ASUHAN KEBIDANAN KOMPREHENSIF PADA NY “H” DI DUSUN KREBET SENDANGSARI PAJANGAN BANTUL

Latar belakang: Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) di Indonesia masih cukup tinggi. Salah satu faktor penyebabnya yaitu kejadian anemia pada ibu. Anemia terjadi karena defisiensi zat besi dalam tubuh yaitu kurangnya pembentukkan sel darah merah pada tubuh yang dapat menyebabkan berat badan bayi lahir rendah (BBLR), prematuritas, cacat bawaan, perdarahan saat persalinan, ketuban pecah dini, gangguan janin dalam rahim, serta asfiksia. Tujuan: Memberikan asuhan kebidanan secara komprehensif pada ibu hamil, bersalin, nifas, dan bayi baru lahir (BBL). Metode : Metode yang digunakan dalam case report adalah deskriptif dengan pendekatan continuity of care atau peneliti melakukan survei kepada pasien dengan cara wawancara, observasi, dan pemberian penatalaksanaan asuhan. Hasil: Asuhan Kebidanan Komprehensif pada Ny. H umur 22 tahun G₁P₀A₀ diberikan sejak ibu hamil TM II, hamil TM III bersalin, nifas dan bayi baru lahir (BBL). Hasil penelitian didukung dengan pemeriksaan Haemoglobin (Hb) untuk mendeteksi komplikasi pada ibu. Sehingga bisa dilakukan pencegahan sampai proses persalinan, nifas, sampai bayi baru lahir (BBL). Kesimpulan: Setelah diberikan Asuhan Kebidanan Komprehensif didapatkan hasil yaitu ibu dapat bersalin secara normal, tidak ada tanda bahaya pada masa nifas dan bayi tidak mengalami komplikasi. Kata kunci : Asuhan Kebidanan, Continuity Of Care, Anemi

Politiets brug af peberspray

English title: Police use of pepper sprayThis article discusses the use of pepper spray by police since its introduction to Denmark in 2008. Pepper spray contains pepper extract and has been assessed as capable of causing serious health risks by the Danish Health Authority. International human rights bodies have also expressed concerns about the use of pepper spray. Despite this, no comprehensive study or evaluation of the use of pepper spray has ever been conducted in Denmark. The article uses qualitative interviews with police officers and people exposed to pepper spray, as well as a review of reports from police officers about their use of pepper spray, in an examination of whether Danish rules and practices fully comply with human rights requirements and recommendations. The situations in which pepper spray is typically used are described with a focus on where it is used and who it is used against. The authors express concern about the use of pepper spray in a number of situations and argue that its authorization should be more restrictive and precisely regulated. Finally, the article describes a dialogue with the Danish National Police and the pending police act regulating pepper spray

Actitud ética y desempeño laboral del servidor público de la Municipalidad Provincial de Huancavelica - 2016

El presente estudio de investigación denominada; “Actitud Ética y Desempeño Laboral del servidor público en la Municipalidad Provincial de Huancavelica 2016”, ha sido desarrollado en la Municipalidad Provincial de Huancavelica; cuyo objetivo principal es “Determinar la influencia de la Actitud Ética y Desempeño Laboral del servidor público en la Municipalidad Provincial de Huancavelica en el año 2016.” Para ello la hipótesis general planteada es: “Existe una influencia directa y significativa entre la Actitud Ética y Desempeño Laboral del servidor público en la Municipalidad Provincial de Huancavelica en el año 2016.”, sobre la base teórica comprendida en qué “la ética pública señala principios y valores deseables para ser aplicados en la conducta del hombre que desempeña una función pública” (Bautista, 2007). Así como también el desempeño laboral de los funcionarios públicos consiste en “La manera como los miembros de la organización trabajan eficazmente, para alcanzar metas comunes, sujeto a las reglas básicas establecidas con anterioridad” (Bravo, 2008); En la institución no se viene implementando mecanismos que promuevan la evaluación de las actitudes éticas de los funcionarios, pese a contar con diversos documentos normativos que regulan el comportamiento, generándose a partir de ello reclamos de la sociedad, sobre la atención que debe recibir de su gobierno. Dicha atención se manifiesta a través de la satisfacción de las demandas de la comunidad huancavelicana así como de una mayor expectativa en el nivel de vida de los ciudadanos. Drucker; citado por Gilli (2011, p. 13) “Que en una sociedad pluralista las principales funciones sociales han sido confiadas a organizaciones, desde la producción de bienes y servicios económicos hasta el cuidado de la salud, la seguridad social. La educación, la investigación y la protección del medio natural”, en consecuencia, dichas organizaciones deben ser competentes y eficaz y, además actuar en un marco de autonomía responsable. La falta de una actitud ética responsable y un desempeño laboral adecuado ha venido generado que las demandas ciudadanas hayan rebasado la capacidad de respuesta de los gobiernos y que las instituciones públicas sean vistas como lentas, ineficaces e ineficientes, lo que a su vez genera que la ciudadanía pierda la confianza en su gobierno. Palabras claves: Ética, valores, funcionario, gobierno, administración pública, código de ética, desempeño, rendimiento, cooperativismo, iniciativa.Tesi

Community cohort study of rotavirus and other enteropathogens: are routine vaccinations associated with sex-differential incidence rates?

