scholarly journals ANALISIS PAKET MANFAAT PELAYANAN TRANSFUSI DARAH DI FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) PADA PERATURAN PRESIDEN NO. 12 TAHUN 2013 PASAL 22 (STUDI IMPLEMENTASI KEBIJAKAN DI KOTA SURABAYA)

2018 ◽  
Vol 21 (2) ◽  
pp. 104-113
Author(s):  
Hidayad Heny Sholikhah ◽  
Wahyu Dwi Astuti
Keyword(s):  
Content Analysis ◽  
Blood Transfusion ◽  
Health Center ◽  
Group Discussion ◽  
Health Centers ◽  
Blood Transfusions ◽  
Referral Service ◽  
Technical Requirements ◽  
Blood Transfusion Service ◽  
Presidential Decree

Background: The need for blood services in Indonesia are still high. These were related to the high number of maternal deaths from hemorrhage during and after childbirth. The National Health Insurance (JKN) provide great opportunities for ensuring the needs of the community blood transfusion services. Presidential Decree No. 12 of 2013 article 22 paragraph 1a.6 mentioned that blood transfusions became one of the health care benefi ts package in the fi rst degree. The purpose of this study to analyze the benefi ts package in the regulation of blood transfusion services, especially in health centers. Methods: This study was conducted in Surabaya. The analysis was performed on the results of Focus Group Discussion with actor implementing policies (health center, Indonesian Cross Red/PMI, Hospitals, and BPJS), by content analysis. Results: The blood transfusion services benefi t package had not been able to do in Health Center (Puskesmas/FKTP), especially Puskesmas in Surabaya. Package benefi ts of blood transfusion services confl ict with other policies. Theauthority to give a blood transfusion was not a health center (puskesmas) but the hospital. The technical requirements of medical support blood transfusion services in health centers did not according to the standard. Referral service was the most likely carried out by the health center when encountered cases of maternal urgency requiring blood transfusions. Conclusion: Package benefi ts of blood transfusion services in Presidential Decree No. 12 of 2013 article 22 contradicted by other policies already set. Availability of medical requirements that support these services had not been fulfilled. Blood transfusion services could not currently be implemented in Puskesmas Surabaya. Recommendation: The content of Presidential Decree no. 12 of 2013 article 22 requires the revision, that the blood transfusion service could only be carried out in health facilities provided medical technical requirements, both human resources and supporting infrastructure. Abstrak Latar Belakang: Kebutuhan pelayanan darah di Indonesia masih tinggi. Ini terkait masih tingginya jumlah kematian ibu akibat perdarahan saat dan pascamelahirkan. Jaminan Kesehatan Nasional (JKN) memberikan peluang terjaminnya kebutuhan masyarakat terhadap pelayanan transfusi darah. Peraturan Presiden (Perpres) no. 12 tahun 2013 pasal 22 ayat 1a.6 menyebutkan bahwa transfusi darah menjadi salah satu paket manfaat di pelayanan kesehatan tingkat pertama. Tujuan kajian untuk menganalisis paket manfaat pelayanan transfusi darah di puskesmas dalam Perpres tersebut. Metode: Kajian ini merupakan studi implementasi kebijakan Perpres no. 12 tahun 2013 yang dilakukan di Surabaya. Analisis dilakukan terhadap hasil FGD dengan aktor pelaksana kebijakan (Puskesmas, PMI, Rumah sakit, dan BPJS), secara content analysis. Hasil: Paket manfaat pelayanan transfusi darah belum dapat dilakukan di FKTP, khususnya Puskesmas di Surabaya, karena bertentangan dengan perundang-undangan yang lebih tinggi dan ditetapkan sebelumnya. Pemberian transfusi merupakan kewenangan rumah sakit. Persyaratan teknis medis penunjang pelayanan transfusi darah di puskesmas belum memenuhi standar. Puskesmas hanya berwenang merujuk ketika menjumpai kasus kegawatan maternal yang memerlukan transfusi darah. Kesimpulan: Pelayanan transfusi darah dalam Perpres no. 12 tahun 2013 pasal 22 kontradiktif dengan kebijakan lain. Pelayanan transfusi darah belum dapat dilaksanakan di Puskesmas Kota Surabaya, karena belum memenuhi persyaratan tranfusi darah yang aman. Rekomendasi: Isi Perpres no. 12 tahun 2013 pasal 22 perlu direvisi, bahwa pelayanan transfusi darah hanya dapat dilakukan di fasilitas kesehatan yang memenuhi persyaratan teknis medisnya, SDM dan sarana prasarana penunjangnya.

