The Effectiveness of Intravenous Admixture Training in a Private Hospital in Surabaya

In this hospital, the nurses face intravenous (iv) admixture problems in preparing and delivering iv injection and/or infusion to patients due to their limited background knowledge of drug stability and incompatibility. The nurses lack comprehension in maintaining the physical and chemical stability of the drugs. When stability is disrupted, incompatibility may occur. The incompatibility will diminish the effectiveness and the safety of drugs. Six small classes are conducted at the hospital, with 184 total attendants. There are three sessions: i. drug stability, ii. iv injection or infusion delivery, iii. case study (preparing and delivering several iv injections and/or infusions). The effectiveness of iv admixture training was evaluated through questionnaires and formative test (pre-test and post-test sessions). A process evaluation is based on both a 5-point Likert scale questionnaires and pencil and paper test distributed for each session. The nurses awareness of iv drug incompability, as an impact of the training, is showed through a percentage of pharmaceutical queries before and after training

Subfertilitas dan Penatalaksanaannya

Melahirkan bayi yang sehat adalah harapan setiap pasangan. Namun, setelah menikah, tidak setiap pasangan dapat segera memiliki anak meskipun berhubungan seksual secara teratur tanpa menggunakan pengaman. Kondisi ini disebut sebagai kurang subur (subfertil) hingga mandul atau steril.1 Gangguan/masalah kesuburan dapat disebabkan oleh faktor wanita, pria, keduanya (pria dan wanita), atau tidak diketahui penyebabnya, serta dapat terjadi di setiap tahapan proses pembuahan dan kehamilan. Normalnya, proses pembuahan dan kehamilan dimulai dari produksi dan pematangan sperma dan sel telur, bertemunya sperma dan sel telur dalam saluran telur, penanaman calon janin dalam rongga rahim, perkembangan janin hingga cukup umur untuk dilahirkan.2 Proses pembuahan dan berbagai hambatan kesuburan diulas lengkap pada buletin edisi kali ini dalam artikel yang berjudul ‘Subfertilitas’. Penatalaksanaan masalah kesuburan, baik non obat maupun obat, tergantung pada penyebabnya, meliputi: operasi, inseminasi buatan, atau Teknologi Reproduksi Berbantu (assisted reproductive technology, ART), penggunaan obat antiestrogen, metformin, gonadotropin beserta analognya, analog hormon pelepas gonadotropin, serta dopamin agonis.3 Pilihan terapi dan kajian efektivitasnya dapat dilihat dalam artikel yang berjudul ‘Terapi Farmakologi Infertilitas pada Wanita’. Editorial kali ini membahas tentang penggunaan kombinasi emtricitabine dan tenofovir disoproxil fumarate untuk indikasi terapi profilaksis infeksi HIV pada pasien dengan risiko tinggi terinfeksi HIV. Akan tetapi, sayang sekali penelitian tentang penggunaan kombinasi obat ini untuk mencegah transmisi penularan HIV pada janin untuk ibu hamil masih belum ada, padahal menurut data WHO 2010 terdapat 35% wanita hamil terinfeksi HIV di seluruh dunia khususnya pada negara dengan tingkat ekonomi rendah dan menenga

Reformulation of the Government Compilation of Islamic Law: Strengthening the Concept of Gender-Sensitive Regulations in Indonesia

The main purpose of this study is to find out the weaknesses in the application of the Compilation of Islamic Law in Indonesia, especially some of the provisions in it that tends to be gender biased; so that innovative ideas can be found to strengthen even the re-formulation of gender-sensitive legislation but still based on Shariah values and customary law. It is normative law research that uses a normative legal case study in the form of legal behavior products, among others by examining the Compilation of Islamic Law especially in the level of its implementation. The subject of the study is the Islamic marriage law which is conceptualized as the norm or rule that applies in the society and becomes the reference of behavior for every Indonesian citizen who embraced Islam.Keywords: Reformulation, Government Compilation, Islamic Law, Strengthening, Concept, Gender Sensitive Regulation

Impact of dietary changes on hepatic homocysteine metabolism in young broilers

Information regarding the impact of sulfur amino acids (SAA) on hepatic homocysteine (Hcy) flux through the various metabolic pathways competing for Hcy in young broilers is lacking. An experiment was conducted to evaluate the impact of varying levels of dietary methionine (Met), choline, and betaine on hepatic Hcy flux in young broiler chickens. A standard starter basal diet was fed to chicks until 8 d of age; 12 experimental diets were given from 8-22 d. The experimental basal diet contained deficient levels of Met and cysteine (Cys); supplemental Met (0, 0.08, 0.16, and 0.24%) was added to the basal diet in combination with isomethyl levels of choline (0 or 0.25%) or betaine (0 or 0.28%). The 12 dietary treatments were replicated with three pens containing five chicks each (15 birds per treatment). Weight gain and feed efficiency increased (P \u3c 0.05) with Met addition and were maximized with the addition of 0.16% digestible Met. No significant interactions (P \u3e 0.05) with choline or betaine addition were noted for weight gain, feed intake, or feed efficiency, but numerical improvements for these variables were observed with the addition of choline and betaine to the Met-deficient basal diet. Analysis of liver tissue indicated that folate-dependent remethylation of Hcy predominated over betaine-dependent remethylation. Further, folate-dependent remethylation of Hcy appeared to be impacted by dietary choline and betaine levels, whereas betaine-dependent remethylation appeared to be more impacted by dietary SAA levels

