Rote Ndao Regency in protecting children includes the areas of child protection and fulfillment of children's rights and the special child protection program. (2) The inhibiting factors of the Department's duties and authority in protecting children include strategic issues and problems in regional development and strategic issues and problems in the sector of women's empowerment and child protection, population control, and family planning.

Endang Sulistyowati

Inovasi Kesehatan Global 2024 Lembaga Pengembangan Kinerja Dosen

Mother and Child Health (MCH) requires efforts through a holistic approach known as Continuity of Care (COC). Continuity is essential throughout a woman's life cycle, including during pregnancy, childbirth, and the postpartum period. To achieve COC, it can be implemented through monitoring and services such as ANC, INC, PNC, and Newborn Care, as well as connecting health care facilities to ensure prompt and accurate handling of emergencies. The aimofthis research is to provide comprehensive midwifery care for pregnant women in the third trimester, during labor, postpartum, care for the newborn, neonates, and family planning. The study was conducted from April to May 2024 at the Special Regional Hospital for Mother and Child, Pertiwi, Makassar. The caremethod in this research involves interviews, observations, and management of the subject 'scare. The subject in this care is Mrs. “N," a woman in her second pregnancy, who has givenbirth once, is currently at 37 weeks and 6 days gestation. The results of comprehensive midwifery care for Mrs. "N" during the third trimester of pregnancy showed well-preparedness for childbirth. Normal delivery occurred, followed by normal care for the newborn and neonatal care. The conclusion of this research is that comprehensive care allows for data collection, determination of actual and potential diagnoses, and timely referral or collaboration with other health care providers in case of issues.

Tatik Dwi Yani; Seftiani Wulandari

Inovasi Kesehatan Global 2024 Lembaga Pengembangan Kinerja Dosen

Family Planning (KB) is an action that assists individuals or married couples in achieving specific objectives, preventing unwanted pregnancies, spacing pregnancies, controlling the timing of childbirth within marital relationships, and determining the number of children in a family. Injectable contraception is one of the most commonly used pregnancy prevention methods in Indonesia. Factors related to the use of injectable contraceptives include Knowledge, Parity, Husband's Support, and Income. To review the literature on the factors influencing the choice of 3-month injectable contraceptive KB. Method: The method of writing this article is a literature review using Google Scholar. Articles were selected based on open access, full text availability in English and Indonesian published in the last decade (2020–2023). There are 6,750 articles identified and published from 2019-2023. Out of these 6,750 articles, 10 articles meet the inclusion and exclusion criteria. Based on the research findings, the 10 reviewed articles indicate that several factors influence the choice of 3-month injectable hormonal contraception. Based on the literature review conducted on the factors influencing the choice of 3-month injectable hormonal contraception KB, it is influenced by Knowledge, parity, husband's support, and income, with Knowledge being the most dominant factor.  

Sri Lasmawanti; Yaumil Hafsani Siregar; Hanny Ghafira; Agustin Elisabeth

Jurnal Pelaksanaan Pengabdian Bergerak bersama Masyarakat 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Adolescent health efforts aim to prepare adolescents to become healthy, intelligent, quality and productive adults and participate in maintaining, maintaining and improving their own health. Healthy Eating is a measure of the suitability of the subject's consumption with the recommended portion sizes of the Balanced Nutrition Guidelines. Maximum IGS means proving that the quality of food consumption is good and in accordance with the recommendations of the Balanced Nutrition Guidelines. In contrast to previous ages, entering the adolescent development stage, the child's daily nutritional adequacy rate (RDA) will automatically increase. According to WHO, teenagers are residents in the age range 10-19 years, according to the Republic of Indonesia Minister of Health Regulation Number 25 of 2014, teenagers are residents in the age range 10-18 years and according to the Population and Family Planning Agency (BKKBN) the age range for teenagers is 10-18 years. 24 years old and not married. The role of balanced nutrition education in teenagers' daily consumption is very necessary so that teenagers understand the nutritional intake needed by the body to support their growth and development from adolescence to adulthood, consuming a variety of foods with various types of food high in calories, protein, carbohydrates, minerals and vitamins to avoid disease and problems related to unbalanced nutrition.