scholarly journals Penanganan Balita Gizi Buruk di Puskesmas Provinsi Banten, Jawa Barat, Kalimantan Barat, dan Nusa Tenggara Timur

2019 ◽  
pp. 175-183
Author(s):  
Astuti Lamid ◽  
Nova Sri Hartati ◽  
Fitriana Fitriana ◽  
Srilaning Driyah
Keyword(s):  
Content Analysis ◽  
Health Center ◽  
Group Discussion ◽  
Health Centre ◽  
Health Centers ◽  
Severe Malnutrition ◽  
Center Staff ◽  
Depth Interview ◽  
Therapeutic Food ◽  
Mix Methods

Abstrak Masalah balita gizi buruk cenderung menurun pada tahun 2018, namun di beberapa daerah kasus gizi buruk meningkat menjadi KLB. Salah satu penanganannya melalui pemulihan di puskesmas. Tujuan penelitian ini untuk mengetahui sejauh mana penanganan gizi buruk dilakukan oleh tenaga kesehatan puskesmas dan kader posyandu. Desain penelitian menggunakan pendekatan mix methods, berlokasi di Kalimantan Barat, Banten, Jawa Barat dan Nusa Tenggara Timur. Dua kabupaten dipilih dari masing-masing provinsi, selanjutnya dari tiap kabupaten diambil satu puskesmas yang banyak kasus gizi buruk. Informan penelitian adalah Tenaga Pelaksana Gizi (TPG) puskesmas dan kader posyandu. Data yang dikumpulkan meliputi pelayanan gizi dan kesehatan, makanan terapi, dan penyuluhan serta peranan kader. Cara pengumpulan data dengan wawancara, in-depth interview dan diskusi kelompok terarah. Analisis data kuantitatif disajikan secara deskriptif dan kualitatif dengan content analysis. Hasil penelitian menunjukkan sebagian besar puskesmas di daerah penelitian menangani gizi buruk dengan cara rawat jalan. Belum semua TPG puskesmas mendapat pelatihan gizi buruk, hanya sebagian puskesmas menggunakan makanan terapi sedangkan lainnya menggunakan makanan tambahan yang tidak sesuai dengan pedoman. Dukungan sebagian kader dalam penanganan gizi buruk di puskesmas berupa penemuan kasus gizi buruk dan merujuknya, membagikan PMT ke rumah balita. Penanganan balita gizi buruk di puskesmas belum optimal karena tidak didukung dengan ketersediaan input berupa makanan terapi dan belum semua TPG mendapat pelatihan gizi buruk. Pelatihan gizi buruk untuk tenaga puskesmas perlu ditingkatkan dan sistem pengadaan makanan terapi di daerah perlu diperbaiki, agar kualitas pelayanan gizi buruk menjadi lebih baik. Kata kunci: gizi buruk, TPG, PMT, sistem pengadaan, pelayanan kesehatan Abstract The problem of severe malnutrition children under five years old tends to decline in 2018. One of the treatment measures was through recovery at the health center. The purpose of this study was to evaluate the extent to which severe malnutrition children was handled by health center nutrition officer and posyandu cadre. Mix methods approach was used as research design and the study was located in West Kalimantan, Banten, West Java and East Nusa Tenggara Provinces. Two districts were chosen, then one health center from each district was selected based on the highest severe malnutrition cases. The informants were nutrition officer of health center and posyandu cadres. The data collected were nutrition and health services, therapeutic food, counseling, and the role of cadres. Data was collected through interview, in-depth interview, and focus group discussion. Quantitative data analysis was presented descriptively and qualitative data was presented with content analysis.The majority of health centers handled severe malnutrition children in outpatient treatment setting. Not all nutrition officer of health centre have received training in handling severe malnutrition. Only some health centers used therapeutic food while others used supplementary foods that was not recommended. The support of cadre was seen in the form of finding cases of malnutrition and distributing supplementary food to the malnourished children’s homes. The handling of malnourished children in health centers was not optimal, because it was not supported by the availability of therapeutic food and not all nutrition officer have been trained. For recommendations, nutrition training for health center staff needs to be increased and the system for provision therapeutic food in the regions needs to be improved in order to improve the quality of nutrition services. Keywords: severe malnutrition, health center nutrition officer, mix methods, indepth interview, content analysis