Profil sensitivitas bakteri Pseudomonas aeruginosa terhadap antibiotik di salah satu rumah sakit swasta di Surabaya: studi deskriptif periode 2001-2009

Antibiotik adalah obat yang digunakan untuk melawan penyakit infeksi yang disebabkan oleh bakteri. Penggunaan antibiotik yang tidak tepat (misalnya dosis yang kurang atau berlebih, lama pemberian yang terlalu singkat atau terlalu lama, penggunaan antibiotik spektrum luas yang berlebihan, dll.) dalam melawan penyakit infeksi dapat meningkatkan risiko terjadinya resistensi/kekebalan bakteri terhadap antibiotik. Di samping itu, penggunuan antibiotik yang tidak adekuat dapat menyebabkan kegagalan pengobatan dan kematian pasien. Pengetahuan yang baik tentang kepekaan bakteri terhadap antibiotik dapat membantu penulis resep dalam menentukan terapi antibiotik empiris. Peneliti melakukan observasi terhadap data antibiotic sensitivity test bakteri Pseudomonas aeruginosa yang dikumpulkan oleh mahasisvva dalam penelitian skripsinya di salah satu rumah sakit swasta di Surabaya padu tahun 2001,2004,2006,2008, dun 2009. Persentase kepekaan bakteri Pseudomonas aeruginosa pada tahun 2001, 2004, 2006, 2008, dan 2009 secara deskriptif disajikan dalam bentuk tabel dan grafik. Data antibiotic sensitivity test bakteri Pseudomonas aeruginosa terhadap berbagai antibiotik pada tahun 2001 menunjukkan sensitivitas lebih dari 60% terhadap lima golongan antibiotik, yaitu golongan aminoglikosida (amikasin), sejalosporin (seftazidim), fluorokuinolon (siprofloksasin), penisilin (piperasilin-tazobaktam), karbapenem (meropenem). Pada tahun 2004 terjadi penurunan sensitivitas terhadap antibiotik amikasin, siprofloksasin, meropenem; dan peningkatan sensitivitas terhadap antibiotik seftazidim dan piperasilin-tazobaktam. Pada tahun 2006 terjadi penurunan sensitivitas terhadap antibiotik kecuali amikasin. Pada tahun 2008 terjadi peningkatan sensitivitas terhadap antibiotik amikasin, piperasilin-tazobaktam, meropenem; dan penurunan sensitivitas terhadap antibiotik seftazidim dan siprofloksasin. Pada tahun2009 terjadi penurunan sensitivitas terhadap antibiotik amikasin, piperasilin-tazobaktanz, meropenern; danpeningkatan sensitivitasterhadap antibiotik seftazidim dansiprofloksasin Sensitivitas bakteri Pseudomonas aeruginosa dari waktu ke waktu terhadap berbagai antibiotik berbeda. Perlu dilakukan surveilens secara terus-menerus dan penelitian lebih lanjut tentang hubungan tingkat penggunaan antibiotik dan sensitivitas bakteri terhadap antibiotik sehingga dapat dijadikan masukan bagi rumah sakit dalam menentukan kebijakan pengendalian antibiotik di rumah sakit

Indonesian Fisheries Policy Reform: Compliance with Stringent Food Safety Requirement Of Importing Countries

The main objective of this research is to discover the idea of innovation of Indonesia's legislation system on food security/seafood which has been heavily influenced by trade relations between Indonesia and the European Union as a group of major importing countries. This is a case study that largely examines and presents trade disputes between Indonesia and some major importing countries, especially with the EU countries as a major group of country importers of fishery products and seafood from Indonesia. The various disputes and complaints found in this case study demonstrate the fact that the marine fisheries sector as one of Indonesia's mainstay sectors has a very potential economic value for the country's foreign exchange earnings. There is a very close relationship between the fisheries sector with the fulfillment of people's living needs as well as the development of the economic sector in general, including food safety aspects. This should be addressed appropriately and efficiently by the government by adjusting and even updating laws and regulations in this sector by the international food standard/food security; given the numerous demands and rejection of most of Indonesia's trading partner countries in this sector. Keyword: Indonesian Fisheries, Policy Reform, Compliance, Food Safety Requirements, Importing Countries

Water, rather than temperature, dominantly impacts how soil fauna affect dissolved carbon and nitrogen release from fresh litter during early litter decomposition

