The HIV/AIDS pandemic threatens to undo the considerable progress made over the past 3 decades in the field of mother and child health. WHO and UNAIDS estimate that about 1000 infants are infected with HIV each day with most such infants acquiring HIV from their mothers. However mother-to-child HIV transmission is now largely preventable when HIV-infected mothers do not breast-feed their infants. In Thailand by 1995 800000 people had already become infected with HIV while the prevalence in pregnant women was 1-8% depending upon the region. In response the government implemented a multisector AIDS program based upon efforts to inform the public protecting the basic human rights of HIV-infected individuals research appropriate to the Thai situation and the provision of a substantial budget for prevention and care. The comprehensive program involved from the beginning all government ministries nongovernmental organizations donors and private businesses. A few years after the start of this collaborative effort Thailand experienced a sharp decrease in the incidence of HIV infection. Within the program Thailand specifically tackled vertical HIV transmission and the Thai Food and Drug Administration has approved the use of zidovudine to prevent pediatric AIDS. Both industrialized and developing countries can learn from Thailands success in preventing perinatal HIV infection.

Preventing mother-to-child transmission of HIV.

https://doi.org/10.1016/j.lansea.2022.05.002

Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention

Turizem pomembno prispeva k podnebnim spremembam in je tudi eden od sektorjev, ki jih to močno prizadene. Turizem znatno prispeva k ogljičnemu odtisu, saj turistične aktivnosti temeljijo na energiji, ki se pridobiva iz fosilnih goriv, zato je v prihodnosti nujno izboljšati spremljanje izpustov, opredeliti vloge različnih oblik turizma in identificirati ukrepe za zmanjševanja ogljičnega odtisa turizma na destinaciji. Osrednje pričakovane posledice podnebnih sprememb, ki bodo pomembno vplivale na turizem, so čedalje več ekstremnih vremenskih pojavov, spremembe temperature zraka, drugačen padavinski režim in dvigovanje morske gladine. Poglavje izpostavlja aktivno vlogo in potenciale destinacijskega managementa pri oblikovanju analiz ranljivosti destinacij in tveganj za ponudnike, spodbujanju medsektorskega sodelovanja za dosego boljše podnebne odpornosti destinacij ter ozaveščanju o kolektivni soodgovornosti za učinke podnebnih sprememb in o vlogi turizma pri trajnostnem prehodu. 

Turizem in podnebne spremembe: vloga destinacijskega managementa

Nature conservation efforts cannot succeed without stakeholder participation. The inherent complexity of nature-based ecotourism has made the development of sustainable ecotourism operations a challenge, so it is essential to increase community stakeholder participation. Hence, this study investigates local community participation in Lar National Park (LNP) and the Jajrud Protected Area with the Sustainable Use of Natural Resource Areas (JPA) in Iran and evaluates how this influences the sustainability of ecotourism. This study found that in LNP, sustainable ecotourism development involving local communities is increasing because of the high level of attachment and interest to this part of pristine nature. In the JPA, the relationship between local community participation and ecotourism sustainability is significant too. As a result, natural habitats have been degraded and sustainability has decreased. To conserve these critically endangered natural areas, managers and decision-makers must increase community participation and education to encourage local communities to engage more in developing sustainable ecotourism.

/pdf/relationship-analysis-of-local-community-participation-in-2aqsteyd.pdf

Relationship Analysis of Local Community Participation in Sustainable Ecotourism Development in Protected Areas, Iran

Health tourism is a unique form of tourism that mixes vacations with the prevention and treatment of physical and mental conditions. It refers to all relationships and phenomena that result from a change in location and residence of individuals and aims to promote, stabilize, and restore, as needed, their physical, mental, and emotional health and well-being using services in a location that is not their permanent place of residence or employment. Wellness tourism encompasses all interactions and phenomena resulting from the travel and stay of individuals whose primary objective is to restore, preserve, and improve their physical and mental health and social well-being. Wellness is a combination of attitudes and behaviors designed to prevent disease, improve health, and enhance the quality of life. This paper aims to investigate the contribution of wellness tourism to enhancing the quality of life. In addition, cognitive and emotional characteristics of the tourist traveler's personality that can be enhanced through wellness tourism and contribute to the general improvement of life quality are investigated. This article is an overview review of research conducted over the past ten years. The results underlined, among other things, the role of wellness tourism in enhancing the quality of life in its many facets, including physical and mental health, well-being, and social environment. In addition, enhancing cognitive function and emotional well-being, both of which can be attained through wellness tourism, are two additional determinants of a harmonious quality of life. Health tourism in general and wellness tourism can bring numerous benefits, both at the individual level to the physical and psychological health of the beneficiary of the tourist product and at the community level by contributing to their economic and social vibrancy. As a result, upgrading tourist facilities and infrastructure and attracting investment funds to strengthen health and wellness tourism in tourist-travel destinations is considered an unavoidable necessity, as it can bring substantial social, economic, and cultural benefits to the local communities of states. 