scholarly journals TRALI-SYNDROME: DIAGNOSTICS, PREVENTION, TREATMENT

2019 ◽  
Vol 16 (2) ◽  
pp. 44-50 ◽  
Author(s):  
M. I. Neymark
Keyword(s):  
Acute Lung Injury ◽  
Blood Transfusion ◽  
Lung Injury ◽  
Causes Of Death ◽  
Late Diagnosis ◽  
Blood Transfusions ◽  
Blood Transfusion Service

The lecture is devoted to transfusion-related acute lung injury (TRALI), which is rarely encountered and therefore poorly studied by clinicians. With late diagnosis and inadequate management, the injury can be fatal. In some countries, it is ranked third among causes of death associated with complications developed due to blood transfusions. The lecture discusses issues of etiology, pathogenesis, symptoms, and diagnostics of TRALI. Special attention is paid to prevention, in particular, improvement of the blood transfusion service.

scholarly journals PERSEPSI PESERTA BPJS KESEHATAN TERHADAP PROGLAM PENGELOLAAN PENYAKIT KRONIS DI PUSKESMAS I DENPASAR BARAT DAN PUSKESMAS II DENPASAR TIMUR

2019 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Putu Inok Puspaeni ◽  
Desak Putu Yuli Kurniati ◽  
Putu Ayu Indrayathi
Keyword(s):  
Focus Group ◽  
Health Center ◽  
Chronic Disease Management ◽  
Group Discussion ◽  
Health Centers ◽  
Purposive Sampling ◽  
Qualitative Descriptive ◽  
Fear And Anxiety ◽  
The Impact ◽  
Depth Interviews

ABSTRAK Pada era Jaminan Kesehatan Nasional salah satu upaya yang dilaksanakan untuk menanggulangi penyakit kronis adalah Prolanis. Puskesmas se-Kota Denpasar telah melaksanakan program prolanis tetapi terdapat perbedaan rasio kunjungan peserta prolanis tertinggi dan terendah. Tujuan penelitian ini untuk mengetahui gambaran persepsi peserta BPJS Kesehatan terhadap program pengelolaan penyakit kronis di Puskesmas I Denpasar Barat dan Puskesmas II Denpasar Timur. Penelitian ini merupakan penelitian deskriptif kualitatif dengan purposive sampling menggunakan metode wawancara mendalam dan focus group discusion. Penelitian ini dilaksanakan di Puskesmas I Denpasar Barat dan Puskesmas II Denpasar Timur dari bulan Mei-Juni 2017. Informan penelitian berjumlah sembilan belas orang yang terdiri dari kepala puskesmas, pemegang program prolanis dan peserta BPJS Kesehatan yang tergabung dalam kelompok prolanis. Hasil penelitian menunjukkan peserta prolanis di Puskesmas I Denpasar Barat merasa rentan terkena penyakit diabetes/ hipertensi dan dampak penyakit tersebut menimbulkan ketakutan dan kecemasan pada peserta karena efek keseriusan penyakit sudah dilihat/ dirasakan. Besarnya manfaat yang dirasakan mampu menutupi hambatan yang dialami, selain itu dukungan teman dan rasa kekeluargaan meningkatkan partisipasi peserta prolanis. Maka dari itu puskesmas yang rasio kunjungan prolanis rendah perlu mengundang keluarga yang menderita diabetes/ hipertensi untuk memberikan testimoni. Kata Kunci : Prolanis, Persepsi, Puskesmas   ABSTRACT In the era of National Health Insurance, one of the efforts undertaken to tackle chronic illness is Prolanis. Health centers throughout Denpasar have implemented prolanis programs but there are differences in the ratio of visits of the highest and lowest prolanis participants. The purpose of this study was to determine the description of BPJS Health participants' perceptions of chronic disease management programs in Puskesmas I Denpasar Barat and Puskesmas II Denpasar Timur. This research is a qualitative descriptive study with purposive sampling using in-depth interviews and focus group discussion methods. The research was conducted at the Health Center I of West Denpasar and Health Center II of East Denpasar from May-June 2017. The informants of the study consisted of nineteen people consisting of the head of the puskesmas, the prolanist program holder and BPJS Health participants who were members of the prolanist group. The results showed prolanis participants in Puskesmas I Denpasar Barat felt vulnerable to diabetes / hypertension and the impact of the disease caused fear and anxiety in participants because the seriousness of the disease had been seen / felt. The amount of benefits felt is able to cover the obstacles experienced, in addition to the support of friends and a sense of family to increase participation of prolanist participants. Therefore a puskesmas with a low prolanis visit ratio needs to invite families suffering from diabetes / hypertension to provide testimonials. Keywords: Prolanis, Perception, Puskesmas