Dio Fani Prakasa; Novriyenni Novriyenni; Lina Arlianan Nur Kadim

Repeater : Publikasi Teknik Informatika dan Jaringan 2024 Asosiasi Riset Teknik Elektro dan Informatika Indonesia

Healthy lifestyles are habits of doing something, be it food, healthy behavior so as to avoid the disturbance of all kinds of diseases, both physical and non-physical diseases, as well as birth control users must also strive for a healthy lifestyle, such as managing a healthy diet, rest, exercise, eating vegetables and fruits, doing optimal physical activity, not consuming alcohol, and maintaining a healthy body. In this problem, many family planning users do not pay attention to a healthy lifestyle because they think that the family planning tools used have no risk to health, but the use of family planning has side effects on health such as menstruation is not smooth, the body is obese, the body feels warm or feverish, there are blood clots, nausea, bloating, changes in vision, difficulty in getting back to normal, headaches, and others. To be able to attract the attention of the community in implementing a healthy lifestyle for family planning users, it is very necessary to have a system that can help people in changing their unhealthy lifestyle to a healthier one by grouping family planning user data based on variables that have been determined using the clustering method, to group data on healthy lifestyles for family planning users which later the results of this study can be used as input and guidance for a healthy lifestyle for family planning users, so that family planning users are more careful and have a healthy life. Of the 20 data, there are 3 groups, namely group 1 there are 4 data and group 2 there are 4 data and group 3 there are 12 data from the above results it can be seen that in cluster 3 is a group on family planning users based on a lot with a total of 12 data and is located in the contraceptive type group (X) is injectable birth control, and for the lifestyle group (Y), namely Frequent Night Baths and Risk (Z), namely Decreased Bone Strength.  

Yuliani Rizqi Amalia; Himatul Khoeroh; Sri Mulyani

Jurnal Ilmu Keperawatan dan Kebidanan 2024 Asosiasi Riset Ilmu Kesehatan Indonesia

Pregnancy with breech presentation is where the fetus lies longitudinally in the uterus while the head is at the fundus uteri and in the buttocks position below the uterine cavity (Putri and Ningrum, 2019). Cases of breech presentation both mother and fetus experience a large increase in risk and for labor with breech location have high mortality and morbidity (Putra 2015). The maternal mortality rate (MMR) according to WHO 2021 is 32.9/100,000 KH. ASEAN 2021 MMR is 235/100,000. Indonesian Ministry of Health 2021 AKI 7,389 people, Central Java Health Office 2023 AKI as much as 485. Data from the Brebes Health Office 2022 as many as 50 cases while from the kaliwadas puskesmas area in 2022 there was 1 case of death. Researchers implement comprehensive midwifery care using Varney and SOAP documentation. This study uses descriptive qualitative methods through direct approaches, interviews, observation and documentation. The main informant is Mrs.H while for additional informants there are village midwives, puskesmas midwives, husbands and Mrs.H's family. Based on the results of research obtained from the care of pregnancy, childbirth, postpartum, LBW and family planning, problems were found in the form of pregnancy with breech presentation and cesarean delivery for indications of failed induction.

