Kasus-Kasus Maternal di Berita Online Menyangkut Hak Asasi yang Patut Menjadi Pelajaran dalam Pendidikan Bidan di Indonesia

Abstrak Gerakan menghormati hak asasi manusia dalam pelayanan kesehatan maternal di berbagai negara mendorong petugas kesehatan bertindak lebih manusiawi. Perempuan selama ini diam karena tidak ingin memutus hubungan harmonis dengan bidan serta jarangnya isu ini diangkat dalam pertemuan profesi dan publikasi ilmiah menyebabkan perhatian yang rendah terhadap hak asasi manusia dalam pelayanan kesehatan maternal. Penelitian ini bertujuan untuk mengidentifikasi kegagalan dalam pemenuhan hak kesehatan ibu hamil dan bersalin serta mengeksplorasi alasan-alasan yang menyebabkan hal tersebut terjadi. Metode penelitian dilakukan dengan melakukan penelusuran berita online kompas.com, tribunnews.com, dan detiknews.com tahun 2016-2018 dengan kata kunci “malpraktik” dan “bidan”, tentang persoalan hak asasi manusia dalam pelayanan bidan. Kami mengikuti kasus dalam lebih dari satu media online, disertai perkembangan berita tentang kasus tersebut. Hasil penelitian menunjukkan bahwa dominasi bidan dalam pelayanan kesehatan maternal di Indonesia, berdampak pada pengabaian hak asasi perempuan dan keselamatan. Kejadian ini pada kelompok orang dengan pendapatan rendah dan kelompok yang mampu. Didapatkan praktik bidan di luar kewenangan, kemungkinan motivasi mendapatkan keuntungan, dominasi bidan, posisi sosial perempuan yang rendah dalam pelayanan kesehatan maternal, dan keterlibatan masyarakat yang rendah untuk mendukung perempuan yang mengalami ketidakadilan dalam layanan kesehatan. Kepercayaan dan ketergantungan perempuan pada bidan, berdampak pengabaian hak asasi dan keselamatan ibu, tindakan di luar kewenangan, untuk pencarian keuntungan dalam praktik pribadi. Organisasi profesi dan pendidik bidan harus memasukkan penerapan hak asasi manusia dalam praktik kebidanan melalui kasus-kasus dari berita online dalam pertemuan berkala asosiasi profesi, serta kurikulum pendidikan, untuk mencegah dampak buruk pengabaian hak asasi ibu di masa depan. Kata kunci: pengabaian hak asasi dalam layanan bidan, kasus malpraktik bidan, penguatan pendidikan bidan Abstract The movement to respect human rights in maternal health services in various countries encourages health workers to act more humanely. Low attention to human rights issue in maternal health services due to the silent of the victims-because women do not want to break the harmonious relationship with midwives, and this issue is rarely raised in professional meetings and scientific publications. This study aims to identify failures in fulfilling the health rights of pregnant women and childbirth and explore the reasons for this. The research method is done by searching online news kompas.com, tribunnews.com, and detiknews.com in 2016-2018 with the keywords “malpractice” and “midwife”, about human rights issues in midwifery services. We followed the case in more than one online media, accompanied by the case progress report. The results of the study show that the dominance of midwives in maternal health services in Indonesia has an impact on neglecting women’s human rights and safety. This event is in the group of people with low income and groups who are able. The practice of midwive’s out of authority, possible motivations for profit, dominance of midwives, low social position of women in maternal health services, and low community involvement in supporting women who experience inequality in maternal health services. Trust and dependence of women on midwives, impact on neglecting human rights and maternal safety, actions that are beyond authority, for seeking profit in private practice. Midwife professional organizations and educators must incorporate the application of human rights in midwifery practice through cases from online news in periodic meetings of professional associations, as well as educational curricula, to prevent the adverse effects of neglecting maternal rights in the future. Keywords: neglect of human rights in midwife services, midwife malpractice case, strengthening midwifery educatio

Electron Microscopy of Lipid Deposits in Human Atherosclerosis

The filipin probe associated with tannic acid stain was used to study intra-and extracellular lipids in surgically removed human atherosclerotic lesions (n = 20). In particular, intimal thickenings, fatty streaks and fibrolipidic plaques have been investigated by using mainly transmission and scanning electron microscopy. In the intimal thickenings, the lipid deposits were mainly localized in the subendothelial space as homogeneously sized particles (40-140 nm) and more heterogeneous uni-multilamellar vesicles (35-700 nm). Intermediate lipid forms were also observed. In the fatty streaks, the lipid deposits were intracellular and mainly observed in cells with a monocyte/macrophagic phenotype. Lipid inclusions, lipid lysosomal bodies and intracellular cholesterol crystals very similar to those observed in experimentally induced atherosclerosis were documented. In the fibrolipidic plaque the lipid deposits were found both in the intracellular and in the extracellular compartments. Lipids accumulated within arterial macrophages and smooth muscle cells, usually as lipid droplets. Clusters of lipoprotein-like particles (50 nm in diameter) as well as larger uni-multilamellar lipids (700 nm) with an occasional compound appearance were particularly observed bound to elastic tissue and collagen fibers. These morphological observations outline the complexity of lipid metabolism in the various histological aspects of human atherosclerosis

PELATIHAN PENELITIAN TINDAKAN KELAS SEBAGAI BENTUK PENGEMBANGAN PROFESIONALISME GURU

Penelitian Tindakan Kelas (PTK) merupakan penelitian yang dapat dilakukan oleh guru dalam memperbaiki proses pembelajaran di kelas. PTK sebagai bentuk pengembangan profesionalisme guru dalam meningkatkan kinerjanya. Kegiatan ini dilakukan dengan metode pelatihan terstruktur yang dilakukan secara virtual zoom meeting. Jumlah seluruh peserta yang mendaftar sebanyak 143 orang. Hasil dari pelatihan menunjukan bahwa terdapat peningkatan pemahaman peserta pelatihan dalam memahami PTK dengan baik. Hasil lain juga menunjukan bahwa melalui kegiatan pelatihan pemahaman peserta pelatihan mengenai PTK menjadi lebih baik

Role of Intrinsic Subtype Analysis with PAM50 in Hormone Receptors Positive HER2 Negative Metastatic Breast Cancer: A Systematic Review.