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS PADA IBU HAMIL

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Negative Impact ◽  
Univariate Analysis ◽  
Good Condition ◽  
Health Centers ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>

HUBUNGAN ANTARA UMUR BALITA DAN PENGETAHUAN IBU DENGAN KEJADIAN PNEUMONIA PADA BALITA DI PUSKESMAS CAMBAI TAHUN 2016

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri
Keyword(s):  
Health Center ◽  
Sampling Technique ◽  
Health Centers ◽  
Survey Method ◽  
Maternal Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Workers ◽  
Important Health

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.

scholarly journals Left Atrial Strain Identifies Increased Atrial Ectopy in Patients with Beta-Thalassemia Major

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Maria Vlachou ◽  
Vasileios Kamperidis ◽  
Efthymia Vlachaki ◽  
Georgios Tziatzios ◽  
Despoina Pantelidou ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Left Atrial ◽  
Systolic Pressure ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Tape Recording ◽  
Blood Transfusions ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Beta Thalassemia Major

Patients with beta-thalassemia major (β-ΤΜ) may develop cardiac arrhythmias through a multifactorial mechanism. The current study evaluated the association of cardiac structure and function on echocardiography with atrial ectopic burden on 24-hour tape recording in β-ΤΜ patients. This prospective study included consecutive β-ΤΜ patients. Demographic, laboratory, echocardiographic, cardiac magnetic resonance (CMR) T2* and 24-hour tape recording data were prospectively collected. The patients were classified according to the median value of premature atrial contractions (PACs) on 24-hour tape. In total, 50 β-TM patients (37.6 ± 9.1 years old, 50% male) were divided in 2 groups; PACs ≤ 24/day and > 24/day. Patients with PACs > 24/day were treated with blood transfusion for a longer period of time (39.0 ± 8.6 vs. 32.0 ± 8.9 years, p < 0.007), compared to their counterparts. Older age (OR: 1.121, 95% CI: 1.032–1.217, p = 0.007), longer duration of blood transfusion (OR:1.101, 95% CI:1.019–1.188, p = 0.014), larger LV end-diastolic diameter (OR: 4.522, 95% CI:1.009–20.280, p = 0.049), higher values of LA peak systolic strain (OR: 0.869, 95% CI: 0.783–0.964, p = 0.008), higher MV E/E′ average (OR: 1.407, 95% CI: 1.028–1.926, p = 0.033) and higher right ventricular systolic pressure (OR: 1.147, 95% CI: 1.039–1.266, p = 0.006) were univariably associated with PACs > 24/day. LA peak systolic strain remained significantly associated with PACs > 24/day after adjusting for the duration of blood transfusions or for CMR T2*. The multivariable model including blood transfusion duration and LA peak systolic strain was the most closely associated with PACs > 24/day. Receiver operating characteristic curve analysis identified a left atrial peak systolic strain of 31.5%, as the best cut-off value (83% sensitivity, 68% specificity) for prediction of PACs > 24/day. In β-TM patients, LA peak systolic strain was associated with the atrial arrhythmia burden independently to the duration of blood transfusions and CMR T2*.