Budi Prabowo; Annisa Lailatul Qomariyah; Fitra D. P. I. Santoso; Palupi, Kirana Woro; Luana Shiany Margareta +1 more

Pandawa : Pusat Publikasi Hasil Pengabdian Masyarakat 2024 Asosiasi Riset Ilmu Pendidikan Indonesia

Stunting is a chronic nutritional problem in young children that has serious implications for physical growth, cognitive development, and individual productivity. This condition is caused by a range of complex factors, including poor maternal nutrition and environmental conditions affecting quality of nutrition. The first 1,000 days of life represent a critical period for stunting prevention, as children's brain growth and development are particularly rapid during this time. Socialization regarding the importance of balanced nutrition and Family Planning programs is a strategic step to support optimal child growth and prevent stunting. This program begins with obtaining permits and coordinating with the Head of Kemiri Village to identify appropriate targets, as well as involving local neighborhood association in surveying facilities and infrastructure. The initiative aims to raise awareness in Kemiri Village about stunting and its prevention, and to educate the importance of balanced nutrition for supporting optimal child growth. Through socialization and counseling, it is hoped that the community will be able to recognize signs of stunting and take appropriate actions. This aligns with the village’s sustainable development goals (SDGs), particularly in achieving the target of a hunger-free village. By reducing the prevalence of stunting, the quality of life for the community can be significantly improved.

Wida Nur Hanita; Aris Prio Agus Santoso; Kresna Agung Yudhianto

Jurnal Ilmu Pertahanan, Politik dan Hukum Indonesia 2024 Asosiasi Peneliti dan Pengajar Ilmu Hukum Indonesia

Article 54 of Law No. 35/2014 on Child Protection, an amendment to Law No. 23/2002, states that children in the educational environment must be protected from physical and psychological violence, sexual crimes, and other crimes that may be committed by educators, education personnel, fellow students, or other parties. However, despite this regulation, cases of bullying in schools still occur frequently. This study aims to evaluate the application of Article 54 of Law No. 35 of 2014 concerning Child Protection and legal protection efforts for children who are victims of bullying with a legal certainty approach. The research method used is descriptive with qualitative data analysis. The results showed that Article 54 has been well implemented by the Surakarta City Office of Women's Empowerment and Child Protection and Population Control and Family Planning. They conduct socialization in schools and communities as a preventive measure and assist the mediation process for case resolution as a repressive measure. In addition, for the legal protection of child victims of bullying with a legal certainty approach, the Office also integrates bullying prevention and handling programs, facilitates and fosters education units, and provides educational facilities.

Abdurrahim Abdurrahim; Firmansyah Kusumayadi; Kartin Aprianti

Jurnal Manajemen Bisnis Era Digital 2024 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

This study aims to analyze the influence of work discipline and work ability on the work performance of employees at the Office of the National Population and Family Planning Agency (BKKBN) of Bima City. The research method used is a quantitative approach with survey techniques. Data was collected through a questionnaire distributed to Bima City BKKBN employees. The results of the study show that work discipline and work ability significantly affect employee work performance. Good work discipline can improve employee performance, while adequate work skills also make a positive contribution to work performance. This finding provides practical implications for BKKBN management in an effort to improve employee work performance through strengthening discipline and developing work skills.

Karningsih Karningsih

Family Planning program is very important because it can suppress the birth rate and minimize the number of people , but in the era of reform and implemented regional autonomy, family planning programs can not run smoothly, it is because not all local government district / city committed to the program of population and family plans. The purpose of the study was to analyze the decentralization family planning program in the Era of Regional Autonomy in District / City .The research method uses       Qualitative and descriptive method, and also using secondary data. Research results the existence  that family planning is not a priority in developing regions, and the materialistic  perspective will only make this program further drown. Efforts to revive the program can be done through advocacy approaches and instensif again. We recommend that all elements of policy makers, especially (regent / Mayor) had the foresight and understanding that family planning is a long term investment remains conserved.The management of the Family Planning program in the Regency/City in the era of regional autonomy is no longer carried out by the agency that handles the Family Planning Program, but has been combined with other programs, from the organizational structure there has been a change, previously responsible to the province, now entirely to the respective regents/mayors. The position and function of the Provincial Population and Family Planning Agency are less advantageous because this institution is still a vertical institution (centralization), but also  this institution must deal with regional institutions that already have their own paradigms in the organization.