Quality of Life and Health Tourism: A Conceptual Roadmap of Enhancing Cognition and Well-Being

/pdf/hubungan-faktor-individu-dan-budaya-organisasi-dengan-3lwc08l4zo.pdf

Hubungan Faktor Individu dan Budaya Organisasi dengan Perilaku Caring Perawat Pelaksana di Ruang Rawat Inap Rumah Sakit Umum Ganesha Gianyar

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan cara multistage random sampling. Data kualitatif dikumpulkan melalui wawancara mendalam kepada 13 penyedia pelayanan kesehatan yang dipilih secara purposive sampling. Data kuantitatif dianalisis secara deskriptif dan data kualitatif dianalisis dengan analisis tematik. Dari hasil penelitian, pelayanan di puskesmas perawatan berstatus BLUD di Gianyar dinilai kurang memuaskan karena keterbatasan peralatan medis dan kurangnya tenaga yang kompeten dalam pengelolaan keuangan. Pelatihan pengelolaan keuangan pada staf puskesmas dan perekrutan tenaga berlatar belakang akuntansi penting untuk dilakukan. Quality of Services in Health Care Center with General Services Agency Status The policy of primary health care as local public service agencies (BLUD) was established to improve the quality of basic health care services. The public service agencies primary health care policy has been implemented to all primary health care in Gianyar district since 2010. The implementation does not always improving health service quality. This research was aimed to overview the quality of services in primary health care with general services agency status in Gianyar district. This research was a crosssectional study with mixed of quantitative and qualitative approaches.This research was conducted in Gianyar between August and December 2013. The quantitative data was collected through questionaire survey to 105 patients in four primary health care who were chosen with multistage random sampling technique. The qualitative data was collected through in-depth interviews to 13 health care providers in primary health care who were chosen with pusposive sampling. The quantitative data was analysed descriptively and the qualitative data was analysed using thematic analysis. The result of the study was primary health care quality in BLUD puskesmas with inpatient services was perceived as poor due to the limited availability of medical equipment and lack of staff who major in financial management. Training on financial management and recruitment of staff with accounting background should be conducted.

/pdf/mutu-pelayanan-puskesmas-perawatan-yang-berstatus-badan-4c0jmpc4fi.pdf

Mutu Pelayanan Puskesmas Perawatan yang Berstatus Badan Layanan Umum Daerah

Background and objectives: Reported microbial resistance to antibiotics is increasing. One of the main factors is patient non-compliance in use of antibiotics. Pharmacist counseling has been shown to be effective in increasing compliance with the use of several types of medications, but its effectiveness of on compliance with antibiotic use has not been widely published. The purpose of this study was to determine the effectiveness of pharmaceutical counseling in a pharmacy setting to increase compliance with antibiotic use.Method: A randomized controlled trial was conducted on 104 adult patients aged 18 years and over who purchased antibiotics by prescription at a pharmacy in Denpasar City, Bali Province. The number of subjects was determined with a confidence level of 95% and a power of 90% with the effect size of 20%. Subjects were divided into two groups using the block randomization method, namely 52 subjects in the intervention group and 52 subjects in the control group. The intervention group was provided with pharmaceutical counseling by a pharmacist at the time of delivery of the drug at the pharmacy, while the control group was provided drug information according to the pharmacy service standard. Subject compliance was measured by telephone interview using the Morisky Medication Adherence Scale-8 questionnaire within 3-5 days after purchasing the medication. Statistical analysis with the Mann Whitney U Test was performed to determine the difference in mean rank of compliance scores between the intervention group and the control group. The proportion of compliance among the intervention group was divided by proportion of compliance in the control group to get the compliance ratio. Logistic regression analysis was conducted to determine the adjusted compliance ratio.Results: The number of subjects analyzed was 98, as 5 subjects could not be contacted by telephone and 1 subject was hospitalized. The mean rank of compliance scores in the intervention group (61.05) was significantly higher (p<0.001) than the comparison group (37.95). The proportion of compliance in the intervention group was 65.3% and the control group was 18.4%, with the proportion ratio (PR) of 3.56 (95%CI=1.90-6.64). Logistic regression analysis showed that variables which significantly increased compliance with antibiotic use were pharmacist counseling (APR=9.33; 95%CI: 3.24-26.87), frequency of taking medication (APR=6.94; 95%CI: 2.01-23.92) and method of payment (APR=4.30; 95%CI: 1.18-15.66).Conclusion: Pharmaceutical counseling at a pharmacy setting was found to increase compliance of antibiotic use. Compliance of antibiotic use is also influenced by the frequency of taking medication and the method of payment. Pharmacist counseling when accessing medication at a pharmacy is crucial for improving patient compliance of antibiotic use.