scholarly journals Development and validation of the Readiness to Train Assessment Tool (RTAT)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ianita Zlateva ◽  
Amanda Schiessl ◽  
Nashwa Khalid ◽  
Kerry Bamrick ◽  
Margaret Flinter
Keyword(s):  
United States ◽  
Factor Analysis ◽  
Conceptual Framework ◽  
Health Center ◽  
Assessment Tool ◽  
Training Programs ◽  
Health Professions ◽  
Internal Consistency Reliability ◽  
The United States ◽  
Health Centers

Abstract Background In recent years, health centers in the United States have embraced the opportunity to train the next generation of health professionals. The uniqueness of the health centers as teaching settings emphasizes the need to determine if health professions training programs align with health center priorities and the nature of any adjustments that would be needed to successfully implement a training program. We sought to address this need by developing and validating a new survey that measures organizational readiness constructs important for the implementation of health professions training programs at health centers where the primary role of the organizations and individuals is healthcare delivery. Methods The study incorporated several methodological steps for developing and validating a measure for assessing health center readiness to engage with health professions programs. A conceptual framework was developed based on literature review and later validated by 20 experts in two focus groups. A survey-item pool was generated and mapped to the conceptual framework and further refined and validated by 13 experts in three modified Delphi rounds. The survey items were pilot-tested with 212 health center employees. The final survey structure was derived through exploratory factor analysis. The internal consistency reliability of the scale and subscales was evaluated using Chronbach’s alpha. Results The exploratory factor analysis revealed a 41-item, 7-subscale solution for the survey structure, with 72% of total variance explained. Cronbach’s alphas (.79–.97) indicated high internal consistency reliability. The survey measures: readiness to engage, evidence strength and quality of the health professions training program, relative advantage of the program, financial resources, additional resources, implementation team, and implementation plan. Conclusions The final survey, the Readiness to Train Assessment Tool (RTAT), is theoretically-based, valid and reliable. It provides an opportunity to evaluate health centers’ readiness to implement health professions programs. When followed with appropriate change strategies, the readiness evaluations could make the implementation of health professions training programs, and their spread across the United States, more efficient and cost-effective. While developed specifically for health centers, the survey may be useful to other healthcare organizations willing to assess their readiness to implement education and training programs.

scholarly journals Exploring country-wide equitable government health care facility access in Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Dowhaniuk
Keyword(s):  
Health Care ◽  
Random Forest ◽  
Health Center ◽  
Travel Time ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Walking Distance ◽  
Laboratory System ◽  
Government Health ◽  
Sub Saharan

Abstract Background Rural access to health care remains a challenge in Sub-Saharan Africa due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Sub-Saharan Africa often lack equity, leaving disproportionately less health center access for the poorest residents with the highest health care needs. Lack of health care equity in Sub-Saharan Africa has become of increasing concern as countries enter a period of simultaneous high infectious and non-communicable disease burdens, the second of which requires a robust primary care network due to a long continuum of care. Bicycle ownership has been proposed and promoted as one tool to reduce travel-related barriers to health-services among the poor. Methods An accessibility analysis was conducted to identify the proportion of Ugandans within one-hour travel time to government health centers using walking, bicycling, and driving scenarios. Statistically significant clusters of high and low travel time to health centers were calculated using spatial statistics. Random Forest analysis was used to explore the relationship between poverty, population density, health center access in minutes, and time saved in travel to health centers using a bicycle instead of walking. Linear Mixed-Effects Models were then used to validate the performance of the random forest models. Results The percentage of Ugandans within a one-hour walking distance of the nearest health center II is 71.73%, increasing to 90.57% through bicycles. Bicycles increased one-hour access to the nearest health center III from 53.05 to 80.57%, increasing access to the tiered integrated national laboratory system by 27.52 percentage points. Significant clusters of low health center access were associated with areas of high poverty and urbanicity. A strong direct relationship between travel time to health center and poverty exists at all health center levels. Strong disparities between urban and rural populations exist, with rural poor residents facing disproportionately long travel time to health center compared to wealthier urban residents. Conclusions The results of this study highlight how the most vulnerable Ugandans, who are the least likely to afford transportation, experience the highest prohibitive travel distances to health centers. Bicycles appear to be a “pro-poor” tool to increase health access equity.

