Gambaran Kepuasan Ibu Hamil Pada Pelayanan Antenatal Care Di Puskesmas Jambu Kebupaten Semarang

Latar Belakang: : Salah satu upaya yang dilakukan dalam penurunan AKI dengan melakukan pelayanan kesehatan melalui pelayanan antenatal care, terjadi penurunan kunjungan pemeriksaan ibu hamil berdasarkan buku kunjungan pada bulan Maret, April, Mei, Juni, Agustus, September. Salah satu yang mempengaruhi kunjungan ANC ibu hamil yakni kepuasan pasien. Metode Penelitian: Penelitian ini menggunakan penelitian kuantitatif dengan desain penelitian cross sectional. Populasi 55 ibu hamil yang memeriksakan kehamilannya di poli KIA Puskesmas Jambu pada bulan September 2023. Sampel 48 responden yang diambil dengan teknik accidental sampling dan intrumen menggunakan kuesioner. Analisis data menggunakan distribusi frekuensi. Hasil Penelitian: Kepuasan ibu hamil pada pelayanan Antenatal care di Puskesmas Jambu sebagian besar puas 60% dan kurang puas 40%. Kepuasan ibu hamil berdasarkan dimensi Tangiables, sebagian puas 73% dan kurang puas 27%, dimensi Realibility, sebagian puas 21% dan kurang puas 79%, dimensi Responsiveness, sebagian puas 58% dan kurang puas 42%, dimensi Assurance, sebagian puas 29% dan kurang puas 71%, dimensi Empathy, sebagian puas 98% dan kurang puas 2%. Kesimpulan: Berdasarkan hasil penelitian ini pelayanan antenatal care harus dipertahankan dan perlu ditingkatkan pada dimensi reability dan assurance supaya ibu hamil melakukan pemeriksaan secara rutin dengan melakukan kunjungan ulang

The expert in hemostasis and thrombosis in the Italian health system: role and requirements for a specific clinical and laboratory expertise

Hemorrhagic and thrombotic diseases are highly heterogeneous disorders that may affect a large proportion of the population, as in the case of patients taking antithrombotic drugs. The appropriate management of such conditions requires the availability of specific diagnostic assays, together with knowledge of the possible clinical syndromes and of their appropriate treatment. This can only be achieved through second-level specialized laboratories supervised by trained personnel. Such diagnostic and therapeutic organization is not widely available in Italy except in a very limited number of those large hospitals that are centers of excellence on a national scale. Increasing the availability of such resources would be of great benefit to patients, and could also be cost-effective for the national healthcare system. This document is promoted by the Italian Society for the Study on Hemostasis and Thrombosis (SISET) and by the main Italian scientific societies involved in the field during the years 2011-2012. It aims to identify the level of scientific and professional training required to define a physician as a Hemostasis and Thrombosis Expert, graded according to the levels of skill required for different clinical settings

F9 Missense mutations impairing factor ix activation are associated with pleiotropic plasma phenotypes

Background: Circulating dysfunctional factor IX (FIX) might modulate distribution of infused FIX in haemophilia B (HB) patients. Recurrent substitutions at FIX activation sites (R191-R226, >300 patients) are associated with variable FIX activity and antigen (FIXag) levels. Objectives: To investigate i) expression of a complete panel of missense mutations at FIX activation sites and ii) contribution of F9 genotypes on the FIX pharmacokinetics (PK). Methods: FIXag and activity assays in plasma and after recombinant expression of FIX variants. Analysis of infused FIX PK parameters in patients (n=30), mostly enrolled in the F9 Genotype and PK HB Italian Study (GePKHIS; EudraCT ID2017-003902-42). Results: The variable FIXag amounts and good relation between biosynthesis and activity of multiple R191 variants result in graded moderate-to-mild severity of the R191C>L>P>H substitutions. Recombinant expression may predict the absence in the HB mutation database of the benign R191Q/W/K and R226K substitutions. Equivalent changes at R191/R226 produced higher FIXag levels for R226Q/W/P substitutions, as also observed in p.R226W female carrier plasma. PK analysis in patients suggested that infused FIX Alpha distribution and Beta elimination phases positively correlated with endogenous FIXag levels. Mean residence time was particularly prolonged (79.4 hrs, 95% CI 44.3-114.5) in patients (n=7) with the R191/R226 substitutions, which in regression analysis were independent predictors (β coefficient 0.699, p=0.004) of Beta half-life, potentially prolonged by the increasing over time ratio between endogenous and infused FIX. Conclusions: FIXag levels and specific features of the dysfunctional R191/R226 variants may exert pleiotropic effects both on HB patients’ phenotypes and substitutive treatment

Guidelines for the diagnosis and management of von Willebrand disease in Italy

von Willebrand disease (vWD) is a bleeding disorder caused by quantitative (type 1 and 3) or qualitative (type 2) defects of von Willebrand factor (vWF). The molecular basis of type 2 and 3 vWD are now known and those of type 1 vWD are being understood. Phenotypic diagnosis is based on the measurements of plasma and platelet vWF, of the ability of vWF to interact with platelet receptors and the analysis of the multimeric structure of vWF. Due to the heterogeneity of vWF defects and the variables that interfere with vWF levels, a correct diagnosis of types and subtypes may sometimes be difficult but is very important for therapy. The aim of treatment is to correct the dual defects of haemostasis, i.e. abnormal intrinsic coagulation expressed by low levels of factor VIII (FVIII) and abnormal platelet adhesion. Desmopressin is the treatment of choice in patients with type 1 vWD, who account for approximately 70% of cases, because it corrects FVIII-vWF levels and the prolonged bleeding time (BT) in the majority of these patients. In type 3 and in severe forms of type 1 and 2 vWD patients, desmopressin is not effective and it is necessary to resort to plasma concentrates containing FVIII and vWF. Treated with virucidal methods, these concentrates are effective and safe, but they cannot always correct BT defect. Platelet concentrates or desmopressin can be used as adjunctive treatments when poor correction of BT after plasma concentrate treatment is associated with continued bleeding

Visualisation of Chord Diagrams and Tables

Scripts and data for visualisation of chord diagrams and tables for the paper "What Makes Us Feel Good? A Data-driven Investigation of Positive Emotion Experience

7. Effects of Farming in Biodiversity

Recent shifts in agricultural practices to become more intensive have led to habitat degradation and the displacement of native flora and fauna, reducing the biodiversity associated with farmlands. Biodiversity is important for the health of the ecosystem in the affected area and our project aims to investigate modern agricultural practices to determine which aspects are responsible for the decline in biodiversity and what is threatening the recovery of endangered species. Direct effects of cultivation practices, indirect effects of pesticide use, and farmers’ perspective on the value of wildlife will all be investigated for their potential link to biodiversity declines. By working with the Ontario Federation of Agriculture, and local farmers, we hope to come up with feasible recommendations to improve levels of biodiversity. These recommendations will focus on altering methods of agriculture to increase the diversity of species on farmland and to help the recovery of species at risk including the birds bobolink, and eastern meadowlark, as well as the milk snake, to name a few. The aim of these recommendations is to not only improve habitat for wildlife, but to provide the farmers involved with beneficial ecosystem services that are more sustainable than current practices. By doing so, the presence of wildlife could be seen as a valuable contribution to their operation, not as a burden to productivity.</jats:p