OBJECTIVE: Community studies in West Africa have demonstrated that routine vaccinations may have non-targeted effects, the female-male mortality ratio being reduced after administration of BCG and increased after diphtheria-tetanus-pertussis (DTP). We examined whether immunisation status was associated with infection with rotavirus and other enteropathogens. METHODS: We recruited 200 children shortly after birth and followed them until 2 years of age with weekly morbidity interviews and stool sampling. Vaccination status for each child was classified according to the most recent vaccination as documented by vaccination card. MAIN OUTCOME MEASURES: The female-male incidence rate ratios (IRR) of infection with an enteropathogen and of enteropathogen-associated diarrhoea were estimated for children according to whether they had received BCG or DTP as their last vaccination. RESULTS: For children who received BCG as their last vaccine, the adjusted female-male IRRs for primary rotavirus-infection and diarrhoea were 1.05 (95% CI: 0.21-5.28) and 0.0 (95% CI: 0-3.02), respectively. For children who received DTP as their last vaccine, the adjusted female-male IRRs were 1.93 (0.89-4.21) and 1.92 (0.70-5.32), respectively, for rotavirus-associated infection and diarrhoea. Restricted to the rotavirus season, the female-male IRRs for rotavirus infection and diarrhoea were 2.56 (1.17-5.63) and 2.63 (0.94-7.34), respectively. The female-male IRR for rotavirus-associated diarrhoea differed significantly among BCG and DTP recipients (p=0.02). Infections with enteropathogens not associated with diarrhoea were associated with lower female-male IRRs after BCG of 0.82 (0.55-1.23) and higher female-male IRRs after DTP vaccination of 1.32 (1.03-1.70) for primary infection (p=0.05). Though there were few infections with other diarrhoea-causing enteropathogens, these were also associated with a lower female-male IRR after BCG of 0.62 (0.26-1.52) and a higher female-male IRR after DTP vaccination of 1.51 (1.04-2.20) for all infection. CONCLUSION: Routine immunisations may affect morbidity for non-targeted infections. As in studies of infant mortality, BCG is associated with lower risk for girls, whereas, DTP is associated with higher risk for girls relative to boys

Protective efficacy of standard Edmonston-Zagreb measles vaccination in infants aged 4.5 months: interim analysis of a randomised clinical trial

Objective To examine the protective efficacy of measles vaccination in infants in a low income country before 9 months of age

Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival.

BACKGROUND: Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. METHODS: To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. RESULTS: In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09-.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4-6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. CONCLUSIONS: Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4-6 months (earlier than currently recommended) and a booster dose at 9-12 months of age. CLINICAL TRIALS REGISTRATION: NCT00168558

Recombinant FXIII (rFXIII-A(2)) Prophylaxis Prevents Bleeding and Allows for Surgery in Patients with Congenital FXIII A-Subunit Deficiency

Recombinant factor XIII-A(2) (rFXIII-A(2)) was developed for prophylaxis and treatment of bleeds in patients with congenital FXIII A-subunit deficiency.mentor (TM) 2 (NCT00978380), a multinational, open-label, single-arm, multiple-dosing extension to the pivotal mentor (TM) 1 trial, assessed long-term safety and efficacy of rFXIII-A(2) prophylaxis in eligible patients (patients with severe [= 6 years. Patients received 35IU/kgrFXIII-A(2) (exactdosing) every 28 +/- 2 days for >= 52 weeks. Primary endpoint was safety (adverse events including immunogenicity); secondary endpoints were rate of bleeds requiring FXIII treatment, haemostatic response after one 35 IU/kg rFXIII-A(2) dose for breakthrough bleeds and withdrawals due to lack of rFXIII-A(2) efficacy. Steady-state pharmacokinetic variables were also summarized. Elective surgery was permitted during the treatment period. Sixty patients were exposed to rFXIII-A(2); their median age was 26.0 years (range: 7.0-77.0). rFXIII-A(2) was well tolerated without any safety concerns. No non-neutralizing or neutralizing antibodies (inhibitors) against FXIII were detected. Mean annualized bleeding rate (ABR) was 0.043/patient-year. Mean spontaneous ABR was 0.011/patient-year. No patients withdrew due to lack of efficacy. Geometric mean FXIII trough levelwas 0.17 IU/mL. Geometric terminal half-life was 13.7 days. rFXIII-A(2) prophylaxis provided sufficient haemostatic coverage for 12 minor surgeries without the need for additional FXIII therapy; eight procedures were performed within 7 days of the patient's last scheduled rFXIII-A(2) dose, and four were performed 10 to 21 days after the last dose.Peer reviewe

Non-specific effects of standard measles vaccine at 4.5 and 9 months of age on childhood mortality: randomised controlled trial

Objective To examine in a randomised trial whether a 25% difference in mortality exists between 4.5 months and 3 years of age for children given two standard doses of Edmonston-Zagreb measles vaccines at 4.5 and 9 months of age compared with those given one dose of measles vaccine at 9 months of age (current policy)