Longstanding observations suggest that dissolved materials are lost from fresh litter through leaching, but the role of soil fauna in controlling this process has been poorly documented. In this study, a litterbag experiment employing litterbags with different mesh sizes (3 mm to permit soil fauna access and 0.04 mm to exclude fauna access) was conducted in three habitats (arid valley, ecotone and subalpine forest) with changes in climate and vegetation types to evaluate the effects of soil fauna on the concentrations of dissolved organic carbon (DOC) and total dissolved nitrogen (TDN) during the first year of decomposition. The results showed that the individual density and community abundance of soil fauna greatly varied among these habitats, but Prostigmata, Isotomidae and Oribatida were the dominant soil invertebrates. At the end of the experiment, the mass remaining of foliar litter ranged from 58% for shrub litter to 77% for birch litter, and the DOC and TDN concentrations decreased to 54%-85% and increased to 34%-269%, respectively, when soil fauna were not present. The effects of soil fauna on the concentrations of both DOC and TDN in foliar litter were greater in the subalpine forest (wetter but colder) during the winter and in the arid valley (warmer but drier) during the growing season, and this effect was positively correlated with water content. Moreover, the effects of fauna on DOC and TDN concentrations were greater for high-quality litter and were related to the C/N ratio. These results suggest that water, rather than temperature, dominates how fauna affect the release of dissolved substances from fresh litter

Venture capital activities in Europe

Els aspectes de les activitats de capital de risc a Europa s'exploren en aquest treball. Un conjunt de dades de panell que cobreix 23 països de la UE / EEE entre 2.000-2.017, des d'una perspectiva macro, s'analitza empíricament amb resultats que donen suport a la investigació teòrica de la literatura de finances empresarials. El capital risc s'utilitzarà com a pla de finançament innovador alternatiu per a les empreses durant els períodes de crisi. Les variacions pel que fa a l'impacte de la crisi financera en la recaptació de fons de capital de risc i les activitats d'inversió a Europa, el creixement de el sector sanitari arran de les inversions de capital de risc dirigides a el sector, i el paper influent dels factors macroeconòmics en les sortides de capital de risc europeu, són totes questions importants per explicar la pertinència de les activitats de capital risc a Europa. Els resultats són sòlids fins i tot quan es controlen altres variables macroeconòmiques, com els fons de capital de risc com a percentatge de PIB, el cost de l'atenció mèdica com percentatge de el PIB i la despesa per càpita en salut, risc polític, impost sobre les guanys de capital.Los aspectos de las actividades de capital de riesgo en Europa se exploran en este trabajo. Un conjunto de datos de panel que cubre 23 países de la UE/EEE entre 2000-2017 desde una perspectiva macro se analiza empíricamente con resultados que apoyan la investigación teórica de la literatura de finanzas empresariales. El capital de riesgo se utilizará como plan de financiación innovador alternativo para las empresas durante los períodos de crisis. Las variaciones en cuanto al impacto de la crisis financiera en la recaudación de fondos de capital de riesgo y las actividades de inversión en Europa, el crecimiento del sector sanitario a raíz de las inversiones de capital de riesgo dirigidas al sector, y el papel influyente de los factores macroeconómicos en las salidas de capital de riesgo europeo, son todas cuestiones importantes para explicar la pertinencia de las actividades de capital riesgo en Europa. Los resultados son sólidos incluso cuando se controlan otras variables macroeconómicas, como los fondos de capital de riesgo como porcentaje del PIB, el costo de la atención médica como porcentaje del PIB y el gasto per cápita en salud, riesgo político, impuesto sobre las ganancias de capital.The aspects of venture capital activities in Europe are explored in this manuscript. A panel data covering 23 EU/EEA countries between 2000-2017 from a macro perspective are empirically analyzed with results that support theoretical research from entrepreneurial finance literature. Venture capital to be used as alternative innovative financing scheme for businesses during crisis periods, variations as regards the impact of the financial crisis on venture capital fundraising and investment activities in Europe, health sector growth being explained by venture capital investments directed to the sector, and the influencing role of macroeconomic factors on European venture capital exits, are all important issues in explaining the relevance of venture capital activities in Europe. The results are robust even when controlling for other macroeconomic variables such as venture capital funds as a percentage of GDP, healthcare cost as a percentage of GDP and per-capita expenditure on health, political risk, capital gains tax

Invertebrate Fauna of Devils Den, a Sandstone Cave in Northwestern Arkansas

The same invertebrate fauna of 17 species was found in Devils Den Cave, Washington County, Arkansas, in 1969 and 1979. The fauna consists of 1 trogloxene, 14 troglophiles, and 2 troglobites, a spider, Porrhomma cavernicolum, and a collembolan, Pseudosinella dubia. Devils Den Cave has a well developed cavernicolous fauna, although it is in sandstone which generally supports a poor cave adapted fauna. The troglobites probably evolved in the vicinity of northwestern Arkansas in limestone caves or in deep forest soils of the Ozark region. They then dispersed overland, perhaps as recently as the late Wisconsinan, to occupy this sandstone cave