Endocrine therapy (ET), associated with CDK 4/6 inhibitors, represents the first choice of treatment for HR+/HER2- metastatic breast cancer (mBC). Primary or secondary endocrine resistance could develop; however validated biomarkers capable of predicting such a conditions are not available. Several studies have shown that HR+/HER2- mBC comprises five intrinsic subtypes. The purpose of this systematic review was to analyze the potential correlations between intrinsic subtype, efficacy of treatment, and patient outcome. Five papers that analyzed the intrinsic subtype with PAM50 assay in patients (pts) with HR+/HER2- mBC treated with ET (alone or in combination) within seven phase III clinical trials (EGF30008, BOLERO-2, PALOMA-2,3, MONALEESA-2,3,7) were identified. Non-luminal subtypes are more frequent in endocrine-resistant pts and in metastatic sites (vs. primary tumors), have less benefit from ET, and worse prognosis. Among these, HER2-enriched subtypes are similar to HER2+ tumors and benefit from the addition of anti-HER2 agents (lapatinib) and, for less clear reasons, of ribociclib (unconfirmed data for palbociclib and everolimus). Basal-like subtypes are similar to triple-negative tumors, making them more sensitive to chemotherapy. The intrinsic subtype is also not static but can vary over time with the evolution of the disease. Currently, the intrinsic subtype does not play a decisive role in the choice of treatment in clinical practice, but has potential prognostic and predictive value that should be further investigated

Development of a Rotation Device for Microvascular Endothelial Cell Seeding

A rotation device (RD) specifically designed to achieve sterile endothelial cell (EC) seeding of vascular grafts has been developed. The basic characteristics of the RD include: small dimensions, fully autoclavable components, and perfectly sealed graft holders. These features make it possible to maintain sterility during all the steps of EC seeding. This was documented by negativity of all bacteriological assays performed . Moreover, the RD can simultaneously support three vascular grafts with different lengths (20, 40, and 60 cm) and diameters (4-8 mm). EC seeding is performed in the climatized chamber (37 °C; 5 % C02) with constant rotation (0.1 -3 rpm). The rotation cycle can be completed automatically. The practical efficacy of the RD was investigated by seeding 2 x 105/cm2 of human microvascular EC on 20 cm length, 4 mm internal diameter (ID) fibronectin- coated polytetrafluoroethylene (ePTFE) grafts for 24 and 48 hours respectively . Further, the effect of a highly viscous plasma expander, i.e., haemagel, on cell retention was also evaluated. Results were not as favorable as expected. However, it should be emphasized that after 48 hours of eel! incubation by using the RD, 42 % of the initially seeded EC were still present and approximately 15 % were fully spread over the graft surface. Moreover, the 10 minute perfusion with haemagel did not decrease the number of adherent microvascular EC

HIV-1 Integrase Inhibitor Resistance and Its Clinical Implications

With the approval in 2007 of the first integrase inhibitor (INI), raltegravir, clinicians became better able to suppress virus replication in patients infected with human immunodeficiency virus type 1 (HIV-1) who were harboring many of the most highly drug-resistant viruses. Raltegravir also provided clinicians with additional options for first-line therapy and for the simplification of regimens in patients with stable virological suppression. Two additional INIs in advanced clinical development—elvitegravir and S/GSK1349572—may prove equally versatile. However, the INIs have a relatively low genetic barrier to resistance in that 1 or 2 mutations are capable of causing marked reductions in susceptibility to raltegravir and elvitegravir, the most well-studied INIs. This perspective reviews the genetic mechanisms of INI resistance and their implications for initial INI therapy, the treatment of antiretroviral-experienced patients, and regimen simplification

Triple positive breast cancer. A distinct subtype?

Breast cancer is a heterogeneous disease, and within the HER-2 positive subtype this is highly exemplified by the presence of substantial phenotypical and clinical heterogeneity, mostly related to hormonal receptor (HR) expression. It is well known how HER-2 positivity is commonly associated with a more aggressive tumor phenotype and decreased overall survival and, moreover, with a reduced benefit from endocrine treatment. Preclinical studies corroborate the role played by functional crosstalks between HER-2 and estrogen receptor (ER) signaling in endocrine resistance and, more recently, the activation of ER signaling is emerging as a possible mechanism of resistance to HER-2 blocking agents. Indeed, HER-2 positive breast cancer heterogeneity has been suggested to underlie the variability of response not only to endocrine treatments, but also to HER-2 blocking agents. Among HER-2 positive tumors, HR status probably defines two distinct subtypes, with dissimilar clinical behavior and different sensitivity to anticancer agents. The triple positive subtype, namely, ER/PgR/Her-2 positive tumors, could be considered the subset which most closely resembles the HER-2 negative/HR positive tumors, with substantial differences in biology and clinical outcome. We argue on whether in this subgroup the "standard" treatment may be considered, in selected cases, i.e., small tumors, low tumor burden, high expression of both hormonal receptors, an overtreatment. This article review the existing literature on biologic and clinical data concerning the HER-2/ER/PgR positive tumors, in an attempt to better define the HER-2 subtypes and to optimize the use of HER-2 targeted agents, chemotherapy and endocrine treatments in the various subsets