/pdf/pharmacist-counseling-intervention-to-improve-patient-2hon6lumwx.pdf

Pharmacist counseling intervention to improve patient antibiotic compliance

Village AIDS Cadres (KDPA) Program has been conducted in Denpasar district since 2010 Despite the importance of community participation for a successful community based program, no research has been conducted to explore community perception regarding KDPA programThis research is aimed to explore community perceptions regarding acceptability, utilization, and adoption of the KDPA program from community perspectiveThe design used in this research is descriptive with qualitative data collection method through six focus group discussions in six villages in Denpasar Data was analysed using thematic analysisKDPA is well-accepted as it is perceived as an important issue to be tackled in the community However, many opinions arise concerning who should be given the role "cadre" Lack of program introduction to the community, also high stigma and discrimination resulted in low utilization of the program Villages with active KDPA have conducted a variety of HIV-related activities rarely carried out by the less active villages There is Lack of community participation on HIV-related activities Inequity of access to HIV information exists between adults and teenagers, between men and women, and between the member of traditional and non-traditional hamlets Program adoption is hampered by the lack of commitment of village authorities and limited resources of KDPA programThe utilization and adoption of KDPA program are sub-optimal Introduction of KDPA program to the community and provision of program resources should be improved

Akseptabilitas, utilisasi dan adopsi upaya penanggulangan hiv melalui kader desa peduli aids dari perspektif masyarakat di kota denpasar

Background and purposes: The number of Jaminan Kesehatan Nasional or National Health Insurance (NHI) participants switching their fasilitas kesehatan tingkat pertama or primary healthcare (PHC) providers is increasing and dominated by self-paid participants. This switching could result in unequal distribution of NHI participants and amount of capitation among PHC providers. This study aims to explore the reasons underlying self-paid NHI participants to switch PHC providers.Method: This is a qualitative study using in-depth interviews with a total of 14 participants recruited purposively, consisted of ten NHI self-paid participants who had switched and four participants who intend to switch PHC providers.  Semi-structured interview guide incorporated the aspects of Consumer Switching Behavior Model. The interviews explored four aspects of participants’ intention to switch providers including inconvenience, service encounter failures, core health service failures, and attraction by competitor. The verbatim transcripts were analyzed thematically.Results: Self-paid NHI participants in this study cited four main reasons for switching PHC providers. The first reason is inconvenience in accessing PHC provider’s services due to long distance, long waiting times, unsuitable opening hours, and poor facilities. Secondly, patients cited the poor interaction between healthcare providers and patients specifically, lack of attentiveness, poor eye contact, poor delivery of health information, lack of consideration of patients’ opinions, and lack of responsiveness to patients’ complaints. The third reason is core healthcare service failures, including hasty examinations, inaccurate diagnoses, and errors in prescribing medication. Finally, informants reported that they wished to switch PHC providers due to the attractiveness of other providers, in terms of facilities availability, professionalism of healthcare providers, additional health programs, and ease of access to fasilitas kesehatan rujukan tingkat lanjut or referral healthcare facilities.Conclusion: Self-paid NHI participants’ intention to switch PHC providers was mainly attributed to the perceived poor healthcare quality of the provider and superiority of the others. Continuous quality improvement should be undertaken by PHC providers to increase participants’ loyalty.

/pdf/switching-of-primary-health-care-providers-among-self-paid-2e6x50ejhj.pdf

Switching of primary health care providers among self-paid health insurance participants in Denpasar, Bali, Indonesia

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