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Analisis Molekuler Phylogenetic Human Immunodeficiency Virus (HIV) Pada Pasien di Surabaya, Jawa Timur

Nasronudin Nasronudin, Maria Inge Lusida, Retno Handajani, Lindawati Lindawati, Ferry Efendi, Takako Utsumi

Abstract

The Human Immunodeficiency Virus Type 1 (HIV-1) isolates are classified in three main groups: group M (main), group O (outlier) as well as group N (non-M/non-O). The HIV-1 M group, responsible for the majority of infections in the HIV-1 worldwide epidemic, can be further subdivided into 10 recognized phylogenetic subtypes or clades, A–D and F-K. HIV-1 phylogenetic classifications are currently based on nucleotide sequences derived from such as gag p17 region of the same isolates or on full-length genome sequence analysis. We do not know HIV subtype distribution in HIV suspected patients, in Surabaya, East Java. The aims of this study was to do molecular analysis HIV in patients with HIV infection, in Surabaya, East Java. Antibody to HIV were detected using 3 methods, paper and EIA (Acon) and ELISA (Axion) techniques from 51 plasma obtained from the patients suspected HIV infection, in Surabaya, Indonesia All of the samples were subjected to Polymerase Chain Reaction (PCR) using pairs of primers based on HIV gag p17 genes. The PCR positive samples were sequenced and analysed to identify the HIV subtype using Genetic Version 9 program. Fourty nine (96.08%) HIV antibody were detected from 51 patients suspected HIV infection and 57.14% (28/49) HIV RNA determination positives. All of 21 positives HIV DNA except one sample that have been analyzed was CRFs of HIV with mayority CRF01-AE subtype similar with HIV CRF01-AE subtype in Asia countries, e.g. Thailand, Japan, Malaysia, Cina and Hongkong. Those one sample has 18 nucleotides insertion look like a HIV new subtype but it is needed to confirm further. From gag p7 HIV gene in this study, one HIV has and CRF01-AE is majority HIV subtype in Surabaya, East Java which is located in the same branch with HIV common CRF01-AEHIV subtype in Asia.

Keywords: HIV subtype, gag p17 gene, Surabaya, Indonesia
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KAJIAN SUMBER DAYA MANUSIA KESEHATAN DI INDONESIA

DAFTAR ISI BUKU SDM KESEHATAN
BAB 1 Sumber Daya Manusia Kesehatan
Pendahuluan
Definisi Sdm Kesehatan
Daftar Pustaka
BAB 2 Manajemen Sumber Daya Manusia Kesehatan
Definisi
Perencanaan Sdm Kesehatan
Rekrutmen dan Seleksi
Monitoring dan Evaluasi
Pendidikan dan Latihan
Aspek Legal dan Regulasi
Sejarah Regulasi Dokter
Sejarah Regulasi Perawat
Sejarah Regulasi Bidan
Daftar Pustaka
Bab 3 Tantangan Sdm Kesehatan
Pendahuluan
Jumlah Tenaga Kesehatan
Jenis Tenaga Kesehatan
Mutu Tenaga Kesehatan
Distribusi Tenaga Kesehatan
Daftar Pustaka
Bab 4 Tool Sumber Daya Manusia Kesehatan
Pendahuluan ………………………………………………………………………. 59
Tool 1: Pemetaan/Mapping Sdm Kesehatan……………………….. 60
Tool 2: Analisis Stok/Ketersediaan Sdm Kesehatan
Menggunakan International Standard
Classification of Occupations (Isco )……………………………. 66
Pendidikan Sdm Kesehatan………………………………………………… 72
Kesimpulan…………………………………………………………………………. 72
Daftar Pustaka…………………………………………………………………….. 73
Bab 5 S tudi Kasus Sdm Kesehatan…………………………………. 75
Studi Kasus I—Desentralisasi Sebagai Peluang
Meningkatkan Ketersediaan Tenaga Kesehatan di
Dtpk Sub 1…………………………………………………………………… 76
Studi Kasus II—Sdm Kesehatan di Wilayah
Perbatasan Negara…………………………………………………………. 96
Studi Kasus III—Studi Insentif Finansial pada Dokter dan
Bidan di Daerah Sangat Terpencil………………………………….. 108
Studi Kasus IV—Faktor yang Memengaruhi Retensi
Perawat di Dtpk …………………………………………………………… 119
Daftar Pustaka…………………………………………………………………….. 124
Bab 6 S umber Daya Manusia Kesehatan Global………………. 135
Skenario Sdm Kesehatan Global………………………………………… 136
Migrasi Tenaga Kesehatan…………………………………………………… 137
Kode Praktik Global Internasional Rekrutmen……………………. 145
Daftar Pustaka…………………………………………………………………….. 146
Referensi Online………………………………………………………………… R -1
Indeks……………………………………………………………………………….. I -1

Nurses can create change

From: http://news.nurse.com/article/20120123/NATIONAL01/101230024
By Heather Stringer
For Beverly Malone, RN, PhD, FAAN, the empowerment of nurses is much more than an esoteric theory to help RNs feel better about themselves; it’s requisite for the delivery of quality patient care.

Malone, the CEO of the National League for Nursing based in New York City, experienced firsthand how empowerment could change a patient’s outcome when she was a staff nurse caring for a 16-year-old girl with bone cancer. A resident surgeon had scheduled a procedure to amputate the patient’s legs, but Malone knew the girl wanted to keep her limbs during the time she had left. When the surgeon did not change his decision after hearing this, Malone sought out several managers to advocate for the girl. In the end, her persistence paid off. The surgery was canceled, and the girl was relieved.

Malone describes empowerment as the ability to authorize oneself to act in the pursuit of safe, quality, patient-centered care. She is among a growing cadre of nurse leaders and researchers who are spreading the message that nurses need to recognize the power they have to affect change by mobilizing resources or people to deliver the best care to patients. Failing to do so can cultivate a sense of powerlessness, which can have dramatic implications on the quality of care nurses deliver and, ultimately, on whether they decide to stay in the profession say nursing experts.

But there is hope, according to Malone. “If you ask nurses how much power they have, most will say that they do not have a powerful position,” she said. “But I believe that helping someone to live is one of the most powerful jobs in the world. If we can recognize this power, then we can manage it in a healthy, effective and caring way.”

Results of powerless attitudes

Catherine Garner, RN, DrPH, MSN, MPA, FAAN, dean of health sciences and nursing at Aurora, Colorado-based American Sentinel University, suggested harboring a sense of powerlessness ultimately can lead to an ethical dilemma for nurses.

“When nurses feel that they can’t control their environment or influence the direction an organization is going, they can become dissatisfied,” Garner said. “There are studies that show that nurses who are dissatisfied do not deliver the best quality of care, and that leads us to an ethical question: If nurses are not satisfied professionally, how in good conscience can hospital leaders feel that they are giving the best care?”

Linda Aiken, RN, PhD, FRCN, FAAN, professor in the University of Pennsylvania School of Nursing in Philadelphia, is one of several researchers who examined survey data from more than 95,000 nurses in four large states to explore job satisfaction levels. The February 2011 study published in Health Affairs, found nurses providing direct patient care in hospitals or nursing homes had a much higher job dissatisfaction and burnout rate than nurses working in other settings, such as the pharmaceutical industry. Aiken has conducted other studies that suggest this dissatisfaction results in reduced quality of care and poorer patient outcomes. Read more…