Efficacy of aprotinin in children undergoing craniofacial surgery

2003 ◽  
Vol 99 (2) ◽  
pp. 287-290 ◽  
Author(s):  
Celia C. D'Errico ◽  
Hamish M. Munro ◽  
Steven R. Buchman ◽  
Deborah Wagner ◽  
Karin M. Muraszko
Keyword(s):  
Placebo Group ◽  
Blood Transfusion ◽  
Pediatric Patients ◽  
Craniofacial Surgery ◽  
Blood Transfusions ◽  
Double Blind ◽  
Craniofacial Reconstruction ◽  
Content Type ◽  
Transfusion Requirements ◽  
Fine Print

Object. This prospective, randomized, placebo-controlled, double-blind trial was undertaken to assess the efficacy of aprotinin in reducing the need for blood transfusions in 39 children undergoing reconstructive craniofacial surgery. Methods. Two demographically similar groups—a total of 39 patients with a mean age of 1.2 ± 1.2 years—were studied. The efficacy of aprotinin (240 mg/m2 administered intravenously over 20 minutes, followed by infusions of 56 mg/m2/hr) was compared with that of an equal infusion of 0.9% saline (placebo). Patients in the aprotinin group received less blood per kilogram of body weight than patients in the placebo group (32 ± 25 ml/kg compared with 52 ± 34 ml/kg, respectively; p = 0.04). Those patients in whom aprotinin was administered experienced less change in their hematocrit levels during surgery (aprotinin −33 ± 13% compared with placebo −44 ± 9%, p = 0.01). Each patient underwent a transfusion as per study protocol, and there was no significant change in hematocrit levels from the beginning to the end of surgery. The surgical faculty judged blood loss in patients in the aprotinin group to be significantly less than usual (p = 0.03). The use of aprotinin was also associated with reduced blood transfusion requirements during the first 3 postoperative days (p = 0.03). There was no adverse event reported in either the aprotinin or placebo group. Conclusions. Aprotinin decreased blood transfusion requirements in pediatric patients undergoing craniofacial reconstruction, thereby reducing the risks associated with exposure to banked blood components.

scholarly journals Type A7 Coxsackie (type 4 poliomyelitis) virus infection in Scotland

1962 ◽  
Vol 60 (3) ◽  
pp. 323-332 ◽  
Author(s):  
N. R. Grist
Keyword(s):  
Tissue Culture ◽  
Blood Transfusion ◽  
Virus Infection ◽  
Technical Assistance ◽  
Animal Experiments ◽  
Rapid Identification ◽  
National Institutes Of Health ◽  
Reference Laboratory ◽  
Blood Transfusion Service ◽  
The Many

Coxsackie A 7 virus was isolated from thirty-seven patients during an outbreak in Scotland in 1959. Seven cases were paralytic, one of them fatal. Evidence is presented that Coxsackie A 7 virus caused these paralytic illnesses. The virus was also isolated from a paralytic case in 1956 and from a non-paralytic case in 1961. Serological surveys suggest that it has been active in the community for some years. Specific haemagglutination by Coxsackie A 7 virus was useful for rapid identification of viruses and for measurement of serum antibodies.I am grateful to Dr A. D. Macrae of the Virus Reference Laboratory, Colindale, London, for prototype Coxsackie A 7 virus; to Dr K. Habel of the National Institutes of Health, Bethesda, U.S.A., for tissue culture-adapted ABIV virus; to Dr J. Wallace of the Blood Transfusion Service, West of Scotland Region, for samples of blood donor sera; to Dr M. Rentsch, Klinik für Kinderkrankheiten, University of Berne, Switzerland, for permission to quote the results of virological tests of his cases; to Miss R. McLelland, F.A.T.A., and to Mr C. McLean F.I.M.L.T., for technical assistance with animal experiments; to Mr H. G. Carson, F.I.M.L.T. and to Mr J. Kerr, A.I.M.L.T., for technical assistance with neutralization tests; and to the many clinical colleagues who provided specimens and information for this study.

Sign in / Sign up

Export Citation Format

Share Document