Kesiapan Petugas Puskesmas dalam Penanggulangan Infeksi Menular Seksual dan Hiv/aids pada Pelayanan Antenatal

Background: Prevalence HIV/AIDS among housewife has been increasing which was notice by higher cases of HIVpositive babies. An effective intervention effort in the health sector is to accelerate the decreasing of Maternal Mortality Rate (MMR) through integrated approach of reproductive health care and STD HIV/AIDS. One of reproductive health services was to prevention and treatment of STD-HIV/AIDS. When this program was integrated with antenatal care it will prevents transmission of HIV from mother to child. The program called Prevention Mother To Child Transmission or PMTCT. Recently in Indonesia program antenatal care has not yet optimally integrated with STD-HIV/AIDS service. The objectiive of this study was to know how far preparedness of health center personnel in prevention transmission of STD, HIV/AIDS integrated with antenatal care. Methods: This study was exploration research. Respondents of this study were personals of public health center that have task related to antenal care and prevention program of STD, HIV/AIDS. Locations of study were Surabaya Malang Blitar Tulungagung, Semarang, Surakarta, Denpasar and Batam. Dara collection was done by interviewed and Focus Group Discussion. Results: The result of the study revealed the unprepared-ness of PHC personnel in term of knowledge about reproductive health and skill in universal precaution practice in integrated program of prevention STD, HIV/AIDS and antenatal care. Lack of facilities and its supporting system including the laboratory equipment and reagents also make activities of this integrated program being obstacle. Health service program still conducted fragmented because there was no standard operational procedure (SOP) of integrated program of STD, HIV/AIDS prevention and antenatal care. It was suggested to conduct a comprehensive program of reproductive health by increasing health personnel knowledge and skill with training; arrange SOP of integrated program of STD, HIV/AIDS prevention and antenatal care. It also needs to complete the facility with laboratory equipment i.e. rapid test and drugs to support this integrated program

Intravascular Ultrasound-Guided Troubleshooting in a Large Hematoma Treated With Fenestration Using a Cutting Balloon

Intramural hematoma formation is not a well-studied complication of percutaneous coronary intervention. We describe a patient with stable angina who developed an intramural hematoma during elective percutaneous coronary intervention (PCI) in the right coronary artery (RCA). Total occlusion with dense dye staining developed a long way from the distal RCA, near the posterior descending artery bifurcation site. The true lumen was compressed by the enlarged, tense, false lumen. The patient was successfully treating with intravascular ultrasound-guided fenestration using a cutting balloon, and a stent was implanted in the distal RCA

A Case of Intra- and Extra-Mural Hematomas During Recanalization for Chronic Total Occlusion

An intramural hematoma is an accumulation of blood between the internal and external elastic membranes within the medial space, whereas an extramural hematoma is a dilution and/or dissemination of blood throughout the adventitia. Intra- and extra-hematomas are observed by intravascular ultrasound during percutaneous coronary intervention (PCI). The patient described herein presented with angina pectoris. Her coronary angiogram showed diffuse narrowing of the mid-left anterior descending artery and total occlusion of the distal right coronary artery (RCA). Intra- and extra-mural hematomas developed during PCI of the RCA; however, the lesions were covered successfully using long drug-eluting stents

Customer Interaction and Innovation in Hybrid Offerings:Investigating Moderation and Mediation Effects for Goods and Services Innovation

Hybrid offerings are bundles of goods and services offerings provided by the same firm. Bundling value offerings affects how firms innovate, interact with customers, and customize their goods and services. However, it remains unclear how customer interaction might drive the innovation performance of various bundled components. Therefore, this study investigates the effects of customer interactions and service customization on both goods and services innovations in a hybrid offering context, using a unique data set of 146 information technology and manufacturing firms. Customer interaction appears beneficial to both goods and services innovation in a hybrid offerings context, but service customization has different direct effects on goods versus services innovation. As a potential mediator, customer knowledge mobilization resources exert different effects on the goods and services elements of hybrid offerings. Furthermore, for high-interaction customers, medium levels of technical modularity lead to most favorable innovation outcomes for services innovation. The results thus suggest that providers of hybrid offerings should foster customer interactions, to drive the innovation performance of the good and service components, while still making sure to implement service customization strategies. These findings have notable implications for service innovation research